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Neto Castro B, Martins D, João DA, Graça S, Oliveira M. Anterior Cervical Cystic Lymphangioma in an Adult Patient. ACTA MEDICA PORT 2024; 37:398-399. [PMID: 38639719 DOI: 10.20344/amp.20960] [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: 11/16/2023] [Accepted: 02/22/2024] [Indexed: 04/20/2024]
Affiliation(s)
- Bárbara Neto Castro
- General Surgery Department. Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - Daniel Martins
- General Surgery Department. Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - David Afonso João
- Department of Pathology. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - Susana Graça
- General Surgery Department. Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - Manuel Oliveira
- General Surgery Department. Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
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Bourimi C, El Hamzi A, Abaair Y, Mzouri K, Boualaoui I, Ibrahimi A, El Sayegh H, Nouini Y. Tubular ectasia of the rete testis: A benign yet unrecognized condition. Urol Case Rep 2024; 54:102732. [PMID: 38638889 PMCID: PMC11024563 DOI: 10.1016/j.eucr.2024.102732] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024] Open
Abstract
Tubular ectasia of the rete testis (TERT) presents as multiple cystic structures within the rete testis, often incidentally detected on ultrasound as echo-free intratesticular cystic lesions. Despite its benign nature, assessing testicular cystic lesions can sometimes be challenging. The primary importance of identifying this uncommon condition lies in its distinction from cystic testicular malignancies and thus avoiding further radical procedures. We report an instance of TERT within the right testis discovered incidentally in a patient with a medical background of epididymitis, presenting for management of left testis cryptorchidism, and bilateral inguinal hernia.
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Affiliation(s)
- Chadi Bourimi
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Abir El Hamzi
- Central Radiology Departement, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Youssef Abaair
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Khalid Mzouri
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Imad Boualaoui
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Ahmed Ibrahimi
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Hachem El Sayegh
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Yassine Nouini
- Departement of Urology A, Hospital Ibn Sina, Rabat, Morocco
- Mohamed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
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Zhang J, Fu B, Li T, Wang G. Adult giant cystic lymphangioma of the ascending mesocolon: A case report. Asian J Surg 2024:S1015-9584(24)00579-7. [PMID: 38604868 DOI: 10.1016/j.asjsur.2024.03.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Jianfeng Zhang
- The Second Department of General Surgery, The 4th Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang, Hebei, China
| | - Bao Fu
- Department of General Surgery, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang, 050011, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, 169 Changle West Rd, Xi'an, 710032, China.
| | - Guiying Wang
- General Surgery, The 2nd Hospital of Hebei Medical University, 215 Heping Road, Shijiazhuang, Hebei, China.
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Dervas E, Cigler P, Hatt JM, Kummrow MS. Morphological evidence for the physiological nature of follicular atresia in veiled chameleons (Chamaeleo calyptratus). Anim Reprod Sci 2024; 261:107409. [PMID: 38215629 DOI: 10.1016/j.anireprosci.2023.107409] [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: 09/04/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
Follicular atresia (FA) has been assumed to serve different functions in reptiles, e.g. helping to develop hierarchies, limiting clutch size, and regression of ovarian structures. Reproductive output is dependent on a balance between ovulations and FA. Excessive rates of FA may not only be detrimental for the survival of a population, but have also been associated with pathological conditions. In order to gain insights into the physiological and potentially pathological processes of FA, we performed a decriptive study on the morphological features of the ovaries in sexually mature female veiled chameleons (Chamaeleo calyptratus, VC). Of 60 clinically healthy female VC with continuous ovarian cycling and at least one confirmed cycle with FA over at least 1.5 years, 30 were selected for macroscopic evaluation of ovarian appearance and 7 were subjected to histology and immunohistology. While FA of previtellogenic follicles happened at a low rate, expected for a species with two germinal beds per ovary and polyautochronic reproductive pattern, atresia in the late vitellogenic stage affected entire generations of follicles, consequential to ovulatory failure. Histologically, no pathological processes were identified in any of the animals. Rather, three stages of FA (early, middle, late) were defined and vitellogenic follicles showed two distinct morphological types of FA: yolky and cystic. Yolky FA was found in 21/30 (70%) animals, while cystic FA co-occurred in 9/30 (30%) of the animals.
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Affiliation(s)
- Eva Dervas
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 268, 8057 Zurich, Switzerland.
| | - Pia Cigler
- Clinic for Zoo Animals, Exotic Pets and Wildlife, University of Zurich, 8057 Zurich, Switzerland
| | - Jean-Michel Hatt
- Clinic for Zoo Animals, Exotic Pets and Wildlife, University of Zurich, 8057 Zurich, Switzerland
| | - Maya S Kummrow
- Clinic for Zoo Animals, Exotic Pets and Wildlife, University of Zurich, 8057 Zurich, Switzerland
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Grisales-Gallo JE, Salinas-Castro KJ, Nasner D, Toro-Gutiérrez JS. Mature cystic teratoma overlapping with giant serous cystadenoma of the ovary: A case report. Radiol Case Rep 2024; 19:218-222. [PMID: 38028279 PMCID: PMC10651425 DOI: 10.1016/j.radcr.2023.10.030] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Ovarian lesions represent a diagnostic challenge for the radiologist and should be approached according to the patient's age, menstrual cycle, and imaging characteristics. These lesions can be cystic, mixed, or solid-predominant structures. Generally, the occurrence of benign lesions surpasses that of malignant ones at a ratio of 3:1. However, within infantile and juvenile age groups, this becomes an infrequent occurrence, making up only about 5% of ovarian tumor cases. This case report sheds light on a unique scenario involving a pediatric patient who harbored 2 benign tumors simultaneously: a mature cystic teratoma and a serous cystadenoma.
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Affiliation(s)
| | | | - Daniela Nasner
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
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Wang L, Deng JY, Li KP, Yin S, Zhu PY. Perioperative and oncological outcomes of robot-assisted laparoscopic partial nephrectomy for cystic and solid renal masses: Evidence from controlled trials. Asian J Surg 2024; 47:16-24. [PMID: 37597984 DOI: 10.1016/j.asjsur.2023.08.048] [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: 05/18/2023] [Accepted: 08/06/2023] [Indexed: 08/21/2023] Open
Abstract
To evaluate the outcomes of robot-assisted partial nephrectomy (RAPN) for solid and cystic renal tumors. We systematically searched the Cochrane Library, PubMed, EMBASE, and Scopus databases up to March 2023. Review Manager 5.4 performed a pooled analysis of the data for random effects. Besides, sensitivity and subgroup analyses to explore heterogeneity, Newcastle-Ottawa scale, and GRADE to evaluate study quality and level of evidence. Five observational studies comprising 1353 patients (Cystic tumor: 183; Solid tumor: 1083) were included in this study. Compared to solid masses, cystic masses were associated with fewer major complications (odds ratio [OR] = 2.2; 95% confidence intervals [CI] = 1.17 to 4.13; p = 0.01). Additionally, no significant differences were observed between the two groups in terms of operative time, warm ischemia time, blood loss, hospital stay, intraoperative complications, postoperative complications, transfusion rate, postoperative estimated glomerular filtration rate (eGFR), eGFR preservation, positive surgical margin (PSM), recurrence, overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS) and trifecta achievement. RAPN can be performed in cystic renal tumors with perioperative, functional, and oncologic outcomes like those achievable in solid tumors. However, our findings need further validation in a large-sample prospective randomized study.
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Affiliation(s)
- Li Wang
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing-Ya Deng
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Kun-Peng Li
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Shan Yin
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ping-Yu Zhu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
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Shrateh ON, Jobran AWM, Bakri IA, Saa SA. Rare clinical entity of cystic meningioma in an elderly patient: A case report and review of the literature. Int J Surg Case Rep 2023; 107:108384. [PMID: 37301093 DOI: 10.1016/j.ijscr.2023.108384] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Meningiomas, the most prevalent extra-axial neoplasm, are frequent tumors of the central nervous system that make up around 15 % of all intracranial malignancies. Although atypical and malignant meningiomas do exist, benign meningiomas make up the majority of cases. On both computed tomography and magnetic resonance imaging, a well-circumscribed, homogeneously enhancing, extra-axial mass is a typical imaging feature. An associated cyst is a rare imaging characteristic that may make it challenging to differentiate the tumor from a primary intra-axial glial neoplasm. Peritumoral edema can also lead to false positive results. CASE PRESENTATION A 64-year-old female patient presented to the emergency department of our hospital due to difficulty of the speech with a 3-week duration associated with unilateral headache, gait unsteadiness, and urinary incomitance. Neuroimaging of the brain by magnetic resonance imaging (MRI) with and without gadolinium contrast revealed an extra-axial cystic lesion located in the left fronto-temporal area, measuring about 4 cm × 4 cm × 4 cm. The patient underwent a craniotomy for removal of the lesion and the resected tissue was sent to pathology. Histopathological assessment revealed a pure cystic meningioma. CLINICAL DISCUSSION Cystic meningioma's preoperative diagnosis is not often easy to make. Compared to CT screening, brain MRI with gadolinium offers a higher diagnostic yield. To confirm the category and subtype of the tumor, a histopathological assessment of the tumor cells should always be performed. CONCLUSION Although its rare, cystic meningioma should be considered in the differential diagnosis of cystic brain lesions.
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Affiliation(s)
- Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
| | | | - Izzeddin A Bakri
- Department of Pathology, Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Shadi Abu Saa
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine; Department of Neurosurgery, Palestinian Medical Complex (PMC), Ramallah, Palestine
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Killoran C, Badri D, Walton A, Perry-Keene J, Copertino N. Peritoneal inclusion cysts in a young male: A case report. Int J Surg Case Rep 2023; 106:108248. [PMID: 37105030 PMCID: PMC10164883 DOI: 10.1016/j.ijscr.2023.108248] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Peritoneal inclusion cyst is a rare benign condition with low potential for malignant transformation but high recurrence rates. Debulking surgery is the recommended first line management for these patients, however, recurrence rates are up to 50 % (Padmanabhan et al., 2020; Chapel and Husain, 2021). CASE PRESENTATION A 26-year-old male being worked up for non-specific abdominal pain with cross-sectional imaging showing multiple multicystic lesions in the abdomen and pelvis. There was a pre-operative suspicion of Pseudomyxoma Peritonei and decision was made for diagnostic laparoscopy and biopsy. Mucin and an abnormal small bowel mesentery was found intraoperatively and sampled leading to the diagnosis of peritoneal inclusion cyst. CLINICAL DISCUSSION Treatment of peritoneal inclusion cyst range from surveillance to aggressive treatment with complete cytoreductive surgery with involved field peritonectomy and hyperthermic intra-peritoneal chemotherapy. CONCLUSION First line management of peritoneal inclusion cysts is for debulking surgery. Arguments for less invasive and more aggressive management has been proposed, however, further data needs to be collected to determine gold standard of treatment.
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Affiliation(s)
- Callie Killoran
- Department of General Surgery, Sunshine Coast university Hospital, 6 Doherty St, Birtinya, QLD 4575, Australia.
| | - Danniel Badri
- Department of General Surgery, Sunshine Coast university Hospital, 6 Doherty St, Birtinya, QLD 4575, Australia.
| | - Alexandra Walton
- Department of Pathology, Sunshine Coast University Hospital, 6 Doherty St, Birtinya, QLD 4575, Australia.
| | - Joanna Perry-Keene
- Department of Pathology, Sunshine Coast University Hospital, 6 Doherty St, Birtinya, QLD 4575, Australia.
| | - Nicolas Copertino
- Department of General Surgery, Sunshine Coast university Hospital, 6 Doherty St, Birtinya, QLD 4575, Australia.
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Yang S, Jing L, Chen L, Zhao F, Pi Y, Jiang D, Xie X, Jiao C, Hu Y, Shi W, Guo Q. Favourable clinical, arthroscopic and radiographic outcomes after autologous osteoperiosteal transplantation for massive medial cystic osteochondral defects of the talus. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07397-w. [PMID: 37010532 DOI: 10.1007/s00167-023-07397-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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The purpose of this study was to retrospectively evaluate the clinical, arthroscopic and radiological outcomes of autologous osteoperiosteal transplantation for massive cystic osteochondral defects of the talus. METHODS Cases of autologous osteoperiosteal transplantation for medial massive cystic defects of the talus between 2014 and 2018 were reviewed. The visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and Ankle Activity Scale (AAS) were assessed preoperatively and postoperatively. The Magnetic Resonance Observation of Cartilage Tissue (MOCART) system and the International Cartilage Repair Society (ICRS) score were evaluated after surgery. The ability to return to daily activity and sport, as well as complications, were recorded. RESULTS Twenty-one patients were available for follow-up, with a mean follow-up of 60.1 ± 11.7 months. All subscales of preoperative FAOS had significant (P < 0.001) improvement at the final follow-up. The mean AOFAS and VAS scores significantly (P < 0.001) improved from 52.4 ± 12.4 preoperatively to 90.9 ± 5.2 at the last follow-up and from 7.9 ± 0.8 to 1.5 ± 0.9, respectively. The mean AAS decreased from 6.0 ± 1.4 preinjury to 1.4 ± 0.9 postinjury and then increased to 4.6 ± 1.4 at the final follow-up (P < 0.001). All 21 patients resumed daily activities after a mean of 3.1 ± 1.0 months. Fifteen patients (71.4%) returned to sports after a mean of 12.9 ± 4.1 months. All patients underwent follow-up MRI with a mean MOCART score of 68.6 ± 5.9. Eleven patients underwent second-look arthroscopy, and the average ICRS was 9.4 ± 0.8. No donor site morbidity was found in any patient during the follow-up. CONCLUSION Autologous osteoperiosteal transplantation provided favourable clinical, arthroscopic and radiographic outcomes in patients with massive cystic osteochondral defects of the talus during a minimum 3-year follow-up. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Shuai Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Lizhong Jing
- Department of Orthopedics, Affiliated Hospital to Shandong University of Traditional Chinese Medicine, 250011, Jinan, People's Republic of China
| | - Linxin Chen
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Feng Zhao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Yanbin Pi
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Dong Jiang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Xing Xie
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Chen Jiao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Yuelin Hu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China
| | - Weili Shi
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China.
| | - Qinwei Guo
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China.
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Yogi A, Hirata Y, Linetsky M, Ellingson BM, Salamon N. Qualitative and quantitative evaluation for the heterogeneity of cortical tubers using structural imaging and diffusion-weighted imaging to predict the epileptogenicity in tuberous sclerosis complex patients. Neuroradiology 2023; 65:845-853. [PMID: 36456893 DOI: 10.1007/s00234-022-03094-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE We aimed to evaluate whether the heterogeneity of tuber imaging features, evaluated on the structural imaging and apparent diffusion coefficient (ADC) map, can facilitate detecting epileptogenic tubers before surgery in tuberous sclerosis complex (TSC) patients. METHODS Twenty-three consecutive patients, who underwent tuber resection at our institute, were retrospectively selected. A total of 125 tubers (39 epileptogenic, 86 non-epileptogenic) were used for the analysis. Tuber heterogeneity was evaluated, using a 5-point visual scale and standard deviation of ADC values (ADCsd). A 5-point visual scale reflected the degree of T1/T2 prolongation, presence of internal cystic degeneration, and their spatial distribution within the tuber. These results were statistically compared between epileptogenic and non-epileptogenic groups, and their performance in predicting the epileptogenicity was also evaluated by receiver operating characteristic (ROC) analysis. RESULTS A 5-point visual scale demonstrated that more heterogeneous tubers were significantly more epileptogenic (p < 0.001). Multiplicity of internal cystic degeneration moderately correlated with epileptogenicity (p < 0.03) based on the comparison between class 4 and class 5 tubers. ADCsd was significantly higher in epileptogenic tubers (p < 0.001). ROC curves revealed that a 5-point visual scale demonstrated higher area under the curve (AUC) value than ADCsd (0.75 and 0.72, respectively). CONCLUSION Tuber heterogeneity may help identify the epileptogenic tubers in presurgical TSC patients. Visual assessment and standard deviation of ADC value, which are easier to implement in clinical use, may be a useful tool predicting epileptogenic tubers, improving presurgical clinical management for TSC patients with intractable epilepsy.
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Affiliation(s)
- Akira Yogi
- Department of Radiology, University of the Ryukyus Hospital, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan.
- Department of Radiological Science, David Geffen School of Medicine, University of California, 924 Westwood Blvd, Los AngelesLos Angeles, CA, 90024, USA.
| | - Yoko Hirata
- Department of Radiological Science, David Geffen School of Medicine, University of California, 924 Westwood Blvd, Los AngelesLos Angeles, CA, 90024, USA
- Department of Neurosurgery, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan
| | - Michael Linetsky
- Department of Radiological Science, David Geffen School of Medicine, University of California, 924 Westwood Blvd, Los AngelesLos Angeles, CA, 90024, USA
| | - Benjamin M Ellingson
- Department of Radiological Science, David Geffen School of Medicine, University of California, 924 Westwood Blvd, Los AngelesLos Angeles, CA, 90024, USA
| | - Noriko Salamon
- Department of Radiological Science, David Geffen School of Medicine, University of California, 924 Westwood Blvd, Los AngelesLos Angeles, CA, 90024, USA
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Bhusal A, Rai P, Pradhan A, Agrawal A. Cystic endometriosis in a degenerated sub-serous myoma in a sub-fertile woman: A case report. Int J Surg Case Rep 2023; 105:107975. [PMID: 36940541 PMCID: PMC10036934 DOI: 10.1016/j.ijscr.2023.107975] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Leiomyoma is the most common gynecologic tumor which may show atypical locations and degenerations. Cystic degeneration is said to be found in 4 % of all degenerations. Endometriosis, the presence of endometrial glands and stroma at extrauterine sites, is a common gynaecological condition seen in 10 % to 15 % of reproductive-age women usually being associated with various degrees of fertility problems. CASE PRESENTATION 40 years old woman with P1L1A2, with secondary sub-fertility for 5 years, presented with chief complaints of dysmenorrhoea for 1 year initially around the menstrual cycle relieving with analgesics but later not limited to the menstrual cycle and pain not relieving with analgesics since 1 month. The patient underwent fertility-sparing laparoscopic removal avoiding a laparotomy and definitive hysterectomy. Manual morcellation was achieved. CLINICAL DISCUSSION Cystic degeneration is rare in Leiomyoma although it is the more common gynaecological tumor in women and is associated with endometriosis probably due to retrograde menstruation. CONCLUSIONS Laparoscopic removal of leiomyoma without laparotomy and definitive hysterectomy for a case of cystic endometriosis in a degenerated subserous myoma which to the best of our knowledge according to our search of articles on the relevant topic is the first reported case pertaining to the topic from Nepal.
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Affiliation(s)
| | | | - Anju Pradhan
- Department of Pathology, BP Koirala Institute of Health Sciences, Nepal
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McBennett KA, Davis PB. Toward a Broader Understanding of Cystic Fibrosis Epidemiology and Its Impact on Clinical Manifestations. Clin Chest Med 2022; 43:579-90. [PMID: 36344067 DOI: 10.1016/j.ccm.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The incidence of cystic fibrosis remains constant in North America and Western Europe is 1 in 3500 live births, but survival and quality of life have improved. The cystic fibrosis population has shifted toward the adult age range with a concomitant shift in the spectrum of complications. Survival increased because of aggressive symptomatic therapy, earlier diagnosis by newborn screening, and the introduction of modulators of the cystic fibrosis transmembrane conductance regulator, so that predicted median survival age is now about 50 years. In the United States, members of low socioeconomic status populations or members of racial or ethnic minorities have benefitted less from these advances.
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Lohkamp LN, Kulkarni AV, Drake JM, Rutka JT, Dirks PB, Taylor M, Ibrahim GM, Hamilton J, Bartels UK. Preservation of endocrine function after Ommaya reservoir insertion in children with cystic craniopharyngioma. J Neurooncol 2022; 159:597-607. [PMID: 35925530 DOI: 10.1007/s11060-022-04099-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/16/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Children with craniopharyngiomas (CP) can experience significant morbidities caused by extensive surgery and/or radiation. Ommaya reservoir insertion (ORI) into cystic CP represents a minimally invasive approach allowing immediate decompression and aims to avoid additional injuries. The purpose of this study was to determine the surgical outcome and relevance of upfront ORI (± intracystic treatment) for preservation of endocrine function. METHODS We performed a retrospective chart review of children with CP treated at the Hospital for Sick Children between 01/01/2000 and 15/01/2020. Endocrine function was reviewed at the time of initial surgery and throughout follow-up. New endocrinological deficits related to the index procedure were defined as immediate failure (IF), whereas postoperative duration of endocrinological stability (ES) was analyzed using the Kaplan-Meier method. The rate of IF and ES was compared between the treatment groups. RESULTS Seventy-nine patients were included and had a median age of 8.3 years (range 2.1-18.0 years); 31 were males. Fifty-three patients with upfront surgical treatment, including 29 ORI and 24 gross total or partial resections had sufficient endocrinological follow-up data. Endocrine dysfunction occurring immediately after the index procedure (IF) was observed in 15 patients (62.5%) in the resection group compared to two patients (6.8%) in the ORI group, odds ratio: 0.05 (CI: 0.01-0.26, p < 0.0001). Excluding those with immediate endocrinological deficits, mean ES after ORI was 19.4 months (CI: 11.6-34.2), compared to 13.4 months (CI:10.6-NA) after surgical resection. CONCLUSIONS Endocrine function was preserved in patients with upfront ORI (± intracystic treatment), which was confirmed as a minimally invasive procedure with an overall low morbidity profile.
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Affiliation(s)
- Laura-Nanna Lohkamp
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Abhaya V Kulkarni
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James M Drake
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James T Rutka
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Peter B Dirks
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Michael Taylor
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - George M Ibrahim
- Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jill Hamilton
- Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Ute K Bartels
- Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G2J9, Canada.
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Lahfidi A, Traore W, Imrani K, Ayadi C, Nassar I, Billah NM. Perirenal cystic lymphangioma mimicking a renal cyst in an elderly patient: Case report. Int J Surg Case Rep 2022; 97:107403. [PMID: 35870216 PMCID: PMC9403095 DOI: 10.1016/j.ijscr.2022.107403] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/07/2023] Open
Abstract
Cystic lymphangioma is a congenital benign lymphatic tumor commonly diagnosed in childhood. Cervical and axillary locations are the most usual, while retroperitoneal involvement is exceptional. Perirenal cystic lymphangioma may be revealed by urological signs or by incidental findings. Imaging plays an essential role in characterizing the tumor, however differential diagnosis with benign or malignant renal tumors is not always possible, thus requiring histological evidence. We report the case of a 50-year-old man who presented with a cystic lymphangioma of the left kidney revealed by lumbar pain with imaging features mimicking an exocortical developing renal cyst. The work has been reported in line with the SCARE criteria.
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Abstract
In spite of the significant technical and technological progress in neurosurgery and the continuous discoveries by the basic research, adamantinomatous craniopharyngioma remains a significant clinical challenge. Actually, the huge size of the tumor, its multiple cystic components, the encasement of Willis' circle and optic pathways, and the invasion of the hypothalamus often prevent its safe surgical resection. Moreover, the local aggressiveness of the tumor accounts for a high risk of recurrence even after a gross total resection. For these reasons, more and more efforts are being dedicated to enhance the knowledge about AC and improve the tools for its treatment.This paper is dedicated to the most recent advances concerning the AC management. Promising, new insights come for the basic research, thanks to the updates on the role of the WNT-β-catenin pathway (important for the tumor genesis and progression, not yet developed enough for a safe target therapy in children but useful for determining the prognosis) and the inflammatory mediators (widely overexpressed, especially by the cyst of the tumor, and for which target therapies are being developed). Moreover, further factors and pathways are under investigation.Also the development of new treatment strategies accounts for the improvement of the prognosis and the quality of life of AC patients. The enhancement of the experience with the endoscopic techniques (both transsphenoidal and transventricular approaches) actually allows to perform a less invasive but effective surgery that can be coupled with new modalities of radiation therapy aiming at obtaining a reliable control of the disease and protecting the endocrinological, ophthalmological, and neurological functions. A special mention is finally deserved by the techniques specifically designed for the intracystic therapy (as cyst fenestration alone or in combination with administration of radionuclides or bleomycin or interferon-α) that are here analyzed together with the aforementioned advances.
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Affiliation(s)
- Federico Bianchi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Benato
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Massimi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Università Cattolica del Sacro Cuore-Rome, Rome, Italy.
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Lahkim M, Andour H, Laamrani FZ, Nouali HE, Fenni JE. Cystic meningioma: A case report with a literature review. Radiol Case Rep 2021; 16:2958-2961. [PMID: 34401033 PMCID: PMC8350377 DOI: 10.1016/j.radcr.2021.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/18/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/03/2023] Open
Abstract
Cystic meningiomas are very rare tumors of the central nervous system. We report the case of a 62-year-old female how presented headaches resistant to usual analgesics with behavior disorders. Cerebral CT scan showed a right frontal extra-axial tumor with firm and cystic component, brain MRI evoked the diagnosis, surgery removed the entire tumor and histological examination confirmed it. A cystic meningioma should not be omitted from the differential diagnosis of brain tumors with a cystic component and which clinical, radiological, histological and therapeutic features are discussed.
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Affiliation(s)
- Mohamed Lahkim
- Radiology department, Mohammed V - Military Hospital, Rabat, Morocco
| | - Hajar Andour
- Radiology department, Mohammed V - Military Hospital, Rabat, Morocco
| | | | - Hassan En Nouali
- Radiology department, Mohammed V - Military Hospital, Rabat, Morocco
| | - Jamal El Fenni
- Radiology department, Mohammed V - Military Hospital, Rabat, Morocco
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17
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Tuan NA, Van Du N, Van Hiep P. Giant cystic lymphangioma of right mesocolon: A case report. Int J Surg Case Rep 2021; 86:106326. [PMID: 34481132 PMCID: PMC8416641 DOI: 10.1016/j.ijscr.2021.106326] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/22/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Cystic lymphangiomas are rare benign tumors of the lymph vessels and are usually found in children. However, abdominal cystic lymphangioma in mesocolon is extremely rare in adult patients. Presentation of case We reported a 15-year-old female with giant cystic lymphangioma of the right mesocolon. On examination, only abdominal pain was confirmed. Abdominal computed tomography (CT) showed a large multiseptated cystic mass. The patient underwent a total right mesocolic excision with the lesion. The patient recovered well on postoperative follow-up and was discharged on the fifth day. No evidence of recurrence had also been found in three months follow-up period. Discussion The diagnosis of intra-abdominal cystic lymphoma is often dismissed because the clinical symptoms are nonspecific. It is easy confusion because the ultrasound and CT scan images are relatively similar to the mesenteric and omental cysts. Sclerosing therapies may cause long-term consequences such as local recurrences with a very high proportion. Complete resection, including resection of the involved organs, is necessary. With tumors surrounding the colon, surgeons should consider performing removal block colon-lesion. Conclusion Complete tumor removal is the optimal choice for the management of intra-abdominal cystic lymphangioma. However, incomplete resection may lead to local recurrence. Intra-abdominal cystic lymphangiomas are rare benign tumors. The most common location in mesenteric small bowel, in mesocolon is extremely rare. Complete tumor removal is optimal choice for lymphangioma
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Affiliation(s)
- Nguyen Anh Tuan
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
| | - Nguyen Van Du
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam.
| | - Pham Van Hiep
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
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Chen F, Wu H, Liu Y, Lv M, Zhong J. Adenomyoepithelioma of the breast with prominent cystic changes: a case report. BMC Womens Health 2021; 21:284. [PMID: 34348700 PMCID: PMC8336073 DOI: 10.1186/s12905-021-01432-z] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adenomyoepithelioma (AME) of the breast is a rare subtype of breast tumor. Most of AMEs reported are solid, however, cystic or prominent cystic changes are extremely rare. CASE PRESENTATION A 51-year-old woman presented a lump in the upper outer quadrant of right breast, and it was accompanied by continuous breast pain and bilateral axillary itching for more than 2 months. There were no other symptoms found. Preoperative mammography and ultrasound examination were performed. Mammography showed a noncalcified lobulated mass, and it was considered to be a benign cyst with septum on ultrasound, but ductal carcinoma of breast, adenoid cystic carcinoma could not be excluded. At first, AME was not considered preoperatively, because the imaging features of this rare tumor may vary widely, which may result in an incorrect diagnosis. But eventually, AME was diagnosed by postoperative pathology and immunohistochemistry. CONCLUSION We herein present a rare case of breast AME with prominent cystic changes. AME has no-specific imaging features, but the benign or malignant nature of the lesion might be suspected on imaging.
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Affiliation(s)
- Feng Chen
- Department of Radiology, Zigong First People's Hospital, Zigong, 643000, Sichuan, People's Republic of China.
| | - Hengping Wu
- Department of Radiology, Zigong First People's Hospital, Zigong, 643000, Sichuan, People's Republic of China
| | - Yujian Liu
- Department of Radiology, Zigong First People's Hospital, Zigong, 643000, Sichuan, People's Republic of China
| | - Minli Lv
- Department of Radiology, Zigong First People's Hospital, Zigong, 643000, Sichuan, People's Republic of China
| | - Jianquan Zhong
- Department of Radiology, Zigong First People's Hospital, Zigong, 643000, Sichuan, People's Republic of China
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Yagisawa T, Takagi T, Yoshida K, Hata K, Iizuka J, Muromiya Y, Kondo T, Tanabe K. Surgical outcomes of robot-assisted laparoscopic partial nephrectomy for cystic renal cell carcinoma. J Robot Surg 2021. [PMID: 34342799 DOI: 10.1007/s11701-021-01292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
To compare the surgical outcomes of robot-assisted partial nephrectomy (RAPN) between patients with cystic renal cell carcinoma (cRCC) and those with solid RCC (sRCC). We retrospectively analyzed 1065 patients who underwent RAPN between 2013 and 2020 for a pathological diagnosis of RCC. Patients were divided into two groups: cRCC and sRCC. cRCC was diagnosed according to the Bosniak classification system. To minimize selection bias between the two groups, patient variables (patient characteristics) and tumor factors (such as size and complexity) were adjusted using 1:1 propensity score matching. Of the 1065 patients, 94 (9%) were diagnosed with cRCC. Bosniak categories of IIF, III, and IV were noted in 4 (4.2%), 31 (33%), and 59 (63%) patients, respectively. After matching, 83 patients each were assigned to the cRCC and sRCC groups. The operation time in cRCC tended to be longer than in sRCC but not significantly different (164 vs. 150 min, P = 0.0767). Other surgical outcomes, such as change in estimated glomerular filtration rate ( - 5.2 vs. - 7.2%, P = 0.1577), perioperative complications (14.5 vs. 15.7%, P = 0.9225), estimated blood loss (62 vs. 58 mL, P = 0.5613), or negative surgical margin status (100 vs 99%, P = 0.236), were not significantly different between the two groups. During the follow-up period of about 2 years, one and two patients showed recurrence in the cRCC and sRCC groups, respectively. The surgical outcomes of RAPN were similar between cRCC and sRCC, demonstrating the feasibility of RAPN for cRCC.
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20
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Marcos-Ramírez ER, Treviño-Martínez MI, Téllez-Aguilera A, Ochoa-Aguilar JM, Vásquez-Fernández F. Carcinoma del cístico, a propósito de un caso. CIR CIR 2021; 89:542-546. [PMID: 34352868 DOI: 10.24875/ciru.20000275] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
El carcinoma primario en el conducto cístico es un tumor raro y abarca del 0.1% al 0.2% de los carcinomas del tracto gastrointestinal. Presentamos el caso de un varón con pérdida de peso e ictericia, en el que se demuestra por imagen una dilatación de vías intrahepática y extrahepática condicionada por una compresión extrínseca del colédoco. Se realiza colangiografía pancreática retrógrada endoscópica que confirma la compresión, por lo que se lleva a cabo una exploración quirúrgica que evidencia una tumoración del conducto cístico. Se realiza colecistectomía con resección de ganglios linfáticos, además de anastomosis hepatoyeyunal. La tumoración se reporta como carcinoma del conducto cístico sin involucro ganglionar. Primary cystic duct carcinoma is a rare tumor and comprises 0.1% to 0.2% of carcinomas of the gastrointestinal tract. We present a case of a male with weight loss and jaundice. Evidence is shown by imaging of intrahepatic and extrahepatic duct dilatation conditioned by extrinsic bile duct compression. An endoscopic retrograde pancreatic cholangiography was performed confirming the compression, so a surgical exploration was preformed showing a tumor of the cystic duct, a cholecystectomy with resection of regional lymph nodes, as well as a hepatic-jejunal anastomosis. The tumor is reported as cystic duct carcinoma without lymph node involvement.
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Affiliation(s)
- Edson R Marcos-Ramírez
- Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - María I Treviño-Martínez
- Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Alejandra Téllez-Aguilera
- Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - José M Ochoa-Aguilar
- Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Francisco Vásquez-Fernández
- Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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21
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Nayak SB, Shetty SD, Vasudeva SK. Complete enclosure of gall bladder inside the lesser omentum - a rare anomaly. Morphologie 2021; 106:206-208. [PMID: 34147369 DOI: 10.1016/j.morpho.2021.06.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
Gall bladder is known for many congenital anomalies such as duplication, intrahepatic position, floating position etc. Most of its anomalies can be detected in ultrasound examination and radiography. We report an extremely rare congenital anomaly of gall bladder as observed in a male cadaver during dissection classes. The gall bladder was totally enclosed in the right free margin of the lesser omentum, in front of the usual contents of the right free margin of lesser omentum. The size, shape and blood supply of the gall bladder were normal. Though this anomaly might not cause any functional disturbances, it might result in complications during laparoscopic cholecystectomy.
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Affiliation(s)
- S B Nayak
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Madhav Nagar, Manipal, Karnataka State, India.
| | - S D Shetty
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Madhav Nagar, Manipal, Karnataka State, India
| | - S K Vasudeva
- Department of Mathematics, Manipal Institute of Technology, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Karnataka State, India
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22
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Corwin MT, Mitchell AS, Wilson M, Campbell MJ, Fananapazir G, Loehfelm TW. Accuracy of focal cystic appearance within adrenal nodules on contrast-enhanced CT to distinguish pheochromocytoma and malignant adrenal tumors from adenomas. Abdom Radiol (NY) 2021; 46:2683-2689. [PMID: 33415383 DOI: 10.1007/s00261-020-02925-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/14/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine the accuracy of cystic appearance within adrenal masses on contrast-enhanced CT in distinguishing pheochromocytomas and malignant adrenal tumors from adenomas. METHODS We performed a retrospective review of adult patients with pathologically proven adrenal tumors who underwent contrast-enhanced abdominal CT. There were 92 patients (mean age 64.7 years, 52 men) with 22 pheochromocytomas, 34 malignant masses, and 36 adenomas. Two abdominal radiologists independently reviewed CT images to determine the presence of cystic appearance within the adrenal masses, defined as focal regions of low attenuation within the tumor that subjectively had fluid density. RESULTS Cystic appearance was present in 12/22 (55%, 95% CI 32-76%) pheochromocytomas (mean size 5.3 cm), 15/34 (44%, 95% CI 27-62%) malignant masses (mean size 5.8 cm), and 2/36 (5.6%, 95% CI 0.7-9%) adenomas (mean size 3.2 cm). Sensitivity and specificity of cystic appearance for distinguishing pheochromocytoma or malignant masses from adenomas were 48.2% (95% CI 34.7-62.0%) and 94.4% (95% CI 81.3-99.3%), respectively. Cystic appearance was a significant predictor of tumor type (p = 0.015) even after controlling for tumor size. Reader agreement for cystic appearance was almost perfect with a kappa of 0.85. CONCLUSION Cystic appearance in adrenal tumors on contrast-enhanced CT has high specificity and low sensitivity for distinguishing pheochromocytoma and malignant adrenal masses from adenomas.
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Affiliation(s)
- Michael T Corwin
- Department of Radiology, Davis Medical Center, University of California, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
| | - Ana S Mitchell
- Department of Radiology, Davis Medical Center, University of California, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA
| | - Machelle Wilson
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue, Med-Sci 182 B, Davis, CA, 95616, USA
| | - Michael J Campbell
- Department of Surgery, Davis Medical Center, University of California, 2221 Stockton Blvd, Sacramento, CA, 95817, USA
| | - Ghaneh Fananapazir
- Department of Radiology, Davis Medical Center, University of California, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA
| | - Thomas W Loehfelm
- Department of Radiology, Davis Medical Center, University of California, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA
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Al-Mahboob A, Alhabib SF, Abdelsamad Y, Alzhrani F. Cochlear implantation in common cavity deformity: a systematic review. Eur Arch Otorhinolaryngol 2021. [PMID: 34052873 DOI: 10.1007/s00405-021-06884-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/12/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Cochlear implantation became a valid hearing rehabilitation option in common cavity deformity. This study aimed to assess the audiological and speech outcomes of cochlear implantation in common cavity deformity patients and to address the surgical aspect used in this population. METHODS A comprehensive systematic literature review based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline from database inception through April 2020. Eighteen published articles including 138 patients with common cavity deformity met the inclusion criteria. These articles studied the surgical techniques and the audiological outcomes of cochlear implantation in patients with common cavity deformity in English language. RESULTS Trans-mastoid labyrinthotomy was the common surgical approach in these patients. The average speech intelligibility rating and categories of auditory performance scores in common cavity deformity were lower than in normal cochlea subjects (p < 0.05), and non-significant (p > 0.05) compared with other types of inner ear malformations. CONCLUSION Patients with common cavity deformity who underwent cochlear implantation showed a beneficial audiological and speech outcome. However, their performance is highly variable. Therefore, pre-operative counseling of the parents is necessary. The surgical approaches should be individualized according to clinical, radiological, and surgical findings.
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Nithya S, Saxena S, Kharbanda J. Peripheral adenomatoid odontogenic tumor of mandible - A synchronous presentation or a subtype?! J Oral Maxillofac Pathol 2021; 25:167-170. [PMID: 34349430 PMCID: PMC8272493 DOI: 10.4103/jomfp.jomfp_450_20] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/01/2021] [Indexed: 12/04/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) with its unique and varied presentations histologically and clinically has always been an enigma. AOTs are multifaceted in their appearance with reports pointing out to its occurrence as a synchronous tumor, a purely cystic variant or with multiple foci; however, the three commonly encountered forms are Follicular/Coronal, Extra Follicular/Extra Coronal and Peripheral variants. Here, we present a subtype of the Peripheral AOT (PAOT) seen synchronous with an intraosseous cystic variant of AOT in a 16-year-old female in the anterior mandible. This case is unique in that a PAOT occurring adjacent to a focally aggressive intraosseous cystic AOT (not associated with impacted tooth) could either be synchronous with no connection to the intraosseous component or could actually be an erupted intraosseous cystic variant with peripheral manifestation. Features of cortical expansion, perforation and displacement of teeth without resorption were seen. Histologically, all the classical features of AOT along with abundant eosinophilic amorphous fibrinous deposits, cellular vacuolization, clearing of cells, dystrophic and reactive bone formation and a cystic lining were seen. Thus, this case of PAOT would add to the myriad presentation of AOT making it one of the most often discussed odontogenic tumor.
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Affiliation(s)
- S Nithya
- Department of Oral Pathology and Microbiology, ESIC Dental College and Hospital, Delhi, India
| | - Susmita Saxena
- Department of Oral Pathology and Microbiology, ESIC Dental College and Hospital, Delhi, India
| | - Jitin Kharbanda
- Department of Oral Pathology and Microbiology, ESIC Dental College and Hospital, Delhi, India
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Gao H, Wang W, Zhang W, Xu H, Wu C, Li H, Ni Q, Yu X, Liu L. The distinctive characteristics of the micro-vasculature and immune cell infiltration in cystic pancreatic neuroendocrine tumors. J Endocrinol Invest 2021; 44:1011-1019. [PMID: 32856225 DOI: 10.1007/s40618-020-01396-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/15/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE Hypervascularity is a main characteristic of pancreatic neuroendocrine tumors (PanNETs), and cystic PanNETs (CPanNETs) are unique type of PanNETs in which the microenvironment remains unknown. We aim to compare the micro-vasculature features and immune cell infiltration between CPanNETs and solid PanNETs (SPanNETs). METHODS Data of 301 SPanNET and 36 CPanNET patients from a high-volume institution were evaluated. CD4, CD8, CD11c, CD15, CD20, CD68, CD34 and α-SMA expression levels were assessed by immunohistochemistry and immunofluorescent double staining. The microvessel density (MVD) and microvessel integrity (MVI) were examined. RESULTS MVD and MVI expression levels in CPanNETs were significantly higher than those in SPanNETs (p = 0.025 and 0.0092, respectively). CPanNETs had higher proportions of T1 (p = 0.023) and G1 (p = 0.052) than SPanNETs. In SPanNETs, higher MVD occurred in stages T1, N0 and G1 than in the T2/T3, N1 and G2 subgroups. In CPanNETs, CD34-MVD was uncorrelated with the T stage or grade. Higher CD34-MVD, but not MVI, was associated with better DFS (HR 0.3209, 95% CI 0.1259-0.8176, p = 0.004). There were significantly more peritumoral infiltrating immune cells than their intratumoral counterparts (p < 0.001 for each) in CPanNETs and SPanNETs. The mean number of peritumoral CD68 + TAM in CPanNETs was significantly lower than that in SPanNETs (p = 0.008). The counts of other peritumoral immune cells did not significantly differ between CPanNETs and SPanNETs. CONCLUSIONS CPanNETs had a microenvironment distinct from that of SPanNETs, including higher CD34-MVD, higher MVI and lower TAM. This specific microenvironment structure may partially help predicting the prognosis of patients with PanNET.
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Affiliation(s)
- H Gao
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - W Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - W Zhang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - H Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - C Wu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - H Li
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - Q Ni
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China
| | - X Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China.
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China.
| | - L Liu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 20032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
- Department of Pancreatic Surgery, Shanghai Pancreatic Cancer Institute, Shanghai, 200032, People's Republic of China.
- Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China.
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Schwartz FR, Clark DP, Ding Y, Ramirez-Giraldo JC, Badea CT, Marin D. Evaluating renal lesions using deep-learning based extension of dual-energy FoV in dual-source CT-A retrospective pilot study. Eur J Radiol 2021; 139:109734. [PMID: 33933837 DOI: 10.1016/j.ejrad.2021.109734] [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] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Dual-source (DS) CT, dual-energy (DE) field of view (FoV) is limited to the size of the smaller detector array. The purpose was to establish a deep learning-based approach to DE extrapolation by estimating missing image data using data from both tubes to evaluate renal lesions. METHOD A DE extrapolation deep-learning (DEEDL) algorithm had been trained on DECT data of 50 patients using a DSCT with DE-FoV = 33 cm (Somatom Flash). Data from 128 patients with known renal lesions falling within DE-FoV was retrospectively collected (100/140 kVp; reference dataset 1). A smaller DE-FoV = 20 cm was simulated excluding the renal lesion of interest (dataset 2) and the DEEDL was applied to this dataset. Output from the DEEDL algorithm was evaluated using ReconCT v14.1 and Syngo.via. Mean attenuation values in lesions on mixed images (HU) were compared calculating the root-mean-squared-error (RMSE) between the datasets using MATLAB R2019a. RESULTS The DEEDL algorithm performed well reproducing the image data of the kidney lesions (Bosniak 1 and 2: 125, Bosniak 2F: 6, Bosniak 3: 1 and Bosniak 4/(partially) solid: 32) with RSME values of 10.59 HU, 15.7 HU for attenuation, virtual non-contrast, respectively. The measurements performed in dataset 1 and 2 showed strong correlation with linear regression (r2: attenuation = 0.89, VNC = 0.63, iodine = 0.75), lesions were classified as enhancing with an accuracy of 0.91. CONCLUSION This DEEDL algorithm can be used to reconstruct a full dual-energy FoV from restricted data, enabling reliable HU value measurements in areas not covered by the smaller FoV and evaluation of renal lesions.
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Affiliation(s)
- Fides R Schwartz
- Duke University Health System, Department of Radiology, 2301 Erwin Road, Box 3808, Durham, NC, 27710, United States.
| | - Darin P Clark
- Quantitative Imaging and Analysis Lab, Department of Radiology, Duke University, Durham, NC, 27710, United States.
| | - Yuqin Ding
- Duke University Health System, Department of Radiology, 2301 Erwin Road, Box 3808, Durham, NC, 27710, United States; Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, 200032, People's Republic of China.
| | - Juan Carlos Ramirez-Giraldo
- CT R&D Collaborations at Siemens Healthineers, 2424 Erwin Road - Hock Plaza, Durham, NC, 27705, United States.
| | - Cristian T Badea
- Quantitative Imaging and Analysis Lab, Department of Radiology, Duke University, Durham, NC, 27710, United States.
| | - Daniele Marin
- Duke University Health System, Department of Radiology, 2301 Erwin Road, Box 3808, Durham, NC, 27710, United States.
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Mastronardi L, Campione A, Boccacci F, Scavo CG, Carpineta E, Cacciotti G, Roperto R, Sufianov A, Zomorodi A. Koos grade IV vestibular schwannomas: considerations on a consecutive series of 60 cases-searching for the balance between preservation of function and maximal tumor removal. Neurosurg Rev 2021; 44:3349-3358. [PMID: 33598820 DOI: 10.1007/s10143-021-01501-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
Koos grade IV vestibular schwannomas (VS) (maximum diameter > 3 cm) compress the brainstem and displace the fourth ventricle. Microsurgical resection with attention to the right balance between preservation of function and maximal tumor removal is the treatment of choice. Our series consists of 60 consecutive patients with unilateral VS, operated on from December 2010 to July 2019. All patients underwent microsurgical removal via the retrosigmoid approach. The adherence of VS' capsule to the surrounding nervous structures and the excessive tendency of tumor to bleed during debulking, because of a redundant vascular architecture, was evaluated by reviewing video records. Microsurgical removal of tumor was classified as total (T), near-total (NT: residue < 5%), subtotal (ST: residue 5-10%), or partial (P: residue > 10%). Maximal mean tumor diameter was 3,97 cm (SD ± 1,13; range 3,1-5,8 cm). Preoperative severely impaired hearing or deafness (AAO-HNS classes C-D) was present in 52 cases (86,7%). Total or NT resection was accomplished in 46 cases (76,7%), 65,8% in cases with, and 95,4% without tight adhesion of capsule to nervous structures (p < 0,001). Endoscopic-assisted microsurgical removal of VS in the IAC was performed in 23 patients: in these cases, a T resection was obtained in 78,3% versus 45,9% of microsurgery only (p < 0,001). The capsule of VS was tightly adherent to nervous structures in 63,3% of patients, whereas hypervascular high-bleeding tumors represented 56,7%. Hearing preservation was possible in 2 out of 8 patients with preoperative class B hearing. At last follow-up, 34 (56,7%) patients had a normal postoperative FN outcome (HBI), 9 (15,0%) were HBII, 8 (13,3%) HBIII, and 9 (15,0%) HBIV. The total NT resection of solid and low-bleeding VS, without tight capsule adhesion, was associated with better FN outcome. Mortality was zero; permanent complications were observed in 2 cases (diplopia, hydrocephalus), transient in 9. Microsurgery of Koos grade IV VS seems to be associated with more than acceptable functional results, with high rate of T and NT removal of tumor. Long-term FN results seem to be worse in patients with cystic Koos grade IV VS, in cases with tight capsule adherences to nervous structures and in high-bleeding tumors.
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Affiliation(s)
- Luciano Mastronardi
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy. .,Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health, Moscow, Russian Federation.
| | - Alberto Campione
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Fabio Boccacci
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Ettore Carpineta
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Raffaelino Roperto
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Albert Sufianov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health, Moscow, Russian Federation.,Federal Centre of Neurosurgery, Tyumen, Russian Federation
| | - Ali Zomorodi
- Vascular Neurosurgery Medical Director, Co-Director of Skull Base Surgery Center, Duke University Medical Center, Durham, NC, USA
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Dama M, Diallo O, Coulibaly O, Ouologem M, Kanikomo D. [ Cystic meningioma of falx cerebri: About one case and literature review]. Mali Med 2021; 36:73-74. [PMID: 38200717] [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] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Cystic meningioma of the falx is a rare extra-axial tumor, representing 4 to 7% of all intracranial meningioma. We report the case of a 23 years old patient with relative personal health history who has presented for nearly two years generalized headache associated with left hemiparesis. The head CT scan and MRI showed a right posterior parietal tumor with a cystic and fleshy component which was interpreted as glioma. The patient was operated and the intraoperative aspect was an extra axial lesion inserted to the middle tier of the falx cerebri with a clear cleavage plan with the cerebrum. A total ablation of the lesion was down and the histological study confirm the diagnosis. The cystic meningioma is a rare variant of intracerebral meningioma of which only histology makes it possible give the diagnosis of certainty.
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Affiliation(s)
- M Dama
- Service de Neurochirurgie CHU hôpital du Mali
| | - O Diallo
- Service de Neurochirurgie CHU hôpital du Mali
| | - O Coulibaly
- Service de Neurochirurgie CHU hôpital du Mali
| | - M Ouologem
- Service de Neurologie CHU Kati Koulikoro
| | - D Kanikomo
- Service de Neurochirurgie CHU Gabriel Toure
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Bathla G, Kandemirli SG, Gupta S, Agarwal A. Unique imaging appearance of neurosarcoidosis as a solitary cystic mass with mural enhancement. Surg Neurol Int 2020; 11:463. [PMID: 33408948 PMCID: PMC7771406 DOI: 10.25259/sni_830_2020] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/05/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Sarcoidosis is an idiopathic, granulomatous, and multi-system inflammatory disorder that can also involve the central nervous system in the form of meningeal, parenchymal, or cranial nerve involvement. Imaging findings can be non-specific and may overlap with other inflammatory, infectious and neoplastic processes, and posing diagnostic challenges. Parenchymal involvement in neurosarcoidosis (NS) predominantly manifests as either non-enhancing white matter lesions or as enhancing parenchymal granulomas. Granulomas usually manifest as multiple solid lesions with nodular enhancement. Case Description: A 72-year-old man presented with right-eye visual field changes with the non-contrast head computed tomography showing a large cystic lesion in the left frontoparietal lobe. Subsequent contrast-enhanced magnetic resonance imaging study revealed a large cystic mass with irregular rim enhancement and mural nodule concerning for glial neoplasm. Cyst decompression with biopsy and histopathological analysis revealed gliosis and prominent perivascular granulomatous inflammation with mixed picture of CD4 and CD8-positive cells suggestive of sarcoidosis. Further subsequent work-up showed mediastinal and cervical lymphadenopathy which on biopsy showed non-necrotizing granulomatous inflammation, consistent with sarcoidosis. Conclusion: Herein, we report unique imaging findings of a NS case manifesting as a solitary cystic intraparenchymal lesion with an enhancing nodular component, mimicking primary intra-cranial tumor. This appearance is highly atypical and rarely been reported earlier.
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Affiliation(s)
- Girish Bathla
- Department of Radiology University of Iowa, Iowa, United States
| | | | - Sarika Gupta
- Department of Pathology, University of Iowa, Iowa, United States
| | - Amit Agarwal
- Department of Radiology, University Texas Southwestern, Dallas, Texas, United States
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Cheng Y, Wu D, Wang L, Liu H, Xiong Y, Xu J, Hu S, Zhan H. Cystic Pancreatic Neuroendocrine Tumors Represent a Distinct Clinical Entity with Less Aggressive Biological Behaviors. J Surg Res 2020; 260:134-140. [PMID: 33340866 DOI: 10.1016/j.jss.2020.11.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/26/2020] [Accepted: 11/01/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Pancreatic neuroendocrine tumors (pNETs) uncommonly present as cystic lesions. There is a gap in knowledge of their clinicopathological characteristics and biological behaviors. Previous reported studies remained inconsistent and controversial. The purpose of this study is to investigate the clinicopathological features of cystic pNET and determine if it represents a distinct clinical entity by comparing its characteristics with those of solid pNETs. METHODS Patients with pNETs who underwent surgical resections from January 2014 to April 2019 at Qilu Hospital of Shandong University were reviewed retrospectively. Demographics, clinical characteristics, surgical data, and oncological as well as histological characteristics of cystic pNETs and their solid counterparts were collected and analyzed. RESULTS A total of 122 patients were included in this study, and 10.7% (13/122) patients were cystic. There is no significant difference between cystic pNETs and solid pNETs in age (43.6 ± 15.8 versus 50.9 ± 14.5 y, P = 0.093) and sex distribution (P = 0.085). Cystic pNETs are more likely to be asymptomatic (61.5% versus 23.9%, P = 0.008) and nonfunctional (92.3% versus 52.7%, P = 0.006) than solid pNETs. However, the tumor size (4.8 ± 4.5 versus 2.8 ± 1.9 cm, P = 0.124), proportion of multiple endocrine neoplasia type 1 (92.3% versus 98.2%, P = 0.289), and tumor location (P = 0.154) are similar in both groups. Compared with solid pNETs, cystic pNETs have a lower Ki-67 index and incidence of liver metastasis, but the difference is not significant. CONCLUSIONS Cystic pNETs are more likely to be nonfunctional and indolent and seem to exhibit less aggressive biological behaviors than solid pNETs. Conservative approach should be considered for certain selected patients.
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Affiliation(s)
- Yugang Cheng
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Dong Wu
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Lei Wang
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Han Liu
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Yacheng Xiong
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Jianwei Xu
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Sanyuan Hu
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Hanxiang Zhan
- Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
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Soejitno A, Niryana IW, Sriwidyani NP, Susilawathi NM, Witari NP, Sudewi AR. Neuro cysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report. IDCases 2020; 22:e01004. [PMID: 33204635 PMCID: PMC7649621 DOI: 10.1016/j.idcr.2020.e01004] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022] Open
Abstract
Neurocysticercosis (NCC) is an endemic zoonotic infection in pork-eating region, including Bali. Despite its high prevalence, diagnosing an NCC can be challenging due to the protean clinical manifestations. Herein we describe an NCC case mistakenly diagnosed as a brain tumor, only later that we discovered the active larvae of Taenia solium, the pathogen which causes NCC. A high index of suspicion towards NCC should always be maintained, particularly among patients originated from endemic area. Appropriate treatment with anthelminthic may result in full disease resolution, thus precluding unnecessary invasive approach.
Introduction Neurocysticercosis (NCC) is an infection of the central nervous system by the larval stage of pork tapeworm (Taenia solium/T. solium). Diagnosing NCC can be challenging, particularly among those who reside in areas with rare occurrence of NCC and atypical manifestation such as a solitary parenchymal lesion. We treated a patient whose initially was diagnosed with brain abcess and later, brain tumor, only finally revealed to be an NCC case. Case report A 25-year old male suffered from multiple focal-to-bilateral tonic clonic seizures, was initially diagnosed as brain abscess. He was given antibiotics and anti-seizure medication but the seizure relapsed with a typical semiology. Physical examination demonstrated grade I papilledema, grade 4+ hemiparesis, and headache of vascular origin. Patient was suspected to have oligodendroglioma after underwent head MRI examination and subsequent tumor resection was performed. Pathological anatomy evaluation demonstrated multiple cystic segments containing larva of tapeworm, supporting a diagnosis of active NCC infection. After 14-day course of antheminthic treatment and resumed AED, patient was seizure-free and NCC was not found upon follow-up CT scan. Conclusion NCC, with respect to clinical and radiological manifestations, can be protean. A high index of suspicion towards NCC should always be maintained, particularly among patients originated from endemic area. Appropriate treatment with anthelminthic may result in full disease resolution, thus precluding unnecessary invasive approach.
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Affiliation(s)
- Andreas Soejitno
- Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
| | - I Wayan Niryana
- Departement of Neurosurgery, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
| | - Ni Putu Sriwidyani
- Departement of Pathological Anatomy, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
| | - Ni Made Susilawathi
- Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
- Corresponding authors at: Jl. Kesehatan no. 1, Denpasar, 80114, Indonesia.
| | - Ni Putu Witari
- Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
| | - A.A. Raka Sudewi
- Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia
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Massaad E, Hamidi N, Goetz J, Padmanaban V, Mau C, Tsang D, de Moraes FY, Chung C, Zacharia BE, Mansouri A. Equivalent Efficacy and Safety of Radiosurgery for Cystic and Solid Vestibular Schwannomas: A Systematic Review. World Neurosurg 2021; 146:322-331.e1. [PMID: 33212274 DOI: 10.1016/j.wneu.2020.11.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/06/2020] [Accepted: 11/07/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cystic vestibular schwannomas (VS) are associated with unpredictable growth behavior and potentially worse surgical outcomes compared with their solid counterparts. Growth control and potential adverse effects of radiosurgery for cystic VS have created concerns surrounding this modality. We sought to compare the treatment efficacy and safety profile of radiosurgery between cystic and solid VS through a systematic review. METHODS PubMed, EMBASE, Web of Science, and Cochrane were searched for related terms and studies reporting radiosurgical outcomes of cystic and solid VS. A meta-analysis was performed to compare the rates of tumor control. Random-effect models with generic inverse variance method was used to calculate overall pooled estimates. Study quality was assessed with the Newcastle Ottawa Criteria. RESULTS In total, 2989 studies were retrieved, and 6 including 1358 VS (79.89% solid; 20.11% cystic, median follow-up range 31.8-150 months) were selected. The median maximal dose was 25 Gy (range, 13-36 Gy) and the median marginal tumor dose was 12 Gy (10-18 Gy). There was no difference between cystic and solid VS (risk ratio, 1.02; 95% confidence interval 0.94-1.10; P = 0.69; I2 = 78%). Transient enlargement of cystic tumors may be associated with trigeminal or facial neuropathy. CONCLUSIONS The evidence collected by this study suggests that radiosurgery for cystic VS exhibits effective tumor control probabilities similar to solid VS. Consensus definitions and standard criteria are needed in the future to better understand the patterns of tumor growth and response to treatment following radiosurgery for cystic VS, as well as long-term neurological and functional outcomes.
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Padmanabhan N, Ishibashi H, Nishihara K, Sako S, Katayama K, Wakama S, Kamada Y, Yonemura Y. Multi cystic peritoneal mesothelioma treated with complete cytoreductive surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy-A case report. Int J Surg Case Rep 2020; 74:152-157. [PMID: 32846277 PMCID: PMC7452569 DOI: 10.1016/j.ijscr.2020.07.074] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 02/07/2023] Open
Abstract
Multicystic Peritoneal mesothelioma is a distinct type of peritoneal mesothelioma with borderline malignant potential and tendency to recur after tumor debulking. Morphologically MCPM has grapelike cysts filled with clear fluid and microscopically it has cystic spaces lined by cuboidal epithelium. There are areas of increased proliferative activity in the background of benign cyst representing potential for aggressiveness. Peritoneal free floating cysts can be formed from disintegration of main mass and deposit in other areas to form metastatic deposits. Comprehensive treatment – Complete cytoreduction, involved peritonectomy and HIPEC is required for treatment of macroscopic tumor and microscopic residue.
Background Multicystic Peritoneal mesothelioma is a rare and distinct variety of peritoneal mesothelioma with borderline malignant potential. Conventional Tumor bulking has been associated with recurrence of 45–50 %. Hence a comprehensive treatment with Complete cytoreductive surgery with involved field peritonectomy (CRS) and Hyperthermic Intra-peritoneal chemotherapy (HIPEC) is being increasingly adopted for MCPM. Case presentation A 47 year old lady evaluated for peri-menopausal disturbance was diagnosed to have a multicystic lesion in the pelvis. With a preoperative suspicion of diagnosis of pseudomyxoma peritonei, CRS with HIPEC was planned. On exploration a diffuse multicystic mass was found in omentum and pouch of douglas with typical morphological features of MCPM. Complete cytoreduction was achieved with anterolateral and sub-diaphragmatic peritonectomy, omentectomy and panhystrectomy. HIPEC was performed with cisplatin 50 mg/m2 for 40 min. Pathological examination revealed MCPM of omentum and uterine surface with focal clusters of mesothelial proliferation. However there was low proliferative activity 1–2 %. Discussion MCPM presents with wide spread peritoneal spread but with relative sparing of visceral invasion. Literature review suggests the disease spread is similar to PMP and treatment with CCRS and HIPEC has yielded long term survivals in MCPM. Conclusions This patient with voluminous disease burden in abdomen required surgical management and HIPEC for her condition. Whether CCRS alone without HIPEC can be an alternative for limited disease will be interesting research for future clinical reports.
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Affiliation(s)
- Naveen Padmanabhan
- Department of Surgical Oncology, Apollo Cancer Insitutes, Chennai, India; NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Haruaki Ishibashi
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Kazurou Nishihara
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Shouzou Sako
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Kanji Katayama
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Satoshi Wakama
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuyuki Kamada
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Yonemura
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Freeman K, Hays R, Kouri J. Giant tumefactive perivascular spaces: A case report. Surg Neurol Int 2020; 11:191. [PMID: 32754362 PMCID: PMC7395519 DOI: 10.25259/sni_532_2019] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 05/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background Perivascular spaces are interstitial fluid-filled regions located deep to the pia mater. They play roles in lymphatic drainage and the central nervous system immunological function. When they enlarge, they are referred to as giant tumefactive perivascular spaces. Often misdiagnosed as cystic neoplasms, they require a high degree of clinical suspicion and key radiological features to be accurately diagnosed. We describe an interesting case in which a man presented with worsening headache, subsequently found on neuroimaging to have this phenomenon. Case Description A 32-year-old man with low testosterone presented to the ER for worsening headache, blurred vision, and photophobia. Computed tomography of the brain showed hydrocephalus with follow-up magnetic resonance imaging revealing several enlarged cystic spaces within the brain, concerning for neoplasm. He ultimately left against medical advice before the further evaluation was done. He followed up with a neurosurgeon as an outpatient, where further review showed characteristic features indicative of giant tumefactive perivascular spaces, thus avoiding the need for unnecessary biopsy and potential surgery. Conclusion Often misdiagnosed as cystic neoplasms, giant tumefactive perivascular spaces are benign processes that can have a broad presentation with the most common finding being a headache. Key radiologic features, including smooth margins, isointensity to cerebrospinal fluid, and lack of postcontrast enhancement, are crucial to diagnosis, preventing unnecessary surgery with increased morbidity.
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Affiliation(s)
- Keith Freeman
- Departments of Internal Medicine, Wellington Regional Medical Center, Forest Hill Boulevard, Wellington, Florida, United States
| | - Richard Hays
- Departments of Internal Medicine, Wellington Regional Medical Center, Forest Hill Boulevard, Wellington, Florida, United States
| | - Joshua Kouri
- Departments of Neurosurgery, Wellington Regional Medical Center, Forest Hill Boulevard, Wellington, Florida, United States
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Sharma M, Madrigal FC, Altstadt T. Unusual Malignant Thoracic Cystic Lesion. World Neurosurg 2020; 139:423-5. [PMID: 32348891 DOI: 10.1016/j.wneu.2020.04.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022]
Abstract
Malignant cystic lesions in the spine are rare. In this report, we present a 65-year-old man who presented with imbalance on walking of 1-week duration with intact motor examination. Magnetic resonance imaging of the thoracic spine showed large expansile, T2-hyperintense mass involving T8 vertebral body, replacing the posterior elements causing cord compression with associated edema. He underwent uneventful T8 corpectomy, placement of expandable interbody cage, and T5-T11 posterolateral fusion using bilateral transpedicular approach. However, he died 5 months later due to progression of moderately differentiated metastatic lung cancer. To our knowledge, this is the first report showing the near-complete replacement of vertebral body and posterior elements with a malignant cystic lesion.
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AlGhamdi M, AlMutairi B, AlOsaimi A, Felemban A, AlYahya M. Mature cystic ovarian teratoma without intracystic fat: Case report with the "fat within the wall" sign. Radiol Case Rep 2020; 15:367-370. [PMID: 32055261 PMCID: PMC7005499 DOI: 10.1016/j.radcr.2020.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/23/2019] [Revised: 12/01/2019] [Accepted: 01/07/2020] [Indexed: 11/30/2022] Open
Abstract
Mature cystic teratoma is the most common ovarian neoplasm among young females. Diagnosed through radiological imaging as it exhibits typical radiological features; typically, fat. However, complete cystic teratoma without visible fat is a very rare and challenging diagnosis. It is difficult to distinguish it from malignant neoplasm, due to the presence of enhancing components, for example, Rokitansky nodule and the presence of diffusion restriction from keratinized products. We present a case of an incidental mature cystic teratoma without visible intracystic fat, where the correct diagnosis based on imaging was failed. Mature cystic teratoma was then confirmed upon histologic examination.
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Affiliation(s)
- Maram AlGhamdi
- Department of Medical Imaging, Prince Sultan Military Medical City, P. Box. 7897, Riyadh, Saudi Arabia
- Corresponding author.
| | - Badr AlMutairi
- Department of Diagnostic Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz AlOsaimi
- Department of Diagnostic Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Afaf Felemban
- Department of Obstetrics and Gynaecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mauth AlYahya
- Department of Histopathology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Tahri R, Barkiyou M, Chokairi O, Lamalmi N, Rouas L, Cherradi N. Congenital cervical choristoma of the neck mimicking cystic lymphangioma. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:497-499. [PMID: 31983630 DOI: 10.1016/j.anorl.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Choristoma is a mass presenting normal histology, but in an abnormal location. Cystic choristoma is rarely reported in the head and neck region. Neonatal cystic masses in the neck suggest usually correspond to a diagnosis of cystic lymphangioma. CASE REPORT We report a case of a congenital cystic choristoma of the neck clinically and radiologically mimicking cystic lymphangioma. DISCUSSION Congenital cystic choristoma is an extremely rare lesion, essentially described in neonates, composed of various types of tissues. The diagnosis of congenital cystic choristoma may be suggested on imaging and must be confirmed by histopathological examination. Treatment consists of complete surgical resection.
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Affiliation(s)
- R Tahri
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco.
| | - M Barkiyou
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco
| | - O Chokairi
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco
| | - N Lamalmi
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco; Service d'anatomie pathologique, hôpital des Enfants de Rabat, CHU de Rabat, Rabat, Morocco
| | - L Rouas
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco; Service d'anatomie pathologique, hôpital des Enfants de Rabat, CHU de Rabat, Rabat, Morocco
| | - N Cherradi
- Faculté de médecine et de pharmacie de Rabat, Université Mohammed V Rabat, Rabat, Morocco; Service d'anatomie pathologique, l'hôpital des Spécialités de Rabat, CHU de Rabat, Rabat, Morocco
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Abstract
Teratoma of the kidney is uncommon. We report a case of a young boy with a large, right-sided retroperitoneal cyst suspected as lymphangioma causing hydronephrosis. His renal pelvis was dilated, containing purulent fluid, and a nephrectomy was performed. Histopathology revealed a mature cystic teratoma of the renal pelvis.
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Zhu JK, Wu D, Xu JW, Huang X, Jiang YY, Edil BH, Li M, Hu SY, Zhan HX. Cystic pancreatic neuroendocrine tumors: A distinctive subgroup with indolent biological behavior? A systematic review and meta-analysis. Pancreatology 2019; 19:738-750. [PMID: 31160191 DOI: 10.1016/j.pan.2019.05.462] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES The clinicopathological features and biological behaviors of cystic pancreatic neuroendocrine tumors (pNETs) are unclear and controversial. Here we performed a systematic review and meta-analysis to investigate the unique characteristics of cystic pNETs, to determine whether they represent a distinct clinical entity. METHODS We selected comparative studies published since January 2000 that explore the differences between clinicopathological features of cystic and solid pNETs. Demographic information, pathological characteristics, and survival information were analyzed. RESULT The 12 selected studies comprised 355 and 1530 patients diagnosed with cystic and solid pNETs, respectively. Compared with solid pNETs, cystic pNETs were less likely to be functional (odds ratio, OR = 0.31, 95% confidence interval (CI) 0.19-0.50, p < 0.00001), more likely to affect males (OR = 1.56, 95% CI 1.22-2.00, p = 0.0005), and significantly associated with multiple endocrine neoplasia type 1 (OR = 2.71). Cystic pNETs were more likely to present with G1 and G2 rather than G3 (OR = 1.66). Cystic pNETs were associated with less frequent distant organs and lymph node metastasis, microvascular invasion, perineural invasion, and a low Ki-67 index and mitotic count. There were no significant differences between 5- and 10-year overall survival. However, the 5-year disease-free survival (DFS) and 10-year DFS rate of patients with cystic pNETs was significantly higher compared with those with solid pNETs (94.6% vs 83.5%, OR = 3.00; 92.7% vs 63.6%, OR = 5.92, respectively). CONCLUSIONS Cystic pNETs represent a distinct subgroup of pNETs that present with an indolent biological behavior, and patients experience better DFS. Observation and surveillance should be considered in some selected cases.
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Affiliation(s)
- Jian-Kang Zhu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China
| | - Dong Wu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China
| | - Jian-Wei Xu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China
| | - Xin Huang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China
| | - Yuan-Yuan Jiang
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital Shandong University, Jinan, 250012, China
| | - Barish H Edil
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Min Li
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - San-Yuan Hu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China
| | - Han-Xiang Zhan
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, 250012, China.
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Jain S, Nanda S, Sethi D, Lamba S. Cysticercosis masquerading as tuberculous lymphadenitis in supraclavicular region. Trop Parasitol 2019; 9:59-61. [PMID: 31161095 PMCID: PMC6542305 DOI: 10.4103/tp.tp_22_18] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2019] [Indexed: 11/17/2022] Open
Abstract
Cysticercosis is a parasitic infestation caused by the larvae of the tapeworm Taenia solium. In humans, cysticercosis spreads through fecal–oral route by ingesting food contaminated with eggs of pork tapeworm. The most frequent sites affected are central nervous system, eye, subcutaneous tissue, and skeletal muscle. We report a case of cysticercosis presenting as left supraclavicular swelling which is a rare site, diagnosed on fine-needle aspiration.
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Affiliation(s)
- Sonam Jain
- Department of Pathology, ESI Hospital, Delhi, India
| | - Saumya Nanda
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Divya Sethi
- Department of Pathology, ESI Hospital, Delhi, India
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Shah A, Akram J, Abdelaal A, Alateeq L, Ben-Gashir M, Hammouda A. Cystic poorly differentiated squamous cell carcinoma of the scalp, a rare scalp tumor: Case report and literature review. Int J Surg Case Rep 2019; 60:21-24. [PMID: 31185453 PMCID: PMC6558230 DOI: 10.1016/j.ijscr.2019.05.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/27/2019] [Revised: 05/10/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Cutaneous cystic lesions have broad differentials ranging from common benign entity to rare malignant lesions. Clinical evaluation of the lesion is the key to differentiation, as some rare malignant entities may simulate benign lesions. A high index of suspicion should be maintained for any aggressive behavior, which may require more thorough evaluation, including histopathology and radiographic imaging studies. We report a rare case of cystic poorly differentiated squamous cell carcinoma (CPDSCC) of the scalp. CASE PRESENTATION We report a case of a 37-year-old Filipino expatriate male who presented with a scalp swelling which had been gradually increasing in size for four months and was operated upon with a working diagnosis of sebaceous cyst. On post-op excisional biopsy, it turned out to be poorly differentiated cystic squamous cell carcinoma of the scalp. On further workup, no metastasis or other primary was found. Complete re-excision of the lesion with no evidence of residual tumor was achieved. Long-term follow-up was lost, as the patient left for his native country. CONCLUSION Though cystic cutaneous lesions are very commonly encountered in clinical practice, high suspicion for malignancy should be maintained if the lesion shows any aggressive behavior. Prompt investigation should be done before surgery to determine the nature of the disease and the most effective management for the patient. Poorly differentiated cystic squamous cell carcinoma should also be considered in the differential diagnosis of cystic cutaneous lesions show aggressive behavior.
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Affiliation(s)
- Amjad Shah
- Department of General Surgery, Hamad General Hospital, HMC, Doha, Qatar.
| | - Jaweria Akram
- Department of General Surgery, Hamad General Hospital, HMC, Doha, Qatar
| | | | - Layth Alateeq
- Department of General Surgery, Hamad General Hospital, HMC, Doha, Qatar
| | | | - Atalla Hammouda
- Department of Plastic Surgery, Rumailah Hospital, HMC, Doha, Qatar
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Chatterjee A, Gallan AJ, He D, Fan X, Mustafi D, Yousuf A, Antic T, Karczmar GS, Oto A. Revisiting quantitative multi-parametric MRI of benign prostatic hyperplasia and its differentiation from transition zone cancer. Abdom Radiol (NY) 2019; 44:2233-43. [PMID: 30955071 DOI: 10.1007/s00261-019-01936-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE This study investigates the multiparametric MRI (mpMRI) appearance of different types of benign prostatic hyperplasia (BPH) and whether quantitative mpMRI is effective in differentiating between prostate cancer (PCa) and BPH. MATERIALS AND METHODS Patients (n = 60) with confirmed PCa underwent preoperative 3T MRI. T2-weighted, multi-echo T2-weighted, diffusion weighted and dynamic contrast enhanced images (DCE) were obtained prior to undergoing prostatectomy. PCa and BPH (cystic, glandular or stromal) were identified in the transition zone and matched with MRI. Quantitative mpMRI metrics: T2, ADC and DCE-MRI parameters using an empirical mathematical model were measured. RESULTS ADC values were significantly lower (p < 0.001) in PCa compared to all BPH types and can differentiate between PCa and BPH with high accuracy (AUC = 0.87, p < 0.001). T2 values were significantly lower (p < 0.001) in PCa compared to cystic BPH only, while glandular (p = 0.27) and stromal BPH (p = 0.99) showed no significant difference from PCa. BPH mimics PCa in the transition zone on DCE-MRI evidenced by no significant difference between them. mpMRI values of glandular (ADC = 1.31 ± 0.22 µm2/ms, T2 = 115.7 ± 37.3 ms) and cystic BPH (ADC = 1.92 ± 0.43 µm2/ms, T2 = 242.8 ± 117.9 ms) are significantly different. There was no significant difference in ADC (p = 0.72) and T2 (p = 0.46) between glandular and stromal BPH. CONCLUSIONS Multiparametric MRI and specifically quantitative ADC values can be used for differentiating PCa and BPH, improving PCa diagnosis in the transition zone. However, DCE-MRI metrics are not effective in distinguishing PCa and BPH. Glandular BPH are not hyperintense on ADC and T2 as previously thought and have similar quantitative mpMRI measurements to stromal BPH. Glandular and cystic BPH appear differently on mpMRI and are histologically different.
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Abstract
Since the mid-1990s detailed studies and field investigations on the Tibetan Plateau have revealed human echinococcosis to be an under-reported major public health problem, particularly in the dominant pastoral communities in the eastern and central regions. Human prevalence surveys showed that cystic echinococcosis (CE, caused by Echinococcus granulosus) and alveolar echinococcosis (AE, caused by Echinococcus multilocularis) are co-endemic with higher burdens of each disease than other endemic world regions. Epidemiological investigations identified some major risk factors for human CE and AE including dog ownership, husbandry practices and landscape features. Dogs appear to be the major zoonotic reservoir for both E. granulosus and E. multilocularis, but the latter is also transmitted in complex wildlife cycles. Small mammal assemblages especially of vole and pika species thrive on the Plateau and contribute to patterns of E. multilocularis transmission which are influenced by landscape characteristics and anthropogenic factors. Tibetan foxes are a principal definitive host for both E. multilocularis and E. shiquicus. In 2006 a national echinococcosis control programme was initiated in Tibetan communities in northwest Sichuan Province and rolled out to all of western China by 2010, and included improved surveillance (and treatment access) of human disease and regular deworming of dogs with annual copro-testing. Control of echinococcosis in Tibetan pastoral communities poses a difficult challenge for delivery and sustainability.
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Affiliation(s)
- Phil S Craig
- School of Environment and Life Sciences, University of Salford, Greater Manchester, United Kingdom.
| | - Patrick Giraudoux
- Department of Chrono-Environment, UMR UFC/CNRS, Université de Franche-Comté, Besancon, France; Laboratory of Wildlife Management and Ecosystem Health, Yunnan University of Finance and Economics, Kunming, China.
| | - Zheng Huan Wang
- School of Life Sciences, and Shanghai Key Laboratory of Urbanization and Ecological Restoration, East China Normal University, Shanghai, China; Joint Translational Science and Technology Research Institute, Shanghai, China
| | - Qian Wang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
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Shawash S, Abdeljalil R, Haddad H. Multifocal pulmonary mucinous cystic neoplasm with ovarian-like stroma: Once in a blue moon-case report. Respir Med Case Rep 2019; 26:276-280. [PMID: 30828544 PMCID: PMC6383178 DOI: 10.1016/j.rmcr.2019.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/21/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/17/2022] Open
Abstract
Mucinous cystic neoplasm of the lung is a rare well known entity in the WHO classification of lung tumors. It is defined as "a localized cystic mass filled with mucin and surrounded by a fibrous wall lined by well-differentiated columnar mucinous epithelium." The presence of ovarian-like stroma is not mentioned in this definition. Reviewing the literature, we have found only one reported case mentioning this finding, described by Geramizadeh et al., in 2014. Here we present a similar case of a patient who was initially thought to have lung metastases. Hence, our case is the second one to be reported in the literature. After gross dissection of the received specimens, microscopic examination was performed. The H&E slides revealed that the lesions are composed of non-infiltrative biphasic proliferation of benign mucious epithelial cells forming cysts and gland-like structures with intervening cellular ovarian-like stroma. Differential diagnosis included hamartoma and sclerosing pneumocytoma. Additionally, ancillary studies were performed including cytokeratin AE1/AE3, EMA, TTF-1, MUC5AC, ER, CD10, SMA, CD34, S100, Inhibin, PAS, PAS/D and Mucicarmine. Immunohistochemistry showed Cytokeratin AE1/AE3, EMA and TTF-1 are positive in the epithelial cells and negative in the stromal cells. MUC5AC is weakly positive at the surface of the epithelial cells. The cells of the ovarian-like stroma are positive for ER and CD10 and focally positive for SMA. PAS, PAS/D and Mucicarmine highlighted mucin in the cystic spaces and the surface of epithelial cells. CD34, S100 and Inhibin are negative. Mucinous cystic neoplasm with ovarian-like stroma is a well-known entity in the pancreas and liver. Its occurrence in the lung has been reported in a single case in the English-written literature. We believe that it should be considered in the differential diagnosis of benign biphasic pulmonary lesions. To our knowledge, our case is the second one to be ever reported.
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Affiliation(s)
- Sarah Shawash
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Jordan
| | | | - Hussam Haddad
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Jordan
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Brigell RH, Cagney DN, Martin AM, Besse LA, Catalano PJ, Lee EQ, Wen PY, Brown PD, Phillips JG, Pashtan IM, Tanguturi SK, Haas-Kogan DA, Alexander BM, Aizer AA. Local control after brain-directed radiation in patients with cystic versus solid brain metastases. J Neurooncol 2019; 142:355-363. [PMID: 30715665 DOI: 10.1007/s11060-019-03106-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/14/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Brain metastases can be radiographically cystic or solid. Cystic metastases are associated with a greater intracranial disease burden and poorer oncologic outcomes, but the impact of cystic versus solid appearance on local control after radiation remains unknown. We investigated whether cystic versus solid nature is predictive of local control after management with stereotactic or whole brain radiation (WBRT) and whether the radiation modality utilized is an effect modifier. METHODS We identified 859 patients with 2211 newly-diagnosed brain metastases managed with upfront stereotactic radiation or WBRT without preceding resection/aspiration at Brigham and Women's Hospital/Dana-Farber Cancer Institute between 2000 and 2015. Multivariable Cox regression with an interaction term and sandwich covariance matrix was used to quantify local failure. RESULTS Cystic lesions were more likely to recur than solid ones when managed with stereotactic radiation (HR 2.33, 95% CI 1.32-4.10, p = 0.004) but not WBRT (HR 0.92, 95% CI 0.62-1.36, p = 0.67), p-interaction = 0.007. 1 year local control rates for cystic versus solid metastases treated with stereotactic radiation were 75% versus 88%, respectively; estimates with WBRT were 76% versus 76%, respectively. However, no significant differences were noted between the two cohorts in post-radiation outcomes including all-cause mortality and neurologic death (p > 0.05). CONCLUSIONS Among patients with brain metastases, stereotactic radiation yields improved local control and less morbidity than WBRT, and consequently for many patients the cystic versus solid designation does not impact treatment selection. However, our results suggest that in patients with a large number of cystic brain metastases, a lower threshold to consider WBRT, as opposed to stereotactic radiation, should be employed. If our results can be confirmed, further investigation into the underlying mechanism(s) would be warranted.
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Affiliation(s)
- Rachel H Brigell
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Daniel N Cagney
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
| | - Allison M Martin
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Luke A Besse
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Paul J Catalano
- Department of Biostatistics, Department of Biostatistics and Computational Biology, Harvard T. H. Chan School of Public Health, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Eudocia Q Lee
- Department of Neuro-Oncology, Dana-Farber / Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Patrick Y Wen
- Department of Neuro-Oncology, Dana-Farber / Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - John G Phillips
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Itai M Pashtan
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Shyam K Tanguturi
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Daphne A Haas-Kogan
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Brian M Alexander
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Ayal A Aizer
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
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Macki M, Anand SK, Jaratli H, Dabaja AA. Penile Lymphangioma: review of the literature with a case presentation. Basic Clin Androl 2019; 29:1. [PMID: 30705756 PMCID: PMC6348653 DOI: 10.1186/s12610-018-0081-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Penile lymphangiomas are rare manifestations of lymphangiomas or lymphatic malformations which are more commonly found in the head or neck region of the body. Lymphangiomas are further categorized as lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, or acquired lymphangiomas (also known as lymphangiectasia), based on their depth and etiology. Results A literature review revealed only 30 cases of penile lymphangioma between 1947 and March 30, 2018. Several causes were attributed to the acquired penile lymphangiomas, including trauma, phimosis, and infection. While penile lymphangiomas can be initially mistaken for an infection, a thorough history and physical examination is sufficient to clinically diagnose a lymphangioma of the penis. Historically, surgical excision has been the gold standard of treatment for this condition. When asymptomatic, patients may opt for conservative management with avoidance of mechanical trauma alone. Other physicians have revealed novel treatment plans to rid patients of their penile lymphangioma such as a staged laser procedure. Conclusion In this article, we elucidate the causes, symptoms, treatments, and outcomes associated with penile lymphangiomas found in the literature while also presenting the case of a 30-year-old African-American man diagnosed with acquired penile lymphangioma.
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Affiliation(s)
- Mohamed Macki
- Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Sharath Kumar Anand
- Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Hayan Jaratli
- Department of Pathology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Ali A Dabaja
- 3Department of Vattikuti Urology Institute, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
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Luo W, Hofstetter WL, Tan D. Gastroesophageal junction Paneth cell carcinoma with extensive cystic and secretory features - case report and literature review. Diagn Pathol 2019; 14:1. [PMID: 30621725 PMCID: PMC6323739 DOI: 10.1186/s13000-018-0775-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 05/11/2018] [Accepted: 12/06/2018] [Indexed: 12/22/2022] Open
Abstract
Background Carcinomas composed predominantly or purely of malignant Paneth cells were rarely reported in gastrointestinal system. They have not been reported at gastroesophageal junction nor has the association with Barrett esophagus been explored. None of the previous studies has mentioned any peculiar histologic features other than typical adenocarcinoma containing neoplastic Paneth cells. The Her2/neu status and the expression of beta-catenin in Paneth cell carcinoma at gastroesophageal junction have not been studied although the activated beta-catenin pathway was recently demonstrated in neoplastic Paneth cells in colon. Case presentation A 70-year-old Caucasian male who initially presented in the emergency room due to upper gastrointestinal bleeding was subsequently found to have a submucosal nodule at gastroesophageal junction. A diagnosis of adenocarcinoma was rendered on biopsy. Histologic examination of the subsequent endoscopic mucosal resection revealed an adenocarcinoma with various levels of differentiation which are zonally distributed. The deeper portion of the tumor showed well-differentiated bland-appearing glands with extensive cystic and secretory changes. The cytoplasm of tumor cells and secretion demonstrated marked reactivity with lysozyme antibody on immunohistochemical stain. The tumor had a peculiar Her2/neu staining pattern with cytoplasmic and nuclear stain in poorly-differentiated area and no stain in well-differentiated area. Only membranous stain was detected with beta-catenin antibody. Conclusion We reported the first case of Paneth cell carcinoma at gastroesophageal junction. The tumor had well-differentiated area which, when sampled in small biopsies, can mimic benign lesions including those related to proton pump inhibitor therapy. Lysozyme immunohistochemical stain may be helpful when difficulty in diagnosis arises. Her-2/neu was negative but showed a distinct staining pattern. In contrast to neoplastic Paneth cells in colon, beta-catenin pathway did not seem to be activated. More studies are needed for the etiology, pathogenesis, clinical course, prognosis and treatment of Paneth cell carcinoma.
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Affiliation(s)
- Wenyi Luo
- Department of Pathology, MD Anderson Cancer Center, Houston, USA
| | - Wayne L Hofstetter
- Department of Thoracic and Cardiovascular surgery, MD Anderson Cancer Center, Houston, USA
| | - Dongfeng Tan
- Department of Pathology, MD Anderson Cancer Center, Houston, USA.
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Wang X, Li P, Zhou P, Fu Y, Lai Y, Che G. Intrapulmonary metastasis from primary pulmonary meningioma presenting as multiple cystic lesions: a case report. BMC Pulm Med 2019; 19:8. [PMID: 30621651 PMCID: PMC6325864 DOI: 10.1186/s12890-018-0773-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/13/2018] [Accepted: 12/27/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cystic lung lesions involving both lungs include a variety of diseases, such as pulmonary Langerhans cell histiocytosis, lymphangioleiomyomatosis and pulmonary metastasis. Primary pulmonary meningioma accompanied with intrapulmonary metastasis was extremely rare and we were not aware of previous studies reporting with cystic radiological manifestation. CASE PRESENTATION A 64-year-old female patient was admitted to our department for a mass located in right posterior mediastinum with multiple cystic pulmonary lesions. A thoracoscopic lung biopsy was performed and the diagnosis was confirmed as bilateral pulmonary metastasis from primary pulmonary meningioma. CONCLUSIONS Intrapulmonary metastasis from a primary pulmonary meningioma may manifest as multiple thin-walled cystic lesions on computed tomography. Differential diagnosis of cystic pulmonary disease should include this situation. Our case shows the new CT manifestation of metastatic primary pulmonary meningioma and the importance of immunomolecular analysis.
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Affiliation(s)
- Xin Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Pengfei Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Ping Zhou
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yiyun Fu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yutian Lai
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
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Nakashima Y, Ohtsuka T, Nakamura S, Mori Y, Nakata K, Miyasaka Y, Ishigami K, Matsuda R, Oda Y, Nakamura M. Clinicopathological characteristics of non-functioning cystic pancreatic neuroendocrine tumors. Pancreatology 2019; 19:50-56. [PMID: 30497875 DOI: 10.1016/j.pan.2018.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/28/2018] [Accepted: 11/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES The biological features of cystic pancreatic neuroendocrine tumors (PNETs) remain unclear. The aim of this study was to clarify the clinicopathological characteristics of non-functioning PNETs (NF-PNETs) with a cystic component. METHODS The medical records of 75 patients with NF-PNETs who had undergone resection in our institution were retrospectively reviewed. Clinicopathological factors were compared between PNETs with and without a cystic component. Expression of somatostatin 2 receptor (SSTR-2) was also analyzed. RESULTS Cystic PNETs were diagnosed in 14 patients (19%). The proportion of men was significantly higher for cystic than solid PNETs (79% vs. 44%, P < 0.05) and cystic PNETs were significantly larger than solid PNETs (25 mm vs. 17 mm, P < 0.01). However, there were no significant differences in the prevalence of lymph node metastases (14% vs. 10%, P = 0.64), hepatic metastasis (7% vs. 3%, P = 0.54), or disease-free survival rate (both 86%, P = 0.29) between PNETs with and without a cystic component. SSTR-2 expression was more frequently observed in PNETs with a cystic component than in those without (100% vs. 70%, P < 0.01). CONCLUSIONS Although cystic PNETs were larger upon diagnosis than solid PNETs in this study, prognosis after surgical resection did not differ significantly between these types of PNET. Somatostatin receptor scintigraphy and somatostatin analogues may be more useful for diagnosing and treating cystic PNETs, respectively.
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Affiliation(s)
- Yohei Nakashima
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takao Ohtsuka
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - So Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhisa Mori
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Miyasaka
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kosei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryota Matsuda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Hannah-Shmouni F, MacNeil L, Potter M, Jobling R, Yoon G, Laughlin S, Blaser S, Inbar-Feigenberg M. Severe cystic degeneration and intractable seizures in a newborn with molybdenum cofactor deficiency type B. Mol Genet Metab Rep 2019; 18:11-3. [PMID: 30619713 DOI: 10.1016/j.ymgmr.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/15/2018] [Accepted: 12/15/2018] [Indexed: 01/08/2023] Open
Abstract
Newborns with cystic degeneration with or without intractable seizures should be investigated for inborn errors of metabolism, including molybdenum cofactor deficiency (MoCoD). MoCoD may present with non-specific hypoxic ischemic injury in the neonatal period with MRI showing extensive prenatally acquired cystic encephalomalacia involving grey and white matter. Most newborns with MoCoD will present with normal head size and brain appearance at birth and postnatally rapidly develop cystic encephalomalacia. A significant minority will present with signs of prenatal brain injury or malformation. It is important to consider the diagnosis in both scenarios. Low plasma urate and homocysteine may help direct the diagnostic evaluation. Herein, we describe the clinical, radiological and biochemical features of a newborn with MoCoD that was initially suspected of having the condition on biochemical screening and confirmed on rapid whole exome sequencing.
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