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Lotfi S, Madankan A, Fazli F, Jaliliyan A. Diagnosis of gastric mucosal choristoma of the tongue: A case report. Int J Surg Case Rep 2024; 117:109508. [PMID: 38471209 PMCID: PMC10945238 DOI: 10.1016/j.ijscr.2024.109508] [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: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Gastric mucosal choristoma of the tongue is an extremely rare benign tumor characterized by ectopic gastric mucosa in the tongue. Since first reported in 1927, only around 100 cases have been documented. Herein, we investigated an adult case of Gastric mucosal choristoma who was referred to an ENT clinic with a chief complaint of a solid tumor at the posterior portion of the tongue. CASE PRESENTATION A 32-year-old female presented with a posterior tongue mass initially noticed years ago that progressed over months. A surgical excision was performed. Microscopic examination revealed a gastric mucosal choristoma, with glandular structures resembling gastric mucosa. The postoperative course was uneventful. CLINICAL DISCUSSION Lingual gastric choristoma is uncommon but deserves mention due to its rarity. The pathogenesis is unknown but likely represents developmental heterotopia. Clinically, lesions present as asymptomatic tongue nodules often mistaken for more common entities. Thus, histopathology is essential for diagnosis. Microscopy shows gastric mucosa with fundic glands, parietal cells, chief cells, and foveolar epithelium in tongue squamous epithelium. CONCLUSION Gastric choristoma should be considered when evaluating tongue nodules to guide management. Increased awareness of this rare entity can enable accurate diagnosis and treatment. Complete surgical excision is curative with an excellent long-term prognosis. Further study of pathogenesis can elucidate optimal management.
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Affiliation(s)
- Saeed Lotfi
- Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Madankan
- Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Fazli
- Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Jaliliyan
- Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran..
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Boushabi A, Benali HA, Shimi M. Intramuscular desmoid tumor of the leg leading to external popliteal sciatic neuropathy: A case study and literature review. Int J Surg Case Rep 2024; 116:109333. [PMID: 38308981 PMCID: PMC10848038 DOI: 10.1016/j.ijscr.2024.109333] [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: 11/25/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Desmoid tumors (DT), rare benign neoplasms of soft tissues, exhibit local aggressiveness and high recurrence rates. Originating from myofibroblast proliferation, complete surgical intervention is the preferred treatment. Despite their benign nature, these tumors are infrequent, predominantly affecting women between 15 and 60, with a higher incidence in adolescence. CASE PRESENTATION A 44-year-old woman with a DT in the leg mimicking external popliteal sciatic neuropathy. Diagnosis confirmed by biopsy, surgery performed with preservation of the external popliteal nerve, ensuring optimal nerve function. Two-year follow-up with no recurrence, demonstrating the success of the surgical intervention. CLINICAL DISCUSSION DTs, although rare, exhibit three distinct genomic mutations, with the 45F genotype associated with the highest risk of recurrence. Generally sporadic, these tumors can be linked to familial adenomatous polyposis (FAP) and influenced by states of hyperestrogenism. DTs typically present as deep-seated masses, with frequent local recurrence despite complete resection. CONCLUSION DTs pose diagnostic and therapeutic challenges, often requiring complete surgical intervention. Management depends on symptomatology, with careful monitoring for small asymptomatic tumors and adjuvant radiotherapy in case of incomplete resection. Despite surgical success, frequent recurrence underscores the need for in-depth research to enhance therapeutic approaches.
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Affiliation(s)
- Ayoub Boushabi
- Orthopedics and Trauma-surgery Department, MOHAMMED VI University Hospital Center, Tangier, Morocco.
| | - Hicham Ait Benali
- Orthopedics and Trauma-surgery Department, MOHAMMED VI University Hospital Center, Tangier, Morocco
| | - Mohammed Shimi
- Orthopedics and Trauma-surgery Department, MOHAMMED VI University Hospital Center, Tangier, Morocco
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3
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Jentzsch C, Fuchs J, Agaimy A, Vokuhl C, Escherich G, Blattmann C, Warmann SW, Schmidt A, Schäfer J, Brecht IB, Schneider DT, Abele M. Solid pseudopapillary neoplasms of the pancreas in childhood and adolescence-an analysis of the German Registry for Rare Pediatric Tumors (STEP). Eur J Pediatr 2023; 182:5341-5352. [PMID: 37733117 PMCID: PMC10746605 DOI: 10.1007/s00431-023-05203-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
Solid pseudopapillary neoplasms (SPNs) are the most common entity among pediatric pancreatic tumors. Still, these are rare tumors with an annual incidence of 0.1-0.2/1,000,000, and little is known about their optimal treatment. This analysis aimed to increase knowledge about the occurrence and treatment strategies of SPN in childhood. Data regarding diagnostics, treatment, and outcome of children aged 0-18 years with SPN recorded in the German Registry for Rare Pediatric Tumors (STEP) were analyzed. Thirty-eight patients were identified with a median age of 14.5 years at diagnosis (range: 8-18) and a female preponderance (81.6%). The most frequent location of the tumor was the pancreatic tail. In histopathological and immunohistochemical examination, pseudopapillary, solid, and cystic lesions as well as expression of beta-catenin, progesterone receptors, and cyclin D1 were the most common findings. All patients underwent surgical resection. Most patients underwent open resection, predominantly tail resection for tumors in the tail region and pylorus-preserving pancreaticoduodenectomy for tumors in the head region. The main postoperative sequela was exogenous pancreatic insufficiency (23.7%), especially with SPN in the pancreatic head. No recurrence occurred during follow-up, although two patients underwent resection with microscopic residue. CONCLUSION SPN of the pancreas in childhood are low-grade malignancies with usually favorable treatment outcomes. However, therapy can lead to relevant long-term sequelae. To prevent recurrence, complete surgical resection is recommended, sparing as much healthy pancreatic tissue as possible. Interdisciplinary collaboration between specialists is essential to optimize treatment. Molecular genetic analysis of these tumors could improve understanding of their genesis. WHAT IS KNOWN • Solid pseudopapillary neoplasms (SPNs) of the pancreas are very rare tumors in childhood. • Little is known about tumorigenesis, and there are no specific guidelines for treatment and follow-up in pediatric patients. WHAT IS NEW • Characteristics, treatment, and outcome were comprehensively assessed in a large cohort of pediatric patients with SPN. • We propose recommendations for diagnosis, treatment, and follow-up of children with SPN, based on our analysis and considering published experience.
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Affiliation(s)
- Christian Jentzsch
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Jörg Fuchs
- Pediatric Surgery and Pediatric Urology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Christian Vokuhl
- Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Blattmann
- Department of Pediatric Oncology, Hematology and Immunology, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany
| | - Steven W Warmann
- Pediatric Surgery and Pediatric Urology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Andreas Schmidt
- Pediatric Surgery and Pediatric Urology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Jürgen Schäfer
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik T Schneider
- Clinic of Pediatrics, Klinikum Dortmund, University Witten/Herdecke, Dortmund, Germany
| | - Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany.
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4
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Abele M, Kunstreich M, Lessel L, Seitz G, Vokuhl C, Lapa C, Schneider DT, Brecht IB, Redlich A, Kuhlen M. Bronchial carcinoid tumors in children and adolescents - A report and management considerations from the German MET studies. Lung Cancer 2023; 183:107320. [PMID: 37549472 DOI: 10.1016/j.lungcan.2023.107320] [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: 04/03/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES Bronchial carcinoid tumors (BC) are exceptionally rare in childhood, with an incidence of <0.2/1,000,000 per year. Typical low-grade BCs are distinguished from atypical, intermediate-grade BCs. Little is known about BCs in pediatric patients and management guidelines are missing. In this study, we explored characteristics and outcome of pediatric patients with BC prospectively registered with the Malignant Endocrine Tumor studies. MATERIAL AND METHODS We performed a retrospective multicenter study in children, adolescents, and young adults (aged 0-20 years) with BC reported to the German MET registry between January 1997 and December 2022. Data were last updated on 28 of February 2023. RESULTS Thirty-two patients were diagnosed at a median age of 15.0 years (range, 9.8-19.2). Atypical BCs (23.3%) were less frequent than typical, but more common than in adulthood. Lymph node metastases were present in 14.3% of cases (atypical BC: 28.6%, typical BC: 10.5%), distant metastases in one (3.1%) patient with atypical BC. 92.6% of patients were in complete remission after surgical resection (median follow-up: 2.7 years). The patient with metastatic spread and one patient with atypical BC and multiple recurrences were on treatment at last follow-up. 5-year event-free survival of typical BC was 100% and 83.3% in atypical BC. CONCLUSIONS Completely resected localized BCs in pediatric patients have a favorable outcome also with lung tissue sparing surgery. Atypical BC with risk of metastatic spread and recurrence occurred more frequently compared to adults. Interdisciplinary management and collaborative efforts are needed to improve our understanding and the management of pediatric BC.
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Affiliation(s)
- Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany.
| | - Marina Kunstreich
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Lienhard Lessel
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Guido Seitz
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Marburg, Germany
| | - Christian Vokuhl
- Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - Constantin Lapa
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Dominik T Schneider
- Clinic of Pediatrics, Klinikum Dortmund, University Witten/Herdecke, Dortmund, Germany
| | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Redlich
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Michaela Kuhlen
- Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
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Shashidhar TB, Srivastava T, Yadav A, Nambiar VS. Uncovering a Novel Site of Ewing's Sarcoma: the Hypopharynx. Indian J Otolaryngol Head Neck Surg 2023; 75:2630-2633. [PMID: 37636598 PMCID: PMC10447781 DOI: 10.1007/s12070-023-03821-2] [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: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 08/29/2023] Open
Abstract
Ewing's sarcoma is usually seen in bones but 20-30% are found in extra skeletal soft tissues like in head and neck region. We present the case of Ewing sarcoma of hypopharynx in a 1 year old child who presented to us with acute respiratory distress. Child was intubated using videolaryngoscope and mass was removed using microdebrider. Final histopathological examination revealed Ewing sarcoma. EWSR1 gene rearrangement studies were advised, which the patient refused. Post-operative patient was started on adjuvant chemotherapy. PET CT after 2 months showed no FDG avid lesions within or elsewhere in the region of the body surveyed. There is no case of Ewing's sarcoma in hypopharynx reported to date. The clinical presentation, management and outcome has been discussed with a review of the literature.
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Affiliation(s)
| | | | - Ankita Yadav
- Artemis Health Institue, Gurugram, Haryana India
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Chabrillac E, Even C, Costes-Martineau V, Fakhry N, Digue L, Moya-Plana A, Baujat B, Righini CA, De Gabory L, Verillaud B, Vergez S, Thariat J. [Rare cancers of the head and neck on behalf of the REFCOR, part 1]. Bull Cancer 2023; 110:692-699. [PMID: 37169603 DOI: 10.1016/j.bulcan.2023.04.008] [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: 02/18/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/13/2023]
Abstract
Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology, which determines their local invasiveness, and their hematogenous/nodal spread. Their diagnosis can be difficult and often requires comprehensive immunohistochemistry and genomic techniques. Expert pathology review is recommended in the cases of undifferentiated tumors, sarcomas and at the slightest diagnostic doubt. These rare cancers can also be rare by their anatomical location when arising from the paranasal sinuses, salivary glands and ear. Their location requires knowledge of their specific extension routes, and may call for a specific surgical technique (skull base endoscopic sinus surgery, extended total parotidectomy, etc.) and adapted radiotherapy to spare healthy organs surrounding the tumor. This article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the French ENT Cancer Expertise Network (REFCOR) concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. A second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.
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Affiliation(s)
- Emilien Chabrillac
- Institut universitaire du cancer Toulouse - Oncopole, département de chirurgie, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Caroline Even
- Institut Gustave Roussy, département d'oncologie médicale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Valérie Costes-Martineau
- CHU de Montpellier, département de biopathologie, 191, avenue du doyen Gaston-Giraud, 34295 Montpellier, France
| | - Nicolas Fakhry
- Hôpital La Conception, département de chirurgie ORL et cervico-faciale, 147, boulevard Baille, 13005 Marseille, France
| | - Laurence Digue
- Hôpital Saint-André, département d'oncologie médicale, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - Antoine Moya-Plana
- Institut Gustave Roussy, département de chirurgie ORL et cervico-faciale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Bertrand Baujat
- Hôpital Tenon, département de chirurgie ORL et cervico-faciale, 4, rue de la Chine, 75020 Paris, France
| | - Christian-Adrien Righini
- CHU de Grenoble-Alpes, département de chirurgie ORL et cervico-faciale, 1, avenue du maquis du Grésivaudan, 38700 La Tronche, France
| | - Ludovic De Gabory
- CHU Pellegrin, département de chirurgie ORL et cervico-faciale, 1, place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Benjamin Verillaud
- Hôpital Lariboisière, département de chirurgie ORL et cervico-faciale, 2, rue Ambroise Paré, 75010 Paris, France
| | - Sébastien Vergez
- CHU de Toulouse-Larrey et institut universitaire du cancer Toulouse - Oncopole, département de chirurgie ORL et cervico-faciale, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Juliette Thariat
- Centre François-Baclesse, département de radiothérapie, 3, avenue du général-Harris, 14000 Caen, France.
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Chabrillac E, Even C, Costes-Martineau V, Fakhry N, Digue L, Moya-Plana A, Baujat B, Righini CA, De Gabory L, Verillaud B, Vergez S, Thariat J. [Rare cancers of the head and neck on behalf of the REFCOR, part 2]. Bull Cancer 2023:S0007-4551(23)00202-3. [PMID: 37169602 DOI: 10.1016/j.bulcan.2023.04.007] [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: 02/18/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/13/2023]
Abstract
Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology as well as their anatomical location when arising from the paranasal sinuses, salivary glands and ear. The management of these heterogeneous rare diseases of complex treatment has considerably been structured over the last 15 years, in particular via the French ENT Cancer Expertise Network (REFCOR) and international networks and registries (EURACAN, etc.). Structuration also favors research with identification of new entities and setting up of specific therapeutic trials. A first article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the REFCOR concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. This second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.
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Affiliation(s)
- Emilien Chabrillac
- Institut universitaire du cancer Toulouse-oncopole, département de chirurgie, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Caroline Even
- Institut Gustave Roussy, département d'oncologie médicale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Valérie Costes-Martineau
- CHU de Montpellier, département de biopathologie, 191, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France
| | - Nicolas Fakhry
- Hôpital La Conception, département de chirurgie ORL et cervico-faciale, 147, boulevard Baille, 13005 Marseille, France
| | - Laurence Digue
- Hôpital Saint-André, département d'oncologie médicale, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - Antoine Moya-Plana
- Institut Gustave-Roussy, département de chirurgie ORL et cervico-faciale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Bertrand Baujat
- Hôpital Tenon, département de chirurgie ORL et cervico-faciale, 4, rue de la Chine, 75020 Paris, France
| | - Christian-Adrien Righini
- CHU de Grenoble-Alpes, département de chirurgie ORL et cervico-faciale, 1, avenue du Maquis du Grésivaudan, 38700 La Tronche, France
| | - Ludovic De Gabory
- CHU de Pellegrin, département de chirurgie ORL et cervico-faciale, 1, Place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - Benjamin Verillaud
- Hôpital Lariboisière, département de chirurgie ORL et cervico-faciale, 2, rue Ambroise-Paré, 75010 Paris, France
| | - Sébastien Vergez
- Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse-Larrey, département de chirurgie ORL et cervico-faciale, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Juliette Thariat
- Centre François-Baclesse, département de radiothérapie, 3, avenue du Général-Harris, 14000 Caen, France.
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Sforza S, Palmieri VE, Raspollini MR, Roviello G, Mantovani A, Basso U, Affinita MC, D'Angelo A, Antonuzzo L, Carini M, Minervini A, Masieri L. Robotic approach with neoadjuvant chemotherapy in adult Wilms' tumor: A feasibility study report and a systematic review of the literature. Asian J Urol 2023; 10:128-136. [PMID: 36942112 PMCID: PMC10023547 DOI: 10.1016/j.ajur.2021.10.004] [Citation(s) in RCA: 2] [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: 08/20/2020] [Revised: 06/04/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022] Open
Abstract
Objective The incidence of Wilms' tumor (WT) among adult individuals accounts for less than 1% of kidney cancer cases, with a prognosis usually less favorable when compared to younger individuals and an overall survival rate of 70% for the adult patients versus 90% for the pediatric cases. The diagnosis and treatment of WT are complex in the preoperative setting; neoadjuvant chemotherapy (NAC) or robotic surgery has rarely been described. This study aimed to review the literature of robotic surgery in WT and report the first adult WT management using both NAC and robotic strategy. Methods We reported a case of WT managed in a multidisciplinary setting. Furthermore, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations, a systematic review of the literature until August 2020 of WT treated with a robotic approach was carried out. Results A 33-year-old female had a diagnosis of WT. She was scheduled to NAC, and according to the clinical and radiological response to a robotic radical nephrectomy with aortic lymph nodes dissection, she was managed with no intraoperative rupture, a favorable surgical outcome, and a follow-up of 25 months, which did not show any recurrence. The systematic review identified a total number of 230 cases of minimally invasive surgery reported in the literature for WT. Of these, approximately 15 patients were carried out using robotic surgery in adolescents while none in adults. Moreover, NAC has not been administered before minimally invasive surgery in adults up until now. Conclusion WT is a rare condition in adults with only a few cases treated with either NAC or minimally invasive approach so far. The advantage of NAC followed by the robotic approach could lead to favorable outcomes in this complex scenario. Notwithstanding, additional cases of adult WT need to be identified and investigated to improve the oncological outcome.
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Affiliation(s)
- Simone Sforza
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
- Department of Pediatric Urology, Meyer Children Hospital, University of Florence, Florence, Italy
- Corresponding author. Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy.
| | | | - Maria Rosaria Raspollini
- Histopathology and Molecular Diagnostics, Careggi Hospital, University of Florence, Florence, Italy
| | | | - Alberto Mantovani
- Department of Pediatric Urology, Meyer Children Hospital, University of Florence, Florence, Italy
| | - Umberto Basso
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Maria Carmen Affinita
- Hematology Oncology Division, Department of Women's and Children's Health, Padova University Hospital, Padua, Italy
| | - Alberto D'Angelo
- Department of Biology and Biochemistry, University of Bath, Bath, UK
| | - Lorenzo Antonuzzo
- Clinical Oncologic Unit, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Lorenzo Masieri
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
- Department of Pediatric Urology, Meyer Children Hospital, University of Florence, Florence, Italy
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Hemerková P, Matulová H, Vališ M, Soukup J, Kanta M, Jandura J. Synovial sarcoma of the tibial nerve - case report of a rare tumor in a rare location requiring early diagnosis. BMC Neurol 2023; 23:65. [PMID: 36765281 PMCID: PMC9912578 DOI: 10.1186/s12883-023-03061-5] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/15/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND We present the case of a patient with a rare synovial sarcoma (SS) of the tibial nerve. So far, only 4 cases of patients with SS originating from the tibial nerve have been described in the literature, and our patient is only the second patient whose limb was saved during treatment. Synovial sarcomas are malignant mesenchymal tumors, i.e., tumors arising from connective tissue. Synovial sarcomas account for 5-10% of all soft tissue sarcomas. However, the name synovial sarcoma is misleading, because the tumor does not originate from synovial cells, but rather from primitive mesenchymal cells. The name most likely originated from the localization around the large joints on the limbs, more often on the lower ones, in the area of the knee joints. We point out the aspects of correct and quick diagnosis and subsequent treatment, which has very important effect on the patient's prognosis. Primary less radical excision without prior biopsy verification leads to a higher risk of local recurrence, even if a proper reexcision was performed immediately after biopsy verification of the sarcoma. CASE PRESENTATION A woman born in 1949 began to suffer at the end of 2020 with escalating pain under the left inner ankle with a projection to the sole and fingers. Her personal, family work and social history were insignificant. After the initial neurological examination, the patient was sent for an ultrasound examination of the ankle, which showed a lobular mass measuring 50 × 22 × 16 mm and according magnetic resonance imaging, the finding appeared to be a suspicious neurinoma of the tibial nerve. The tumor was surgically excised, without prior biopsy verification: a 50 × 20 mm tumor was dissected in the distal part of the tarsal canal, which grew through the structure of the tibial nerve and in some places into the surrounding area and appeared intraoperatively as a neurofibroma. But histologically the tumor was classified as monophasic synovial sarcoma. The patient was indicated for a wide reexcision of the skin with the subcutaneous tissue of size 91 × 20 × 15 mm. Now the patient is being treated with external radiotherapy to the tumor bed and she is able to walk. CONCLUSION This report draws attention to a rare type of malignant nerve tumor, which both clinically and radiologically can mimic benign peripheral nerve sheath tumors. Synovial sarcoma should be considered in very painful resistances, typically located around the joints of the lower limbs, the growth of which can be slow. Because the size of the tumor is a negative prognostic factor, it is necessary to make a timely diagnosis using MR imaging and a biopsy with histological examination and to start treatment quickly. Surgical treatment should take place only after a biopsy with histological examination of the tumor so that it is sufficiently radical and does not have to undergo an additional reoperation, as happened in the case of our patient.
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Affiliation(s)
- Pavlína Hemerková
- Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
| | - Hana Matulová
- grid.412539.80000 0004 0609 2284Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Martin Vališ
- grid.412539.80000 0004 0609 2284Department of Neurology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jiří Soukup
- grid.412539.80000 0004 0609 2284The Fingerland department of Pathology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Martin Kanta
- grid.412539.80000 0004 0609 2284Department of Neurosurgery, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jiří Jandura
- grid.412539.80000 0004 0609 2284Department of Radiology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Mansour S, Kluger Y, Khuri S. Adult Primary Retroperitoneal Lymphangioma: Updated Facts. World J Oncol 2023; 14:15-20. [PMID: 36896002 PMCID: PMC9990737 DOI: 10.14740/wjon1561] [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: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 02/28/2023] Open
Abstract
Lymphangioma is a rare, benign tumor of the lymphatic system. It is believed to be a congenital malformation, when part of the lymphatic channels fail to connect to the main lymphatic system. Lymphangioma is a tumor of the pediatric age, with 50% of patients presenting at birth. The head and neck are the main affected sites (75%), while the retroperitoneal cavity is the least affected area, and comprises less than 1% of cases. Adult lymphangioma is an extremely rare tumor, and adult retroperitoneal lymphangioma (ARL) is even a rarer tumor. Over the last two decades, we have experienced a significant increase in reports published in the English literature discussing ARL. As reports have increased, several questions about previously known facts regarding this tumor arose: For years, it was known that ARL is usually an asymptomatic tumor which is incidentally found - is it a true claim? Is abdominal magnetic resonance imaging the radiological test of choice for diagnosis? What is the best therapeutic option? The main aim for this article is to review the current and old English literature concerning ARL, in order to collect data regarding demographic features, clinical presentation, imaging tests used for diagnosis, therapeutic options and follow-up. This in turn will give precise updated answers for the previous questions. In addition, it will raise awareness for the treating physician regarding the most effective approach for early diagnosis and best therapeutic option to be selected.
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Affiliation(s)
- Subhi Mansour
- General Surgery Department, Rambam Medical Center, Haifa, Israel
| | - Yoram Kluger
- General Surgery Department, Rambam Medical Center, Haifa, Israel
- HPB and Surgical Oncology Unit, Rambam Medical Center, Haifa, Israel
| | - Safi Khuri
- General Surgery Department, Rambam Medical Center, Haifa, Israel
- HPB and Surgical Oncology Unit, Rambam Medical Center, Haifa, Israel
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Abstract
Primary tumors of the spleen are rare, with an incidence rate of about 0.1%. These tumors could be benign, usually asymptomatic, or malignant which are usually symptomatic with abdominal pain being the most common symptom. Lymphoid neoplasms are the most common primary splenic tumors. Primary angiosarcoma is one of the extremely rare malignant vascular neoplasms of the spleen, which carries a dismal prognosis. It constitutes almost 7.4% of all primary malignant splenic neoplasms and is well known as an aggressive tumor with high local recurrence and distant metastasis rates. Overall survival is up to 12 months following diagnosis, regardless of management strategy. Due to the broad differential diagnosis of splenic tumors, this tumor is often forgotten, and is very challenging to diagnose early. Less than 300 cases of primary splenic angiosarcoma have been reported in the English literature. The main issue of this article is to review the current English literature to figure out the characteristic demographic features, clinical presentation, imaging findings and management of such tumors, in order to increase awareness of the treating physicians to improve diagnosis, management, as well as overall survival.
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Affiliation(s)
- Mira Damouny
- General Surgery Department, Rambam Medical Center, Haifa, Israel
| | - Subhi Mansour
- General Surgery Department, Rambam Medical Center, Haifa, Israel
| | - Safi Khuri
- General Surgery Department, Rambam Medical Center, Haifa, Israel,HPB and Surgical Oncology Unit, Rambam Medical Center, Haifa, Israel,Corresponding Author: Safi Khuri, HepatoPancreatoBiliary Surgical Unit, General Surgery Department, Rambam Medical Care Center, Haa’leya Hashniya, Haifa 31096, Israel.
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12
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Abstract
Retroperitoneal tumors (RPTs) are very rare tumors that arise in the large space of the retroperitoneum. About two-third of these tumors are malignant, of which soft tissue sarcoma (STS) is the most common and comprises almost one-third of malignant RPTs. Twenty to thirty percent of RPTs are benign. The retroperitoneal cavity has a very large potential space for tumor enlargement to a very high diameters without causing specific symptoms, especially during the initial phase of tumor enlargement. On diagnosis, the average tumor weight is 15 - 20 kg and tumor diameter is 20 - 25 cm. The most common retroperitoneal sarcoma type is liposarcoma, which account for 20% of all sarcoma types and 40% of all retroperitoneal sarcomas (RPSs). Other less common STS arise in the retroperitoneum include leiomyosarcoma and undifferentiated pleomorphic type. Giant liposarcoma is usually defined either as tumor diameter of 30 cm or more or tumor weight of 20 kg or higher. This specific type of sarcoma is very uncommon, with few case reports published in the English literature. Herein, we present a case of a healthy 33-year-old male patient, who was admitted due to abdominal distension and increased body weight since few months. An abdominopelvic computed tomography (CT) scan demonstrated a giant retroperitoneal mass of almost 40 cm in diameter in its largest dimension, located in the right retroperitoneal space. Ultrasound (US)-guided fine needle biopsy (FNB) was consistent with well differentiated liposarcoma. Surgical resection of the tumor along with the right colon, right ureter and kidney, third and fourth duodenal parts and part of the right iliopsoas muscle was contemplated. Histopathological report revealed well-differentiated liposarcoma of 50 cm in diameter, with foci of dedifferentiation, presented by pleomorphic sarcoma. Surgical margins were microscopically negative.
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Affiliation(s)
- Subhi Mansour
- Department of General Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Nassim Azzam
- Department of General Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Yoram Kluger
- Department of General Surgery, Rambam Medical Care Center, Haifa, Israel,HepatoPancreatoBiliary and Surgical Oncology Unit, Rambam Medical Care Center, Haifa, Israel
| | - Safi Khuri
- Department of General Surgery, Rambam Medical Care Center, Haifa, Israel,HepatoPancreatoBiliary and Surgical Oncology Unit, Rambam Medical Care Center, Haifa, Israel,Corresponding Author: Safi Khuri, HepatoPancreatoBiliary and Surgical Oncology Unit, General Surgery Department, Rambam Medical Care Center, Haa’leya Hashniya, Haifa 31096, Israel.
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13
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De Luca P, Scarpa A, Viola P, Motta G, Iacobelli A, Gencarelli A, Masola R, Oliva F, Bocchetti M, Camaioni A, Ricciardiello F. Collision tumors of the larynx: A retrospective single-center case series of an extremely rare phenomenon. Oral Oncol 2022; 134:106096. [PMID: 36041357 DOI: 10.1016/j.oraloncology.2022.106096] [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: 08/16/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy; Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy.
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Giovanni Motta
- Ear, Nose, and Throat Unit, AORN "Antonio Cardarelli", Naples, Italy
| | | | | | - Roberta Masola
- Department of Anesthesia and Intensive Care, AORN Cardarelli Hospital, Naples, Italy
| | - Flavia Oliva
- Ear, Nose, and Throat Unit, AORN "Antonio Cardarelli", Naples, Italy
| | - Marco Bocchetti
- Laboratory of Molecular and Precision Oncology, Biogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
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14
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Mansour S, Derkach E, Abergil V, Khuri S. Carcinosarcoma of the Gallbladder: A Rare Tumor. World J Oncol 2022; 13:103-106. [PMID: 35837320 PMCID: PMC9239502 DOI: 10.14740/wjon1495] [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: 05/14/2022] [Accepted: 06/13/2022] [Indexed: 02/05/2023] Open
Abstract
Malignant tumors of the gallbladder are rare, with adenocarcinoma being the most common histological subtype. Carcinosarcoma of the gallbladder, first described in 1907 by Landsteiner, is an extremely rare tumor which comprises less than 1% of the uncommon gallbladder cancers. This unique type of tumor can develop at any major organ, with the uterus being the most common one. Being a tumor that contains epithelial and mesenchymal components, histopathological diagnosis of such rare tumor is a challenging issue. Up to date, there are less than 100 cases of gallbladder carcinoasarocoma reported in the English literature. Therefore, experience and knowledge regarding this rare disease are very limited. Due to the fact that gallbladder carcinosarcoma is a rare and highly forgotten tumor, this article aims to review the English literature to increase awareness of the treating physician to improve diagnosis, management, as well as overall survival.
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Affiliation(s)
- Subhi Mansour
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Elena Derkach
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | | | - Safi Khuri
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
- HPB and Surgical Oncology Unit, Surgery Department, Rambam Health Care Campus, Haifa, Israel
- Corresponding Author: Safi Khuri, HPB and Surgical Oncology Unit, General Surgery Department, Rambam Health Care Campus, Haa’leya Hashniya, Haifa 31096, Israel.
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15
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Koizumi T, Otsuki K, Tanaka Y, Kanda S. Epidemiology of neuroendocrine neoplasmas in Japan: based on analysis of hospital-based cancer registry data, 2009 - 2015. BMC Endocr Disord 2022; 22:105. [PMID: 35443668 PMCID: PMC9022253 DOI: 10.1186/s12902-022-01016-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Neuroendocrine neoplasms are rare disease and could originate from throughout the body, however, there have been little epidemiological studies in Japan, especially the organ distribution. This study was to examine the epidemiological information of neuroendocrine neoplasms in the Japanese population using data from a hospital-based cancer registry. METHODS Using data from the national database of hospital-based cancer registries, we examined the organ distribution, the stage and initial treatment of neuroendocrine neoplasms newly diagnosed and treated in designated and non-designated cancer care hospitals between 2009 and 2015. In the present study, neuroendocrine neoplasms consisted of neuroendocrine tumors and carcinoma. RESULTS A total of 33,215 (17,485 neuroendocrine carcinomas and 15,730 neuroendocrine tumors) cases were diagnosed. The majority in neuroendocrine carcinoma occur in lung (31.1%) followed in decreasing frequency by stomach (12.9%), pancreas (7.5%), rectum (6.7%) and esophagus (5.8%). On the other hand, the half of neuroendocrine tumor originated rectum (50.9%) and followed by pancreas (13.9%), duodenum (9.0%), lung/bronchus (8.9%), and stomach (8.7%). Neuroendocrine carcinoma presented at more advanced stage and higher age than neuroendocrine tumors. Most cases of neuroendocrine tumors were treated surgically, while half of neuroendocrine carcinomas were treated with non-surgical therapy consisting of chemotherapy with or without radiotherapy. CONCLUSIONS Our results demonstrated that neuroendocrine neoplasms could originate from various organs and the site distribution was different between neuroendocrine carcinoma and tumor. The national database of hospital-based cancer registries in Japan is a valuable source for evaluating the organ distribution of the rare systemic disease.
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Affiliation(s)
- Tomonobu Koizumi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
| | - Kengo Otsuki
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Yuriko Tanaka
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Shintaro Kanda
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
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16
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Tormen F, Banchelli F, Masciale V, Maiorana A, Morandi U, Aramini B. The importance of medical treatment before surgery in pleomorphic carcinoma of the lung: A case series study. Int J Surg Case Rep 2021; 86:106275. [PMID: 34392016 PMCID: PMC8365429 DOI: 10.1016/j.ijscr.2021.106275] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction and importance Pleomorphic carcinoma of the lung is a rare malignant epithelial tumor. Due to its rarity, its clinicopathological characteristics are not clear, and there is no defined therapeutic path for this type of tumor. Case presentation We retrospectively analyzed the medical and pathological reports of 8 patients who underwent surgical resection for pleomorphic carcinoma between 2007 and 2010. Clinical discussion Eight patients were analyzed (7 males and 1 female, mean age 60). All patients underwent CT scans, and the average diameter of the nodules was 56 mm. Four patients were also investigated with FDG-PET with hypermetabolic activity in all four cases. In four patients, the carcinomatous component was adenocarcinoma (all with sarcomatoid component of spindle cell and giant cell carcinoma), although in two patients, it was squamous cell carcinoma (one with spindle cell and one with giant cell). In the two remaining patients, one showed a non-small cell carcinoma with giant cell carcinoma, and the other was a non-small cell carcinoma and squamous cell carcinoma with spindle and giant cell carcinoma. All cases were treated with surgical resection. Only two patients underwent neoadjuvant chemotherapy. At the time of data analysis, only one patient treated with neoadjuvant chemotherapy was alive. Conclusion The prognosis for these patients with a diagnosis of pleomorphic carcinoma undergoing surgery is generally better than those not treated with surgical resection, however the survival remains poor. Although with low number of patients, our research would suggest to consider neoadjuvant chemotherapy an appropriate approach for improving the outcomes before surgery. Pleomorphic carcinoma of the lung Rare malignant epithelial tumor Clinicopathological characteristics unclear Not defined therapeutic path Neoadiuvant chemotherapy improves the prognosis.
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Affiliation(s)
- Francesco Tormen
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Banchelli
- Center of Statistic, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Italy
| | - Valentina Masciale
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Antonino Maiorana
- Institute of Pathology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Italy.
| | - Uliano Morandi
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Beatrice Aramini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Wan S, Sun X, Chang W, Mi J. Laparoscopic surgery in the treatment of rare adrenal tumors. Asian J Surg 2021; 44:759-760. [PMID: 33642149 DOI: 10.1016/j.asjsur.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Shun Wan
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - Xiaohong Sun
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Wei Chang
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - Jun Mi
- Division of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
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18
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Huda T, Parwez MM, Pandya B. Metastatic Hepatic Epitheloid Hemangioendothelioma in a Young Male: A Rare Presentation. Gastrointest Tumors 2021; 8:58-62. [PMID: 33981683 DOI: 10.1159/000513963] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022] Open
Abstract
Hepatic EHE (epithelioid hemangioendothelioma) is an uncommon entity of vascular origin and a low-grade malignant tumor. Primary hepatic EHE is rare. These tumors can be multifocal at presentation like in the soft tissues, bones, brain, liver, and small intestine. First described by Weiss and Enzinger in 1982 as a malignant vascular neoplasm with indolent behavior. We report the case of a 23-year-old male, known case of chronic liver disease, who presented with incisional hernia following exploratory laparotomy 8 months back, performed for intestinal obstruction. Contrast-enhanced computed tomography abdomen revealed an incisional hernia with a large defect along with multiple lesions in the liver (suspected metastases) and peritoneal deposits and a few discrete lung nodules. Some areas of interloop collections were also noted. Biopsies were taken from the liver which revealed benign cirrhotic lesion. Relevant to the findings, multiple biopsies were performed and fluid was sent for evaluation. The liver biopsy came out positive for borderline vascular malignancy (epithelioid hemangioendothelioma). This was confirmed with the immunohistochemistry report. Epithelioid hemangioendothelioma occurs mostly in soft tissues of extremity and lungs. The involvement of the liver may be seen as metastasis or rarely as a primary tumor. The incidence of primary malignant hepatic hemangioendothelioma is about 0.1/100,000; the mean age at the time of diagnosis is 41.7 years, and male:female ratio is 2:3. Liver transplantation, hepatectomy, chemoembolization, radiotherapy, and chemotherapeutic agents are reported treatment regimens. Malignant EHE of liver presents as multiple hepatic nodules. Being locally aggressive, it can invade the peritoneum, gut, and lungs. Orthoptic liver transplantation appears to be the only remedy because of the multifocal nature of the disease. Partial hepatectomy is possible for localized tumors.
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Affiliation(s)
- Tanweerul Huda
- Department of General Surgery, AIIMS, Bhopal, Madhya Pradesh, India
| | | | - Bharati Pandya
- Department of General Surgery, AIIMS, Bhopal, Madhya Pradesh, India
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Lorini L, Ardighieri L, Bozzola A, Romani C, Bignotti E, Buglione M, Guerini A, Lombardi D, Deganello A, Tomasoni M, Bonini SA, Sigala S, Farina D, Ravanelli M, Bossi P. Prognosis and management of recurrent and/or metastatic head and neck adenoid cystic carcinoma. Oral Oncol 2021; 115:105213. [PMID: 33578204 DOI: 10.1016/j.oraloncology.2021.105213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 09/04/2020] [Revised: 01/10/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023]
Abstract
Adenoid cystic carcinoma (ACC) is a rare tumor, usually arising in the salivary gland, accounting for 1% of all head and neck cancers. ACC may have a long-term poor prognosis, as about 40% of radically treated patients will recur locoregionally and up to 60% will develop distant metastasis. Factors influencing risk of recurrence have been well studied, but few data exist about prognostic factors in Recurrent/Metastatic (RM) setting. Moreover, treatment of RM ACC is often a challenge for clinicians, in the context of a rare disease, which may have an indolent clinical behavior or less frequently a quicker growth and with a paucity of available clinical trials. This review critically analyzes pathological and molecular prognostic factors in RM ACC and make an overview on actual therapeutic choices and future direction of therapy. Recognized prognostic factors in RM ACC are the presence and site of distant metastasis (lung vs other), the presence of nodal metastasis and of extranodal extension, skull base recurrence, disease free interval, lymphovascular invasion, solid histotypes and grading of disease, and the presence of mutation of NOTCH1 family, PI3K, and TP53. Due to disappointing results with chemotherapy, new approaches are under study, also on the basis of biomolecular research. Ongoing clinical trials are evaluating treatment targeting MYB and NOTCH1 alterations, immunotherapy or combination of targeted treatments and immune checkpoint inhibitors.
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Affiliation(s)
- Luigi Lorini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Laura Ardighieri
- Department of Pathology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Anna Bozzola
- Department of Pathology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Chiara Romani
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST-Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Eliana Bignotti
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST-Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Michela Buglione
- Radiation Oncology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Andrea Guerini
- Radiation Oncology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Davide Lombardi
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Deganello
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Sara Anna Bonini
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Sandra Sigala
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Davide Farina
- Department of Radiology, University of Brescia, Italy
| | | | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
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Chen ZZ, Huang W, Wei ZQ. Small-cell neuroendocrine carcinoma of the rectum - a rare tumor type with poor prognosis: A case report and review of literature. World J Clin Cases 2020; 8:6095-6102. [PMID: 33344610 PMCID: PMC7723721 DOI: 10.12998/wjcc.v8.i23.6095] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/02/2020] [Accepted: 10/27/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Small-cell neuroendocrine carcinoma (SNEC) of the rectum is a rare tumor associated with poor prognosis. CASE SUMMARY We report a case of a 77-year-old male who came into our hospital because of blood with his stool. An endoscopy revealed a cauliflower-like neoplasm in his rectum. Imaging examination showed that the lesion in the upper rectum was likely rectal cancer, and there was no evidence of metastasis. The patient was treated with surgery. Pathological examination confirmed SNEC of the rectum and an R0 resection was achieved. However, 1 mo after the operation, the patient developed intestinal and ureteral obstructions due to peritoneal metastases. Finally, the patient died from renal failure. CONCLUSION SNEC of the rectum is a high-grade carcinoma with an aggressive phenotype, and surgery should be cautiously considered.
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Affiliation(s)
- Zhen-Zhou Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Wang Huang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
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Gamboa-Hoil SI, Silva-Godínez JC, Abrego-Vásquez JA. Adenoid cystic carcinoma of head and neck. A 5-year retrospective study: Experience in a single third-level reference center. CIR CIR 2020; 88:34-40. [PMID: 31967612 DOI: 10.24875/ciru.19000919] [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] [Indexed: 11/17/2022]
Abstract
Introduction Adenoid cystic carcinoma (ACC) is a rare tumor, with an annual incidence of 3-4.5 cases/million. Materials and methods We conducted a descriptive and retrospective study. We included patients diagnosed with ACC of head and neck of a single third-level referral center, from January 2008 to December 2013. Results A total of 23 patients were included in the study, 10 males (43.5%) and 13 females (56.5%) (F:M ratio 1.3:1). Median age was 52 years. Localization was predominantly observed in the oral cavity (26%) followed by the palate (17.4%). At presentation, 15 patients (65.2%) had clinical Stage II. The most frequent histology was the cribriform type in 10 patients (43.5%). Following resection, positive margins were observed in 15 (65.2%), neural invasion in 8 (34.8%), and lymphovascular invasion in 2 (8.7%) patients. The median time to recurrence in our population was 23 months. Recurrence at 5 years was observed in 15 patients (65%). At 2 years, recurrence was predominantly local in 7 patients (46%); whereas after 2 years, it was predominantly pulmonary 6 patients (40%). Overall, 5 year-survival was 78%. Conclusions Cystic adenoid carcinoma is characterized by a high recurrence rate. Nevertheless, it has a high overall 5-year survival, which justifies an aggressive treatment.
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Affiliation(s)
- Sergio I Gamboa-Hoil
- Departamento de Cabeza y Cuello. Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguridad Social, Ciudad de México, México
| | - Juan C Silva-Godínez
- Departamento de Cirugía. Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguridad Social, Ciudad de México, México
| | - José A Abrego-Vásquez
- Departamento de Cirugía. Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguridad Social, Ciudad de México, México
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22
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Dumont B, Lemelle L, Cordero C, Couloigner V, Bernard S, Cardoen L, Brisse HJ, Jehanno N, Fréneaux P, Helfre S, Rouffiange L, Réguerre Y, Orbach D. Esthesioneuroblastoma in children, adolescents and young adults. Bull Cancer 2020; 107:934-945. [PMID: 32896369 DOI: 10.1016/j.bulcan.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/25/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022]
Abstract
The esthesioneuroblastoma (ENB) is characterized as a rare malignant sinonasal tumor of neuroectodermal origin. Its starting point is the olfactory epithelium located in the upper part of the nasal cavities. Different nomenclatures have been proposed, but the most common are "esthesioneuroblastoma" and "olfactory neuroblastoma". ENBs have a bimodal distribution and mainly occur in teenagers, young adults and people aged 50-60. It is a very rare tumor in pediatrics since only around 100 cases have been reported so far. Within ENBs, we can distinguish tumors with different biological behavior ranging from localized forms with slow evolution to aggressive and metastatic forms at onset. In addition, precisely diagnosing undifferentiated tumors and distinguishing them from other etiologies of sinonasal tumors are sometime difficult. Added to its very low incidence, these characteristics make the study of ENB complicated. The standard treatment currently includes broad surgery followed by radiation therapy in localized resectable tumors. Neoadjuvant chemotherapy is indicated in large unresectable tumors and in metastatic forms. However, in certain indications, such as high-grade operable tumors, the role of perioperative chemotherapy remains to be defined. The objective of this analysis is to detail current knowledge regarding ENBs' epidemiological, biological, clinical and radiological characteristics as well as how to manage ENB in young patients.
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Affiliation(s)
- Benoit Dumont
- PSL research university, Institut Curie, SIREDO oncology center (care, innovation and research for children and AYA with cancer), Paris, France.
| | - Lauriane Lemelle
- PSL research university, Institut Curie, SIREDO oncology center (care, innovation and research for children and AYA with cancer), Paris, France
| | - Camille Cordero
- PSL research university, Institut Curie, SIREDO oncology center (care, innovation and research for children and AYA with cancer), Paris, France
| | - Vincent Couloigner
- Assistance publique-Hôpitaux de Paris, hôpital Necker-Enfants malades, department of head and neck surgery, Paris, France
| | - Sophie Bernard
- Assistance publique-Hôpitaux de Paris, hôpital Robert-Debré, department of head and neck surgery, Paris, France
| | | | - Hervé J Brisse
- Institut Curie, department of medical imaging, Paris, France
| | - Nina Jehanno
- Institut Curie, department of nuclear medicine, Paris, France
| | - Paul Fréneaux
- Institut Curie, department of diagnostic and theranostic medicine, Paris, France
| | - Sylvie Helfre
- Institut Curie, department of radiotherapy, Paris, France
| | - Lucie Rouffiange
- PSL research university, Institut Curie, SIREDO oncology center (care, innovation and research for children and AYA with cancer), Paris, France
| | - Yves Réguerre
- CHU de Saint-Denis, pediatric oncology and hematology unit, Saint-Denis, La Reunion, France
| | - Daniel Orbach
- PSL research university, Institut Curie, SIREDO oncology center (care, innovation and research for children and AYA with cancer), Paris, France
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23
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Hassani Y, Ramla S, Zouak A, Ahouansou N, Beltramo G, Pages PB, Georges M, Bonniaud P. [Sclerosing pneumocytoma: A rare and benign tumor]. Rev Mal Respir 2020; 37:743-747. [PMID: 32868166 DOI: 10.1016/j.rmr.2020.08.003] [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: 06/09/2020] [Accepted: 08/05/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sclerosing pneumocytoma is a benign and rare lung tumor affecting epithelial cells. In most cases, patients are asymptomatic and the diagnosis is made on an X ray or a CT scan performed for other enquiry. Sex ratio favors women. Epidemiological studies report that middle-aged Asian women are more frequently affected. Radiological investigations find a solitary nodule or a mass with peripheric localization. When performed, histological analysis shows a tumor composed of at least two of the four following architectures: papillary, sclerosing, hemangiomatous and solid, with two types of cells that can be round or cubic cells. CASES REPORT We report two cases of multiple sclerosing pneumocytoma in two caucasien men. The first patient was asymptomatic, the second complain from moderate dyspnea. A wedge resection was performed in both, allowing diagnosis. Anatomopathology revealed respectively a predominant sclerosing and solid architecture and a sclerosing and papillary architecture. There was no progression of the other concomitant nodules after three years follow-up. CONCLUSION Pneumocytoma is a benign, slow-growing tumor with good prognosis.
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Affiliation(s)
- Y Hassani
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - S Ramla
- Service d'Anatomo-pathologie, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France
| | - A Zouak
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - N Ahouansou
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - G Beltramo
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France; Inserm U123-1, Dijon, France
| | - P-B Pages
- Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France; Service de chirurgie cardiovasculaire et thoracique, Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - M Georges
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France
| | - P Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adulte de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France; Inserm U123-1, Dijon, France.
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24
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Matsuo K, Machida H, Matsuzaki S, Grubbs BH, Klar M, Roman LD, Sood AK, Gershenson DM, Wright JD. Evolving population-based statistics for rare epithelial ovarian cancers. Gynecol Oncol 2020; 157:3-11. [PMID: 31954534 DOI: 10.1016/j.ygyno.2019.11.122] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/18/2019] [Revised: 10/30/2019] [Accepted: 11/29/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe how population-based statistics for rare epithelial ovarian cancers are evolving. METHODS This is a retrospective observational study examining the Surveillance, Epidemiology, and End Results Program from 1988 to 2016. Overall survival (OS) of clear cell (OCCC), mucinous (MOC), and low-grade serous (LGSOC) ovarian cancers were compared to high-grade serous ovarian cancer (HGSOC) by fitting a propensity score matching. RESULTS Among 113,365 ovarian malignancies, 5780 OCCCs (5.1%), 7561 MOCs (6.7%), and 2021 LGSOCs (1.8%) were compared to 38,199 HGSOCs. OCCCs and MOCs were more likely to be diagnosed with stage I disease compared to HGSOC (57.0-59.5% versus 8.6%, P<0.001). For early-stage disease, OCCC (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.82-1.01) and MOC (HR 0.94, 95%CI 0.85-1.04) had similar OS to HGSOC whereas LGSOC had superior OS (HR 0.93, 95%CI 0.89-0.97) versus HGSOC. Conversely, for advanced-stage disease, OCCC (HR 1.42, 95%CI 1.32-1.53) and MOC (HR 1.11, 95%CI 1.09-1.13) had poorer OS whereas LGSOC (HR 0.86, 95%CI 0.84-0.89) had superior OS compared to HGSOC. OCCC (HR range, 1.92-2.45) and MOC (HR range, 1.73-2.22) had particularly poorer OS in the first three years following diagnosis compared to HGSOC. Population-level statistics for advanced-stage disease showed that 5-year OS rates have increased in HGSOC (16.9% to 36.8%, P<0.001) and LGSOC (50.8% to 66.4%, P=0.010); but remain unchanged for OCCC (21.0% to 28.2%, P=0.174) and MOC (21.4% to 16.5%, P=0.102). CONCLUSION OCCC, MOC, and LGSOC comprise 2-7% of ovarian malignancies, have distinct characteristics and survival compared to HGSOC. While these rare tumors have a favorable to comparable prognosis in early-stage disease, disproportionally poor survival in advanced-stage OCCC and MOC highlights the need for further research into novel treatment strategies.
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Affiliation(s)
- Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
| | - Hiroko Machida
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Shinya Matsuzaki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Maximilian Klar
- Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany
| | - Lynda D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Anil K Sood
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD-Anderson Cancer Center, Houston, TX, USA
| | - David M Gershenson
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD-Anderson Cancer Center, Houston, TX, USA
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Huang Y, Yang W, Hu J, Zhu Z, Qin H, Han W, Wang H. Diagnosis and treatment of pancreatoblastoma in children: a retrospective study in a single pediatric center. Pediatr Surg Int 2019; 35:1231-8. [PMID: 31338582 DOI: 10.1007/s00383-019-04524-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Pancreatoblastoma is a very rare malignant pancreatic tumor in children. Pancreatoblastoma is the most common pancreatic tumor in children less than 10 years of age, accounting for 25% of the pancreatic neoplasm. There were only a few published literatures about the standardized diagnostic and management protocol for PB in the last decade. OBJECTIVE To summarize our experience in the management of pancreatoblastoma in children and adolescents with emphasis on the presentation, diagnosis, treatment, and outcomes. A management strategy will also be discussed. METHODS This was a retrospective case-series study of all pancreatoblastoma in patients < 18 years of age who were treated at Beijing children's hospital (BCH) from January 2002-January 2015. The diagnoses of PB were confirmed by histopathology analysis of the resected specimen. The variables being analyzed included patient demographics, age at diagnosis, clinical presentation, tumor size, metastasis if present, tumor markers (AFP), type of surgery, length of follow-up, and outcome. The assessment of the tumor location, size, extent of the tumor, and distant metastasis was made by ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging (MRI). RESULT 21 patients with pancreatoblastoma were diagnosed at a median age of 4 years, 7 girls, and 14 boys. The diagnosis of pancreatoblastoma was identified by the histology examination. The most common syndrome was abdominal mass (n = 11), followed by abdominal pain (N = 10), elevated serum AFP levels were noted in almost all cases (17/18), 17 patients with disease initially unresectable on diagnosis accepted neo-adjuvant chemotherapy consisting of CDV, OPEC, PLADO, IEV, and AVCP. All patients underwent surgery, including pancreaticoduodenectomy (Whipple's procedure), the Pylorus-preserving pancreaticoduodenectomy (traverse-Longmire procedure), Spleen-preserving distal pancreatectomy, and distal pancreatectomy with en bloc splenectomy, Roux-en-Y end-to-end pancreatojejunostomy. In all, 13 children were disease free with a median follow-up of 53 months (range 11-156 months). CONCLUSIONS The pancreatoblastoma in children and adolescents is a malignant tumor. Complete resection combined with chemotherapy is associated with long-term survival. For the unresectable tumor at diagnosis, preoperative chemotherapy was recommended to reduce tumor volume. AFP is critical for diagnosis and monitoring the disease as a tumors marker.
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26
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Chen S, Luo P, Yang L, Zheng B, Sun Z, Yan W, Wang C. Prognostic analysis of surgically treated clear cell sarcoma: an analysis of a rare tumor from a single center. Int J Clin Oncol 2019; 24:1605-1611. [PMID: 31243628 PMCID: PMC6861539 DOI: 10.1007/s10147-019-01487-x] [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: 04/13/2019] [Accepted: 06/05/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND The objective of this retrospective study was to evaluate the prognostic value of various factors in clear cell sarcoma patients after radical surgery. METHODS Forty-two clear cell sarcoma patients from August 2006 to March 2018 were included in the study. Curves of disease-free survival and overall survival were calculated using the Kaplan-Meier method, and univariate and multivariate analyses of various prognostic factors were performed using a Cox proportional hazard regression model. Laboratory test of peripheral blood was recorded before surgery. The optimal cutoff value of systemic inflammatory markers was defined by receiver-operating curve analysis. RESULTS The 5-year DFS and 5-year OS rate were 22% and 46%, respectively. The median DFS and OS times were 12 and 41.5 months, respectively. In univariate analysis, there was a significant association between shorter DFS and tumor size larger than 5 cm (p = 0.0043), positive surgical margin (p = 0.0233), and the neutrophil-to-lymphocyte ratio (NLR) higher than 2.73 (p = 0.0009). Furthermore, we observed a significant association between shorter OS and tumor size larger than 5 cm (p = 0.0075), positive surgical margin (p = 0.0101), NLR higher than 2.73 (p = 0.0126), the platelet-to-lymphocyte ratio (PLR) higher than 103.89 (p = 0.0147) and the lymphocyte-to-monocyte ratio (LMR) lower than 4.2 (p = 0.0445). A multivariate analysis demonstrated that the surgical margin (p = 0.013) and NLR (p = 0.001) were significantly associated with DFS. Tumor size (p = 0.010) and NLR (p = 0.013) were independent prognostic factors for OS. CONCLUSIONS This study had the second largest sample around the world and preoperative NLR may be a useful prognostic factor in CCS patients after radical surgery.
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Affiliation(s)
- Shiqi Chen
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Peng Luo
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Lingge Yang
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Biqiang Zheng
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhengwang Sun
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wangjun Yan
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Chunmeng Wang
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Yang HB, Namgoong JM, Kim KH, Kim DY, Park J, Shin HB, Youn JK, Lee S, Lee JW, Jung SE, Chung JH, Choe YM, Heo TG, Ho IG, Kim HY. Pediatric Adenocarcinoma in Korea: A Multicenter Study. Cancer Res Treat 2019; 52:117-127. [PMID: 31163958 PMCID: PMC6962484 DOI: 10.4143/crt.2019.092] [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: 03/13/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose Adenocarcinoma is an extremely rare malignancy in the pediatric population. Research regarding pediatric adenocarcinoma is very rare in Korea. This study aimed to investigate the clinical features of pediatric adenocarcinomas of various primary organ sites in Korea. Materials and Methods Pediatric patients under 18 years, diagnosed with adenocarcinoma of various sites between January 1995 and December 2016, were included. We retrospectively reviewed patient and tumor characteristics and calculated survival estimates, reported as 5-year survival rate and 95% confidence interval. Results Of 80 patients (median age, 15 years; range, 10 to 17 years), 37 (46.3%) were men, and 24 (30%) had a family history of cancer or underlying disease relevant to malignancy. The cancer locations were the colon and rectum (n=32), ovaries (n=18), stomach (n=15), lung (n=4), small bowel (n=1), and other sites (n=10). Totally, 54.8% patients (42/77) had stage 3 or 4 disease. The median follow-up period was 2.0 years (range, 0 to 20.4). The 5-year overall survival estimate for all patients, and for those with stomach, colorectal, ovarian, and other cancer sites were 57.9%±11.5%, 58.2%±25.7%, 41.5%±18.2%, 87.5%±16.2%, and 64.0%±34.4%, respectively. The 5-year survival rate differed significantly between categories of adenocarcinomas into gastrointestinal (GI) (44.7%) and non-GI adenocarcinomas (78.8%) (p=0.007). The 5-year survival rate also differed significantly according to carcinoembryonic antigen level (69.3% in < 3 ng/mL, 23.8% in > 3 ng/mL; p < 0.001). Conclusion In pediatric patients, adenocarcinomas arise from various organs and are often diagnosed at advanced stages. Large, prospective studies for their accurate clinical characteristics and prognostic factors are needed.
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Affiliation(s)
- Hee-Beom Yang
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Jung-Man Namgoong
- Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Hoon Kim
- Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Dae Yeon Kim
- Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinyoung Park
- Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Beak Shin
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Eun Jung
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hee Chung
- Department of Pediatric Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Mee Choe
- Department of Pediatric Surgery, Inha School of Medicine, Incheon, Korea
| | - Tae Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University, Goyang, Korea
| | - In Geol Ho
- Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
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Darrason M, Martin A, Soussan M, Chouahnia K, Pailler MC, Boudabous H, Brillet PY, Bousquet G, Zelek L, Duchemann B. Immunotherapy for LELC: Case Report and a Focused Review. Clin Lung Cancer 2018; 20:e393-e401. [PMID: 30691964 DOI: 10.1016/j.cllc.2018.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 08/09/2017] [Revised: 10/15/2018] [Accepted: 12/10/2018] [Indexed: 12/28/2022]
Abstract
Lymphoepithelioma-like carcinoma of the lung (LELC) is a rare, Epstein-Barr virus-associated tumor. LELC occurs mostly in young, Asian nonsmokers. A few hundred cases have been reported, mostly from retrospective Asian studies. Optimal treatment has not been clearly established. Treatment options are based on surgery for early stage and on cisplatin-based chemotherapy as first-line therapy for metastatic disease. Prognosis may seem better than for other types of non-small-cell lung cancer, but it remains poor in advanced disease, with a median survival of 24 months, and new treatments options are still warranted. Immunotherapies are now key players in the treatment of non-small-cell lung cancer. However, few data are available for this rare histologic subgroup. We have reviewed the available data on LELC with a focus on the first few cases reported with a response to a programmed cell death 1 inhibitor.
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Affiliation(s)
- Marie Darrason
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Antoine Martin
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Michael Soussan
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Kader Chouahnia
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Marie-Christine Pailler
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Hanene Boudabous
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Pierre-Yves Brillet
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Guilhem Bousquet
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Laurent Zelek
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Boris Duchemann
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France.
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De Martino L, Errico ME, Ruotolo S, Cascone D, Chiaravalli S, Collini P, Ferrari A, Muto P, Cinalli G, Quaglietta L. Pediatric lung adenocarcinoma presenting with brain metastasis: a case report. J Med Case Rep 2018; 12:243. [PMID: 30172261 PMCID: PMC6119591 DOI: 10.1186/s13256-018-1781-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 07/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of primary lung adenocarcinoma in children remains challenging given its rarity. Here we highlight the clinical history, pathological evaluation, genomic findings, and management of a very young patient with metastatic lung adenocarcinoma. CASE PRESENTATION A 10-year-old white girl presented with brain metastases due to primary pulmonary adenocarcinoma. Next generation sequencing analysis with "Comprehensive Cancer Panel" highlighted the presence of multiple non-targetable mutations in the FLT4, UBR5, ATM, TAF1, and GUCY1A2 genes. She was treated aggressively with chemotherapy, surgery, and radiation therapy for local and distant recurrence. Eventually, therapy with nivolumab was started compassionately, and she died 23 months after diagnosis. CONCLUSIONS Extremely rare cancers in children such as lung adenocarcinoma need accurate and specific diagnosis in order to develop an optimal plan of treatment. It is also necessary to underline that "children are not little adults," thus implying that an adult-type cancer in the pediatric population might have a different etiopathogenesis. Diagnostic confirmation and primary treatment of such rare conditions should be centralized in reference centers, collaborative networks, or both, with multidisciplinary approaches and very specific expertise.
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Affiliation(s)
- Lucia De Martino
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy.
| | - Maria Elena Errico
- Department of Pathology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Serena Ruotolo
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy
| | - Daniele Cascone
- Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Stefano Chiaravalli
- Department of Pediatric Oncology, Fond. IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Collini
- Soft Tissue and Bone Pathology, Histopathology and Pediatric Pathology Unit, IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Ferrari
- Department of Pediatric Oncology, Fond. IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Muto
- Radiation Oncology Unit, National Tumor Institute of Naples, Foundation G. Pascale, Naples, Italy
| | - Giuseppe Cinalli
- Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Lucia Quaglietta
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy
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Kubota K, Miyamoto T, Ota K, Fukayama H, Minakuchi S. Anesthetic management of a patient with benign tracheal tumor identified at induction of general anesthesia. J Clin Anesth 2017; 43:66-67. [PMID: 29035704 DOI: 10.1016/j.jclinane.2017.09.019] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 09/19/2017] [Accepted: 09/29/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Kazumasa Kubota
- Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Tomoyuki Miyamoto
- Department of Anesthesiology and Clinical Physiology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kotomi Ota
- Department of Anesthesiology and Clinical Physiology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhisa Fukayama
- Department of Anesthesiology and Clinical Physiology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Abstract
Background Sarcomas are a rare type of breast malignancies and malignant peripheral nerve sheath tumors of the breast are even rarer. There are no specific clinical and radiological features for the diagnosis of this tumor and histological features are also reported to be nonspecific. Therefore, immunohistochemistry is required for its diagnosis. A definitive treatment protocol is unavailable because of its rarity. Case presentation We report a case of a sporadic form of breast malignant peripheral nerve sheath tumor found in a 16-year-old Asian Bangladeshi girl. She experienced local recurrence and she had multiple left breast lumps four times in a very short period after repeated surgeries. However, she was later managed successfully with chemotherapy and locoregional radiotherapy. A chemotherapy protocol with ifosfamide, vincristine, and actinomycin was used and radiotherapy was given with a total dose of 50 Gy given in 25 fractions of 2 Gy by a 6 MV photon linear accelerator followed by 10 Gy boost given in 5 fractions of 2 Gy by 9 MeV electron energy. With more than 3 years of periodic follow-up, she is still well without any locoregional and metastatic recurrence. Conclusions This report suggests proper immunohistochemical analysis whenever a breast sarcoma is found in order to find a rare histological variety. We believe that malignant peripheral nerve sheath tumor of the breast can be managed by total mastectomy followed by adjuvant chemotherapy and radiotherapy. Long-term meticulous follow-up is required to develop an optimum therapeutic strategy.
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Affiliation(s)
- Md Shuayb
- Oncology & Radiotherapy Centre, Square Hospitals Ltd, Dhaka-1205, Bangladesh.
| | - Rabeya Begum
- USAID DFID NGO Health Services Delivery Project, Population Service & Training Centre (PSTC), House 93/3, Road 8, Block C, Niketon, Gulshan 1, Dhaka-1212, Bangladesh
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Ricci S, Stone RL, Fader AN. Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Gynecol Oncol 2017; 145:208-216. [PMID: 28209496 DOI: 10.1016/j.ygyno.2017.02.019] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [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: 01/17/2017] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 12/17/2022]
Abstract
Leiomyosarcoma, a rare tumor subtype, accounts for 1% of all uterine malignancies, but contributes to a significant proportion of uterine cancer deaths. Surgery is considered the mainstay of treatment for all soft tissue sarcomas, including uterine variants. However, uterine leiomyosarcoma is challenging to diagnose preoperatively and can mimic the appearance of benign uterine leiomyomas. Recently, concerns have grown in this regard, as surgeons have utilized uterine morcellation and myomectomy procedures unknowingly in the setting of occult uterine sarcoma. Because of aggressive tumor biology and relative chemotherapy and radiotherapy resistance, efficacious therapies to achieve prolonged survival or cure in those with both early and advanced-stage uterine leiomyosarcoma have been elusive. The strongest determinant of survival remains stage at diagnosis, though prediction models may provide a more accurate prognosis. Given the aggressive nature of this sarcoma subtype, novel early detection strategies and targeted therapies are the focus of several recently published and ongoing studies. While gemcitabine/docetaxel and doxorubicin remain the most active regimens in the treatment of advanced or recurrent disease, currently available cytotoxic regimens remain inadequate, with 5-year disease-specific survival of <30%. Pazopanib, trabectedin and olaratumab, are FDA-approved, targeted therapies with activity in uterine and other leiomyosarcomas, while aromatase inhibitors and immunotherapies are under active investigation. This review provides a critical appraisal of the literature regarding the contemporary surgical and medical management of uterine leiomyosarcoma, the role of targeted therapies, and the implications of uterine morcellation on gynecologic surgical practice.
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Affiliation(s)
- Stephanie Ricci
- Division of Gynecologic Oncology, Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rebecca L Stone
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amanda N Fader
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Abstract
Clear cell "sugar" tumors of the lung are rare pulmonary tumors. This case study illustrates a patient who was found to have a persistent nodule in the left-upper lobe of the lung. Positron emission tomographic scanning showed mild-moderate 18-fluorodeoxyglucose uptake. Based on these findings, a video-assisted resection of the tumor was undertaken. The mass was identified histologically, as a clear cell "sugar" tumor of the lung. This case report discusses the benign versus malignant nature of this rare tumor.
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Khuri S, Gilshtein H, Sayidaa S, Bishara B, Kluger Y. Primary Ewing Sarcoma/Primitive Neuroectodermal Tumor of the Stomach. Case Rep Oncol 2016; 9:666-671. [PMID: 27920700 PMCID: PMC5118824 DOI: 10.1159/000449126] [Citation(s) in RCA: 8] [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: 08/15/2016] [Accepted: 08/15/2016] [Indexed: 01/04/2023] Open
Abstract
Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is a tumor of small round cells arising in skeletal tissues. These tumors rarely arise in the stomach. We present a 31-year-old healthy female patient who was admitted to our surgical ward due to upper gastrointestinal hemorrhage. Upper endoscopy revealed a large ulcerated bleeding mass originating from the lesser curvature. Biopsy revealed tumor cell immunoreactivity positive for CD99, vimentin, and Ki67 (an index of proliferation). These findings were compatible with gastric ES/PNET. The fluorescence in situ hybridization analysis result for the EWSR1 gene rearrangement (11: 22 translocation) was positive. The patient refused neoadjuvant treatment and thus underwent an operation during which a mass at the lesser curvature of the stomach was found. The mass was adhering to the pancreatic tail and to the mesentery of the transverse and descending colon. Total gastrectomy, distal pancreatectomy, splenectomy, and left adrenalectomy were done. The patient refused adjuvant treatment. She is free of disease 3 years after surgery.
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Affiliation(s)
- Safi Khuri
- Rambam Health Care Campus, Haifa, Israel
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35
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García-Pérez J, Morales-Piga A, Gómez-Barroso D, Tamayo-Uria I, Pardo Romaguera E, López-Abente G, Ramis R. Residential proximity to environmental pollution sources and risk of rare tumors in children. Environ Res 2016; 151:265-274. [PMID: 27509487 DOI: 10.1016/j.envres.2016.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/01/2016] [Accepted: 08/01/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Few epidemiologic studies have explored risk factors for rare tumors in children, and the role of environmental factors needs to be assessed. OBJECTIVES To ascertain the effect of residential proximity to both industrial and urban areas on childhood cancer risk, taking industrial groups into account. METHODS We conducted a population-based case-control study of five childhood cancers in Spain (retinoblastoma, hepatic tumors, soft tissue sarcomas, germ cell tumors, and other epithelial neoplasms/melanomas), including 557 incident cases from the Spanish Registry of Childhood Tumors (period 1996-2011), and 3342 controls individually matched by year of birth, sex, and region of residence. Distances were computed from the residences to the 1271 industries and the 30 urban areas with ≥75,000 inhabitants located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to industrial and urban pollution sources were calculated, with adjustment for matching variables and socioeconomic confounders. RESULTS Children living near industrial and urban areas as a whole showed no excess risk for any of the tumors analyzed. However, isolated statistical associations (OR; 95%CI) were found between retinoblastoma and proximity to industries involved in glass and mineral fibers (2.49; 1.01-6.12 at 3km) and organic chemical industries (2.54; 1.10-5.90 at 2km). Moreover, soft tissue sarcomas registered the lower risks in the environs of industries as a whole (0.59; 0.38-0.93 at 4km). CONCLUSIONS We have found isolated statistical associations between retinoblastoma and proximity to industries involved in glass and mineral fibers and organic chemical industries.
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Affiliation(s)
- Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Antonio Morales-Piga
- Rare Disease Research Institute (IIER), Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Rare Diseases (CIBERER), Madrid, Spain.
| | - Diana Gómez-Barroso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Ibon Tamayo-Uria
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - Elena Pardo Romaguera
- Spanish Registry of Childhood Tumors (RETI-SEHOP), University of Valencia, Valencia, Spain.
| | - Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Rebeca Ramis
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
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Abstract
Small bowel adenocarcinomas (SBAs) are rare tumors, but their incidence is increasing. The most common primary location is the duodenum. Even though SBAs are more often sporadic, some diseases are risk factors. Early diagnosis of small bowel adenocarcinoma remains difficult, despite significant radiologic and endoscopic progress. After R0 surgical resection, the main prognostic factor is lymph node invasion. An international randomized trial (BALLAD [Benefit of Adjuvant Chemotherapy For Small Bowel Adenocarcinoma] study) will evaluate the benefit of adjuvant chemotherapy. For metastatic disease, retrospectives studies suggest that platinum-based chemotherapy is the most effective treatment. Phase II studies are ongoing to evaluate targeted therapy in metastatic SBA.
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Affiliation(s)
- Thomas Aparicio
- Gastroenterology and Digestive Oncology Unit, Avicenne Hospital, HUPSSD, APHP, Université Paris 13, Sorbonne Paris Cité, 125 rue de Stalingrad, Bobigny 93000, France.
| | - Aziz Zaanan
- Gastroenterology and Digestive Oncology Unit, Georges Pompidou Hospital, APHP, Paris Descartes University, 20 Rue Leblanc, Paris 75015, France
| | - Florence Mary
- Gastroenterology and Digestive Oncology Unit, Avicenne Hospital, HUPSSD, APHP, Université Paris 13, Sorbonne Paris Cité, 125 rue de Stalingrad, Bobigny 93000, France
| | - Pauline Afchain
- Oncology Unit, Saint Antoine Hospital, APHP, 184 Rue du Faubourg Saint-Antoine, Paris 75012, France
| | - Sylvain Manfredi
- Hepato-Gastroenterology Unit, Dijon Hospital, 14 rue Paul Gaffarel, Dijon 21079, France
| | - Thomas Ronald Jeffry Evans
- Translational Cancer Therapeutics department, The Beatson West of Scotland Cancer Centre, University of Glasgow, 1053 Great Western Road, Glasgow G12 0YN, UK
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Binesh F, Moghadam RN, Shabani M, Mortazavizadeh MR, Zare S. Malignant Myopericytoma of Shoulder: A Rare Lesion. APSP J Case Rep 2016; 7:21. [PMID: 27398322 PMCID: PMC4921218 DOI: 10.21699/ajcr.v7i3.421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 03/12/2016] [Accepted: 05/11/2016] [Indexed: 11/21/2022] Open
Abstract
Myopericytoma is a soft tissue tumor with perivascular myoid differentiation. It accounts for 1% of the vascular tumors and involves mostly cutaneous or subcutaneous tissue of the limbs in adults. Malignant myopericytoma is exceedingly rare. A 15-year old girl presented with slowly progressive mass over left shoulder region. Histopathology and immunohistochemistry after complete excision revealed it as malignant myopericytoma.
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Affiliation(s)
- Fariba Binesh
- Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Nafisi Moghadam
- Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Shabani
- Department of Radiotherapy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Saeedeh Zare
- Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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38
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Merveilleux du Vignaux C, Girard N, Salles G, Cordier JF. [Mucosa-associated lymphoid tissue-derived (MALT) lymphoma]. Rev Pneumol Clin 2016; 72:95-100. [PMID: 26850454 DOI: 10.1016/j.pneumo.2015.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 10/05/2015] [Accepted: 10/16/2015] [Indexed: 06/05/2023]
Abstract
Pulmonary Mucosa-Associated Lymphoid Tissue (MALT)-type lymphoma is the most frequent primary pulmonary lymphoma. We report the case of a patient who presented a pulmonary MALT-type lymphoma treated with chloraminophen, with a recurrence 5 years later characterized with pulmonary lesions associated with a gastric location. This observation underlines some anatomical and clinical aspects of pulmonary MALT-type lymphoma, and leads to discuss the evolution of its physiopathological and therapeutic concepts. In particular, the contributions of positron emission tomography and molecular biology allow the analysis of possible multifocal affections of this disease.
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Affiliation(s)
- C Merveilleux du Vignaux
- Service de pneumologie, centre de référence des maladies pulmonaire rares, unité pilote pour la prise en charge des tumeurs malignes rares de l'adulte, hôpital Louis-Pradel, Hospices Civils de Lyon, 69677 Lyon, France
| | - N Girard
- Service de pneumologie, centre de référence des maladies pulmonaire rares, unité pilote pour la prise en charge des tumeurs malignes rares de l'adulte, hôpital Louis-Pradel, Hospices Civils de Lyon, 69677 Lyon, France.
| | - G Salles
- Service de pneumologie, centre de référence des maladies pulmonaire rares, unité pilote pour la prise en charge des tumeurs malignes rares de l'adulte, hôpital Louis-Pradel, Hospices Civils de Lyon, 69677 Lyon, France; Service d'hématologie clinique, centre hospitalier Lyon-Sud, 69495 Pierre-Bénite, France
| | - J-F Cordier
- Service de pneumologie, centre de référence des maladies pulmonaire rares, unité pilote pour la prise en charge des tumeurs malignes rares de l'adulte, hôpital Louis-Pradel, Hospices Civils de Lyon, 69677 Lyon, France
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Quintyn-Ranty ML, Gordien K, Caveriviere P, Mery É, Jamme-Lallemand M, Wuithier P, Palasse J, Reyre J, Laborie V, Despax B, Rolland V, Thibaut I, Maissongrosse V, Escourrou G, Duprez-Paumier R, Bauvin É, Jacob M, Lacroix-Triki M. [Improving practice in breast pathology: 34-months experience of the regional SENOPATH network and webinars as a tool for diagnosis of difficult lesions of the breast]. Bull Cancer 2015; 102:823-33. [PMID: 26384691 DOI: 10.1016/j.bulcan.2015.07.006] [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: 05/17/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
Pathologists commonly face breast lesions that are difficult to diagnose. To reduce second opinion delay, erase geographical barrier and provide continuing education, we aimed to develop a telepathology-based regional network of pathologists. With the support of ONCOMIP network, we founded a peer-group named SENOPATH, composed of experienced breast pathologists practising in private laboratories, university hospitals or comprehensive cancer center in the region of Midi-Pyrénées in France. Submitted cases are digitalized at the University Hospital, stored in a shared space with a possible access via Internet prior to the SENOPATH sessions. The group meets monthly, via a synchronized webinar and multihead microscope session. A consensual diagnosis and final pathology report is issued for each case, and sent to the referring clinician via the patient medical file securely hosted by ONCOMIP. Between 2012 and 2014, 142 cases were reviewed, for either diagnostic 'routine' difficulty or rare histological type. The SENOPATH group, also regularly called by oncologists to solve difficult cases, has considerably improved the pathologist network in Southern France. Supported by the webinar tool, its educational impact is prominent, with a considerable progress in the region with regards to standardization of pathology processes, literature review and knowledge sharing.
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Affiliation(s)
- Marie-Laure Quintyn-Ranty
- CHU de Toulouse, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Karine Gordien
- Réseau de cancérologie de Midi-Pyrénées ONCOMIP, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Paul Caveriviere
- Laboratoire d'anatomie et de cytologie pathologiques des feuillants, 116, route d'Espagne, 31000 Toulouse, France
| | - Éliane Mery
- Institut Claudius-Regaud, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Muriel Jamme-Lallemand
- Clinique Claude-Bernard, service d'anatomie et de cytologie pathologiques, 1, rue Père-Colombier, 81030 Albi cedex 09, France
| | - Pascal Wuithier
- Laboratoire d'anatomie et de cytologie pathologiques, 13, rue Carnot, 65000 Tarbes, France
| | - Julien Palasse
- Laboratoire d'anatomie et de cytologie pathologiques, 9, rue Viscose, 31100 Toulouse, France
| | - Joelle Reyre
- Laboratoire d'anatomie et de cytologie pathologiques des feuillants, 116, route d'Espagne, 31000 Toulouse, France
| | - Vincent Laborie
- Laboratoire d'anatomie et de cytologie pathologiques de Montauban, 43, avenue Charles-de-Gaulle, 82000 Montauban, France
| | - Brigitte Despax
- Laboratoire d'anatomie et de cytologie pathologiques, 62, boulevard des récollets, 31400 Toulouse, France
| | - Véronique Rolland
- Laboratoire d'anatomie et de cytologie pathologiques, 62, boulevard des récollets, 31400 Toulouse, France
| | - Isabelle Thibaut
- Centre de pathologie des coteaux, 5, rue Boyssonne, BP 14001, 31078 Toulouse cedex 4, France
| | - Véronique Maissongrosse
- Institut Claudius-Regaud, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Ghislaine Escourrou
- CHU de Toulouse, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Raphaëlle Duprez-Paumier
- CHU de Toulouse, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Éric Bauvin
- Réseau de cancérologie de Midi-Pyrénées ONCOMIP, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Michel Jacob
- Université Paul-Sabatier, département TIC/TICE et multimédia (DTSI), 118, route de Narbonne, 31062 Toulouse cedex 9, France
| | - Magali Lacroix-Triki
- Institut Claudius-Regaud, service d'anatomie et de cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
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Kim DY, Lim KT, Kwon YS. Endometrial Stromal Sarcomas: A clinico-pathological analysis of 27 patients. Pak J Med Sci 2013; 29:72-6. [PMID: 24353511 PMCID: PMC3809180 DOI: 10.12669/pjms.291.2235] [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: 03/12/2012] [Revised: 10/31/2012] [Accepted: 11/02/2012] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate clinico-pathological features and prognostic valuses of Endometrial stromal sarcomas (ESS) through comparison of the two grade groups (low- and high-grade disease). METHODOLOGY We retrospectively analyzed the medical records of 27 patients who were diagnosed with ESS at a single institute between March 1988 and November 2009. Our retrospective chart review was approved by our local institutional Review Board (IRB). RESULTS The median age of the patients was 44.0 years, the median follow-up period was 101.0 months and the 10-year survival rate was 74.2%. The median uterine weight was 215.0 gm. Twenty-three (70.4%) and four patients (29.6%) had low- and high-grade disease, respectively. As primary treatment, twenty-four (70.4%) and three patients (11.1%) underwent type I hysterectomy and type III hysterectomy, respectively. Total six cases were recurred and two cases of the six-recurred patients were distant metastasis (lung) and four cases were died of the disease. Univariate analysis revealed that the histologic grade and the uterine tumor weight were significantly related with longer disease-free survival (p=0.025 and 0.043 respectively). CONCLUSION ESSs with high-grade or larger tumor size have to be carefully and sufficiently managed, because of its rarity and aggressive behavior. To determine the proper adjuvant treatment of ESS with high risks, further clinical data should be collected and studied.
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Affiliation(s)
- Dae-Young Kim
- Dr. Dae-Young Kim, Departments of Anesthesiology and Pain Management, Ulsan University Hospital, Collage of Medicine, Ulsan University, Ulsan, Korea
| | - Kyung-Taek Lim
- Dr. Kyung-Taek Lim, Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Dong-gu Ulsan, Korea
| | - Yong-Soon Kwon
- Dr. Yong-Soon Kwon, Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Dong-gu Ulsan, Korea
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Abstract
Gastrointestinal stromal tumors (GISTs) are rare abdominal tumors which arise from the interstitial cells of Cajal in the gastrointestinal tract. Gastric GISTs are the most commonly seen GIST tumors and may grow to a very large size. They are often associated with abdominal pain, anorexia and weight loss. Most of them can be detected by CT. These tumors have been found to harbor mutations in CD117 which causes constitutional activation of the tyrosine kinase signaling pathway and is considered to be pathognomic. Tyrosine kinase inhibitors such as imatinib have revolutionized the treatment of these tumors, which are otherwise resistant to conventional chemotherapy and radiotherapy. Although surgical resection is the mainstay of treatment, tyrosine kinase inhibitors have been useful in prolonging the recurrence-free survival of these patients. Resistance to imatinib has been reported in GISTs with specific mutations. We present a case of gastric GIST which grew to a very large size and was associated with abdominal pain and weight loss. It was successfully resected and the patient was commenced on imatinib therapy.
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Affiliation(s)
| | - Achuta K. Guddati
- Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, Mass., USA
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42
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Abstract
OBJECTIVE To characterize the clinical behavior of rare sinonasal malignancies. METHODS Clinical data from the cases of rare sinonasal malignancies at Gujarat Cancer and Research Institute during 2001-2007 were extracted. Data for histologic type of tumor, tumor stage and survival were analyzed. RESULTS Eighty-nine cases of the non-squamous cell malignancy were identified. The mean patient age was 54 years. In this study, we found minor salivary gland tumor in 31 patients, sarcoma in 19 patients, spindle cell carcinoma (SpCC) in 19 patients, undifferentiated carcinoma in 9 patients, lymphoma in 6 patients and melanoma in 3 patients. Adenoid cystic carcinoma exhibited the best survival rate (3 years survival rate was 77%), whereas melanoma and undifferentiated carcinoma exhibited poor survivals (1 year survival was 25% and 33%, respectively and 3 years survival rate is 0%). CONCLUSIONS Adenoid cystic carcinoma is the most common squamous cell carcinoma (SCC) of the sinonasal track. Survival for the patients with undifferentiated carcinoma and melanoma involving the sinonasal track is poor.
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