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Matas-Nadal C, Soria X, Gonzalez-Farré M, Baradad M, Tuset N, Rius Riu F, González M, Gatius S, Vilardell F, López-Ortega R, Martí RM. Abdominal tumors in patients with neurofibromatosis type I: Genotype-phenotype relationships. Eur J Med Genet 2022; 65:104609. [PMID: 36096471 DOI: 10.1016/j.ejmg.2022.104609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gastrointestinal stromal tumors have been detected in 25% of the necropsies performed on NF1 patients, but have been reported only in 7% of NF1 patients in the largest series. Such data imply an important gap between the true presence of tumors and those diagnosed. Few genotype-phenotype relationships have been described but to date none referring to abdominal tumors. OBJECTIVES Evaluate retrospectively the efficacy of a regular and proactive follow-up of NF1 patients to early diagnose abdominal tumors and report their mutations. METHODS Cohort study performed between 2010 and 2020, with 43 NF1 adult patients followed at our Dermatology department. RESULTS Eight abdominal tumors were diagnosed in six patients, meaning that 14% of the followed patients developed an abdominal tumor. Five patients (83%) were asymptomatic. Five (83.3%) had a family history of NF1 with abdominal tumors (patients 1,2 and 3,4,5 were relatives). CONCLUSIONS Although currently gastrointestinal routine screening investigations for asymptomatic patients are not recommended in the guidelines, the family aggregation in our series suggests it should be considered a close follow-up of the relatives of a patient with an NF1-related abdominal tumor. Also, for the first time, two mutations [c.2041C > T (p.Arg681Ter) and c.4537C > T (p.Arg1513*)] have been associated with family aggregation of abdominal tumors in NF1 patients.
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Affiliation(s)
- C Matas-Nadal
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain.
| | - X Soria
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain
| | - M Gonzalez-Farré
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; University of Lleida, Spain
| | - M Baradad
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain; University of Lleida, Spain
| | - N Tuset
- Medical Oncology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - F Rius Riu
- Endocrinology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - M González
- General Surgery Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - S Gatius
- IRB Lleida, Spain; Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - F Vilardell
- IRB Lleida, Spain; Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - R López-Ortega
- Laboratori Clínic ICS Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - R M Martí
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain; Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of Lleida, Spain
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2
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Portale G, Rulli R, Spolverato YC, Mascellino P. Reminder for the clinician: abdominal manifestations of type 1 neurofibromatosis are not so uncommon. BMJ Case Rep 2022; 15:e250951. [PMID: 35918081 PMCID: PMC9351337 DOI: 10.1136/bcr-2022-250951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2022] [Indexed: 11/03/2022] Open
Abstract
We describe the case of a woman in her 50s with abdominal pelvic masses suspected to be an ovarian lesion with metastases. At laparoscopy, it appeared as a possible abdominal location of neurofibromatosis type 1 (NF-1). A 50 cm of small bowel was resected to remove multiple nodular lesions. On histopathology, small bowel lesions (n=14) were all classified as GISTs. Clinicians should recognise and consider gastrointestinal manifestations of NF-1 in the diagnostic flow chart. Surgical treatment may resolve symptomatic cases and prevent local infiltration or malignant degeneration of abdominal neoplasms occurring in patients with NF-1.
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Affiliation(s)
| | - Roberto Rulli
- Gynecology, Azienda ULSS 6 Euganea, Cittadella, Italy
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3
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Hammami A, Hasnaoui B, Guerfala M, Mabrouk MB, Farhat W, Ksiaa M, Jaziri H, Elleuch N, Brahem A, Ajmi S, Ali AB, Sriha B, Slama AB, Jmaa A. Gastrointestinal stromal tumor (GIST) inpatient with Von Recklinghausen's disease. Presse Med 2018; 47:404-408. [PMID: 29588106 DOI: 10.1016/j.lpm.2018.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/16/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Aya Hammami
- Departement of Gastroenterology, Sahloul City, Tunisia.
| | | | | | | | - Waad Farhat
- Departement of Surgery, Sahloul City, Tunisia
| | - Mehdi Ksiaa
- Departement of Gastroenterology, Sahloul City, Tunisia
| | - Hanen Jaziri
- Departement of Gastroenterology, Sahloul City, Tunisia
| | - Nour Elleuch
- Departement of Gastroenterology, Sahloul City, Tunisia
| | - Ahlem Brahem
- Departement of Gastroenterology, Sahloul City, Tunisia
| | - Salem Ajmi
- Departement of Gastroenterology, Sahloul City, Tunisia
| | - Ali Ben Ali
- Departement of Surgery, Sahloul City, Tunisia
| | | | | | - Ali Jmaa
- Departement of Gastroenterology, Sahloul City, Tunisia
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4
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Abdessayed N, Gupta R, Mestiri S, Bdioui A, Trimech M, Mokni M. Rare triad of periampullary carcinoid, duodenal gastrointestinal stromal tumor and plexiform neurofibroma at hepatic hilum in neurofibromatosis type 1: a case report. BMC Cancer 2017; 17:579. [PMID: 28851321 PMCID: PMC5575842 DOI: 10.1186/s12885-017-3567-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 08/18/2017] [Indexed: 12/21/2022] Open
Abstract
Background Neurofibromatosis type 1 is a relatively common inherited disorder. Patients with neurofibromatosis type 1 are at high risk of developing neurogenic, neuroendocrine and mesenchymal intra-abdominal tumors. Although coexistence of multiple tumors of different types is frequent in neurofibromatosis type 1, simultaneous occurrence of abdominal tumors of three types in very rare. Case presentation A 66-year-old lady with neurofibromatosis type 1 presented with painless progressive jaundice for six months. Laboratory investigations revealed iron deficiency anemia and conjugated hyperbilirubinemia. Tumor markers were normal. Abdominal computed tomography showed a 3 × 2 cm heterogenous mass in the periampullary region with mild dilation of the common bile duct and another 2 × 1.7 cm mass in the fourth portion of the duodenum. Endoscopic biopsy confirmed the diagnosis of periampullary carcinoid. At surgery, multiple small nodules were detected at the hepatic hilum. Frozen section suggested them to be neurofibromas. Patient underwent pancreatoduodenectomy and had uneventful recovery with no recurrence at two months. Microscopic examination of the resected specimen confirmed presence of three tumors: periampullary well differentiated neuroendocrine tumor, gastrointestinal stromal tumor of the fourth part of duodenum and plexiform neurofibroma at the hepatic hilum. Conclusion Patients of neurofibromatosis type 1 with abdominal symptoms should be treated with high index of clinical suspicion and thoroughly evaluated to rule out multiple tumors.
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Affiliation(s)
- Nihed Abdessayed
- Department of pathology, Farhat Hached Hospital, Avenue Farhat Hached, 4000, Sousse, Tunisia.,Research Lab: transfer in technology in anatomic pathology (LR12SP08), Sousse, Tunisia
| | - Rahul Gupta
- Department of HPB surgery, CARE hospital, Hyderabad, India
| | - Sarra Mestiri
- Department of pathology, Farhat Hached Hospital, Avenue Farhat Hached, 4000, Sousse, Tunisia
| | - Ahlem Bdioui
- Department of pathology, Farhat Hached Hospital, Avenue Farhat Hached, 4000, Sousse, Tunisia
| | - Mounir Trimech
- Department of pathology, Farhat Hached Hospital, Avenue Farhat Hached, 4000, Sousse, Tunisia
| | - Moncef Mokni
- Department of pathology, Farhat Hached Hospital, Avenue Farhat Hached, 4000, Sousse, Tunisia. .,Research Lab: transfer in technology in anatomic pathology (LR12SP08), Sousse, Tunisia.
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5
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Wilson A, Slopis J, Andrassy R, Dhingra S, Austin M. Surgical management of an appendiceal neurofibroma in a neurofibromatosis-1 patient: A case report. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2015. [DOI: 10.1016/j.epsc.2015.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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6
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A rare malignancy in a patient with neurofibromatosis: gastric adenocarcinoma. North Clin Istanb 2015; 2:162-164. [PMID: 28058360 PMCID: PMC5175097 DOI: 10.14744/nci.2015.33042] [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: 12/12/2014] [Accepted: 04/08/2015] [Indexed: 12/01/2022] Open
Abstract
Neurofibromatosis is an autosomal dominant disease that is characterized by cutaneous hyperpigmentation and multiple neurofibromas and often accompanied by localized peripheral and central neural tumors. Gastrointestinal involvement is seen in 25% of the cases. Gastrointestinal stromal tumors, pancreatic and duodenal neuroendocrine tumors are the most common tumors in patients with neurofibromatosis. Neurofibromatosis and gastric adenocarcinoma constitute an extremely rare combination. In this case report we aim to present a patient with neurofibromatosis operated due to gastric adenocarcinoma.
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7
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Management of advanced plexiform neurofibromatosis of the foot presenting with skeletal deformation and intractable pain: an indication for proximal amputation. Foot (Edinb) 2015; 25:30-5. [PMID: 25496857 DOI: 10.1016/j.foot.2014.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 11/03/2014] [Accepted: 11/05/2014] [Indexed: 02/04/2023]
Abstract
Plexiform neurofibromas of the foot are rare and often present with significant pain, deformity, and functional impairment secondary to their locally invasive behavior. While treatment has traditionally focused on attempts at radical resection, a lack of consensus among surgeons has hindered the establishment of a well-defined algorithm to guide the management of these highly co-morbid peripheral nerve sheath tumors. We present the case of an advanced plexiform neurofibroma of the right foot in a 24-year-old male with neurofibromatosis type 1. The patient presented following accelerated tumor growth with extensive osseous erosion, intractable pain, and progressive ankle instability that limited his capacity to ambulate and wear shoes. A modified transtibial amputation with a vascularized fibular bone graft (Ertl procedure) was performed without complication. Following graduated rehabilitation, postoperatively, the patient regained functional independence and was able to ambulate without pain in a customized prosthesis after 3 months. Plexiform neurofibromas of the foot present a complex challenge for foot and ankle surgeons. On the basis of our experience and previously reported cases, we advocate for amputation over aggressive attempts at advanced limb salvage for patients with extensive skeletal destruction, joint instability, and/or intractable pain caused by tumor mass effect.
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8
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Tanaka M, Kataoka H, Joh T. Neurofibroma of the esophagus complicating Von Recklinghausen's neurofibromatosis. Am J Gastroenterol 2013; 108:1935-6. [PMID: 24300874 DOI: 10.1038/ajg.2013.297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Mamoru Tanaka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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9
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Aortic disease in the young: genetic aneurysm syndromes, connective tissue disorders, and familial aortic aneurysms and dissections. Int J Vasc Med 2013; 2013:267215. [PMID: 23401778 PMCID: PMC3557640 DOI: 10.1155/2013/267215] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 12/13/2012] [Accepted: 12/18/2012] [Indexed: 01/15/2023] Open
Abstract
There are many genetic syndromes associated with the aortic aneurysmal disease which include Marfan syndrome (MFS), Ehlers-Danlos syndrome (EDS), Loeys-Dietz syndrome (LDS), familial thoracic aortic aneurysms and dissections (TAAD), bicuspid aortic valve disease (BAV), and autosomal dominant polycystic kidney disease (ADPKD). In the absence of familial history and other clinical findings, the proportion of thoracic and abdominal aortic aneurysms and dissections resulting from a genetic predisposition is still unknown. In this study, we propose the review of the current genetic knowledge in the aortic disease, observing, in the results that the causative genes and molecular pathways involved in the pathophysiology of aortic aneurysm disease remain undiscovered and continue to be an area of intensive research.
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10
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Yalagachin G, Mahantshetti P. Obstructive jaundice secondary to ampullary adenocarcinoma in neurofibromatosis type 1. Indian J Surg 2012; 75:113-5. [PMID: 24426533 DOI: 10.1007/s12262-012-0513-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 04/25/2012] [Indexed: 10/28/2022] Open
Abstract
Neurofibromatosis type 1 is an autosomal dominant genetic disorder with an estimated birth incidence of 1 in 3000-4000. The major diagnostic criterion includes multiple cutaneous neurofibromas, axillary or inguinal freckling, and café au lait spots. Gastrointestinal neoplasms have a reported occurrence of 2-25 % of which neurofibromas are the most frequently diagnosed benign neoplasm. Periampullary tumors in patients with neurofibromatosis are usually carcinoids and very rarely adenocarcinoma. We report a case of 40-year old woman with neurofibromatosis type 1 who presented with epigastric pain and jaundice. She was diagnosed to have ampullary tumor after investigations, and she underwent pancreaticoduodenectomy. The resected specimen histologically showed adenocarcinoma of the ampulla.
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11
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Nthumba PM, Juma PI. Malignant peripheral nerve sheath tumors in Africa: a clinicopathological study. ISRN SURGERY 2011; 2011:526454. [PMID: 22084762 PMCID: PMC3200093 DOI: 10.5402/2011/526454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/16/2011] [Indexed: 11/23/2022]
Abstract
Introduction. Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas associated with poor prognosis, that most commonly affect patients aged 20 to 50 years, but have also been reported in children. There is little reported in literature on these tumors in Africa. Materials and Methods. A search of the hospital pathology database between 1992 and 2008 revealed 333 nerve sheath tumors, of which 31 were MPNSTs. Four representative case reports are presented. Discussion. MNPSTs have rarely been reported from sub-Saharan Africa; in this study, they constituted 9.3% of all nerve sheath tumors. The trunk (42%) and limbs (45%) were the most frequently affected anatomical sites. Late presentation of malignant lesions in this environment is exemplified by the four case presentations patients. Conclusions. This report confirms observations from studies on MPNSTs from other environments. Anatomically centrally located MPNSTs may have a higher incidence in sub-Saharan Africa than in the West. Because NF1-associated MPNSTs are difficult to diagnose clinically, and because surgery is the only mode of therapy that offers a complete cure, a lifetime follow-up is important, as this would enable diagnosis of early lesions amenable to surgical extirpation.
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Affiliation(s)
- Peter M Nthumba
- Plastic, Reconstructive and Hand Surgery Unit, AIC Kijabe Hospital, Kijabe 00220, Kenya
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12
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Kato K, Nagase A, Onodera K, Matsuda M, Iwasaki Y, Kato Y, Kato K, Kawakami T, Taniguchi M, Furukawa H. Primary adenocarcinoma of the stomach in von Recklinghausen's disease with high serum levels of multiple tumor markers: a case report. J Med Case Rep 2011; 5:521. [PMID: 22018031 PMCID: PMC3212996 DOI: 10.1186/1752-1947-5-521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 10/23/2011] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Gastric tumors in patients affected by neurofibromatosis type 1 are usually carcinoids or stromal tumors, and rarely adenocarcinomas. CASE PRESENTATION We report a case of an adenocarcinoma of the stomach in a 53-year-old Japanese man with neurofibromatosis type 1. An abdominal computed tomography scan and ultrasonography showed tumors in his liver. Gastric fibroscopy revealed a Borrmann type III tumor on his cardia that had spread to his esophagus and was highly suspicious for malignancy. Multiple biopsies showed an adenocarcinoma of the stomach, which was evaluated as gastric cancer, stage IV. Chemotherapy with TS-1 was performed. Our patient died four weeks after initial admission. Histological examination of a liver needle biopsy showed metastatic adenocarcinoma in his liver. CONCLUSION To the best of our knowledge, high serum levels of α-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 72-4, resulting from gastric adenocarcinoma, have not been reported previously in a patient with neurofibromatosis type 1. We report this rare case along with a review of the literature.
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Affiliation(s)
- Kazuya Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 Cyome Nakamachi, Pippu Town Kamikawa-gun, Hokkaido, 078-0343, Japan
| | - Atsushi Nagase
- Department of Surgery, Asahikawa Medical Center, 4048, 7 Cyome Hanasaki-cyou, Asahikawa, 070-8644, Japan
| | - Kazuhiko Onodera
- Department of Surgery, Hokuyu Hospital, 5-1, 6-6 Higashi-Sappro, Shiroishi-ku Sapporo, 003-0006, Japan
| | - Minoru Matsuda
- Department of Surgery, Nihon University, 1-8-13 Surugadai Kanda, Chiyoda-ku Tokyo, 010-8309, Japan
| | - Yoshiaki Iwasaki
- Department of Digestive Internal Medicine, Okayama University, 2-5-1 Shikata Town, Okayama City, Okayama, 700-8558, Japan
| | - Yurina Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 Cyome Nakamachi, Pippu Town Kamikawa-gun, Hokkaido, 078-0343, Japan
| | - Kimitaka Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 Cyome Nakamachi, Pippu Town Kamikawa-gun, Hokkaido, 078-0343, Japan
| | - Takako Kawakami
- Department of Surgery, Pippu Clinic, 2-10, 1 Cyome Nakamachi, Pippu Town Kamikawa-gun, Hokkaido, 078-0343, Japan
| | - Masahiko Taniguchi
- Department of Surgery, Asahikwa Medical College, 1-1, 2-1 Midorigaoka, Asahikawa, 078-8510, Japan
| | - Hiroyuki Furukawa
- Department of Surgery, Asahikwa Medical College, 1-1, 2-1 Midorigaoka, Asahikawa, 078-8510, Japan
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Relles D, Baek J, Witkiewicz A, Yeo CJ. Periampullary and duodenal neoplasms in neurofibromatosis type 1: two cases and an updated 20-year review of the literature yielding 76 cases. J Gastrointest Surg 2010; 14:1052-61. [PMID: 20300877 DOI: 10.1007/s11605-009-1123-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 11/25/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with neurofibromatosis type 1 (NF1) are at increased risk to develop tumors throughout the gastrointestinal tract, including neuromas, gastrointestinal stromal tumors (GIST), and periampullary somatostatin-rich carcinoids. Here, we briefly describe two male patients with NF1 and review the recent literature on this topic. METHODS Databases for PubMed and MEDLINE were searched for English-language articles since 1989 using a list of keywords, as well as references from review articles. RESULTS The results generated by the search yielded 50 articles and 74 cases. Patients most commonly presented with jaundice, weight loss, GI bleeding, or anemia. The mean age at presentation was 47.9 years, with 59% of patients being female. Mean tumor size was 3.8 cm (range 0.9-27 cm). Tumor location was the duodenum (60%), ampulla (31%), pancreas (5%), or bile duct/gallbladder (4%). Tumor type was reported as somatostatinoma (40%), GIST (34%), adenocarcinoma (8%), carcinoid (6%), neurofibroma (5%), schwannoma (4%), or gangliocytic paraganglioma (3%). Treatment included classic Whipple procedure (42%), local excision (25%), pylorus-preserving pancreaticoduodenectomy (17%), and other resection (6%). Mean follow-up was 31 months postresection (range 0-99 months): 75% of patients were alive with no evidence of disease. CONCLUSIONS These results underscore the importance of a thorough evaluation for tumors in NF1 patients with gastrointestinal symptoms, as well as subsequent surgical management when findings suggest a tumor in the periampullary region, as resection remains the mainstay of treatment.
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Affiliation(s)
- Daniel Relles
- Department of Surgery, Thomas Jefferson University and the Jefferson Pancreas, Biliary, and Related Cancer Center, Philadelphia, PA, USA
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14
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Suh BS, Shin DW, Lee JS, Kim SY, Han EM, Jang EJ. Gastric Outlet Obstruction due to Submucosal Neurofibromatous Proliferation of Duodenal Bulb in Neurofibromatosis Type 1 Patient. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2010. [DOI: 10.4174/jkss.2010.79.suppl1.s31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Byung Sun Suh
- Department of Surgery, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Dong Woo Shin
- Department of Surgery, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Jung Seob Lee
- Department of Surgery, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Se Young Kim
- Department of Surgery, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Eun Mee Han
- Department of Pathology, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Eun Jeong Jang
- Division of Gastroenterology, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
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Abstract
Peripheral nerve tumors are most often benign tumors of the nerve sheath; uncommonly they come from the nerve cells or are metastatic tumors. A precise diagnosis is required for well-adapted and effective treatment, as is good knowledge of fibromatosis diseases. In some cases, the diagnosis of the nerve tumor will lead to a diagnosis of phakomatosis. Surgical treatment must be clearly discussed, which, in case of schwannomas gives very good functional results. Primitive malignant tumors remain an unsolved therapeutic problem.
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16
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Huang JH, Johnson VE, Zager EL. Tumors of the peripheral nerves and plexuses. Curr Treat Options Neurol 2006; 8:299-308. [PMID: 16942673 DOI: 10.1007/s11940-006-0020-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Peripheral nerve tumors are a diverse group of lesions histologically and in their clinical behavior. The genetic disorders neurofibromatosis type 1 and 2 and schwannomatosis are significant risk factors for the development of peripheral nerve tumors. An understanding of these disorders is important in allowing appropriate management. Active treatment of peripheral nerve tumors is reserved for lesions that are malignant or causing neurologic dysfunction, pain, compressive symptomatology, or cosmetic concern. The mainstay of treatment is surgical intervention, the nature of which will vary with the type of tumor and anatomical location. In the case of malignant tumors, adjuvant chemotherapy and radiotherapy are commonly used. Developments in the understanding of the genetics and molecular biology of peripheral nerve tumors are opening up potentially exciting new avenues of treatment. The prognosis of benign peripheral nerve tumors is excellent, with a recurrence rate of just 5% or less after successful surgery. Malignant tumors have proven to be more challenging, with a much higher recurrence rate and a 5-year survival rate of 64%.
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Affiliation(s)
- Jason H Huang
- Department of Neurosurgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Silverstein 3, Philadelphia, PA 19104, USA.
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17
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Abstract
The purpose of this review is to discuss the contemporary diagnosis and treatment options for nerve sheath tumors. Common nerve sheath tumors include schwannomas, neurofibromas and malignant nerve sheath tumors. Nerve sheath tumors can be associated with genetic disorders such as neurofibromatosis and schwannomatosis. There is great variation in terms of tumor location, clinical presentation and treatment strategy. Magnetic resonance imaging is the diagnostic study of choice for nerve sheath tumors and surgery has become the mainstay of treatment for most symptomatic lesions. Progress in microsurgical techniques has resulted in significant improvement in surgical outcome, with preservation of neurologic function. Complete resection of benign nerve sheath tumors is the goal of surgical intervention and this results in cure. In contrast, malignant nerve sheath tumors remain a major challenge with poor outcomes overall. Progress in multidisciplinary research may ultimately lead to novel therapeutic strategies.
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Affiliation(s)
- Jason H Huang
- Department of Neurosurgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Yuca K, Yılmaz N, Çınal A, Etlik Ö, Kırış M. A CASE OF FACIAL ASYMMETRY Neurofibromatosis type 1 with subcutaneous mass in occipital region, bilateral lisch nodules of iris and cafe- au- lait spots. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2005. [DOI: 10.29333/ejgm/82341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Plexiform neurofibroma often causes significant pain, deformity, and functional problems in the affected part of the body. Surgical management of the condition can be challenging, and local recurrence is common because of inadequate resection of the tumor. One patient with a large recurrent plexiform neurofibroma of the foot and ankle was treated successfully with a complete resection of the tumor, followed by a free latissimus dorsi muscle transfer with a skin graft for soft-tissue reconstruction. The patient has regained good contour of the foot and ankle, and has been symptom-free with no evidence of local recurrence in the affected area for 18 months. The authors believe that thorough preoperative planning and state-of-the-art reconstructions, as described here, are the keys to their success.
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Affiliation(s)
- Lee L Q Pu
- Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
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20
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Abstract
The management of children with soft tissue sarcomas has changed and survival has improved markedly during the past three decades. This is, in large part, due to the multi-modal approach to pediatric malignancies; decreasing the need for radical surgical procedures, while improving survival and decreasing morbidity. The management of patients with rhabdomyosarcomas (RMS) and nonrhabdomyosarcomas soft-tissue sarcomas (NRSTS) as well as neurofibromatosis and related tumors is best accomplished in an organized and systematic fashion with the surgeon involved early in the planning, diagnostic, and treatment phases. Cooperative trials for rhabdomyosarcoma, as part of the Intergroup Rhabdomyosarcoma Study, have led to improved survival with less radical surgery. Ongoing trials of the Soft Tissue Sarcoma Group of the Children's Oncology Group are under way. Since these tumors are rare, cooperative trials are essential to answering the remaining questions regarding extent of surgery and adjuvant therapy.
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Affiliation(s)
- Richard J Andrassy
- Department of Surgery, University of Texas Medical School at Houston, Pediatric Surgical Oncology, University of Texas M.D. Anderson Cancer Center, 6431 Fannin, MSB 4.020, 77030, USA.
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