101
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Coronado Martín PJ, Fasero Laiz M, García Santos J, Ramírez Mena M, Vidart Aragón JA. [Overexpression and prognostic value of p53 and HER2/neu proteins in benign ovarian tissue and in ovarian cancer]. Med Clin (Barc) 2007; 128:1-6. [PMID: 17266884 DOI: 10.1157/13096935] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the prognostic value of p53 and HER2/neu overexpression in epithelial ovarian cancer (EOC). PATIENTS AND METHOD p53 and HER2/neu immunostaining were performed in 198 tissue samples, 124 EOC, 44 benign ovarian tumors and 30 normal ovaries. Nuclear p53 and membranous HER2/neu immunostaining were evaluated. RESULTS Neither p53 nor HER2/neu overexpression was seen in the benign ovarian tumors. HER2/neu immunostaining was observed in one normal ovary. P53 overexpression was found in 25% EOC and was related with advanced stage, endometrioid, clear cell and undifferentiated types, grade G3, and sub-optimal surgery. HER2/neu immunostaining was observed in 24.2% and it was associated with advanced stage, clear cell and undifferentiated types, and suboptimal surgery. Both, p53 and HER2/neu overexpression decreased overall and progression-free survival, but in the multivariant analysis, only HER2/neu overexpression was an independent prognostic factor of overall survival (RR = 2.8; 95% confidence interval [CI], 1.2-5.6) and recurrence (RR = 2.8; 95% CI, 1.1-7.1). Simultaneous p53 and HER2/neu overexpression made the prognosis worse (p < 0.01). CONCLUSIONS HER2/neu overexpression (but not p53 overexpression) is a major prognostic factor in EOC.
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MESH Headings
- Aged
- Biomarkers, Tumor
- Confidence Intervals
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/genetics
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/genetics
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Endometriosis/genetics
- Endometriosis/pathology
- Endometriosis/surgery
- Female
- Follow-Up Studies
- Genes, p53
- Humans
- Immunohistochemistry
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Ovarian Diseases/genetics
- Ovarian Diseases/pathology
- Ovarian Diseases/surgery
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Prognosis
- Proportional Hazards Models
- Receptor, ErbB-2/genetics
- Risk
- Survival Analysis
- Teratoma/diagnosis
- Teratoma/genetics
- Teratoma/pathology
- Teratoma/surgery
- Time Factors
- Tumor Suppressor Protein p53/genetics
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102
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Morel O, Rohmer V, Girault S, Muratet JP, Berthelot C, Jallet P. Abnormal iodine-131 uptake in a benign mucinous ovarian cystadenoma mimicking struma ovarii. Clin Nucl Med 2007; 32:64-6. [PMID: 17179812 DOI: 10.1097/01.rlu.0000249548.55877.3d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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103
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Zhou JP, Dong M, Zhang Y, Kong FM, Guo KJ, Tian YL. Giant mucinous biliary cystadenoma: a case report. Hepatobiliary Pancreat Dis Int 2007; 6:101-3. [PMID: 17287176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Biliary cystadenoma is a very rare cystic neoplasm of the liver. Its clinical features, diagnosis, pathologic characteristics, and optimal surgical management have not been defined clearly. In this article we describe the details of this rare disease. METHODS A 40-year-old woman with a mass of the liver was verified by ultrasonography and LT. Ultrasonography showed a mixed echo of 18.4 cm x 14.72 cm x 15.54 cm in the left lobe of the liver. CT showed a vesicula of 19.9 cm x 13.5 cm in the right epigastrium, with a low density, clear edge, uneven density, and calcified shadow. The patient received successfully a left hepatectomy. Laboratory examination showed an elevation of CA125 to 62.62 U/ml and CA199>1000 U/ml. RESULTS After the left hepatectomy, the patient was fully recovered. Her biliary cystadenoma was characterized by specific histological findings. During operation, a large cystic lesion was seen in the left hepatic lobe; its surface was dark red with abundant blood supply. Gross examination showed that the tumor almost occupied. The whole left lobe with a small amount of normal liver tissue close to the deltoid ligament. Pathologically, additional lobulated spaces were seen in the tumor with a lot of mucusa. The interior wall was lined with bile duct tissue, indicating a benign mucinous biliary cystadenoma. CONCLUSIONS Ultrasonography and CT are the major methods for the diagnosis of mucinous biliary cystadenoma liver. Operation is the best way of treatment.
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104
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Tugrul S, Pekin O, Ayvaci H, Tarhan N, Uludoğan M. Giant benign mucinous cystadenoma growing during pregnancy: a case report. CLIN EXP OBSTET GYN 2007; 34:126-7. [PMID: 17629173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A 32-year-old woman, gravida 4, para 2, was diagnosed with a benign right ovarian mucinous cystadenoma. It was diagnosed in the tenth week of pregnancy, measured 47 x 69 mm, and reached 190 x 152 mm at 23 weeks of gestation. Laparotomy was performed and the ovarian cystic mass was removed in the second trimester. The patient had postoperative tocolytic therapy and progesterone medication. She is at the 35th gestation week and no other antenatal complication has been reported. A case of giant mucinous cystadenoma is presented with clinical follow-up details.
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105
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106
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Tohme C, Choucair A, Hachem JE. Unusual presentation of digestive tumour. Gut 2006; 55:1780, 1788. [PMID: 17124157 PMCID: PMC1856485 DOI: 10.1136/gut.2005.090266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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107
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Chen M, Wang WC, Zhou C, Zhou NN, Cai K, Yang ZH, Zhao WF, Li SY, Li GZ. Differentiation between malignant and benign ovarian tumors by magnetic resonance imaging. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2006; 21:270-5. [PMID: 17249204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To determine the magnetic resonance (MR) imaging findings of an ovarian mass which are most predictive of malignancy and assess the value of intravenous gadolinium administration in the characterization of an ovarian mass. METHODS Totally 74 consecutive patients with a clinically or sonographically indeterminate adnexal mass underwent MR imaging, of whom 59 had subsequent surgical resection of 70 adnexal masses. These 59 patients formed the study population. MR imaging studies were prospectively and independently reviewed by a senior and a junior radiologist. The senior radiologist also reevaluated the studies in a blind fashion after a minimum 6 months interval. The sensitivity, specificity, positive predictive value, and negative predictive value of contrast-enhanced and unenhanced MR imaging were evaluated. RESULTS The most predictive MR imaging findings for malignancy were presence of vegetations in a cystic lesion and presence of necrosis in a solid lesion. The odds ratio was even higher when the ancillary finding of peritoneal metastasis or ascites was present. Contrast media contributed significantly to lesion characterization. Total 70 ovarian masses were detected by contrast-enhanced MR imaging including 37 malignant ovarian masses and 33 benign ovarian masses with 87% (61/70) accuracy, 86% (32/37) sensitivity, 88% (29/33) specificity, 89% (32/36) positive predictive value, and 85% (29/34) negative predictive value, whereas 70 ovarian masses were detected by unenhanced MR imaging with 74% (52/70) accuracy, 73% (27/37) sensitivity, 76% (25/33) specificity, 77% (27/35) positive predictive value, and 71% (25/35) negative predictive value. There were significant differences in accuracy (P < 0.01), sensitivity (P < 0.01), specificity (P < 0.01) between contrast-enhanced and unenhanced MR imaging. CONCLUSION Contrast-enhanced MR imaging is highly accurate in detection and characterization of complex adnexal masses.
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108
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Goh BKP, Tan YM, Yap WM, Cheow PC, Chow PKH, Chung YFA, Wong WK, Ooi LLPJ. Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms. World J Surg 2006; 30:1553-9. [PMID: 16773248 DOI: 10.1007/s00268-005-0749-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The preoperative distinction between serous cystic neoplasms (SCNs) and mucinous cystic neoplasms (MCNs) is essential, as all MCNs are considered malignant or potentially malignant and should be surgically resected, whereas SCNs are almost always benign. However, the radiologic distinction between SCNs and MCNs is frequently difficult especially with serous oligocystic adenoma (SOA), a morphologic variant of SCN, as both SOA and MCN appear on cross-sectional imaging as a solitary macrocystic lesion in the pancreas. We reviewed all SOAs managed at our institution to determine if any clinicopathologic features would prove useful for establishing a preoperative diagnosis. METHODS Over a 15-year period, 64 patients with a pathologically confirmed diagnosis of a pancreatic cystadenoma or cystadenocarcinoma treated at Singapore General Hospital were retrospectively reviewed. There were 27 MCNs and 37 SCNs including 12 SOAs. In addition, 40 cases of SOA previously reported in the literature were reviewed and analyzed together with the 12 patients, making this a series of 52 SOAs. RESULTS In our experience, SOAs comprised 32.4% of the SCNs, and females predominated (7/12). The median age of the patients was 42.5 years (range 22-74 years), and only 4 of the 12 patients were symptomatic. Most of the cysts were located in the body or tail of the pancreas (9/12), and the median cyst size was 52.5 mm (range 10-190 mm). When the clinicopathologic features of SOAs and serous microcystic adenomas (SMAs) were compared, there was no difference between the patients with SOAs and SMAs in terms of age, sex, presence of symptoms, cyst size, or site of the lesion. However, SOAs occurred in the women less frequently (67.3% vs. 96.3%, P=0.004), were smaller [40 mm (range 10-190 mm) vs. 95 mm (range 25-180 mm), P<0.001], and occurred more commonly in the head of the pancreas [25 (48.1%) vs. 2(7.4%)] compared to MCNs. None of the SOAs were frankly malignant compared to the 29.6% of MCNs that were. CONCLUSIONS SOAs and SMAs have similar clinicopathologic features. On the other hand, SOAs differ from MCNs by their relatively higher male/female ratio, higher frequency of tumors occurring in the head of the pancreas, and smaller cyst size. Knowledge of these distinguishing clinical features when used in combination with other diagnostic modalities such as endoscopic ultrasonography/fine-needle aspiration will enable clinicians to better differentiate these two pathologic entities preoperatively.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Cystadenocarcinoma, Mucinous/diagnosis
- Cystadenocarcinoma, Mucinous/surgery
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/surgery
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/surgery
- Female
- Humans
- Male
- Middle Aged
- Pancreatectomy
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/surgery
- Preoperative Care
- Retrospective Studies
- Tomography, X-Ray Computed
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109
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Phillips J, Katz A, Zopolsky P. Intraductal papillary mucinous neoplasm in an ectopic pancreas located in the gastric wall. Gastrointest Endosc 2006; 64:814-5; discussion 815. [PMID: 17055883 DOI: 10.1016/j.gie.2006.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 05/26/2006] [Indexed: 12/10/2022]
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110
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Trummer A, Oldhafer KJ, Flemming P, Hollerbach S. Detection of recurrent extrahepatic hepatobiliary cystadenoma by EUS (with video). Gastrointest Endosc 2006; 64:658-60. [PMID: 16996370 DOI: 10.1016/j.gie.2006.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2005] [Accepted: 04/27/2006] [Indexed: 02/08/2023]
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111
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Butte JM, Torres J, Henríquez IM, Pinedo G. Appendicular mucosal intussusception into the cecum secondary to an intramural mucinous cystoadenoma of the appendix. J Am Coll Surg 2006; 204:510. [PMID: 17324789 DOI: 10.1016/j.jamcollsurg.2006.07.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Revised: 07/11/2006] [Accepted: 07/20/2006] [Indexed: 11/16/2022]
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112
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Abstract
Hepatobiliary cystadenomas are rare tumors that are difficult to diagnose preoperatively. They can reach large sizes that make them real intraoperative “surprises”. A 63-year-old woman, presented with a symptomatic huge abdominal cystic mass, underwent complete resection of the mass with safety margins. Histopathological report revealed mucinous hepatic cystadenoma with “ovarian-like” stroma and areas of sclerohyalinization. The differential diagnosis of the large cystic tumors which occupy the right hemiabdomen must include the biliary cystadenoma; the complete resection of the tumor with safety margins avoids local recurrence, and therefore represents the optimal therapy because of the malignant potential of the disease. The postoperative follow-up includes abdominal ultrasound or CT scan and CA 19-9 measurement.
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113
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Capaldi M, Alessandroni L, Bertolini R, Barreca M, Campanelli A, D'Amata G, Marini P, Mancacci R, Sorgi G, Tersigni R. [Cystic pancreatic tumors. Review of literature and proposal of a diagnostic-therapeutic pathway]. G Chir 2006; 27:281-8. [PMID: 17062201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In this paper the Authors consider the epidemiological, clinical, pathological, instrumental, chemical and physical findings of every type of pancreatic cystic lesions. They perform a critical examination of each of them. In this way, they can identify the most important features of every single class. A pathway consisting in four main groups of instrumental and chemical tests (abdominal ultrasonography / EUS, CT, MR, FNA / biopsy/ assay of tumoral markers and amylase of cystic fluid) was chosen to know all these informations according to careful principles of specificity, sensitivity and diagnostic accuracy taken from international scientific literature. In each subgroup of cystic pancreatic tumor, at last, the most reliable therapeutic project is suggested according to the common international scientific agreement.
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MESH Headings
- Aged
- Biomarkers, Tumor
- Biopsy
- Cystadenocarcinoma, Mucinous/diagnosis
- Cystadenocarcinoma, Mucinous/diagnostic imaging
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenocarcinoma, Mucinous/surgery
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/diagnostic imaging
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/diagnostic imaging
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Female
- Humans
- Male
- Middle Aged
- Pancreas/pathology
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/diagnostic imaging
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Pancreatic Pseudocyst/diagnosis
- Pancreatic Pseudocyst/diagnostic imaging
- Pancreatic Pseudocyst/pathology
- Radiography, Abdominal
- Sensitivity and Specificity
- Tomography, X-Ray Computed
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114
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Abstract
Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal adenocarcinoma. Although not as well studied or characterized as pancreatic adenocarcinoma there are many distinct lesions which exhibit diverse biological behaviors and varying degrees of malignancy. These lesions include: endocrine neoplasms, cystic tumors, solid pseudopapillary tumors, acinar cell carcinoma, squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common neoplasms are being diagnosed more frequently as the number and sensitivity of diagnostic imaging studies increase. This review article discusses the clinical course, diagnosis, and treatment of these less common, but quite relevant, neoplasms of the pancreas.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/therapy
- Carcinoma, Acinar Cell/diagnosis
- Carcinoma, Acinar Cell/therapy
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/therapy
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/therapy
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/therapy
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/therapy
- Endocrine Gland Neoplasms/diagnosis
- Endocrine Gland Neoplasms/therapy
- Humans
- Lymphoma/diagnosis
- Lymphoma/therapy
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/therapy
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115
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Abstract
Reports of intraductal papillary mucinous tumors of the pancreas have become substantially more frequent in the literature in the past several years. This increased prevalence is due, among other things, to improved screening techniques, especially high-resolution spatial imaging. These tumors are characterized by proliferation of the intraductal epithelium, mucin production, and ductal dilatation. They grow slowly. Their potential for malignancy is high (although the precise risk remains difficult to assess), but their prognosis, when identified during the first stage of neoplastic transformation (before invasion), is far better than that of 'pancreatic ductal adenocarcinoma. Early diagnosis allows patients to be treated before carcinomatous degeneration. Specific diagnosis makes it possible to define an appropriate treatment strategy - either surgery or monitoring, especially when only the intralobular ducts are affected. In that case, the risk of malignant degeneration is much lower than with lesions in the pancreatic duct or in combined forms.
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MESH Headings
- Carcinoma, Pancreatic Ductal/diagnosis
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/surgery
- Cholangiopancreatography, Endoscopic Retrograde
- Cystadenocarcinoma, Mucinous/diagnosis
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenocarcinoma, Mucinous/surgery
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Diagnosis, Differential
- Humans
- Magnetic Resonance Imaging
- Palliative Care
- Pancreas/pathology
- Pancreatectomy
- Pancreatic Ducts/pathology
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/diagnostic imaging
- Pancreatic Neoplasms/mortality
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Prognosis
- Tomography, X-Ray Computed
- Ultrasonography
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116
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Djuranovic SP, Spuran MM, Kovacevic NV, Ugljesic MB, Kecmanovic DM, Micev MT. Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver: report of a case. World J Gastroenterol 2006. [PMID: 16610012 DOI: 10.1016/s0893-9659(98)00180-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups: focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liver. Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
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117
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Djuranovic SP, Spuran MM, Kovacevic NV, Ugljesic MB, Kecmanovic DM, Micev MT. Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver: Report of a case. World J Gastroenterol 2006; 12:1975-7. [PMID: 16610012 PMCID: PMC4087531 DOI: 10.3748/wjg.v12.i12.1975] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups: focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liver. Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
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118
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Conde-Muiño R, Puyalto de Pablo P, Villán-Marco D. [Pancreatic cyst in a 60-year-old woman]. Med Clin (Barc) 2006; 126:349-54. [PMID: 16650369 DOI: 10.1157/13085736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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119
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Bronzino P, Abbo L, Bagnasco F, Barisone P, Dezzani C, Genovese AM, Iannucci P, Ippoliti M, Sacchi M, Aimo I. [Appendiceal mucocele due to mucinous cystadenoma: case report and review of the literature]. G Chir 2006; 27:97-9. [PMID: 16681869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Mucinous cystadenomas of the appendix are rare tumours. In this article we describe the case of a young woman who presented with abdominal pain and a clinical pattern likely to a chronic appendicitis. At laparotomy we found a dilatation of the appendix which contained an abundant quantity of mucus. Histological examination showed a mucinous cystadenoma of the appendix. This neoplasm requires a surgical treatment, usually only appendectomy and right hemicolectomy in case of involvement of the caecum. During operation, the surgeon must take care in handling the appendix because of the risk of rupture with consequent dissemination of epithelial cells in the peritoneal cavity (pseudomyxoma peritonei).
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120
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Pelaez-Luna M, Chari ST. Cyst fluid analysis to diagnose pancreatic cystic lesions: an as yet unfulfilled promise. Gastroenterology 2006; 130:1007-9; discussion 1009. [PMID: 16530543 DOI: 10.1053/j.gastro.2005.11.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Accepted: 11/17/2005] [Indexed: 12/02/2022]
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121
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Sri Paran T, Mortell A, Devaney D, Pinter A, Puri P. Mucinous cystadenoma of the ovary in perimenarchal girls. Pediatr Surg Int 2006; 22:224-7. [PMID: 16416281 DOI: 10.1007/s00383-005-1624-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Accepted: 11/24/2005] [Indexed: 10/25/2022]
Abstract
Ovarian masses in children are an uncommon occurrence. They represent less than 2% of all tumours in girls less than 16 years of age. Mucinous tumours of the ovary occur principally in middle adult life and are extremely rare prior to menarche. To the best of our knowledge, there are only 13 previous cases of benign mucinous cystadenoma (MCA) of the ovary in perimenarchal girls reported in the literature. We present six cases of this rare tumour. We reviewed the charts of six patients who presented with large MCA of the ovary. The patient's ages ranged from 13 to 14 years (mean 13.6 years). Two were premenarchal and four were within 1 year of menarche. All children presented with marked abdominal distension and discomfort. Except for one child who had ultrasound scan alone, all the others had either CT or MRI scan as well. Ultrasound demonstrated a large multiloculated cystic mass arising from the pelvis reaching the level of the xiphoid. CT demonstrated an enormous mass occupying almost the entire abdomen. The mass was partly solid, partly cystic and the cystic elements were multiloculated in all patients. Three patients demonstrated contralateral hydronephrosis on imaging. Laparotomy revealed a tumour arising from the left ovary in five patients and from the right ovary in one. Several litres of fluid were aspirated in order to deliver the tumour from the abdomen. All patients underwent oophorectomy or salpingo-oophorectomy. Histology revealed benign MCA of the ovary in all cases. On follow up, ranging from 2.4 to 5 years, all patients were well with no evidence of recurrence. MCA in perimenarchal girls usually affects the left ovary. Although this tumour is rare, this diagnosis should be considered in 11 to 15-year-old girls presenting with a very large abdominal mass.
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122
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Zagorianakou N, Stefanou D, Makrydimas G, Zagorianakou P, Briasoulis E, Karavasilis V, Pavlidis N, Agnantis NJ. Clinicopathological study of metallothionein immunohistochemical expression, in benign, borderline and malignant ovarian epithelial tumors. Histol Histopathol 2006; 21:341-7. [PMID: 16437378 DOI: 10.14670/hh-21.341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Metallothioneins (MTs) are a family of cystein-rich metal-binding proteins, which are expressed in normal cells during fetal and postnatal life but also in a variety of human neoplasms. MT expression in human tumors has been linked to resistance to anticancer drugs and differentiation and progression in some types of tumors. This study examined the immunohistochemical expression of MTs in benign, borderline and malignant tumors of ovarian surface epithelium and the possible correlations with clinicopathological parameters and survival. A total of 87 cases with diagnosis of ovarian surface epithelial tumors were included. Specifically, 21 cases of benign cystadenomas (11 serous and 10 mucinous), 14 borderline (low malignant potential tumors, 8 mucinous and 6 serous) and 52 cases of ovarian cancer were analysed. Immunohistochemical expression of MT (cut-off level > 10% of tumor cells) was clearly associated with malignancy. A statistically significant correlation was found between the expression of MT in cancer cases and benign tumors (p < 0.0001) and cancer cases and borderline tumors p = 0.003. In cancer cases a difference was observed between grade I and III (p = 0.002). There was no correlation of MT overexpression with survival in the small number of ovarian carcinoma patients where it was analysed. MT constitutes a marker that characterizes aggressiveness and a high malignant potential in ovarian epithelial tumors. In diagnostic problems MT may help distinguish between benign, borderline and malignant tumors.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Carcinoma/chemistry
- Carcinoma/diagnosis
- Carcinoma/pathology
- Cell Differentiation/genetics
- Cell Proliferation
- Cystadenoma, Mucinous/chemistry
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Serous/chemistry
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/pathology
- Diagnosis, Differential
- Disease Progression
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Metallothionein/analysis
- Metallothionein/genetics
- Metallothionein/physiology
- Middle Aged
- Ovarian Neoplasms/chemistry
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/pathology
- Tumor Suppressor Protein p53/analysis
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/physiology
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123
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Timmerman D, Testa AC, Bourne T, Ferrazzi E, Ameye L, Konstantinovic ML, Van Calster B, Collins WP, Vergote I, Van Huffel S, Valentin L. Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group. J Clin Oncol 2006; 23:8794-801. [PMID: 16314639 DOI: 10.1200/jco.2005.01.7632] [Citation(s) in RCA: 301] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To collect data for the development of a more universally useful logistic regression model to distinguish between a malignant and benign adnexal tumor before surgery. PATIENTS AND METHODS Patients had at least one persistent mass. More than 50 clinical and sonographic end points were defined and recorded for analysis. The outcome measure was the histologic classification of excised tissues as malignant or benign. RESULTS Data from 1,066 patients recruited from nine European centers were included in the analysis; 800 patients (75%) had benign tumors and 266 (25%) had malignant tumors. The most useful independent prognostic variables for the logistic regression model were as follows: (1) personal history of ovarian cancer, (2) hormonal therapy, (3) age, (4) maximum diameter of lesion, (5) pain, (6) ascites, (7) blood flow within a solid papillary projection, (8) presence of an entirely solid tumor, (9) maximal diameter of solid component, (10) irregular internal cyst walls, (11) acoustic shadows, and (12) a color score of intratumoral blood flow. The model containing all 12 variables (M1) gave an area under the receiver operating characteristic curve of 0.95 for the development data set (n = 754 patients). The corresponding value for the test data set (n = 312 patients) was 0.94; and a probability cutoff value of .10 gave a sensitivity of 93% and a specificity of 76%. CONCLUSION Because the model was constructed from multicenter data, it is more likely to be generally applicable. The effectiveness of the model will be tested prospectively at different centers.
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MESH Headings
- Adnexal Diseases/classification
- Adnexal Diseases/diagnosis
- Adnexal Diseases/surgery
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- CA-125 Antigen/blood
- Cystadenoma, Mucinous/classification
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Papillary/classification
- Cystadenoma, Papillary/diagnosis
- Cystadenoma, Papillary/surgery
- Cystadenoma, Serous/classification
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Female
- Humans
- Logistic Models
- Middle Aged
- Multivariate Analysis
- Ovarian Cysts/classification
- Ovarian Cysts/diagnosis
- Ovarian Cysts/surgery
- Ovarian Neoplasms/classification
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/surgery
- Ovariectomy
- Preoperative Care/statistics & numerical data
- Prospective Studies
- Reproducibility of Results
- Sensitivity and Specificity
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124
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Ji Y, Zhu XZ. [Mucin gene family and its role in diagnosis of pancreas neoplasms]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2006; 35:113-6. [PMID: 16630488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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125
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Ji Y, Tan YS, Zhu XZ, Zeng HY, Kuang TT, Jin DY. [Diagnosis and differential diagnosis of intraductal papillary mucinous neoplasm of pancreas]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2006; 35:77-81. [PMID: 16630480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To study the clinicopathologic features of intraductal papillary mucinous neoplasm (IPMN) and its distinction from mucinous cystic neoplasm of pancreas. METHODS The clinical, radiologic and histologic features of 17 cases of IPMN and 13 cases of mucinous cystic neoplasm (MCN) were reviewed. Mucin profiles (MUC1, MUC2 and MUC5AC) were studied by histology (HE) and immunohistochemistry (EnVision). RESULTS 10 of the 17 cases of IPMN were males. 13 cases of the IPMN were located in head of pancreas. Communication with the main pancreatic duct was demonstrated in 15 cases. Histologically, there were mild to severe papillary ingrowths of dysplastic epithelial cells, associated with intervening normal or atrophic pancreatic parenchyma. Ovarian-like stroma was not seen. Ancillary investigations showed that MUC2 and MUC5AC were detected in tumor cells of 9 and 4 cases respectively. The 4 cases with invasive component showed MUC1 positivity. On the other hand, 11 of the 13 cases of MCN occurred in middle-aged to elderly females and were located in the body and tail of pancreas. Ovarian-like stroma was commonly seen and there was no connection with the main pancreatic duct. All non-invasive MCN, regardless of the degree of cytologic atypia, were positive for MUC5AC (but not MUC2). In the 2 cases with invasive component, MUC1 expression was observed, as in IPMN. CONCLUSIONS The age and sex of patients, tumor location, absence of ovarian-like stroma, communication with main pancreatic duct and characteristic mucin profiles represent useful parameters in distinguishing IPMN from MCN of pancreas. The tumor cells of IPMN express mainly MUC2, while those of MCN express MUC5AC. MUC1 may also be a useful marker in demonstration of stromal invasion in these tumors.
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MESH Headings
- Adult
- Age Factors
- Aged
- Antigens, Neoplasm/metabolism
- Biomarkers, Tumor/metabolism
- Carcinoma, Pancreatic Ductal/diagnosis
- Carcinoma, Pancreatic Ductal/metabolism
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/metabolism
- Carcinoma, Papillary/pathology
- Cystadenocarcinoma, Mucinous/diagnosis
- Cystadenocarcinoma, Mucinous/metabolism
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/metabolism
- Cystadenoma, Mucinous/pathology
- Diagnosis, Differential
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Mucin 5AC
- Mucin-1
- Mucin-2
- Mucins/metabolism
- Pancreas/metabolism
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/metabolism
- Pancreatic Neoplasms/pathology
- Precancerous Conditions/diagnosis
- Precancerous Conditions/metabolism
- Precancerous Conditions/pathology
- Sex Factors
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