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Koukourakis IM, Zygogianni A, Kouloulias V, Koukourakis MI. Successful Treatment of a Locally Recurrent and Metastatic Malignant Phyllodes Tumor with Accelerated Radiotherapy and Nab-Paclitaxel, Cisplatin, and Liposomal Doxorubicin Chemotherapy. Chemotherapy 2021; 66:82-86. [PMID: 34233328 DOI: 10.1159/000517246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022]
Abstract
Phyllodes tumors are rare breast lesions of fibroepithelial origin. Malignant transformation with metastases is linked with poor prognosis. We present a case of a 62-year-old woman with a recurrent malignant phyllodes tumor of the breast and lung metastases. The patient was originally presented with a borderline phyllodes tumor (7.4 cm) of the left breast, treated with wide local excision. A year later, the patient returned with palpable left breast masses. On PET-CT, increased uptake of 18F-FDG by large breast tumors was evident. A right lung lesion of metastatic origin was also present. A simple left breast mastectomy was performed. Histopathological report described 2 malignant phyllodes tumors (7 cm and 6.5 cm). One month later, during the CT simulation for radiotherapy planning, encysted fluid in the chest wall and 2 additional pulmonary lesions of the right lung were identified, confirming progressive lung metastatic disease. Both the chest wall and the regional lymph node area were irradiated with hypofractionated and accelerated radiotherapy. Biweekly chemotherapy with albumin-bound paclitaxel, cisplatin, and liposomal doxorubicin was also prescribed at the start of radiotherapy for 12 cycles. At the end of chemotherapy, complete regression of lung metastases was achieved, and there was no evidence of local recurrence. Within 2 years of follow-up, the patient is free of disease and treatment-related toxicities. Accelerated hypofractionated radiotherapy is effective in the locoregional control of malignant phyllodes tumors. The combination of cisplatin with nab-paclitaxel and liposomal doxorubicin chemotherapy has acceptable toxicity and is highly effective in eradicating metastatic lesions.
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Affiliation(s)
- Ioannis M Koukourakis
- 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Zygogianni
- 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilios Kouloulias
- 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael I Koukourakis
- Department of Radiotherapy/Oncology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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152
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Raiter A, Pawlak KM, Kozłowska-Petriczko K, Petriczko J, Szełemej J, Wiechowska-Kozłowska A. On the Track of New Endoscopic Alternatives for the Treatment of Selected Gastric GISTs-A Pilot Study. ACTA ACUST UNITED AC 2021; 57:medicina57060625. [PMID: 34208475 PMCID: PMC8234534 DOI: 10.3390/medicina57060625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/04/2022]
Abstract
Background and Objectives: GISTs (Gastrointestinal stromal tumors) are the most common mesenchymal gastrointestinal tract tumours and are mainly located in the stomach. Their malignant potential depends on size, location, and type. Endoscopic techniques are a less invasive modality for patients not eligible for surgery. ESD (endoscopic submucosal dissection) is mainly used for the removal of smaller GISTs, with intraluminal growth and a more superficial location. Thus, R0 resection capability in some cases may be not sufficient, limited by tumour size, location in the gastric wall, and its connection level with the muscularis propria. In such cases, an endoscopic full-thickness resection can become a new alternative. In this retrospective pilot study, we evaluated ESD and hybrid resection techniques in terms of safety, efficacy, and disease recurrence for selected types of gastric GISTs. Materials and Methods: A retrospective comparison was conducted in a group of patients who underwent ESD or a hybrid technique combining endoscopic resection with endoscopic suturing using the OverStitch system (HT) for type II or III gastric GISTs. A total of 21 patients aged 70 ± 8 years underwent endoscopic resection. Seventeen lesions were treated with ESD and four with the HT. Results: R0 resection was achieved in all patients treated using HT (type III lesions) and in 53% of those treated with ESD (p = 0.08). None of the type III lesions treated with ESD were excised with R0. Lesions treated with R0 ESD resections were significantly smaller (1.76 ± 0.35 cm) than those with R1 ESD resections (2.39 ± 0.40 cm) (p < 0.01). The mean lesion size treated with the HT was 2.88 ± 0.85 cm. Conclusions: HT may be a new resection modality for large gastric GISTs with high muscularis propria connection grades. Further studies are required to evaluate its safety and efficacy and to form precise inclusion criteria for endoscopic resection techniques.
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Affiliation(s)
- Artur Raiter
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, 58-309 Wałbrzych, Poland; (A.R.); (J.S.)
| | - Katarzyna M. Pawlak
- Endoscopy Unit, Department of Gastroenterology, Ministry of Interior and Administration, ul. Jagiellońska 44, 70-382 Szczecin, Poland;
- Correspondence: ; Tel.: +48-601447543
| | | | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, 70-382 Szczecin, Poland;
| | - Joanna Szełemej
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, 58-309 Wałbrzych, Poland; (A.R.); (J.S.)
| | - Anna Wiechowska-Kozłowska
- Endoscopy Unit, Department of Gastroenterology, Ministry of Interior and Administration, ul. Jagiellońska 44, 70-382 Szczecin, Poland;
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153
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Chodyla M, Demircioglu A, Schaarschmidt BM, Bertram S, Morawitz J, Bauer S, Podleska L, Rischpler C, Forsting M, Herrmann K, Umutlu L, Grueneisen J. Evaluation of the Predictive Potential of 18F-FDG PET and DWI Data Sets for Relevant Prognostic Parameters of Primary Soft-Tissue Sarcomas. Cancers (Basel) 2021; 13:cancers13112753. [PMID: 34206128 PMCID: PMC8199532 DOI: 10.3390/cancers13112753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To evaluate the potential of simultaneously acquired 18F-FDG PET- and MR-derived quantitative imaging data sets of primary soft-tissue sarcomas for the prediction of neoadjuvant treatment response, the metastatic status and tumor grade. METHODS A total of 52 patients with a high-risk soft-tissue sarcoma underwent a 18F-FDG PET/MR examination within one week before the start of neoadjuvant treatment. For each patient, the maximum tumor size, metabolic activity (SUVs), and diffusion-restriction (ADC values) of the tumor manifestations were determined. A Mann-Whitney-U test was used, and ROC analysis was performed to evaluate the potential to predict histopathological treatment response, the metastatic status or tumor grade. The results from the histopathological analysis served as reference standard. RESULTS Soft-tissue sarcomas with a histopathological treatment response revealed a significantly higher metabolic activity than tumors in the non-responder group. In addition, grade 3 tumors showed a significant higher 18F-FDG uptake than grade 2 tumors. Furthermore, no significant correlation between the different outcome variables and tumor size or calculated ADC-values could be identified. CONCLUSION Measurements of the metabolic activity of primary and untreated soft-tissue sarcomas could non-invasively deliver relevant information that may be used for treatment planning and risk-stratification of high-risk sarcoma patients in a pretherapeutic setting.
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Affiliation(s)
- Michal Chodyla
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
| | - Aydin Demircioglu
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
| | - Benedikt M. Schaarschmidt
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
| | - Stefanie Bertram
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Janna Morawitz
- Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, 40225 Dusseldorf, Germany;
| | - Sebastian Bauer
- Sarcoma Center, Western German Cancer Center, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Lars Podleska
- Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (C.R.); (K.H.)
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (C.R.); (K.H.)
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
| | - Johannes Grueneisen
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (M.C.); (A.D.); (B.M.S.); (M.F.); (L.U.)
- Correspondence: ; Tel.: +49-(0)201/723-1501
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154
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Efrima B, Ovadia J, Drukman I, Khoury A, Rath E, Dadia S, Gortzak Y, Albagli A, Sternheim A, Segal O. Cryo-surgery for symptomatic extra-abdominal desmoids. A proof of concept study. J Surg Oncol 2021; 124:627-634. [PMID: 34043245 DOI: 10.1002/jso.26528] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/05/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Extra abdominal desmoid tumors are rare, highly aggressive, and invasive benign soft tissue tumors. Current treatment modalities show high levels of recurrence and comorbidities. Cryo-surgery as an alternative was subsequently investigated. METHODS In this retrospective, single center study 11 patients showing symptomatic tumors were treated with individualized cryo-surgery. Treatment protocol included preoperative planning using computer rendered 3D models, intraoperative navigation and execution using cone beam guidance, and postoperative magnetic resonance imaging image analysis using a gaussian mixture model software. Subjective outcomes were reported using Short Form Health Survey (SF-36) questionnaires. RESULTS Sixteen ablations were performed, each demonstrating a complete match with the determined preoperative plan and model. A total of 9/11 (82%) of patients showed improvements in symptoms and a reduction in tumor volume while 2/11 (18%) did not. Average reduction in tumor volume and viable segments were 36.7% (p = 0.0397) and 63.3% (p = 0.0477), respectively. Mild complications according to the SIR Adverse Event Classification Guidelines were experienced in 3/16 (19%) ablations. SF-36 scores showed a statistically significant improvement (p = 0.0194) in the mental health category and a nonsignificant (p = 0.8071) improvement in the physical health category. CONCLUSION Cryo-surgery using the three-phase protocol as described may improve the overall outcome of future ablation procedures.
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Affiliation(s)
- Ben Efrima
- Division of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joshua Ovadia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Drukman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Radiology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Amal Khoury
- Division of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ehud Rath
- Division of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Solomon Dadia
- Division of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yair Gortzak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,National Department of Orthopaedic Oncology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Assaf Albagli
- Division of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Sternheim
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,National Department of Orthopaedic Oncology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ortal Segal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,National Department of Orthopaedic Oncology, Tel Aviv Medical Center, Tel Aviv, Israel
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155
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Allen M, Silvino D, Kamrava M, Shon W, Brien E. Hypofractionated radiation therapy and wound healing after massive sarcoma resection: Case report and review of the literature. Int J Surg Case Rep 2021; 83:106005. [PMID: 34044264 PMCID: PMC8167288 DOI: 10.1016/j.ijscr.2021.106005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/09/2021] [Accepted: 05/16/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Large high-grade sarcomas are commonly managed with five weeks of pre-operative radiation with chemotherapy followed by surgical resection. Wound complications occur in about one out of three patients with this regimen. Hypofractionated radiation therapy (HFRT) is a developing pre-operative approach that delivers radiation over a shorter duration of 5–10 treatments. Presentation of case Two patients underwent HFRT with neoadjuvant chemotherapy followed by tumor resection. The first patient had high-grade de-differentiated liposarcoma, and the second patient a high-grade myxofibrosarcoma. Neither patient developed post-operative wound complications despite the massive tumor size. Discussion Less is understood regarding rates and risk factors associated with wound complications using this shortened radiation approach. With attention to surgical detail, and advancing radiation delivery technologies, rates of complications can be minimized. Conclusion We discuss our experience with a neoadjuvant hypofractionated chemoradiation protocol in two patients with large volume sarcomas resected from the chest wall and the thigh who did not develop acute wound complications. Further evaluation of this shortened regimen is warranted. Wound complications are common after sarcoma resection with preoperative radiation. Hypofractionated Radiation Therapy (HFRT) may be a safe alternative to conventional dose radiation. HFRT can be utilized with massive volume sarcomas safely.
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Affiliation(s)
- Michael Allen
- Department of Orthopaedic Surgery, Community Memorial Health System, 147 N Brent St. Ventura, CA 93003, United States of America.
| | - Daniella Silvino
- NYIT College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, NY 1145, United States of America
| | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America
| | - Wonwoo Shon
- Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America
| | - Earl Brien
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America
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156
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Makris EA, Sharma AK, Bergstrom EN, Xu X, de la Torre J, Banerjee S, Nguyen V, Hosseini M, Burgoyne A, Harismendy O, Alexandrov LB, Sicklick JK. Synchronous, Yet Genomically Distinct, GIST Offer New Insights Into Precise Targeting of Tumor Driver Mutations. JCO Precis Oncol 2021; 5:PO.20.00384. [PMID: 34250403 PMCID: PMC8232556 DOI: 10.1200/po.20.00384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Eleftherios A Makris
- Department of Surgery, Division of Surgical Oncology, UC San Diego School of Medicine, San Diego, CA.,Moores Cancer Center, UC San Diego, La Jolla, CA
| | - Ashwyn K Sharma
- Department of Surgery, Division of Surgical Oncology, UC San Diego School of Medicine, San Diego, CA.,Moores Cancer Center, UC San Diego, La Jolla, CA
| | - Erik N Bergstrom
- Department of Cellular and Molecular Medicine, UC San Diego School of Medicine, San Diego, CA.,Department of Bioengineering, UC San Diego Jacobs School of Engineering, San Diego, CA
| | - Xiaojun Xu
- Moores Cancer Center, UC San Diego, La Jolla, CA.,Department of Medicine, Division of Biomedical Informatics, UC San Diego School of Medicine, San Diego, CA
| | - Jorge de la Torre
- Department of Surgery, Division of Surgical Oncology, UC San Diego School of Medicine, San Diego, CA.,Moores Cancer Center, UC San Diego, La Jolla, CA
| | - Sudeep Banerjee
- Moores Cancer Center, UC San Diego, La Jolla, CA.,Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Vi Nguyen
- Department of Surgery, Division of Surgical Oncology, UC San Diego School of Medicine, San Diego, CA.,Moores Cancer Center, UC San Diego, La Jolla, CA
| | - Mojgan Hosseini
- Department of Pathology, UC San Diego School of Medicine, San Diego, CA
| | - Adam Burgoyne
- Moores Cancer Center, UC San Diego, La Jolla, CA.,Department of Medicine, Division of Hematology-Oncology, UC San Diego School of Medicine, San Diego, CA
| | - Olivier Harismendy
- Moores Cancer Center, UC San Diego, La Jolla, CA.,Department of Medicine, Division of Biomedical Informatics, UC San Diego School of Medicine, San Diego, CA
| | - Ludmil B Alexandrov
- Moores Cancer Center, UC San Diego, La Jolla, CA.,Department of Cellular and Molecular Medicine, UC San Diego School of Medicine, San Diego, CA.,Department of Bioengineering, UC San Diego Jacobs School of Engineering, San Diego, CA
| | - Jason K Sicklick
- Department of Surgery, Division of Surgical Oncology, UC San Diego School of Medicine, San Diego, CA.,Moores Cancer Center, UC San Diego, La Jolla, CA
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157
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Li C, Wu H, Li H, Wang Q, Li Y, Gao ZD, Yang XD, Ye YJ, Jiang KW. Different Medical Features and Strategies of Large Rectal Gastrointestinal Stromal Tumor: A Multi-Central Pooling Analysis. Cancer Manag Res 2021; 13:1591-1600. [PMID: 33628049 PMCID: PMC7898204 DOI: 10.2147/cmar.s291269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The rectum is a rare site for gastrointestinal stromal tumors (GISTs). Tumors in this critical anatomical site are prone to develop local recurrence, and this occurs at a high level even in low-risk tumors. Previous studies found that high-risk was the most common category in rectal gastrointestinal stromal tumors (RGISTs), and size was the most important factor affecting the long-term prognosis. We aimed to find out the most influential factor on clinical outcomes, and describe demographics, oncological differences, and surgical procedures in patients with poor prognosis. Patients and Methods Data on consecutive patients with RGIST, who were diagnosed at Peking University People’s Hospital, Shandong Province Hospital, and The First Affiliated Hospital of Shandong First Medical University from 2010 to 2020, were retrospectively evaluated. Further, a literature search was conducted by retrieving data from PubMed, EMBASE, and the Cochrane Library databases from inception up to March 20, 2020. Results In all, 50 patients were diagnosed with RGIST at three medical centers, and 86 published records were finally included in the literature review. Combined analysis of the whole individual patient data showed that 5.5 cm was deemed an appropriate cut-off value for L-RGIST, and that patients usually showed a male predominance (67.59%), younger age at onset (56.61 years), higher operative difficulty, and poorer prognosis. Conclusion Separation of patients with large RGIST from general patients may contribute to the recognition of the oncological characteristics and clinical management of this rare type of tumor.
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Affiliation(s)
- Chen Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Hao Wu
- Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Han Li
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, People's Republic of China
| | - Quan Wang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Yang Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Zhi-Dong Gao
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xiao-Dong Yang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Ying-Jiang Ye
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
| | - Ke-Wei Jiang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China
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158
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Cieri M, Contieri R, De Carlo C, Lughezzani G, Maffei D, Colombo P. Delayed Diagnosis of a Testicular Mass During COVID-19 Pandemic in Lombardy: A Case Report. Res Rep Urol 2021; 13:41-44. [PMID: 33537246 PMCID: PMC7847766 DOI: 10.2147/rru.s297880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
Signs and symptoms associated with testicular and paratesticular structures should not be underestimated because they may hide diseases requiring immediate evaluation and treatment, such as germline tumors or sarcomas, with the latter histotypes being more common among elderly patients. Unfortunately, the COVID-19 pandemic in Italy has led to a diagnostic delay of several malignancies and the impact of this delay has likely been underestimated. Paratesticular leiomyosarcoma represents a very rare subtype of sarcoma. Here we describe a 57-year-old man who presented to the emergency department with dyspnea and a voluminous mass in the right paratesticular region. At the appearance of the scrotal mass 9 months prior, he had refused to undergo a urological evaluation due to fear of contracting COVID-19. We present this case for its histological rarity and to document a case of diagnostic and therapeutic delay during the pandemic in Lombardy.
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Affiliation(s)
- Miriam Cieri
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Roberto Contieri
- Department of Urology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Camilla De Carlo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Davide Maffei
- Department of Urology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
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