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Dimakakos E, Zarokosta M, Sapsakos TM, Nousios G, Apostolopoulos AP, Angelis S, Filippou DK. Massive Localized Lymphedema: Two Rare Case Reports of this Peculiar Entity and Anatomic Distortion. J Long Term Eff Med Implants 2020; 29:225-229. [PMID: 32478995 DOI: 10.1615/jlongtermeffmedimplants.2020034007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Massive localized lymphedema (MLL), also called pseudosarcoma in the literature, constitutes a rare benign clinical disorder presenting in obese patients and characterized by chronic accumulation of lymph and adipose tissue due to lymphatic flow obstruction. PRESENTATION OF CASE A 43-year-old, morbidly obese white woman proceeded to our institution with extended lymphedema. In addition, a 54-year-old white man sought medical advice for the same clinical issue. Surgical excision of the soft tissue mass was performed in both cases so that the patients could regain mobility of their limbs. The operation was uneventful. The histopathologic analysis asserted the diagnosis of MLL. A meticulous review of the literature was conducted as well. DISCUSSION MLL is a scarce, non-malignant clinical entity that may mimic an abundance of soft tissue tumors. Patients with MLL are typically obese females with body mass index (BMI) > 40 kg/m2 who present with non-specific symptoms. The diagnosis of MLL is challenging, and its etiology and treatment are not completely elucidated. CONCLUSION Surgeons' deep knowledge regarding this peculiar clinical disorder is the cornerstone for the establishment of a correct diagnosis and warrants the adequate treatment, in addition to the elimination of the potentiality of malignant transformation of MLL to angiosarcoma or liposarcoma and of probable recurrence of MLL.
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Affiliation(s)
- Evangelos Dimakakos
- Angiologist-Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Maria Zarokosta
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece and Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Theodoros Mariolis Sapsakos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece and Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Georgios Nousios
- Department of Anatomy, School of Physical Education and Sport Sciences, Serres, Aristotles University of Thessaloniki, Greece
| | - Alexandros P Apostolopoulos
- Trauma and Orthopaedic Department, "Korgialenio-Benakio" Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
| | - Stavros Angelis
- 2nd Orthopaedic Department, General Children's Hospital, Athens, Greece; Orthopaedic and Trauma Department, Hellenic Red Cross Hospital, Athens, Greece
| | - Dimitrios K Filippou
- Department of Anatomy and Surgical Anatomy, Medical School of National and Kapodistrian University of Athens, Athens, Greece
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Nikolouzakis TK, Stivaktakis PD, Apalaki P, Kalliantasi K, Sapsakos TM, Spandidos DA, Tsatsakis A, Souglakos J, Tsiaoussis J. Effect of systemic treatment on the micronuclei frequency in the peripheral blood of patients with metastatic colorectal cancer. Oncol Lett 2019; 17:2703-2712. [PMID: 30854044 PMCID: PMC6365930 DOI: 10.3892/ol.2019.9895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/12/2018] [Indexed: 12/31/2022] Open
Abstract
Colorectal cancer (CRC) is the third most diagnosed type of cancer affecting males, and the second most diagnosed type of cancer affecting females, and one of the leading causes of cancer-related mortality globally. The estimation of the micronuclei (MN) frequency in peripheral blood lymphocytes (PBLs) from patients with CRC is proposed as a prognostic/predictive easy-to-use biomarker. In this study, we aimed to investigate the effects of systemic treatment on the MN frequency in PBLs from patients with CRC in order to determine the effectiveness of the MN frequency as a biomarker. For this purpose, from 2016 to 2018, we quantified the MN frequency as a prognostic/predictive biomarker in serial samples from 25 patients with metastatic CRC (mCRC) using cytokinesis block micronucleus assay (CBMN assay). The MN frequency in the PBLs of the patients was evaluated before, during the middle and at the end of the therapy (approximately 0, 3 and 6 months). The results revealed a common pattern regarding the fluctuation in the MN frequency. Statistical analysis confirmed that when the disease response was estimated with radiological criteria, a good response was depicted at the MN frequency and vice versa. Consequently, the findings of this study suggest that the MN frequency may serve as a promising prognostic/predictive biomarker for the monitoring of the treatment response of patients with CRC.
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Affiliation(s)
| | | | - Paraskevi Apalaki
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Katerina Kalliantasi
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Theodoros Mariolis Sapsakos
- Laboratory of Anatomy and Histology, Nursing School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - John Souglakos
- Department of Medical Oncology, University General Hospital of Heraklion, 71110 Heraklion, Greece
| | - John Tsiaoussis
- Laboratory of Anatomy-Histology-Embryology, Medical School, University of Crete, 71110 Heraklion, Greece
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Bistaraki A, Zarokosta M, Sapsakos TM, Skarpas G, Nousios G, Apostolopoulos AP, Angelis S, Filippou DK. The Accessory Soleus Muscle: A Narrative Review of the Literature. J Long Term Eff Med Implants 2019; 29:239-246. [PMID: 32478997 DOI: 10.1615/jlongtermeffmedimplants.2020034017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Although the accessory soleus muscle is a rare supernumerary muscle of the leg, its presence has been well discussed in the literature. This rare anatomic variation has been described mainly in the anatomic, surgical, and radiology literature. Awareness of the muscle's presence and its clinical presentation can help with diagnosis without surgical exploration. This narrative review summarizes the available data describing the anatomy, clinical presentation, diagnosis, associated pathologies, and treatment options of this accessory muscle. METHODS A literature review was performed to provide a comprehensive report of the existing data regarding the accessory soleus muscle. PubMed, Heal Link, and Google Scholar were searched for articles in English reporting on the accessory soleus muscle. The search was conducted using the following key words: "soleus muscle" and "accessory soleus muscle". PubMed was searched primarily, and then cross-referenced articles were found via Heal Link and Google Scholar. Results from non-English studies were excluded. RESULTS A total of 148 articles were reviewed. The majority of the articles was composed of case reports along with a review of the literature. After the initial screening, 33 irrelevant studies, 47 duplicates, and 9 non-English articles were excluded; thus, 59 studies were eligible for analysis. CONCLUSION Although the accessory soleus muscle is a rare anatomic variation, many cases have been reported in the literature. Nonetheless, the results reported in this literature review are still inconclusive regarding why some patients are symptomatic and others are not, and the recommendation of therapy protocols. Recognizing this anomaly is important in deciding the right diagnosis and planning the appropriate treatment. However, further research is needed to investigate the symptoms' presentations and propose specific treatment protocols.
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Affiliation(s)
- Aggeliki Bistaraki
- Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Maria Zarokosta
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece and Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Theodoros Mariolis Sapsakos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece and Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - George Skarpas
- Anatomy and Histology Laboratory, Nursing School, University of Athens, Greece
| | - Georgios Nousios
- Department of Anatomy, School of Physical Education and Sport Sciences, Serres, Aristotles University of Thessaloniki, Greece
| | - Alexandros P Apostolopoulos
- Trauma and Orthopaedic Department, "Korgialenio-Benakio" Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
| | - Stavros Angelis
- 2nd Orthopaedic Department, General Children's Hospital, Athens, Greece; Orthopaedic and Trauma Department, Hellenic Red Cross Hospital, Athens, Greece
| | - Dimitrios K Filippou
- Department of Anatomy and Surgical Anatomy, Medical School of National and Kapodistrian University of Athens, Athens, Greece
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Nikolouzakis TK, Vassilopoulou L, Fragkiadaki P, Sapsakos TM, Papadakis GZ, Spandidos DA, Tsatsakis AM, Tsiaoussis J. Improving diagnosis, prognosis and prediction by using biomarkers in CRC patients (Review). Oncol Rep 2018; 39:2455-2472. [PMID: 29565457 PMCID: PMC5983921 DOI: 10.3892/or.2018.6330] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/21/2018] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) is among the most common cancers. In fact, it is placed in the third place among the most diagnosed cancer in men, after lung and prostate cancer, and in the second one for the most diagnosed cancer in women, following breast cancer. Moreover, its high mortality rates classifies it among the leading causes of cancer‑related death worldwide. Thus, in order to help clinicians to optimize their practice, it is crucial to introduce more effective tools that will improve not only early diagnosis, but also prediction of the most likely progression of the disease and response to chemotherapy. In that way, they will be able to decrease both morbidity and mortality of their patients. In accordance with that, colon cancer research has described numerous biomarkers for diagnostic, prognostic and predictive purposes that either alone or as part of a panel would help improve patient's clinical management. This review aims to describe the most accepted biomarkers among those proposed for use in CRC divided based on the clinical specimen that is examined (tissue, faeces or blood) along with their restrictions. Lastly, new insight in CRC monitoring will be discussed presenting promising emerging biomarkers (telomerase activity, telomere length and micronuclei frequency).
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Affiliation(s)
| | - Loukia Vassilopoulou
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71409 Heraklion, Crete, Greece
| | - Persefoni Fragkiadaki
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71409 Heraklion, Crete, Greece
| | - Theodoros Mariolis Sapsakos
- Laboratory of Anatomy and Histology, Nursing School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Z. Papadakis
- Foundation for Research and Technology Hellas (FORTH), Institute of Computer Sciences (ICS), Computational Biomedicine Laboratory (CBML), 71003 Heraklion, Crete, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Crete, Greece
| | - Aristides M. Tsatsakis
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71409 Heraklion, Crete, Greece
| | - John Tsiaoussis
- Laboratory of Anatomy-Histology-Embryology, Medical School, University of Crete, 71110 Heraklion, Greece
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Laios K, Sapsakos TM, Kotrotsios A, Tsoucalas G, Sgantzos M. The anatomy of vena cava in the work of Aretaeus of Cappadocia. Ital J Anat Embryol 2015; 120:40-43. [PMID: 26738257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Aretaeus of Cappadocia did not deal systematically with the study of anatomy, as it can be assumed from the thorough study of his remaining work, as well as the references to the topics and the fragments of his lost treatises. We could also extract useful information on anatomy through his analytical descriptions about the various diseases in his remaining work. A perfect example is the anatomy of the upper and inferior vena cava exposed in his work on acute diseases.
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