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Haberecht H, Tekin B, Warren K, Guo RR. Cutaneous Malignant Mixed Tumor With Pulmonary Metastasis: A Case Report and Literature Review. Am J Dermatopathol 2024; 46:212-217. [PMID: 38354373 DOI: 10.1097/dad.0000000000002629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Cutaneous malignant mixed tumor (MMT) is a rare sweat gland-derived tumor characterized by admixed malignant epithelial cells and chondromyxoid stroma. Approximately 50 cases have been described in the literature. Metastasis, which may occur in more than one-third of cases, is most common in the lung. METHODS We summarized the clinicopathologic features of a patient with cutaneous MMT metastatic to the lungs. A literature review of similar cases was completed using Web of Science, Scopus, and PubMed databases. RESULTS A woman in her 70s presented with an enlarging mass on her left eyebrow; histopathologic examination showed large islands of atypical cells with increased mitotic activity, admixed with necrosis on a background of fibrotic and chondromyxoid stroma. Multiple lung nodules were identified during follow-up. Examination of a pulmonary core needle biopsy specimen was consistent with metastatic cutaneous MMT. Literature review identified 10 cases published between 1980 and 2017. Most primary tumors were large (≥4 cm). Local recurrence was uncommon, and the lung was the only metastatic site in 5 cases. Histopathologically, metastatic tumors were described as more cellular, with diminished stromal tissue compared with the primary lesion. CONCLUSION This is 1 of the 11 reports of cutaneous MMT with metastasis to the lungs found in the English-language literature published after 1980. Of note, most reports were published before 1990, making this case study one of the few contemporary descriptions of cutaneous MMT with pulmonary metastases. We think that the present case report will increase the awareness of this rare tumor.
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Affiliation(s)
| | - Burak Tekin
- Departments of Laboratory Medicine and Pathology and Dermatology, Mayo Clinic, Rochester, MN
| | - Krista Warren
- Department of Pathology, Essentia Health, Duluth, MN; and
| | - Ruifeng Ray Guo
- Departments of Laboratory Medicine and Pathology and Dermatology, Mayo Clinic, Jacksonville, FL
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Li GB, Shi WK, Zhang N, Lin GL. [Anal adenocarcinoma combined with perianal Paget disease involving vulva: a case report]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:75-76. [PMID: 38262904 DOI: 10.3760/cma.j.cn441530-20230505-00145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
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3
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Gniesmer S, Sonntag SR, Schiemenz C, Ranjbar M, Heindl LM, Varde MA, Emmert S, Grisanti S, Kakkassery V. Diagnosis and treatment of malignant eyelid tumors. Ophthalmologie 2024; 121:33-39. [PMID: 37851118 DOI: 10.1007/s00347-023-01945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Malignant tumors of the eyelid are much less frequent than benign eyelid alterations. These are frequently incidental findings without symptoms which are often overlooked or misinterpreted by patients. OBJECTIVE This article gives an overview of clinical aspects, diagnostics and treatment of the five most common malignant eyelid tumors and exemplarily explains the essential principles of evidence-based treatment of malignant eyelid tumors. METHODS This narrative review was prepared based on a selective literature search. The depiction of the treatment of eyelid tumors is supported by illustrations of clinical cases. RESULTS The medical history and inspection provide initial indications of malignancy. Every eyelid change suspected of being malignant should be examined histologically to confirm a diagnosis. By far the most common malignant eyelid tumor in Europe is basal cell carcinoma, which metastasizes only in exceptional cases. Squamous cell carcinomas, sebaceous adenocarcinomas, melanomas and Merkel cell carcinomas occur much less frequently. In these cases, potential metastasis in particular must be considered when making the diagnosis and staging has to be initiated. Surgical excision into healthy tissue with tumor-free margins is the gold standard for malignant eyelid tumors. Non-surgical adjuvant or neoadjuvant forms of evidence-based treatment can be initiated based on the individual case to minimize the risk of recurrence and metastasis. CONCLUSION It is essential to recognize eyelid changes at an early stage, to classify them correctly and to initiate the appropriate treatment. The interaction between the general condition and the personal needs of a patient as well as state of the art medicine are the keys to a good personalized treatment.
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Affiliation(s)
- S Gniesmer
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | - S R Sonntag
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - C Schiemenz
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - M Ranjbar
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - L M Heindl
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinikum Köln, Universität zu Köln, Köln, Germany
- Centrum für Integrierte Onkologie (CIO) Aachen-Bonn-Köln-Düsseldorf, Köln, Germany
| | - M A Varde
- Augenklinik, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Augenklinik Universitätsspital Zürich, Zürich, Switzerland
| | - S Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Rostock, Germany
| | - S Grisanti
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - V Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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4
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Woltsche JN, Smolle M, Szolar D, Bergovec M, Leithner A. Prevalence and characteristics of benign cartilaginous tumours of the shoulder joint. An MRI-based study. Skeletal Radiol 2024; 53:59-66. [PMID: 37269383 PMCID: PMC10661778 DOI: 10.1007/s00256-023-04375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/28/2023] [Accepted: 05/28/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Enchondromas (EC) of the shoulder joint are benign intraosseous cartilage neoplasms, with atypical cartilaginous tumours (ACT) representing their intermediate counterpart. They are usually found incidentally on clinical imaging performed for other reasons. Thus far the prevalence of ECs of the shoulder has been analysed in only one study reaching a figure of 2.1%. MATERIALS AND METHODS The aim of the current study was to validate this number via retrospective analysis of a 45 times larger, uniform cohort consisting of 21.550 patients who had received an MRI of the shoulder at a single radiologic centre over a time span of 13.2 years. RESULTS Ninety-three of 21.550 patients presented with at least one cartilaginous tumour. Four patients showed two lesions at the same time resulting in a total number of 97 cartilage tumours (89 ECs [91.8%], 8 ACTs [8.2%]). Based on the 93 patients, the overall prevalence was 0.39% for ECs and 0.04% for ACTs. Mean size of the 97 ECs/ACTs was 2.3 ± 1.5 cm; most neoplasms were located in the proximal humerus (96.9%), in the metaphysis (60.8%) and peripherally (56.7%). Of all lesions, 94 tumours (96.9%) were located in the humerus and 3 (3.1%) in the scapula. CONCLUSION Frequency of EC/ACT of the shoulder joint appears to have been overestimated, with the current study revealing a prevalence of 0.43%.
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Affiliation(s)
- Johannes Nikolaus Woltsche
- Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Maria Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
| | | | - Marko Bergovec
- Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
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Shaker N, Phelps R, Cabala CT, Niedt G, Sangueza OP, Pradhan D. Navigating the Complexity of Dual Clonality in Cutaneous Lymphoma: Challenge. Am J Dermatopathol 2023; 45:e103-e104. [PMID: 37982477 DOI: 10.1097/dad.0000000000002575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Carlos Torres Cabala
- Department of Dermatopathology and Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Departments of Dermatology and Dermatopathology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Kervarrec T, Imbeaud S, Veyer D, Pere H, Puech J, Pekár-Lukacs A, Markiewicz D, Coutts M, Tallet A, Collin C, Berthon P, Bravo IG, Seris A, Jouary T, Macagno N, Touzé A, Cribier B, Battistella M, Calonje E. Digital Papillary Adenocarcinoma in Nonacral Skin: Clinicopathologic and Genetic Characterization of 5 Cases. Am J Surg Pathol 2023; 47:1077-1084. [PMID: 37505796 DOI: 10.1097/pas.0000000000002096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Digital papillary adenocarcinoma (DPA) is a rare sweat gland neoplasm that has exceptionally been reported outside acral locations. Recently, human papillomavirus 42 was identified as the main oncogenic driver of DPA. Herein, we report 5 tumors arising in extra-acral locations predominantly in the female anogenital skin. Four patients were female and 1 patient was male. The mean age at the diagnosis time was 65 years (range: 55 to 82 y). Tumors were located on the vulva (n=3), perianal area (n=1), and forearm (n=1). Histologically, all tumors were lobular and mainly solid and composed of sheets of cells with rare focal papillae and frequent glandular structures in a "back-to-back" pattern and lined by atypical basophilic cells. Immunohistochemistry showed diffuse positivity for SOX10. Epithelial membrane antigen and carcinoembryonic antigen highlighted the luminal cells and staining for p63 and p40 revealed a consistent and continuous myoepithelial component around glandular structures. Follow-up was available in 3 cases (mean duration: 12 mo [range: 8 to 16 mo]). One patient developed local recurrence and 1 experienced regional lymph node metastases. HPV Capture Next-generation sequencing revealed the presence of the HPV42 genome in all samples. Viral reads distributions were compatible in the 5 cases with an episomal nature of the viral genome, with a recurrent deletion in the E1 and/or E2 open reading frames. In conclusion, this study demonstrates that digital DPA may rarely present in nonacral locations mainly in the female anogenital area, usually with a more solid pattern as compared with those cases presenting on the digits and it is also associated with HPV42.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology
- Biologie des infections à polyomavirus" team, UMR INRAE ISP 1282, Université de Tours, Tours
- CARADERM Network
| | - Sandrine Imbeaud
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université
| | - David Veyer
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université
- Department of Virology, European Georges Pompidou Hospital, APHP, Université de Paris
| | - Helene Pere
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université
- Department of Virology, European Georges Pompidou Hospital, APHP, Université de Paris
| | - Julien Puech
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université
| | - Agnes Pekár-Lukacs
- Department of Oncology and Pathology, Lund University, Lund, Sweden
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas's Hospital, London
| | - Dorota Markiewicz
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas's Hospital, London
| | - Michael Coutts
- Department of Cellular Pathology, Maidstone Hospital, Kent, UK
| | - Anne Tallet
- Platform of Somatic Tumor Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours
| | - Christine Collin
- Platform of Somatic Tumor Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours
| | - Patricia Berthon
- Biologie des infections à polyomavirus" team, UMR INRAE ISP 1282, Université de Tours, Tours
| | - Ignacio G Bravo
- French National Center for Scientific Research (CNRS), Laboratory MIVEGEC (CNRS IRD Univ Montpellier), Montpellier
| | - Alice Seris
- CARADERM Network
- Department of Dermatology, Hospital Center of Pau, Pau
| | - Thomas Jouary
- CARADERM Network
- Department of Dermatology, Hospital Center of Pau, Pau
| | - Nicolas Macagno
- Department of Pathology, APHM, Timone University Hospital
- Aix-Marseille University, INSERM U1251, MMG, Marseille
| | - Antoine Touzé
- Biologie des infections à polyomavirus" team, UMR INRAE ISP 1282, Université de Tours, Tours
| | - Bernard Cribier
- Clinique dermatologique, Hôpitaux Universitaires & Université de Strasbourg, Hôpital Civil, Strasbourg, France
| | - Maxime Battistella
- Department of Pathology, APHP Hôpital Saint Louis, INSERM U976, Université Paris Cité7, Paris
| | - Eduardo Calonje
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas's Hospital, London
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Jang YC, Hung WC, Su TC, Wu WP. Primary pulmonary epithelioid hemangioendothelioma. BMJ Case Rep 2023; 16:e254915. [PMID: 37709495 PMCID: PMC10503352 DOI: 10.1136/bcr-2023-254915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumour of vascular origin with low to intermediate malignancy. Typical radiological finding on CT is multiple small nodules in bilateral lungs, and some will have punctate calcifications and pleural thickening. The diagnosis of PEH is confirmed by histopathological findings and positive immunohistochemistry staining. We report a case of a woman in her 50s with a medical history of lung adenocarcinoma. Later, regular chest CT during a routine cancer follow-up revealed multiple small pulmonary nodules and increased sizes of these nodules on serial images, initially misdiagnosed as multiple lung metastases. The histopathological diagnosis was made on a pulmonary wedge resection. Finally, PEH was diagnosed on the basis of positive immunohistochemical staining for CD31, ERF and TFE3. In the current study, the clinicopathological features and review of the literature were investigated. Our case highlights the importance of a histological diagnosis to avoid misdiagnosis.
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Affiliation(s)
- Yong Ching Jang
- Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
| | - Wei-Chien Hung
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tzu-Cheng Su
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Pei Wu
- Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Fattah YH, Liu SS, Susa J, Hanly A, Russo J, Karai LJ. Spindle Cell Lipoma With Florid Primary Follicular Lymphocytic Hyperplasia: A Novel Association With Potential Diagnostic Pitfalls. Am J Dermatopathol 2023; 45:563-566. [PMID: 37462206 DOI: 10.1097/dad.0000000000002483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
ABSTRACT Spindle cell lipoma (SCL) is a benign subcutaneous lipomatous neoplasm with a heterogeneous histologic appearance that varies greatly depending on the amount of fat, collagen, and myxoid stroma, which define the multiple subtypes of SCL, such as fat poor SCL, pseudoangiomatous SCL, and dendritic fibromyxolipoma. Cutaneous lymphoid hyperplasia is a spectrum of benign conditions characterized by reactive B-cell and T-cell cutaneous lymphocytic infiltrates. Cutaneous B-cell lymphoid hyperplasia is a heterogeneous group of non-neoplastic conditions that can be observed as reactive phenomena to infections, medications, allergens, or neoplasms and must be distinguished from cutaneous B-cell lymphomas. Here, we report a novel case of spindle cell lipoma, associated with B-cell primary lymphoid follicular hyperplasia, mixed within the tumor in a peculiar pattern, while discussing potential diagnostic pitfalls with low-grade B-cell lymphomas. This is the first report of such association in the literature.
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Affiliation(s)
- Yasmin H Fattah
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
| | - Shuo S Liu
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
| | - Joseph Susa
- Pro Path, Sonic Health Care USA, Dallas, TX; and
| | - Andrew Hanly
- Global Pathology, Sonic Health Care USA, Miami Lakes, FL
| | | | - Laszlo J Karai
- Global Pathology, Sonic Health Care USA, Miami Lakes, FL
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Kent T, Scott G, Seifert R. A case of clinically aggressive EBV-negative ENKTL in a non-Asian female patient. J Hematop 2023; 16:33-38. [PMID: 38175370 DOI: 10.1007/s12308-023-00529-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The patient was a 65-year-old White woman who presented to dermatology with a painless, rapidly growing exophytic nodule on her left upper cheek. AIMS/PURPOSE In this case report, we aim to demonstrate the difficulty of diagnosing Epstein-Barr virus-negative extranodal NK cell lymphomas given the broad differential of NK cell lymphomas and the rarity of EBV-negative extranodal NK cell lymphoma. METHODS Immunohistochemical studies confirmed the diagnosis of cutaneous, extranodal NK cell lymphoma. Interestingly, Epstein-Barr virus in situ hybridization was negative, which is unusual for most NK cell lymphomas. RESULTS/CONCLUSIONS In our view, a combination of immunohistochemistry, clonality assessment, sequencing, and flow cytometric studies is required.
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Affiliation(s)
- Thomas Kent
- University of Florida College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Gregory Scott
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Robert Seifert
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL, USA
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Jin QQ, Mei J, Hong L, Wang R, Wu SY, Wang SL, Jiang XY, Yang YT, Yao H, Zhang WY, Zhu YT, Ying J, Tian L, Chen G, Zhou SG. Identification and Validation of the Anoikis-Related Gene Signature as a Novel Prognostic Model for Cervical Squamous Cell Carcinoma, Endocervical Adenocarcinoma, and Revelation Immune Infiltration. Medicina (Kaunas) 2023; 59:358. [PMID: 36837559 PMCID: PMC9958637 DOI: 10.3390/medicina59020358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives: Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) are malignant disorders with adverse prognoses for advanced patients. Anoikis, which is involved in tumor metastasis, facilitates the survival and separation of tumor cells from their initial site. Unfortunately, it is rarely studied, and in the literature, studies have only addressed the prognosis character of anoikis for patients with CESC. Materials and Methods: We utilized anoikis-related genes (ANRGs) to construct a prognostic signature in CESC patients that were selected from the Genecards and Harmonizome portals. Furthermore, we revealed the underlying clinical value of this signature for clinical maneuvers by providing clinical specialists with an innovative nomogram on the basis of ANRGs. Finally, we investigated the immune microenvironment and drug sensitivity in different risk groups. Results: We screened six genes from fifty-eight anoikis-related differentially expressed genes in the TCGA-CESC cohort, and we constructed a prognostic signature. Then, we built a nomogram combined with CESC clinicopathological traits and risk scores, which demonstrated that this model may improve the prognosis of CESC patients in clinical therapy. Next, the prognostic risk scores were confirmed to be an independent prognostic indicator. Additionally, we programmed a series of analyses, which included immune infiltration analysis, therapy-related analysis, and GSVA enrichment analysis, to identify the functions and mechanisms of the prognostic models during the progression of cancer in CESC patients. Finally, we performed quantitative reverse transcription polymerase chain reaction (qRT-PCR) to verify the six ANRGs. Conclusions: The present discovery verified that the predictive 6-anoikis-related gene (6-ANRG) signature and nomogram serve as imperative factors that might notably impact a CESC patient's prognosis, and they may be able to provide new clinical evidence to assume the role of underlying biological biomarkers and thus become indispensable indicators for prospective diagnoses and advancing therapy.
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Affiliation(s)
- Qin-Qin Jin
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Jie Mei
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Lin Hong
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Rui Wang
- Office of Health Care, Hefei Municipal Health Commission, Hefei 230071, China
| | - Shuang-Yue Wu
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Sen-Lin Wang
- Department of Clinical Laboratory, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Xi-Ya Jiang
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Yin-Ting Yang
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Hui Yao
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Wei-Yu Zhang
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Yu-Ting Zhu
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Jie Ying
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Lu Tian
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Guo Chen
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
| | - Shu-Guang Zhou
- Department of Gynecology, Maternal and Child Medical Centre of Anhui Medical University, Hefei 230001, China
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei 230001, China
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Musacchio E, Michielin A, Sartori L. Misdiagnosis and Mistreatment of a Rare Case of Intracranial Oncogenic Osteomalacia with an Altered Amino Acid Profile. Medicina (Kaunas) 2022; 58:medicina58121875. [PMID: 36557077 PMCID: PMC9782468 DOI: 10.3390/medicina58121875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Background. Oncogenic osteomalacia (OO), also known as tumor-induced osteomalacia (TIO), is a rare paraneoplastic syndrome caused by mesechymal tumors secreting fibroblast growth factor 23 (FGF23). Common in middle age, these tumors are often disclosed by progressive generalized bone pain and muscle weakness, along with an altered biochemical profile. Despite its characteristic presentation, the disease is often underrecognized with delayed onset of surgical or pharmacological intervention that can have serious repercussions on the patients' health and quality of life. Case presentation. We describe the case of a 65-year-old Caucasian man presenting TIO with intracranial and spinal localizations and Fanconi-like aminoaciduria. The condition was misdiagnosed and mistreated for three years, leading to loss of self-sufficiency and depression. Following proper identification, the spinal mass was excised with complete remission of the functional symptoms. As it was not possible to remove the intracranial lesion, the patient was treated conservatively with calcitriol and phosphorous supplements that granted good metabolic control up to the time of a recent follow-up visit (at 5 years). Conclusions. The finding of an altered amino acid profile, not usually reported in these cases, should prompt clinicians to a wider usage of these molecules as suitable candidates for metabolic diseases. In addition to providing central information, they are easy to obtain and inexpensive to analyze. Such determination could help to speed up the diagnostic process, as a long-lasting history of misdiagnosis and mistreatments can lead primarily to clinical worsening, but also to the use of expensive, useless medications with side effects that contribute to poor patient health.
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Affiliation(s)
- Estella Musacchio
- Clinica Medica 1, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-821-2154
| | - Alberto Michielin
- Medicina Generale, Montebelluna General Hospital AULSS 2, 31044 Montebelluna, Italy
| | - Leonardo Sartori
- Clinica Medica 1, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy
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Dokić M, Milenković S, Jovanović L, Milošević B, Andrić L, Šaponjski D, Kesić V. Curious Case of Superfitial Spreading Cervical Squamocellular Carcinoma with Adnexal Involvement. Medicina (Kaunas) 2022; 58:1655. [PMID: 36422194 PMCID: PMC9694448 DOI: 10.3390/medicina58111655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 10/22/2023]
Abstract
Background and Objectives: Cervical squamous cell carcinoma (SCC) usually showed an infiltrative growth pattern into endocervical stroma. In rare cases, SCC spreads superficially as an intraepithelial lesion to proximal uterine segments, and more rarely, involves invasive and more aggressive behavior on secondary sites. Materials and Methods: In this study, we present the case of an interesting form of cervical SCC growth and we discuss the possible reasons for that presentation. Results: After clinical examination and repeated histomorphological analysis, we found remarkable cervical epithelial dysplasia (a high-grade squamous intraepithelial lesion-H-SIL). A histopathology report after conization and hysterectomy showed squamocellular carcinoma with microinvasive focuses. Interestingly, squamocellular carcinoma was found in the proximal uterine and adnexal structure, as well as intraepithelial and microinvasive lesions. Conclusions: Our study described a rare presentation of primary cervical SCC with unusual adnexal involvement. This pattern of tumor growth should be especially considered for patients who are proposed for sparing surgical procedures. A detailed and multidisciplinary approach for every patient is very important because unpredictable cases are present. However, they are rare.
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Affiliation(s)
- Milan Dokić
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Svetlana Milenković
- Department of Pathology and Medical Cytology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ljubiša Jovanović
- Department of Pathology and Medical Cytology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Branislav Milošević
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Luka Andrić
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Dušan Šaponjski
- Center for Radiology Imaging-Magnetic Resonance, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Vesna Kesić
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
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Ou Z, Lin S, Qiu J, Ding W, Ren P, Chen D, Wang J, Tong Y, Wu D, Chen A, Deng Y, Cheng M, Peng T, Lu H, Yang H, Wang J, Jin X, Ma D, Xu X, Wang Y, Li J, Wu P. Single-Nucleus RNA Sequencing and Spatial Transcriptomics Reveal the Immunological Microenvironment of Cervical Squamous Cell Carcinoma. Adv Sci (Weinh) 2022; 9:e2203040. [PMID: 35986392 PMCID: PMC9561780 DOI: 10.1002/advs.202203040] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/10/2022] [Indexed: 05/07/2023]
Abstract
The effective treatment of advanced cervical cancer remains challenging. Herein, single-nucleus RNA sequencing (snRNA-seq) and SpaTial enhanced resolution omics-sequencing (Stereo-seq) are used to investigate the immunological microenvironment of cervical squamous cell carcinoma (CSCC). The expression levels of most immune suppressive genes in the tumor and inflammation areas of CSCC are not significantly higher than those in the non-cancer samples, except for LGALS9 and IDO1. Stronger signals of CD56+ NK cells and immature dendritic cells are found in the hypermetabolic tumor areas, whereas more eosinophils, immature B cells, and Treg cells are found in the hypometabolic tumor areas. Moreover, a cluster of pro-tumorigenic cancer-associated myofibroblasts (myCAFs) are identified. The myCAFs may support the growth and metastasis of tumors by inhibiting lymphocyte infiltration and remodeling of the tumor extracellular matrix. Furthermore, these myCAFs are associated with poorer survival probability in patients with CSCC, predict resistance to immunotherapy, and might be present in a small fraction (< 30%) of patients with advanced cancer. Immunohistochemistry and multiplex immunofluorescence staining are conducted to validate the spatial distribution and potential function of myCAFs. Collectively, these findings enhance the understanding of the immunological microenvironment of CSCC and shed light on the treatment of advanced CSCC.
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Wu J, Tang W, Wang Y, Gong W, Zhang C. Schmorl Node Can Cause Increased 68Ga-FAPI Activity on PET/CT. Clin Nucl Med 2022; 47:537-538. [PMID: 35353715 DOI: 10.1097/rlu.0000000000004161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT 68Ga-FAPI is a newly developed tumor imaging agent with promising clinical applications. However, benign lesions may also show increased FAPI activity. We accidentally discovered that Schmorl node expressed FAPI activity in a patient with sweat gland cancer. Thus, greater awareness is needed that Schmorl nodes are a potential reason for false-positive uptake on 68Ga-FAPI PET/CT.
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Affiliation(s)
- Junhao Wu
- From the Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; and Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China
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15
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Pruthi H, Bhujade H, Kundu R, Gy S. Bilateral renal metastases from extraskeletal mesenchymal chondrosarcoma of thigh. BMJ Case Rep 2022; 15:e246375. [PMID: 34996769 PMCID: PMC8744114 DOI: 10.1136/bcr-2021-246375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/04/2022] Open
Abstract
Mesenchymal chondrosarcoma (MC) is a rare cartilaginous tumour that occurs in the extraskeletal locations in about one-third of cases. It is aggressive in behaviour and may involve the lower extremities, central nervous system or spine. Mesenchymal tumours are known for distant metastasis; however, metastasis to bilateral kidneys after treatment has not been reported earlier. We present a case of a soft-tissue intramuscular MC of the thigh in a 38-year-old patient which had been surgically excised after neoadjuvant chemotherapy. The patient presented with bilateral dense calcified renal masses after 6 years, which were cytologically proven as MC metastases. In the evaluation of bilateral calcified renal masses in patients with a history of MC, metastasis should be considered.
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Affiliation(s)
- Himanshu Pruthi
- Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harish Bhujade
- Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Reetu Kundu
- Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Srinivasa Gy
- Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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16
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Brückel J. [Chronic progressive bone pain in an 82-year-old male patient]. Internist (Berl) 2021; 62:1343-1348. [PMID: 34652464 DOI: 10.1007/s00108-021-01184-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
The case of an 82-year-old man who suffered from bone pain is reported. This was due to osteomalacia with hypophosphatemia. The cause was renal phosphate wasting mediated by fibroblast growth factor 23 (FGF-23) with oncogenic osteomalacia. The mesenchymal tumor could be detected at the elbow by positron emission tomography-computed tomography (PET/CT) scanning with 68 Ga-DOTATATE. After resection of this hemangiopericytoma (phosphaturic mesenchymal tumor, PMT) the phosphate level quickly returned to normal.
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Affiliation(s)
- Joachim Brückel
- Innere Medizin, Oberschwabenklinik, Westallgäu-Klinikum Wangen, Am Engelberg 29, 88239, Wangen im Allgäu, Deutschland.
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Krogerus C, Frydkjær AG, Wagenblast AL, Venzo A. [Primary cutaneous sarcomas]. Ugeskr Laeger 2021; 183:V12200899. [PMID: 34477087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Primary cutaneous sarcomas are a heterogenous group of malignant soft tissue tumours arising in the dermal and subcutaneous layers of the skin. These tumours are rare and have a variety of clinical manifestations. They differ from deep soft tissue sarcomas in terms of prognosis, which for most types of cutaneous sarcomas is favourable. The tumours are primarily managed by complete surgical excision with margin control. The purpose of this review is to present some of these rare tumors and describe their management.
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Abstract
Tumor-induced osteomalacia (TIO) is a rare, acquired condition of phosphate wasting due to phosphaturic mesenchymal tumors. Because the incidence and prevalence of TIO is unknown, we conducted an observational cohort study using national Danish health registers for the period 2008 to 2018 to obtain such information. The study also aimed to describe the demographics of the TIO population and the prognosis. The operational definition was based on hypophosphatemia or adult osteomalacia diagnoses, combined with prescriptions used in the initial management and procedures consistent with advanced imaging used for locating tumors. The incidence of TIO in Denmark was found to be below 0.13 per 100,000 person years for the total population of the country and 0.10 per 100,000 in adult-onset disease. The prevalence of TIO was estimated to be no more than 0.70 per 100,000 persons for the total population and 0.43 per 100,000 in adults. In 2018, there were a maximum of nine new cases of TIO in Danish adults. Mortality was low but few patients fulfilled the protocol cure criterion during the observation period. TIO has no ICD-10 code and limitations to the study include lack of information on serum biochemistry and on the use of phosphate supplements. Strengths include the use of long-term longitudinal, national hospital and prescription data from a country with universal healthcare. Given the very small patient population with TIO and the known delay to diagnosis and cure, management of patients with suspected TIO should be centralized.
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Affiliation(s)
- Bo Abrahamsen
- Open Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, 5000, Odense C, Denmark.
- Department of Medicine, Holbæk Hospital, 4300, Holbæk, Denmark.
- Nuffield Dept of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX2 6NN, UK.
| | - Christopher D Smith
- Open Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, 5000, Odense C, Denmark
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Miller RE, Guillen PT, Chen YH, Riedel BB. An Aggressive Digital Papillary Adenocarcinoma and a Grossly Similar, Contralateral Callus: A Case Report. JBJS Case Connect 2021; 11:01709767-202109000-00047. [PMID: 34319919 DOI: 10.2106/jbjs.cc.19.00538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE This is a case of a 44-year-old man with 10 years of history of painful callus-like swellings of bilateral index fingers. Sudden enlargement of the left index finger prompted biopsy, which revealed aggressive digital papillary adenocarcinoma (ADPA) that was treated with partial amputation. Biopsy of the contralateral finger revealed acanthotic skin with no evidence of malignancy. CONCLUSION Several case reports cite antecedent insult and chronic swelling before diagnosis. We describe a case of bilateral lesions with similar gross appearances, a long history of occupational repetitive trauma, and sudden enlargement of 1 lesion leading to the diagnosis of ADPA.
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Affiliation(s)
- Ryan Edward Miller
- Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California
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Affiliation(s)
- Kei Iimori
- Department of Gastroenterology and Hepatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Japan
| | - Tadayuki Kou
- Department of Gastroenterology and Hepatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Japan
| | - Shujiro Yazumi
- Department of Gastroenterology and Hepatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Japan
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魏 慧, 刘 蕊, 王 占, 姚 中. [Hypophosphatemic osteomalacia caused by urinary mesenchymal tumor: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2019; 51:1169-1172. [PMID: 31848524 PMCID: PMC7433593 DOI: 10.19723/j.issn.1671-167x.2019.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Indexed: 06/10/2023]
Abstract
This case report concerns a 34-year-old woman who had been diagnosed with ankylosing spondylitis (AS), fibromyalgia syndrome (FMS), osteoarthritis (OA), lumbar disc herniation and the like in different hospitals during the past 18 months. She had progressive osteoarthrosis, significant muscle weakness, gait abnormalities in weightbearing areas, however without typical inflammatory low back pain, while the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was invalid, with normal inflammation index, negative results for rheumatic factor (RF) and human leukocyte antigen (HLA)-B27, and normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). She had hyphosphatemia, normal serum calcium, 1,25-(OH)2-D3 reduction, elevated alkaline phosphatase (ALP) and normal parathyroid hormone (PTH), however with elevated urinary phosphorus. Finally, the medial thigh nodule was found in the subcutaneous of her inner leg by careful examination and imaging scans including B-ultrasound and PET/CT. The final pathology confirmed that the nodule was phosphate urinary mesenchymal tumors. After the tumor was removed, the patient was treated with anti-osteoporosis and phosphorus supplementation. The symptoms of bone pain and muscle weakness were alleviated, and hypophosphatemia was corrected. It was confirmed that the patient had low-phosphorus osteomalacia due to tumor. Tumor-induced hypophosphatemia osteomalacia (TIO) was a rare paraneoplastic syndrome which was caused by excessive phosphorus excretion induced by the tumor, and was thus categorized as an acquired hypophosphatemic osteomalacia. TIO had an occult onset and was associated with a high rate of misdiagnosis, although TIO has some typical clinical features. Early diagnosis, correctly positioning of the tumor, and surgical resection can achieve good outcomes.
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Affiliation(s)
- 慧 魏
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 蕊 刘
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 占辉 王
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 中强 姚
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
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Kalia V. Advanced MRI Features to Help Differentiate Benign versus Malignant Cartilaginous Lesions. Radiol Imaging Cancer 2019; 1:e194010. [PMID: 33778688 PMCID: PMC7983714 DOI: 10.1148/rycan.2019194010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Kin Y, Ogawa H, Matsumoto G, Mitsui S, Matsumoto T, Nishioka Y, Sakai S, Kimura K, Shimizu N, Hokka D, Tanaka Y, Maniwa Y. [Tumor-induced Hypophosphatemic Osteomalacia Caused by a Chest Wall Tumor]. Kyobu Geka 2019; 72:570-573. [PMID: 31353346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic disease characterized by hypophosphatemia and skeletal undermineralization. Overproduction of fibroblast growth factor 23( FGF23) from the responsible tumor is reported to be a causative factor. Removing the tumor is the only effective treatment for TIO, but identifying the tumor is sometimes difficult. A 43-year-old man complained of heel pain 4 years earlier, and the pain gradually expanded to the whole body. As a blood test showed the elevation of the serum FGF23 level and hypophosphatemia, he was diagnosed with FGF23-related hypophosphatemia. Chest computed tomography (CT) showed a 10-mm nodule in the right chest wall. Venous sampling for FGF23 revealed considerable elevation of the FGF23 level in the right subclavian vein. Therefore, a chest wall tumor was suspected as the tumor responsible for TIO, and surgical resection was performed. After surgery, hypophosphatemia improved within several days, and the FGF23 level also normalized.
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Affiliation(s)
- Yasuo Kin
- Department of Thoracic Surgery, Kobe University, Kobe, Japan
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Abstract
The ultrastructure of a dog mastocytoma examined with the electron microscope after fixation in glutaraldehyde, post-fixation in osmiumtetroxide and butyl-methyl methacrylate embedding is described. The ultrastructural characteristics with particular regard to the submicroscopic morphology of specific granules were studied in details, also with the aid of comparative observations on thick sections stained by Giemsa and toluidine blue. On the basis of their observations, the authors describe the following characteristics of neoplastic mastcells: microvilli, a well-developed Golgi region, centrioles, mithocondria, ribosomes, endoplasmic reticulum and 4 different types of granules. Other mastcells, with various degree of regressive phoenomena, had almost no microvilli, multiple interruptions of plasma membrane, mithocondrial swelling as well as vacuolar and fibrillar aspect of the cytoplasm. The morphology of different types of intracytoplasmic granules is discussed also in the light of parallel observations made by other authors. Expulsions of granules were not observed. The hypothesis of the phospholipidic nature of the lamellar component of granules is suggested.
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Manara M, Sinigaglia L. "Slow and steady wins the race": the importance of perseverance in the management of oncogenic osteomalacia. Endocrine 2017; 57:1-2. [PMID: 27900654 DOI: 10.1007/s12020-016-1187-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Maria Manara
- Division of Rheumatology, Gaetano Pini Institute, Milan, Italy
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Abstract
Utilizing a modified capillary tube technique, analysis revealed a significantly higher mean blood coagulation time in a group of 14 dogs with mastocytoma when compared to the mean coagulation time of 70 non-mastocytoma dogs. In dogs with mastocytoma, approximately one third had intermediate size tumors and a prolonged mean coagulation time and two thirds had a mean coagulation time that did not differ significantly from the mean of the non-mastocytoma dogs. Evidence for heparin release and possible heparin inactivating mechanisms is reviewed.
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Abstract
BACKGROUND Gastrointestinal stromal tumours (GISTs), previously classified as benign or malignant smooth muscle tumours, are the most common mesenchymal tumours of the gastrointestinal tract. GISTs express a growth factor receptor with tyrosine kinase activity, termed KIT. Mutations of KIT are common in malignant GISTs and lead to constitutional activation of tyrosine kinase function, which causes cellular proliferation and resistance to apoptosis. GISTs are notoriously unresponsive to chemotherapy and, until the recent introduction of the KIT inhibitor imatinib, there has been no effective therapy for advanced, metastatic disease. METHODS A Medline literature search was preformed to locate all articles relating to gastrointestinal tumours, GISTs, KIT and imatinib. RESULTS AND CONCLUSIONS The 5-year survival rate after complete resection of GISTs is approximately 50 per cent. The median duration of survival for patients with a metastatic GIST is approximately 20 months, and 9-12 months for patients with local recurrence. Phase II trials have investigated the effect of imatinib on irresectable or metastatic GISTs. In these trials more than 50 per cent of patients responded to imatinib within a few months and approximately 12 per cent had disease progression. Uptake of [(18)F]fluoro-2-deoxy-D-glucose demonstrated by positron emission tomography has been found to be reduced after starting imatinib. The potential for cure and the optimal length of treatment is currently unknown. Imatinib is the first effective systemic therapy for metastatic and locally irresectable GISTs. Large multi-institutional clinical trials to investigate the efficacy of imatinib as adjuvant or neoadjuvant therapy for GISTs are now required.
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Affiliation(s)
- E M Connolly
- Department of Surgery, St James Hospital and Trinity College Dublin, Dublin 8, Ireland
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Abstract
An analysis of the types of tumour in children in the Manchester hospital region indicates that approximately two-thirds arose in the reticuloendothelial or nervous systems. The high mortality is largely due to the nature or site of the tumours, the majority of which cannot be eradicated by purely local measures. The most likely means of causing any significant improvement would be by greater centralization in the treatment of these children.
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32
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[Proceedings of the 28th annual musculoskeletal tumor meeting of the Japanese Orthopaedic Association. Abstracts]. Nihon Seikeigeka Gakkai Zasshi 1995; 69:S945-1273. [PMID: 7650414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
There has been a continuous acceleration of medical/scientific inquiry and of actual improvements in management of patients with neoplasms of the mesenchymal tissues over the last four decades. The number of publications in this field has increased from 1140 in 1970 and then to 1700 in 1990. Important advances discussed over this period include: establishment of sarcoma teams in major oncology centers; staging systems for both soft tissue and osseous sarcomas; demonstration of genetic determinants in the development of, at least, some of the sarcomas; the revolutionary change in quality of diagnostic imaging by the introduction of CT and MRI; use of immunohistochemistry in diagnostic pathology; the drastic gains in survival of patients with osteogenic sarcoma, Ewing's sarcoma and rhabdomyosarcoma due to the efficacy of multi-drug and multi-cycle chemotherapy protocols; major advances in surgical techniques which have made limb salvage practical; cell lines derived from human sarcomas have been shown to have in vitro radiation sensitivity comparable to that of cell lines from epithelial tumors; the combination of conservative surgery and moderate doses of radiation yields local control and survival results equivalent to that of radical surgery with a much improved functional and cosmetic outcome; intra-operative electron beam radiation therapy improves the outcome of patients with retroperitoneal sarcomas when given after grossly complete resection combined with external beam radiation therapy (pre- or postoperatively); radiation is a highly effective alternative to extensive surgery for desmoid tumors; local control of giant cell tumors by modern radiation techniques is approximately 80% and the incidence of radiation induced tumors at 10 years is approximately 3%; to decrease the incidence of radiation induced sarcoma, resection has replaced radiation in the management of selected patients with primary Ewing's sarcoma when the response to chemotherapy has been excellent and the morbidity/functional decrement consequent upon the surgery judged reasonable; proton beam radiation therapy has been accepted as being superior to conventional external beam radiation therapy for chondrosarcoma and chordoma of the skull base; and attempts to utilize brachytherapy for sarcomas of the spine/sacrum appear to offer promise. Projected advances in the coming two decades includes:Designation of sarcoma type on genetic characterization; molecular genetics will provide prognostic information as to probability of distant metastasis, response to chemotherapeutic agents and radiation; important further reductions in the radiation treatment volume due to the many technical developments entering, or soon to enter the clinic; non-invasive assessment of the response to chemotherapy; much increased appreciation of the late sequella of treatment, both radiation and chemotherapy.
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Affiliation(s)
- H Suit
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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34
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The first joint meeting of the North-American Musculoskeletal Tumor Society and the European Musculoskeletal Oncology Society. Bologna, September 11-14, 1989. Proceedings. Chir Organi Mov 1990; 75:1-269. [PMID: 2249499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
One hundred twenty patients with primary retrorectal tumors (79 congenital, 14 neurogenic, 13 osseous, and 14 miscellaneous) had their initial treatment at the Mayo Clinic from 1960 to 1979. The mean age was 43 years (100 patients were adults). Female predominance was associated with congenital cysts (15:1) and male predominance with chordomas (5:1). Forty-three percent of the patients had malignant lesions. No dermoid cysts were found in this series. Diagnosis was made by digital examination or sacral radiographs in all patients. Computed tomography scan was the most important diagnostic method; the rate of positive findings was 100 percent in 20 patients. Approach to the tumor was posterior in 79 of 102 patients in whom resection was possible. Ten of 66 patients with benign tumors had recurrence. The five-year survival rate for patients with chordomas was 75 percent and for patients with other malignant lesions was 17 percent. Because preoperative biopsy can cause tumor spread, abscess, fecal fistula, or meningitis, it should not be performed if tumors are potentially resectable. Whenever possible, total resection should be done.
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Gardner DL. Diseases of connective tissue: a consensus. J Clin Pathol Suppl (R Coll Pathol) 1978; 12:223-38. [PMID: 282295 PMCID: PMC1347142] [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: 12/14/2022]
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[Primary osteo-cartilaginous tumors of the thoracic wall. Bibliography]. Ann Chir Thorac Cardiovasc 1978; 17:43-7. [PMID: 677783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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38
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Lemoine JM, Fauvet J. [Malignant bronchial tumors in women]. Bronches 1974; 24:162-74. [PMID: 4410061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Djupesland G. [Tumor colli]. Tidsskr Nor Laegeforen 1972; 92:2025-32. [PMID: 4343975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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40
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Rizzi I. [Tumors of the soft tissues]. Minerva Med 1969; 60:3451-74. [PMID: 4310164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Cruse JM. Tumor-type transformation related to antigenic structure. Z Immunitatsforsch Allerg Klin Immunol 1969; 138:332-41. [PMID: 4241261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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