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Sample records for carcinoma clinical presentation

  1. Clinical presentation of renal cell carcinoma

    International Nuclear Information System (INIS)

    Most common malignant tumour of the kidney is Renal Cell Carcinoma (RCC) and is known for its unpredictable clinical behaviour. Aetiology and risk factors are not completely understood. Extensive workup is being done in the understanding of the disease, especially to diagnose early and to treat promptly. The objective of this study was to determine the clinical presentation and pathological pattern of RCC. Methods: After approval from ethical committee a retrospective review of records was conducted extending from January 2012 to January 2014 to identify clinical characteristics of renal cell carcinomas. The study included all renal cancer patients presented to Sheikh Zayed Hospital Lahore with in this specified period. The data was retrieved regarding, history, physical examination and necessary investigations such as ultrasonography of abdomen and pelvis and CT scan of abdomen and pelvis. Results: There were total of 50 cases. The male to female ratio was 3:2. Mean age of patients were 52.38 (18-93) years old. Most common clinical presentation was gross haematuria(66%).The mean tumour size was 8.34 (3-24) cm. Tumour histology were clear cell (84%), papillary transitional cell carcinoma (12%) and oncosytoma contributed 4%. Conclusion: We observed that large number of the patients with RCC presented with haematuria and most of them were male. Common pathological type was clear cell carcinoma. (author)

  2. Collision tumours, squamous cell carcinoma of larynx, papillary thyroid carcinoma, metastatic lymphatic node. Clinical Presentation

    International Nuclear Information System (INIS)

    Male patient with 35 years old, merchant from Capiata, no history of smoking or alcoholism, with 2 months history of bilateral neck nodes, sore throat, weight loss of 8 kg., dysphonia, progressive dyspne a on medium efforts dyspne a at rest so you see the urgency of the Hospital de Clinicas. On examination: lucid, collaborator, normosomico, with dysphonia, stri dor and dyspne a. P S: 2. No hemodynamic or fever. Neck: tumor mass of 6 cm in diameter, infrahiodea right, accompanying the movement of swallowing, bilateral jugular carotid lymphadenopathy high of 2 cm in diameter, solid-elastic smooth, mobile; lymphadenopathy average lower right carotid and jugular similar characteristics. Laryngoscopy smooth, submucosal, nodular lesion on right vocal cord, paralytic in middle position; aritenoides edematous law, glottal gap of 10%. Mobile left vocal cord. Remainder of the examination: Normal. Emergency tracheotomy performed. Biopsy of the lesion: invasive carcinoma, without other specifications. Laboratory tests: Hb: 11gr% eosinophilia. ECG, Rx. Chest and abdominal ultrasound: within normal limits. CT: tumor mass of 4.5 cm in diameter in right vocal cord, which is in middle position, and infiltrates the thyroid cartilage soft tissue. In thyroid lobe right: node 5 cm diameter. Cervical lymphadenopathy 2 cm in diameter in bilateral high carotid jugular region, medium and low carotid jugular right. 2/9/09 Surgery: Tumor infiltrating infrahiodea right muscles, jugular Total laryngectomy with bilateral carotid dissection, level 2,3 and 4. Right Thyroid lobectomy. Infrahiodea muscle resection. Pathology: 1-larynx neoplasms consist collision, poorly differentiated right infraglotis (3.2 cm.) Keratinizing squamous carcinoma infiltrating focally in depth the laryngeal cartilage through it, and a papillary carcinoma right thyroid lobe (3.4 cm.) massively infiltrating peritiroideo fibroadipose and skeletal muscle tissue infiltrating through the laryngeal cartilage and extending to

  3. Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

    International Nuclear Information System (INIS)

    Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

  4. Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

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    Vieira, Cristina C. [Department of Radiology, New York University School of Medicine (United States); Mercado, Cecilia L. [Department of Radiology, New York University School of Medicine (United States)], E-mail: Cecilia.mercado@nyumc.org; Cangiarella, Joan F. [Department of Pathology, New York University School of Medicine (United States); Moy, Linda; Toth, Hildegard K. [Department of Radiology, New York University School of Medicine (United States); Guth, Amber A. [Department of Surgery, New York University School of Medicine (United States)

    2010-01-15

    Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

  5. [Acinic cell carcinoma of glandule parotidea presenting untypical clinical symptoms and their bad prognosis].

    Science.gov (United States)

    Komorski, Józef Andrzej; Nienartowicz, Jan Marian

    2009-01-01

    Differential diagnosis of neck tumours puts precedence on diagnosing neoplastic lesions. In the case of neck tumours, these are unfortunately late signs, but in patients with a primary neoplastic focus within the head and neck, neck tumour is often the first sign of the disease. The authors describe a clinical case of neck tumour with initially unclear etiology. The preoperative diagnostics including ultrasonography, thin-needle puncture, MRI, carotid angiography and videostroboscopy was significant for surgical treatment planning; yet it was the intraoperative clinical picture which indicated that the tumour derived from the inferior parotid pole. The preoperative histopathological diagnosis using thin-needle biopsy: cellulae carcinomatosae and the clinical picture resulted in block operation with neck lymphatic system removal and tissue defect reconstruction by means of a pectoral flap. The histopathological examination confirmed non-cornifying basal cell epithelioma only in the essential lesion with no metastases to lymph nodes and surrounding tissue margins free of infiltrates. Two and a half years after the procedure, the patient presented with a tumour localized on the front thoracic wall and two rapidly enlarging tumours in the nape of the neck. In the collected specimen of the tumour on the front thoracic wall, a diagnosis of acinic cell carcinoma was made. The deteriorating general condition of the patient, his cancer emaciation, problems with movement and suspected liver metastases confirmed by abdominal USG as well as radiological bone lesions resulted in the abandonment of surgical treatment due to disseminated neoplastic process and the patient was referred for palliative care. PMID:20169911

  6. Intraluminal versus infiltrating gallbladder carcinoma: Clinical presentation, ultrasound and computed tomography

    Institute of Scientific and Technical Information of China (English)

    Tze-Yu Lee; Sheung-Fat Ko; Chung-Cheng Huang; Shu-Hang Ng; Jiun-Lung Liang; Hsuan-Ying Huang; Min-Chi Chen; Shyr-Ming Sheen-Chen

    2009-01-01

    AIM: To compare clinical presentation and ultrasound (US) and computed tomography (CT) sensitivity between intraluminal and infiltrating gallbladder carcinoma (GBCA).METHODS: This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminal-GBCA ( n = 37) and infiltrating-GBCA ( n = 28) groups. The clinical and laboratory findings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies,and outcome were compared between the two groups.RESULTS: There were no significant differences between the two groups with respect to female predominance,presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes.Compared with the patients with intraluminal-GBCA, those with infiltrating-GBCA were significantly older (65.49 ± 1.51 years vs 73.07 ± 1.90 years), had a higher frequency of jaundice (3/37 patients vs 13/28 patients) and fever (3/37 patients vs 10/28 patients), higher alkaline phosphatase (119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L) and total bilirubin (1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L) levels, higher frequency of gallstones (12/37 patients vs 22/28 patients), smaller gallbladder size (length, 7.47 ± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm), and greater proportion of patients with < 12 mo survival (16/37 patients vs 18/28 patients). The sensitivity for diagnosing intraluminal- GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively.The sensitivity for diagnosing infiltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by CT, respectively.CONCLUSION: In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infiltrating-GBCA.

  7. Paraneoplastic dermatomyositis as presentation of thymic carcinoma.

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    Dell'Amore, Andrea; Asadi, Nizar; Caroli, Guido; Dolci, Giampiero; Bini, Alessandro; Stella, Franco

    2013-07-01

    Thymic carcinomas are very rare and heterogeneous groups of anterior mediastinum neoformations with an extremely aggressive behavior. Often, the diagnosis is made in the advanced stages. Paraneoplastic syndromes associated with thymic carcinoma are extremely rare. We report a case of a 64-year-old man presenting with early stage thymic carcinoma which was discovered because of associated paraneoplastic dermatomyositis. The dermatomyositis disappeared completely after radical resection of the tumor. After 20-month follow-up, the patient is in good clinical condition without recidivism of disease. PMID:22907201

  8. Sebaceous carcinoma. Presenting a case

    International Nuclear Information System (INIS)

    Patient of feminine sex of 65 years of age with tumor of approximately 1.5 cm of diameter, located in the right palpebral region, being put under ample exeresis of a tumor more pastia, whose anatomopathology result revealed sebaceous carcinoma with free edges. This is a rare malignant carcinoma that originates in perioculars sebaceous glands like the glands of Meibomio that affects the superior flicker. Clinically it appears like a small nodule, of small growth and its diagnose is based on a high degree of suspicion in any chronic process of the flicker. The selection processing is the surgery, the x-ray, radiotherapy is useful in the postoperating attention and like palliative therapy. (The author)

  9. Clinical parotid carcinoma analysis

    International Nuclear Information System (INIS)

    We clinically analyzed 48 consecutive retrospective cases of parotid carcinoma initially treated between 1988 and 2007. Subjects were 30 males and 18 females ranging from 5 to 85 years old (average: 57.9 years). Of the 12 histological types seen, the most common was mucoepidermoid carcinoma, seen in 12 subjects (25.0%). We studied their survival based on 5 potential prognostic factors-stage, T stage, neck metastasis, facial nerve palsy, and malignancy grade-together with features of mortality and recurrence. Overall 5-year disease-specific survival was 71.2% and 10-year survival 54.9%. Survival rates were significantly lower in stage IV and high-grade malignancy groups than in stage I-III and low-grade malignancy groups. T stage, neck metastasis, and facial nerve palsy tended to compromise survival. Recurrence developed in 2 subjects, in whom significant recurrence risk factors were stage III-IV (particularly, stage IV), T3-4, and high-grade malignancy. Of 18 deaths, causes were distant failure in 11 and local failure in 5. None died of nodal failure. Analysis of these prognostic factors is important in selecting appropriate surgery and in determining indications for postoperative radiotherapy and chemotherapy, leading to better treatment outcome in those with parotid carcinoma. (author)

  10. Occult breast carcinoma presenting as axillary metastases

    International Nuclear Information System (INIS)

    Purpose: Breast carcinoma presenting with axillary lymphadenopathy and no clinical or radiological evidence of a primary tumor is a rare presentation. We aimed to examine the management of the breast by observation, radiation therapy, or mastectomy. Methods and Materials: Departmental records from 1979 to 1996 of unknown primary presentations and cases of T0N1-2M0 breast carcinoma were reviewed to find cases of occult breast carcinoma presenting as axillary lymphadenopathy with no clinical or imaging evidence of a primary tumor. Results: There were 6047 presentations of breast carcinoma with 20 cases of occult breast carcinoma meeting the criteria. The breast was treated by observation in 6 cases, mastectomy in 2 cases, and radiotherapy to the intact breast in 12 cases. Eighty-three percent of patients (5 of 6 patients) who had observation of the breast had a local recurrence, compared to 25% who had radiotherapy to the intact breast (3 of 12 patients) and 0% who had a mastectomy (0 of 2 patients). The median recurrence-free survival was 7 months in patients who had observation of the breast, compared to 182 months in patients who had local treatment. Three of the 6 patients who underwent breast observation have died whereas 1 of the 14 who had local treatment have died, with a mean follow-up of 73 months. It was found that patients having observation of the breast had a poorer recurrence-free survival (p = 0.003) and overall survival (p = 0.05) compared to those having local treatment of the breast. Conclusions: Patients with such a presentation should have a complete physical examination, mammography, ultrasound, and MRI of the breasts. If there remains no evidence of a primary tumor, an axillary dissection should be carried out and the breast treated by radiotherapy or mastectomy. Observation of the breast is not a recommended option

  11. Inflammatory Breast Carcinoma Presenting with Two Different Patterns of Cutaneous Metastases: Carcinoma Telangiectaticum and Carcinoma Erysipeloides

    OpenAIRE

    Yaghoobi, Reza; Talaizade, Abdolhasan; Lal, Karan; Ranjbari, Nastaran; Sohrabiaan, Nasibe; Feily, Amir

    2015-01-01

    Cutaneous metastases can have many different clinical presentations. They are seen in patients with advanced malignant disease; however, they can be the initial manifestation of undetected malignancies. Inflammatory breast carcinoma is a rare and aggressive form of breast cancer that has a nonspecific appearance mimicking many benign conditions including mastitis, breast abscesses, and/or dermatitis. The authors report the case of a 40-year-old woman with inflammatory breast carcinoma present...

  12. Unusual Presentation of Cystic Papillary Thyroid Carcinoma

    OpenAIRE

    Patil, Vijayraj S.; Abhishek Vijayakumar; Neelamma Natikar

    2012-01-01

    Papillary thyroid carcinoma is the most common thyroid malignancy, accounting for 80% of all thyroid cancers. The most common presentation of thyroid cancer is an asymptomatic thyroid mass or a nodule. Usually as thyroid enlarges, it extends in to mediastinum. Papillary thyroid carcinoma presentation as multiple true cystic swelling extending from neck to anterior chest wall in subcutaneous plane is not present in the literature. We present a rare case of cystic papillary thyroid carcinoma wh...

  13. Clinical presentation of minimally invasive and in situ squamous cell carcinoma of the anus in homosexual men.

    Science.gov (United States)

    Forti, R L; Medwell, S J; Aboulafia, D M; Surawicz, C M; Spach, D H

    1995-09-01

    From January 1988 to December 1993, we identified six men with minimally invasive (stage I) squamous cell carcinoma of the anus and 10 men with anal carcinoma in situ (CIS). Of the six patients with invasive carcinoma, four were infected with human immunodeficiency virus (HIV), including one with AIDS. Of the 10 patients with CIS, eight were infected with HIV, including four with AIDS. Anal pain and bleeding were the most common symptoms of minimally invasive anal cancer and anal CIS. Anal irritation, burning, or pruritus occurred more frequently in patients with CIS, whereas anal ulcers, masses, or abscesses were more frequent in patients with minimally invasive cancer. Several patients with CIS had a discrete area of leukoplakia in the anal canal or a pigmented plaque of the anus and anal canal. These lesions were not observed in patients with minimally invasive anal cancer. The symptoms and signs of early-stage anal cancer in men at risk for developing HIV infection or men infected with HIV often resemble those of other common anorectal diseases in homosexual men. Anal cancer in HIV-infected men is not limited to those individuals with AIDS. PMID:8527551

  14. Ocular Metastatic Renal Carcinoma Presenting With Proptosis.

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    Rai, Ruju; Jakobiec, Frederick A; Fay, Aaron

    2015-01-01

    Metastatic renal carcinoma is the third most common source of ocular and second most common source of orbital metastases. This is the first published case of von Hippel-Lindau (vHL) disease that developed renal cell carcinoma metastatic to an eye with a retinal hemangioblastoma. A 73-year-old woman had a history of vHL disease that included prior retinal hemangioblastomas, 2 cerebellar hemangioblastomas, and bilateral renal cell carcinomas with sacral metastasis. After presenting with progressive, painful proptosis secondary to a large mass observable by ocular CT, an enucleation-orbitotomy was performed, and the surgical specimen was sent for histopathological analysis. The ophthalmic renal metastatic tumor, like the primary tumor, was a clear cell variant that involved both the eyeball and orbit in continuity. The intraocular component was larger than the extraocular portion, which was interpreted as an outward extension of an initial retinal metastasis that probably first settled within a hemangioblastoma. Clusters of ectatic ghost vessels with thickened walls produced by periodic acid Schiff-positive, redundant basement membrane material were partially infiltrated by tumor cells at their periphery, thereby lending some support for this hypothesis. Immunohistochemical positivity for the biomarkers cytokeratin 18, vimentin, carbonic anhydrase IX, PAX2, and PAX 8 confirmed the diagnosis. The patient has refused further treatment. Her anophthalmic socket has comfortably retained a porous polyethylene implant without clinical evidence of local recurrence during 5 months of follow up. PMID:24828963

  15. Leprosy neuropathy: clinical presentations.

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    Nascimento, Osvaldo J M

    2013-09-01

    Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment. PMID:24141500

  16. Renal Cell Carcinoma Presenting as Dysphagia

    OpenAIRE

    Chauhan, Sharad; Yadav, Sher Singh; Tomar, Vinay

    2015-01-01

    Renal cell carcinoma presenting with dysphagia is rare. We report a case who presented with dysphagia as the only manifestations of renal malignancy. Biopsy from the pyriform fossa nodules revealed a clear cell neoplasm. Immuno-histochemical analysis of tissue confirmed metastasis of renal cell carcinoma.

  17. Renal cell carcinoma presenting with malignant ascites

    OpenAIRE

    Jennison, Erica; Wathuge, Gayathri W; Gorard, David A

    2015-01-01

    Lesson It is rare for renal cell carcinoma to involve the peritoneum and cause malignant ascites. Furthermore, it is uncommon for malignant ascites to be a presenting feature of this cancer. An unusual case of renal cell carcinoma presenting with malignant ascites is reported, and its response to sunitinib described.

  18. Gall bladder carcinoma presenting with spinal metastasis: A rare phenomenon

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    Mohit K Joshi

    2013-01-01

    Full Text Available Skeletal metastasis as a primary presentation of gall bladder carcinoma is rare. A 50-year-old lady presented with neck pain and weakness in her right upper limb of 3 months duration. Clinical and imaging work-up suggested locally advanced gall bladder carcinoma with metastasis to cervical vertebra and sternum. Only one case till date has been reported where the patient presented with neurological symptoms due to pathological fracture secondary to metastasis from an occult gall bladder carcinoma. Although rare, an occult gall bladder cancer may present with neurological symptoms due to pathological fracture of spine secondary to metastasis. We present a brief review of literature of patients who presented with skeletal metastases in clinically silent gall bladder malignancy. Palliative care issues in advanced gall bladder carcinoma have also been discussed.

  19. Laryngeal carcinoma presenting as polymyositis: A paraneoplastic syndrome

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    Ritesh Sahu

    2016-01-01

    Full Text Available Laryngeal carcinoma is rarely associated with paraneoplastic syndrome. Inflammatory myopathy presenting as paraneoplastic event is commonly associated with carcinomas of ovary, lung, pancreas, stomach, colorectal, and non-Hodgkin′s lymphoma. We report a case of elderly male, who presented with proximal muscle weakness and found to be associated with laryngeal carcinoma. Diagnosis of polymyositis (PM was confirmed based on clinical features, laboratory test, and muscle biopsy. Exclusion of other commonly associated malignancies was done. This patient improved gradually after 6 months of immunosuppressive therapy and management of underlying cancer.

  20. Carcinoma cervix presenting with clivus metastasis

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    Arpitha S Rao

    2015-01-01

    Full Text Available We present an unusual case of a large metastatic lesion from carcinoma cervix located in the clivus. Patient presented with severe headache and vomiting, mimicking an intracranial pathology. Radiological imaging suggested metastatic origin of the lesion and later on investigations revealed primary in the uterine cervix. The anatomic importance of extradural neural axis component in the process of metastasis of carcinoma cervix to the clivus is highlighted in this case report.

  1. Unusual presentation of cutaneous metastasis from bladder urothelial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Chin-Pao Chang; I-Yen Lee; Hung-Jen Shih

    2013-01-01

    Cutaneous metastases from urothelial carcinoma of the bladder are a rare disease.In previous reports,the most common metastatic cutaneous lesions were non-tender nodules on the abdominal skin.We report a patient with bladder urothelial carcinoma with cutaneous metastases initially presenting as right leg and suprapubic lymphedema.Bladder tumor was the incidental finding by magnetic resonance venography.Urothelial carcinoma (clinical stage Ⅳ) was diagnosed,and chemotherapy was performed.Extensive painful erythematous plaques with an erysipelas-like appearance located on the suprapubic area,chest and abdomen were noted,and cutaneous metastases were confirmed by histopathology.Subsequently,extensive scrotal and prepuce ulcerative changes developed.This paper reports a rare case of extensive cutaneous metastasis of bladder urothelial carcinoma who presented an interesting clinical course.

  2. Occult distal urethral carcinoma presenting as metastatic carcinoma in the inguinal lymph nodes.

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    Hammer-Hansen, Niels; Høyer, Søren; Jensen, Jørgen Bjerggaard

    2015-02-01

    A 65-year-old man presented with metastatic squamous cell carcinoma in the inguinal lymph nodes from an unknown primary tumour. The initial work-up lacked clinical examination of the glans penis, in part due to the patient having phimosis. More than a year after presentation, a primary tumour, located distally on the penis, was diagnosed. A discussion of urethral carcinoma as well as inguinal lymph-node metastasis of unknown primary tumour is presented. PMID:25313619

  3. A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis

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    Jennifer Walsh

    2015-01-01

    Full Text Available A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT. Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel’s thyroiditis. A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes.

  4. BRONCHIAL CARCINOMA PRESENTING WITH PNEUMOTHORAX

    OpenAIRE

    2006-01-01

    Spontaneous pneumothoraxs are usually caused by subpleural apical bleps but may also be secondary to metastasis to the lung and rarely primary lung cancer. We present a 56-years-old man with spontaneous pneumothorax secondary to non-small cell lung cancer. Key words: Lung cancer, spontaneus pneumothorax

  5. Unusual bone metastasis from follicular carcinoma thyroid: presenting as a primary bone malignancy

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    Saurabh Varshney

    2014-12-01

    Full Text Available Osseous metastasis in patients of thyroid carcinoma is not very common, and appendicular skeleton is very rare. Bone metastasis represents a complication, especially of follicular thyroid carcinoma and severely reduces the quality of life causing pain, and fractures. Diagnosis is typically done by correlating clinical suspicion with imaging. Occult clinical presentations usually delay the detection and management of patients with bone metastasis from thyroid carcinoma. There is limited information about the clinical presentations and prognosis of patients with follicular thyroid carcinoma with bone metastasis. We hereby present a case report of right arm swelling diagnosed as metastatic carcinoma having metastasis from thyroid primary.

  6. Renal cell carcinoma presenting as mandibular metastasis

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    Hassan Ahmadnia

    2013-01-01

    Full Text Available Renal clear cell carcinoma (RCC has different manifestations, including uncommon metastasis and paraneoplastic syndromes. Here we report a rare case of RCC presenting as metastasis to the mandible. A 57-year-old patient with mandibular swelling was referred to the dentist. After necessary evaluations, an incisional biopsy of mandible showed metastatic RCC. The patient was referred to the urologist. The patient underwent right radical nephrectomy. Pathological examination showed clear renal cell carcinoma. Every abnormal bone lesion in the oral cavity should be evaluated carefully and the possibility of a malignant lesion should always be considered.

  7. Unusual presentation of carcinoma of penis

    International Nuclear Information System (INIS)

    A case of carcinoma of the penis in a 55-year-old landlord is described. He presented with a fungating growth on the shaft of his penis with an unusual history. The lesion started as a nodule in the coronal sulcus leading to thinning of urinary stream and ultimately retention of urine, which was diagnosed and treated as a case of urethral stricture. Wedge biopsy of the growth revealed the case of squamous cell carcinoma of penis. Ultrasonography and CT scan of pelvis and abdomen proved the disease to be localized to penis and total penectomy was carried out. (author)

  8. Atypical presentations and rare metastatic sites of renal cell carcinoma: a review of case reports

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    Cindolo Luca; Metaxa Linda; Sountoulides Petros

    2011-01-01

    Abstract Renal cell carcinoma is a potentially lethal cancer with aggressive behavior and a propensity for metastatic spread. Due to the fact that the patterns of metastases from renal cell carcinomas are not clearly defined, there have been several reports of cases of renal cell carcinoma associated with rare metastatic sites and atypical presenting symptoms. The present review focuses on these atypical rare clinical presentations of renal cell carcinomas both at the time of diagnosis of the...

  9. Clinical Aspects of Hepatocellular Carcinoma

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    Verhoef, Cornelis

    2008-01-01

    textabstractHepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third most common cause of cancer mortality1. Despite the high numbers of patients diagnosed worldwide (the estimated number of people is 0.5 million cases per year), HCC continue to pose challenging clinical problems. The assessment of the tumor and treatment options needs a multi-disciplinary approach in which the surgeon plays a central role. The aim of this thesis is to update on the incidence,...

  10. Clinical review of mucoepidermoid carcinomas

    International Nuclear Information System (INIS)

    Mucoepidermoid carcinoma is a rare head and neck cancer tumor, composed of both mucous and epidermoid cells. We retrospectively reviewed the case of 36 such patients hospitalized in the last 24 years (between 1978 and 2002) at Kurume University Hospital, focusing on origin, treatment, and treatment outcome. In this study, 33 patients undergoing currative treatment were studied in detail. Tumors originated in major salivary glands in 24 and in the oral cavity, paranasal cavity, and oropharynx in 3 each. Salivary gland carcinomas were graded, clinically and histopathologically based on the criteria of Goode et al. as follows: low (n=3), intermediate (n=3), and high (n=18). All patients underwent radical surgery. Lymph node metastasis was detected in 9, distant metastasis in 6 (lung: 4; liver: 1; bone: 1), and local recurrence in 5 patients. Lymph node recurrence was detected in 3. Survival was calculated with Kaplan-Meier's methods. Five-year overall survival was 64%, i.e., 56% in salivary gland malignancy, 67% in oral cavity malignancy, 100% in paranasal cavity malignancy and 100% in oropharyax malignancy. Five-year survival was 76% in T2, 75% in T3, 51% in T4. Five-year survival in N0 was 80% and 22% in N+ cases, with a statistically significant difference (p<0.05). Five-year survival was 71% in stage I, 83% in stage II, and 54% in stage IV. Five-year survival in low and intermediate grade was 100%, whereas that in high grade was 43%. The 21 patients undergoing modified neck dissection has a 5-year survival of 52%. In 20 patients undergoing postoperative radiotherapy, 4 died of local recurrence. In 31 patients not undergoing chemotherapy, 6 died of distant metastasis. These results emphasize the necessity of radiotherapy and chemotherapy after surgical treatment for head and neck mucoepidermoid carcinoma. (author)

  11. Carcinoma Gall Bladder: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Ghosh Y

    2014-12-01

    Full Text Available Carcinoma gall bladder is a very aggressive disease with poor outcomes. Despite achievements in the field of advanced imaging techniques, there is a very high mortality rate of the disease Cancer is the second most common disease in India responsible for maximum mortality with about 0.3 million deaths per year. The magnitude of cancer problem in the Indian Sub-continent (sheer numbers is increasing due to poor to moderate living standards and inadequate medical facilities. Women are more commonly affected than men. The peak incidence occurs in people in their 60s, but the disease age range is from 29 to 90 years of age and there is great geographic and ethnic variation. Carcinoma gall bladder, a disease of old age, is now found in the younger age group and presents with greater ferocity.

  12. Fibrolamellar Hepatocellular Carcinoma Presenting as Obstructive Jaundice: Uncommon Presentation of a Rare Entity

    International Nuclear Information System (INIS)

    Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor, significantly different from generic hepatocellular carcinoma with distinct demographics, risk factors, imaging features, histopathology and prognosis. Unlike conventional hepatocellular carcinoma, it presents in young individuals with no preexisting hepatitis or cirrhosis and does not cause elevation of serum alpha feto proteins in most cases. This paper presents a case report of this rare tumor in a young female with an unusual clinical manifestation of obstructive jaundice (which has not been reported so far) along with a review of its imaging and pathological features, with treatment options. Fibrolamellar HCC is a rare variant of classic HCC with different epidemiology, risk factors, clinical manifestations, radiological, pathological and prognostic features. Therefore, it is important to be familiar with the entity for its early diagnosis and management

  13. Clinical analysis of parotid carcinoma

    International Nuclear Information System (INIS)

    The histopathology of parotid carcinoma is varied, and in many cases, it is difficult to make a diagnosis preoperatively. A clinical analysis was performed on 28 cases of parotid carcinoma initially treated between 1994 and 2011. We compared preoperative diagnosis based on fine-needle aspiration biopsy (FNA) or frozen section biopsy (FSB) with the final diagnosis. Sensitivity for malignancy was 45.8% in FNA and 85.7% in FSB. Diagnostic accuracy for histologic diagnosis was 20.8% in FNA and 42.9% in FSB. We performed a superficial lobectomy conserving the facial nerve in classified T1 or T2, and low-grade malignancy. We also performed a total or extended parotidectomy with total removal of the facial nerve in classified T3 or T4 and high-grade malignancy. Neck dissection was performed in 11 patients. Supraomohyoid neck dissection was performed in 6 patients and total neck dissection in 5 patients with high-grade T3 or T4, and clinically positive neck metastasis. Postoperative radiotherapy was performed in 12 patients with close safety margin, pathological T3 or T4, high-grade malignancy, multiple neck metastasis and extranodal extension. The factors influencing a poor outcome were high-grade malignancy (p=0.0268), stage IV (p=0.0069), and N+ stage (p=0.0005). Of 10 deaths, causes were local failure in 3 and distant failure in 5. We consider that preoperative histologic diagnosis is important for deciding surgical management. Appropriate surgery and indications for postoperative radiotherapy and chemotherapy are required in patients with high-grade malignancy, stage IV, and N+. (author)

  14. Xanthogranulomatous endometritis presenting as pyometra and mimicking carcinoma on imaging

    Directory of Open Access Journals (Sweden)

    Col Ajay Malik

    2016-01-01

    Full Text Available Xanthogranulomatous endometritis (XGE is an uncommon but well-established histopathological entity seen affecting the kidney and gallbladder. Involvement of the endometrium is very rare, with only a few case reports in world literature till date. Histologically, it is characterized by the replacement of the endometrium by sheets of foamy histiocytes, plasma cells, lymphocytes, giant cells, and siderophages. We present a case of a 74-year-old female who presented with foul-smelling discharge and postmenopausal bleeding of a short duration. Clinical examination and imaging studies revealed a pyometra, cervical stenosis. A suspicion of carcinoma was raised. Since XGE may mimic an endometrial carcinoma clinically and pathologically, knowledge of this unusual and rare inflammatory pathology is important for both the gynecologists and the pathologists.

  15. Management of renal cell carcinoma presenting as inflammatory renal mass

    OpenAIRE

    Ehab Eltahawy; Mohamed Kamel; Mahmoud Ezzet

    2015-01-01

    Introduction: Renal cell carcinoma (RCC) can have a wide spectrum of clinical presentations. In the immunocompromised patient fever and an inflammatory renal mass can harbor RCC. Materials and Methods: We reviewed the charts of patients who were managed at our department during 1998-2008 as renal abscess or perinephric collection. Renal ultrasound and subsequently abdominal CT was done. Medical treatment in the form of antibiotics, control of diabetes and drainage was done. Percutaneous ...

  16. Thymic carcinoma presenting as atypical chest pain.

    Science.gov (United States)

    Siddiqui, Sadiq; Connelly, Tara; Keita, Luther; Blazkova, Sylvie; Veerasingam, Dave

    2015-01-01

    A 58-year-old woman with a 2-month history of atypical chest pain was referred to the chest pain clinic by the general practitioner. Exercise stress test was positive and subsequent coronary angiogram revealed significant triple vessel disease with left ventricular impairment requiring a coronary artery bypass graft (CABG). The patient had a chest X-ray as part of the preoperative work up. Chest X-ray revealed a large anterior mediastinal mass. Subsequent thorax CT revealed a 7.2 cm anterior mediastinal mass. CT-guided biopsy of the mass revealed the diagnosis of a poorly differentiated thymic basaloid carcinoma. The patient was successfully treated with concomitant surgery involving complete resection of the mass and a CABG procedure. PMID:26607199

  17. Carcinoma of Maxillary Sinus. A case Presentation.

    Directory of Open Access Journals (Sweden)

    Blas Jorge González Manso

    2007-08-01

    Full Text Available Tumors of the nasosinuous tract developed in the air cavities usually present a considerable growing before the patient feel any symptom or sign. Great part of the symptomatology is given due to the invasion of the tumor to neighbour structures such as oral and nasal cavities and orbits. A case of a 62 year-old male patient is presented after being under a dental extraction. A bucco-sinuous communication was diagnosed. It did not respond to different treatments and after some moths an epidermoid carcinoma of the right maxillary sinus appeared. It is of great interest to let this case been known in order to outstand the importance of an early diagnosis to get a better vital prognosis in this kinds of lesions.

  18. Insular Carcinoma of Thyroid Presenting as a Giant Skull Lesion: A Dilemma in Treatment.

    Directory of Open Access Journals (Sweden)

    Bhattacharya A

    2013-01-01

    Full Text Available Thyroid surgeons are becoming increasingly more aware of a histologically distinct subset of thyroid carcinoma whose classification falls between well-differentiated and anaplastic carcinomas with respect to both cell differentiation and clinical behavior. This subtype of tumors has been categorized as poorly differentiated or insular carcinoma, based on its characteristic cell groupings. Although the differentiation of insular carcinoma from other thyroid carcinomas has important prognostic and therapeutic significance, relatively little about insular carcinoma has been published in the otolaryngology literature. In this article, we discuss a case of insular carcinoma of thyroid presenting with concurrent distant metastasis to skull, lung, ribs, and inguinal region with review of the literature. We conclude that insular thyroid carcinoma warrants aggressive management with total thyroidectomy and excision of accessible giant lesion followed by radioactive iodine ablation of any remaining thyroid tissue.

  19. Painless pulsatile mass as first presentation of renal cell carcinoma

    OpenAIRE

    Kimberley Hoyland; Nikhil Vasdev; Paul Nathan; Damian Hanbury

    2014-01-01

    Renal cell carcinoma rarely presents with typical features of abdominal pain, flank mass and haematuria, and up to 30% of patients present with metastases. We present the case of an 81 year old man who presented with a painless, pulsatile sternal metastasis as an initial presentation of renal cell carcinoma. This case highlights the importance of recognizing even unusual presentations of renal cell carcinoma, and that although sternal metastases are rare, when they do occur there should be a ...

  20. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Directory of Open Access Journals (Sweden)

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  1. Metastasis from renal cell carcinoma to thyroid presenting as rapidly growing neck mass

    OpenAIRE

    Afshin Mohammadi; Seyed Babak Mosavi Toomatari; Mohammad Ghasemi-Rad

    2014-01-01

    INTRODUCTION: Renal cell carcinoma (RCC) is commonly known as the “internist's tumor” because of its unpredictable behavior. Metastasis to the thyroid gland is rarely found in clinical practice. PRESENTATION OF CASE: We report a rare case of non-thyroid malignancies NTM from renal cell carcinoma 1.5 years after radical nephrectomy in a 58-year-old man with a rapidly growing neck mass. DISCUSSION: Malignant melanoma, breast carcinoma, lung, and skin cancer are the most common sources of ...

  2. Endometriosis presenting as carcinoma colon in a perimenopausal woman

    Directory of Open Access Journals (Sweden)

    Tanuja Muthyala

    2015-01-01

    Full Text Available Endometriosis is a common benign disease of reproductive age women, and can involve the intestinal tract. Inconsistent clinical presentation, similar features on radiological imaging and colonoscopy with other inflammatory and malignant lesions of the bowel makes the preoperative diagnosis of bowel endometriosis difficult. We present a case of a 42-year-old perimenopausal female clinically presented, investigated and managed in the lines of carcinoma of sigmoid colon. She underwent terminal ileac resection with end to end anastomoses, Hartmann′s procedure and total hysterectomy with bilateral salpingoophorectomy. The histopathological report revealed endometriosis of small intestine, large intestine, mesentery, right ovary and adenomyoma of uterus. Thus, bowel endometriosis should also be considered as differential diagnosis in reproductive age women with gastrointestinal symptoms or intestinal mass of uncertain diagnosis.

  3. Clinical guideline SEOM: hepatocellular carcinoma

    OpenAIRE

    Sastre, J.; Díaz-Beveridge, R.; García-Foncillas, J; Guardeño, R.; C. López; Pazo, R.; Rodriguez-Salas, N.; Salgado, M; Salud, A; Feliu, J

    2015-01-01

    Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death worldwide. Surveillance with abdominal ultrasound every 6 months should be offered to patients with a high risk of developing HCC: Child-Pugh A–B cirrhotic patients, all cirrhotic patients on the waiting list for liver transplantation, high-risk HBV chronic hepatitis patients (higher viral load, viral genotype or Asian or African ancestry) and patients with chronic hepatitis C and bridging fibrosis. Acc...

  4. Nocardial mycetoma: Diverse clinical presentations

    Directory of Open Access Journals (Sweden)

    Sharma Nand

    2008-01-01

    Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

  5. Metastatic Renal Cell Carcinoma Initially Presented as a Tongue Mass

    Directory of Open Access Journals (Sweden)

    Deniz ALTINEL

    2010-09-01

    Full Text Available Renal cell carcinoma is one of the most common tumours after lung and breast cancer to metastasize to the head and neck. Initial presentation by tongue metastasis is extremely rare. A 67-year-oldmale presented with a 4.8 cm mass on his tongue. The result of the punch biopsy from the tongue was diagnosed as a clear cell variant of squamous cell carcinoma. The biopsy was reevaluated due to the renal mass found during the check-up and the rapid enlargement of the mass. The excision of the tongue mass and the radical nephrectomy material confirmed the diagnosis of a metastatic renal cell carcinoma in the tongue and renal cell carcinoma in the kidney. Since metastasis of renal cell carcinoma to the tongue is uncommon it may cause difficulties in diagnosis and proper management. The metastasis of renal cell carcinoma should always be considered in the differential diagnosis among the clear cell neoplasms.

  6. Delayed recurrence of renal cell carcinoma presenting as a haemorrhoid

    OpenAIRE

    Davies, James R.L.; Smith, Gavin; Cornaby, Andrew J.; Thomas, Teresa; Lamparelli, Michael J.

    2015-01-01

    Metastatic non-colorectal cancer of the anal canal is a rare entity. To date, only four cases have been described in the literature. We present a 76-year-old man who was referred with an unusual perianal lesion. He had a history of renal cell carcinoma 7 years previously. Histologically, the lesion revealed clear cell carcinoma in keeping with metastasis. To our knowledge, this is only the second time a renal carcinoma metastasis to the anal canal has been identified.

  7. Nocardial mycetoma: Diverse clinical presentations

    OpenAIRE

    Sharma Nand; Mahajan Vikram; Agarwal Santwana; Katoch Vishwa; Das Ram; Kashyap Meera; Gupta Poonam; Verma Ghanshyam

    2008-01-01

    Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis), mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioid...

  8. Clinical and radiological manifestations of paraneoplastic syndrome of bronchogenic carcinoma

    Directory of Open Access Journals (Sweden)

    Goldner Branislav

    2005-01-01

    Full Text Available The objective of this study was to present some clinical and radiological manifestations of PNS in relation to bronchogenic carcinoma (BC and to evaluate the usefulness of imaging findings in the diagnosis of asymptomatic BC. In the study group of 204 patients (146 male and 58 female with proven bronchogenic carcinoma, PNS was present in 18 (8.62% patients. The patients with PNS were divided into two groups. The first one consisted of 13 (72.2% patients with symptoms related to primary tumours while the second one consisted of 5 (27.7% patients with symptoms, at initial appearance, indicative of disorders of other organs and systems. The predominant disorder was Lambert-Eaton Syndrome, associated with small-cell carcinoma. Endocrine manifestations included: inappropriate antidiuretic hormone production syndrome (small-cell carcinoma, a gonadotropin effect with gynaecomastia and testicular atrophy (planocellular carcinoma, small-cell carcinoma, a case of Cushing Syndrome (small-cell carcinoma, and hyper-calcaemia, due to the production of the parathyroid hormone-related peptide, which was associated with planocellular carcinoma. A rare case of bilateral exophthalmos was found as PNS at adenocarcinoma. Digital clubbing and hypertrophic osteoarthropathy (HO were associated with planocellular and adenocarcinoma, while clubbing was much more common than HO, especially among women. The differences between the two groups were related to the time of PNS appearance. In the first group, PNS occurred late on in the illness, while in the second group, PNS preceded the diagnosis of BC. Alternatively, the disappearance of a clinical or a radiological manifestation of PNS after surgery or chemotherapy may be an indicator of an improvement in health or PNS may be the first sign of illness recurrence. Radiological manifestations of PNS in asymptomatic patients may serve as a useful screen for identifying primary BC. In symptomatic patients, it may be an

  9. Nasopharyngeal carcinoma presenting as Gradenigo’s syndrome

    OpenAIRE

    Jana, Avik Kumar; Jaswal, Abhishek; Sikder, Biswajit; Jana, Utpal; Nandi, Tapan Kumar

    2006-01-01

    Nasopharyngeal carcinoma usually has an insidious onset and non-specific features in the initial stages. This makes early diagnosis difficult. The most usual presenting features are cervical lymphadenopathy, otological symptoms (serous otitis media) and involvement of adjacent cranial nerves. We report a case of Gradenigo’s syndrome in a patient of undifferentiated nasopharyngeal carcinoma.

  10. Clinical presentation of cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Cianfoni, Alessandro [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Pravatà, Emanuele, E-mail: emanuele.pravata@gmail.com [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); De Blasi, Roberto [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Tschuor, Costa Silvia [Dipartimento di Radiologia, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Bonaldi, Giuseppe [U.O. Neuroradiologia, Ospedali Riuniti di Bergamo, Largo Barozzi, 1, 24128 Bergamo (Italy)

    2013-10-01

    Presentation of a cerebral aneurysm can be incidental, discovered at imaging obtained for unrelated causes, can occur in the occasion of imaging obtained for symptoms possibly or likely related to the presence of an unruptured aneurysm, or can occur with signs and symptoms at the time of aneurismal rupture. Most unruptured intracranial aneurysms are thought to be asymptomatic, or present with vague or non-specific symptoms like headache or dizziness. Isolated oculomotor nerve palsies, however, may typically indicate the presence of a posterior circulation aneurysm. Ruptured intracranial aneurysms are by far the most common cause of non-traumatic subarachnoid hemorrhage and represent a neurological emergency with potentially devastating consequences. Subarachnoid hemorrhage may be easily suspected in the presence of sudden and severe headache, vomiting, meningism signs, and/or altered mental status. However, failure to recognize milder and more ambiguous clinical pictures may result in a delayed or missed diagnosis. In this paper we will describe the clinical spectrum of unruptured and ruptured intracranial aneurysms by discussing both typical and uncommon clinical features emerging from the literature review. We will additionally provide the reader with descriptions of the underlying pathophysiologic mechanisms, and main diagnostic pitfalls.

  11. Clinical presentation of cerebral aneurysms

    International Nuclear Information System (INIS)

    Presentation of a cerebral aneurysm can be incidental, discovered at imaging obtained for unrelated causes, can occur in the occasion of imaging obtained for symptoms possibly or likely related to the presence of an unruptured aneurysm, or can occur with signs and symptoms at the time of aneurismal rupture. Most unruptured intracranial aneurysms are thought to be asymptomatic, or present with vague or non-specific symptoms like headache or dizziness. Isolated oculomotor nerve palsies, however, may typically indicate the presence of a posterior circulation aneurysm. Ruptured intracranial aneurysms are by far the most common cause of non-traumatic subarachnoid hemorrhage and represent a neurological emergency with potentially devastating consequences. Subarachnoid hemorrhage may be easily suspected in the presence of sudden and severe headache, vomiting, meningism signs, and/or altered mental status. However, failure to recognize milder and more ambiguous clinical pictures may result in a delayed or missed diagnosis. In this paper we will describe the clinical spectrum of unruptured and ruptured intracranial aneurysms by discussing both typical and uncommon clinical features emerging from the literature review. We will additionally provide the reader with descriptions of the underlying pathophysiologic mechanisms, and main diagnostic pitfalls

  12. Clinical Presentations of Acute Leukemia

    International Nuclear Information System (INIS)

    Objective: To document the clinical presentation and epidemiology of various types of acute leukemia with their respective referral source at a tertiary level centre in Peshawar. Study Design: An observational study. Place and Duration of Study: Department of Pathology, Hayatabad Medical Complex (HMC), Peshawar, from January 2011 to May 2012. Methodology: A total of 618 bone marrow biopsy reports were reviewed. All biopsy reports labeled as acute leukemia were reviewed for age, gender, address, referring unit, diagnosis on bone marrow examination, presenting complaints, duration of illness and findings of clinical examination. Results: Ninety-two patients were diagnosed as suffering from acute leukemias (15%). ALL was most prevalent (46%), followed by AML (38%) and undifferentiated acute leukemia (16%). Males were affected more compared to females (60% vs. 40%). ALL and AML were predominant in pediatric (64%) and adults (77%) patients respectively. Patients from Afghanistan accounted for 33% of all cases followed by Peshawar (14%). Fever (77%), pallor (33%) and bleeding disorders (23%) were the main presenting complaints. Enlargement of liver, spleen and lymph nodes together was associated with ALL compared with AML (p = 0.004). Conclusion: ALL-L1 and AML-M4 were the most common sub-types. Fever, pallor and bleeding disorders were the main presenting complaints. Enlargement of liver, spleen and lymph nodes was more frequently associated with ALL compared to AML. (author)

  13. Meningitis, clinical presentation of tetanus.

    Science.gov (United States)

    Moniuszko, Anna; Zajkowska, Agata; Tumiel, Ewa; Rutkowski, Krzysztof; Czupryna, Piotr; Pancewicz, Sławomir; Rutkowski, Ryszard; Zdrodowska, Agnieszka; Zajkowska, Joanna

    2015-01-01

    Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease. PMID:25789186

  14. Meningitis, Clinical Presentation of Tetanus

    Directory of Open Access Journals (Sweden)

    Anna Moniuszko

    2015-01-01

    Full Text Available Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease.

  15. Clinical management of uterine papillary serous carcinoma.

    Science.gov (United States)

    Roelofsen, Thijs; van Ham, Maaike A; de Hullu, Joanne A; Massuger, Leon F

    2011-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive variant of endometrial cancer. Owing to its rarity, most clinicians are unfamiliar with the clinical aspects and management of UPSC. Furthermore, little prospective evidence exists regarding how best to treat this subset of patients. In anticipation of prospective clinical trials, this article summarizes the latest results of various clinical management options in the different substages of UPSC, with a special focus on the effects of cytoreductive surgery, comprehensive surgical staging and different adjuvant treatment options in relation to recurrence rate and survival outcome. PMID:21166512

  16. Clinical presentations of food allergy.

    Science.gov (United States)

    Mansoor, Darlene K; Sharma, Hemant P

    2011-04-01

    Food allergies are immune-mediated responses to food proteins. Because of differences in the underlying immunologic mechanisms, there are varying clinical presentations of food allergy. This article discusses the manifestations of IgE-mediated disorders, including urticaria and angioedema, rhinoconjunctivitis, asthma, gastrointestinal anaphylaxis, generalized anaphylaxis, food-dependent exercise-induced anaphylaxis, and oral allergy syndrome. It also reviews the presentations of mixed IgE- and cell-mediated disorders, including atopic dermatitis and eosinophilic gastrointestinal disorders. Finally, the manifestations of cell-mediated food allergies are discussed, including dietary protein-induced proctitis and proctocolitis, food protein-induced enterocolitis syndrome, celiac disease, and food-induced pulmonary hemosiderosis. PMID:21453804

  17. Differentiated thyroid carcinoma : treatment and clinical consequences of therapy

    NARCIS (Netherlands)

    Hoftijzer, Hendrieke Catherijn

    2011-01-01

    The first chapters of this thesis describe the treatment of radioiodine non-avid thyroid carcinoma with the tyrosine kinase inhibitor sorafenib. The remainder of the thesis describes the clinical consequences of the treatment of thyroid carcinoma.

  18. Mucoepidermoid carcinoma of parotid presenting as unilocular cyst

    International Nuclear Information System (INIS)

    An interesting case of a 09 years old girl is reported who presented with a painless, mobile, spherical, fluctuant and brilliantly translucent swelling in front of left ear. The fine needle aspiration revealed turbid dark yellow colour fluid. This cystic swelling was completely excised and the specimen on histopathology was reported as low grade Mucoepidermoid carcinoma. Recovery was uneventful. This unusual presentation of Mucoepidermoid carcinoma as a preauricular cyst is one of the rare unique reported case. (author)

  19. LATE PRESENTATION OF BASAL CELL CARCINOMA - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Phani Kumar

    2013-12-01

    Full Text Available PURPOSE: To present a case of basal cell carcinoma with late presentation. METHODS: A 55year - old woman with gradual progressive, nodular, small brown lesion at the left lower eye lid for past 3 years was examined with, computed tomography (CT and then Excisional biopsy was done. RESULTS: The presenting symptom s of the patient were gradual progressive, nodular, sma ll brown lesion at the left lower eye lid . Excisional bi opsy with frozen section of the lesion was performed. Histopathologic evaluation of the eyelid lesion disclosed Trichoblastic (basal cell carcinoma of lower eye lid with large nodular and cribiform (a denoid patterns without any lymph - vascula r and perineural invasion. Post - operative period was uneventful. CONCLUSION: We are hereby reporting this case of eyelid BCC, with no history of skin cancer, or radiation treatment but exposure to sunlight. With earl y adequate treatment the prognosis is good KEYWORDS: B asal cell carcinoma, Excisional biopsy, Trichoblastic carcinoma .

  20. Clinical presentation of primary hypothyroidism

    International Nuclear Information System (INIS)

    Objective: To determine the clinical preparation of primary hypothyroidism at the time of diagnosis. Design: It was an observational and prospective study. Place and Duration of Study: Civil Hospital, Karachi from 1st January 1997 to 31st December 1997. Subjects and Methods: Forty-eight consecutive cases of primary hypothyroidism were included. A detailed history with special emphasis on symptoms and signs was conducted and the findings observed were noted in previously made proforma. Results: Primary hypothyroidism was found to be 5 times more common in female patients, with male to female ratio 1:5, majority of cases (33.33%) were between 41 to 50 years of age. The common symptoms at the time of presentation were tiredness (95.8%), weakness (91.6%), weight gain (85.4%), hoarseness of voice (83.3%), cold intolerance (77.0%) and constipation (75.0%) in patients. Physical signs observed were delayed relaxation of ankle jerk (93.7%), periorbital edema (83.3%), thick tongue (62.5%), goiter (50.0%), dry and coarse skin (47.9%) in patients. Serum, TSH, T4 and T3 were performed in all cases through immunoradiometric technique. Serum TSH was markedly elevated, with normal to reduced T4 and T3 levels in all cases. Conclusion: Primary hypothyroidism was found more common in female than male of the age group 41-50 years. Weakness, tiredness, hoarseness of voice and constipation were the common symptoms noted. The diagnosis is almost certain on clinical grounds if the patient happens to have delayed relaxation of ankle jerks and periorbital puffiness. (author)

  1. Metastasis of feline pulmonary carcinoma presenting as multiple digital swelling

    International Nuclear Information System (INIS)

    Multiple digital swelling and painful lameness in four cats was found on clinical, radiographic and post mortem examination to be due to metastasis of primary bronchial carcinoma. Metastases were identified in several organs at necropsy and histological findings were consistent with arterial dissemination from the primary lesion

  2. Parathyroid carcinoma: a review and presentation of two case histories

    International Nuclear Information System (INIS)

    Parathyroid carcinoma is extremely rare, accounting for only 0.005% of all cancers. This paper reviews the pathological and clinical aspects of this neoplasm and reports the histories of two cases seen at the Princess Royal University Hospital, Farnborough. (authors)

  3. Large Cell Neuroendocrine Carcinoma of Urinary Bladder; Case Presentation

    OpenAIRE

    Ayşegül SARI; Ermete, Murat; Canan SADULLAHOĞLU; Bal, Kaan; Ahmet BOLÜKBAŞI

    2013-01-01

    Large cell neuroendocrine tumor of the urinary bladder is very rare. It is a type of neuroendocrine carcinoma that is morphologically different from small cell carcinoma.This manuscript describes a 67-year-old man who presented with hematuria. Ultrasonogrophic and computer tomography revealed a 5 cm mass in right posterolateral wall of the bladder that invaded perivesical tissue and he subsequently underwent transurethral resection. Microscopic examination showed a tumor with a sheet-like and...

  4. Oral cavity metastasis: An unusual presentation of carcinoma prostate

    OpenAIRE

    Damodaran, Dileep; Kathiresan, N.; Satheesan, B.

    2008-01-01

    Oral cavity cancers form the third most common cancers among men in south India. The oral cavity is a very rare site for metastases and has been described in various cancers, particularly lung, breast, kidney and colon carcinoma. Here a very rare case of a buccal metastasis from prostate carcinoma that was originally evaluated as a primary oral cavity malignancy is presented. Histopathological examination of a biopsy of the lesion revealed papillary adenocarcinoma Grade II, nuclear Grade II, ...

  5. Unusual Presentation of Renal Cell Carcinoma: Gluteal Metastasis

    OpenAIRE

    Yunus Emre Goger; Mehmet Mesut Piskin; Mehmet Balasar; Mehmet Kilinc

    2013-01-01

    Renal cell carcinoma (RCC) has widespread and unpredictable metastatic potential. The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, and brain; however the soft tissue metastasis is rare (2,3). Here we report a 76-year-old male patient who had renal cell carcinoma presented with gluteal metastasis. To our knowledge this is the first renal cell cancer case with gluteal metastasis at the initial diagnosis.

  6. Carcinoma verrucoso: uma variante clínico-histopatológica do carcinoma espinocelular Verrucous carcinoma: a clinical-histopathologic variant of squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Maurício Zanini

    2004-10-01

    Full Text Available O carcinoma verrucoso é uma rara e indolente forma do carcinoma espinocelular descrita por Ackerman em 1948. Sua localização preferencial é a cavidade oral. Clinicamente manifesta-se como lesão verrucosa, de progressivo e lento crescimento e bom prognóstico. O tratamento de escolha é a exérese cirúrgica, devendo o paciente ser regularmente acompanhado devido ao risco de recorrências.Verrucous carcinoma is a rare and indolent variant of the squamous cell carcinoma described by Ackerman in 1948. The oral cavity is a most common site. Clinically, it presents most often as a slow-growing verrucous lesion. The prognosis is good. Treatment of choice is surgery. Patients require frequent reevaluation because recurrences may occur.

  7. Presentation extra ocular sebaceous carcinoma; case report and literature review

    International Nuclear Information System (INIS)

    Full text: Introduction. The Sebaceous carcinoma is a rare adnexal tumor is characterized for aggressive prone to local recurrence and dissemination. 75% is 25% peri ocular and extra ocular. Their presence may be related to Mu ir Syndrome Tower which is a dominant autosomal geno dermatosis. Target. To review the literature from the presentation of a clinical case with multiple local recurrence and distant metastases. Materials and methods. Analyzed the story of a 21 year old patient carrying a carcinoma inter ciliary sebaceous level diagnostic presented many difficulties, with tendency to local recurrence and progressive aggressiveness in which it was established the definitive diagnosis when it reaches a stage IV. Results. Was treated in a story with multiple surgical resections, the last recurrence penalty off surgery for extensive commitment: cranial, and spinal meninges cord. Treatment was palliative hypo fractionated radiotherapy on cervical spine reaching 18 Gy in 3 fractions and then combined chemotherapy based on single drug Capecitabine at doses of 1650 mg/m2 day concurrent with 60Gy radiation reaching in fractions of 2.4 Gy of the primary lesion. with good initial symptomatic response but rapid evolution after treatment completed died a month with extensive bone progression. Conclusions. Curative treatment is surgery, within these Mo hs technique is that of choice. In our patient, disease extension planteable resection did opting for hypofractionated radiotherapy to total doses greater than 60 Gy, the which demonstrated good symptom control and palliative judiciously Fluropirimidinas association to radiotherapy was based on previous studies suggesting a benefit of the combination despite being considered such as radio-resistant tumors. not still available randomized phase III due to the rareness of these tumors

  8. Adrenal metastasis as first presentation of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Zacharakis Evangelos

    2005-07-01

    Full Text Available Abstract Background Metastases from hepatocellular carcinoma (HCC can be found in the lung and adrenal gland. We report case of a patient who presented with adrenal metastasis as the first clinical manifestation of HCC. Case presentation A patient was referred for surgical treatment for a tumor in retro-peritoneal space. The computerized tomography (CT scan revealed a mass originating from the left adrenal gland. The patient underwent left adrenalectomy and the exploration of abdominal cavity did not reveal any other palpable lesions. Histologically, the resected lesion was a poorly differentiated metastatic tumor from HCC. Seven months later patient was readmitted complaining of cachexia, icterus, and significant weight loss. CT scan revealed hyperdense lesions of the liver Conclusion HCC may have atypical presentations like in present case. Fine needle aspiration/tru-cut® biopsy might be useful in the investigation of an accidentally discovered adrenal mass regardless of the size and can lead to the detection of a primary tumor.

  9. The diagnostic value of xero-mammography in clinically occult breast carcinoma

    International Nuclear Information System (INIS)

    Seventh-four clinically occult breast carcinomas were detected in 7535 patients who were examined clinically and by xeromammography. The criteria by which a diagnosis of clinically occult breast carcinoma was established are described in detail. The most frequent finding of a clinically occult breast carcinoma in the xeromammogram was an irregular mass density 1 cm in diameter or less with microcalcifications. Axillary lymph node metastases were present in 29.7% of the total group of patients, which is much fewer than what might have been expected if the carcinomas had been discovered by palpation during the clinical examination or by the patient herself. This means a better prognosis and a lower death rate from breast carcinoma. Screening xeromammography is encouraged for all women after the age of 40, especially for those who belong to the high-risk group, even though they are quite asymptomatic, as there is hope of detecting cancers before they become palbale. (orig.)

  10. Carcinoma en cuirasse : A rare presentation of breast cancer

    Directory of Open Access Journals (Sweden)

    Mahore Sadhana

    2010-04-01

    Full Text Available Carcinoma en cuirasse is a form of cutaneous metastasis. Although this condition is rare, it is most commonly associated with breast carcinoma with local recurrence after mastectomy. Cutaneous metastasis presents most commonly a few months or years after the primary has been diagnosed. Less frequently a metastasis is diagnosed at the same time as the primary tumor or presents as the first manifestation of the disease. We report a case of carcinoma en cuirasse in a 50-year-old female who presented with elevated, finely nodular, indurated skin lesions on left anterior chest wall, axillary region and keloid - like patch on left upper arm. On further examination a breast mass was detected. Fine needle aspiration of all the lesions was performed. Cytodiagnosis was given as infiltrating duct carcinoma of breast with metastatic carcinoma involving left anterior chest wall, axilla and left upper arm. We should not disregard keloid-like or indurated patches on skin which should be investigated thoroughly.

  11. Metastatic Renal Cell Carcinoma Initially Presented as a Tongue Mass

    OpenAIRE

    Altinel, Deniz; Demet ETİT; Tan, Ayça; Ümit BAYOL; Volkan BULUT; Gökçöl Erdoğan, Işın; Beyhan, Rafet; Yusuf YALÇIN

    2010-01-01

    Renal cell carcinoma is one of the most common tumours after lung and breast cancer to metastasize to the head and neck. Initial presentation by tongue metastasis is extremely rare. A 67-year-oldmale presented with a 4.8 cm mass on his tongue. The result of the punch biopsy from the tongue was diagnosed as a clear cell variant of squamous cell carcinoma. The biopsy was reevaluated due to the renal mass found during the check-up and the rapid enlargement of the mass. The excision of the tongue...

  12. PIGMENTED BASAL CELL CARCINOMA: A RARE CLINICAL AND HISTOPATHOLOGICAL VARIANT

    OpenAIRE

    Chandralekha; Vijaya Bhaskar; Bhagyalakshmi; Sudhakar; Sumanlatha

    2015-01-01

    Basal cell carcinoma is a common malignant tumour of skin , commonly referred to as „rodent ulcer‟. It is common in the head and neck region. Exposure to ultraviolet radiation is an important risk factor. Pigmented basal cell carcinoma is a clinical and histological variant of basal cell carcinoma that exhibits inc reased pigmentation. It is a rare variant that can clinically mimic malignant melanoma. It is more common in males than females. Herein , we are...

  13. Clinical and laboratory features of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Andrés Cárdenas

    2007-02-01

    Full Text Available

    The clinical presentation of hepatocellular carcinoma (HCC differs between patients in developing countries (African and Chinese populations from those in industrialized countries. In industrialized countries, HCC co-exists with symptomatic cirrhosis in 80% of cases and clinical manifestations are usually related to those of the underlying disease. On the other hand, patients from developing countries have HCC and cirrhosis in approximately 40% of cases. Underlying cirrhosis in many cases is not advanced and does not produce any symptoms or associated symptoms are masked by those of the tumor (right upper quadrant pain, mass in the upper abdomen, weight loss and weakness. In a subset of patients, there are no clinical manifestations as HCC may occur in the context of hepatitis B infection without cirrhosis.

    Clinical Manifestations

    In Western countries, nearly 35% percent of patients with HCC are asymptomatic. Some of the most common clinical manifestations include: abdominal pain (53-58% of patients, especially in epigastrium or right upper quadrant, abdominal mass (30%, weight loss, malaise, anorexia, cachexia, jaundice or fever.

    Physical Exam

    Physical findings vary with the stage of disease. The patient may exhibit slight or moderate wasting when first seen. In patients with cirrhosis, typical stigmata of chronic liver disease may be present. In advanced stages of HCC the liver may be enlarged and there is significant tenderness. An arterial bruit may be heard over the liver

  14. Hepatocellular Carcinoma Presenting with Obstructive Jaundice during Pregnancy

    OpenAIRE

    Huan-wei Chen; Feng-jie Wang; Jie-yuan Li; Eric C. H. Lai; Wan Yee Lau

    2014-01-01

    Introduction. Both hepatocellular carcinoma (HCC) presenting during pregnancy and HCC presenting with obstructive jaundice due to a tumor cast in the biliary tract are very rare. The management of these patients remains challenging. Presentation of Case. A 23-year-old lady presented with obstructive jaundice at 38 weeks of gestation. Investigations showed HCC with a biliary tumor thrombus. She received percutaneous transhepatic biliary drainage (PTBD) and caesarean section. Right hepatectomy,...

  15. Clinical and biological features of familial nonmedullary thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    高健

    2014-01-01

    Objective To analyze the clinical and biological features of familial nonmedullary thyroid carcinoma(FNMTC).Methods Clinical data of 66 FNMTC cases of 32pedigrees was retrospectively analyzed,compared with that of 182 control cases taken randomly from the patients with sporadic papillary thyroid carcinoma(SPTC),who

  16. Unusual presentation of an Amazon parrot (Amazon a species) with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Non-haematopoietic hepatic malignancies are uncommon in birds. The clinical presentation (i.e, chronic buphthalmos) and non-specific radiographic findings observed in this adult Amazon parrot (Amazona spp,) were not consistent with previous reports describing the natural behaviour of metastatic hepatocellular carcinoma in birds

  17. Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

    OpenAIRE

    2010-01-01

    Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

  18. Isolated abdominal wall metastasis from renal cell carcinoma: Unusual presentation

    OpenAIRE

    Suresh Kumar; Pramod Kumar Sharma; Malay Kumar Bera

    2015-01-01

    Fifty-seven-year-old gentleman, who was a known victim of left-sided clear cell renal cell carcinoma (RCC), presented with isolated huge parietal swelling in left anterolateral aspect of abdomen. He had undergone open left radical nephrectomy 2 years back. Parietal swelling was widely excised and histopathology revealed clear cell RCC, nuclear Fuhrman grade 2.

  19. Pilomatrix carcinoma presenting as an extra axial mass: clinicopathological features

    Directory of Open Access Journals (Sweden)

    Gibbons David

    2008-11-01

    Full Text Available Abstract Pilomatrix carcinoma is the rare malignant counterpart of pilomatrixoma, a skin adnexal tumour originating from hair matrix cells. Pilomatrix carcinoma can arise as a solitary lesion de novo, or through transformation of a pilomatrixoma. Pilomatrixoma was first described erroneously as being of sebaceous gland origin but was later discovered to be derived from hair matrix cells. They are rare, slow growing tumours of the skin found in the lower dermis and subcutaneous fat and are predominantly found in the neck and the scalp. While known to be locally aggressive, no malignant form was thought to exist until it was described relatively recently. Since then, approximately ninety cases of pilomatrix carcinoma have been reported. We report the case of a 41 year old mentally retarded male who had a longstanding lesion in the left neck for approximately fifteen years previously diagnosed as a pilomatrixoma. He presented with severe headache, falls and visual disturbance and a biopsy showed pilomatrix carcinoma of the occipital region which, on computed tomography ( CT invaded the occipital bone, the cerebellum and the left temporal lobe. At his initial presentation he had a craniotomy and subtotal excision of the lesion but received no adjuvant therapy. After an early intracranial recurrence he had further debulking and adjuvant external beam radiotherapy. He has had no further intracranial recurrence after three and a half years of follow-up. Here we present the pathological features of this uncommon tumour.

  20. Pilomatrix carcinoma presenting as an extra axial mass: clinicopathological features.

    LENUS (Irish Health Repository)

    Aherne, Noel J

    2008-01-01

    Pilomatrix carcinoma is the rare malignant counterpart of pilomatrixoma, a skin adnexal tumour originating from hair matrix cells. Pilomatrix carcinoma can arise as a solitary lesion de novo, or through transformation of a pilomatrixoma. Pilomatrixoma was first described erroneously as being of sebaceous gland origin but was later discovered to be derived from hair matrix cells. They are rare, slow growing tumours of the skin found in the lower dermis and subcutaneous fat and are predominantly found in the neck and the scalp. While known to be locally aggressive, no malignant form was thought to exist until it was described relatively recently. Since then, approximately ninety cases of pilomatrix carcinoma have been reported.We report the case of a 41 year old mentally retarded male who had a longstanding lesion in the left neck for approximately fifteen years previously diagnosed as a pilomatrixoma. He presented with severe headache, falls and visual disturbance and a biopsy showed pilomatrix carcinoma of the occipital region which, on computed tomography ( CT ) invaded the occipital bone, the cerebellum and the left temporal lobe. At his initial presentation he had a craniotomy and subtotal excision of the lesion but received no adjuvant therapy. After an early intracranial recurrence he had further debulking and adjuvant external beam radiotherapy. He has had no further intracranial recurrence after three and a half years of follow-up. Here we present the pathological features of this uncommon tumour.

  1. Ruptured renal cell carcinoma in pregnancy: a rare case presentation

    Directory of Open Access Journals (Sweden)

    Prameela RC

    2016-05-01

    Full Text Available Malignancy in pregnancy is rare. Carcinomas in pregnancy are mostly kidney cell mass. Renal cell carcinoma (RCC is the commonest malignancy in pregnancy. Because of softness and increased vascularity, rupture of renal cell carcinoma is not uncommon. Here we are presenting a rare case of renal cell carcinoma in pregnancy with spontaneous rupture resulting in massive hemoperitoneum and serious outcome because of late presentation renal cell carcinoma seldom ruptures. A 26 year old woman G2P1L1 with term pregnancy was referred to hospital 80kms away from periphery with non-progression of labour. There was antenatal record suggesting hypertensive disorder of pregnancy in second trimester. On examination, patient was in hypovolemic shock with profuse distension of abdomen. Diagnosis of abruption grade 3 or rupture uterus was made and immediate laparotomy was done. On opening the abdomen, there was hemoperitoneum but uterus was intact. Emergency LSCS done extracted a stillborn baby. There were no retro placental clots also. There was lot of necrotic tissue in the abdomen and there was a tumour arising from lower pole of left kidney which had invaded the renal vessels and had ruptured. Peripartum hysterectomy and left nephrectomy was done. Women did not respond to treatment and died. The objective of presenting this case is the dilemmas faced by the obstetrician in case of shock in 2nd stage of labour. Simple diagnostic tool like renal ultrasound will help to detect at an early stage which could improve the outcome. All cases of hypertensive disorders of pregnancy should be investigated for secondary causes of hypertension. Abdominal USG must be done for all cases of hypertensive disorders of pregnancy in 2nd trimester. Prompt diagnosis and early treatment is the key in management of such condition in pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1677-1679

  2. Insular Carcinoma of Thyroid Presenting as a Giant Skull Lesion: A Dilemma in Treatment.

    OpenAIRE

    Bhattacharya A; Sandeep Bansal; Amit Shankar; Gupta, Ashok K.; Rijuneeta Gupta; Amanjit Bal

    2013-01-01

    Thyroid surgeons are becoming increasingly more aware of a histologically distinct subset of thyroid carcinoma whose classification falls between well-differentiated and anaplastic carcinomas with respect to both cell differentiation and clinical behavior. This subtype of tumors has been categorized as poorly differentiated or insular carcinoma, based on its characteristic cell groupings. Although the differentiation of insular carcinoma from other thyroid carcinomas has important prognostic ...

  3. Clinical analysis of primary anaplastic carcinoma of the small intestine

    Institute of Scientific and Technical Information of China (English)

    Tsutomu Namikawa; Kazuhiro Hanazaki

    2009-01-01

    Primary anaplastic carcinoma is a rare variant of small intestinal cancer. Most reports of primary anaplastic carcinoma of the small intestine are isolated case reports, therefore the clinicopathological features, therapeutic management, and surgical outcome of this tumor type remain unclear. This review analyzes the available clinical characteristics of primary anaplastic carcinoma of the small intestine and investigates key differences from differentiated adenocarcinoma of the small intestine. A Medline search was performed using the keywords 'small intestine' and 'anaplastic carcinoma' or 'undifferentiated carcinoma'. Additional articles were obtained from references with in the papers identified by the Medline search. The literature revealed a poor prognosis for patients who underwent surgical resection for anaplastic carcinoma of the small intestine, which gave a 3-year overall survival rate of 10.8% and a median survival time of 5.0 mo. The literature suggests that anaplastic carcinoma is markedly more aggressive than differentiated adenocarcinoma of the small intestine. Surgical resection with the aim of complete tumor removal provides the only beneficial therapeutic option for patients with anaplastic carcinoma of the small intestine, because chemotherapy and radiation therapy have no significant effect on the rate of survival. However, despite complete tumor resection, most patients with anaplastic carcinoma of the small intestine are at great risk of disease recurrence. Multicenter clinical trials are expected to provide additional therapeutic strategies and establish the efficacy of multimodality adjuvant therapy. This report also highlights the importance of a systematic diagnostic approach for anaplastic carcinoma of the small intestine.

  4. CLINICAL STUDY OF CARCINOMA OF OESOPHAGUS

    Directory of Open Access Journals (Sweden)

    Rajshekhar

    2015-09-01

    Full Text Available There is no cancer that is common anywhere that is not are somewhere else . This applied to oesophageal carcinoma particularly to its dramatic feature in varying incidence in different parts of the world. T he aetiology of this disease is still an enigma, so many factors being responsible for causation of the disease. The epidemiological study in high incidence are like iran, north west china, Afghanistan showed the different factor were responsible for the prevalence of the disease.in our country also, the frequency with it occurs varies in diffent parts. The average life expectancy of untreated patients with carcinoma oesophagus is only a few months to a maximum of 1 year. By the time the patient presents with dysphagia, usually the disease has extended beyond the curable limits. This is particularly due to the close relationship to other vital mediastinal structures. Nevertheless due to the advent of new techniques in radiology early detection of the disease is now possible. There has been a change in treatment modalities also in the form newer surgical techniques, radiotherapy and chemotherapy. There has been an increase in prognostic index in recent years. As this disease is common in this part of the country, an attempt has been made to analyse the various aetiological factors, clinicopathological correlation and various treatment modalities. All these cases were studied carefully, thoroughly investigated and treated appropriately. R elevant literature was reviewed and an attempt of comparative study also has been done. .

  5. Endodontic microsurgery, presentation of a clinical case

    International Nuclear Information System (INIS)

    A literature review is conducted on endodontic surgery. The report of a clinical case is facilitated. The technique chosen according to the clinical and radiographic examination was endodontic microsurgery, the case has presented a positive evolution of four years

  6. Chronic hepatitis C presenting with a diagnosis of hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Hallager, Sofie; Weis, Nina

    2014-01-01

    Chronic hepatitis C (CHC) affects around 16,000 individuals in Denmark of whom about 50% are diagnosed. In the presence of CHC and cirrhosis the annual risk of hepatocellular carcinoma (HCC) is 1-5%. We report on two patients who presented with disseminated HCC at the time of CHC diagnosis. At the...... time of diagnosis only non-curative treatment was available. An earlier diagnosis of CHC could potentially have led to a cure and prevention of HCC....

  7. Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses

    OpenAIRE

    KIM Dong-Wook; Hah, J. Hun; An, Soo-Youn; Chang, Hak; Kim, Kwang Hyun

    2011-01-01

    Mandibular metastasis of thyroid carcinoma is extremely rare. We present the case of a 46-year-old woman who had bilateral huge cheek masses that had grown rapidly over several years. Intra-oral mucosal tissue biopsy and imaging work-up including computed tomography scan and magnetic resonance imaging were performed and the initial diagnosis was presumed to be central giant cell granuloma. Incidentally detected thyroid lesions were studied with ultra-sonography guided fine needle aspiration a...

  8. Large-cell Neuroendocrine Carcinoma of the Lung: Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Serra Valdés

    2014-11-01

    Full Text Available Lung cancer is the leading cause of death among malignant tumors. Pulmonary neuroendocrine tumors encompass a broad spectrum of tumors including the large-cell neuroendocrine carcinoma. The case of a 57-year-old white housewife with a history of smoking, diabetes, hypothyroidism and hypertension who sought medical attention because of headache, vomiting, weight loss, neuropsychiatric symptoms and metastatic inguinal lymphadenopathy is presented. The symptoms resulted from the extrapulmonary metastases found. Imaging studies, histology and immunohistochemistry confirmed the diagnosis of large-cell carcinoma of the lung with neuroendocrine pattern. This type of highly aggressive tumor is usually diagnosed when there are already multiple metastases, which affects the short-term prognosis. The aim of this paper is to inform the medical community of this case due to the scarce reports in the literature.

  9. Invasive lobular carcinoma: a rare presentation in the male breast.

    Science.gov (United States)

    Melo Abreu, Elisa; Pereira, Pedro; Marques, José Carlos; Esteves, Gonçalo

    2016-01-01

    Breast cancer in men is uncommon, accounting for ratio and familial history (BRCA 2 and 1). The authors present a case of a 52-year-old man with no relevant predisposing factors to breast cancer, who presented with a painless, firm nodule, fixed to the nipple on the left breast, associated with nipple retraction and ulceration, and fully characterised by mammogram and ultrasound. Histopathological and immunohistochemical analysis revealed the diagnosis of invasive lobular breast carcinoma and the patient underwent left radical mastectomy, followed by adjuvant chemotherapy, radiotherapy and hormonotherapy. A brief review of the literature is presented. PMID:27151060

  10. Clinical trials of antiangiogenic therapy for hepatocellular carcinoma.

    Science.gov (United States)

    Taketomi, Akinobu

    2016-04-01

    Angiogenesis is a promising therapeutic target to inhibit tumor growth. This review summarizes data from clinical trials of antiangiogenic agents in hepatocellular carcinoma. A systematic search of PubMed was performed to identify clinical trials of specific antiangiogenic agents in hepatocellular carcinoma treatment, particularly phase III trials involving treatment guidelines for advanced hepatocellular carcinoma. Sorafenib is the only systemic drug approved for the treatment of advanced hepatocellular carcinoma. Two large-scale, randomized phase III trials using sorafenib involving patients with unresectable HCC showed a significant survival benefit compared with placebo control groups. However, subsequent phase III trials of antiangiogenic agents in hepatocellular carcinoma have failed to improve survival compared with standard treatment protocols using sorafenib. The efficacy of antiangiogenic agents in combination with other drugs, transarterial chemoembolization, and surgical resection is currently being investigated. Future research is expected to optimize antiangiogenic therapies in combination with standard treatment with sorafenib. PMID:26899258

  11. Large Cell Neuroendocrine Carcinoma of Urinary Bladder; Case Presentation

    Directory of Open Access Journals (Sweden)

    Ayşegül SARI

    2013-01-01

    Full Text Available Large cell neuroendocrine tumor of the urinary bladder is very rare. It is a type of neuroendocrine carcinoma that is morphologically different from small cell carcinoma.This manuscript describes a 67-year-old man who presented with hematuria. Ultrasonogrophic and computer tomography revealed a 5 cm mass in right posterolateral wall of the bladder that invaded perivesical tissue and he subsequently underwent transurethral resection. Microscopic examination showed a tumor with a sheet-like and trabecular growth pattern comprising necrotic areas which infiltrated the muscularis propria. Tumoral cells had coarse chromatin, prominent nucleoli, moderate amount of cytoplasm and immunohistochemically stained strongly positive with synaptophysin, chromogranin and CD56.There are only few case reports of large cell neuroendocrine tumor of the urinary bladder so the biological behavior and the treatment protocol of these tumors are still obscure. Appropriate management protocols and prognostic estimation could be achived by the increased number of cases being reported. Therefore in a case of a poorly differentiated tumor in bladder, although rare, it is important to consider large cell neuroendocrine carcinoma in differential diagnosis.

  12. Clinical, pathological and sonographic characteristics of unexpected gallbladder carcinoma

    OpenAIRE

    Jin-huan WANG; Liu, Bo-Ji; Xu, Hui-Xiong; Sun, Li-ping; Li, Dan-Dan; Guo, Le-Hang; Liu, Lin-Na; Xu, Xiao-Hong

    2015-01-01

    Objectives: To investigate the clinical, pathological, and sonographic characteristics of unexpected gallbladder carcinoma (UGC). Methods: Of 5424 patients who had undergone cholecystectomy from December 2006 to October 2013, 54 patients with primary gallbladder carcinomas confirmed by pathological diagnosis were identified. The patients were divided into two groups: diagnosed before operation (n=34) and UGC groups (n=20), of whom the clinical, pathological, and sonographic characteristics we...

  13. Familial renal cell carcinoma: clinical and molecular genetic aspects

    OpenAIRE

    Maher, E. R.; Yates, J. R. W.

    1991-01-01

    Renal cell carcinoma (RCC) accounts for 2% of all human cancer, but familial cases are infrequent. Riches (1963) and Griffin et al. (1984) in a population-based case-control study found a family history of renal cell carcinoma in 2.4% of affected patients compared to 1.4% of controls. Nevertheless the importance of inherited tumours in clinical practice and medical research is disproportionate to their frequency. In clinical practice recognition of familial RCC can provide opportunities to pr...

  14. Clinical Application of 18F-FDG PET in Urothelial Carcinoma, Vulva and Vaginal Carcinoma

    International Nuclear Information System (INIS)

    Clinical experience on FDG PET in urothelial tumors, vulva and vaginal carcinoma is still limited. The main interest of this review is to study a bibliographic review and applications of PET for urothelial tumors, vulva and vaginal carcinoma. The role of positron emission tomography (PET) is still evolving but is likely to be most important in determining early spread of disease in patients with aggressive tumors and for monitoring response to therapy. More extensive clinical investigations are necessary to support this indications

  15. Clinical Application of {sup 18}F-FDG PET in Urothelial Carcinoma, Vulva and Vaginal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun [Kwandong University College of Medicine, Koyang (Korea, Republic of)

    2008-12-15

    Clinical experience on FDG PET in urothelial tumors, vulva and vaginal carcinoma is still limited. The main interest of this review is to study a bibliographic review and applications of PET for urothelial tumors, vulva and vaginal carcinoma. The role of positron emission tomography (PET) is still evolving but is likely to be most important in determining early spread of disease in patients with aggressive tumors and for monitoring response to therapy. More extensive clinical investigations are necessary to support this indications.

  16. Present and future possibilities for early diagnosis of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Piotr Stefaniuk, Janusz Cianciara, Alicja Wiercinska-Drapalo

    2010-01-01

    Full Text Available Hepatocellular carcinoma (HCC represents the fifth most common cancer in the world, and the third most frequent oncological cause of death. The incidence of HCC is on the increase. HCC typically develops in patients with chronic liver diseases, and cirrhosis, usually with viral etiology, is the strongest predisposing factor. Nowadays HCC diagnosis is a multistage process including clinical, laboratory, imaging and pathological examinations. The prognosis of HCC is mostly poor, because of detection at an advanced, non-resectable stage. Potentially curative treatment (surgery is limited and really possible only for cases with small HCC malignancies. For this reason, more effective surveillance strategies should be used to screen for early occurrence of HCC targeted to the population at risk. So far, the generally accepted serological marker is α-fetoprotein (AFP. Its diagnostic accuracy is unsatisfactory and questionable because of low sensitivity, therefore there is a strong demand by clinicians for new HCC-specific biomarkers. In this review, we will focus on other biomarkers that seem to improve HCC diagnosis, such as AFP-L3, des-γ-carboxyprothrombin, α-l-fucosidase, γ-glutamyl transferase, glypican-3, squamous cell carcinoma antigen, a new generation of immunoglobulin M-immunocomplexes, and very promising gene-expression profiling.

  17. Presentation of Apocrine Breast Carcinoma in a Woman with Bilateral Silicone Prosthesis

    International Nuclear Information System (INIS)

    We present a case of apocrine breast carcinoma in a 45 year-old woman with bilateral silicone breast prosthesis whose clinical manifestations and mammography were that of a palpable nodule-high glandular density, rounded and with imprecise borders devoid of any visible microcalcifications. A bibliographical revision confirmed the infrequent association of this type of tumor with the presence of silicone breast implants, precisely in which we consider its radiological interest to lie. (Author) 11 refs

  18. Cranium Metastasis: An Unusual Presentation of Differentiated Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Ayşe Kubat Üzüm

    2013-09-01

    Full Text Available Distant metastasis may be the initial sign of differentiated thyroid carcinoma in rare cases. In this instance, the treatment approach is usually individualized. Unlike most other cancers, local treatment of the primary tumor (total thyroidectomy is preferred as ablative surgery; so that radioactive iodine therapy should be more effective. Repeated doses of I-131 and radiotherapy for metastatic lesions may be needed. We report a female who presented with bone metastasis with fatal progression. Turk Jem 2013; 17: 71-4

  19. Nasopharyngeal bursitis: from embryology to clinical presentation

    OpenAIRE

    AE El-Shazly; S Barriat; PP Lefebvre

    2010-01-01

    AE El-Shazly, S Barriat, PP LefebvreDepartment of Otorhinolaryngology and Head and Neck Surgery, Liege University Hospital, Liege, BelgiumAbstract: Nasopharyngeal bursitis is a relatively rare syndrome characterized by a collection of symptoms that multidisciplinary specialists should be aware of. Here we present an audit of cases presenting to a rhinology clinic over a two-year period, as well as an overview of the relevant embryology and different clinical presentations of nasopharyngeal bu...

  20. Appendiceal Diverticulitis Clinically Masquerading as an Appendiceal Carcinoma

    Directory of Open Access Journals (Sweden)

    Tadashi Terada

    2014-01-01

    Full Text Available Appendiceal diverticulosis is a rare condition. Herein reported is a case of appendiceal diverticulosis and diverticulitis clinically masquerading as appendiceal carcinoma. A 62-year-old woman presented with abdominal pain. US and CT showed a tumor measuring 5 × 4 × 4 cm in vermiform appendix. Colon endoscopy showed mucosal elevation and irregularity in the orifice of vermiform appendix. A biopsy of the appendiceal mucosa showed no significant changes. Clinical diagnosis was appendiceal carcinoma and wide excision of terminal ileum, appendix, cecum, and ascending colon was performed. Grossly, the appendix showed a tumor measuring 5 × 3 × 4 cm. The appendiceal lumen was opened, and the appendiceal mucosa was elevated and irregular. The periappendiceal tissue showed thickening. Microscopically, the lesion was multiple appendiceal diverticula. The diverticula were penetrating the muscle layer. The mucosa showed erosions in places. Much fibrosis, abscess formations, and lymphocytic infiltration were seen in the subserosa. Abscesses were also seen in the diverticular lumens. Some diverticula penetrated into the subserosa. The pathologic diagnosis was appendiceal diverticulitis. When they encounter an appendiceal mass, clinicians should consider appendiceal diverticulitis as a differential diagnosis.

  1. Microvessel Density in Thyroid Carcinoma and Its Clinical Significance

    Institute of Scientific and Technical Information of China (English)

    XUE Gang(薛刚); YAO Zhenxiang(姚榛祥)

    2002-01-01

    Objective: To investigate the relationships between angiogenesis and development, metastasis as well as prognosis of thyroid carcinoma. Methods:48 cases of thyroid carcinoma and 5 cases of thyroid adenoma were studied.Density of microvessels of the tumors were identified by immunohistochemical staining in formalin -fixed and paraffin-embedded sections with anti-CD34 monoclonal antibody, and counted microscopically (×200).Results :The mean value of MVD in tumors>2cm in diameter was (174.92±72.63)/field, while that in tumors≤2cm was ( 117.40± 39.95)/field ( t = 3.3298, P = 0.0026).The number of microvessels was also significantly different in respect to the histotype of the thyroid carcinomas, such as papillary thyroid carcinoma(PTC), follicular thyroid carcinoma(FTC)and medullary thyroid carcinoma(MTC) ( F = 14. 95, P = 0. 0001), but not significantly different in respect to patients'age nor sex ( P>0.05). Conclusions:By studying microvessel density (MVD) of thyroid arcinomas and correlated with their clinical features and biological behaviors, it is concluded that ngiogenesis is important in tumor growth and metastasis as well as prognosis of thyroid carcinomas. Measures to combat angiogenesis may be beneficial in the treatment for thyroid carcinomas.

  2. A clinical study of thymic carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Eiichi; Nakano, Takayuki; Nakashima, Nariyasu [Kagawa Medical Univ., Miki (Japan)] [and others

    2003-05-01

    We reviewed ten patients with resected thymic carcinoma. The mean age was 55.0 years, ranging from 36 to 71 years, with five males and five females. The histological types were squamous cell carcinoma in 9 cases, and squamous cell carcinoma combined with small cell carcinoma in one case. One of the 10 patients was in stage I, 7 were in stage III, one was in stage IVa, and one was in stage IVb. Eight of the ten patients underwent complete resection, and induction chemotherapy was performed in one of the 8 cases, while induction chemoradiotherapy was performed in two of the 8 cases. Postoperative radiotherapy was performed in all cases (20-50 Gy). In recurrence cases, operation was positively performed for resectable cases. The five-year and ten-year survival rates were 78.7%, 52.5%, respectively. We expect that patients with thymic carcinoma can be cured completely or survive for long periods with multimodal therapy and resection of recurrences. (author)

  3. Cervical Lymph Node Metastasis: Unusual Presentation of Adenoid Cystic Carcinoma - Diagnosed By FNAC

    Directory of Open Access Journals (Sweden)

    Archana Buch

    2015-01-01

    Full Text Available Adenoid cystic carcinoma (ACC is a rare neoplasm that usually arises from minor salivary glands. It is characteristically locally infiltrative, exhibiting perineural invasion, has a tendency for local recurrence and prolonged clinical course. A 60 year old male, chronic smoker presented with swelling of the left cervical lymph node since two months. Examination revealed a solitary firm, non tender, non mobile left cervical swelling measuring 2 x 1 cm. Fine Needle Aspiration Cytology (FNAC was done from the cervical lymph node. The diagnosis of metastatic deposits of ACC was given. Detail examination of the oral cavity revealed a small swelling at the floor of the mouth. Biopsy of the swelling confirmed ACC on histopathological examination. An unusual feature of adenoid cystic carcinoma is the low incidence of metastases to regional lymph nodes. The case is presented to highlight its unusual presentation and utility of FNAC in rapid diagnosis.

  4. Large Cell Neuroendocrine Carcinoma of the Rectum Presenting with Extensive Metastatic Disease

    Directory of Open Access Journals (Sweden)

    Vinay Minocha

    2014-01-01

    Full Text Available Introduction. Rectal large cell neuroendocrine carcinoma (LCNEC is a poorly differentiated neoplasm that is very rare and belongs within the poorest prognostic subgroup among primary colorectal neoplasms. Here, we describe a case of LCNEC of the rectum, which highlights the aggressive clinical course and poor prognosis associated with this disease. Case Presentation. We report a case of a 63-year-old male who presented to our hospital with a one-month history of lower abdominal pain, constipation, and weight loss. A computed tomography (CT scan of the chest, abdomen, and pelvis revealed a rectal mass as well as metastatic disease of the liver and lung. Flexible sigmoidoscopy revealed a fungating, ulcerated and partially obstructing rectal mass located 6 cm from the anal verge. This mass was biopsied and pathological examination of the resected specimen revealed features consistent with a large cell neuroendocrine carcinoma. Conclusion. Rectal large cell neuroendocrine carcinomas are rare and have a significantly worse prognosis than adenocarcinomas. At diagnosis, a higher stage and metastatic disease are likely to be found. It is important to differentiate large cell, poorly differentiated neuroendocrine carcinomas from adenocarcinomas of the colon and rectum pathologically because patients may benefit from alternative cytotoxic chemotherapeutic regimens.

  5. A clinical study of oral carcinoma

    International Nuclear Information System (INIS)

    Data of a total of 62 patients with oral carcinoma treated at the University of Tsukuba Hospital between January 2001 and December 2010 were reviewed. Out of the 62 patients, in 59, the tumors were histopathologically diagnosed as squamous cell carcinoma (SCC), and the remaining three as verrucous carcinoma. Treatment for each patient was determined according to the tumor, nodes and metastasis (TNM) classification (Union for International Cancer Control (UICC), 1997) and the histopathological features. The three patients with verrucous carcinoma in whom the tumors were insensitive to radiation or chemotherapy were treated surgically. For stage I or II SCC cases, except for tongue cancer, full-dose irradiation was the treatment of choice. For cases of stage I or II tongue cancer, brachytherapy (RALS) or surgery was the treatment of choice. In stage III or IV cases, the treatment of choice was a combination of surgery, radiotherapy and chemotherapy. The 5-year survival rate of the SCC cases, overall, was 62.6% as analyzed by the Kaplan-Meier method, while the rates for the stage I, II, III, and IV cases were 100%, 75.6%, 37.5%, and 40.7%, respectively. (author)

  6. Laryngeal squamous cell carcinoma presenting as a prelaryngeal neck abscess: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Op de Beeck, K.; Hermans, R.; Marchal, G. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Delaere, P.R. [Dept. of Otorhinolaryngology, Univ. Hospitals, Leuven (Belgium); Bogaert, W. van den [Dept. of Radiation Oncology, University Hospitals, Leuven (Belgium)

    2001-12-01

    Head and neck tumours presenting as a neck abscess are extremely rare. Two patients with laryngeal squamous cell carcinoma, presenting with a prelaryngeal abscess, are described. Although clinically and on the CT studies these cases were suspect for underlying malignancy, the initial biopsies were negative for cancer. Because of persistent suspicion, repeat biopsies finally confirmed the presence of a squamous cell carcinoma. Pathological examination after total laryngectomy showed cancer localised in one of the true vocal cords, invading the anterior commissure and thyroid cartilage. However, the prelaryngeal soft tissues were free of tumour, showing only inflammatory changes and collections of pus. These cases emphasize the importance of repeat targeted biopsies and follow-up CT-studies in patients with a prelaryngeal abscess of obscure aetiology, in order to exclude or confirm a possible underlying malignancy. (orig.)

  7. An unusual presentation of primary hyperparathyroidism: multiple brown tumors and coexisting thyroid carcinoma.

    Science.gov (United States)

    Basaran, Y; Ince, S; Alagoz, E; Meric, C; Taslipinar, A

    2016-01-01

    We present a patient with a complex clinical picture of primary hyperparathyroidism with multiple destructive skeletal lesions suspicious of bone metastases and concomitant multifocal papillary thyroid carcinoma with a metastatic central lymph node. He presented with progressively worsening right hip pain and restricted motion. Magnetic resonance imaging revealed multiple lytic lesions involving predominantly the right trochanter minor and the left inferior and posterior pubic rami. Biochemical tests were consistent with primary hyperparathyroidism. Neck ultrasound and parathyroid scintigraphy revealed a single parathyroid adenoma and a thyroid nodule, preoperative cytology of which confirmed papillary thyroid carcinoma, as did the final surgical specimen. Biochemical results, regarding hyperparathyroidism, declined to normal levels and his complaints gradually decreased after surgery. Postoperative whole body bone scintigraphy showed increased tracer uptakes at multiple sites, but they were proved to be metabolically inactive by fluorodeoxyglucose positron emission tomography/computed tomography. PMID:27036887

  8. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected.Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.

  9. Clinical presentation of adult coeliac disease.

    LENUS (Irish Health Repository)

    Tajuddin, T

    2012-02-01

    The mode of presentation of coeliac disease has been changing to more atypical or silent disease. Few studies described the clinical presentation of adult coeliac disease in Ireland in recent years. We retrospectively collected the clinical data for all patients who had a diagnosis of coeliac disease made in our centre between January 07 and December 08. Forty seven adults, predominantly females (n = 30), had a confirmed diagnosis of coeliac disease made during the study period. In our patient cohort, the presenting symptom was diarrhoea in 19 (40%) patients, while 16 patients (34%) did not have any G.I. symptoms, 10 (21%) presented with anaemia. Females presented at a significantly younger age compared to males, with median ages at diagnosis of 44.5 and 57 years, respectively (p = 0.04). Females also presented more commonly with non G.I. symptoms (p = 0.07). The reasons behind this gender difference need further study.

  10. Clinical presentation of juvenile Huntington disease

    Directory of Open Access Journals (Sweden)

    Ruocco Heloísa H.

    2006-01-01

    Full Text Available OBJECTIVE: To describe the clinical presentation a group of patients with juvenile onset of Huntington disease. METHOD: All patients were interviewed following a structured clinical questioner. Patients were genotyped for the trinucleotide cytosine-adenine-guanine (CAG repeat in the Huntington Disease gene. High resolution brain MRI was performed in all patients. RESULTS: We identified 4 patients with juvenile onset of disease among 50 patients with Huntington disease followed prospectively in our Neurogenetics clinic. Age at onset varied from 3 to 13 years, there were 2 boys, and 3 patients had a paternal inheritance of the disease. Expanded Huntington disease allele sizes varied from 41 to 69 trinucleotide repeats. The early onset patients presented with rigidity, bradykinesia, dystonia, dysarthria, seizures and ataxia. MRI showed severe volume loss of caudate and putamen nuclei (p=0.001 and reduced cerebral and cerebellum volumes (p=0.01. CONCLUSION: 8% of Huntington disease patients seen in our clinic had juvenile onset of the disease. They did not present with typical chorea as seen in adult onset Huntington disease. There was a predominance of rigidity and bradykinesia. Two other important clinical features were seizures and ataxia, which related with the imaging findings of early cortical atrophy and cerebellum volume loss.

  11. Verrucous carcinoma of the hand: a rare presentation evaluated by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Verrucous carcinoma is a variant of squamous cell carcinoma seen in mucous membranes and skin, and rarely found in the hand. The present report describes a case of two lesions on the dorsum of the hand, with no contact to each other, which underwent en-block resection and were confirmed as verrucous carcinoma. (author)

  12. Verrucous carcinoma of the hand: a rare presentation evaluated by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Jailson Rodrigues; Rosemberg, Laercio Alberto; Lourenco, Rafael Burgomeister; Cerri, Giovanni Guido [Universidade de Sao Paulo (InRad/HC/USP), SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Rodrigues, Marcelo Bordalo [Universidade de Sao Paulo (IOT/HC/USP), SP (Brazil). Hospital das Clinicas. Instituto de Ortopedia e Traumatologia

    2011-07-15

    Verrucous carcinoma is a variant of squamous cell carcinoma seen in mucous membranes and skin, and rarely found in the hand. The present report describes a case of two lesions on the dorsum of the hand, with no contact to each other, which underwent en-block resection and were confirmed as verrucous carcinoma. (author)

  13. Systemic Chemotherapy for Advanced Hepatocellular Carcinoma: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Masafumi Ikeda

    2015-12-01

    Full Text Available Systemic chemotherapy is one of the most important treatment modalities for advanced hepatocellular carcinoma (HCC. Before the introduction of sorafenib, cytotoxic agents, hormonal therapies, or many combinations of these were the mainly used modalities for systemic chemotherapy of advanced HCC. However, such regimens were of only limited value in clinical practice, because some randomized controlled studies comparing promising regimens with no treatment or doxorubicin alone failed to show any overall survival advantage. In two pivotal phase III placebo-controlled studies, the SHARP trial and the Asia-Pacific trial, sorafenib was demonstrated to significantly delay the time to progression and the overall survival time in patients with advanced HCC. Therefore, sorafenib therapy has come to be acknowledged as a standard therapy for advanced HCC worldwide. After the introduction of sorafenib, a number of phase III trials of various molecular-targeted agents vs. sorafenib as first-line chemotherapy and of various molecular-targeted agents vs. placebo as second-line chemotherapy have been conducted to determine if any of these agents could offer a survival benefit, however, none of the agents examined so far has been demonstrated to provide any survival benefit over sorafenib or placebo. Recently, favorable treatment efficacies have been reported in some clinical trials of molecular-targeted agents in the biomarker-enriched population. Development of individualized cancer treatments using molecular-targeted agents based on the results of genome-sequencing is aggressively ongoing. Furthermore, immune-oncologic agents, such as anti-CTLA-4 antibody and anti-PD-1/PD-L1 antibody, have been reported to provide promising outcomes. Thus, various novel systemic chemotherapeutic agents are currently under development, and further improvements in the treatment outcomes are expected.

  14. Idiopathic granulomatous mastitis; Clinical presentation, radiological features and treatmant

    International Nuclear Information System (INIS)

    To determine the clinical characteristic, clinical presentations and radiological features of diopathic granulomatous mastitis, and the best treatment approaches of this clinical entity. Between 1996 and 2003 the files and histopathology reports of 25 patients with granulomatous mastitis at King Abdul-Aziz University Hospital Jeddah, Kindom of Saudi Arabia were reviewed. The data were analyzed and a Medline search was carried out from 1970 to 2003 to review relevant cases. The age of patients ranged from 24-66 years and the mean age was 36.6+-9.43 years. All patients were females. The most common clinical presentation was palpable tender mass. The most common mammographic finding was ill-defined mass. However, mixed hypo- and hyper-echogenic lesions with tubular connections were the common ultrasonic findings. Treatment approaches were conservative or surgical excision or steroid. Conservative treatment associated with the higher rate of complications, while treatment with steroid showed complete remission of disease. Idiopathic granulomatous mastitis is a rare, benign breast disease that is usually underestimated or misdiagnosed. The clinical and radiological features resemble those of infectious mastitis or breast carcinoma. Early recognition and initiation of steroid treatment will result in complete remission of the disease and prevent complications. (author)

  15. Angioedema: Clinical Presentations and Pharmacological Management.

    Science.gov (United States)

    Collins-Yoder, Angela Smith

    2016-01-01

    Angioedema (AE) is a unique clinical presentation of an unchecked release of bradykinin. The origin of this clinical presentation can be either genetic or acquired. The outcome within the patient is subcutaneous swelling of the lower layers of the epidermis. Symptoms are most often localized to the upper airway or the gastrointestinal tract. A typical course resolves in 5 to 7 days, but in some patients, the clinical manifestations exist up to 6 weeks. Hereditary AE is rare and genetically linked, and typically, the patient has episodes for many years before diagnosis. Episodes of acquired AE may be drug induced, triggered by a specific allergen, or idiopathic. Angioedema can elicit the need for critical care interventions, for advanced airway management, or unnecessary abdominal surgery. The treatment for these patients is evolving as new pharmacological agents are developed. This article addresses subtypes of AE, triggers, pharmacology, and information for interdisciplinary team planning of individualized case management. PMID:27258954

  16. A clinical study of oral carcinoma

    International Nuclear Information System (INIS)

    Seventy patients of oral carcinoma, including lip and tongue cancer, were treated at University of Tsukuba Hospital from March 1988 to March 1998. Treatment for each patient was determined according to TNM classification (UICC, 1987). Eight cases of non-squamous cell carcinoma, which were insensitive to radiation or chemotherapy, were surgically treated. Out of 70 cases, sixty-two were pathologically categorized as squamous cell carcinoma (SCC). For SCC cases of stage I or II, full-dose irradiation, including brachytherapy as well as conventional irradiation, was fundamentally the treatment of choice, but in six cases surgical treatment was performed after irradiation of 50 Gy in order to assure curability. In cases of stage III or IV, the treatment of choice was a combination of the surgery and radiotherapy. Fifteen cases, however, were treated only by conventional radiotherapy, brachytherapy (RALS) and/or chemotherapy, because of the patient's refusal to surgery, local or systemic condition, his or her age, and so on. Our treatment plans have consequently resulted in the overall 5-year survival rate of 75.2% for oral SCC. (author)

  17. Nasopharyngeal bursitis: from embryology to clinical presentation

    Directory of Open Access Journals (Sweden)

    AE El-Shazly

    2010-10-01

    Full Text Available AE El-Shazly, S Barriat, PP LefebvreDepartment of Otorhinolaryngology and Head and Neck Surgery, Liege University Hospital, Liege, BelgiumAbstract: Nasopharyngeal bursitis is a relatively rare syndrome characterized by a collection of symptoms that multidisciplinary specialists should be aware of. Here we present an audit of cases presenting to a rhinology clinic over a two-year period, as well as an overview of the relevant embryology and different clinical presentations of nasopharyngeal bursitis. For 2008–2009, six patients were diagnosed to have nasopharyngeal bursitis, including four males and two females, of mean age 54 years. Two distinct pathologic types were observed, comprising three patients with classical Tornwaldt’s cyst and three with crust-type bursitis. This audit highlights the importance of recognition of the crust-type of nasopharyngeal bursitis and its anatomic and clinical features. A combined endonasal and transoral endoscopic approach is a minimally invasive procedure and an effective method of treating both types of the disease. Our findings are discussed in relation to the embryology of the disorder, with a clinical emphasis on crust-type nasopharyngeal bursitis.Keywords: nasopharyngeal bursitis, crust type, Tornwaldt’s cyst, endoscopic disruption

  18. Large thymic carcinoma presenting with right ventricular failure: a case report.

    Science.gov (United States)

    Saleem, T; Fatimi, S H; Khalid, U

    2011-01-01

    Thymic carcinoma is an overall rare tumour with variable clinical manifestations. Right ventricular failure remains an uncommon occurrence and has not been reported in literature so far. A 40-year-old lady presented with the complaints of progressively worsening retrosternal chest pain, shortness of breath, easy fatigability and cough since 1 year. Computed tomography scan of the thorax revealed a mass measuring 12 x 10 cm in the anterior mediastinum. This mass appeared to be adherent to both lungs and pericardium and was impinging on the right atrium and right ventricle. It appeared to be infiltrating the ascending aorta, pulmonary arteries and superior vena cava. Ultrasound of the abdomen showed hepatomegaly and moderate ascites. Echocardiography showed evidence of right ventricular dysfunction as well as elevated right ventricular systolic pressures secondary to extrinsic compression. Percutaneous biopsy of the thymus was performed showing a malignant thymoma. Radical thymectomy with resection of pericardium was planned. Intra-operatively, the tumour was separated from the right and left lungs, pulmonary artery and aortic arch. Morphologically, immunochemically and clinically, the features were consistent with those seen in Masoka stage III thymic carcinoma. She also received six cycles of chemotherapy (PAC regimen) including cisplatin (50 mg/m2), doxorubicin (50 mg/m2) and cyclophosphamide (500 mg/m2). Radiation therapy in the adjuvant setting was planned but the patient was lost to follow-up after 4 months. Although right ventricular failure is a very rare presentation of thymic carcinoma, clinicians should be aware of this presentation to appreciate the complete clinical spectrum of presentation of this neoplasm. PMID:21938989

  19. An unusual clinical presentation of gingival melanoacanthoma

    Directory of Open Access Journals (Sweden)

    S. P. K. Kennedy Babu

    2013-01-01

    Full Text Available Gingival melanoacanthoma is a rare, benign pigmented lesion characterized clinically by sudden onset and rapid growth of a macular brown black lesion and histologically by acanthosis of superficial epithelium and proliferation of dendritic melanocytes. This article reports a previously undescribed case of pigmented unilateral diffuse gingival enlargement, which on histopathological examination proved to be melanoacanthoma. Intraoral examination revealed pigmented unilateral diffuse gingival enlargement in relation to second and third quadrants buccally, palatally/lingually. Based on these clinical findings, gingivectomy was performed and the excised tissue was sent for biopsy. Microscopic examination revealed acanthotic and parakeratotic surface epithelium with dendritic melanocytes distributed in basal and suprabasal layers of the epithelium. 1 year follow-up recall revealed no recurrence of lesion at the surgical sites. Our patient exhibits an unusual clinical presentation of melanoacanthoma of gingiva. Pigmented gingival overgrowth of recent origin and without any etiologic factors warrants histopathologic examination.

  20. Unusual presentation of oesophageal carcinoma with adrenal metastasis

    International Nuclear Information System (INIS)

    Adrenal gland is a common site of metastasis in many cancers but it is very rare in oesophageal carcinoma. We report one such case found to have adrenal metastasis on follow-up PET/computed tomography scan

  1. Clinical presentation of pili torti - Case report*

    Science.gov (United States)

    Yang, Jeane Jeong Hoon; Cade, Karine Valentim; Rezende, Flavia Cury; Pereira, José Marcos; Pegas, José Roberto Pereira

    2015-01-01

    Pili torti also known as ‘twisted hairs’ (Latin: pili=hair; torti=twisted) is a rare, congenital or acquired clinical presentation, in which the hair shaft is flattened at irregular intervals and twisted 180º along its axis. It is clinically characterized by fragile, brittle, coarse and lusterless hairs, due to uneven light reflection on the twisted hair surface. Pili torti may be associated with neurological abnormalities and ectodermal dysplasias. There is no specifi c treatment for this condition, but it may improve spontaneously after puberty. We report a case of pili torti in a child who presented fragile, brittle, diffi cult to comb hair. The patient had no comorbidities. PMID:26312667

  2. Insular Ischemic Stroke: Clinical Presentation and Outcome

    OpenAIRE

    Lemieux, F.; Lanthier, S.; Chevrier, M.-C.; de Gioia, L.; I. Rouleau; Cereda, C.; Nguyen, D.K.

    2012-01-01

    Background The insula is a small but complex structure located in the depth of the sylvian fissure, covered by the frontal, parietal and temporal operculum. Ischemic strokes limited to the insula are rare and have not been well studied. Our objective is to better define the clinical presentation and outcome of insular ischemic strokes (IIS). Methods We reviewed the institutional prospective, consecutive stroke database from two centers to identify patients with IIS seen between 2008 and 2010....

  3. Lid leishmaniasis an atypical clinical presentation

    International Nuclear Information System (INIS)

    Localized cutaneous leishmaniasis (CL) typically presents as nodules, or noduloulcerative plaques located mostly on face and extremities. Various unusual clinical presentations have also been reported in literature. Eyelid is one of the rare sites for the sand fly to bite and produce CL. An elderly male is reported here with extensive lesion of CL involving whole of his right upper lid and making him unable to open his eye. He was treated with melamine antimonite compound and was cured in about 4 weeks. (author)

  4. Congenic tuberculosis. Presentation of clinical case

    International Nuclear Information System (INIS)

    We are presenting the case of less than to 2 month old and premature infant, she had hyaline membrane disease and required mechanical ventilation during 6 days, at the first month. She presented a viral rhinopharyngitis symptomatology, perioral cyanosis with apnoea, and respiratory distress, the chest x-ray showed multiple bilateral hyperlucid images, mainly at the right side afterwards the patient presented intermittent fever of long evolution and initially received treatment for cavitary bronchopneumonia and sequel of mechanical ventilation, receiving multiple antimicrobial antibiotics, the mother had intermittent fevers since the sixth month of pregnancy and was hospitalized for suspected endometritis after delivery, she presented clinical impairment which evolved to sepsis and died in the ICU, the endometrial histopathology showed granulomas suggesting tuberculosis, due to long history of fevers in the baby and the genital tuberculosis in the mother a tuberculosis study was performed in the girl which resulted positive

  5. [Metal implant sensitivity: clinical and histological presentation].

    Science.gov (United States)

    Hartmann, D; Letulé, V; Schneider, J J; Flaig, M J

    2016-05-01

    Metal implant sensitivity (intolerance) can cause pain, reduced mobility, loosening of the implant and skin rashes. Knowledge of differential diagnoses, histology and appropriate diagnostics are essential for proper diagnosis. To outline typical clinical signs and histology in metal-implant-associated skin lesions we present three exemplary patients from our implant allergy outpatient department and give an overview of the current literature regarding metal implant sensitivity. In patients with a negative patch test the lymphocyte transformation test may reveal metal sensitization. Even "pure" titanium alloys may contain traces of nickel. The histology of implant-associated skin reactions goes from teleangiectatic postimplantation erythema to eczema and vasculitis. Based on the synopsis of history, clinical picture, allergological testing and histology, metal implant sensitivity can be diagnosed more precisely. PMID:27090521

  6. Detection, staging and clinical implications of renal cell carcinoma

    International Nuclear Information System (INIS)

    To compare the epidemiologic, clinical and pathologic characteristics of symptomatic and incidental renal cell carcinoma (RCC)in Jordan.Results were compared with published Western figure. Records of 119 patients with renal tumors diagnosed during the period January1992 to December 2001at Jordan University of Science and Technology, Irbid, Jordan were reviewed. Age,gender, radiologic and biologic workup, treatment,features of tumor were reviewed. The mean patient age was 54 and the male to female ratio was 3.4:1. 26% of tumors were discoverd accidentlly.The incidental detction group had significantly small size of tumor.,lower stage and lower histological grading.In symptomatic group woman have significantly lower mean size of tumor than men. A radical nephrectomy was performed in 92% of the cases, and in 8% of the cases, conservative mangement was adopted. The present study showed that the incidence rate of RCC in Jordan is less than Western countries. Significant number of RCC were detected incidently with lower pathological stage and grade. Subsequently these clinically and histologically less aggressive lesions lead to better survival. These data efforts should be directed to the devlopment of screening protocol to detect these lesions early. (author)

  7. Sternal metastasis as an initial presentation of renal cell carcinoma: a case report

    OpenAIRE

    Batista, Raquel Ribeiro; Marchiori, Edson; Takayassu, Tatiana Chinem; Cabral, Fernanda Caseira; Cabral, Rafael Ferracini; Zanetti, Gláucia

    2009-01-01

    Renal cell carcinoma accounts for 85% of all solid renal tumors in adults. Nearly one quarter of patients has distant metastasis at presentation while another 50% develop metastasis during follow-up. A small percentage of these are solitary metastasis. We report here a case of solitary bone sternal metastasis as an initial presentation of clear-cell renal cell carcinoma in a 56-year-old woman. The prognosis for patients with metastasized renal cell carcinoma is poor; treatment of metastasis i...

  8. Abdominal tuberculosis: clinical presentation and outcome

    International Nuclear Information System (INIS)

    To study the clinical presentation and outcome of cases of Abdominal Tuberculosis. Fifty four patients of Abdominal Tuberculosis were seen during the study period. Four patients were lost to follow-up, which were excluded. Detailed information of all the patients including age, sex, symptoms, signs, investigations and management was recorded, analyzed and compared with local and international data. Out of the 50 patients with Abdominal Tuberculosis, 31 were females and 19 males. Their ages ranged from 17 to 63 years, with a mean age of 25.1 years. Thirty five cases were admitted through Emergency and 15 through Outpatients departments. Abdominal pain was the most common symptom found in 44 (88%) patients followed by vomiting in 33 (66%). Abdominal tenderness was seen in 22 (44%) patients, while 16 (32%) patients had rigidity and other features of peritonitis. Surgery was performed in all these patients, limited right hemicolectomy in 17 (34%), segmental resection and anastomosis in 12 (24%), ileostomy and strictureplasty in six (12%) each, repair of perforation in five (10%) and adhesiolysis in four (8%) patients. Overall mortality was 8% due to septicaemia and multiorgan failure. Abdominal Tuberculosis is a significant clinical entity with lethal complications in neglected cases. It affects a younger age group and is more common in females. Clinical features are rather non-specific but vague ill health, low grade fever, weight loss and anorexia may help to diagnose the case. (author)

  9. Clinical significance of survivin in the diagnosis and prognosis of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yanxiang Cheng; Gantao Chen; Yanjun Cheng; Demin Pu

    2006-01-01

    Objective: To investigate the clinical significance of survivin in endometrial carcinoma and to investigate the relationship between the expression of survivin and Ki-67. Methods: Immunohistochemical S-P (streptavidin-biotin-peroxidase complex)method was performed to detect the expression of survivin and Ki-67 antigen in 15 cases of normal endometrium, 21 cases of endometrial simple and complex hyperplasia, 22 cases of endometrial atypical hyperplasia, and 61 cases of endometrial carcinoma. Results: Survivin was hardly detected in some normal endometrium in the proliferative phase and in the secretory phase. However, the level of survivin expression in atypical hyperplasia endometrium(72.73%)was higher than that in normal endometrium (7.14%)(P < 0.05), including simple and complex hyperplasia (42.38%)(P < 0.01), and was lower than that in endometrial carcinoma (90.17%)(P < 0.05). Moreover, significant correlation was present between the expression of survivin and the characteristics of endometrial carcinoma, including clinical stage, histological grade and the presence of invasion to myometrium (P < 0.05). In addition, Ki-67 antigen expression was positively correlated with survivin expression in all specimen. Ki-67 labeled indexes (LIs)in hyperplasia endometrium were significantly lower than those in atypical hyperplasia endometrium and endometrial carcinoma (P < 0.01 ), while there was no significant difference in Ki-67 LIs between atypical hyperplasia endometrium and endometrial carcinoma(P > 0.05). There was no significant relationship between Ki-67 LIs and the characteristics of endometrial carcinoma, including histological grade, clinical stage or the invasion to myometrium(P > 0.05). Conclusion: Survivin may participate in the onset and progression of endometrial carcinoma through inhibiting apoptosis and promoting proliferation. Survivin expression is correlated with the malignant degree and prognosis of tumor. Ki-67 is also associated with

  10. Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Sequard syndrome: a case report

    LENUS (Irish Health Repository)

    Kaballo, Mohammed A

    2011-08-02

    Abstract Introduction Intramedullary spinal cord metastasis is very rare. The majority are discovered incidentally during autopsy. Most symptomatic patients present with rapidly progressive neurological deficits and require immediate examination. Few patients demonstrate features of Brown-Séquard syndrome. Radiotherapy is the gold-standard of therapy for Intramedullary spinal cord metastasis. The overall prognosis is poor and the mortality rate is very high. We present what is, to the best of our knowledge, the first case of Intramedullary spinal cord metastasis of colorectal carcinoma presenting as Brown-Séquard syndrome. Case presentation We present the case of a 71-year-old Caucasian man with colonic adenocarcinoma who developed Intramedullary spinal cord metastasis and showed features of Brown-Séquard syndrome, which is an uncommon presentation of Intramedullary spinal cord metastasis. Conclusion This patient had an Intramedullary spinal cord metastasis, a rare form of metastatic disease, secondary to colonic carcinoma. The metastasis manifested clinically as Brown-Séquard syndrome, itself a very uncommon condition. This syndrome is rarely caused by intramedullary tumors. This unique case has particular interest in medicine, especially for the specialties of medical, surgical and radiation oncology. We hope that it will add more information to the literature about these entities.

  11. Rare Presentation of Gastroesophageal Carcinoma with Rectal Metastasis: A Case Report

    Science.gov (United States)

    Makker, Jasbir; Karki, Niraj; Sapkota, Binita; Niazi, Masooma; Remy, Prospere

    2016-01-01

    Patient: Female, 60 Final Diagnosis: Gastroesophageal carcinoma with rectal metastasis Symptoms: Bloating • constipation • weight loss Medication: — Clinical Procedure: Endoscopy • flexible sigmoidoscopy • lower endoscopic ultrasound Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Gastroesophageal cancers, previously considered rare, are rapidly increasing worldwide. We present here a unique case of gastroesophageal carcinoma with metastasis to the rectum. Case Report: A 60-year-old female patient presented with constipation, bloating, and weight loss of 4-month duration. She had undergone sleeve gastrectomy 6 years before. Endoscopies performed revealed a friable-looking mucosa in the lower esophagus and a polypoid rectal mass. Histopathological examination from both the esophageal and rectal lesions revealed poorly differentiated adenocarcinoma cells. Immunohistochemistry stain from both specimens was positive for CK7 supporting the gastric site primary with metastasis to the rectum. Further evaluation also revealed metastasis to bone and malignant pleural effusion. Chemotherapy with palliative intent was initiated. Conclusions: Colorectal metastasis is commonly seen from cancers of the breast, stomach, melanoma, kidney, prostate, and ovaries. However, colorectal metastasis from gastroesophageal cancer has never been reported in the medical literature. Diagnosis relies on histopathologic examination and immunohistochemical staining of the tumor. Treatment depends on the tumor stage. Tumors with widespread metastatic disease are candidates for palliative chemotherapy. PMID:27558656

  12. Squamous cell carcinoma of rectum presenting in a man: a case report

    Directory of Open Access Journals (Sweden)

    Chowdri Nissar A

    2010-11-01

    Full Text Available Abstract Background Primary squamous cell carcinomas of the colorectum are very uncommon. Until now, to the best of our knowledge, only 114 cases of squamous cell carcinoma in the colorectum exist in the reported literature. Here we report a case of squamous cell carcinoma of the rectum in the ethnic Kashmiri population in northern India. Case Presentation The case of a 60-year-old male patient (Asian with a pure squamous cell carcinoma of the rectum is presented here. The patient underwent a curative surgery with concomitant chemotherapy. Two years after the initial curative resection of the tumor he is still alive. Conclusion The prognosis for squamous cell carcinoma of the colorectum is worse than for that of adenocarcinoma, because of the delayed diagnosis. The etiopathogenicity of squamous cell carcinoma of the colorectum is discussed. Surgical resection of the lesion seems to be the treatment of choice. Chemotherapy also helps in improvement of the prognosis.

  13. A rare cutaneous malignancy with poorly described clinical features: Lymphoepithelioma-like carcinoma of the skin

    Directory of Open Access Journals (Sweden)

    Lale Mehdi

    2015-09-01

    Full Text Available Lymphoepithelioma-like carcinoma can be originated from different organs, including nasopharynx, larynx, stomach, salivary glands, lung, thymus, cervix and bladder. Lymphoepithelioma-like carcinoma of the skin is a rare malignancy with low metastatic potential and is defined by a histologic picture simulating indifferentiated nasopharynx carcinoma. There are only a few case reports in the literature and the clinical features of the tumor are not well described. It presents usually with flesh-colored or reddish firm nodules and plaques which are nonspecific. The head and neck region is the predilection site of the tumor, but it can be seen in many other areas. We present here an 84-year-old male admitted to the dermatovenereology department with a slowly growing purplish-red asymptomatic plaque, 2x2 cm in diameter which was diagnosed as lymphoepithelioma-like carcinoma of the skin upon histopathologic examination. The tumor was excised and metastasis was not detected. Local recurrence was not observed in a one-year follow-up period. Lymphoepithelioma-like carcinoma of the skin should also be considered in the clinical differential diagnosis of slowly growing solitary nodules and infiltrated plaques. An other important feature of our case was the arm localization of the tumor which has been very rarely reported.

  14. Recurrent Pancreatitis Due to a Cystic Pancreatic Tumor: A Rare Presentation of Acinar Cell Carcinoma

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    Raimondo M

    2004-05-01

    Full Text Available CONTEXT: Acinar cell carcinoma is an uncommon malignancy of the pancreas. It has characteristic histomorphology, immunohistochemistry profile, and clinicopathological behavior. CASE REPORT: We report a rare case of recurrent pancreatitis secondary to acinar cell carcinoma of the pancreas. We describe the endoscopic ultrasound characteristic, treatment and the surgical outcome. CONCLUSIONS: Acinar cell carcinoma should be considered in the differential diagnosis of cystic pancreatic tumors presenting with recurrent pancreatitis.

  15. Metastasis to Paranasal Sinuses as the First Presenting Sign of Renal Cell Carcinoma

    OpenAIRE

    Hélio Assuncao Gouveia; José Anacleto Dutra Resende Júnior; Gustavo Ruschi Bechara; Thomás Accioly de Souza

    2012-01-01

    The clear cell carcinoma is a relatively rare tumor, represented approximately 85% by renal cell carcinoma (RCC), but has a characteristic of early metastatic, which sometimes spread to unusual places. Metastatic tumors in the paranasal sinuses are very rare. This case report a 65 years-old patient who presented sinusitis and epitaxis as a first sign of renal cell carcinoma with metastasis to the right maxillary sinus, which was opereted at Lagoa Hospital—RJ and strengthen the inclusion of th...

  16. Pigmented Basal Cell Carcinoma: A Clinical Variant, Report of Two Cases

    OpenAIRE

    K., Deepadarshan; M., Mallikarjun; N. Abdu, Noshin

    2013-01-01

    Basal cell carcinoma is the most common malignant tumour of skin, comprising 80% of non-melanoma cancers. Intermittent exposure to ultraviolet radiation is an important risk factor. Pigmented basal cell carcinoma is a clinical and histological variant of basal cell carcinoma that exhibits increased pigmentation. It is a very rare variant, although its frequency can reach upto 6% of total basal cell carcinomas in Hispanics. Herein, we are reporting 2 cases of pigmented basal cell carcinoma.

  17. Presentation of Apocrine Breast Carcinoma in a Woman with Bilateral Silicone Prosthesis; Presentacion de un carcinoma apocrino de mama en una mujer con protesis bilateral de silicona

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, J. A.; Salvador, R.; Salvador, M.; Barranco, C.

    2003-07-01

    We present a case of apocrine breast carcinoma in a 45 year-old woman with bilateral silicone breast prosthesis whose clinical manifestations and mammography were that of a palpable nodule-high glandular density, rounded and with imprecise borders devoid of any visible microcalcifications. A bibliographical revision confirmed the infrequent association of this type of tumor with the presence of silicone breast implants, precisely in which we consider its radiological interest to lie. (Author) 11 refs.

  18. Clinical enigma: A rare case of clear cell odontogenic carcinoma

    OpenAIRE

    Cheshta Walia; Rudra Prasad Chatterjee; Sanchita Kundu; Sudip Roy

    2015-01-01

    Clear cell odontogenic carcinoma is a rare, aggressive neoplasm of the jaw with only 74 reported cases. It occurs predominantly in the mandibular anterior region during fifth to seventh decades of life. Clinically it manifests as intra-bony swelling with a variable degree of pain. Microscopically, it reveals nests of cells with clear cytoplasm in connective tissue stroma arranged in different patterns. It is often misdiagnosed due to the rarity of lesion and confusing histopathology. Immunohi...

  19. Clinical presentation in patients with systemic sclerosis

    International Nuclear Information System (INIS)

    Introduction: systemic sclerosis is an autoimmune disease characterized by endothelial damage, and skin, vessel and internal organ fibrosis and inflammation. There are differences in terms of frequency, severity and prognosis for the different ethnic groups, what reinforces the importance of the study in each geographical region with the purpose of enabling early diagnosis of its incipient symptoms.Methods: we conducted a descriptive and retrospective study form March 2006 through March 2008, including patients with a final diagnosis of systemic sclerosis, who are treated at the Systemic Autoimmune Diseases Unit at the Clinicas Hospital. Results: 31 women were included in the study, average follow-up of patients was 39.2 months, and average age at the time of diagnosis was 47.6 years. Eleven patients (35,5) presented diffuse disease and 20 (64.5) of them evidenced limited disease. Thirty patients presented Raynaud's phenomenon. In 92 of cases capilaroscopy showed a sclerodermiform pattern. In terms of the respiratory system, we found interstitial pathology in 25 of cases, pulmonary arterial hypertension in 22.2 and are restrictive pattern in respiratory function studies in 35.5. Also, 67.7 presented digestive manifestations and 9.6 developed sclerodermic renal crisis. We found anti-nuclear antibodies (ANA) in 29 out of 31 patients (93,5) patients; 16 presented anticentromere antibodies and five anti-topoisomerasa-I antibodies. The four patients (12.9)who died during follow-up presented common elements such as diffuse sclerosis, digital ulcers and severe respiratory compromise. Conclusions: the clinical and immune characteristics found in our study were similar to those described in other series. Should there be no specific treatment, it is essential to perform regular assessment of visceral impact in order to control and delay complications which result in high morbimortality rates. (author)

  20. Clinical presentation and staging of Hodgkin lymphoma.

    Science.gov (United States)

    Gallamini, Andrea; Hutchings, Martin; Ramadan, Safaa

    2016-07-01

    In the present chapter the authors present a brief overview of the diagnostic methods proposed over time for Hodgkin lymphoma (HL) spread detection, moving from surgical procedures, through standard radiological and functional imaging techniques to the present state of the art for HL staging. The main body of the review will be dedicated to the recently published guidelines for lymphoma staging (including HL) agreed by the experts during the 12th International Congress for Malignant Lymphoma in Lugano. The recommendations of the panel on how to integrate flurodeoxyglucose positron emission tomography (FDG-PET) scan in the armamentarium of staging procedures will be presented and commented, with a special emphasis on the utility of special procedures, such as bone marrow trephine biopsy, which is deemed no longer needed in the PET era. While the HL diagnosis is straightforward in most cases, sometimes HL is a subtle disease, difficult to diagnose for the paucity of symptoms, the absence of physical findings, or for concomitant immunologic disorders: a compete overview of the common and rare patterns of HL clinical presentation will be also offered. The future perspective of PET scan use will be based on a operator-independent, quantitative readings of the scan thanks to a plethora of sophisticated dedicated software, which are now available, able to quantify every voxel captured by the tumor to display the metabolically active tumor volume. Moreover, new tracers are now available able to track the new pathways of cellular metabolism beside glycolysis such as amino acids or purine-analogues or specific oncoproteins; the preliminary, promising results will be reported. Preliminary results from other imaging techniques, such as diffusion-weighted magnetic resonance (DW-MRI) will be also reported. PMID:27496305

  1. Clinical significance of expression of Klotho and β-Catenin in esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    汤小伟

    2013-01-01

    Objective To investigate the clinical significance of expression of Klotho and β-Catenin in esophageal carcinoma. Methods Tissue microarray technique and immunohistochemistry were used to examine Klotho and β-Catenin expression in 75 esophageal carcinoma tissue

  2. The clinical assessment of intraductal ultrasonography in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To assess and compare the clinical value of intraductal ultrasonography (IDUS) in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis with conventional imaging methods. Methods: IDUS was carried out in eighteen patients with pancreatic carcinoma and chronic pancreatitis

  3. A Case of Hypopharyngeal Squamous Cell Carcinoma with Peritonead and Liver Metastasis Presenting Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Hashem Sharifian

    2009-01-01

    Full Text Available "nIntroduction: Squamous cell carcinoma (SCC of the head and neck is usually confined to local and regional sites but occasionally patients may present with rare manifestation of distant metastasis. We reported a case of hypopharyngeal SCC with liver and peritoneal metastasis. "nClinical picture: A 50-year-old female with advanced hypopharyngeal SCC was treated in this center by laryngoesophagectomy and gastric pull up. "nOne year later she presented with signs of bowel obstruction. CT scan showed an 11×15 centimeter mass with a large necrotic center in the peritoneal cavity which caused bowel obstruction. "n Some other necrotic masses were seen in the liver too. After surgery, histopathologic examination shows these masses are metastatic SCC. Abdominal fluid showed malignant cells. "nConclusion: These rare and aggressive presentations of SCC of the head and neck remind us that they may show atypical manifestations and may need more aggressive search of the distant disease in at least some subgroups of the head and neck carcinoma. "n"n  

  4. Simultaneous development of craniopharyngioma and choroid plexus carcinoma in the childhood -a clinical case

    International Nuclear Information System (INIS)

    We present a clinical case of 9 years old girl with concomitant brain tumors - choroid plexus carcinoma and craniopharyngioma diagnosed in 2009. After three operations, cranio-spinal irradiation with boost for the remaining tumor located in left ventricular trigonum to a total dose of 55 Gy and 7 courses chemotherapy, local tumor control was achieved for the choroid plexus carcinoma. Four years following the achievement of local tumor control of the choroid plexus carcinoma, an increase of the tumor formation located in the left side of the pituitary was reported. The diagnosis cystic craniopharyngeoma was found during the surgical operation. With this clinical case we would like to stress on the achieved local tumor control following the complex treatment of carcinoma of the choroid plexus, as well as on the slow growth of simultaneously diagnosed craniopharyngeoma. This case report raises the question of the genetic predisposition of the brain tumors in children, as well as possibility of malignant transformation of craniopharyngeoma following radiotherapy. The differential diagnosis of neuroectodermal brain tumors requires immunohistochemical analysis and if necessary genetic analysis. Key words: Complex treatment. Choroid plexus carcinoma. Craniopharyngioma. Radiotherapy. Malignant transformation. Simultaneity

  5. Case report from Mayo Clinic. Locally advanced Bartholin gland carcinoma

    International Nuclear Information System (INIS)

    Tumors of the Bartholin gland are rare, comprising less than 5% of all vulvar malignancies. Treatment is largely based on that of vulvar and anal squamous cell carcinomas. A case of invasive, grade 4, poorly differentiated squamous cell carcinoma of the Bartholin gland is presented. Our patient, a 47-year-old woman, had a history significant for cervical intraepithelial neoplasia treated with conization, type 2 diabetes mellitus, and tobacco use. The course of treatment included preoperative radiotherapy plus 5-fluorouracil and cisplatin chemotherapy, followed by restaging and posterior exenteration in combination with vaginal reconstruction. (author)

  6. Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

    International Nuclear Information System (INIS)

    Purpose: To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Methods and Materials: Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Results: Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Conclusions: Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.

  7. Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Charles, E-mail: Charles_Lin@health.qld.gov.au [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Tripcony, Lee; Keller, Jacqui [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Poulsen, Michael [Mater Hospital, Brisbane, Queensland (Australia); Martin, Jarad [St. Andrews Hospital, Toowoomba, Queensland (Australia); Jackson, James; Dickie, Graeme [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia)

    2012-01-01

    Purpose: To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Methods and Materials: Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Results: Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Conclusions: Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.

  8. Skin carcinomas: Radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have led to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of properties and routes of spread of the diverse

  9. Nasopharyngeal carcinoma. Clinical diagnosis, external radiotherapy and brachytherapy. Status of the art in 2001

    International Nuclear Information System (INIS)

    Nasopharynx carcinomas (NPC) are a very special head and neck cancer, in term of epidemiology, clinic and pathology. Endemic disease in South East Asia, undifferentiated nasopharynx carcinoma are very frequent CT scan and NMR allow a better knowledge of the modalities of the clinical presentation. Prognostic factors include local and regional extension. NPC is a well known radiosensitive disease with a dose-response curve well established. Modern imaging modalities and modification of the ballistic explain the amelioration of the local control and the diminution of therapeutic sequelae. Brachytherapy is an interesting modalities for the boost and the treatment of recurrent disease. The exact place of 3 D CRT and IMRT is not yet known as modifications of fractionation. Local control for T1 T2 tumor is excellent but is related to clinical extension (cranial and neurologic involvement) and nodal extension (supra clavicular N3) and show the interest of combined chemo-radiotherapy protocols. (authors)

  10. Renal cell carcinoma in India demonstrates early age of onset & a late stage of presentation

    Directory of Open Access Journals (Sweden)

    Shalini Agnihotri

    2014-01-01

    Full Text Available Background & objectives: Clinical spectrum of most of the diseases in developing countries is different from the west. Similarly whether renal cell carcinomas (RCC in a developing country like India is seen in the same spectrum in relation to the age at presentation as in the west is not described in the literature. This study was carried out to investigate the spectrum of RCC in India with regards to age of onset, stage at presentation and survival. Methods: Patients with renal tumour, treated between January 2000 to December 2012 in a tertiary care hospital in north India, were analyzed for age at presentation, clinical features and histopathological characteristics. Clinical diagnosis was made by contrast enhanced computerized tomography (CECT scans and/or magnetic resonance imaging (MRI. Renal masses diagnosed as angiomyolipoma, infective masses and hydatid cysts were excluded from the analysis. Impact of various age groups on gender, tumour size, TNM stage, Fuhrman grade, histopathological subtypes, lymph node, inferior vena cava (IVC involvement and survival was analyzed. Patients were grouped in five age groups i.e. ≤39, 40-49, 50-59, 60-69 and more than 70 yr of age. Results: Of the total 617 patients with 617 renal tumours (2 patients had bilateral tumours but only the larger tumour was considered clinically suspected as RCC, 586 had epithelial cell tumour and the remaining 31 had non epithelial cell tumour. The mean tumour size was 8.08±3.5 cm (median 7, range 1-25 cm. Tumour of less than 4 cm size was present in only 10.4 per cent patients. The mean age at diagnosis was 55.15±13.34 (median 56, range 14-91 yr years. A total of 30.03 per cent of renal tumours presented in patients younger than 50 yr of age. Though there was no difference in stage, Fuhrman′s grade, IVC involvement and lymph nodal spread among various age groups, younger patients had higher proportion of non clear cell RCC and only 48.59 per cent of them presented

  11. Metastatic Renal Cell Carcinoma Presenting as Nasal Mass: Case Report and Review of Literature.

    Science.gov (United States)

    Mahajan, Ritesh; Mayappa, Nagaraj; Prashanth, V

    2016-09-01

    Sinonasal neoplasms are rare and exceptional site for metastatic tumours and comprising CT scan revealed a tumour in the right nasal cavity and maxillary sinus. The presence of primary renal cell carcinoma was recognized only after surgical removal of metastatic tumour. Very few reports have been presented in literature of metastatic renal cell carcinoma in the sinonasal region. We present this case to document its occurrence; highlight the rarity, presentation and difficulties in diagnosis and treatment along with review of literature. PMID:27508143

  12. Right leg swelling as primary presentation of metastatic Merkel cell carcinoma.

    Science.gov (United States)

    Noto, R; Giaquinta, A; Alessandria, I; Soma, P; Latteri, S; Grasso, G; Fraggetta, F

    2008-06-01

    Merkel cell carcinoma (MCC) is a rare malignant cutaneous neuroendocrine tumour with an aggressive behaviour and frequent regional lymph node and distant metastases. It mostly occurs in old patients and the commonest sites are the skin of the head, neck and the extremities. Typically, the primary tumour presents as a fast-growing, painless, reddish nodule with an iceberg-like effect, broadening in the depth. Although the pathogenesis of MCC remains largely unknown, ultraviolet radiation and immunosuppression are likely to play a significant pathogenetic role. The authors describe an unusual case of MCC clinically presenting as lymphedema on the right leg due to an inguinal lymphonodal metastasis. Although extensive investigations were performed the authors were unable to discover the cutaneous primary tumor. The authors examine the etiopathogenesis and hypothesis of this rare tumour and describe the clinical differential diagnosis. They suggest that clinical features together with imaging studies and morphological and immuno-histochemical findings are important for the correct diagnosis. PMID:18497730

  13. Menopausal syndrome: clinical presentation and management

    Directory of Open Access Journals (Sweden)

    Sunil Somnath Patil

    2016-03-01

    Conclusions: There is need of setting menopausal clinics and centres to help women with symptoms and signs of estrogen deprivation. Counseling and education are main treatment modalities. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 757-761

  14. Clinical Significance of Langerhans Cells in Squamous Cell Carcinoma of the Larynx

    Science.gov (United States)

    Esteban, Francisco; Ruiz-Cabello, Francisco; Gonzalez-Moles, Miguel Angel; Lopez-Gonzalez, Miguel Angel; Funez, Rafael; Redondo, Maximino

    2012-01-01

    Langerhans cells (LCs) may be involved in the immunosurveillance against tumors as antigen-presenting cells. Our objective has been to determine the relevance of LC in progression of larynx squamous cell carcinomas and their relationship with different subpopulations of tumor-infiltrating cells. LCs were investigated by immunohistochemical methods using anti-CD1 antibody. LCs were detected in most of the primary tumors studied (44 out of 50) and also in metastases (6 out of 10) and recurrences (2 out of 3), but we did not find any statistical association between number of LCs and clinical-pathological parameters or survival. However, the number of LCs was increased in patients with evident infiltration of lymphocytes, mainly cytotoxic T cells. We can conclude that although LCs did not show clinical utility as prognostic marker, they may play a role in releasing an active immune response in larynx carcinomas, according to their ability to present antigens to sensitized T cells. PMID:22481933

  15. Clinical Significance of Langerhans Cells in Squamous Cell Carcinoma of the Larynx

    Directory of Open Access Journals (Sweden)

    Francisco Esteban

    2012-01-01

    Full Text Available Langerhans cells (LCs may be involved in the immunosurveillance against tumors as antigen-presenting cells. Our objective has been to determine the relevance of LC in progression of larynx squamous cell carcinomas and their relationship with different subpopulations of tumor-infiltrating cells. LCs were investigated by immunohistochemical methods using anti-CD1 antibody. LCs were detected in most of the primary tumors studied (44 out of 50 and also in metastases (6 out of 10 and recurrences (2 out of 3, but we did not find any statistical association between number of LCs and clinical-pathological parameters or survival. However, the number of LCs was increased in patients with evident infiltration of lymphocytes, mainly cytotoxic T cells. We can conclude that although LCs did not show clinical utility as prognostic marker, they may play a role in releasing an active immune response in larynx carcinomas, according to their ability to present antigens to sensitized T cells.

  16. Nonpalpable thyroid carcinoma: clinical controversies on preoperative selection.

    Science.gov (United States)

    Carpi, Angelo; Nicolini, Andrea; Casara, Dario; Rubello, Domenico; Rosa Pelizzo, Maria

    2003-06-01

    This article emphasizes some controversies concerning the preoperative selection of nonpalpable thyroid tumors. The prevalence of occult thyroid carcinoma in surgical series (1.8-10%) is not higher than in autopsy thyroid series (2.7-24%). The prevalence of occult thyroid carcinoma in thyroid glands examined in the same institution by ultrasound, for a clinical thyroid abnormality or for investigation of other neck structures without clinically evident or suspected thyroid disease, varies from 3% to 8% and is very similar independent of the fact that a thyroid abnormality is or is not the indication for ultrasonography. These data suggest that the presence of a thyroid disease is not a risk factor for harboring an occult thyroid carcinoma (except for C-cell hyperplasia in the rare case of MEN 2 syndromes). As it is not cost effective to examine all the nonpalpable lesions with fine-needle aspiration (FNA) guided by ultrasounds, it is necessary to define to which extent ultrasound is useful in selecting those lesions to be examined cytologically by FNA. The use of ultrasound to select these lesions is very controversial. Ultrasound-guided cytologic diagnosis of nonpalpable nodules is not as accurate as in the case of palpable nodules. Sampling of material adequate for cytologic analysis depends on the lesion size; it is 64% for a 0.7-cm lesion and it increases to 86.7% for a mean size of 1.1 cm. For the diagnosis of occult thyroid carcinomas (limit for dividing thyroid nodules in probably innocuous or potentially dangerous categories and because the cytologic diagnosis of nodules of this size is sufficiently reliable. For the smaller incidentally discovered thyroid nodules following ultrasound, physicians should discuss with the patient whether and when to perform an ultrasound-guided FNA considering the patient's data (risk factors, age, health state, etc.), the natural history of a small thyroid carcinoma, as well as the accuracy of ultrasound and ultrasound

  17. Expression and clinical significance of aquaglyceroporins in human hepatocellular carcinoma.

    Science.gov (United States)

    Chen, Xiao-Feng; Li, Chuan-Fei; Lü, Lin; Mei, Zhe-Chuan

    2016-06-01

    Aquaglyceroporins (AQPs) are a subset of the aquaporin family, and are permeable to water and glycerol. The aim of the present study was to determine the expression and clinical significance of three AQPs, AQP3, 7 and 9 in hepatocellular carcinoma (HCC). Fresh HCC and adjacent non‑tumorous liver tissues were collected from 68 patients diagnosed with HCC. The expression levels of AQP3, 7 and 9 were detected by reverse transcription‑quantitative polymerase chain reaction, western blotting and immunohistochemical analysis. The association between the expression of AQPs and clinicopathological parameters of HCC were investigated. Compared with non‑tumorous liver tissue, HCC tissues exhibited a significant (P<0.05) increase in the expression of AQP3 and a concomitant reduction in the expression levels of AQP7 and AQP9, at both the mRNA and protein levels. Immunohistochemistry revealed that AQP9 was dominantly localized on the plasma membrane of hepatocytes, while AQP3 and AQP7 exhibited a predominantly cytoplasmic and nuclear distribution. High expression of AQP3 was significantly (P<0.05) associated with low expression levels of AQP7 and AQP9. High expression of AQP3 was correlated with tumor grade (P=0.017), tumor stage (P=0.010) and lymphatic metastasis (P=0.031). Low expression of AQP7 was correlated with tumor grade (P=0.043). AQP3 was upregulated, and AQP7 and AQP9 were downregulated in HCC. A high expression of AQP3 and low expression of AQP7 was significantly associated with the aggressive features of HCC. PMID:27121567

  18. A clinical case of the penile metastasis from the rectal carcinoma

    OpenAIRE

    Yildirim, Mehmet; Coskun, Ali; Pürten, Mete; Oztekin, Ozgur; Ilhan, Enver

    2010-01-01

    Background Penile metastases are rare and usually secondary to genitourinary and colorectal cancer. Case report We present a case of a 77-year-old man with penile metastasis who was operated for rectal carcinoma. He was referred to our clinic for penile ulcerous lesion, semierectile penis and voiding dysfunction. Imaging studies showed nodular lesion at glans penis and multiple bone metastases. He did not respond to chemoradiotherapy and he had bad prognosis. Conclusions Imaging methods and b...

  19. The present approach to treatment of renal cell carcinoma

    International Nuclear Information System (INIS)

    Until the turn of the millennium, metastatic renal cell carcinoma (mRCC) was regarded as one of the most refractory cancers; highly resistant to both radiation and systemic therapy, and only small group of patients responded to immune modulation. Involved targeted therapies, which influence specific signal transduction pathways of tumor formation and progression, opened new options of treatment to give patients a new hope. After the first experiences with the new biologic agents we can claim, that these patients have improved a quality of life, provided stabilization of disease and prolong life of patients, but the cure is not available. However, there are so many studies with target therapies in RCC, but the most correct algorithm of treatment does not exist. Targeted therapies rarely achieve remission, prevailing a stabilisation of disease so patients have to undergo chronic treatment. In choice of optimal treatment is necessary to regard for quality of life, so usually the winner is the drug with the lowest toxic potential. (author)

  20. Clinical oncology in Malaysia: 1914 to present

    OpenAIRE

    Lim, GCC

    2006-01-01

    A narration of the development of staff, infrastructure and buildings in the various parts of the country is given in this paper. The role of universities and other institutions of learning, public health, palliative care, nuclear medicine and cancer registries is described together with the networking that has been developed between the government, non-governmental organisations and private hospitals. The training of skilled manpower and the commencement of the Master of Clinical Oncology in...

  1. Wernicke encephalopathy: MR findings and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Weidauer, Stefan; Lanfermann, Heinrich; Zanella, Friedhelm E. [Institute of Neuroradiology, University of Frankfurt, Frankfurt (Germany); Nichtweiss, Michael [Department of Neurology, Municipal Hospital of Wismar, Wismar (Germany)

    2003-05-01

    Wernicke encephalopathy (WE) is a severe neurological disorder caused by vitamin B1 deficiency. The aim of the study was to analyse MRI findings typical for this disease and to evaluate the significance of their correlations with clinical symptoms. Magnetic resonance images and clinical features of 12 patients with WE were analysed. The patients underwent MR imaging within 3-14 days after onset of clinical symptoms. In 7 of 12 patients MR imaging showed symmetrical diencephalic and midbrain lesions. Postcontrast T1-weighted images from 5 of 9 patients examined during the initial 6 days of acute WE showed a subtle enhancement of the mamillary bodies, the tectal plate, the periaqueductal area and the periventricular region of the third ventricle including the paramedian thalamic nuclei. In addition, T2-weighted and fluid-attenuated inversion recovery (FLAIR) images revealed hyperintense signals in these regions (except for 2 patients where the mamillary bodies were normal). Hyperintense lesions on T2-weighted images without any enhancement on postcontrast T1-weighted images were detected in 2 patients by MR imaging performed 11 or 14 days after onset of WE. Patients with hyperintensities on T2-weighted images of the periventricular region of the third ventricle and the paramedian thalamic nuclei had poor recovery from their mental dysfunction. The MR examination in case of WE shows a typical pattern of lesions in 58% of cases. Enhancement of the mamillary bodies, the periventricular region of the third ventricle including the paramedian thalamic nuclei, and the periaqueductal area on postcontrast T1-weighted images can be observed in the initial period after clinical onset of symptoms and are characteristic signs of the acute stage of WE. Hyperintense lesions in the periventricular region and the paramedian thalamic nuclei on T2-weighted and FLAIR images in the subacute stage of WE and enhancement on postcontrast T1-weighted images of the mamillary bodies and the

  2. Bradyarrhythmias: Clinical Presentation, Diagnosis, and Management.

    Science.gov (United States)

    Wung, Shu-Fen

    2016-09-01

    Bradyarrhythmias are common clinical findings consisting of physiologic and pathologic conditions (sinus node dysfunction and atrioventricular [AV] conduction disturbances). Bradyarrhythmias can be benign, requiring no treatment; however, acute unstable bradycardia can lead to cardiac arrest. In patients with confirmed or suspected bradycardia, a thorough history and physical examination should include possible causes of sinoatrial node dysfunction or AV block. Management of bradycardia is based on the severity of symptoms, the underlying causes, presence of potentially reversible causes, presence of adverse signs, and risk of progression to asystole. Pharmacologic therapy and/or pacing are used to manage unstable or symptomatic bradyarrhythmias. PMID:27484658

  3. Clinical Presentation of Atypical Genital Herpes

    Institute of Scientific and Technical Information of China (English)

    李俊杰; 梁沛杨; 罗北京

    2002-01-01

    Objective: To make a clinical analysis on the basis of 36cases of atypical genital herpes (GH) patients. Methods: Thirty-six cases of atypical GH were diagnosedclinically, and their case histories, symptoms and signs wererecorded in detail and followed up. Polymerase chain reaction(PCR) was adopted for testing HSV2-DNA with cotton-tippedswabs. Enzyme-linked immuno sorbent assay (ELISA) forserum anti-HSV2-IgM was done to establish a definfiivediagnosis. Other diagnoses were excluded at the same time bytesting for related pathogens including fungi, Chlamydia,Mycoplasma, Treponema pallidum, gonococci, Trichomonas,etc. Results: The main clinical manifestations of atypical GHwere: (1) small genital ulcers; (2) inflammation of urethralmeatus; (3) nonspecific genital erythema; (4) papuloid noduleson the glands; (5) nonspecific vaginitis. Twenty-three cases(64%) tested by PCR were HSV2-DNA sera-positive, and 36cases (100 %) anti-HSV2-IgM sera-positive by ELISA. Conclusion: atypical HSV is difficult to be diagnosed. Butthe combination of PCR and ELIAS will be helpful to thediagnosis of atypical HSV.

  4. Clear cell carcinoma, not otherwise specified/hyalinising clear cell carcinoma of the salivary gland: The current nomenclature, clinical/pathological characteristics and management.

    Science.gov (United States)

    Daniele, Luca; Nikolarakos, Dimitrios; Keenan, Jonathon; Schaefer, Nathan; Lam, Alfred King-Yin

    2016-06-01

    Clear cell carcinoma, not otherwise specified (NOS)/hyalinising clear cell carcinoma (HCCC) is a rare entity in salivary gland tumour. The aim of the research is to review the current concepts and characteristics of this carcinoma. The clinical and pathological data of the disease obtained from literature and two original cases were analysed. Overall, 152 cases were reviewed up to the year 2014. The carcinomas were noted often in woman, in the seventh decade of life, located in oral cavity and as early-stages cancers. On pathological examination, they were characterized by tumour cells having clear cell morphology with hyalinised stroma. Immunohistochemical studies revealed that the carcinoma is positive for cytokeratin and negative for myoepithelial differentiation. EWSR1-ATF1 fusion is specific for the carcinoma. Also, 9% of the reported cases had local nodal metastasis, with 6 cases demonstrating distant metastases at presentation. On follow-up, 22% of patients had recurrent or with persistent diseases after surgery. The time for the first recurrence could be as long as 24 years. Risk factors for recurrence include advanced stage at diagnosis and metastases at presentation. To conclude, HCCC is a low grade malignancy but have the potential for local metastases, recurrence, distant metastases and cancer-related death. PMID:27150676

  5. Oral squamous cell carcinoma misdiagnosed as a denture-related traumatic ulcer: A clinical report.

    Science.gov (United States)

    Valente, Vitor Bonetti; Takamiya, Aline Satie; Ferreira, Lígia Lavezo; Felipini, Renata Callestini; Biasoli, Éder Ricardo; Miyahara, Glauco Issamu; Bernabé, Daniel Galera

    2016-03-01

    A 65-year-old woman presented with an ulcerated lesion in the alveolar ridge mucosa, which appeared after new dentures had been inserted. Despite many treatment attempts, the lesion did not recede, even with the interruption of denture wearing. A biopsy was performed, and histopathologic examination revealed an ulcerated, invasive, poorly differentiated oral squamous cell carcinoma. The time from the patient's first contact with the prosthodontist because of the lesion until the appropriate diagnosis was established was approximately 6 months. This clinical report documents a significant delay in the oral squamous cell carcinoma diagnosis and treatment because of a clinical misdiagnosis of a traumatic ulcer resulting from complete dentures. Prosthodontists should be aware of the importance of early diagnosis of oral cancer among elderly prosthesis wearers. PMID:26581660

  6. Gardner’s syndrome presenting as duodenal carcinoma in a young male

    Directory of Open Access Journals (Sweden)

    Sarma YS

    2015-10-01

    Full Text Available Gardners syndrome (GS is a variant of familial adenomatous polyposis (FAP and presents with both colonic and extra colonic manifestations. It is an autosomal dominant disorder and results from mutations in adenomatous polyposis coli (APC gene. Patients with GS if not treated early will invariably develop colonic cancers at a much younger age than those with sporadic colonic carcinoma. These patients also develop other malignant tumours like duodenal cancers, gastric cancer, hepatoblastoma, papillary carcinoma of the thyroid and multifocal cholangiocarcinomas. With early diagnosis and treatment of colonic polyposis, adenocarcinoma of the duodenum has become the leading cause of death in FAP patients. The mean age at which duodenal carcinoma is diagnosed in FAP is 45-52 years. We report the rare occurrence of duodenal carcinoma as the presenting feature of Gardner’s syndrome in a young 25-year-old male with no obvious malignant changes in the colonic adenomas.

  7. Skin carcinomas: Radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas: (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have lead to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of tumor biological properties of the diverse malignant

  8. Skin carcinomas: radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have lead to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of tumor biological properties of the diverse malignant

  9. Endobronchial metastasis of follicular thyroid carcinoma presenting as hemoptysis: A case report

    Directory of Open Access Journals (Sweden)

    Kushwaha RAS

    2008-01-01

    Full Text Available Endobronchial metastasis secondary to follicular thyroid carcinoma is extremely rare. Here, we report a case of follicular thyroid cancer in 58-year-old male who presented with hemoptysis. Computed tomography of the chest revealed multiple lung metastases. Flexible fiberoptic bronchoscopy revealed a fragile polypoid mass 5 cm distal to the vocal cords; biopsy taken from this mass revealed follicular thyroid carcinoma.

  10. A case of lobular carcinoma in situ presenting as a solid mass

    OpenAIRE

    Zhang, X.; Hanamura, N; Yamasita, M; Kashikura, Y; Ogawa, T.; Taizo, S

    2011-01-01

    A patient presented with a 2 cm lump in the lower outer quadrant of the left breast. Mammogram and ultrasonography showed a solid mass with a microlobulated contour, partially irregular border and microcalcifications. MRI showed an irregular mass with early enhancement and high signal intensity, and the late-phase image demonstrated a partial washout pattern. These findings suggest that the tumour was a malignant invasive carcinoma. Non-invasive ductal carcinoma was diagnosed after a fine nee...

  11. Tongue metastasis as an initial presentation of renal cell carcinoma: a case report and literature review

    OpenAIRE

    Azam Faisal; Abubakerr Muneer; Gollins Simon

    2008-01-01

    Abstract Introduction Primary tumour of the kidney metastasizing to the tongue is very unusual and only anecdotal cases have been reported. An exhaustive literature review covering the period from 1911 onwards disclosed 28 cases. Out of those, only 3 cases presented initially with tongue metastases before the diagnosis of primary renal cell carcinoma. The prognosis for patients with lingual metastasis of renal cell carcinoma is poor. Treatment of tongue metastasis is usually palliative and ai...

  12. Histological, Immunohistological, and Clinical Features of Merkel Cell Carcinoma in Correlation to Merkel Cell Polyomavirus Status

    Directory of Open Access Journals (Sweden)

    T. Jaeger

    2012-01-01

    Full Text Available Merkel cell carcinoma is a rare, but highly malignant tumor of the skin with high rates of metastasis and poor survival. Its incidence rate rises and is currently about 0.6/100000/year. Clinical differential diagnoses include basal cell carcinoma, cyst, amelanotic melanoma, lymphoma and atypical fibroxanthoma. In this review article clinical, histopathological and immunhistochemical features of Merkel cell carcinoma are reported. In addition, the role of Merkel cell polyomavirus is discussed.

  13. Vesical Leiomyoma: Presentation of a clinical case

    International Nuclear Information System (INIS)

    The vesical leiomyoma is a tumor of mesenchymal origin, and extremely rare. Most of them are diagnosed casually after the pathologic study of samples collected after surgery. Few cases were found in the reviewed literature, leading us to think of the scarce incidence of this kind of tumors. We present a case treated in our service, of an 18-years-old female patient, assisting to our consultation presenting a polaquiuria, ardor and mictional effort. The complementary exams led to the surgical treatment and follow up of the patient

  14. Clinical Neurotoxic Disorders : Past, Present and Future

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    Nag Devika

    2001-01-01

    Full Text Available Neurotoxins have existed on the earth from times immemorial. Old neurotoxic disorders were due to ingestion/ exposure of heavy metals and food like lathyrus sativus over a long period of time. The 20th Century with rapid industrialsation and expanding chemical and drug industry has spawned several new, hitherto unknown disorders. Old disorders continue to exist e.g. fluorosis, arsenicosis, lathyrism, manganism and lead neuropathy, along with new diseases like Minamata disease, subacute myelo optic neuropathy (SMON, MPTP-Parkinsonian syndorme, triorthcresyl phosphate (TOCP neuroparalytic disease, pesticide induced seizures, tremor and neuropathy, solvent encephalopthy, antipileptic drug foetal syndrome and excitotoxin induced behavioural disorders. Studies on pesticides Organochlorine and organophosphates, synthetic pyrethrins, solvents, heavy metals and substances abuse in the Indian context confirm the neurotoxic nature of many synthetic substances. Future problems envisaged are of concern to clinical neurologists as many of these neurotoxic disorders mimic syndromes of well known neurological disease. The new millenium poses a challenge to the clinician as newer compounds in industry, food, drugs and chemical war agents are being developed. Molecular genetics has advanced rapidly with release of the human genome map. Animal cloning and genetically modified plant products have entered the food chain. How safe are these new inventions for the central nervous system is a big question? India cannot afford disasters like Union Carbide′s Bhopal gas leak nor be a silent spectator to manipulative biotechnology. Unless it is proven beyond all doubt to be a safe innovation, Chemicals have to be cautiously introduced in our environment. To Study, ascertain and confirm safety or neurotoxicity is an exciting challenge for the neuroscientists of the 21st century.

  15. The clinical application of 18F-FDG PET/CT scan in the thyroid carcinoma

    International Nuclear Information System (INIS)

    The incidence of thyroid cancer is the top ranking among endocrine carcinoma worldwide. Many imaging modalities have been applied in diagnosing, characterization of the biological behaviors and predicting the outcomes of various thyroid carcinoma. Over the years, 18F-FDG PET/CT has been largely used to identify undifferentiated thyroid carcinoma cells in thyroid carcinoma patients with or without 131I avid lesion. The purpose of this mini-review was to update the clinical role and positive impact of 18F-FDG PET/CT in various thyroid carcinoma patients. (authors)

  16. Gastroesophageal reflux: clinical presentations, diagnosis and management.

    Science.gov (United States)

    Waterfall, W E; Craven, M A; Allen, C J

    1986-11-15

    Symptomatic gastroesophageal reflux occurs daily in an estimated 7% of adults and weekly or monthly in 29%. Untreated it can lead to esophageal erosions, ulceration and stricture formation. The pathogenesis is often multifactorial: defects in the function of the lower esophageal sphincter, esophageal clearance mechanisms and gastric emptying combine to produce frequent lengthy periods during which the lower esophagus is bathed in regurgitated acid. In most patients reflux disease is easily recognized as recurrent heartburn, regurgitation or dysphagia, or a combination. When acute chest pain or respiratory illness is the primary presenting complaint the patient needs particularly careful investigation to determine whether the symptoms are due to a primary cardiac or respiratory condition, are secondary to gastroesophageal reflux alone or represent a combination of disorders. Endoscopy with biopsy and long-term pH monitoring are the most reliable ways of determining whether reflux disease is present. Additional investigations, such as exercise testing, cardiac catheterization or inhalation challenge, may be needed in patients with cardiac or respiratory symptoms. Treatment should follow a stepped-care approach and in most patients should begin with changes in lifestyle, including dietary manipulation, reducing alcohol and cigarette consumption, and raising the head of the bed, together with appropriate use of antacids or alginate-antacid combinations. H2-receptor antagonists and agents to improve both gastric emptying and the tone of the lower esophageal sphincter may be added in sequence. Most patients will respond well to this regimen. Surgery should be considered only for those with intractable symptoms or with complications (e.g., stricture formation, bleeding, development of dysplastic epithelium in those with Barrett's esophagus, or secondary pulmonary disease that does not respond to medical management). It is successful in 85% of well-selected patients and

  17. Improving clinical trial design for hepatocellular carcinoma treatments

    Directory of Open Access Journals (Sweden)

    Garrett Hisatake

    2011-12-01

    Full Text Available Despite its place as the third leading cause of cancer deaths worldwide, there are currently no approved chemotherapeutic agents, devices or techniques to treat hepatocellular carcinoma. Importantly, there have been no phase III studies demonstrating survival benefit, nor any randomized studies of treatment except for transarterial chemoembolization and most recently sorafenib. The importance of well-designed clinical trials of agents to treat HCC has never been greater. However, general clinical study design issues, combined with HCC-specific issues pose significant challenges in structuring such studies. HCC-related challenges include the heterogeneity of this cancer and the fact that it is frequently accompanied by significant comorbidities at diagnosis, such as active hepatitis B or C virus replication, substantial past or on-going alcohol use, and cirrhosis, itself often a fatal disease. The recently published comparison of a newer treatment, nolatrexed to doxorubicin, and comments about this study’s initial HCC diagnostic criteria, staging system, comparator therapy and choice of endpoints have provided a platform to discuss the challenges unique to the design of HCC clinical trials. The difficulty in accurately framing study results obtained from the constantly changing HCC clinical landscape and approaches to meet these challenges will be reviewed.

  18. Lobomycosis: epidemiology, clinical presentation, and management options.

    Science.gov (United States)

    Francesconi, Valeska Albuquerque; Klein, Ana Paula; Santos, Ana Paula Botelho Gualda; Ramasawmy, Rajendranath; Francesconi, Fábio

    2014-01-01

    Lobomycosis is a subcutaneous mycosis of chronic evolution caused by the Lacazia loboi fungus. Its distribution is almost exclusive in the Americas, and it has a particularly high prevalence in the Amazon basin. Cases of lobomycosis have been reported only in dolphins and humans. Its prevalence is higher among men who are active in the forest, such as rubber tappers, bushmen, miners, and Indian men. It is recognized that the traumatic implantation of the fungus on the skin is the route by which humans acquire this infection. The lesions affect mainly exposed areas such as the auricles and upper and lower limbs and are typically presented as keloid-like lesions. Currently, surgical removal is the therapeutic procedure of choice in initial cases. Despite the existing data and studies to date, the active immune mechanisms in this infection and its involvement in the control or development of lacaziosis have not been fully clarified. In recent years, little progress has been made in the appraisal of the epidemiologic aspects of the disease. So far, we have neither a population-based study nor any evaluation directed to the forest workers. PMID:25328400

  19. Lobomycosis: epidemiology, clinical presentation, and management options

    Directory of Open Access Journals (Sweden)

    Francesconi VA

    2014-10-01

    Full Text Available Valeska Albuquerque Francesconi,1 Ana Paula Klein,2 Ana Paula Botelho Gualda Santos,2 Rajendranath Ramasawmy,3 Fábio Francesconi4 1Department of Dermatology, Tropical Medicine Foundation Heitor Vieira Dourado, Manaus, Amazonas, Brazil; 2Amazon Federal University, Manaus, Amazonas, Brazil; 3Department of Immunogenetics, 4Department of Dermatology, Tropical Medicine Foundation Heitor Vieira Dourado, Manaus, Amazonas, Brazil Abstract: Lobomycosis is a subcutaneous mycosis of chronic evolution caused by the Lacazia loboi fungus. Its distribution is almost exclusive in the Americas, and it has a particularly high prevalence in the Amazon basin. Cases of lobomycosis have been reported only in dolphins and humans. Its prevalence is higher among men who are active in the forest, such as rubber tappers, bushmen, miners, and Indian men. It is recognized that the traumatic implantation of the fungus on the skin is the route by which humans acquire this infection. The lesions affect mainly exposed areas such as the auricles and upper and lower limbs and are typically presented as keloid-like lesions. Currently, surgical removal is the therapeutic procedure of choice in initial cases. Despite the existing data and studies to date, the active immune mechanisms in this infection and its involvement in the control or development of lacaziosis have not been fully clarified. In recent years, little progress has been made in the appraisal of the epidemiologic aspects of the disease. So far, we have neither a population-based study nor any evaluation directed to the forest workers. Keywords: infection, Lacazia loboi, lobomycosis, lacaziosis, mycosis 

  20. Clinical analysis on primary salivary gland type nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical characteristics , therapeutic outcomes , and prognostic factors of primary salivary gland type nasopharyngeal carcinoma (SNPC). Methods: The medical records of 54 patients with SNPC at single institution between 1963 and 2006 were reviewed, 2 patients received surgery alone, 30 patients received radiotherapy alone and 22 patients received combined modality therapy consisting of surgery (S) and radiotherapy (RT) (S + RT in 15 and RT + S in 7). Of them, 8 patients received chemotherapy , including post-operative adjuvant chemotherapy in 1 patient, palliative chemotherapy in 6 patients and concurrent chemotherapy in 1 patient. 36 patients had adenoid cystic carcinoma (ACC), 11 mucoepidermoid carcinoma (MEC), and 7 primary traditional adenocarcinoma (AC) . The Kaplan-Meier method was used to calculate the overall survival (OS), locoregional failure-free survival (LRFFS) , and distant failure-free survival (DFFS) rates. Univariate analyses were performed using the Log-rank method.Comparisons of variables between cases were performed using Pearson chi-square test. Results: The follow-up was 89%. The 2-, and 5-year overall survival rates, loco-regional failure free survival rates and distant failure free survival rates were 85% and 61%, 74% and 55%, 92% and 70%, respectively. Among the 35 patients with treatment failure, 26 patients had locoregional failure (1 in primary site and cervical lymph node ,23 in primary site and 2 in cervical lymph node), and 13 had distant metastasis. The lung was the most common site of metastasis (n =10) , followed by liver (n = 3), bone (n = 2) , brain (n = 1), and subcutaneous tissue (n = 1). Univariate analyses indicated that histological subtypes correlated with overall survival (χ2 = 15.29, P = 0.000) and cervical lymph node metastases correlated with distant failure-free survival (χ2 =9.08, P = 0.003). Conclusions: Primary salivary gland type nasopharyngeal carcinoma is a locally aggressive disease

  1. Thyroid follicular carcinoma presenting as metastatic skin nodules

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    Asad Jehangir

    2015-02-01

    Full Text Available Background: Follicular thyroid cancer (FTC metastasizes most commonly to the lungs and non-cranial bones. Skull and skin are uncommon sites and usually manifest well after the diagnosis of primary malignancy. Metastasis to skull and skin as the presenting feature of FTC is infrequently reported in the literature. Case presentation: A 65-year-old Caucasian woman with a history of thyroid nodule presented with the complaint of rapidly growing skull nodules which had been present for 3 years but were stable previously. She denied any fevers, chills, history of trauma, or weight loss. She denied any history of smoking or head and neck irradiation. On physical examination, she had two non-tender gray cystic lesions – one on her left temporal region and the other on the right parietal region. Biopsy was consistent with metastatic FTC. Magnetic resonance imaging of the brain demonstrated 7.1×3.8 cm and 3.7×4.5 cm fairly homogeneous, enhancing, relatively well-defined masses centered in the posterior and left anterior lateral calvarium with intracranial and extracranial extensions but without any vasogenic edema or mass effect on the brain. Thyroid ultrasound showed numerous nodules in both lobes. The patient underwent a total thyroidectomy. Histopathological studies of the thyroid gland revealed a well-differentiated FTC in the left lobe. Then she underwent resection of the tumor in multiple stages. She did not have any recurrence of the FTC or metastases during the follow-up period and will be receiving radioactive iodine treatment. Conclusion: Bone and lung are the common sites of metastasis from FTC, but involvement of skull or skin is unusual, particularly as the presenting feature. Metastases from FTC should be in the differential of patients with new osteolytic hypervascular skull lesions or cutaneous lesions in head and neck area.

  2. Clinical presentation and risk factors of osteoradionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chronopoulos, Aristeidis

    2015-03-26

    Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive

  3. Clinical presentation and risk factors of osteoradionecrosis

    International Nuclear Information System (INIS)

    Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive

  4. Clinical and Para-Clinical Presentations of Endobronchial Tuberculosis

    Directory of Open Access Journals (Sweden)

    Seyyed Hosein Ahmadi Hoseini

    2015-11-01

    Full Text Available Introdution: Tuberculosis (TB, with different types of respiratory tract involvements, has a high rate of mortality all around the world. Endobronchial involvement, which is a slightly common tuberculous infection, requires special attention due to its severe complications such as bronchostenosis. Aim of study of this study was describes, one type of pulmonary tuberculosis with less diagnosed and delayed treatment. High suspicious needs to diagnose and may be need bronchoscopy for confirmed the diagnosis. It can be associated with sever complication and early diagnosis and treatment are necessary for prevention of adverse effect.   Materials and Methods: This retrospective study was conducted in a teaching hospital during 2005-2010. Patients diagnosed with endobronchial tuberculosis through bronchoscopic biopsy were included in the study. Diagnosis was confirmed by observation of caseous necrosis, bronchial lavage fluid or positive acid-fast staining in tissue samples obtained through bronchial biopsy. Moreover, demographic information, endobronchial view, lab tests, as well as clinical and radiographic findings were reviewed and evaluated retrospectively. Results: A total of 20 cases were confirmed with endobronchial tuberculosis, 75% of whom were female with the mean age of 60 years. The results showed that the most common clinical symptom was cough (80%, the most common finding in the chest X-ray was consolidation (75%, and the most common bronchoscopic feature was anthracosis (55%. Conclusion: TB is still a major concern, particularly in the developing countries. Thus, in order for early diagnosis and prevention of this disease, we need to pay meticulous attention to its clinical manifestations and bronchoscopic features.

  5. Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: a case report and literature review.

    LENUS (Irish Health Repository)

    Romics, Laszlo

    2009-01-01

    The term "intracystic papillary ductal carcinoma in situ" has recently changed and is now more appropriately referred to "intracystic papillary carcinoma". Intracystic papillary carcinoma in men is an extremely rare disease with only a few case presentations published in the literature so far.

  6. Epidermoid Carcinoma of the Cervix and Pregnancy. A case presentation.

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    Práxedes Rojas Quintana

    2007-12-01

    Full Text Available A 25 year-old female patient with a 12 week pregnancy was presented. She was diagnosed with an ultered Pap test. She was referred to the cervix uterine pathology specialist where an exophytic lesion compatible to cervix uterine cancer in advanced stages. The treatment as well as the conduct followed by the specialist was really hard due to the patient´s pregnant condition.

  7. Presentation of Axillary Metastases from Occult Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xin Wang

    2007-01-01

    Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians.Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confirmed,a preoperative workup should be done.The current experience is based on several relatively small retrospective reviews and case reports.It is difficult to determine the best management of occult breast cancer.However,treatmenl of axillary Iymph node dissection is recommended for local control and complete staging information.Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy.Adjuvant systemic treatment should be offered.

  8. An unusual Case of Transitional Cell Carcinoma of Renal Pelvis Presenting with Brain Metastases

    Directory of Open Access Journals (Sweden)

    MR Razzaghi

    2009-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case which should be diagnosed and treated in order to prevent further damages. Case: We report a rare case, who had presented with a constellation of neurological symptoms (due to multiple brain metastases, but without any urological symptoms. During evaluation of patient, we found transitional cell carcinoma (TCC of left renal pelvis, for which palliative radical nephroureterectomy was performed . Conclusion: Although transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case, but the patient was managed with gamma knife stereotactic radiosurgery for the metastatic lesions. Afterward he received four cycles of paclitaxel and carboplatin chemotherapy. The patient is alive with stable disease at 32- months’ follow-up.

  9. Present situation and development of chemotherapy of nasopharyngeal carcinoma%鼻咽癌化疗现状及进展

    Institute of Scientific and Technical Information of China (English)

    冼献清; 谢民强; 江刚

    2013-01-01

    Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy,concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.

  10. Cutis verticis gyrata in a patient with multiple basal cell carcinomas; case presentation and review of the literature

    Directory of Open Access Journals (Sweden)

    Simona-Roxana Georgescu

    2016-04-01

    Full Text Available Cutis verticis gyrata is a rare disease characterized by convoluted folds and deep furrows of the scalp, resembling the gyri and sulci of the cerebral cortex. Basal cell carcinoma is the most frequent cancer in Caucasians, patients frequently presenting multiple tumors. We report the case of a 62 year old male, Caucasian patient, from the urban area, who addressed the dermatology department of our hospital for multiple tumors located on the face and upper trunk. A careful examination revealed cerebriform folding of the skin of the scalp. Neurological, psychological, ophthalmological and endocrine disorders were disproven. The patient was diagnosed with cutis verticis gyrata based on the clinical picture and anamnesis, and basal cell carcinoma based on the histopathological examination. Since cutis verticis gyrata predated the BCCs by four decades, and no other conditions were associated, the patient was diagnosed with primary essential cutis verticis gyrata.

  11. CARCINOMA PENIS, CLINICAL STUDY OF VARIOUS MODALITY OF TREATMENT

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    Vipin Kumar Pal

    2015-07-01

    Full Text Available INTRODUCTION: Cancer of penis is a rare tumor in developed country and affects the elderly patient population. The aim of this paper was to analyze and study the char a ct e ristics of this tumor in our patient population. MATERIAL & METHODS: A total of 40 patients taken up for study from LLR & Associated H ospital and JK Cancer I nstitute out of which 21 cases formed the retrospective part and 19 cases formed the prospective part of study. RESULTS: Out of 40 cases diagnosed a nd treated the median age of presentation was 51.3 years, common in uncircumcised hindus and commonest presenting feature is penile growth followed by penile ulceration. Surgery alone for 27.5%, surgery and radiotherapy for 35%, Surgery and chemotherapy fo r 27.5% and chemotherapy for 7.5% and radiotherapy for 2.5%. 22.5% mortality and 12.5% left follow - up. CONCLUSION: Carcinoma of penis is a pathology which mostly affects elderly patients. In our series the highest incidence observed in uncircumcised patien ts in age group of 41 - 50 years. The most common histological type epidermoid carcinoma in its various forms of presentation.

  12. Basisquamous Carcinoma

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    Yesudian Devakar P

    1997-01-01

    Full Text Available A 50 year old woman presented with an ulceroproliferative mass in the value of 4 month duration. Biopsy of the lesion showed features of a basisquamous cell carcinoma. This is a rare tumour showing histopathological features of both basal cell and squamous cell carcinomas. The clinical, histopathological and histogenetic status of this tumour are discussed.

  13. A Clinical Pitfall: Optimal Management of Single Dural-based Metastatic Carcinoma of the Breast Mimicking Meningioma.

    Science.gov (United States)

    Li, Chiao-Zhu; Li, Chiao-Ching; Lin, Meng-Chi; Chih-Chuan, Hsieh; Chen, Nan-Fu; Chen, Chun-Lin; Tang, Chi-Tun

    2015-11-01

    Meningioma is the most common benign brain lesion in adults. Conservative treatment is suggested if there is no obvious neurological symptom or mass effect, but cerebral metastases require aggressive therapy. Single dural-based metastatic carcinoma mimicking meningioma is uncommon. Here is a case of clinical dilemma between meningioma and metastatic carcinoma mimicking meningioma. A woman with a history of invasive ductal carcinoma of the breast presented with headache and blurred vision. Brain computed tomography and magnetic resonance imaging (MRI) both gave the impression of meningioma. After surgical resection of the brain lesion, histopathology revealed that it was a metastatic lesion from the breast. This report discussed the optimal management of single dural-based metastatic carcinoma mimicking meningioma. PMID:26566041

  14. Verrucous carcinoma over the penis presenting as nail-like cutaneous horn

    Directory of Open Access Journals (Sweden)

    Varadraj V Pai

    2012-01-01

    Full Text Available Cutaneous horn over the penis presents as a rare conical, hyperkeratotic nodule. About one-third of the cases are associated with malignancy. Herein, we report a case of verrucous carcinoma over the penis, presenting as a nail.

  15. Influence of Clinical and Pathologic Parameters on Prognosis of Cervical Carcinoma in China

    Institute of Scientific and Technical Information of China (English)

    LUPing; LIANGQiudong; ZHENGQuanqing

    2003-01-01

    Objective: To explore the influence of clinical and pathologic parameters on the prognosis of squamous cell carcinoma and adenocarcinoma. Methods: 702 cases of cervical carcinoma were retrospec-tively studied. Cox regression model was informed in multi-variable analysis. Results: The retrospective analysis showed that 630 out of 702 cases of cervical carcinoma were squamous cell carcinoma, cumulative rate 89.4% and 72 case were adenocarcinoma, cumulative rate 10.6% respectively. The 5-year survival rate was lower for patients with adenocarcinoma than for patients with squamous cell carcinoma (58.3% vs 57.3%), but there was no significant difference. Cox regression model showed that the variable into equation for squamous cell carcinoma included tumor grade of differentiation, lymph node metastasis and FIGO stage, but only lymph node metastasis and FIGO stage for adenocarcinoma. Conclusion: FIGO stage and lymph node metastasis was independent parameter evaluating prognosis of cervical carcinoma.

  16. A Case of Primary Adenosquamous Carcinoma of the Liver Presented with Liver Abscess

    OpenAIRE

    Kwon, Oh Sang; Lee, Hong Sik; Koh, Dong Wook; Cho, Young Jig; Park, Yeon Ho; Park, Dong Kyu; Oh, Yong Leul; Seo, Jae Hong; Chun, Hoon Jai; Um, Sun Ho; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

    2001-01-01

    Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultra...

  17. Digital Acrometastasis as Initial Presentation in Carcinoma of Lung A Case Report and Review of Literature.

    Science.gov (United States)

    Sahoo, Tapan Kumar; Das, Saroj Kumar; Majumdar, Saroj Kumar Das; Senapati, Surendra Nath; Parida, Dillip Kumar

    2016-06-01

    Bony metastases develop in 30% of all the cancers, but out of which only 1% to 3% occurs in the hand. Lung is the most common site for acrometastasis, followed by breast and renal cell cancer. Metastases to the digits are with non-specific presentation. We reported a case of 79-year-old male patient with initial presentation of swelling over left index finger, which was found to be squamous cell carcinoma of finger on histopathological examination. He was subsequently diagnosed as a case of squamous cell carcinoma of lung with acrometastasis. PMID:27504389

  18. Primary apocrine adenocarcinoma of scrotum suspected as urothelial carcinoma metastasis: A clinical and pathological dilemma

    Directory of Open Access Journals (Sweden)

    Sean Huang

    2015-01-01

    Full Text Available A 78-year-old man presented with an enlarging, tender mass in the scrotum separate to the testes. This was on the background of radical cystoprostatectomy, urethrectomy, and ileal conduit formation for high-grade urothelial carcinoma of the bladder invading submucosa 3 years prior. Examination revealed a 4 × 5 cm lesion, which was hard, fixed to the overlying skin and nodular to palpation. Ultrasound confirmed a solid mass in the scrotum extending into the perineum. Computerized tomography of the chest, abdomen, and pelvis revealed enlargement of inguinal lymph nodes but no other metastases. Complete resection of the scrotal lesion and selective removal of regional lymph nodes was performed. Rather than a cutaneous scrotal metastasis from the bladder urothelial carcinoma, histological examination suggested a primary apocrine adenocarcinoma of the scrotum. This case report explores the clinical and pathological features associated with both of these unusual differential diagnoses.

  19. Primary apocrine adenocarcinoma of scrotum suspected as urothelial carcinoma metastasis: A clinical and pathological dilemma.

    Science.gov (United States)

    Huang, Sean; Frydenberg, Mark; Pham, Alan; Grummet, Jeremy P

    2015-01-01

    A 78-year-old man presented with an enlarging, tender mass in the scrotum separate to the testes. This was on the background of radical cystoprostatectomy, urethrectomy, and ileal conduit formation for high-grade urothelial carcinoma of the bladder invading submucosa 3 years prior. Examination revealed a 4 × 5 cm lesion, which was hard, fixed to the overlying skin and nodular to palpation. Ultrasound confirmed a solid mass in the scrotum extending into the perineum. Computerized tomography of the chest, abdomen, and pelvis revealed enlargement of inguinal lymph nodes but no other metastases. Complete resection of the scrotal lesion and selective removal of regional lymph nodes was performed. Rather than a cutaneous scrotal metastasis from the bladder urothelial carcinoma, histological examination suggested a primary apocrine adenocarcinoma of the scrotum. This case report explores the clinical and pathological features associated with both of these unusual differential diagnoses. PMID:25657556

  20. Primary hyperaldostronisim as initial presentation of adrenal cortical carcinoma with liver metastasis: a case report.

    Science.gov (United States)

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver. PMID:24505527

  1. Primary Hyperaldostronisim as Initial Presentation of Adrenal Cortical Carcinoma with Liver Metastasis: A Case Report

    OpenAIRE

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver.

  2. Unusual Presentation of Squamous Cell Carcinoma on Long-Standing Sacrococcygeal Pilonidal Sinus

    OpenAIRE

    Ahmad Monabbati; Hooman Riazi; Ali Akbar Mohammadi; Shahram Bolandparvaz; Bita Geramizadeh

    2009-01-01

    Pilonidal disease consists of a hair-containing sinus or abscessoccurring most frequently in intergluteal cleft. This disease isgenerally benign. Although very uncommon entity, it seemsreasonable to be aware of possible malignancy in longstandingcases. We report a case of squamous cell carcinoma in a 52-year-old man, with a prolonged history of pilonidal diseaseand ulceration since 3 months before referring to our clinic.We excised the cyst, and the pathologic evaluation reportedmoderate diff...

  3. Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

    International Nuclear Information System (INIS)

    Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. These improved methods for the detection of

  4. Atypical presentation of hepatocellular carcinoma: a mass on the left thoracic wall

    International Nuclear Information System (INIS)

    Hepatocellular carcinoma is a common malignancy for which chronic hepatitis B infection has been defined as the most common etiologic factor. The most frequent metastatic sites are the lung, bone, lymphatics, and brain, respectively. Metastases to the chest wall have been reported only rarely. We report a patient with hepatocellular carcinoma who presented with an isolated metastatic mass on the left anterolateral chest wall in the axillary region. Metastasis of HCC should be included in the differential diagnosis of rapidly growing lesions in unusual localizations, particularly in patients with chronic liver disease even if a primary tumor can not be radiologically identified

  5. Synchronous presentation of invasive ductal carcinoma and mantle cell lymphoma: a diagnostic challenge in menopausal patients

    OpenAIRE

    Woo, Edward J.; Baugh, Aaron D.; Ching, Karen

    2016-01-01

    Synchronous presentation of breast carcinoma and non-Hodgkin lymphoma (NHL) is a rare occurrence (Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol 2010;146:265–72; Dutta Roy S, Stafford JA, Scally J, Selvachandran SN. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma. World J Surg Oncol 2003;1:27; Suresh Attili VS, Dadhich HK, Rao CR, Bapsy PP, Batra U, Anupama G et al. A case ...

  6. An unusual presentation of clear cell odontogenic carcinoma in mandibular anterior region

    Directory of Open Access Journals (Sweden)

    Sindhu M Ganvir

    2014-01-01

    Full Text Available Clear cell odontogenic carcinoma (CCOC is a rare, potentially aggressive odontogenic epithelial tumor with tendency for recurrence. It was first described as a clinicopathological entity in 1985 and to date only 73 cases has been reported in English literature. A case of CCOC in 64-year-old male patient in mandibular anterior region is presented which when recurred in soft tissue 5 years after wide surgical resection of mandible, revealed a biphasic pattern as against monophasic pattern of primary neoplasm and was unusually associated with primary squamous cell carcinoma, suggestive of hybrid tumor.

  7. Renal metastasis from cervical carcinoma presenting as a renal cyst: A case report

    OpenAIRE

    FAN, GANG; Xie, Yu; PEI, XIAMING; Lei, Jian; YE, MINGJI; ZENG, GONGQIAN; LI, FEIPING; XIONG, YINGYING; HAN, WEIQIN

    2015-01-01

    In the present study, the case of a 51-year-old female with a metastatic tumor in the left kidney originating from cervical carcinoma, is reported. The patient had undergone chemoradiotherapy for stage IIB squamous-cell carcinoma of the uterine cervix 3 years earlier. Computed tomography (CT) identified low-density left renal nodules, which were diagnosed post-operatively as renal cysts during the follow-up conducted 2 years later. The next year, the patient was admitted to the Hunan Provinci...

  8. Fibroepithelioma of Pinkus in continuity with nodular basal cell carcinoma: A rare presentation

    Science.gov (United States)

    Dongre, Atul M.; Khopkar, Uday S.; Kalyanpad, Yogesh N.; Gole, Prachi V.

    2016-01-01

    Fibroepithelioma of Pinkus and nodular basal cell carcinoma (BCC) are different morphological variants of BCC. It is very rare to see both the variants together in a single lesion. Here we report a case of a 56-year-old female who presented with a nodule on the trunk, which on biopsy showed features of both nodular BCC and fibroepithelioma of Pinkus. PMID:27559504

  9. Clinical characteristics and prognosis of three rare and poor-prognostic subtypes of primary liver carcinoma

    Institute of Scientific and Technical Information of China (English)

    李智宇

    2014-01-01

    Objective To explore the clinicopathological features and prognostic factors of three rare and poor-prognostic pathological subtypes of primary liver carcinoma,and to improve the clinical diagnosis and surgical treatment.Methods A retrospective analysis of clinicopathological data of 69 patients with rare pathological subtypes of primary liver carcinoma,diagnosed by postoperative

  10. A retrospective analysis of clinical and pathological features of thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    李晓静

    2014-01-01

    Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were

  11. Clinical presentation of abdominal tuberculosis in HIV seronegative adults

    OpenAIRE

    Guran Mithat; Ince Ali T; Sokmen Mehmet H; Akbayir Nihat; Dalay Remzi A; Kendir Tulin; Bolukbas Fusun F; Bolukbas Cengiz; Ceylan Erkan; Kilic Guray; Ovunc Oya

    2005-01-01

    Abstract Background The accurate diagnosis of abdominal tuberculosis usually takes a long time and requires a high index of suspicion in clinic practice. Eighty-eight immune-competent patients with abdominal tuberculosis were grouped according to symptoms at presentation and followed prospectively in order to investigate the effect of symptomatic presentation on clinical diagnosis and prognosis. Methods Based upon the clinical presentation, the patients were divided into groups such as non-sp...

  12. Clinical outcomes in patients with isolated serous tubal intraepithelial carcinoma (STIC): A comprehensive review.

    Science.gov (United States)

    Patrono, Maria Guadalupe; Iniesta, Maria D; Malpica, Anais; Lu, Karen H; Fernandez, Rodrigo Orozco; Salvo, Gloria; Ramirez, Pedro T

    2015-12-01

    OBJECTIVE. Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with 'isolated' STIC remains elusive. The aim of this study is to review the published literature on isolated STIC to determine outcomes of these ients and present a summary of management strategies. METHODS. A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid, Scopus, EBSCO host, Cochrane Library of articles published from February 2006 to April 2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy (RRSO), BRCA mutation carriers, non-BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows: the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies, the presence of ovarian intraepithelial lesions, and articles that did not include any clinical information and were restricted to pathology information only. RESULTS. A total of 78 patients with isolated STIC were included in our analysis. The median age for all patients was 53.7 years (range; 37-83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients received chemotherapy after the diagnosis of STIC. The follow-up time ranged from 2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO. CONCLUSIONS. The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive and routine surveillance with tumor markers

  13. Squamous cell carcinoma of the renal pelvis presenting as sacral bone metastasis

    OpenAIRE

    Hameed, Zeeshan B M; Pillai, Sunil Bhaskara; Hegde, Padmaraj; Talengala, Bhat Shaila

    2014-01-01

    We present a rare presentation of squamous cell carcinoma of the kidney with chronic low backache. The diagnosis of this uncommon tumour of the renal pelvis was achieved after incidentally detecting a large staghorn calculus, which on further imaging with contrast-enhanced CT of the abdomen and pelvis was suggestive of the features of renal tumour with sacral bone lesion. The rarity of this metastatic tumour, with its unusual presentation, is discussed.

  14. Invasive lobular carcinoma of the breast presenting as retroperitoneal fibrosis: a case report

    Directory of Open Access Journals (Sweden)

    Al-Haddad Sahar

    2010-06-01

    Full Text Available Abstract Introduction Invasive lobular carcinoma of the breast represents approximately 6.3% of mammary malignancies. Distant metastasis of invasive lobular carcinoma to the peritoneum or retroperitoneum has been reported fairly frequently. Case presentation We report the case of a 59-year-old Caucasian-Canadian woman with invasive lobular carcinoma of the breast presenting with retroperitoneal fibrosis and bilateral ureteral obstruction. Intra-operative pathology consultation did not reveal malignancy. The diagnosis, however, was confirmed on permanent sections by histological appearance in addition to immunohistochemistry. To the best of our knowledge, this is the first reported case of invasive lobular carcinoma of the breast presenting with retroperitoneal fibrosis. Conclusion In a case of unexplained ureteric obstruction and retroperitoneal fibrosis, more comprehensive physical examination and additional ancillary studies may be warranted to rule out malignancy as an underlying etiology. This case also emphasizes that intra-operative frozen section consultation cannot always be fully relied upon to exclude a malignancy as the etiology of retroperitoneal fibrosis. Moreover, in permanent histopathology sections, immunohistochemistry testing can be of value to rule out metastatic disease where the morphology is not salient. There is a need for a thorough physical examination of patients with retroperitoneal fibrosis, including the breast and gynecological organs.

  15. Mucoepidermoid carcinoma ex pleomorphic adenoma of the lacrimal gland: A rare presentation

    Directory of Open Access Journals (Sweden)

    Lily Daniel

    2014-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma in lacrimal gland is a rare entity unlike its salivary gland counterpart. This rare tumor poses a diagnostic challenge to clinicians as pre-operative diagnosis is difficult and diagnosis is only by careful pathological assessment. We report this uncommon lesion in a 62-year-old lady, wherein the malignant component was mucoepidermoid carcinoma. The elderly patient remained clinically and radiologically free of the tumor for two years after complete excision of the tumor but computed tomography at the end of two and a half years showed a recurrent lesion in the region of the lacrimal gland. This makes long term follow up of patients with these rare lacrimal tumors imperative with a minimum period of at least five years.

  16. Unusual Presentation of Squamous Cell Carcinoma on Long-Standing Sacrococcygeal Pilonidal Sinus

    Directory of Open Access Journals (Sweden)

    Ahmad Monabbati

    2009-06-01

    Full Text Available Pilonidal disease consists of a hair-containing sinus or abscessoccurring most frequently in intergluteal cleft. This disease isgenerally benign. Although very uncommon entity, it seemsreasonable to be aware of possible malignancy in longstandingcases. We report a case of squamous cell carcinoma in a 52-year-old man, with a prolonged history of pilonidal diseaseand ulceration since 3 months before referring to our clinic.We excised the cyst, and the pathologic evaluation reportedmoderate differentiated squamous cell carcinoma. So, reoperationon the lesion site to excise a 2-cm margin wasperformed and the defect was covered with Limberg cutaneusflap. We recommend early excision of pilonidal cysts toprevent possible malignant degeneration. Histologicalexamination of the excised materials to prevent missing raremalignant cases is recommended.

  17. Clinical outcome of primary small cell carcinoma of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Hou CP

    2013-08-01

    Full Text Available Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and the overall survival of these patients. We also compare the clinical outcomes between patients of bladder small cell carcinoma (SCC and bladder urothelial carcinoma (UC. Materials and methods: We reviewed the charts of patients with bladder tumors from January 1995 to December 2012 in the Chang Gung Memorial Hospital. A total of 2421 malignant bladder tumor patients were reviewed and there were 18 patients who were diagnosed with primary bladder SCC. The patients' characteristics, including age, gender, smoking history, presented symptoms, tumor size, locations, clinical stages, treatment modalities, pathology appearance, recurrence conditions, and survival conditions were all recorded. We also compared the clinical outcomes and the overall survival rates between patients with bladder SCC and those with UC. Results: Bladder SCC accounted for about 0.74% of all bladder malignancies in our institution. The mean age at diagnosis was 70.67 years, and the male-to-female ratio was 2.6:1. Thirteen patients had a history of cigarette smoking. All patients presented with symptoms of gross hematuria, and three of them had bladder tamponade requiring blood clot evacuation by cystoscopy. Only one patient had T1 disease, ten patients had stage III disease, and seven patients had lymph node or distant metastasis (stage IV disease. The mean tumor size was 4.29 cm in diameter. For the majority (61.11% of patients, SCC coexisted with UC components. The average survival time

  18. KAI1 gene expression in colonic carcinoma and its clinical significances

    Institute of Scientific and Technical Information of China (English)

    De-Hua Wu; Li Liu; Long-Hua Chen; Yan-Qing Ding

    2004-01-01

    AIM: To investigate KAI1 gene expression in the progression of human colonic carcinoma and its clinical significances.METHODS: KAI1 expression was detected by in situ hybridization and immunohistochemistry in the 4 established cell lines of colorectal carcinoma with different metastatic potentials, and in 80 specimens of colonic carcinoma, 21 colonic carcinoma specimens with lymphatic metastasis and 20 controls of normal colonic mucosa.RESULTS: The expressions of KAI1 in HT29 and SW480 cell lines were higher than those in LoVo and SW620. The expression of KAI1 gene was significantly higher in colorectal carcinoma compared with normal colonic mucosa and lymphatic metastasis (X2=46.838, P<0.01). The expression of KAI1 gene had no relationship with histological grade.The KAI1 expressions in Dukes A and B carcinoma were higher at both mRNA and protein levels compared to Dukes C carcinoma (X2=16.061, P<0.05). The expression of KAI1 in colonic carcinoma specimens with lymphatic metastasis was almost lost. The results of in situ hybridization were in concordance with immunohistochemistry.CONCLUSION: KAI1 is highly related to the metastasis of colonic carcinoma and may be a useful indicator of metastasis in colonic carcinoma.

  19. Varied presentations of ectopic breast - polymastia, fibroadenoma, and carcinoma arising from ectopic breast tissue

    Directory of Open Access Journals (Sweden)

    Yasmeen Khatib

    2015-01-01

    Full Text Available Ectopic breast is a congenital anomaly of the breast which can have varied presentations because of its different sites and pathologies arising from it. Lesions of ectopic breast tissue (EBT are commonly seen due to persistence of embryonic remnants along the milk line. They have also been reported from other sites like face, vulva, and perineum. They are prone to the same physiological and pathological alterations seen in the normal breast. Only 0.3% of breast carcinomas arise in the ectopic breast, whereas only a few cases of fibroadenoma have been reported at this site. We present a case of polymastia in a 21-year-old female in the inframammary region. We report two cases of fibroadenoma and carcinoma arising from EBT in the axilla of a 26 and 45-year females. Fibroadenoma was treated by simple excision while for carcinoma modified radical mastectomy was done followed by radiation and chemotherapy. Patient developed metastasis in the sternum. Carcinoma arising from EBT has a poorer prognosis and needs early diagnosis and treatment.

  20. Clinical studies of hepatocellular carcinoma with liver cirrhosis and ascites.

    Directory of Open Access Journals (Sweden)

    Yuasa,Shiro

    1984-06-01

    Full Text Available A comparison was made of the clinical findings of 59 patients with liver cirrhosis (LC accompanied with hepatocellular carcinoma (HCC (of which 35 had ascites and 24 did not at the time of admission and 164 patients with LC, but without HCC (of which 39 had ascites and 125 did not. HCC patients were older and more often had hepatomegaly, vascular spider and pleural effusion than LC patients. Ascites was more frequently observed in HCC than in LC patients when the serum albumin level and the indocyanine green disappearance rate were relatively well maintained and when peripheral edema was absent. There was no difference in the ascitic protein concentration between LC and HCC patients. Malignant cells were detected in ascites only in 14% of the HCC patients. These facts indicate the presence of ascites-inducing factors in HCC patients which have no direct relation to serum colloid osmotic pressure and effective hepatic blood flow. Almost all of the HCC patients with ascites (96% died with ascites, whereas 54% of the LC patients with ascites recovered from the ascitic condition.

  1. A clinical analysis of cases with stage IV laryngeal carcinoma

    International Nuclear Information System (INIS)

    Forty-four cases with stage IV laryngeal carcinoma treated in our department between 1991 and 2009 were clinically analyzed. The cases were equivalent to 16.8% of the total laryngeal cases, and 77.3% of the stage IV cases were of the supraglottic type. The disease-specific 5-year survival rate of all of the stage IV cases was 67.2%. Differences in the prognoses between under T3 and T4 were not statistically significant. Although the differences in the prognoses between surgical and nonsurgical treatment of the larynx were not statistically significant, neck dissection cases had a significantly better prognosis compared to cases without neck dissection. Neither radiotherapy nor chemotherapy had any influence on the prognosis. Therefore, positive treatment is needed even though the stage of the cases is advanced, and especially in cases with neck lymph node metastasis, neck dissection is strongly recommended. For histopathologically high-risk cases in which radiotherapy and chemotherapy were indicated in this study, appropriate additional treatment will be effective in order to prevent prognostic deterioration. (author)

  2. Clinical implications of basic research in hepatocellular carcinoma.

    Science.gov (United States)

    Dhanasekaran, Renumathy; Venkatesh, Sudhakar K; Torbenson, Michael S; Roberts, Lewis R

    2016-03-01

    A 58-year old Caucasian female has compensated hepatitis C related cirrhosis. Her surveillance ultrasound showed hypodense liver nodules and subsequent triple phase CT scan showed five tumor nodules with diameters ranging from 3-5cms involving both hepatic lobes. The nodules showed characteristic radiologic findings on the CT scan and she was diagnosed with hepatocellular carcinoma (HCC) based on non-invasive criteria. There was also associated right portal vein tumor thrombosis. Her functional capacity at diagnosis was slightly limited, but she was capable of performing all activities of daily living and self-care. Her laboratory tests at diagnosis were as follows: sodium 129mmol/L, potassium 3.6mmol/L, blood urea nitrogen 22mg/dL, creatinine 1.0mg/dL, albumin 2.9g/dl, bilirubin 1.8mg/dl, alanine aminotransferase 87U/L, aspartate aminotransferase 68U/L, alkaline phosphatase 139U/L, white blood cell 3.5x10(9)/L, hemoglobin 10.4, platelet count 73x10(9)/L, international normalized ratio 1.9 and alpha-fetoprotein 5200ng/ml. An upper endoscopy was negative for esophageal or gastric varices. Based on the tumor burden, presence of macrovascular invasion, ECOG performance status of 1 and Child-Pugh class A she was classified to have BCLC stage C HCC. She was started on sorafenib therapy at 400mg oral twice daily but unfortunately this had to be discontinued since she experienced severe diarrhea and skin rash. She now returns for follow-up and requests information on the available therapeutic options. This particular case scenario is not uncommon and does raise several clinically relevant questions: This review provides a comprehensive overview of the current state of HCC management and also examines the clinical implications of recent basic research in HCC. PMID:26450813

  3. Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors

    International Nuclear Information System (INIS)

    Brain metastases (BM) from hepatocellular carcinoma (HCC) are extremely rare and are associated with a poor prognosis. The aim of this study was to define clinical outcome and prognostic determinants in patients with BM from HCC. Between January 1994 and December 2009, all patients with HCC and BM treated in Sun Yat-sen University Cancer Center were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possible prognostic factors. Forty-one patients were diagnosed with BM from HCC, an incidence of 0.47%. The median age at diagnosis of BM was 48.5 years. Thirty-three patients (80.5%) developed extracranial metastases at diagnosis of BM, and 30 patients (73.2%) had hepatitis B. Intracranial hemorrhage occurred in 19 patients (46.3%). BM were treated primarily either with whole brain radiation therapy (WBRT; 5 patients), stereotactic radiosurgery (SRS; 7 patients), or surgical resection (6 patients). The cause of death was systemic disease in 17 patients and neurological disease in 23. Patients in a high RPA (recursive partitioning analysis) class, treated with conservatively and without lung metastases, tended to die from neurological disease. Median survival after the diagnosis of BM was 3 months (95% confidence interval: 2.2-3.8 months). In multivariate analysis, the presence of extracranial metastases, a low RPA class and aggressive treatment, were positively associated with improved survival. BM from HCC is rare and associated with an extremely poor prognosis. However, patients with a low RPA class may benefit from aggressive treatment. The clinical implication of extracranial metastases in HCC patients with BM needs further assessment

  4. Primary lymphoepithelioma-like carcinoma of the lung in an adolescent girl with unusual presentations

    Directory of Open Access Journals (Sweden)

    Piyush Ranjan

    2016-04-01

    Full Text Available Primary lymphoepithelioma-like carcinoma (LELC of lung is a rare tumour of lung mostly reported from south-east Asia. It occurs in middle aged persons of either sex and presents with the complaint of cough and haemoptysis. We report a case of primary LELC of lung in a young girl with unusual presentation. [Int J Res Med Sci 2016; 4(4.000: 1282-1285

  5. Primary lymphoepithelioma-like carcinoma of the lung in an adolescent girl with unusual presentations

    OpenAIRE

    Piyush Ranjan; Nair, Sukesh C.; Ankur Goyal; Mehar C Sharma; Vikram, Naval K.; Rita Sood

    2016-01-01

    Primary lymphoepithelioma-like carcinoma (LELC) of lung is a rare tumour of lung mostly reported from south-east Asia. It occurs in middle aged persons of either sex and presents with the complaint of cough and haemoptysis. We report a case of primary LELC of lung in a young girl with unusual presentation. [Int J Res Med Sci 2016; 4(4.000): 1282-1285

  6. Leptomeningeal metastasis from squamous cell carcinoma of oesophagus with unusual presentation

    OpenAIRE

    Akhavan, Ali; Navabii, Hossein

    2012-01-01

    Oesophageal cancer rarely metastasis to the brain but advances in brain imaging and increasing survival of these patients has led to more detection of this condition. Although oesophageal cancer is common in the north of Iran it is less frequent in the central parts such as Yazd. Leptomeningeal metastasis is very uncommon in oesophageal cancer. This paper presents a 73-year-old man with leptomeningeal carcinomatosis from squamous cell carcinoma of oesophagus presented by hoarseness due to tru...

  7. Metastatic Renal cell Carcinoma Presenting as a clear-cell Tumor in Tongue: A Case Report

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    Hamid Abbaszadeh-Bidokhty

    2014-07-01

    Full Text Available Introduction: Metastatic lesions of the oral cavity are extremely rare, accounting for approximately 1% of all malignant oral tumors. The most common primary sources of metastatic tumors in the oral region are, from the most to the least common, the breast, lung, kidney, bone, and colon. Renal cell carcinoma accounts for nearly 3% of all adult malignancies. It usually metastasizes to the lungs, bone, adrenal glands, and regional lymph nodes. The incidence of metastasis from renal cell carcinoma to the head and neck region is very low. The tongue is considered a very rare atypical ear, nose, and throat (ENT location for metastasis of renal cell carcinoma. The present case from Iran reports tongue metastasis of renal cell carcinoma (RCC.   Case Report: The following report is based on an 80-year old male patient with a tongue lesion and ambiguous past medical history that ultimately leads to diagnosis of a metastatic RCC. We also updated a previous literature review that was published 2008. A histopathological differential diagnosis for clear-cell tumors is also discussed.   Conclusion:  Because of the rarity of metastatic tumors of the oral region as well as the presence of other lesions with clear cells, diagnosis of metastatic clear-cell RCC in the oral cavity can be very difficult and challenging.  

  8. Solitary colonic metastasis from renal cell carcinoma presenting as a surgical emergency nine years post-nephrectomy

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    Thrumurthy Sri G

    2010-06-01

    Full Text Available Abstract Late colonic metastasis following curative surgery for renal cell carcinoma has rarely been described. We present the first reported case of solitary colonic renal cell carcinoma metastasis presenting as an intra-abdominal bleed, nine years post-nephrectomy.

  9. Neoantigen Load, Antigen Presentation Machinery, and Immune Signatures Determine Prognosis in Clear Cell Renal Cell Carcinoma.

    Science.gov (United States)

    Matsushita, Hirokazu; Sato, Yusuke; Karasaki, Takahiro; Nakagawa, Tohru; Kume, Haruki; Ogawa, Seishi; Homma, Yukio; Kakimi, Kazuhiro

    2016-05-01

    Tumors commonly harbor multiple genetic alterations, some of which initiate tumorigenesis. Among these, some tumor-specific somatic mutations resulting in mutated protein have the potential to induce antitumor immune responses. To examine the relevance of the latter to immune responses in the tumor and to patient outcomes, we used datasets of whole-exome and RNA sequencing from 97 clear cell renal cell carcinoma (ccRCC) patients to identify neoepitopes predicted to be presented by each patient's autologous HLA molecules. We found that the number of nonsilent or missense mutations did not correlate with patient prognosis. However, combining the number of HLA-restricted neoepitopes with the cell surface expression of HLA or β2-microglobulin(β2M) revealed that an A-neo(hi)/HLA-A(hi) or ABC-neo(hi)/β2M(hi) phenotype correlated with better clinical outcomes. Higher expression of immune-related genes from CD8 T cells and their effector molecules [CD8A, perforin (PRF1) and granzyme A (GZMA)], however, did not correlate with prognosis. This may have been due to the observed correlation of these genes with the expression of other genes that were associated with immunosuppression in the tumor microenvironment (CTLA-4, PD-1, LAG-3, PD-L1, PD-L2, IDO1, and IL10). This suggested that abundant neoepitopes associated with greater antitumor effector immune responses were counterbalanced by a strongly immunosuppressive microenvironment. Therefore, immunosuppressive molecules should be considered high-priority targets for modulating immune responses in patients with ccRCC. Blockade of these molecular pathways could be combined with immunotherapies targeting neoantigens to achieve synergistic antitumor activity. Cancer Immunol Res; 4(5); 463-71. ©2016 AACR. PMID:26980598

  10. Vulvar cancer: epidemiology, clinical presentation, and management options

    Directory of Open Access Journals (Sweden)

    Alkatout I

    2015-03-01

    Full Text Available Ibrahim Alkatout,1 Melanie Schubert,1 Nele Garbrecht,2 Marion Tina Weigel,1 Walter Jonat,1 Christoph Mundhenke,1 Veronika Günther1 1Department of Gynecology and Obstetrics, 2Institute for Pathology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany Epidemiology: Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. Histology: Squamous cell carcinoma (SCC is the most common malignant tumor of the vulva (95%. Clinical features: Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain. Therapy: The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1. A sentinel lymph node (SLN biopsy may be performed to reduce wound complications and lymphedema. Prognosis: The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival. Keywords: vulvar cancer, HPV infection, radical vulvectomy, groin dissection, sentinel lymph node biopsy, overall survival

  11. Colonic duplications: Clinical presentation and radiologic features of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands) and Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands) and Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States)]. E-mail: J.Blickman@rad.umcn.nl; Rieu, P.H.M. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Buonomo, C. [Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States); Hoogeveen, Y.L. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States); Boetes, C. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States)

    2006-07-15

    Diagnosis of colonic duplication can pose a potential problem even for those familiar with gastro-intestinal tract duplications in general but unaware of the condition due to its rarity and its apparently bimodal clinical presentation. In this report of five cases of surgically proven pediatric colonic duplication, we illustrate how the condition manifests clinically and describe the imaging features in an attempt to illustrate this bimodal presentation of the condition. The possible etiology, associated congenital anomalies and modes of clinical presentation are reviewed based on literature review as well as on our own experience.

  12. AB061. Clinical analysis of small cell carcinoma of the bladder: 9 cases report and literature review

    OpenAIRE

    Chen, Zhi; Liu, Qingquan; Chen, Ruibao; Liu, Zhuo; Li, Mingchao; Ling, Qing; Wu, Licheng; Yang, Jun; Liu, Xiaming; Wang, Tao; Wang, Shaogang; Yang, Weimin

    2016-01-01

    Objective To present our experience with nine patients with small cell carcinoma of the bladder (SCCB) who were treated with different modalities and review the literature for patients with SCCB who have been reported in 56 literatures. SCCB is a rare, highly aggressive tumor that presents in an advanced stage and has a propensity for early metastasis. Hematuria is the main clinical manifestations. Surgery, chemotherapy, and radiotherapy, either alone or as part of combined therapy have been ...

  13. A unique presentation of a renal clear cell carcinoma with atypical metastases

    OpenAIRE

    Staderini, F.; Cianchi, F.; Badii, B.; Skalamera, I.; Fiorenza, G.; Foppa, C.; E.Qirici; G. PERIGLI

    2015-01-01

    Introduction: Renal cancer is a relatively common neoplasia with renal clear cell carcinoma being the most frequent histological type. This tumor has a strong tendency to metastasize virtually to all organs. Today, new diagnostic tools allow physicians to distinguish between those patients with “incidental findings” and those with advanced metastatic disease. Presentation of case: A 70-year-old male with multiple indolent subcutaneous masses underwent colonoscopy after a positive fecal scr...

  14. Adrenocortical carcinoma presenting with heterosexual pseudoprecocious puberty shortly after birth: case report and review

    OpenAIRE

    Ghazizadeh, F; M Ebadi; S Alavi; Arzanian, MT; Shamsian, B; Jadali, F

    2013-01-01

    Adrenocortical tumour is rare in children. We report on a female infant with adrenocortical carcinoma presenting with pseudoprecocious puberty at the age of two. She had a history of gradually increasing public hair growth after birth. Physical examination showed signs of virilisation such as pubic hair growth and hirsutism with evidence of facial hair growth. On biochemical evaluation, DHEA-S, 17-OH progesterone, and testosterone levels were elevated. An abdominopelvic spiral computed tomogr...

  15. Haematuria as an uncommon initial presenting symptom of metastatic squamous cell carcinoma (SCC) to kidney

    OpenAIRE

    Kawsar, Hameem I.; Spiro, Timothy P; Daw, Hamed A

    2011-01-01

    A 47-year-old female presented with a 2-week history of painless haematuria. Urine dipstick showed moderate leucocytes. Blood and urine cultures were negative and cytology was negative for malignant cells. Flexible cystoscopy was negative for any bladder pathology. An ultrasonogram of the abdomen showed a mass in the left kidney. CT showed a mass-like lesion within the left kidney suspicious for renal carcinoma, and cavitary lesions in both lungs. Biopsy of the lung showed clusters of atypica...

  16. Longitudinally extensive transverse myelitis as presenting manifestation of small cell carcinoma lung

    OpenAIRE

    Jain, Rajendra Singh; Gupta, Pankaj Kumar; Agrawal, Rakesh; Tejwani, Shankar; Kumar, Sunil

    2015-01-01

    Longitudinally extensive transverse myelitis (LETM) is an unusual manifestation of systemic malignancy. It has been mainly reported with lung cancers and lymphoproliferative malignancy. LETM in systemic malignancy can be caused by either intramedullary metastases or paraneoplastic syndrome. We report an unusual case of small-cell carcinoma lung, who presented with LETM without having any cardinal manifestations of lung malignancy. This case report highlights the important differentiating feat...

  17. Carcinoma of Maxillary Sinus. A case Presentation. Carcinoma de seno maxilar. Presentación de caso.

    Directory of Open Access Journals (Sweden)

    Ángel Luis Cruz Leiva

    2007-01-01

    Full Text Available

    Tumors of the nasosinuous tract developed in the air cavities usually present a considerable growing before the patient feel any symptom or sign. Great part of the symptomatology is given due to the invasion of the tumor to neighbour structures such as oral and nasal cavities and orbits. A case of a 62 year-old male patient is presented after being under a dental extraction. A bucco-sinuous communication was diagnosed. It did not respond to different treatments and after some moths an epidermoid carcinoma of the right maxillary sinus appeared. It is of great interest to let this case been known in order to outstand the importance of an early diagnosis to get a better vital prognosis in this kinds of lesions.

    Los tumores del tracto nasosinusal al desarrollarse en cavidades aéreas, suelen presentar un considerable crecimiento antes de dar lugar a signos y síntomas. Gran parte de la sintomatología se debe a la invasión del tumor a estructuras vecinas, como son la órbita y la cavidad nasal y oral. Se presenta el caso de un paciente masculino, de 62 años de edad, al cual, tras haber sido sometido a una extracción dentaria, se le diagnosticó una comunicación bucosinusal, que no cedió a varias formas de tratamiento, lo que resultó varios meses después en un carcinoma epidermoide del seno maxilar derecho. El interés de dar a conocer este caso, radica en destacar la importancia de un diagnóstico precoz para conseguir mejorar el pronóstico vital en este tipo de afecciones.

  18. CLINICAL BEHAVIOR OF UTERINE CERVICAL CARCINOMA IN AN IMMUNOCOMPROM ISED RENAL TRANSPLANT RECIPIENT WITH LITERATURE ON THE INCIDENCE, PATHOGENESIS AND CLINICAL BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Adi Lakshmi

    2015-04-01

    Full Text Available Incidence of malignancy is 2 - 31% in patients who had renal transplant . Due to advances in immunosuppression the incidence of graft versus host reaction and rejection of transplant are rare . Due to increase in survival of immune suppressed transplant patients , they are prone for acute immune disorders , in fections and malignancies . Literature on cancer after kidney transplantation is limited . The incidence of malignancies in recipients of kidney transplantation patients is higher compared to general population . We report a case of 38 yr s old female renal tr ansplant recipient who presented to us with carcinoma cervix . She had a very aggressive disease and rapid progression of malignancy in spite of aggressive treatment . Here we are discussing this case of renal transplant patient with cervical carcinoma with the review of literature about the incidence , pathogenesis and clinical behavior of cervical carcinoma in immunocompromised renal transplant recipients .

  19. Verrucous carcinoma of the maxillary antrum

    OpenAIRE

    Vaid, Neelam; Nagare, Sachin

    2003-01-01

    Verrucous carcinoma is a well-differentiated variant of squumous cell carcinoma. In this article, we present a patient of verrucous carcinoma of the maxillary annum. There are only 6 reported cases of verrucous carcinoma of the maxillary antrum. Ours is the 7th case. We, here, would like to highlight that our case had a different clinical presentation from the previously reported cases.

  20. Epidemiological and clinical observations on breast carcinoma in Khartoum

    International Nuclear Information System (INIS)

    The prospective study was carried out on 183 patients with histologically proven breast cancer received at Khartoum Teaching Hospital and Soba Hospital between January 1996 to May 1998. Most of the patients were from Khartoum State followed by patients coming from Western, Central and Northern states with incidence of 17%, 16% and 15% respectively. Gaalein, shaigia, mahas and rizigat were the commonest affected tribes in western Sudan. Few patients were from southern and northern Sudan. Genetic and environmental factors may be contributory factors. The incidence of male breast cancer was 3%, which is higher than that reported in the western world. In this study young age group, early menarche, late first pregnancy and nulliparity were the main risk factors. The multiparity, lactation and lack of positive family history did not protect our patients from developing breast cancer. Most of the patients presented with locally advanced for the disease. This is due to the aggressive nature of breast cancer among black population. Lung, bone and liver were the most frequent sites for metastases. Chest x-ray and skeletal survey were diagnostic of metastases. Ductal carcinoma was the commonest type of breast cancer in this study. Laboratory investigations in the form of full blood count, liver function test , blood urea and serum electrolytes have no prognostic value in our patients.(Author)

  1. A CLINICAL STUDY ON CARCINOMA BREAST IN RELATION TO ER AND PR STATUS

    Directory of Open Access Journals (Sweden)

    Ramanaiah

    2015-09-01

    Full Text Available INTRODUCTION : Breast carcinoma is the most common malignant tumor and the leading cause of death in women worldwide 1 . It accounts for 15 % of all cancer deaths 2 . According to the World Health Organisation (WHO, approximately 70% of breast cancers occur in women with none of the known risk factors. Only about 5% of breast cancers are inherited. Various protocols are in use for the assessment of prognosis, and also to assist further management of these cases. Of various parameters, expression of hormonereceptors Estrogen receptor (ER and Progesterone receptor (PR ar e significant AIMS AND OBJECTIVES : To study the occurrence of ER and PR status in breast cancer patients attending S.V.R.R.G.G. Hospital. To correlate the expression of prognostic factors like age at presentation menarche, menopause, parity, tumor size, number of lymph nodes, metastasis histology, grading with ER and PR status. MATERIALS AND METHODS : This clinic opathological study of carcinoma breast was carried out in patients admitted to SVRRGG Hospital, Tirupati during the period from September 2011 to August 2013 after obtaining approval from scientific committee and ethical committee .Forty cases of breast carcinoma were taken into study. The clinical study done by interviewing, detailed examination and subjecting to relevant investigations and surgeries depending upon the stage of the disease. Excised specimen is sent for Histopathological examination in 10% formaline Reports of light microscopy (Hematoxilin and Eosin and immunohistochemistry on tumor histology including MBR (Modified Bloom Richardson grading and Estrogen and Progesterone status is analysed. CONCLUSION: In conclusion, ER and PR status correlates well with histopathological grading and other clinico - pathological parameters. Higher grade is associated with ER PR negativity. Hence. Immunohistochemical assessment of ER and PR status should be incorporated as a routine investigation. This along with

  2. Neuroendocrine differentiated breast carcinoma: imaging features correlated with clinical and histopathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil; Ustuen, Esin Emin; Memis, Aysenur [Department of Radiology, Ege University Hospital, Bornova, 35100 Izmir (Turkey); Zekioglu, Osman; Erhan, Yildiz [Department of Pathology, Ege University Hospital, Bornova, 35100 Izmir (Turkey)

    2003-04-01

    The aim of this study was to describe the imaging features of neuroendocrine differentiated breast carcinoma (NEDBC) and to correlate the radiological findings with the clinical and histopathological findings. A retrospective review of the mammograms of 1845 histopathologically proven breast cancer cases revealed five NEDBC. The clinical, imaging, and histopathological findings were analyzed. On mammography, a high-density mass was seen in all patients. The shape of the mass was round in 4 and irregular in 1 patient. The margins were spiculated in 2, indistinct in 1, microlobulated in 1, and partially obscured in 1 patient. On sonography, 4 patients had homogeneously hypoechoic masses with normal sound transmission. In 1 patient the mass was heterogeneously hypoechoic with mild posterior acoustic enhancement. The margins were microlobulated in 2, irregular in 2, and well-circumscribed in 1 patient. Neuroendocrine differentiated breast carcinoma should be included in the differential diagnosis of mammographically dense, round masses with predominantly spiculated or lobulated margins. Sonographically, they mostly present as irregular or microlobulated, homogeneously hypoechoic masses with normal sound transmission. (orig.)

  3. Nasopharyngeal carcinoma in Indonesia: epidemiology, incidence,signs, and symptoms at presentation

    Institute of Scientific and Technical Information of China (English)

    Marlinda Adham; Antonius N.Kuniawan; Arina Ika Muhtadi; Averdi Roezin; Bambang Hermani; Soehartati Gondhowiardjo; I Bing Tan; Jaap M.Middeldorp

    2012-01-01

    Among all head and neck (H&N) cancers,nasopharyngeal carcinoma (NPC) represents a distinct entity regarding epidemiology,clinical presentation,biological markers,carcinogenic risk factors,and prognostic factors.NPC is endemic in certain regions of the world,especially in Southeast Asia,and has a poor prognosis.In Indonesia,the recorded mean prevalence is 6.2/100 000,with 13 000 yearly new NPC cases,but otherwise little is documented on NPC in Indonesia.Here,we report on a group of 1121 NPC patients diagnosed and treated at Dr.Cipto Mangunkusumo Hospital,Jakarta,Indonesia between 1996 and 2005.We studied NPC incidence among all H&N cancer cases (n=6000) observed in that period,focusing on age and gender distribution,the ethnic background of patients,and the disease etiology.We also analyzed most prevalent signs and symptoms and staging of NPC patients at first presentation.In this study population,NPC was the most frequent H&N cancer (28.4%),with a male-tofemale ratio of 2.4,and was endemic in the Javanese population.Interestingly,NPC appeared to affect patients at a relatively young age (20% juvenile cases) without a bimodal age distribution.Mostly,NPC initiated in the fossa of Rosenmuller and spreaded intracranially or locally as a mass in the head.Occasionally,NPC developed at the submucosal level spreading outside the anatomic limits of the nasopharynx.At presentation,NPC associated with hearing problems,serous otitis media,tinnitus,nasal obstruction,anosmia,bleeding,difficulty in swallowing and dysphonia,and even eye symptoms with diplopia and pain.The initial diagnosis is difficult to make because early signs and symptoms of NPC are not specific to the disease.Early-age Epstein-Barr virus (EBV) infection combined with frequent exposure to environmental carcinogenic co-factors is suggested to cause NPC development.Undifferentiated NPC is the most frequent histological type and is closely associated with EBV.Expression of the EBV-encoded latent membrane

  4. EXPRESSION AND CLINICAL SIGNIFICANCE OF p73A IN BREAST CARCINOMA TISSUES

    Institute of Scientific and Technical Information of China (English)

    ZHOU Xin; SUN Zhi-jun

    2005-01-01

    Objective: To study the expression and clinical significance of p73( in breast carcinomas. Methods: The expression of p73( was detected by immunohistochemistry in 41 breast carcinoma tissues, 13 benign breast tumor tissues and 8 normal tissues and 8 normal breast tissues, respectively. Results: The positive expression of p73( was found in 20/41 (48.8%) of breast carcinoma tissues, 1/13 (7.7%) of benign breast tumor tissues. The positive expression rate of p73( in breast carcinoma tissues was significant1y higher than that in benign breast tumor tissues and normal breast tissues (P<0.05). The expression intensity of p73( increased significantly in breast carcinoma tissues compared with benign breast tumor tissues and normal breast tissues (P<0.05). Significant association of the expression of p73( with lymph node metastases and TNM stages of the carcinoma was found (P<0.05). The expression of p73( displayed a positive correlation with p53 (P<0.05). Conclusion: These results suggest that there is an up-regulation of p73( expression in breast carcinoma tissues, which may be implicated in the tumorigenesis of breast carcinoma as a molecular alteration.

  5. Histological features of early hepatocellular carcinomas and their developmental process: for daily practical clinical application: Hepatocellular carcinoma

    OpenAIRE

    Kondo, Fukuo

    2008-01-01

    Based on clinical and pathological experience, indistinct margin-type hepatocellular carcinomas (HCCs) were considered to be typical early-stage HCCs with good prognosis. For histological diagnosis, the assessment of stromal invasion (tumor invasion into portal tracts and fibrous septa) is very important. In differentiating stromal invasion from pseudoinvasion (benign hepatic tissue in the fibrous stroma), the following 5 items are useful: (1) macroscopic or panoramic views of the histologica...

  6. Unusual presentation of high-grade neuroendocrine carcinoma of the Urinary bladder with small-cell and large-cell features

    Directory of Open Access Journals (Sweden)

    Vitor Fiorin de Vasconcellos

    2013-10-01

    Full Text Available High-grade neuroendocrine carcinoma of the urinary bladder comprehends small-cell and large-cell variants. It is a rare and aggressive neoplasm, mostly diagnosed in advanced stages. It is more frequently encountered among Caucasian men in the sixth decade of life. Urinary symptoms are the most common clinical presentation. Diagnosis is generally not troublesome once the lesions are easily detectable by imaging exams and cystoscopy. This neoplasia is associated with tobacco smoking, and is frequently associated with other carcinomatous components such as urothelial carcinoma, adenocarcinoma, and sarcomatoid carcinoma. The authors report a case of an apparently healthy female patient who presented cervical lymph node enlargement not accompanied by systemic symptoms. The supraclavicular lymph node biopsy revealed metastatic small cell carcinoma. The computed tomography scan showed a bladder wall nodular thickening, enlarged lymph nodes along the iliac, periaortic, mediastinal, cervical and supraclavicular chains, as well as an insufflating lytic bone lesion in the right iliac wing. The positron emission tomography-fluorodeoxyglucose (PET-FDG added to these findings, the presence of a paraesophageal lymph node, lymphadenomegaly in the gluteal region and a vertebral lytic lesion in T10. Resected specimen of the bladder tumor revealed a high-grade neuroendocrine carcinoma with small-cell and large-cell features.

  7. Lipid-Rich Carcinoma of the Breast With Unusual Clinical and Histopathological Features.

    Science.gov (United States)

    Gaspar, Balan Louis; Kumar, Mukin; Gupta, Rahul; Garg, Rashi; Singh, Rajinder; Vasishta, Rakesh Kumar

    2016-09-01

    Lipid-rich carcinoma of the breast is a rare form of invasive breast carcinoma of special type. Most cases are grade 3, hormone receptor negative, and associated with aggressive clinical behavior. We report an unusual case of lipid-rich carcinoma with morphological and immunophenotypical features different from those of cases reported so far in the literature. The index case underscores the fact that there is no consensus with regard to the exact nature of this tumor. Hence, larger studies are needed to draw meaningful conclusions. PMID:26920701

  8. Eliminating "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) terminology in clinical breast practice: The cognitive psychology point of view.

    Science.gov (United States)

    Pravettoni, Gabriella; Yoder, Whitney R; Riva, Silvia; Mazzocco, Ketti; Arnaboldi, Paola; Galimberti, Viviana

    2016-02-01

    There is evidence from the literature that the terms "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) should be eliminated in clinical breast cancer practice and replaced with the new "ductal intraepithelial neoplasia" (DIN) and "lobular intraepithelial neoplasia" (LIN) terminology. The main purpose of the present article is to expand on this argument from a cognitive psychology perspective and offer suggestions for further research, emphasizing how the elimination of the term "carcinoma" in "in situ" breast cancer diagnoses has the potential to reduce both patient and health care professional confusion and misperceptions that are often associated with the DCIS and LCIS diagnoses, as well as limit the adverse psychological effects of women receiving a DCIS or LCIS diagnosis. We comment on the recent peer-reviewed literature on the clinical implications and psychological consequences for breast cancer patients receiving a DCIS or LCIS diagnosis and we use a cognitive perspective to offer new insight into the benefits of embracing the new DIN and LIN terminology. Using cognitive psychology and cognitive science in general, as a foundation, further research is advocated in order to yield data in support of changing the terminology and therefore, offer a chance to significantly improve the lives and psychological sequelae of women facing such a diagnosis. Typology: Controversies/Short Commentary. PMID:26614547

  9. Acid, basic, and neutral peptidases present different profiles in chromophobe renal cell carcinoma and in oncocytoma.

    Science.gov (United States)

    Blanco, Lorena; Larrinaga, Gorka; Pérez, Itxaro; López, José I; Gil, Javier; Agirregoitia, Ekaitz; Varona, Adolfo

    2008-04-01

    Renal cell carcinomas (RCCs) are neoplasias with high prevalence and mortality. We previously reported that several peptidases may be involved in the pathophysiology of clear cell renal cell carcinoma (CCRCC). Now, to gain insight into the reasons that lead the various RCC types to behave very differently with regard to aggressiveness and response to anticancer treatments, we analyzed subsets of chromophobe renal cell carcinoma (ChRCC), and renal oncocytoma (RO), a benign tumor; as well as different grades and stages of CCRCCs. Particulate APN, APB, and APA activities were decreased in both ChRCC and RO (tumor vs. nontumor tissues). Interestingly, activities were downregulated in a tumor-type specific way and the intensities of the decreases were stronger in the benign tumor than in the malignant type. Moreover, when two key histopathological parameters for tumor prognosis (high vs. low stage and grade) were analyzed, increases of activity were also observed in several of these cell surface peptidases (APN, APB). Some soluble activities (APB, Asp-AP) were also downregulated in the RCCs. With respect to genetic expression, PSA and APN were in a positive correlation related to their activities in both ChRCC and RO; but not APB, Asp-AP, APA, and PGI. These results may suggest an involvement of several peptidases in the pathophysiology of renal cancer, since they presented different patterns of activity and expression in tumors with different behaviors. PMID:18216146

  10. A rare case of non-small cell carcinoma of lung presenting as miliary mottling.

    Science.gov (United States)

    Jayaram Subhashchandra, Ballaekere; Ismailkhan, Mohammed; Chikkaveeraiah Shashidhar, Kuppegala; Gopalakrishna Narahari, Moda

    2013-03-01

    Miliary mottling on chest radiography is seen in miliary tuberculosis, certain fungal infections, sarcoidosis, coal miner's pneumoconiosis, silicosis, hemosiderosis, fibrosing alveolitis, acute extrinsic allergic alveolitis, pulmonary eosinophilic syndrome, pulmonary alveolar proteinosis, and rarely in hematogenous metastases from the primary cancers of the thyroid, kidney, trophoblasts, and some sarcomas. Although very infrequent, miliary mottling can be seen in primary lung cancers. Herein, we report the case of a 28-year-old female with chest X-ray showing miliary mottling. Thoracic computed tomography (CT) features were suggestive of tuberculoma with miliary tuberculosis. CT-guided fine needle aspiration cytology confirmed the diagnosis as lower-lobe, left lung non-small cell carcinoma (adenocarcinoma). It is rare for the non-small cell carcinoma of the lung to present as miliary mottling. The rarity of our case lies in the fact that a young, non-smoking female with miliary mottling was diagnosed with non-small cell carcinoma of the lung. PMID:23645961

  11. A Rare Case of Non-Small Cell Carcinoma of Lung Presenting as Miliary Mottling

    Directory of Open Access Journals (Sweden)

    Ballaekere Jayaram Subhashchandra

    2013-03-01

    Full Text Available Miliary mottling on chest radiography is seen in miliary tuberculosis, certain fungal infections, sarcoidosis, coal miner’s pneumoconiosis, silicosis, hemosiderosis, fibrosing alveolitis, acute extrinsic allergic alveolitis, pulmonary eosinophilic syndrome, pulmonary alveolar proteinosis, and rarely in hematogenous metastases from the primary cancers of the thyroid, kidney, trophoblasts, and some sarcomas. Although very infrequent, miliary mottling can be seen in primary lung cancers. Herein, we report the case of a 28-year-old female with chest X-ray showing miliary mottling. Thoracic computed tomography (CT features were suggestive of tuberculoma with miliary tuberculosis. CT-guided fine needle aspiration cytology confirmed the diagnosis as lower-lobe, left lung non-small cell carcinoma (adenocarcinoma. It is rare for the non-small cell carcinoma of the lung to present as miliary mottling. The rarity of our case lies in the fact that a young, non-smoking female with miliary mottling was diagnosed with non-small cell carcinoma of the lung.

  12. Urgent penectomy in a patient presenting with epidermoid carcinoma of the penis associated to myiasis

    OpenAIRE

    Antonio J. Tavares; Rodrigo Barros; Luciano A. Favorito

    2007-01-01

    The objective of this study is to describe the case of a patient presenting advanced epidermoid carcinoma of the penis associated to myiasis. A 41-year-old patient presenting with a necrotic lesion of the distal third of the penis infested with myiasis was attended in the emergency room of our hospital and was submitted to an urgent penectomy. This is the first case of penile cancer associated to myiasis described in the literature. This case reinforces the need for educative campaigns to red...

  13. Urgent penectomy in a patient presenting with epidermoid carcinoma of the penis associated to myiasis

    Directory of Open Access Journals (Sweden)

    Antonio J. Tavares

    2007-08-01

    Full Text Available The objective of this study is to describe the case of a patient presenting advanced epidermoid carcinoma of the penis associated to myiasis. A 41-year-old patient presenting with a necrotic lesion of the distal third of the penis infested with myiasis was attended in the emergency room of our hospital and was submitted to an urgent penectomy. This is the first case of penile cancer associated to myiasis described in the literature. This case reinforces the need for educative campaigns to reduce the incidence of this disease in developing countries.

  14. Urothelial Carcinoma of the Bladder Metastatic to Bone Marrow Presenting as Isolated Thrombocytopenia

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    Robert C. Chan

    2007-01-01

    Full Text Available The skeletal system is a frequent site for metastases of urothelial carcinoma (UC of the bladder (22–37%. Of those cases involving bone, the marrow is infiltrated in 27% of patients. Imaging modalities, such as X-ray and CT, will detect gross skeletal lesions in the vast majority of these patients with bone marrow involvement, however, most patients with bone involvement are symptomatic at presentation. Additionally, there have been few reports in the literature of bone marrow metastases from UC presenting with isolated thrombocytopenia.

  15. Mucinous breast carcinoma presenting as Paget's disease of the nipple in a man: A case report

    Directory of Open Access Journals (Sweden)

    Charalabopoulos Konstantinos

    2008-10-01

    Full Text Available Abstract Introduction Male breast cancer is rare compared to its female counterpart representing less than 1% of cancer in men. Moreover, mucinous carcinoma of the male breast is an extremely rare histological subtype of malignancy. Paget's disease of the nipple is rarely observed in males. Case report Herein, we describe a unique case of an 86 years old man with mucinous breast cancer presenting as Paget's disease of the nipple. According to the immunohistochemical evaluation the neoplastic cells were positive for estrogen (ER and progesterone receptors (PR. Conclusion To our best knowledge this is the first case of mucinous male breast cancer presenting as Paget's disease of the nipple.

  16. Renal cell carcinoma manifests primarily as endobronchial mass: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Rina Mukherjee

    2015-01-01

    Full Text Available Endobronchial metastasis (EBM from renal cell carcinoma (RCC is a very rare entity, though pulmonary metastasis of RCC is common. Here, we present a case of RCC with EBM, in which the primary tumor was detected after the detection of secondary. A 60-year-old man presented with cough for last 2 months. Contrast enhanced computed tomography (CECT chest followed by bronchoscopy revealed an endobronchial mass at left bronhi. CECT whole abdomen revealed a left-sided renal space occupying lesion (SOL. CT guided fine needle aspiration cytology of the SOL proved it as a RCC. Palliative bronchoscopic removal of endobronchial mass by snaring diathermy was done.

  17. Transverse colon tuberculosis. A case presentation and clinical review

    International Nuclear Information System (INIS)

    We describe the clinical case of a 90 year old female patient presenting weight loss and anemia. The physical examination detected an abdominal mass in epigastrio. Abdominal scanner revealed wall thickness at transverse colon. A colonoscopy was performed, finding an infiltrating mass at this level. The biopsies informed colonic tuberculosis. We present a literature review of digestive TBC, emphasising in colonic tuberculosis.

  18. Actual Incidence and Clinical Behaviour of Follicular Thyroid Carcinoma: An Institutional Experience

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    Carmela De Crea

    2014-01-01

    Full Text Available Follicular thyroid carcinoma classically accounts for 10–32% of thyroid malignancies. We determined the incidence and the behaviour of follicular thyroid carcinoma in an endemic goitre area. A comparative analysis between minimally invasive and widely invasive follicular thyroid carcinoma was performed. The medical records of all patients who underwent thyroidectomy from October 1998 to April 2012 for thyroid malignancies were reviewed. Those who had a histological diagnosis of follicular carcinoma were included. Among 5203 patients, 130 (2.5% were included. Distant metastases at presentation were observed in four patients. Sixty-six patients had a minimally invasive follicular carcinoma and 64 a widely invasive follicular carcinoma. In 63 patients an oxyphilic variant was registered. Minimally/widely invasive ratio was 41/26 for usual follicular carcinoma and 25/38 for oxyphilic variant (P<0.05. Patients with widely invasive tumors had larger tumors (P<0.001 and more frequently oxyphilic variant (P<0.05 than those with minimally invasive tumours. No significant difference was found between widely invasive and minimally invasive tumors and between usual follicular carcinoma and oxyphilic variant regarding the recurrence rate (P=NS. The incidence of follicular thyroid carcinoma is much lower than classically retained. Aggressive treatment, including total thyroidectomy and radioiodine ablation, should be proposed to all patients.

  19. Clinical Presentation of Acute Pulmonary Embolism: Survey of 800 Cases

    OpenAIRE

    Miniati, M.; Cenci, C; Monti, S; D. Poli

    2012-01-01

    Background Pulmonary embolism (PE) is a common and potentially fatal disease that is still underdiagnosed. The objective of our study was to reappraise the clinical presentation of PE with emphasis on the identification of the symptoms and signs that prompt the patients to seek medical attention. Methodology/Principal Findings We studied 800 patients with PE from two different clinical settings: 440 were recruited in Pisa (Italy) as part of the Prospective Investigative Study of Acute Pulmona...

  20. Clinical Significance of Positive Pelvic Washings in Uterine Papillary Serous Carcinoma Confined to an Endometrial Polyp.

    Science.gov (United States)

    Hanley, Krisztina Z; Fadare, Oluwole; Fisher, Kevin E; Atkins, Kristen A; Mosunjac, Marina B

    2016-05-01

    Uterine papillary serous carcinoma (UPSC) represents 10% of endometrial carcinomas. Significant number of patients initially present with extrauterine disease. The role of adjuvant treatment in low stage, especially polyp-confined UPSC is controversial. This multi-institutional study evaluated the significance of positive pelvic washing (PW) and adjuvant treatment on disease recurrence in a setting of endometrial polyp-confined UPSC. Surgical pathology files from 3 institutions were searched for cases of endometrial polyp-confined UPSC. Following histologic review, cases were clinically staged as Stage I, without myoinvasion or lymphovascular invasion. Clinicopathologic characteristics, results of PW, and type of adjuvant therapy were recorded. Statistical analysis using the Kaplan-Meier method for survival and Fisher exact test were performed. Thirty-three patients were included in the study. All patients were diagnosed with polyp-confined UPSC. The size of the polyp ranged from 0.3 to 4.3 cm. PW was positive for tumor cells in 8/33 (24%) patients. Twenty-two patients (66.6%) received some type of adjuvant treatment. Six patients (18%) developed recurrent disease. There was no significant difference in disease-free survival in the patients receiving adjuvant treatment versus not (P=0.375). However, there was significant association (P=0.0013) between positive PW and disease recurrence. Data are conflicting whether positive PW affects prognosis in low-stage endometrial carcinomas. Our study showed that in UPSC, malignant cells can be present in PW without lymphovascular invasion or myoinvasion and may have negative prognostic implication. Our data also reflect the controversies in the role of adjuvant treatment in endometrium-confined UPSC. PMID:26535985

  1. Radiological and clinical aspects of the bronchioloalveolar carcinoma based on selected own cases and literature data

    International Nuclear Information System (INIS)

    The objective of the study was to define characteristic radiological changes during bronchioloalveolar carcinoma in correlation with its various histological forms. Nine cases of bronchioloalveolar carcinoma were diagnosed and treated in the Specialistic Complex of Tuberculosis and Pulmonary Diseases in Rzeszow in the years 2000-2005. The material of the study was analyzed in order to determine characteristic radiological patterns and clinical data. Three patient groups were separated based on different features of radiological images (X ray film and CT) of the chest (infiltrative, tubercular and diffuse forms). Correlation between appearance of characteristic radiological pattern and histological type of bronchioloalveolar carcinoma and clinical symptoms was observed. Study data were compared with data from literature; our study showed that the infiltrative form of CT patterns of the bronchioloalveolar carcinoma is dominant (55,5%) and that it is more frequent in females (67%). It was also confirmed that the bronchioloalveolar carcinoma has no connection with nicotinism. In conclusion, the possibility of diagnosing an infiltrative form of bronchioloalveolar carcinoma in the CT examination with the support of characteristic radiological patterns and clinical data was stressed. (author)

  2. Clinical presentation of pili torti--Case report.

    Science.gov (United States)

    Yang, Jeane Jeong Hoon; Cade, Karine Valentim; Rezende, Flavia Cury; Pereira, José Marcos; Pegas, José Roberto Pereira

    2015-01-01

    Pili torti also known as 'twisted hairs' (Latin: pili=hair; torti=twisted) is a rare, congenital or acquired clinical presentation, in which the hair shaft is flattened at irregular intervals and twisted 180º along its axis. It is clinically characterized by fragile, brittle, coarse and lusterless hairs, due to uneven light reflection on the twisted hair surface. Pili torti may be associated with neurological abnormalities and ectodermal dysplasias. There is no specific treatment for this condition, but it may improve spontaneously after puberty. We report a case of pili torti in a child who presented fragile, brittle, difficult to comb hair. The patient had no comorbidities. PMID:26312667

  3. Clinical features and outcome of cryptogenic hepatocellular carcinoma compared to those of viral and alcoholic hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Cryptogenic hepatocellular carcinoma (HCC) is thought to arise due to non-alcoholic fatty liver disease (NAFLD). This study investigated the prevalence, clinical features, and outcomes of cryptogenic HCC and compared them with those of HCC related to hepatitis B virus infection (HBV-HCC), hepatitis C virus infection (HCV-HCC), and alcohol (ALC-HCC) in Korea. The clinical features, treatment modalities, and survival data for 480 patients with HCC consecutively enrolled from January 2003 to June 2012 were analyzed. Computed tomography images were used to measure the visceral fat area (VFA) and liver-spleen density ratio. Cryptogenic HCC accounted for 6.8% of all HCC cases, whereas HBV-HCC, HCV-HCC, and ALC-HCC accounted for 62.7%, 13.5%, and 10.7% of HCC cases, respectively. The cryptogenic HCC group was characterized by older age, a low proportion of male patients, a high proportion of patients with metabolic syndrome or single nodular presentation, and a low proportion of patients with portal vein invasion compared to the viral-HCC and ALC-HCC groups. However, Child Pugh classes, tumor stages, and overall survival rates of cryptogenic HCC patients were similar to those of patients with HCC of other etiologies. VFA in cryptogenic HCC patients was significantly higher than that in viral-HCC patients, but similar to that in ALC-HCC patients. The liver-spleen density ratio did not vary according to HCC etiology. Cryptogenic HCC accounts for approximately 7% of HCC cases in Korea, associated with an older age at diagnosis, more frequent occurrence of metabolic syndrome, and less aggressive tumor characteristics, but similar survival compared to viral-HCC or ALC-HCC. Based on VFA and the liver-to-spleen density ratio, cryptogenic HCC may be burnt-out NAFLD in which visceral fat remains but liver fat is depleted

  4. Unusual presentation of high-grade neuroendocrine carcinoma of the Urinary bladder with small-cell and large-cell features

    OpenAIRE

    Vitor Fiorin de Vasconcellos; João Lapa Lima Trancoso; Aloísio Felipe-Silva; Angélica Braz Simões; Pedro José dos Santos Neto; Oscar Eduardo Hidetoshi Fugita; Carla Rachel Ono; Carlos Alberto Buchpiguel

    2013-01-01

    High-grade neuroendocrine carcinoma of the urinary bladder comprehends small-cell and large-cell variants. It is a rare and aggressive neoplasm, mostly diagnosed in advanced stages. It is more frequently encountered among Caucasian men in the sixth decade of life. Urinary symptoms are the most common clinical presentation. Diagnosis is generally not troublesome once the lesions are easily detectable by imaging exams and cystoscopy. This neoplasia is associated with tobacco smoking, and is fre...

  5. Clinical application of CT-guided 125I seed interstitial implantation for local recurrent rectal carcinoma

    International Nuclear Information System (INIS)

    The present study aimed to explore the safety profile and clinical efficacy of CT-guided radioactive seed implantation in treating local recurrent rectal carcinoma. CT-guided 125I seed implantation was carried out in 20 patients with locally recurrent rectal carcinoma. 14 of the 20 patient had prior adjuvant external-beam radiation therapy (EBRT). The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 120 Gy (range, 100-160 Gy). Of the 20 patients, 12 were male, 8 were female, and ages ranged from 38 to 78, with a median age of 62. Duration of follow-up was 3-34 months. The response rate of pain relief was 85% (17/20). Repeat CT scan 2 months following the procedure revealed complete response (CR) of the tumor in 2 patients, partial response (PR) in 13 patients, stable disease (SD) in 3 patients, and progressive disease (PD) in 2 patients. 75% of patients had either CR or PR. Median survival time was 18.8 months (95% CI: 3.5-22.4 months). 1 and 2 year survival rates were 75% and 25%, respectively. 4 patients died of recurrent tumor; 4 patients died of distant metastases; 9 patients died of recurrent tumor and distant metastases. 3 patients survived after 2 year follow up. Two patients were found to have mild hematochezia, which was reversible with symptomatic management. CT-guided 125I seed implantation appeared to be a safe, useful and less complicated interventional treatment option for local recurrent rectal carcinoma

  6. Medical image of the week: squamous cell carcinoma presenting as an endobronchial mass

    Directory of Open Access Journals (Sweden)

    Snyder L

    2013-02-01

    Full Text Available A 65 year old woman with previously diagnosed emphysema presented with two weeks of worsening dyspnea on exertion. CT scan of the chest showed a 14mm x 12mm irregular endobronchial lesion (arrow occluding the bronchus intermedius. Right-sided compensatory “ball-valve” emphysematous changes are noted. Right posterior atelectasis is also seen. Endobronchial biopsy revealed squamous cell carcinoma. The patient later underwent palliative argon plasma coagulation (APC therapy with removal of the tumor (Figure 2 with re-expansion of the right middle lobe.

  7. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

    2005-07-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  8. Possible fatal acetaminophen intoxication with atypical clinical presentation.

    Science.gov (United States)

    De-Giorgio, Fabio; Lodise, Maria; Chiarotti, Marcello; d'Aloja, Ernesto; Carbone, Arnaldo; Valerio, Luca

    2013-09-01

    Acetaminophen or paracetamol, a commonly used over-the-counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78 μg/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria. PMID:23822653

  9. A CLINICAL STUDY OF LOCALLY ADVANCED CARCINOMA OF BREAST

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    Mrinalini

    2015-06-01

    Full Text Available BACKGROUND : In India it is observed that most of the patients of breast cancer clinically present in late stage due to their ignorance of disease despite so much advancement in its detection and management. Locally advanced breast cancer (LABC accounts for 30 - 35% of all cases of breast cancers in India. This study aims to evaluate C linical features, Investigations, various Treatment modalities and the Clinico - pathological correlation & outcome of various treatment modalities of LABC, with special emphasis on Neo - adjuvant chemotherapy (NACT in Indian setting. MATERIAL AND METHOD : This was a non - randomised prospective observational study. We analyzed 57 patients of LABC Stage IIIB & IIIC presenting at Government Medical College, Nagpur, Maharashtra, a tertiary care C entre from September 2012 to November 2014. RESULTS : Stage IIIB comprised 84.21% patients while remaining 15.79% were having Stage IIIC disease. Skin involvement was observed in 91.23% patients. 15.79% showed supraclavicular lymph node involvement. 32 patients received NACT (2 to 6 cycles. Out of these 32, complete clinical response (cCR was 12.5%, partial response (cPR was 68.75% and pathological CR (pCR was 6.25% with Total Objective response (cCR+cPR 81.25%. Feasibility of Breast Conserving Surgery (BCS was observed in 12.5% patients. 25 patients underwent primary surgery followed by adjuvant chemotherapy. Modified Radical Mastectomy was performed in 89.48% patients. CONCLUSIONS : With overall clinical response of 81.25%, n eoadjuvant chemotherapy is the best treatment option for patients with Locally Advanced Breast Cancer with added advantage of in vivo testing the sensitivity of chemotherapeutic agents, early management of micrometastasis and down staging the primary tumour with feasibility of BCS. Patients presenting LABC constitute a diverse group for whic h a variety of treatment modalities should be instituted with co o rdinated treatment planning among surgeons

  10. Expression and Clinical Significance of HMGB1 and RAGE in Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To study the expression level and clinical significance of HMGB1 and RAGE in cervical squamous epithelial carcinoma.METHODS Real time quantitative polymerase chain reaction (qRT-PCR)was employed to examine the expression of HMGB1 (high mobility group box protein1), and RAGE (receptor for advanced glycation endproducts)in 60 cervical squamous epithelial carcinomas (CSEC), their paraneoplastic tissues (PS) and 30 normal cervix tissues (NCS).RESULTS The expression of HMGB1 in the CSEC samples and PS was similar (P>0.05), but higher compared to NCS (P<0.05). Overexpression of HMGB1 in the CESC tissues was significantly correlated with the tumor (P<0.05), and the presence of metastasis (P<0.01), but not correlated with the tumor diameter or tumor grade. RAGE expression was not significantly different among these tissue types, and showed no significant correlation with the the tumor stage, diameter or grade. But there was a significant positive correlation between RAGE expression and CSEC metastasis.CONCLUSION The results suggest that HMGB1 may be related to the proliferation, progression and metastasis of CSEC. The relationship of HMGB1/RAGE may be of importance for CSEC metastasis. HMGB1 presents a new potential gene target for prevention and treatment of CSEC.Study of HMGB1/RAGE expression will offer an experimental foundation for understanding the pathogenesis of CSES.

  11. Medullary Thyroid Carcinoma Presenting as a Predominantly Cystic Mass on Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Kim, Ah Hyun; Moon, Hee Jung; Kim, Eun Kyung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Jun Jeong [Wonju College of Medicine, Wonju (Korea, Republic of); Kim, Myung Hyun [Gangnam MizMedi Hospital, Seoul (Korea, Republic of)

    2012-03-15

    Most medullary thyroid carcinomas show suspicious malignant features such as hypoechogenicity, a spiculated margin and/or intranodular calcifications, which are well known features of papillary carcinoma. We report here on a case of medullary carcinoma that was seen as a predominantly cystic thyroid mass on ultrasonography. This type of case is not common in the literature and we discuss the way to diagnose a medullary thyroid carcinoma

  12. Oral malignant melanoma: a rare case with unusual clinical presentation

    OpenAIRE

    Ali, Elneel Ahmed Mohamed; Karrar, Musadak Ali; El-Siddig, Abeer Abdalla; Zulfu, Azza

    2015-01-01

    Primary Oral malignant melanoma is a rare tumor with an indigent prognosis. This is a case report of 47-year-old Sudanese female diagnosed as Oral malignant melanoma of the mandible with an unusual pattern of growth and clinical presentation. Furthermore, a possibility of intraosseous origin is suggested.

  13. Central pontine myelinolysis: clinical presentation and radiologic findings

    International Nuclear Information System (INIS)

    Central pontine myelinolysis (CPM) is a neurologic disorder once thought to be uniformly fatal. With the introduction of CT and MRI there was an increasing number of reports on nonfatal cases of CPM. Nearly all reports on nonfata cases describe severe clinical syndromes with tetraparesis, bulbar palsy, and coma. We reviewed nine patients with CPM and compared the size of the pontine lesion on MRI and CT with the severity of clinical presentation. Clinical presentation of CPM was highly variable: The symptoms ranged from severe neurologic disorders to mild neurologic disturbances only. Two of nine patients died from CPM. The size of the pontine lesion did not correlate with the severity of the neurologic illness or the final outcome. Mild forms of CPM might be difficult to diagnose clinically. This applies even more for patients with underlying diseases such as Wernicke's encephalopathy, which in itself might cause a clinical picture similar to that of CPM. Central Pontine Myelinolysis is a major differential diagnosis in acute neurologic deterioration indicating pontine damage. Magnetic resonance imaging is the decisive diagnostic tool for CPM. (orig.)

  14. Early Onset Marfan Syndrome: Atypical Clinical Presentation of Two Cases

    Directory of Open Access Journals (Sweden)

    Ozyurt Abdullah

    2015-06-01

    Full Text Available Early onset Marfan Syndrome (eoMFS is a rare, severe form of Marfan Syndrome (MFS. The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

  15. Primitive neuroectodermal tumor of adrenal: Clinical presentation and outcomes

    Directory of Open Access Journals (Sweden)

    Deep Dutta

    2013-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET of adrenal is an extremely rare tumor of neural crest origin. A nonfunctional left adrenal mass (14.6 × 10.5 × 10.0 cm on computed tomography (CT was detected in a 40-year-old lady with abdominal pain, swelling, and left pleural effusion. She underwent left adrenalectomy and left nephrectomy with retroperitoneal resection. Histopathology revealed sheets and nest of oval tumor cells with hyperchromatic nuclei, prominent nucleoli, scanty cytoplasm, brisk mitotic activity, necrosis, lymphovascular invasion, capsular invasion, and extension to the surrounding muscles; staining positive for Mic-2 (CD-99 antigen, vimentin, synaptophysin, and Melan-A. Thoracocentesis, pleural fluid study, and pleural biopsy did not show metastasis. She responded well to vincristine, adriamycin, and cyclophosphamide followed by ifosfamide and etoposide (IE. This is the first report of adrenal peripheral PNET (pPNET from India. This report intends to highlight that pPNET should be suspected in a patient presenting with huge nonfunctional adrenal mass which may be confused with adrenocortical carcinoma.

  16. Uterine papillary serous carcinoma:Its clinical and fundamental study

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Uterine papillary serous carcinoma (UPSC) was established as a distinct type of endometrial carcinoma by Lauchlan in 1981 and Hendrickson et al in 1982, and accounted for 1% ~ 10% of endometrial cancers. Theoccurencer of papillary patterns of endometrial adenocarcincma had been reportedly recognized since 1900, while until the late 1970s several authors have had described a variant of papillary endometrial cancer. UPSC is a morphologically unique variant of endometrial carcinoma that is pathologically defined by the presence of high nuclear grade, distinct papillary architechtural changes, psammoma bodies, and extensive lymph- vascular space invasion. CA125 is often mentioned a usefultumor marker either for diagnosis before starting treatment or in monitoring recurrence. The ptimal treatment of UPSC is controversial and appears to be dependent upon the stage of the disease. Primary surgery comprised of TAH/BSO and complete staging is the mainstay of treatment. The patients with recurrent UPSC in many studies were treated with various combinations of surgery, radiation therapy, and chemotherapy. The molecular basis for the general poor response of UPSC to adjuvant chemotherapy and radiotherapy is not well understood. UPSC tumors are more often aneuploid and contain overexpressed mutant p53 protein as compared to encdometrioid adenocarcinoma. Unlike patients with adenocarcinoma of the endomeutrium, women with UPSC were less likely to be obese, hypertensive, or diabetic.

  17. Image-guided core breast biopsy of ductal carcinoma in situ presenting as a non-calcified abnormality

    International Nuclear Information System (INIS)

    Objective: Ductal carcinoma in situ (DCIS) typically presents as calcifications which are detected mammographically. Our aim was to evaluate the less common presentations of ductal carcinoma in situ diagnosed by image-guided core biopsy and correlate with histopathologic diagnoses. Methods and Material: Imaging and histopathologic findings were retrospectively reviewed in 11 patients with ductal carcinoma in situ diagnosed at core biopsy that presented as noncalcified radiographic abnormalities. Results: Mammography showed non-calcified, circumscribed nodules, ill-defined nodules and architectural distortion. In two patients, no mammographic abnormality was detected. Sonography showed circumscribed, round or oval, solid masses; irregular, heterogeneous masses; and a tubular structure. Histopathologic diagnoses included multiple architectural subtypes and ranged from low to high nuclear grade. Conclusion: Although image-guided core biopsy diagnosis of ductal carcinoma is typically made when sampling calcifications, DCIS can be diagnosed following biopsy of non-calcified masses or distortion. There is no correlation between histopathologic subtype and radiologic appearance

  18. The reclusive patient-a case report & clinical review of Merkel cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ramanathan C

    2005-01-01

    Full Text Available Advanced Merkel Cell Carcinoma with intra - hepatic metastases in a reclusive gentleman is described. We present an interesting case with learning points and a review of this uncommon malignancy.

  19. Thyroid carcinoma presenting as a dural metastasis mimicking a meningioma: A case report

    Directory of Open Access Journals (Sweden)

    El Mehdi Tazi

    2011-01-01

    Full Text Available Context: Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. Case Report: We report a case of a 41-year old man presented with a solid mass located in the left temporo-occipital region. The 3D computed tomography showed a large solid mass with high vascularity, skull erosion and supra-infratentorial epidural mass effect. After magnetic resonance imaging (MRI a suspect diagnosis of meningioma was made. The patient underwent surgery where a soft mass with transverse sinus invasion was encountered; the tumour was successfully resected employing microsurgical techniques. Histological examination revealed a thyroid follicular neoplasm with positive staining for follicular carcinoma in immunohistochemical analysis. Postoperatively levels of thyroid hormones were normal. Treatment was planned for the thyroid gland, patient receiving 6 courses of chemotherapy including paclitaxel. Conclusions: The present case emphasizes that although they are uncommon, dural metastasis can be mistaken for meningiomas. The definitive diagnosis of a meningioma should be established only after the histopathological analysis. Thyroid follicular carcinoma should be included in the differential diagnosis in cases of extrinsic tumoral lesions.

  20. A Rare Presentation of Primary Hyperparathyroidism with Concurrent Aldosterone-Producing Adrenal Carcinoma

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    Mario Molina-Ayala

    2015-01-01

    Full Text Available Aldosterone-producing adrenocortical carcinomas are an extremely rare cause of hyperaldosteronism (<1%. Coexistence of different endocrine tumors warrants additional screening for multiple endocrine neoplasia syndromes, especially in young patients with large or malignant masses. We present the case of a 40-year-old man with a history of hypertension that presented with an incidental left adrenal tumor during an ultrasound performed for nephrolithiasis. Biochemical assessment showed a mildly elevated calcium (11.1 mg/dL, high parathyroid hormone, and a plasma aldosterone concentration/plasma renin activity ratio of 124.5 (normal < 30, compatible with primary hyperparathyroidism with a concomitant primary hyperaldosteronism. A Tc99m-MIBI scintigraphy showed an abnormally increased tracer uptake in the right superior parathyroid and abdominal computed tomography confirmed a left adrenal tumor of 20 cm. The patient underwent parathyroidectomy and adrenalectomy with final pathology reports of parathyroid hyperplasia and adrenal carcinoma with biochemical remission of both endocrinopathies. He was started on chemotherapy, but the patient developed a frontal cortex and an arm metastasis and finally died less than one year later.

  1. Infiltrating ductal carcinoma of the breast presenting as breast abscess : A case report.

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    Vimal Bhandari

    2013-08-01

    Full Text Available Invasive ductal carcinoma, also known as Infiltrating Ductal Carcinoma (IDC is the most common form of breast cancer. IDC starts in the breast\\s milk ducts and invades the surrounding breast stroma. Breast cancer usually present as a: swelling of all or parts of breast, skin irritation or dimpling, breast pain, nipple pain or retraction, redness or scaliness or thickening of the nipple or breast skin, nipple discharge other than breast milk, or a lump in the axilla. We present a case of a 40 year old female, with no family history of malignancy, who underwent Incision and Drainage (I and D for Right Breast Abscess 2 months back followed by a non-healing wound at the I and D site, associated with fungating growth and Right axillary lymph node enlargement, diagnosed as IDC with Axillary lymph node metastasis. Immunohistochemical studies showed deficient basement membrane and myoepithelial layer confirming the infiltrative nature. [Natl J Med Res 2013; 3(4.000: 422-423

  2. Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma.

    Science.gov (United States)

    Rengifo, C; Titi, S; Walls, J

    2016-05-01

    Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future. PMID:27087339

  3. The clinical presentation and diagnosis of epileptic autonomic auras

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    Marina Revditovna Kremenchugskaya

    2012-12-01

    Full Text Available Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women aged 9 to 27years (mean 18±5years were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI of the brain. Results. In most patients (n = 12, 67%, the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG were present in the frontal, temporal, and frontotemporal regions in 4 (22%, 6 (33%, and 7 (39% patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72% patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.

  4. Management of persistent anal canal carcinoma after combined-modality therapy: a clinical review

    International Nuclear Information System (INIS)

    Anal canal carcinoma is a rare gastro-intestinal cancer. Radiochemotherapy is the recommended primary treatment for patients with non-metastatic carcinoma; surgery is generally reserved for persistent or recurrent disease. Follow-up and surveillance after primary treatment is paramount to classify patients in those with complete remission, persistent or progressive disease. Locally persistent disease represents a clinically significant problem and its management remains subject of some controversy. The aim of this systematic review is to summarise recommendations for the primary treatment of anal canal carcinoma, to focus on the optimal time to consider residual disease as genuine persistence to proceed with salvage treatment, and to discern how this analysis might inform future clinical trials in management in this class of patients

  5. Metastasis of hepatocellular carcinoma presented as a tumor of the maxillary sinus and retrobulbar tumor

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    Kolarević Daniela

    2011-01-01

    Full Text Available Introduction. Hepatocellular carcinoma (HCC is the most frequent primary malignant tumor of the liver. It is usually seen in the 6th and 7th decades of life and chronic hepatitis B is the most frequent cause. Extrahepatic metastasis of HCC is an indicator of a poor prognosis and the most common sites are lungs, bones, lymph nodes, kidneys and adrenal glands. We reported a case of isolated metastasis in the right maxilla, which had been found initially, before the tumor in the liver was diagnosed. Case report. A 70-year-old man underwent dental surgery of the upper right molar. Prolonged bleeding control was difficult for up to two weeks, so the biopsy was performed. Histopathological analysis revealed a metastatic hepatocellular carcinoma. Computerized tomography (CT of the abdomen revealed a diffusely heterogeneous liver parenchyma with irregular borders and two foci of mass lesions. There were metastasis in the spleen and also two pathological retroperitoneal lymph nodes were detected, but no ascit, liver cirrhosis, cholestasis or portal vein thrombosis were seen. CT of the orbital and maxillary regions revealed a tumor mass in the right maxillary sinus, spreading to the alveolar sinus, nasal cavity and partially infratemporal space. A tumor mass was in the right orbit as well, infiltrating the surrounding bones and muscles. Clinically, there was proptosis of the right eye accompanied by amaurosis. The treatment started with chemotherapy based on 5-fluorouracil (sorafenib was not available. After three cycles, control CTs showed a stable disease in the liver, but progression in the right maxillary sinus and orbit. Enucleation of the right eye was performed and postoperative radiotherapy was planed. The patient deteriorated rapidly and died, about 6 months after the disease had been diagnosed. Conclusion. Extrahepatic metastasis of HCC represents a progressive phase of the disease with poor prognosis, so the main aim of the treatment should be

  6. Secondary acute pancreatitis to hypertriglyceridemia: presentation of two clinical cases

    International Nuclear Information System (INIS)

    The acute pancreatitis is a reversible inflammatory process. Hypertriglyceridemia as etiology of the acute pancreatitis reaches frequencies between 1,3 to 11% according to literature when the triglycerides levels of reach values over 1000 mg/dl nevertheless hypertriglyceridemia is observed in 12 to 39% of the acute pancreatitis like factor associate. The objective of the medical treatment is to increase the activity of lipoproteinlipasa and to increase the degradation of vhylomicrones; diminishing therefore the serum triglycerides values of a levels smaller to 500 even to less of 200 mg/dl if is possible with different strategies among of them the insulin. In the present article, we presented two clinical cases of severe pancreatitis induced by hypertriglyceridemia, handled with therapy of insulin infusion with suitable evolution and clinical answer given by significant diminution of the levels of triglycerides, 48 hours post treatment

  7. An unusual presentation of multiple cavitated lung metastases from colon carcinoma

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    Iannace Alessandro

    2011-05-01

    Full Text Available Abstract Background Consolidation with or without ground-glass opacity is the typical radiologic finding of lung metastases of adenocarcinoma from the gastrointestinal tract. Lung excavated metastases from gastrointestinal carcinoma are very rare. Case presentation The authors describe an unusual presentation of multiple cavitated lung metastases from colon adenocarcinoma and discuss the outcome of a patient. The absence both of symptoms and other disease localizations, the investigations related to different diagnostic hypotheses and the empirical treatments caused a delay in correct diagnosis. Only a transparietal biopsy revealed the neoplastic origin of nodules. Conclusions This report demonstrates that although lung excavated metastases are described in literature, initial failure to reach a diagnosis is common. We would like to alert clinicians and radiologists to the possibility of unusual atypical features of pulmonary metastases from colon adenocarcinoma.

  8. Adenoid cystic carcinoma: A rare late presentation of the mobile tongue

    Science.gov (United States)

    Kumar, Sanjay; Agarwal, Padmanidhi; Nimmi, V.

    2016-01-01

    Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. We present a case of a 70-year-old male patient with a swelling over the dorsal and ventral surface of anterior two third of the tongue which was causing him difficulty in mastication since 10 months. Ultrasound and magnetic resonance imaging were done following which the surgical excision of the lesion was performed and histopathological diagnosis of ACC was achieved. It was rare to find ACC in such an old man with such a large lesion presenting so late in the rare site of the mobile tongue. ACC is a slowly growing, highly invasive cancer with a high recurrence rate and chances of metastases, so surgery is the choice of treatment with mandatory long-term follow-up. PMID:27195216

  9. Review of Clinical Presentation and Diagnosis of Mucopolysaccharidosis IVA

    OpenAIRE

    Hendriksz, C.J.; Harmatz, P.; M. Beck; Jones, S; Wood, T; Lachman, R.; Gravance, C.G.; Orii, T; Tomatsu, S.

    2013-01-01

    Mucopolysaccharidosis type IVA (MPS IVA) was described in 1929 by Luis Morquio from Uruguay and James Brailsford from England, and was later found as an autosomal recessive lysosomal storage disease. MPS IVA is caused by mutations in the gene encoding the enzyme, N-acetylgalactosamine-6-sulfate sulfatase (GALNS). Reduced GALNS activity results in impaired catabolism of two glycosaminoglycans (GAGs), chondroitin-6-sulfate (C6S) and keratan sulfate (KS). Clinical presentations of MPS IVA reflec...

  10. Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment and Epidemiology

    OpenAIRE

    Grear, Karrie E; Bushnell, Cheryl D.

    2013-01-01

    Stroke is a neurological emergency that carries a risk of morbidity and mortality. Recent studies have shown that the incidence of stroke, while rare, is increasing in pregnant females. In this review, stroke and other vasculopathies in the pregnant and post-partum female are examined. A discussion of the symptoms and clinical presentation of stroke is provided, as well as the current guideline for treatment of stroke in pregnancy. Finally, the data illustrating the recent increases in stroke...

  11. Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation

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    Al-Ahmad Firas

    2011-10-01

    Full Text Available Abstract Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy.

  12. Clinical Analysis of 45 Patients with Thymic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ruitai Fan; Jingmin Wang; Hongzhi Zhang; Yanna Guo; Hao Gu

    2009-01-01

    OBJECTIVE To retrospectively evaluate the prognostic factors for advanced thymic carcinoma.METHODS The data from 45 patients with advanced thymic carcinoma were retrospectively analyzed according to Masaoka stage criteria. There were 29 Stage Ⅲ patients and 16 Stage Ⅳ patients (13 Stage IVA patients and 3 Stage IVB patients).According to the World Heath Organization Histological Criteria (2004), 25 cases were identified as low-grade and 20 cases were identified as high-grade. All diagnoses were confirmed by biopsy. Five patients underwent gross total resection, 21patients underwent subtotal resection and 19 patients underwent biopsy alone. Forty-two patients received radiotherapy with a median dose of 60 Gy, and 37 patients underwent conventional radiotherapy, including local irradiation and expanded irradiation.Local irradiation volume covered the primary tumor bed and approximately 1-2 cm2 surrounding the tumor (according to preoperative imaging). Expanded irradiation volume covered the full mediastinal and pericardium areas (with or without prophylactic irradiation in the supraclavicular area). Five cases received stereotactic radiotherapy. Thirty-one patients were also treated with chemotherapeutics, including Cisplatin, VP-16,Endoxan, 5-FU and taxol.RESULTS The median follow-up period was 59 months. The overall 3-year survival rate was 57.8%, and the median survival was 45 months. Univariate statistical analysis showed that the histological subtype and Masaoka stage were prognostic factors.The 3-year survival rate was 61.9% in patients treated with gross total resection and 55.0% in those who underwent biopsy only. The 3-year survival rate was 59.5% in patients treated with conventional radiotherapy and 80% in those treated with stereotactic radiotherapy. The 3-year survival rate was 64.5% in patients treated with simultaneous chemotherapy and 42.9%in patients treated without simultaneous chemotherapy (P >0.05). Chemotherapy in combination with radiation

  13. Clinical analysis of lateral oropharyngeal-wall squamous cell carcinoma

    International Nuclear Information System (INIS)

    We retrospectively reviewed 98 cases of lateral-oropharyngeal wall squamous cell carcinoma seen from January 1999 to March 2011. The majority-75 cases-involeved advanced cancer. For these, we conducted concurrent chemoradiotherapy (CCRT) with cisplatin, docetaxel, and 5-FU from 2007. Five-year overall survival was 64.4%. In advanced cases, three-year overall survival was 77.8% in surgery, 71.2% in radiation therapy, and 84.6% in CCRT. While no statistically significant difference was seen, CCRT, appeared to provide more curative effectiveness. (author)

  14. Genomic/Epigenomic Alterations in Ovarian Carcinoma: Translational Insight into Clinical Practice

    Science.gov (United States)

    Dong, Anliang; Lu, Yan; Lu, Bingjian

    2016-01-01

    Ovarian carcinoma is the most lethal gynecological malignancy worldwide. Recent advance in genomic/epigenomic researches will impact on our prevention, detection and intervention on ovarian carcinoma. Detection of germline mutations in BRCA1/BRCA2, mismatch repair genes, and other genes in the homologous recombination/DNA repair pathway propelled the genetic surveillance of most hereditary ovarian carcinomas. Germline or somatic mutations in SMARCA4 in familial and sporadic small cell carcinoma of the ovary, hypercalcemia type, lead to our recognition on this rare aggressive tumor as a new entity of the atypical teratoma/rhaboid tumor family. Genome-wide association studies have identified many genetic variants that will contribute to the evaluation of ovarian carcinoma risk and prognostic prediction. Whole exome sequencing and whole genome sequencing discovered rare mutations in other drive mutations except p53, but demonstrated the presence of high genomic heterogeneity and adaptability in the genetic evolution of high grade ovarian serous carcinomas that occurs in cancer progression and chemotherapy. Gene mutations, copy number aberrations and DNA methylations provided promising biomarkers for the detection, diagnosis, prognosis, therapy response and targets of ovarian cancer. These findings underscore the necessity to translate these potential biomarkers into clinical practice. PMID:27471560

  15. Acute appendicitis: most common clinical presentation and causative microorganism

    International Nuclear Information System (INIS)

    Objective: To determine the most common clinical presentation and causative microorganism for acute appendicitis. Study Design: Descriptive. Place and duration of study: Department of Surgery, Combined Military Hospital Multan, from June 2002 to May 2004. Patients and Methods: Clinical features of all the patients, older than 5 years of age diagnosed with acute appendicitis were recorded. Patients presented with other pathology which mimic acute appendicitis were excluded from the study. Surgery was done under general anaesthesia. Appendices of all the patient as well as pus swabs from abdominal cavity were sent to the laboratory for histopathology and microbiological cultures to confirm the diagnoses of acute appendicitis and causative organism. Results: The mean age of 75 subjects was 32.56 +- 11.93 years. The most common symptom was pain in right iliac fossa (80 % cases) and the most common physical sign was tenderness (92% cases). Some of the patients(9.3%) had a histologically normal appendix. Maximum isolates on culture were E. coli. Conclusion: The most common presentation of acute appendicitis was pain in right iliac fossa while the most sensitive sign was tenderness. Proper history and sharp clinical examination is the key to diagnosis. The most frequent organism of appendicitis was Escherichia Coli. (author)

  16. Mushroom poisoning in children: clinical presentation and outcome

    International Nuclear Information System (INIS)

    A variable clinical picture characterizes mushroom poisoning. The Amatoxin, the main toxic component of these fungi, are responsible for gastrointestinal symptoms as well as hepatic and renal failure. As acute gastroenteritis is extremely common in our set up, so every patient presenting with these symptoms is treated as gastroenteritis of viral aetiology. The authors present the clinical picture of the phalloid syndrome, its treatment and immediate outcome. All children age less than 16 years admitted in Saidu Hospital Swat from January to December 2006 with mushroom poisoning were included in the study. Patients with doubtful history or with associated illness were not included. The diagnosis was based on the clinical picture of the patient, history and the laboratory data. In addition to maintenance of fluid and electrolyte balance and treating sepsis, oral Silymarin and intravenous penicillin was started. Liver function tests, renal functions tests, serum electrolytes and coagulation profile was done in all the patients. The severity of poisoning was graded according to hepatic transaminase elevations and prolongation of prothrombin time. Of the 18 patients, fifteen were above five years of age. Female were twice in number. Fifteen patients developed hepatic failure and three patients developed renal failure. Thirteen patients expired. To start timely management, Mushroom poisoning should be considered in the differential diagnosis in patients presenting with food poisoning particularly coming in groups. Delay in diagnosis is associated with high mortality. (author)

  17. Adrenocortical carcinoma presenting as varicocele and renal vein thrombosis: a case report

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    Horne John M

    2011-08-01

    Full Text Available Abstract Introduction Adrenocortical carcinomas are rare aggressive tumors. Their annual incidence is approximately one to two per million among the population of the United States of America. Patients with active endocrine tumors often present with Cushing's syndrome accompanied by virilizing features. Conversely, patients with non-functioning tumors may present with symptoms related to a mass-occupying lesion, such as abdominal pain and flank pain. Although varicoceles and acute kidney injuries are common problems in medicine, they are uncommon presentations of these rare tumors and easy to miss. We report a case of a large adrenocortical carcinoma that presented as testicular pain, varicocele, and acute kidney injury secondary to renal vein thrombosis. Case presentation A 54-year-old Caucasian man with a left-sided varicocele presented to our emergency department with lower abdominal pain and a decrease in urination. Four months previously, he had noticed pain and swelling in his left groin and had been diagnosed with left-sided varicocele. For one week, he began developing left-sided abdominal pain and decreased urination frequency, so he came to our emergency department for evaluation. His physical examination revealed a hard mass occupying the entire left side of his abdomen, crossing the midline, and extending to the pelvic brim. His blood tests showed acute kidney injury and mild anemia. Computed tomography of his abdomen showed a large retroperitoneal mass on the left side, displacing the left kidney inferiorly and the spleen superiorly with thoracic epidural compression. Thrombus was also identified in his left renal vein and inferior vena cava. Computed tomography of his chest showed bilateral pulmonary nodules. A computed tomography-guided abdominal mass biopsy was performed, and the diagnosis of adrenocortical carcinoma was made on the basis of pathology and immunohistochemistry. His hormonal evaluations were normal. His kidney

  18. Extremely rare presentation of soft tissue metastasis from carcinoma breast as a massive swelling of upper extremity.

    Science.gov (United States)

    Purkayastha, Abhishek; Sharma, Neelam

    2016-04-01

    Soft tissue metastasis from any primary malignancy is considered very rare and a breast carcinoma metastasizing to soft tissue is still rarer. To the best of our knowledge, carcinoma breast with soft tissue metastasis to upper extremity is very uncommon with only six cases been reported in world literature till date and our case is the seventh such case in an 80-year-old female, previously treated for carcinoma right breast 15 years ago. The patient presented with progressive painful massive swelling of right upper arm measuring 21 cm × 17 cm, of 2 months duration. Histopathological examination of the swelling showed metastatic deposits from a poorly differentiated adenocarcinoma. Further immunohistochemical (IHC) analysis revealed tumor cells staining positive for estrogen and progesterone receptors while negative for HER 2-Nu, desmin, epithelial membrane antigen, CK7 and thyroid transcription factor-1 (TTF-1), suggestive of metastasis from a primary breast carcinoma. Only few case series and isolated cases reports have been published regarding any primary malignancy or breast carcinoma metastasizing to soft tissues. A thorough review of literature also reveals that our case is the largest soft tissue metastatic swelling from breast carcinoma ever reported. We hereby present this case with review of literature to highlight its extreme rarity, unusual presentation, clinicopathological characteristics and its overall prognosis. PMID:27121743

  19. [Multi-facetted clinical presentation of thrombotic thrombocytopenic purpura

    DEFF Research Database (Denmark)

    Niemann, C.U.; Jurlander, J.; Daugaard, G.;

    2009-01-01

    Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathic disease. TTP is due to reduced activity of the von Willebrand factor which cleaves ADAMTS13. The disease is characterized by thrombocytopenia (<20 billion/l) intravascular Coombs-negative haemolysis and schistocytes in blood...... smears. Determination of the ADAMTS13-activity is now becoming available as a routine analysis. We present two cases that illustrate the multi-facetted clinical presentation under which TTP occurs. The importance of access to ADAMTS13 measurements is stressed Udgivelsesdato: 2009/1/26...

  20. Notes on "Clinical and Internal Medicine. Past, Present and Future”

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    Ricardo Hodelín Tablada

    2014-06-01

    Full Text Available "Clinical and Internal Medicine. Past, Present and Future" is a book written by Professor Alfredo Darío Espinosa Brito and published by Medical Sciences in 2011. It was awarded the prize of the Cuban Academy of Sciences. This article aims to encourage reading this book, a veritable compendium of the past, present and future of internal medicine. It outlines the issues addressed, from the structure designed for them to a fairly comprehensive assessment of the elements that define the scientific and literary value of this work.

  1. Duplicidad tiroidea y carcinoma papilar en un tiroides ectópico. Presentación de caso Thyroid Duplication and Papillary Carcinoma in an Ectopic Thyroid. A Case Presentation

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    José Alberto Puerto Lorenzo

    2012-07-01

    Full Text Available

    Se presenta una paciente con tumor palpable ubicado en línea media de la región anterior del cuello, encima del hueso hioides, diagnosticado inicialmente como quiste del conducto tirogloso. Se realizó estudio preliminar, tanto clínico, como radiológico y citológico de la lesión. Mediante cirugía por técnica convencional, se extrajo el tumor. La biopsia por parafina definió la existencia de tiroides con carcinoma papilar. Añadido a dicha condición, la paciente presentaba glándula tiroidea en ubicación normal. Se considera un caso curioso, donde se mezclan los conceptos de duplicidad tiroidea y tiroides ectópico, con la presencia en este último de un carcinoma papilar.

    We present the case of a patient with a palpable tumor located in midline of the anterior neck above the hyoid bone, initially diagnosed as a thyroglossal duct cyst. Preliminary study of the lesion was conducted, both clinically and radiologically and cytologically. The tumor was removed through surgery by conventional technique. The paraffin biopsy defined the existence of thyroid papillary carcinoma. Despite this condition, the patient had thyroid gland in normal location. It is considered to be a curious case, combining the concepts of thyroid duplication and ectopic thyroid, with the presence, in this last one, of papillary carcinoma.

  2. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

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    Saxton, V.J. [Dept. of Radiology, Royal Children`s Hospital, Melbourne (Australia); Boldt, D.W. [Dept. of Radiology, Royal Children`s Hospital, Melbourne (Australia); Shield, L.K. [Dept. of Neurology, Royal Children`s Hospital, Melbourne (Australia)

    1995-11-01

    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  3. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

    International Nuclear Information System (INIS)

    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  4. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed

  5. Clinical registration between CT and MRI of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To explore and evaluate the different registration methods between CT and Mill of nasopharyngeal carcinoma. Methods: CT and MRI scans of 8 untreated nasopharyngeal carcinoma patients were carded out in treatment position using mask immobilization. All images were transformed and registered at Ac-QSIM4.9.2 and Pinnacle3 V 7.0 workstation by two physicians and one physicist respectively, as to the point- marker, interactive, normalized mutual information registration. Two physicians evaluated the results and time of registration with four points based on visual evaluation and three points based on registration time were recorded and assessed as well. The four points were: worst; worse; better; best. The three points were: short time( 3 min). Results: Normalized mutual information registration was the method that the results and times of registration were better than the others. The results of registration were improved by the physicians rather than the physicist, especially the point-marker method. The results of registration were similar between physicians and physicist with interactive, normalized mutual information registration. Conclusion: Compared with other methods, normalized mutual information method is adapted to registration during treatment planning. Because it is automatically carried on by software and coefficient, and showing superiority in robust with less subjective effect, it is suggested for the registration of radiotherapeutic planning. (authors)

  6. Clinical variants, stages, and management of basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Lyubomir A Dourmishev

    2013-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common paraneoplastic disease among human neoplasms. The tumor affects mainly photoexposed areas, most often in the head and seldom appears on genitalia and perigenital region. BCC progresses slowly and metastases are found in less than 0.5% of the cases; however, a considerable local destruction and mutilation could be observed when treatment is neglected or inadequate. Different variants as nodular, cystic, micronodular, superficial, pigment BCC are described in literature and the differential diagnosis in some cases could be difficult. The staging of BCC is made according to Tumor, Node, Metastasis (TNM classification and is essential for performing the adequate treatment. Numerous therapeutic methods established for treatment of BCC, having their advantages or disadvantages, do not absolutely dissolve the risk of relapses. The early diagnostics based on the good knowledge and timely organized and adequate treatment is a precondition for better prognosis. Despite the slow progress and numerous therapeutic methods, the basal cell carcinoma should not be underestimated.

  7. Factor xiii deficiency in children-clinical presentation and outcome

    International Nuclear Information System (INIS)

    To determine the demographic features and clinical outcome of children with Factor XIII deficiency. Records of all hospitalized pediatric patients with discharge diagnosis of FXIII D, on the basis of factor XIII assay 5 mol/L urea test were retrospectively reviewed and abstracted on a pre-specified proforma. Demographic features, coagulation profile, family history and outcomes were noted. A total of 10 charts were reviewed. There were 5 boys and 5 girls. Almost all the children (9/10) were less than 5 years of age, out of whom 5 (50%) were infants, and 3 were neonates. Bruises and prolonged bleeding after trauma was the major presenting complaints in 80%, followed by prolonged bleeding from the umbilical stump in 2 patients. Nine patients had past history of prolonged umbilical bleeding. Two patients had history of FXIII D in siblings, while 2 had history of prolonged bleeding in other family members (cause unknown). Consanguinity was present in 80% of the families. Initial coagulation screen were normal in all patients. Two patients had intracranial hemorrhage, proved on neuro-imaging, were managed with plasma infusions and required craniotomy. The rest were managed conservatively with plasma transfusions. All were discharged alive in good clinical condition. Almost all were followed regularly in clinic with monthly cryoprecipitate transfusions. Although factor XIII deficiency is a rare genetic disorder in children with history of bruising, prolonged umbilical bleeding, family history of bleeding and consanguinity with normal initial coagulation screen (PT, APTT and platelets), FXIII D should be ruled out. (author)

  8. Recurrent Pancreatitis Due to a Cystic Pancreatic Tumor: A Rare Presentation of Acinar Cell Carcinoma

    OpenAIRE

    Raimondo M; Krishna M; Nguyen J; Scolapio J; Aqel B

    2004-01-01

    CONTEXT: Acinar cell carcinoma is an uncommon malignancy of the pancreas. It has characteristic histomorphology, immunohistochemistry profile, and clinicopathological behavior. CASE REPORT: We report a rare case of recurrent pancreatitis secondary to acinar cell carcinoma of the pancreas. We describe the endoscopic ultrasound characteristic, treatment and the surgical outcome. CONCLUSIONS: Acinar cell carcinoma should be considered in the differential diagnosis of cystic pancreatic tumors pre...

  9. Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

    Directory of Open Access Journals (Sweden)

    Ricardo Coentre

    2016-01-01

    Full Text Available We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.

  10. [Present status of concurrent chemoreadiotherapy in squamous cell carcinoma of head and neck].

    Science.gov (United States)

    Li, X M; Song, Q

    2016-07-01

    Head neck squamous cell carcinoma (HNSCC) is a common kind of malignancies in human body. For HNSCC in early stage, either surgical operation or radiotherapy can acquire satisfactory treatment results. However, any single treatment modality such as surgery alone or single radiation is insufficient to gain satisfactory tumor control. Multidisciplinary treatment (MDT) has become a mainstay and important therapeutic strategy in the management of HNSCC. Among various approaches in the MDT, concurrent chemoradiotheraqpy (CCR) constitutes a major progress, which implicates a lot in improving outcomes and organ preservations in managing HNSCC. In the present review, the history, mechanisms, indications along with side effects and drawbacks, and perspectives of CCR are to be described and discussed, in the hope of providing effective guidance for the domestic MDT, especially CCR in the management of HNSCC. PMID:27480307

  11. An unusual presentation of multiple cavitated lung metastases from colon carcinoma

    International Nuclear Information System (INIS)

    Consolidation with or without ground-glass opacity is the typical radiologic finding of lung metastases of adenocarcinoma from the gastrointestinal tract. Lung excavated metastases from gastrointestinal carcinoma are very rare. The authors describe an unusual presentation of multiple cavitated lung metastases from colon adenocarcinoma and discuss the outcome of a patient. The absence both of symptoms and other disease localizations, the investigations related to different diagnostic hypotheses and the empirical treatments caused a delay in correct diagnosis. Only a transparietal biopsy revealed the neoplastic origin of nodules. This report demonstrates that although lung excavated metastases are described in literature, initial failure to reach a diagnosis is common. We would like to alert clinicians and radiologists to the possibility of unusual atypical features of pulmonary metastases from colon adenocarcinoma

  12. Expression of thyroid stimulating hormone receptor in differentiated thyroid carcinoma and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    李清怀

    2013-01-01

    Objective To explore the expression of thyroid stimulating hormone (TSH) receptor in differentiated thyroid carcinoma and its clinical significance.Methods Seventy-four patients with differentiated thyroid carcinoma treated in our department from January 2009 to January 2011were selected as the observation group,and 28 patients with nodular goiter were selected as the control group.Expression of TSH receptor in the two groups were detected by immunohistochemistry.Results The positive rate of TSH receptor expression in the observation group was55.4 (41/74) ,significantly lower than that of the control

  13. Clinical outcome of primary small cell carcinoma of the urinary bladder

    OpenAIRE

    Hou CP; Lin YH; Chen CL; Chang PL; Tsui KH

    2013-01-01

    Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and th...

  14. Clinical outcome of primary small cell carcinoma of the urinary bladder

    OpenAIRE

    Tsui, Ke-Hung

    2013-01-01

    Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and t...

  15. A Clinical Study of Photodynamic Therapy for Superficial Esophageal Carcinoma by YAG-OPO Laser

    OpenAIRE

    Kazunari Yoshida; Shigeru Suzuki; Seishiro Mimura; Hiroyuki Narahara; Hiroshi Tanimura; Yugo Nagai; Kaichi Isono; Teruo Kozu; Hisayuki Fukutomi; Akira Nakahara; Hiromasa Kashimura; Toshio Hirashima; Yoko Murata; Hiroko Ide; Harubumi Kato

    1998-01-01

    A cooperative clinical study of photodynamic therapy (PDT) for superficial esophageal carcinoma was conducted at 6 medical institution. PHE (2mg/kg) with high tumor affinity was used as the oncotropic compound. The light source was a pulse wave YAG-OPO laser with high penetration into the tissue. Irradiation was performed at an energy density of 60–180 J/cm2 48–72 h after PHE administration. Eight lesions in 6 patients were treated. All were type 0-II superficial carcinomas. The depth of inva...

  16. Clinical presentation and genotype of hepatitis delta in Karachi

    Institute of Scientific and Technical Information of China (English)

    Tariq Moatter; Zaigham Abbas; Sabhita Shabir; Wasim Jafri

    2007-01-01

    AIM: To assess the clinical presentation and genotypes of delta hepatitis in local population.METHODS: In this prospective study, 39 consecutive patients who were positive for HBsAg and hepatitis D virus (HDV) antibody were included. The patients were divided in two groups on the basis of presence or absence of HDV RNA and a comparative study was done. Genotype of HDV was determined in PCR positive patients.RESULTS: Overall there is male dominance, in which 34 patients out of 39 (87.2%) were male. Twenty (51%) patients were from the adjacent areas of three provinces; Sindh, Punjab and Balochistan indicating the higher prevalence of delta hepatitis in this mid region of Pakistan. Patients of all age groups were affected with delta hepatitis (median 31.5 years, range 12-75).HDV RNA was detectable in 23 patients (59%). All the HDV strains belonged to genotype Ⅰ. HBV DNA was detectable only in 3 cases who were also HBeAg and HDV RNA positive. Patients with detectable HDV RNA were younger than patients with undetectable RNA; mean age 29.7 ± 12.8 years vs 36.8 ± 15.2.There were no statistically significant differences in the clinical presentation and routine biochemical profile of patients with detectable or undetectable HDV RNA.Clinical cirrhosis was present in 19 (49%) patients; 12 with detectable RNA and 7 with undetectable HDV RNA (P = 0.748). Decompensated disease was seen in eight patients; five and three respectively from each group.Four patients with undetectable RNA and two patients with detectable RNA had normal ALT and ultrasound abdomen.CONCLUSION: HDV may infect at any age, usually young adult males. Genotype Ⅰ is prevalent. With time some of the patients become HDV RNA negative or asymptomatic carrier. Most of the patients have suppressed HBV DNA replication. Significant numbers of patients have cirrhosis.

  17. Subacute Thyroiditis: Clinical Presentation and Long Term Outcome

    Directory of Open Access Journals (Sweden)

    Assim A. Alfadda

    2014-01-01

    Full Text Available Few studies have been reported from the Kingdom of Saudi Arabia (SA to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT. Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded. β-Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted.

  18. Multibacillary leprosy: erythema as the only clinical presentation

    Institute of Scientific and Technical Information of China (English)

    WEN Peng-fei; WANG Lin

    2012-01-01

    Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae,which primarily affects the skin and peripheral nerves.In this article,we present a 45-year-old man and a 39-year-old women who suffered fróm asymptomatic irregular erythemas on their trunk and extremities.Since both patients denied the history of exposure to leprosy patients and were absent clinical signs of superficial sensation dysfunction and enlarged peripheral nerves,they were diagnosed of mycosis fungoides and livedo reticularis clinically.Nevertheless the biopsies of erythemas showed perineural and periadnexal foamy-cell granulomas in the dermis and Fite staining revealed a large number of acid-fast bacilli.A diagnosis of multibacillary leprosy was made finally.These cases revealed that since leprosy is still epidemic in some remote area in China and in other developing countries and its clinical manifestations may be very weird sometimes,the dermatologists should be alert of it and skin biopsy could confirm the diagnosis.

  19. Targeted Therapy of Hepatitis B Virus-Related Hepatocellular Carcinoma: Present and Future

    Directory of Open Access Journals (Sweden)

    Sarene Koh

    2016-02-01

    Full Text Available Cancer immunotherapy using a patient’s own T cells redirected to recognize and kill tumor cells has achieved promising results in metastatic melanoma and leukemia. This technique involves harnessing a patient’s T cells and then delivering a gene that encodes a new T cell receptor (TCR or a chimeric antigen receptor (CAR that allow the cells to recognize specific cancer antigens. The prospect of using engineered T cell therapy for persistent viral infections like hepatitis B virus (HBV and their associated malignancies is promising. We recently tested in a first-in-man clinical trial, the ability of HBV-specific TCR-redirected T cells to target HBsAg-productive hepatocellular carcinoma (HCC and demonstrated that these redirected T cells recognized HCC cells with HBV–DNA integration [1] We discuss here the possibility to use HBV-specific TCR-redirected T cells targeting hepatitis B viral antigens as a tumor specific antigen in patients with HBV-related HCC, and the potential challenges facing the development of this new immunotherapeutic strategy.

  20. Choroid plexus carcinoma: clinical and radiological features of four cases and review of literature

    International Nuclear Information System (INIS)

    Choroid plexus carcinoma (CPC) is rare central nervous system (CNS) tumor that accounts for nearly 0.06% of all intracranial neoplasms, most frequently occurring in patients less than 3 years of age. The authors present a clinical and radiological study of four patients with the diagnosis of CPC. The research was undertaken in the archives of radiology in the University Hospital of Curitiba, Parana State, Brazil, in the period from 1990 to 1997. The exams related to the CNS were catalogued and the CPC cases were looked into. Three of the patients were male and the mean age was 13.7 months. The clinical symptoms reported were due to intracranial hypertension, and the most common location was the lateral ventricles. Computed tomography scans show hydrocephalus and a mass hyperdense to the brain parenchyma, with marked enhancement post-contrast. Surgical resection was attempted in all patients. One of them died during the procedures. All of the other underwent relapse and died within an average of 7 months after the diagnosis. (author)

  1. Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: A meta-analysis of clinical evidence

    International Nuclear Information System (INIS)

    The characteristics of cervical lymphatic metastasis in nasopharyngeal carcinoma (NPC) are not completely understood. As such, radiotherapy to the entire lymphatic of the neck bilaterally has been empirically practiced even in early stage disease, although not supported by clinical evidence. We studied the pattern and probability of nodal metastasis through a meta-analysis of published evidences, with an aim to establish an evidence-based guideline for selecting and delineation of clinical target volume of neck lymphatics for conformation radiation for NPC. A literature search yielded an initial 411 original articles, and 13 studies with 2920 NPC cases staged via MRI were included in this analysis. The occurrence of nodal metastasis was calculated and analyzed according to the respective regional nodal levels. 85% of NPC cases presented with lymphadenopathy. The most commonly involved regions include retropharyngeal (69%) and level II lymph nodes (70%). The overall probability of levels III, IV, and V nodal involvement are 45%, 11%, and 27%, respectively. Low-risk node groups included the supraclavicular, levels IA/IB and VI nodes, and parotid nodes with involvement rates at 3%, 0%, 3%, 0%, and 1%, respectively. Nodal metastases followed an orderly pattern and the probability of 'skip' metastasis between levels varied between 0.5-7.9%. Lymph node metastasis in NPC follows a predictable and orderly pattern. The rarity of metastasis in certain nodal groups and 'skip' metastasis suggest that reduced treatment volume is feasible in conformal radiotherapy for NPC

  2. Bladder Carcinoma Data with Clinical Risk Factors and Molecular Markers: A Cluster Analysis

    Directory of Open Access Journals (Sweden)

    Enrique Redondo-Gonzalez

    2015-01-01

    Full Text Available Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments of nonmuscle invasive bladder carcinoma (NMIBC. A population of 45 patients with a new diagnosis of NMIBC was selected. Patients with benign prostatic hyperplasia (BPH, muscle invasive bladder carcinoma (MIBC, carcinoma in situ (CIS, and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventional transurethral resection (TURBT and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR. A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior.

  3. Bilateral breast carcinoma after Hodgkin's disease. Clinical and pathological characteristics: analysis of 13 cases

    International Nuclear Information System (INIS)

    Though Hodgkin's disease (HD) is one of the malignancies in which considerable progress has been made, long-term side effects have been observed, second primary cancer being the most significant. Several recent reports have indicated an increased risk of breast cancer (BC) in girls and young women among HD patients. In a retrospective multicenter analysis, 63 women treated for HD subsequently developed BC. Results that were obtained in 13 women (21 %) who developed either synchronous (5 cases) or metachronous (8 cases) BC were analyzed. The median age at diagnosis of HD was 19 years. 7 patients underwent exclusive radiotherapy (RT) (including 'mantle' supra-diaphragmatic irradiation) and 6 received concomitant radiation therapy and chemotherapy. The first breast tumor occurred after a median delay of 16 years. According to the TNM classification, we showed 9 stage TO (non palpable lesions), 4 stage T1, 5 stage T2, 1 stage T3, 2 stage T4 and 5 stage T x BC. 17 infiltrating carcinomas, 2 fibrosarcomas and 7 ductal carcinomas in situ were observed. Among 15 auxiliary dissections performed for invasive carcinomas, histological involvement was found in 10 cases. 17 tumors were treated by mastectomy and 9 patients underwent conservative surgical treatment. With a 70-month median follow-up (range: 15-125), 3 patients developed locoregional recurrence and 4 other metastases. At present, 8 are alive with no evidence of disease and 1 died of intercurrent disease. According to previous works, BC represents 6.3 to 9 % of all second cancers occurring after HD treatment. The risk is higher in young women treated before 20 year of age, especially before 15 years of age. Factors that favour the development of secondary BC are: supra-diaphragmatic irradiation, very young age at treatment, chemotherapy with alkylating agents, and probably genetic factors. We conclude that young women and girls treated for HD should be carefully monitored at least 10 years after the end of the

  4. Clinical and histopathological characteristics of basal cell carcinoma in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    CHANG Jian-min; GAO Xiao-man

    2013-01-01

    Background The clinical and histopathological characteristics of basal cell carcinoma (BCC) have been relatively well studied in Caucasian population.To characterize BCC in Chinese population,we analyzed the association of the histopathological subtypes with gender,age and anatomical location in this study.Methods The clinical and histopathological data of 243 BCC cases diagnosed at three hospitals in Beijing from January 2000 to April 2009 were reviewed retrospectively.Gender,age,location and histopathological subtype were analyzed.Results Among 243 patients enrolled,118 were males and 125 were females.The male/female ratio was 0.94∶1.The mean age was (65.16±12.62) years old.The head and neck were the most common sites of BCC (77.4%).Of the BCCs,53.9% were nodular,18.9% superficial and 18.5% infiltrative-morphoeic.The nodular,infiltrative-morphoeic and micronodular subtypes were predominant located on the head and neck,whereas the trunk was the most common location for the superficial subtype (P <0.05).The age at first presentation for females was lower than that for males (P<0.05).The age at first presentation for the superficial BCCs was younger than the non-superficial subtypes (P <0.05).Women with superficial BCC subtype visited hospital earlier than men (P <0.05).Conclusions Consistent with previous reports in Caucasian patient,our study find that different histopathological subtypes of BCC has distinct clinical features.It is speculated that the mechanisms underlining the pathogenesis of the superficial BCC may be different than those of non-superficial subtypes of BCC.

  5. Clinical study of T3/T4 laryngeal carcinoma

    International Nuclear Information System (INIS)

    A total of 72 consecutive laryngeal carcinoma patients at stage T3 or T4 were studied. The laryngeal cancer patients were treated first with concurrent chemoradiotherapy (40 Gy) in our department. Patients with residual disease subsequently underwent curative surgery, and chemoradiotherapy was continued to 70 Gy for those without residual disease. The three-year disease-specific-free survival (DSS) rates in patients with supraglottic, glottic and subglottic tumors were 58%, 71% and 100%, respectively. In patients at stage T3/T4, the DSS rates were 75%/46%, and in those with/without lymph node metastasis (N+/N-) the rates were 56%/78%. The three-year laryngeal preservation (LP) rates in patients with supraglottic/glottic/subglottic tumors, T3/T4 and N+/N- tumors were 12%/26%/50%, 28%/4% and 13%/29%, respectively. The recurrence rate was 29%, of which 75% have died, primarily of distant metastasis. These DSS and LP rates were not significantly different among the three subregions and N stages, although those in patients at stage T4 were significantly low, compared with T3 patients (p=0.01). These results suggest that additional treatment may be required for patients with T4 disease. Chemotherapy after surgery is now considered for T4 patients. (author)

  6. Clinical results of salvage surgery in hypopharynx carcinoma after chemoradiotherapy

    International Nuclear Information System (INIS)

    The incidence of post-operative complications and treatment results of 60 cases of hypopharynx carcinoma receiving laryngo-pharyngo-esophagectomy followed by reconstruction with jejunum after chemoradiotherapy (CRT) from 1997 to 2006 in 6 hospitals was analyzed. The overall complication rate was 57%. There were 3 cases with carotid artery rupture (5%), 4 with jejunum necrosis (6%), 6 with major salivary fistula (10%), 8 with minor salivary fistula (13%), 8 with abscess alone (13%), 3 with trachea stoma necrosis (5%), and 3 with skin flap necrosis (5%). The death rate due to surgical complications was 3% (2/60). When the cases were divided into two groups, namely the cases with fistula and the cases without fistula, the number of days that permitted drinking was 18.1 in the latter and 81.8 in the former. The 5-year overall survival rate among all cases was 37%. We found that salvage surgery after CRT was effective for recurrent cases. These findings suggest that reconstruction with jejunum is a suitable type of operation with better surgical results. Care is required to reduce the incidence of post-operative complications. (author)

  7. Clinical presentations and outcomes of Filipino juvenile systemic lupus erythematosus

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    Dans Leonila F

    2011-02-01

    Full Text Available Abstract Objective Juvenile Systemic Lupus Erythematosus (SLE varies by location and ethnicity. This study describes the clinical, laboratory profile and outcome of juvenile SLE seen at Philippine General Hospital (PGH from 2004-2008. Method Medical charts of all Filipino Juvenile SLE cases admitted at PGH during the 5-year period were reviewed collecting demographic profile, clinical and laboratory manifestations and treatment during disease course. Results Seventy-eight cases of juvenile SLE were reviewed. There were 7 boys and 71 girls. The mean age at diagnosis was 14 years (SD 2.7 with a range of 8-18 years. Fever (52.5% and malar rash (41.0% were the most common features at disease onset. At the time of diagnosis, the most common features were malar rash (65.3%, renal involvement (62.8% and photosensitivity (55.1%. Mucocutaneous (92.3%, renal (71.7% and hematologic (69.2% involvement were the most common features during the entire course of illness. Infection (34.5% and neurologic (19.0% complications were observed most frequently. Corticocosteroid treatment was given in most of the patients in the form of prednisone (97.4% and concomitant methylprednisolone intravenous pulses (29.4%. Nine patients died during the study period. The overall 5-year mortality rate was 11.5%. Infection (77.0% was the most frequent cause of death. Conclusion Malar rash was a common feature at disease onset and at diagnosis among Filipinos with juvenile SLE. Throughout the disease course, renal involvement occurs in 71.7% of patients. Infection was the leading cause of complication and death. The clinical presentations of Filipinos with juvenile SLE were similar to juvenile SLE in other countries.

  8. TACE combined with contrast-enhanced sonography guided RFA in treating massive primary hepatocellular carcinomas: a clinical therapeutic evaluation

    Institute of Scientific and Technical Information of China (English)

    许帅

    2014-01-01

    Objective To evaluate the effect of transcatheter arterial chemoembolization(TACE)combined with contrast-enhanced sonography guided radiofrequency ablation(RFA)in treating massive primary hepatocellular carcinomas.Methods Forty-eight patients with massive primary hepatocellular carcinoma were treated with TACE combined with contrast-enhanced sonography guided RFA.The clinical data of these patients,collected in our

  9. Clinical study on treatment of rectal carcinoma with Chinese herbal medicine and high dose fluorouracil emulsion via rectal infusion.

    Institute of Scientific and Technical Information of China (English)

    王晨光

    1999-01-01

    Objective: To study the clinical significance of rectal infusion of Chinese herbal medicine (CHM) plus high dose fluorouracil emulsion in treating rectal carcinoma. Methods: 86 patients of rectal carcinoma were randomly divided into CHM plus chemotherapy group and single chemotherapy group, and the

  10. Pathophysiology and clinical presentations of salt-losing tubulopathies.

    Science.gov (United States)

    Seyberth, Hannsjörg W

    2016-03-01

    At least three renal tubular segments are involved in the pathophysiology of salt-losing tubulopathies (SLTs). Whether the pathogenesis starts either in the thick ascending limb of the loop of Henle (TAL) or in the distal convoluted tubule (DCT), it is the function of the downstream-localized aldosterone sensitive distal tubule (ASDT) to contribute to the adaptation process. In isolated TAL defects (loop disorders) ASDT adaptation is supported by upregulation of DCT, whereas in DCT disorders the ASDT is complemented by upregulation of TAL function. This upregulation has a major impact on the clinical presentation of SLT patients. Taking into account both the symptoms and signs of primary tubular defect and of the secondary reactions of adaptation, a clinical diagnosis can be made that eventually leads to an appropriate therapy. In addition to salt wasting, as occurs in all SLTs, characteristic features of loop disorders are hypo- or isosthenuric polyuria and hypercalciuria, whereas characteristics of DCT disorders are hypokalemia and (symptomatic) hypomagnesemia. In both SLT categories, replacement of urinary losses is the primary goal of treatment. In loop disorders COX inhibitors are also recommended to mitigate polyuria, and in DCT disorders magnesium supplementation is essential for effective treatment. Of note, the combination of a salt- and potassium-rich diet together with an adequate fluid intake is always the basis of long-term treatment in all SLTs. PMID:26178649

  11. Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.

    Science.gov (United States)

    Matcuk, George R; Mahanty, Scott R; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J

    2016-08-01

    Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Insufficiency fractures are common in elderly populations, secondary to osteoporosis, and are typically located in and around the pelvis. They are a result of normal or traumatic loading on abnormal bone. Subchondral insufficiency fractures of the hip or knee may cause acute pain that may present in the emergency setting. Medial tibial stress syndrome is a type of stress injury of the tibia related to activity and is a clinical syndrome encompassing a range of injuries from stress edema to frank-displaced fracture. Atypical subtrochanteric femoral fracture associated with long-term bisphosphonate therapy is also a recently discovered entity that needs early recognition to prevent progression to a complete fracture. Imaging recommendations for evaluation of stress fractures include initial plain radiographs followed, if necessary, by magnetic resonance imaging (MRI), which is preferred over computed tomography (CT) and bone scintigraphy. Radiographs are the first-line modality and may reveal linear sclerosis and periosteal reaction prior to the development of a frank fracture. MRI is highly sensitive with findings ranging from periosteal edema to bone marrow and intracortical signal abnormality. Additionally, a brief description of relevant clinical management of stress fractures is included. PMID:27002328

  12. Clinical presentation and management of neonatal abstinence syndrome: an update

    Directory of Open Access Journals (Sweden)

    Ordean A

    2014-04-01

    Full Text Available Alice Ordean,1 Brian C Chisamore21Department of Family Medicine, 2Department of Pediatrics, St Joseph's Health Centre, and University of Toronto, Toronto, ON, CanadaAbstract: Exposure to prescription medications and illicit drug use during pregnancy has been associated with neonatal abstinence syndrome. The clinical presentation consists of neurological respiratory, gastrointestinal, and vasomotor disturbances. All infants require observation and supportive care to ensure appropriate adaptation and growth in the newborn period. A smaller percentage may also require additional pharmacotherapy, depending on the specific gestational substance exposure. Women should be counseled antenatally about the possible neonatal effects, and mother–baby dyad care should be implemented for this particular patient population.Keywords: neonatal withdrawal, opioids, marijuana, cocaine, benzodiazepines, selective serotonin reuptake inhibitors

  13. A case of clinical Reye syndrome presenting characteristic CT changes

    International Nuclear Information System (INIS)

    A 9-month-old male infant was admitted to our hospital on the second day of cold like syndrome because of high fever, convulsion, coma, and decerebrate rigidity. Serum GOT, GPT, LDH, and CPK were markedly elevated. Serum ammonia was slightly increased, and hypoglycemia was present. The cerebrospinal fluid showed no pleocytosis, normal sugar content, but increased protein. Thus we made a diagnosis of clinical Reye syndrome according to the criteria by Yamashita, et al. A CT on the day of admission showed symmetrical low-density areas in the posterior fossa and the regions of thalamus. Ringed enhancements were seen around the areas of low density in the thalamus on the twenty-second hospital day. We consider that these lesions may represent the infarction due to obstruction of the thalamoperforant arteries caused by cerebral edema in the early stage of the disease. (author)

  14. Empyema Thoracis in Children: Clinical Presentation, Management and Complications

    International Nuclear Information System (INIS)

    Objective: To determine the etiology, clinical manifestation, management (medical and surgical) and complications of children with empyema thoracis in a tertiary care hospital from Karachi, Pakistan. Study Design: Descriptive, analytical study. Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1996 to December 2010. Methodology: Medical records of admitted children aged > a month to 15 years with discharge diagnosis of empyema thoracis and data was collected on demographic features, clinical manifestation, management and complications. Children managed medically were compared with those managed surgically by using interquartile range and median comparison. Mann-Whitney U test was used to compare age in months, weight (kg) and length of stay in days and presenting complaint, duration of illness; chi-square test was used to compare thrombocytosis in between groups and p-value was calculated. Results: Among the 112 patients, 59 (53%) were younger than 5 years of age. Males (n=83, 74%) were predominant. Fifty (45%) children were admitted in winter. Thirty (27%) children found unvaccinated and one fourth (n=27; 24%) were severely malnourished. Fever, cough, and dyspnea were the major presenting symptoms. Sixty-six (59%) were on some antibiotics prior to admission. Staphylococcus aureus (n=13) and Streptococcus pneumoniae (n=5) were the commonest organism isolated from blood and pleural fluid cultures. Majority of the children required some surgical intervention (n=86). Surgically managed children were younger (p=0.01); had less weight (p=0.01) and prolonged fever (p=0.02); and stayed longer in hospital (p < 0.001) as compared to medically managed children. Requiring readmission (n=8), subcutaneous emphysema (n=5) and recollection of pus (n=5) were the major complications. Conclusion: Staphylococcus aureus was the major organism associated with paediatric empyema thoracis. Early identification and empiric

  15. Clinical presentation, aetiology and complications of pancreatitis in children

    International Nuclear Information System (INIS)

    Background: Childhood Pancreatitis is an uncommon but serious condition with incidence on the rise. It manifests as acute or chronic form with epigastric pain, vomiting and elevated serum -amylase and lipase. This study was conducted with the aim to determine the clinical presentation, aetiology, and complications of pancreatitis in children. Method: This descriptive case series was conducted in the Department of Paediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital and the Institute of Child Health, Lahore from 1st January to 31st December 2014. Seventy-two patients up to the age of 15 years having abdominal pain, Amylase >200 IU/L and/or lipase >165 IU/L, with features of acute or chronic pancreatitis on abdominal imaging; were included in study. Data analysis was done using SPSS-20. Results: Of the total 72 patients, 43 (60 percentage) had acute pancreatitis, males were 25 (58 percentage) and females 18 (42 percentage) and chronic pancreatitis was diagnosed in 29 (40 percentage), males 10 (34 percentage) and females 19 (66 percentage). Common clinical features were abdominal pain (100 percentage), nausea and vomiting (79 percentage). Common aetiologies were idiopathic (40 percentage) while choledochal cyst 8 percentage, hyperlipidaemia 7 percentage, biliary tract stones/sludge 7 percentage and abdominal trauma 6percentage. Complications were more frequently associated with acute pancreatitis (60 percentage) than with chronic pancreatitis (34 percentage). Common complications were pseudo-pancreatic cyst (36 percentage), ascites (17 percentage) and pleural effusion (4 percentage). Conclusion: Abdominal pain, nausea and vomiting were common presenting features of childhood pancreatitis. Common aetiologies were idiopathic hyperlipidemia, biliary tract stones/sludge, choledochal cyst and abdominal trauma. Common complications were Pseudo-pancreatic cyst, ascites and pleural effusion. (author)

  16. Intraorbital foreign body: clinical presentation, radiological appearance and management.

    Science.gov (United States)

    Al-Mujaini, Abdullah; Al-Senawi, Rana; Ganesh, Anuradha; Al-Zuhaibi, Sana; Al-Dhuhli, Humoud

    2008-03-01

    Intraorbital foreign bodies usually occur after a high velocity injury such as gunshot or industrial accidents; more rarely they occur following trivial trauma. A retained foreign body can give rise to serious complications, the most devastating of which is loss of the eye. This retrospective, interventional case report reviews the clinical features, radiological appearance and surgical management of two patients who presented at Sultan Qaboos University Hospital, Oman with intraorbital foreign bodies. Details of ocular history, preoperative ocular examination findings including visual acuity, surgical procedure and subsequent management were noted. The two patients, aged 10 years and 9 years old respectively, sustained orbital trauma with sharp objects. Both patients were found to have intraorbital foreign bodies that were documented clearly by computed tomography (CT) scans of the orbit. The first patient presented straight after injury, had no ocular involvement, underwent immediate surgical exploration and ended up with full recovery. The second patient presented to us after a delay of 4 days, and was found to have endophthalmitis. This patient ultimately lost all visual function in the affected eye. A CT scan is the modality of choice for orbital foreign body detection and localization. Early surgical exploration and foreign body extraction greatly influence the visual prognosis and final outcome. PMID:21654960

  17. Cushing’s Syndrome in a Young Woman: A Rare Presentation of Adrenocortical Carcinoma

    Directory of Open Access Journals (Sweden)

    Nikhil Talwar, Manoj Andley, Bina Ravi, Ajay Kumar

    2008-01-01

    Full Text Available Cushing’s Syndrome is rarely caused by a malignant adrenal tumor. We report the case of a 24-year-oldfemale patient with Cushing’s syndrome caused by a functioning adrenocortical carcinoma and recoveredafter adrenalectomy.

  18. Prevalence, clinical presentation and treatment outcome of cryptosporidiosis in immunocompetent adult patients presenting with acute diarrhoea

    International Nuclear Information System (INIS)

    Objective: To document the prevalence, clinical presentation and treatment outcome of cryptosporidiosis in immunocompetent adult patients presenting with acute diarrhoea. Methods: This prospective cohort study was conducted at the Sindh Institute of Urology and Transplantation Karachi from February 1, till September 30, 2012. All immunocompetent adult patients who presented with acute diarrhoea to the gastroenterology clinic at SIUT were included. Data collection sheet was filled and stool studies sent. Modified acid fast stain of stool was performed for cryptosporidium. SPSS 20 was used for statistical analysis. Results: There were 105 patients with acute diarrhoea. Fifty three (50.4%) were males. The mean age was 34+-8.4 years. Of 105, 58 (55%) patients had cryptosporidium isolated in stool studies. Patients with cryptosporidiosis had statistically significant greater stool frequency per day (p<0.001,OR=12.7; CI [4.4-37.1]), abdominal pain (p<0.001, OR= 19.8 [6.1-64.1]), vomiting (p<0.001, OR=7.3 [2.7-19.9]), low grade fever (p<0.001, OR=8.5 [3.5-20.8]), fatigue (p<0.001, OR=8.4 [3.2-21.6]) and dehydration and a shorter duration of illness with more watery diarrhoea. All 58 patients reported resolution of diarrhoea after 7 days of treatment with nitazoxanide. However, 40 (70.1%) patients reported recurrence of diarrhoea within 6 weeks of treatment. Conclusion: Our study demonstrates a high prevalence of cryptosporidiosis in immunocompetent adult patients. Nitazoxanide is the recommended antimicrobial drug for cryptosporidiosis. (author)

  19. Autopsy and clinical findings in case of metastases of the bronchial carcinoma

    International Nuclear Information System (INIS)

    Between the years of 1958 to 1980, 1636 patients suffering from histologically demonstrated bronchial carcinomas were submitted to an intensive radiotherapy at the Robert-Roessle Hospital in Berlin-Buch. The tumors received a minimum dose of 5000 Gy. The autopsy reports of 649 cases could be evaluated. The tumor destruction rate determined by autopsy and the distribution of metastases in dependence on the histologic tumor type are described and compared to the frequency of metastases determined by clinical or X-ray examination. With respect to clinical practice, the conclusion is drawn that a prophylactic radiotherapy to the brain, the upper abdominal lymph nodes and the adrenal glands possibly could improved the therapeutic results because of the high rate of metastases of microcellular and non-differentiated bronchial carcinomas found in these regions. (orig.)

  20. Recurrent TERT promoter mutations in urothelial carcinoma and potential clinical applications.

    Science.gov (United States)

    Kurtis, Boaz; Zhuge, Jian; Ojaimi, Caroline; Ye, Fei; Cai, Dongming; Zhang, David; Fallon, John T; Zhong, Minghao

    2016-04-01

    Increased telomerase activity is associated with almost all types of advanced human cancers with unknown molecular mechanism(s). Two recurrent point mutations in the promoter region of telomerase reverse transcriptase (TERT)-the key subunit of telomerase-have recently been identified in melanoma as well as a small sample of bladder cancer cell lines. However, the incidence and clinical-pathological significance of these mutations in urothelial carcinoma have not been well established yet. We collected 86 specimens of urothelial carcinoma including upper and lower urinary tract: high grade and low grade, invasive and noninvasive, and primary and metastatic. We also included some matched benign urothelium and common benign bladder lesions: cystitis, nephrogenic adenoma, and inverted papilloma. In addition, we collected urine samples for urothelial carcinoma workup; blood samples from patients underwent cystectomy with extensive lymphovascular invasion. All specimens were subject to polymerase chain reaction amplification and bidirectional Sanger sequencing for the TERT promoter mutations: C228T and C250T. We found that 64 (74%) of 86 carcinoma samples harbored 1 of the 2 TERT promoter mutations (C228T, n = 54; C250T, n = 10); the incidences were roughly equal regardless of site of origin, histologic grade, and invasive status. All matched benign and benign lesion samples showed wild-type sequence. These TERT promoter mutations are the most common genetic alterations in urothelial carcinoma and are not associated with tumor locations, grade, or invasiveness. Importantly, the feasibility of detecting these mutations in urine samples may provide a novel method to detect urothelial carcinoma in urine. PMID:27040924

  1. Clinical presentations and MRI findings of angiographically occult vascular malformations

    International Nuclear Information System (INIS)

    Various clinical features as well as MRI findings of AOVM (angiographically occult vascular malformation) were studied. Amongst out patients, since January 1988, there have been 30 cases of symptomatic AOVM (20 males, 10 females) including 4 cases with multiple lesions. The age ranged from 3 to 60 years of age, with a mean of 33.4 years. The locations of symptomatic lesions were in the cerebral hemisphere (15), the thalamus (4), the brain stem (8) and in the cerebellum (3). The initial presentations of these 30 cases were either by hemorrhage (18), convulsive seizure (9) or by progressive neurological deficits (3). The initial presentation was not related to the patient's age and the size of the lesion, but apparently related to the location of AOVM. Most of the lesions in the cerebral hemisphere presented seizures, but all of the lesions in the thalamus, the brain stem and the cerebellum disclosed hemorrhage as an initial presentation. In fact it was noticed that brain stem lesions tend to cause repetitive hemorrhage in a relatively short period. AOVM lesions were clearly visualized with T2-weighted MRI images, consisting of high intensity cores with surrounding low intensity rims. Most of the symptomatic lesions were partially enhanced by Gd-DTPA with varied intensity. Dynamic changes in size and enhancement pattern on MRI were occasionally seen, usually accompanied with episodes such as hemorrhage or neurological deterioration. Although AOVMs were angiographically negative some strands indicating draining veins were observed on MRI in several cases. In contrast, none of the nonsymptomatic lesions (22 lesions) demonstrated enhancement effects with Gd-DTPA. (author)

  2. Small cell carcinoma of the prostate presenting with Cushing Syndrome. A narrative review of an uncommon condition.

    Science.gov (United States)

    Rueda-Camino, José Antonio; Losada-Vila, Beatriz; De Ancos-Aracil, Cristina Lucía; Rodríguez-Lajusticia, Laura; Tardío, Juan Carlos; Zapatero-Gaviria, Antonio

    2016-06-01

    Small cell carcinoma (SCC) of the prostate is an uncommon condition; there are very few cases in which presenting symptoms are consistent with Cushing Syndrome (CS). We report a new case in which CS triggers the suspicion of an SCC of the prostate and a review of the published cases of SCC of the prostate presenting with CS. The origin of these neoplasms is still unclear. It may be suspected when laboratory features appear in patients diagnosed with prostatic adenocarcinoma which becomes resistant to specific therapy. SCC usually occurs after the 6th decade. Patients suffering SCC of the prostate presenting with CS usually present symptoms such as hypertension, hyperglycemia, alkalosis or hypokalemia; cushingoid phenotype is less frequent. Cortisol and ACTH levels are often high. Prostatic-specific antigen levels are usually normal. CT scan is the preferred imaging test to localize the lesion, but its performance may be improved by adding other tests, such as FDG-PET scan. All patients have metastatic disease at the time of diagnosis. Lymph nodes, liver and bone are the most frequent metastases sites. Surgery and Ketokonazole are the preferred treatments for CS. The prognosis is very poor: 2- and 5-year survival rates are 27.5 and 14.3%, respectively. Key messages When a patient presents with ectopic Cushing Syndrome but lungs are normal, an atypical localization should be suspected. We should suspect a prostatic origin if Cushing Syndrome is accompanied by obstructive inferior urinary tract symptoms or in the setting of a prostatic adenocarcinoma with rapid clinical and radiological progression with relatively low PSA levels. Although no imaging test is preferred to localize these tumors, FDG-PET-TC can be very useful. Hormone marker scintigraphy (e.g. somatostatin) could be used too. As Cushing Syndrome is a paraneoplastic phenomenon, treatment of the underlying disease may help control hypercortisolism manifestations. These tumors are usually metastatic by the

  3. Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy.

    Science.gov (United States)

    Ahmed, Samrah; Baker, Ian; Husain, Masud; Thompson, Sian; Kipps, Christopher; Hornberger, Michael; Hodges, John R; Butler, Christopher R

    2016-04-23

    Posterior cortical atrophy (PCA) is characterized by core visuospatial and visuoperceptual deficits, and predominant atrophy in the parieto-occipital cortex. The most common underlying pathology is Alzheimer's disease (AD). Existing diagnostic criteria suggest that episodic memory is relatively preserved. The aim of this study was to examine memory performance at initial clinical presentation in PCA, compared to early-onset AD patients (EOAD). 15 PCA patients and 32 EOAD patients, and 34 healthy controls were entered into the study. Patients were tested on the Addenbrooke's Cognitive Examination (ACE-R), consisting of subscales in memory and visuospatial skills. PCA and EOAD patients were significantly impaired compared to controls on the ACE total score (p skills (p skills compared to EOAD patients (p presentation. The findings suggest that memory impairment must be considered in assessment and management of PCA. Further study into memory in PCA is warranted, since the ACE-R is a brief screening tool and is likely to underestimate the presence of memory impairment. PMID:27128371

  4. Clinical presentation of acute pulmonary embolism: survey of 800 cases.

    Directory of Open Access Journals (Sweden)

    Massimo Miniati

    Full Text Available BACKGROUND: Pulmonary embolism (PE is a common and potentially fatal disease that is still underdiagnosed. The objective of our study was to reappraise the clinical presentation of PE with emphasis on the identification of the symptoms and signs that prompt the patients to seek medical attention. METHODOLOGY/PRINCIPAL FINDINGS: We studied 800 patients with PE from two different clinical settings: 440 were recruited in Pisa (Italy as part of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED; 360 were diagnosed with and treated for PE in seven hospitals of central Tuscany, and evaluated at the Atherothrombotic Disorders Unit, Firenze (Italy, shortly after hospital discharge. We interviewed the patients directly using a standardized, self-administered questionnaire originally utilized in the PISAPED. The two samples differed significantly as regards age, proportion of outpatients, prevalence of unprovoked PE, and of active cancer. Sudden onset dyspnea was the most frequent symptom in both samples (81 and 78%, followed by chest pain (56 and 39%, fainting or syncope (26 and 22%, and hemoptysis (7 and 5%. At least one of the above symptoms was reported by 756 (94% of 800 patients. Isolated symptoms and signs of deep vein thrombosis occurred in 3% of the cases. Only 7 (1% of 800 patients had no symptoms before PE was diagnosed. CONCLUSIONS/SIGNIFICANCE: Most patients with PE feature at least one of four symptoms which, in decreasing order of frequency, are sudden onset dyspnea, chest pain, fainting (or syncope, and hemoptysis. The occurrence of such symptoms, if not explained otherwise, should alert the clinicians to consider PE in differential diagnosis, and order the appropriate objective test.

  5. Expression and clinical significance of angiotensin II type 1 receptor in human hepatocellular carcinoma

    OpenAIRE

    Duan, Yun-fei; Li, Xiao-dong; Zhu, Feng; Zhang, Feng

    2013-01-01

    This study aimed to investigate the expression of angiotensin II type 1 receptor (AT-1R) mRNA and the AT-1R protein in human primary hepatocellular carcinoma (PHC), and to attempt to elucidate their association with pathological and clinical characteristics. Fresh tumor and normal liver tissues were obtained from 44 patients with PHC following hepatectomies. AT-1R mRNA levels were quantitatively analyzed by quantitative polymerase chain reaction (qPCR) while the protein levels were assessed b...

  6. Adenoid cystic carcinoma of the larynx presenting with unusual subglottic mass: Case report.

    Science.gov (United States)

    Kashiwagi, Takashi; Kanaya, Hiroaki; Konno, Wataru; Goto, Kazutaka; Hirabayashi, Hideki; Haruna, Shin-Ichi

    2016-10-01

    A 33-year-old woman presented with an unusual subglottic bulging mass accompanied by prolonged cough and wheeze. Laryngeal endoscopy revealed a bilateral, symmetrical mass immediately below the vocal cords with marked airway obstruction. Chronic subglottic laryngitis with inflammation or another condition such as amyloidosis was initially suspected. Cervicothoracic computed tomography revealed an obvious reduction of laryngeal caliber caused by an engulfing mass extending from just under the vocal cords to the cricoid ring, which was associated with thyroid, arytenoid, and cricoid cartilage destruction. Histopathological diagnosis of a biopsy specimen collected via a tracheotomy revealed that the lesion was a cT4aN0M0 adenoid cystic carcinoma (ACC) originating from the laryngeal minor salivary glands. The patient was treated by total laryngectomy with elective bilateral neck dissection under general anesthesia. Gross inspection of resected tissue confirmed yellowish-white, solid tumor mainly circumferentially encompassing the lumina of the cricoid ring. The histopathological findings confirmed typical ACC accompanied by a predominant cribriform appearance with no evidence of lymph node metastasis. The patient remains well and free of recurrence or metastasis. We herein describe laryngeal ACC and discuss radiological images and the surgical pathology. PMID:26803452

  7. Clear Cell Carcinoma Presented as a Large Polypoid Mass Expanding the Vaginal Fornix: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young; Cho, Jae Ho [Dept. of Radiology, College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2012-11-15

    Primary clear cell carcinoma of the vagina or uterine cervix is a very rare tumor. We report radiologic findings of two cases of clear cell carcinoma, arising in the vagina and uterine cervix in a 16-year-old and a 26-year-old female. These were presented as a large polypoid mass with a stalk and expanding the vaginal fornix. One case with ultrasonography showed relatively homogeneous echoic solid mass; the other case with a CT showed heterogeneously and strongly enhancing mass. All of the two cases showed non-specific signal intensity with heterogeneous and strong enhancement on MRI.

  8. Clear Cell Carcinoma Presented as a Large Polypoid Mass Expanding the Vaginal Fornix: Report of Two Cases

    International Nuclear Information System (INIS)

    Primary clear cell carcinoma of the vagina or uterine cervix is a very rare tumor. We report radiologic findings of two cases of clear cell carcinoma, arising in the vagina and uterine cervix in a 16-year-old and a 26-year-old female. These were presented as a large polypoid mass with a stalk and expanding the vaginal fornix. One case with ultrasonography showed relatively homogeneous echoic solid mass; the other case with a CT showed heterogeneously and strongly enhancing mass. All of the two cases showed non-specific signal intensity with heterogeneous and strong enhancement on MRI.

  9. Open field whole abdomen irradiation of ovarian and endometrial carcinomas - early clinical tolerance

    International Nuclear Information System (INIS)

    Whole abdomen irradiation (WAI) is broadly applied as a part of the complex treatment of ovarian and high risk endometrial carcinomas prone to development and dissemination in the abdominal cavity. The aim of the present study is to evaluate the early clinical tolerance of WAI open field technique in ovarian and endometrial tumors. During the period 1993 - 2007 56 patients received open field WAI treatment in the Radiotherapy department, The clinical material included 20 patients with ovarian carcinomas, 26 - with endometrial cancer, 6 - with lymphomas and 4 - with other localizations of malignant tumors. The median age of the patients from the more numerous groups was 44 years for these with ovarian tumors and 56 - for these with endometrial tumors, all of them having a Karnofsky index of 100. The patients with endometrial tumors were in the Hi clinical stage, while earlier clinical stages were predominant (80%) for the patients with ovarian tumors. The serous-papillary histological types were prevalent in the ovarian tumors - 6 (30%), and the adenocarcinomas prevailed in the endometrial cancer - 18 (69%). The distribution of the patients with ovarian tumors according to the differentiation grade was: G1:G2:G3 -50%:22%:28%, and of those with endometrial tumors - 21%:67%:12%. WAI was delivered to all patients using tele gamma therapeutic equipment. The planned target volume (PTV) included the peritoneal cavity and the retroperitoneum from the diaphragm domes to the pelvis bottom. The irradiation was achieved via 2 opposite fields with daily doses of 1.0 - 1-5 Gy and total dose of 20 - 30 Gy. Lead protection of kidneys was included after total dose 16-18 Gy, and liver protection was applied after total dose 16-20 Gy.The patients with endometrial and ovarian tumors were given pelvic boost and/or boost in para aortal lymphatic chains and the rest of the patients - in the residual formations. The early clinical tolerance was evaluated using the scale of CTCAE v.3NCI

  10. Stage Presentation, Care Patterns, and Treatment Outcomes for Squamous Cell Carcinoma of the Penis

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    Burt, Lindsay M.; Shrieve, Dennis C.; Tward, Jonathan D., E-mail: Jonathan.Tward@hci.utah.edu

    2014-01-01

    Purpose: Penile squamous cell carcinoma (SCC) is a rare entity, with few published series on outcomes. We evaluated the stage distributions and outcomes for surgery and radiation therapy in a U.S. population database. Methods and Materials: Subjects with SCC of the penis were identified using the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) Program database between 1988 and 2006. Descriptive statistics were performed, and cause-specific survival (CSS) was estimated using Kaplan-Meier analysis. Comparisons of treatment modalities were analyzed using multivariate Cox regression. Subjects were staged using American Joint Committee on Cancer, sixth edition, criteria. Results: There were 2458 subjects identified. The median age was 66.8 years (range, 17-102 years). Grade 2 disease was present in 94.5% of cases. T1, T2, T3, T4, and Tx disease was present in 64.8%, 17.1%, 9.5%, 2.1%, and 6.5% of cases, respectively. N0, N1, N2, N3, and Nx disease was noted in 61.6%, 6.9%, 4.0%, 3.7%, and 23.8% of cases, respectively. M1 disease was noted in 2.5% of subjects. Individuals of white ethnicity accounted for 85.1% of cases. Lymphadenectomy was performed in 16.7% of cases. The CSS for all patients at 5 and 10 years was 80.8% and 78.6%. By multivariable analysis grades 2 and 3 disease, T3 stage, and positive lymph nodes were adverse prognostic factors for CSS. Conclusion: SCC of the penis often presents as early-stage T1, N0, M0, grade 1, or grade 2 disease. The majority of patients identified were treated with surgery, and only a small fraction of patients received radiation therapy alone or as adjuvant therapy.

  11. Stage Presentation, Care Patterns, and Treatment Outcomes for Squamous Cell Carcinoma of the Penis

    International Nuclear Information System (INIS)

    Purpose: Penile squamous cell carcinoma (SCC) is a rare entity, with few published series on outcomes. We evaluated the stage distributions and outcomes for surgery and radiation therapy in a U.S. population database. Methods and Materials: Subjects with SCC of the penis were identified using the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) Program database between 1988 and 2006. Descriptive statistics were performed, and cause-specific survival (CSS) was estimated using Kaplan-Meier analysis. Comparisons of treatment modalities were analyzed using multivariate Cox regression. Subjects were staged using American Joint Committee on Cancer, sixth edition, criteria. Results: There were 2458 subjects identified. The median age was 66.8 years (range, 17-102 years). Grade 2 disease was present in 94.5% of cases. T1, T2, T3, T4, and Tx disease was present in 64.8%, 17.1%, 9.5%, 2.1%, and 6.5% of cases, respectively. N0, N1, N2, N3, and Nx disease was noted in 61.6%, 6.9%, 4.0%, 3.7%, and 23.8% of cases, respectively. M1 disease was noted in 2.5% of subjects. Individuals of white ethnicity accounted for 85.1% of cases. Lymphadenectomy was performed in 16.7% of cases. The CSS for all patients at 5 and 10 years was 80.8% and 78.6%. By multivariable analysis grades 2 and 3 disease, T3 stage, and positive lymph nodes were adverse prognostic factors for CSS. Conclusion: SCC of the penis often presents as early-stage T1, N0, M0, grade 1, or grade 2 disease. The majority of patients identified were treated with surgery, and only a small fraction of patients received radiation therapy alone or as adjuvant therapy

  12. Airway inflammation is present during clinical remission of atopic asthma

    OpenAIRE

    Toorn, Leon; Overbeek, Shelley; de Jongste, Johan; Leman, K.; Hoogsteden, Henk; Prins, Jan-Bas

    2001-01-01

    textabstractSymptoms of atopic asthma often disappear at puberty. However, asthmatic subjects in clinical remission will frequently have a relapse later in life. The aim of this study was to investigate whether subjects in clinical remission of atopic asthma have persistent airway inflammation and/or airway remodeling. Bronchial biopsies were obtained from subjects in clinical remission, asthmatic subjects, and healthy control subjects. The presence and/or activation state of eosinophils, mas...

  13. Clinical trials with cyclophosphamide and misonidazole combination for maintaining treatment after radiation therapy of lung carcinoma

    International Nuclear Information System (INIS)

    Fifteen patients with inoperable non oat cell lung carcinoma, who had already been treated with telecobalt therapy in the mediastinum-hilar region, were treated with continuing therapy with misonidazole (MISO) and cyclophosphamide (Cy). MISO was administered in single doses of 1000 mg/m2 and 500 mg/m2, orally. Cy was administered in single doses of 500 mg/m2 and 250 mg/m2, i.v. This treatment was given every 4 weeks. All patients (15/15) suffered from hyporexia, nausea and vomiting within 48 hours from administration; furthermore, 2 patients had hemoragic cystitis, 2 had peripheral neurotoxicity, 3 had fever, and 2 had serious nervous depression. Leukopenia occurred in all patients immediately after drug administration, although it was not present in any patient by the time of the next administration. This clinical trial was concluded in December 1981. The follow-up at 18 months shows 7/15 cases of relapse. Eight of 15 patients are alive with progression of disease from 8 to 18 months

  14. The Varicocele: Clinical Presentation, Evaluation, and Surgical Management.

    Science.gov (United States)

    Lomboy, Jason R; Coward, Robert M

    2016-09-01

    A varicocele is an abnormal dilatation and tortuosity of the veins of the spermatic cord. Although varicoceles are common in the general population and are frequently found on routine physical examinations, they represent the most common correctable cause of male factor infertility. Varicoceles are also often incidental findings on imaging studies, particularly scrotal ultrasound. Importantly, not all varicoceles should be treated equally (or at all), and basic guidelines on the evaluation and indications for treatment of adult varicoceles should be reviewed before counseling and treatment. A semen analysis should be obtained for any male patient of reproductive age considering intervention. The adolescent varicocele is managed much differently than the adult varicocele and remains a source of controversy. This review describes the clinical presentation and the evaluation of adult and pediatric varicoceles, and provides guidance on their diagnosis and workup. It also describes options for surgical repair and the success and complication rates associated with each surgical approach, ultimately supporting microsurgical subinguinal varicocele repair as the current surgical standard. PMID:27582602

  15. Clinical presentation of inappropriate sinus tachycardia and differential diagnosis.

    Science.gov (United States)

    Peyrol, Michael; Lévy, Samuel

    2016-06-01

    Inappropriate sinus tachycardia (IST) is a syndrome characterized by a sinus tachycardia not related to a medical condition, to a physiological response, or to medication or drugs and associated with symptoms, often invalidating and altering the quality of life of affected patients. It occurs predominantly in adolescents and young adults, and in the female sex. The diagnosis requires a complete work-up in order to exclude other causes of sinus tachycardia and one or several additional tests: 24-h ECG ambulatory recordings, echocardiogram, exercise testing, and autonomous nervous system assessment. It should be differentiated from the postural orthostatic tachycardia syndrome, with which it shares a number of symptoms, and other supraventricular tachycardias originating in the high right atrium. An electrophysiological study should be considered in selected cases in order to differentiate IST from other supraventricular tachycardias. The mechanism is still unclear, and possible etiologies may include intrinsic abnormality of the sinus node, autonomic dysfunction, hypersensitivity of the sinus node to catecholamines, blunted vagal system, or a combination of the above. The authors emphasize the wide spectrum of clinical presentations and the need to better define the IST and the criteria required to ascertain its diagnosis. PMID:26329720

  16. Paired-agent imaging for resection during surgery (PAIRS) of head and neck squamous cell carcinomas (Conference Presentation)

    Science.gov (United States)

    Samkoe, Kimberley S.; Tichauer, Kenneth M.; Chen, Eunice; Gunn, Jason R.; Hoopes, P. Jack; Wells, Wendy A.; Hasan, Tayyaba; Pogue, Brian W.

    2016-03-01

    Ninety percent of patients with head and neck squamous cell carcinomas (HNSCC) have overexpression of epidermal growth factor receptor (EGFR), which is correlated with poor prognosis. Complete surgical resection of HNSCC tumors has a large impact on patient survival, where detection of tumor at or close to surgical margins increases the risk of death at 5-years by 90%. In addition, large surgical margins can greatly increase the morbidity experienced by the patient due to functional and cosmetic damage of oral and facial structures. Single fluorescence targeting agents are often used for tumor detection in in vivo pre-clinical imaging; however, the arising signal is qualitative at best because it is a complex mixture of vascular perfusion, vascular leakage, inhibited lymphatic clearance, and receptor binding. In vivo ratiometric receptor concentration imaging (RCI) allows quantification of receptor expression (hence identification of cancerous tissue) by utilizing co-administered paired-agents consisting of a targeted agent and non-targeted perfusion agent to reference the plasma delivery and leakage. A panel of HNSCC tumors with varying levels of EGFR expression (SCC-15 >SCC-25 > SCC-09) have been imaged using ABY-029, a clinically relevant anti-EGFR affibody labeled with IRDye 800CW, and affibody control imaging agent labeled with IRDye 680RD. RCI maps of in vivo tissue have been created and are spatially correlated with EGFR and CD31 immunohistochemistry and basic H and E staining. The RCI threshold parameters for distinguishing tumor from normal tissues (skin and muscle) and the accuracy of margin detection in these tumors will be presented. RCI surgical resection will be further developed using a novel multi-channel, gated fluorescence-guided surgery (FGS) imaging system that is capable of performing RCI in normal room light.

  17. A case of treatment in a patient with synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands: Clinical observation

    Directory of Open Access Journals (Sweden)

    V. R. Latypov

    2014-11-01

    Full Text Available Synchronous bilateral renal cell carcinoma occurs in 1.4 % of cases. The probability of bilateral adrenal metastases from renal cell carcinoma is less than 0.5 %. The clinical observation presents a case of synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands. A 55‑year-old male patient was adm tted with the signs of hematuria and anemia to the Unit of Urology, Clinic of General Surgery, Siberian State Medical University. He was found to have synchronous bilateral renal cell carcinoma and simultaneous bilateral adrenal involvement. Sequential surgical treatment – radical nephrectomy (with adrenal gland removal on the right side and, after 3 months, adrenalectomy and kidney resection on the left side were performed. All the organs removed displayed tumors that proved to be renal cell carcinomas (a clear cell variant. There were lymph node metastases in the right-sided renal portal. Postoperatively, the investigators performed hormone replacement therapy for adrenal insufficiency, an immunotherapy cycle, three cycles of targeted therapy withsorafenib and sunitinib (at an interval of 0.5–2 years, and insulin therapy for new-onset diabetes mellitus. The duration of a follow-up was 6.2 years. When describing the case, the patient was alive and showed a generalized tumorous process with extensive tumor involvement of the solitary kidney. Sunitinib therapy was used.

  18. Clinical Presentation of Klinefelter's Syndrome: Differences According to Age

    Directory of Open Access Journals (Sweden)

    Néstor Pacenza

    2012-01-01

    Full Text Available The aim of the study was to establish the characteristics of presentation of 94 patients with Kinelfelter's syndrome (KS referred to the endocrinologist at different ages. The diagnosis of KS was more frequent in the age group between 11 and 20 years (46.8%. Most of the patients (83.7% showed the classic 47,XXY karyotype and 7.1% showed a 47,XXY/46,XY mosaicism. Half of the patients younger than 18 years presented mild neurodevelopmental disorders. The most frequent clinical findings were cryptorchidism in prepubertal patients, and small testes, cryptorchidism, and gynecomastia in pubertal patients. FSH, LH, AMH, and inhibin B levels were normal in prepubertal patients and became abnormal from midpuberty. Most adults were referred for small testes, infertility, and gynecomastia; 43.6% had sexual dysfunction. Testosterone levels were low in 45%. Mean stature was above the 50th percentile, and 62.5% had BMI ≥25.0 kg/m2. In conclusion, the diagnosis of Klinefelter syndrome seems to be made earlier nowadays probably because pediatricians are more aware that boys and adolescents with neuro-developmental disorders and cryptorchidism are at increased risk. The increasing use of prenatal diagnosis has also decreased the mean age at diagnosis and allowed to get insight into the evolution of previously undiagnosed cases, which probably represent the mildest forms. In adults average height and weight are slightly higher than those in the normal population. Bone mineral density is mildly affected, more at the spine than at the femoral neck level, in less than half of cases.

  19. Renal cell carcinoma presenting as a solitary cutaneous facial metastasis: case report and review of the literature

    OpenAIRE

    Porter, Neil A; Anderson, Helen L; Al-Dujaily, Saad

    2006-01-01

    Background Renal cell carcinoma is well known for its frequency to metastasise, particularly to lungs, liver, bones and brain. Metastasis to the skin is much less common. Presentation as a result of the skin lesion is even more unusual, with only 14 previously reported cases in the English literature. The majority of these cases have been reported in patients with recurrent disease or with other metastases. Case presentation We present only the second case of non-recurrent renal cell carcinom...

  20. [Pain disorders in traumatized individuals - neurophysiology and clinical presentation].

    Science.gov (United States)

    Egloff, N; Hirschi, A; von Känel, R

    2012-01-18

    This overview portrays the salient physiological mechanisms being involved in the clinical manifestation of chronic pain in traumatized patients. A «hypermnesia-hyperarousal-model» is purported to support the neurophysiologic plausibility of the trauma-pain-relationship. We discuss seven characteristic clinical pain entities which alone or in combination can be found in patients with a previous psychological trauma. PMID:22252590

  1. Late course accelerated hyperfractionated radiotherapy for clinical T1-2 esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kuai-Le Zhao; Yang Wang; Xue-Hui Shi

    2003-01-01

    AIM: This retrospective study was designed to analyze the results and the failure patterns of late course accelerated hyperfractionated radiotherapy for clinical T1-2NoMo esophageal carcinoma. METHODS: From Aug. 1994 to Feb. 2001, 56 patients with clinical T1-2 esophageal carcinoma received late course accelerated hyperfractionated radiotherapy in Cancer Hospital,Fudan University. All patients had been histologically proven to have squamous cell carcinoma (SCC) and were diagnosed to be T1-2NoMo by CT scan. All patients were treated with conventional fractionation (CF) irradiation during the first twothirds course of the treatment to a dose of about 41.4Gy/23fx/4 to 5 weeks, Which was then followed by accelerated hyperfractionation irradiation using reduced fields, twice daily at 1.SGy per fraction, to a dose about 27Gy/18 fx. Thus the total dose was 67-70Gy/40-43fx/40-49 d. RESULTS: The 1-, 3- and 5-year overall survival was 90.9 %,54.6 %, 47.8 % respectively. The 1-, 3- and 5-year local control rate was 90.9 %, 84.5 % and 84.5 %, respectively.Twenty-five percent (14/56) patients had distant metastasis and/or lymph nodes metastasis alone. Eight point nine percent (5/56) patients had local disease alone. Another 3.6 % (2/56) patients had regional relapse and distant metastasis. CONCLUSION: Late course accelerated hyperfractionated radiotherapy is effective on clinical T1-2 esophageal carcinoma.The main failure pattern is distant metastasis.

  2. Cytokeratin-positive interstitial reticulum cell sarcoma: extranodal presentations mimicking carcinoma.

    Science.gov (United States)

    Sundersingh, Shirley; Majhi, Urmila; Krishnamurthy, Arvind; Velusami, Sri Devi

    2013-01-01

    Cytokeratin-positive interstitial reticulum cell (CIRC) sarcoma is a rare type of dendritic cell tumor derived from a subset of fibroblastic reticular cells. Expression of cytokeratins and extranodal location of these tumors can lead to a misdiagnosis of carcinoma. We report two cases of CIRC sarcomas primarily involving the scalp and breast. Patients were referred with an initial diagnosis of carcinoma. Case 1 underwent wide local excision of the scalp tumor with left posterolateral neck dissection. Case 2 had modified radical mastectomy for the tumor in left breast. Histopathological examination of both specimens showed an epithelioid to spindle cell malignant tumor that co-expressed CK 8, CK 18, vimentin, and smooth muscle actin. A diagnosis of CIRC sarcoma was made. Pathologists should be aware of this subset of dendritic cell sarcoma. Carcinomas, other sarcomas of the accessory dendritic cell family, and poorly differentiated malignant tumors have to be ruled out by combination of morphology, immunohistochemistry, and electron microscopic studies. PMID:24056661

  3. Tumor characteristics and the clinical outcome of invasive lobular carcinoma compared to infiltrating ductal carcinoma in a Chinese population

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    Cao A-Yong

    2012-07-01

    Full Text Available Abstract Background We sought to compare the baseline demographics, standard pathologic factors and long-term clinical outcomes between ILC and infiltrating ductal carcinoma (IDC using a large database. Methods Clinicopathologic features, overall survival (OS, and recurrence/metastasis-free survival (RFS were compared between 2,202 patients with IDC and 215 patients with ILC. Results ILC was significantly more likely to be associated with a favorable phenotype, but the incidence of contralateral breast cancer was higher for ILC patients than for IDC patients (8.4% vs. 3.9%; P =0.001. The frequencies of recurrence/metastasis (P = 0.980 and death (P = 0.064 were similar among patients with IDC and patients with ILC after adjustment for tumor size and nodal status. The median follow-up was 42.8 months. Conclusions Chinese women with ILCs do not have better clinical outcomes than their counterparts with IDC. Management decisions should be based on individual patient and tumor biologic characteristics, and not on lobular histology.

  4. Vulvar Merkel Carcinoma: A Case Report

    OpenAIRE

    2011-01-01

    This is a new case of Merkel cell carcinoma of the vulva. It is a rare neuroendocrine carcinoma with an aggressive behavior. Because of its rarity in this location, it is not clear whether it behaves differently from the usual neuroendocrine carcinomas of the skin. A case of a 63-year-old patient with vulvar Merkel carcinoma is presented. The clinical presentation, microscopic and immunohistochemical features, and treatment are discussed.

  5. The Clinical and Pathological Presentation of Thyroid Nodules in Children and the Comparison with Adult Population: Experience of a Single Institution.

    Science.gov (United States)

    Solymosi, Tamas; Lukacs Toth, Gyula; Budai, Laszlo; Gal, Istvan

    2016-01-01

    The clinical and pathological presentation of thyroid nodules among younger and adult patients was compared in an iodine-deficient (ID) region. Data of 3,010 consecutive patients younger than 20 years and 3,010 patients older than 20 years were compared. The proportion of nodular goiters (22.8% versus 39.3%), the ratio of surgically treated nodules (33.2% versus 15.2%), and the proportion of malignant nodules (4.3% versus 2.1%) among diseased patients differed significantly between the two groups (younger versus adult). Nine papillary and 1 medullary carcinoma were found among children, while 15 papillary, 2 follicular, 1 insular, 1 anaplastic, and 1 medullary carcinomas occurred among adults. The ratio of follicular adenoma to hyperplastic nodules (3 : 1 to 1 : 1.67), the proportion of follicular variant (77.8% versus 26.7%), T4 tumors (77.8% versus 33.3%), and tumors with lymph node metastasis (88.9% versus 66.7%) were significantly higher among younger papillary carcinoma patients. No malignancies occurred among spongiform and central type cysts. Similarly to iodine-sufficient regions, more nodules are malignant and carcinomas have a clinically more aggressive presentation in children in comparison with adult patients in ID. Taking the significantly greater proportion of adenomas and the lack of follicular carcinoma into account, a conservative approach has to be considered in follicular tumors among children. PMID:27087807

  6. The Clinical and Pathological Presentation of Thyroid Nodules in Children and the Comparison with Adult Population: Experience of a Single Institution

    Directory of Open Access Journals (Sweden)

    Tamas Solymosi

    2016-01-01

    Full Text Available The clinical and pathological presentation of thyroid nodules among younger and adult patients was compared in an iodine-deficient (ID region. Data of 3,010 consecutive patients younger than 20 years and 3,010 patients older than 20 years were compared. The proportion of nodular goiters (22.8% versus 39.3%, the ratio of surgically treated nodules (33.2% versus 15.2%, and the proportion of malignant nodules (4.3% versus 2.1% among diseased patients differed significantly between the two groups (younger versus adult. Nine papillary and 1 medullary carcinoma were found among children, while 15 papillary, 2 follicular, 1 insular, 1 anaplastic, and 1 medullary carcinomas occurred among adults. The ratio of follicular adenoma to hyperplastic nodules (3 : 1 to 1 : 1.67, the proportion of follicular variant (77.8% versus 26.7%, T4 tumors (77.8% versus 33.3%, and tumors with lymph node metastasis (88.9% versus 66.7% were significantly higher among younger papillary carcinoma patients. No malignancies occurred among spongiform and central type cysts. Similarly to iodine-sufficient regions, more nodules are malignant and carcinomas have a clinically more aggressive presentation in children in comparison with adult patients in ID. Taking the significantly greater proportion of adenomas and the lack of follicular carcinoma into account, a conservative approach has to be considered in follicular tumors among children.

  7. Prognostic influence of clinical and pathological factors in medullary thyroid carcinoma: a study of 53 cases

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    Lenine G. Brandão

    2009-01-01

    Full Text Available OBJECTIVES AND INTRODUCTION: Medullary thyroid carcinoma, a neoplasia of intermediate prognosis and differentiation, does not always respond predictably to known treatments. This study aimed to correlate the clinical progression of surgically treated patients with clinical and pathological data. METHODS: A total of 53 patients were followed for 75 months (mean average in tertiary-care hospital. The clinical status of patients at the end of the study period was characterized to determine correlations with a range of disease aspects. A value of p < 0.05 was considered statistically significant. RESULTS: Twenty-two patients (41.5% were alive and disease-free at the end of the follow-up period; twenty-three patients (43.4% had persistent disease; and eight patients (15.1% had recurrent disease. Four patients (7.6% died from medullary thyroid carcinoma with clinical and/or imaging evidence of neoplasia. The following aspects demonstrated statistically significant correlations with the final medical condition: positive initial cervical examination (p = 0.002; neoplastic extensions to the thyroid capsule (p = 0.004 and adjacent tissues (p = 0.034; cervical lymph node metastases (p < 0.001; diameter of neoplasia (p = 0.018; TNM (tumor, node and metastasis Stage (p = 0.001 and evidence of distant and/or cervical diseases in the absence of a cure (p = 0.011. Through logistic regression, the presence of cervical lymph node metastases was considered an independent variable (p < 0.001. CONCLUSIONS: Clinical and pathological aspects of patients with surgically treated medullary thyroid carcinomas are predictors of disease progression. Specifically, even treated cervical lymph node metastases are significantly correlated with disease progression.

  8. Survival advantage of partial over radical nephrectomy in patients presenting with localized renal cell carcinoma

    International Nuclear Information System (INIS)

    Partial nephrectomy (PN) preserves renal function and has become the standard approach for T1a renal cell carcinoma (RCC). However, there is still an ongoing debate as to which patients will actually derive greater benefit from partial than from radical nephrectomy (RN). The aim of this study was to retrospectively evaluate the impact of the type of surgery on overall survival (OS) in patients with localized RCC. Renal surgery was performed in 4326 patients with localized RCC (pT ≤ 3a N/M0) at six German tertiary care centers from 1980 to 2010: RN in 2955 cases (68.3%), elective (ePN) in 1108 (25.6%), and imperative partial nephrectomy (iPN) in 263 (6.1%) cases. The median follow-up for all patients was 63 months. Kaplan-Meier and Cox regression analyses were carried out to identify prognosticators for OS. PN was performed significantly more often than RN in patients presenting with lower tumor stages, higher RCC differentiation, and non-clear cell histology. Accordingly, the calculated 5 (10)-year OS rates were 90.0 (74.6)% for ePN, 83.9 (57.5)% for iPN, and 81.2 (64.7)% for RN (p < 0.001). However, multivariate analysis including age, sex, tumor diameter and differentiation, histological subtype, and the year of surgery showed that ePN compared to RN still qualified as an independent factor for improved OS (HR 0.79, 95% CI 0.66-0.94, p = 0.008). Even allowing for the weaknesses of this retrospective analysis, our multicenter study indicates that in patients with localized RCC, PN appears to be associated with better OS than RN irrespective of age or tumor size

  9. THE STUDY OF COLORECTAL CARCINOMA ASSOCIATED ANTIGEN LEA IN CLINICAL PATHOLOGICAL DIAGNOSIS

    Institute of Scientific and Technical Information of China (English)

    冯慧; 宋今丹

    2002-01-01

    Objective: To study the expression and the clinical significance of LEA in colorectal carcinoma. Methods: Immunohistochemistry S-P method to detect the expression of LEA and CEA in 140 colorectal cancer specimens and 100 non-cancerous colorectal specimens. Results: The expression of LEA is relative to tumor differentiation degree and exhibits higher selectivity in well-differentiated adeno-carcinoma (P0.05). Compared with CEA, the expression of LEA has lower positive rate in non-cancerous tissue (P<0.05). The positive rate of LEA in adenoma is much higher than surrounding non-cancerous mucosa and normal mucosa. In normal mucosa the positive rate of LEA is obviously lower than that of CEA (P<0.05). The expression of LEA and CEA has similar rule except in normal mucosa. In histological diagnosis of colorectal cancer the sensitivity of LEA is 82.9% and the specificity is 48%, while the sensitivity of CEA is 88.6% and the specificity is 35%. Conclusion: The expression of LEA is related to the differentiation degree of colorectal cancer tissue. LEA can be used as an auxiliary index for early diagnosis and a reference for the judgment of the malignancy degree of colorectal carcinoma, thus may be a new tumor marker with applicable clinic value.

  10. Clinical analysis of cases with hypopharyngeal carcinoma who underwent pharyngolaryngectomy and pharyngolaryngoesophagectomy

    International Nuclear Information System (INIS)

    Thirty-seven cases with hypopharyngeal carcinoma who underwent pharyngolaryngectomy and pharyngolaryngoesophagectomy in our department between 1991 and 2008 were clinically analyzed. The cases were equivalent to 31.4% of all hypopharyngeal cases. The ages of the cases ranged from 39 to 83 years old (mean: 65), and the ratio of males was 94.6%. The histopathology of all the cases was squamous cell carcinoma, and the most common clinical stage was stage VIA (67.6%) followed by stage III, stage II, and stage VIB. Regarding surgical procedures, 62.2% of the cases underwent pharyngolaryngectomy and 37.8% pharyngolaryngoesophagectomy. Postoperative radiotherapy was used in 62.2% of cases, and chemotherapy in 40.5%. Recurrence was observed in 37.8%, and the disease-specific 5-year survival rate was 58.5%. Since the prognosis of postoperative radiotherapy cases who were histopathologically high-risk was not significantly different from those of non-radiotherapy cases, postoperative radiotherapy was considered to be useful for these patients. Chemotherapy cases had significantly lower local recurrence rate and better prognosis, suggesting the effectiveness of multidisciplinary treatment including chemotherapy in the treatment of hypopharyngeal carcinoma. (author)

  11. Clinical relevance of copy number profiling in oral and oropharyngeal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Current conventional treatment modalities in head and neck squamous cell carcinoma (HNSCC) are nonselective and have shown to cause serious side effects. Unraveling the molecular profiles of head and neck cancer may enable promising clinical applications that pave the road for personalized cancer treatment. We examined copy number status in 36 common oncogenes and tumor suppressor genes in a cohort of 191 oropharyngeal squamous cell carcinomas (OPSCC) and 164 oral cavity squamous cell carcinomas (OSCC) using multiplex ligation probe amplification. Copy number status was correlated with human papillomavirus (HPV) status in OPSCC, with occult lymph node status in OSCC and with patient survival. The 11q13 region showed gain or amplifications in 59% of HPV-negative OPSCC, whereas this amplification was almost absent in HPV-positive OPSCC. Additionally, in clinically lymph node-negative OSCC (Stage I–II), gain of the 11q13 region was significantly correlated with occult lymph node metastases with a negative predictive value of 81%. Multivariate survival analysis revealed a significantly decreased disease-free survival in both HPV-negative and HPV-positive OPSCC with a gain of Wnt-induced secreted protein-1. Gain of CCND1 showed to be an independent predictor for worse survival in OSCC. These results show that copy number aberrations, mainly of the 11q13 region, may be important predictors and prognosticators which allow for stratifying patients for personalized treatment of HNSCC

  12. Oncocytic carcinoma of parotid gland: a case report with clinical, immunohistochemical and ultrastructural features

    Directory of Open Access Journals (Sweden)

    Giordano Giovanna

    2006-08-01

    Full Text Available Abstract Background Oncocytic carcinoma is an extremely rare neoplasm of the salivary glands. We report a case of oncocytic carcinoma arising in a parotid gland in a 66-year-old female. Method An excisional biopsy of the parotid tumor was performed. The specimen was submitted for histology and after fixation in formalin solution and inclusion in paraffin, 3–5 μm sections were stained with hematoxylin and eosin for conventional evaluation and Periodic acid Schiff stain. Immunohistochemical studies were performed using antibodies against mitochondrial antigen, keratin, S-100, alpha-actin, vimentin, alpha-1-antichymotrypsin as well as an ultrastructural analysis was performed. Results Frozen sections revealed an infiltrative growth pattern and the diagnosis of a malignant epithelial lesion was made. Permanent sections stained with haematoxylin and eosin revealed a neoplasm that had replaced a wide area of the parotid gland and had invaded subcutaneous adipose tissue. Perineural invasion was evident, but vascular invasion was not found. Neoplastic elements were large, round or polyhedral cells and were arranged in solid sheets, islands and cords. The cytoplasm was abundant, eosinophilic and finely granular. The nuclei were large and located centrally or peripherally. The nucleoli were distinct and large. Periodic acid Schiff stain demonstrated a granular cytoplasm. Immunohistochemistry demonstrated mithochondrial antigen, keratin, and chymotrypsin immunoreactivity in the neoplastic cells. Ultrastructural analysis revealed numerous mitochondria packed into the cytoplasm of the neoplastic cells. Thus, the final diagnosis was that of oncocytic carcinoma of parotid gland. Conclusion This neoplasm shows clinical, microscopical, histological and ultrastructural features of oncocytic carcinoma and this must be considered in the differential diagnosis of other proliferations in the parotid gland with abundant granular cytoplasm and metastatic oncocytic

  13. BRAT1 mutations present with a spectrum of clinical severity.

    Science.gov (United States)

    Srivastava, Siddharth; Olson, Heather E; Cohen, Julie S; Gubbels, Cynthia S; Lincoln, Sharyn; Davis, Brigette Tippin; Shahmirzadi, Layla; Gupta, Siddharth; Picker, Jonathan; Yu, Timothy W; Miller, David T; Soul, Janet S; Poretti, Andrea; Naidu, SakkuBai

    2016-09-01

    Mutations in BRAT1, encoding BRCA1-associated ATM activator 1, are associated with a severe phenotype known as rigidity and multifocal seizure syndrome, lethal neonatal (RMFSL; OMIM # 614498), characterized by intractable seizures, hypertonia, autonomic instability, and early death. We expand the phenotypic spectrum of BRAT1 related disorders by reporting on four individuals with various BRAT1 mutations resulting in clinical severity that is either mild or moderate compared to the severe phenotype seen in RMFSL. Representing mild severity are three individuals (Patients 1-3), who are girls (including two sisters, Patients 1-2) between 4 and 10 years old, with subtle dysmorphisms, intellectual disability, ataxia or dyspraxia, and cerebellar atrophy on brain MRI; additionally, Patient 3 has well-controlled epilepsy and microcephaly. Representing moderate severity is a 15-month-old boy (Patient 4) with severe global developmental delay, refractory epilepsy, microcephaly, spasticity, hyperkinetic movements, dysautonomia, and chronic lung disease. In contrast to RMFSL, his seizure onset occurred later at 4 months of age, and he is still alive. All four of the individuals have compound heterozygous BRAT1 mutations discovered via whole exome sequencing: c.638dupA (p.Val214Glyfs*189); c.803+1G>C (splice site mutation) in Patients 1-2; c.638dupA (p.Val214Glyfs*189); c.419T>C (p.Leu140Pro) in Patient 3; and c.171delG (p.Glu57Aspfs*7); c.419T>C (p.Leu140Pro) in Patient 4. Only the c.638dupA (p.Val214Glyfs*189) mutation has been previously reported in association with RMFSL. These patients illustrate that, compared with RMFSL, BRAT1 mutations can result in both moderately severe presentations evident by later-onset epilepsy and survival past infancy, as well as milder presentations that include intellectual disability, ataxia/dyspraxia, and cerebellar atrophy. © 2016 Wiley Periodicals, Inc. PMID:27282546

  14. Aristolochic acid nephropathy: epidemiology, clinical presentation, and treatment.

    Science.gov (United States)

    Luciano, Randy L; Perazella, Mark A

    2015-01-01

    Aristolochic acid (AA) is a compound extracted from the Aristolochia species of herbs. It has been used for centuries as a remedy for various illnesses and diseases. However, in the early 1990s in the setting of a weight loss herbal remedy, AA exposure was associated with a syndrome of kidney injury, termed aristolochic acid nephropathy (AAN). This entity is marked by elevated serum creatinine, significant anemia, and histopathologic changes demonstrating a hypocellular interstitial infiltrate with severe fibrosis. Progression towards end-stage renal disease (ESRD) is rapid, with most patients having chronic kidney disease for less than 2 years. In addition, AAN is associated with a 40-45 % prevalence of urothelial carcinomas. Treatment of AAN is limited to glucocorticoids that have been shown to delay progression in non-randomized trials. As most patients progress to ESRD, need for renal replacement therapy, as either dialysis or kidney transplant, usually ensues. However, given the high malignant potential, care must be taken to minimize future development of upper urinary tract cancers by performing prophylactic bilateral nephroureterectomies and aggressive cancer surveillance. PMID:25446374

  15. Clinical presentation and management of diabetes mellitus in pregnancy

    Directory of Open Access Journals (Sweden)

    Al-Azemi N

    2013-12-01

    Full Text Available Nasser Al-Azemi,1 Michael F Diejomaoh,1,2 Elisavet Angelaki,1 Asiya T Mohammed2 1Maternity Hospital, Shuwaikh, Kuwait; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Safat, Kuwait Objective: To evaluate the clinical presentation, management, and the outcome of diabetes mellitus in pregnancy. Methods: One hundred seventy-one patients with diabetes mellitus admitted between September 1, 2006, and June 30, 2008, to the labor room at Maternity Hospital in Kuwait for induction of labor made up the study population; while an equivalent number of patients without medical complications who also were admitted for induction of labor made up the control group. The patients were assessed at admission, and their medical data were extracted. The study and control patients were monitored through labor/puerperium, and the outcome was documented. Results: Gestational diabetes mellitus was diagnosed in 71.9% of the study patients, a past history of diabetes mellitus was recorded in 81.34% of the study patients, and 49.2% of the patients were admitted at 8–12 weeks of gestation for diabetic control. The mean weight gained in pregnancy was significantly higher for control patients (11.52±5.643 versus [vs] 9.90±5.757 kg/m2; P<0.009, and the body mass index of study patients was higher (32.00±6.160 vs 28.20±5.885 kg/m2; P<0.0001. Of the study population, 64.3% of the patients were managed with diet and increased physical activity and 35.7% with insulin, diet, and increased physical activity. The incidences of maternal morbidity in both study and control groups were comparable, and the incidence of preeclampsia was low, at 2.3%. The gestational age at delivery was higher in the control group (39.02±1.834 weeks vs 38.62±1.773 weeks; P<0.0001, and the percentage of cesarean deliveries was higher in the study population (44.4% vs 33.3%; P=0.046. The Apgar scores of the both groups were comparable and in the normal range, and the

  16. Expression of E-Cadherin in Oral Squamous Cell Carcinoma is Associated with Clinical Prognosis

    Institute of Scientific and Technical Information of China (English)

    Jianming Zhang; Wei Zhang; Ping Gao; Yanqiu Li; Changyi Li; Sakan Maeda

    2006-01-01

    OBJECTIVE To investigate the correlation of E-cadherin expression with clinicopathological parameters and prognosis of patients with oral squamous cell carcinoma.METHODS We examined the expression of the protein E-cadherin in 43 oral squamous cell carcinoma (SCC) surgical speciments by SABC immunohistochemistry.RESULTS There was a significant correlation between the level of Ecadherin expression and tumor stage (P=0.024), invasive pattern (P=0.009) and lymph node metastasis (P=0.023). No relation was found with age (P=0.084), sex (P=1.356) and differentiation (P=0.877). Using the Kaplan-Meier method we demonstrated that those cases which showed E-cadherin expression (-) or (+) had a significantly poorer prognosis compared those cases which showed expression (++) or (+++) (P= 0.0146).CONCLUSION E-cadherin, is an important indicator of clinical diagnoses and prognositic marker for oral SCC patients.

  17. Clinical study of 24 squamous cell carcinomas of the floor of the mouth

    International Nuclear Information System (INIS)

    We clinically analyzed 24 patients with squamous cell carcinoma of the floor of the mouth, comprising 10.8% of 222 patients with head and neck carcinoma treated between 1975 and 1996. The patients consisted of 22 males and 2 females with a mean age of 62 years. There were 5 stage II patients (20.8%), 7 stage III patients (29.2%), and 12 stage IV patients (50.0%). Initial treatment consisted mainly of surgery in 10 patients (41.7%), a combination of surgery and radiotherapy in 7 patients (29.2%), radiotherapy in 4 patients (16.6%), and chemotherapy in 3 patients (12.5%). The 5-year survival rate calculated by the Kaplan-Meier method was 67.2% for the entire group of 24 patients. The outcome was not good in patients with advanced tumors and tumors showing diffuse invasion. (author)

  18. LOCAL RECURRENCE OF TUBULOCYSTIC CARCINOMA 4 YEARS AFTER RENAL RESECTION (A CLINICAL OBSERVATION

    Directory of Open Access Journals (Sweden)

    M. V. Peters

    2014-08-01

    Full Text Available The paper describes a clinical case of a local recurrence of tubulocystic carcinoma (TCC in a 46-year-old man, a relatively good course (the relapse occurred after 4 years, who has been successfully operated on and is being followed up. This disease is a rare renal malignancy and, until recently, it has been referred to as collecting tubular carcinoma. However, this disease has come to be regarded as an independent nosological entity, by taking into account its certain morphological, immunohistohemical, and cytogenetic characteristics, as well as the nature of its course. About 80 TCC cases have been described to date. Further study of this disease and other rare renal malignancies will allow the more accurate elaboration of management tactics for such patients in terms of certain prognostic factors, which calls for a larger number of cases of this disease.

  19. Delay in diagnosis amongst carcinoma lung patients presenting at a tertiary respiratory centre

    Directory of Open Access Journals (Sweden)

    Ruchi Sachdeva

    2014-01-01

    Full Text Available Objective: To determine time delay from the onset of initial symptoms to diagnosis of primary lung cancer. Materials and Methods: Selected information was captured from 49 consecutive pathologically proven cancer lung patients presenting to a tertiary respiratory centre during 1 st January to 30 th June 2012 using semi-structured interview schedule. All patients underwent suitable protocol based diagnostic work-up and referral. Results: Background profile of patient was as follows: Male:Female = 7.1:1; mean age was 61.2 (±9.7 years; Nine out of 49 (18.4% patients were illiterate; Forty-three out of 49 (87.8% belonged to rural native place; Forty-three out of 49 (87.7% were smokers with 25 years as median pack-years. Histological profile showed that adenocarcinoma (40.8% was the predominant form followed by small cell carcinoma (32.7%. Time (median delay in diagnosis was 3.0 days (home remedies/quack therapy, 60.0 days (primary/secondary level and 8 days at tertiary level. Twenty seven of 49 patients (55.1% presented in stage-IV. Higher proportion of patients residing outside the district of study institute had longer delay in diagnosis but did not reach statistical significance (P > 0.05. The most important patient reasons for the delay in diagnosis was procrastinate/did not took symptoms seriously (19/49, 38.7%; no-body to escort (13/49, 26.5%, long distance (5/49, 10.2%, financial constraints (4/49, 8.1%, preferred local practitioner (2/49, 4.0%, family commitment/marriage (2/49, 4.0%, fear of death (1/49, 2.0% and no reason cited (3/49, 6.1%. Three patients were inadvertently diagnosed as tuberculosis and hence the delay. Conclusion: Patient presented at a higher stage within a short span of time; however, there is scope of increasing health system capacity at primary/secondary level including sensitization training, health communication and appropriate referral to higher center.

  20. Multi cranial nerve palsies as the presenting features of prostate carcinoma

    International Nuclear Information System (INIS)

    Full text: Cranial nerve palsies have previously been reported in metastatic prostate carcinoma, usually occurring late in the course of the disease. We describe the case of a 55-year-old man whose diagnosis of prostate cancer was made following investigation of multiple cranial nerve palsies.

  1. Metastatic follicular carcinoma of the thyroid presenting with thyrotoxic induced impaired control of diabetes mellitus.

    OpenAIRE

    Samanta, A; Burden, A C; Jones, G R; Nicol, N. T.

    1986-01-01

    We report a patient with pulmonary and bony metastases due to follicular carcinoma of the thyroid, occurring 12 years after the initial diagnosis. This was brought to light by worsening diabetic control due to thyrotoxicosis from functioning malignant thyroid tissue. Following radio-active iodine therapy, she remains well with good control of her diabetes.

  2. Survey for primary tumor site in patients with initial clinical presentation of bone metastasis

    International Nuclear Information System (INIS)

    Among the patients who were examined with bone scintigraphy between April 1985 and March 1991, there were 27 patients whose initial clinical manifestation was bone metastasis and who were surveyed for the primary tumor site. The primary tumor site could be identified in 20 patients (74%), consisting of 9 patients with lung cancer, 3 with prostate cancer, 3 with hepatoma, 2 with renal cancer, and one each with thyroid cancer, adrenal cancer, and pleural malignant mesothelioma. In 17 of the 20 patients, the primary site had been detected within two months after presentation. Examinations which were helpful in identifying the primary site included chest radiography, sputum cytology, abdominal sonography, serum prostatic acid phosphatase level and pathologic examination of biopsy specimens. 99mTc-pyridoxylenemethyl tryptophan (99mTc-PMT) scintigraphy was useful in the diagnosis of the hepatoma when accumulation was observed at the metastatic sites. In 2 patients, lung cancer had been recognized using follow-up chest, radiography 3 and 6 months after presentation, respectively. One patient was diagnosed at autopsy as having adrenal cancer. In 7 patients the primary site remains unknown. Histology examination of the biopsy specimen performed in 6 of these patients revealed 4 to be adenocarcinoma and 2 undifferentiated carcinoma. The average survival period of the 17 patients who died was 9.5 months. Four patients are alive, and the outcome in the remaining 6 could not be determined. (author)

  3. Clinical impacts of mesothelin expression in gastrointestinal carcinomas.

    Science.gov (United States)

    Einama, Takahiro; Kawamata, Futoshi; Kamachi, Hirofumi; Nishihara, Hiroshi; Homma, Shigenori; Matsuzawa, Fumihiko; Mizukami, Tatsuzo; Konishi, Yuji; Tahara, Munenori; Kamiyama, Toshiya; Hino, Okio; Taketomi, Akinobu; Todo, Satoru

    2016-05-15

    Mesothelin, C-ERC/mesothelin is a 40-kDa cell surface glycoprotein that is normally present on normal mesothelial cells lining the pleura, peritoneum, and pericardium. Moreover, mesothelin has been shown to be overexpressed in several human cancers, including virtually all mesothelioma and pancreatic cancer, approximately 70% of ovarian cancer and extra bile duct cancer, and 50% of lung adenocarcinomas and gastric cancer. The full-length human mesothelin gene encodes the primary product, a 71-kDa precursor protein. The 71-kDa mesothelin precursor is cleaved into two products, 40-kDa C-terminal fragment that remains membrane-bound via glycosylphosphatidylinositol anchor, and a 31-kDa N-terminal fragment, megakaryocyte potentiating factor, which is secreted into the blood. The biological functions of mesothelin remain largely unknown. However, results of recent studies have suggested that the mesothelin may play a role of cell proliferation and migration. In pancreatic cancer, mesothelin expression was immunohistochemically observed in all cases, but absent in normal pancreas and in chronic pancreatitis. Furthermore, the expression of mesothelin was correlated with an poorer patient outcome in several human cancers. The limited mesothelin expression in normal tissues and high expression in many cancers makes it an attractive candidate for cancer therapy. The present review discusses the expression and function of mesothelin in cancer cells and the utility of mesothelin as a target of cancer therapy. PMID:27190694

  4. Metastatic Renal Cell Carcinoma Masquerading as a Primary Ovarian Mass in a Post-Operative Case of Meningioma and Renal Cell Carcinoma

    OpenAIRE

    Sangita Bohara; Biswajit Dey; Swapnil Agarwal; Jyotsna Naresh Bharti; Nita Khurana; Poonam Sachdeva

    2015-01-01

    The clinical presentation of metastatic renal cell carcinoma to ovary is extremely rare as well as confusing due to its close resemblance to primary ovarian tumors, especially clear cell carcinoma. We present a case of metastatic renal cell carcinoma diagnosed in a 48-year-old female, who had renal cell carcinoma of the right kidney and right sphenoid wing meningioma of transitional type.

  5. Hyponatraemia: an overview of frequency, clinical presentation and complications.

    LENUS (Irish Health Repository)

    Thompson, Chris

    2012-03-01

    Hyponatraemia (defined as a serum sodium concentration <136 mmol\\/L) is the most frequently encountered electrolyte disturbance in clinical practice. It is classified according to volume status (hypovolaemia, hypervolaemia or euvolaemia), reflecting the relative proportions of water and sodium within the body. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is the most common cause of euvolaemic hyponatraemia. Although hyponatraemia is associated with poor prognosis and increased length of hospital stay, it is often poorly managed and sometimes underdiagnosed and undertreated. This article provides an overview of the frequency, pathophysiology and complications associated with this common clinical condition.

  6. Black raspberries in cancer clinical trials: Past, present and future

    Science.gov (United States)

    Kresty, Laura A.; Mallery, Susan R.; Stoner, Gary D.

    2016-01-01

    BACKGROUND Black raspberries (BRB) inhibit a broad range of cancers in preclinical models, including in vivo models of oral, esophageal, colon, breast and skin cancer. Promising preclinical results have led to clinical evaluations in cancer patients or patients at increased risk for cancer development. OBJECTIVE To summarize clinical investigations targeting cancer or precancerous lesions with BRB and discuss future directions. METHODS A thorough literature search was conducted through December 1, 2015 to identify all published studies evaluating BRB in cancer focused clinical trials. RESULTS Research investigating BRB in clinical settings report positive effects on preneoplastic lesions or cancers of the oral cavity, esophagus and colon. BRB treatment resulted in: histologic regression of oral intraepithelial neoplasia associated with improved histologic grade and significantly reduced loss of heterozygosity at tumor suppressor gene loci, modulated genes linked to RNA processing and growth factor recycling; in the colon, BRB inhibited FAP-associated polyp progression, demethylated tumor suppressor genes and improved plasma cytokine profiles; in Barrett’s patients, BRB consumption increased tissue levels of GST-pi and decreased 8-isoprostane, a marker of lipid peroxidation/oxidative stress. CONCLUSIONS The precise dose, duration and optimum mode of BRB delivery for cancer inhibition remains to be fully elucidated. Common themes across studies support that BRB are anti-proliferative, anti- inflammatory, reduce oxidative stress and restore tumor suppressive activity. Future directions are included in the conclusions section.

  7. Apocrine Ductal Carcinoma In Situ of the Breast Presented Mass with Morphological Change on Follow-Up Ultrasound: A Report of Case

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Gi Young; Kim Soo Jin; Park, Sung Hee; Lee, Sun Jin; Ryu, Han Suk; Jung, Yoon Yang [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2012-11-15

    Apocrine carcinoma in situ of breast is a rare, unique, and morphologically distinct type of breast carcinoma. Low-grade apocrine ductal carcinoma in situ (DCIS) and apocrine metaplasia with atypia are the pathologic spectrum of apocrine breast lesions. Differentiating these two lesions is difficult due to partial microscopic overlap. We describe a case of apocrine DCIS which presented an asymptomatic hypoechoic mass with morphological change on a follow up ultrasonography.

  8. Apocrine Ductal Carcinoma In Situ of the Breast Presented Mass with Morphological Change on Follow-Up Ultrasound: A Report of Case

    International Nuclear Information System (INIS)

    Apocrine carcinoma in situ of breast is a rare, unique, and morphologically distinct type of breast carcinoma. Low-grade apocrine ductal carcinoma in situ (DCIS) and apocrine metaplasia with atypia are the pathologic spectrum of apocrine breast lesions. Differentiating these two lesions is difficult due to partial microscopic overlap. We describe a case of apocrine DCIS which presented an asymptomatic hypoechoic mass with morphological change on a follow up ultrasonography.

  9. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    2011-02-01

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  10. Carcinomas basocelulares: estudo clínico e anatomopatológico de 704 tumores Basal cell carcinomas: anatomopathological and clinical study of 704 tumors

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    Aurilene Monteiro Bandeira

    2003-02-01

    ório histopatológico.BACKGROUND: A retrospective and anatomopathological study was performed on 704 basal carcinomas of 623 patients, diagnosed from 1991 to 1996, at the Dermatopathology section of the Dermatology Clinic of the Hospital das Clinicas, UFPE and at a private dermatopathology laboratory in the city of Recife. OBJECTIVE: To characterize the clinical and anatomopathological aspects of the basal cell carcinomas diagnosed by the two services of Pernambuco region. METHODS: For the clinical study, the data were collected from the patient files and for the anatomopathological, macro and microscopic study a revision was made of the histological specimens. For determination of vertical growth, methods were used based on Clark and Breslow's histoprognostic techniques applied to malignant melanoma. RESULTS: Clinical: the highest incidence was in the feminine sex (55.7% and in the 55 to 72-year-old age group. Disease duration was highly variable, ranging from one month to 40 years, and the head was the most frequent topographical area (73.8%, mainly nasal (21.1% and zygomatic (18.5%. The nodular pigmented form (47.4% was found most frequently and the size of the lesions did not depend on the disease duration. Histologically the patterns considered based only on the parenchymal arrangements, were the adenoid, compact, plexiform Pinkus fibroepithelioma, pseudocystic, reticulated, superficial and trichoepithelioid, though predominantly the adenoid form (28.3%. The mean growth involved 2/3 of the reticular dermis (32.4%, and the deepest tumors presented intense fibroplasia. There was concomitance of several cellular types within a single tumor and melanin pigment was found mostly in the trichoepithelioid type. CONCLUSION: The clinical and anatomopathological characterization of the basal cell carcinomas is of fundamental importance at these services, where there is no major difference between groups, calling attention to behavioral definitions and propositions for the

  11. Applications of PET CT in clinical practice: Present and future

    Science.gov (United States)

    Costa, Durval Campos

    2007-02-01

    Radionuclide imaging and specially positron emission tomography (PET) has already demonstrated its benefits in three major medical subjects, i.e. neurology, cardiology and particularly clinical oncology. More recently the combination of PET and X-ray computed tomography (CT) as PET-CT led to a significant increment of the already large number of clinical applications of this imaging modality. This "anatomy-metabolic fusion" also known as Metabolic Imaging has its future assured if we can: (1) improve resolution reducing partial volume effect, (2) achieve very fast whole body imaging, (3) obtain accurate quantification of specific functions with higher contrast resolution and, if possible, (4) reduce exposure rates due to the unavoidable use of ionizing radiation.

  12. Pathological clavicular fracture as ifrst presentation of renal cell carcinoma:a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Yan Kong; Jin Wang; Huan Li; Peng Guo; Jian-Fa Xu; He-Lin Feng

    2015-01-01

    Renal cell carcinoma (RCC) accounts for approximately 3%of all cancer cases. RCCs usually metastasize to the lungs, bones, liver, or brain. Only<1%of patients with bone metastases manifested clavicular RCC metastases. hTus, clavicular metastasis as the initial presentation of RCC is extremely rare. We report a patient with RCC metastasis to the letf clavicle, which was ifrst presented with pain caused by a pathological fracture. Magnetic resonance image revealed a renal tumor, and technetium-99m–methylene diphosphonate bone scintigraphy showed multiple osseous metastases. The patient eventually underwent surgery to remove the lateral end of the letf clavicle and right kidney. Histopathology revealed renal tumor and clear cell carcinoma in the clavicle. Finally, we review 17 cases of clavicular metastases originating from different malignancies.

  13. The valuation of radium contact irradiation within the present radiotherapy of vocal cord carcinoma

    International Nuclear Information System (INIS)

    Referring to the comparison of the results after telegamma irradiation and after radium contact irradiation of vocal cord carcinomas the valuation of radium contact irradiation is discussed in the radiotherapy of malignant laryngeal tumours limited to the glottis area. The probable reasons are exposed with regard to the evident superiority of radium contact irradiation in the submitted collectives (preceding removal of endoscopic tumours, safety of tumour-suitable application of radiation, protracted continuous irradiation during 6 to 8 days). The slight and transient radioreaction of larynx tissues allows an unobjectionable tumour follow-up and explains the good results in respect of preservation of voice function. In future, therefore more consideration should again be given to radium contact irradiation in the radiotherapy of vocal cord carcinomas. (orig.)

  14. Clinical presentation of anxiety among patients with epilepsy

    OpenAIRE

    Lopez-Gomez, Mario

    2008-01-01

    M López-Gómez1, M Espinola2, J Ramirez-Bermudez3, I E Martinez-Juarez4, A L Sosa51Departments of Neurology; 2Neuropsychiatry; 3Clinical Research; 4Epilepsy, and 5Cognition and Behavior, National Institute of Neurology and Neurosurgery of Mexico, Delegación Tlalpan, MéxicoAbstract: Different factors have been related with interictal anxiety, reported in 10%–25% of patients with epilepsy. We determined the frequency of interictal anxiety in ...

  15. Metastatic squamous cell carcinoma from hand skin causing small bowel obstruction: an unusual case presentation

    OpenAIRE

    Li, Ruixin; Chen, Zihua; Wen, Qiaocheng; Chen, Zhikang

    2014-01-01

    The small bowel rarely suffers from metastatic tumors from outside the abdomen. Small bowel obstructions caused by the metastatic spread of squamous cell carcinoma (SCC) of the hand to the intestines are even rarer. A 71-year-old man with intermittent abdominal distension and pain for 4 months was diagnosed with partial bowel obstruction. The patient underwent a video capsule endoscopic examination; however, the patient was unable to pass the capsule, which worsened the abdominal distension. ...

  16. Metastatic Renal cell Carcinoma Presenting as a clear-cell Tumor in Tongue: A Case Report

    OpenAIRE

    Hamid Abbaszadeh-Bidokhty; Mina Motallebnejad; Mahdieh Rajabi-Moghaddam

    2014-01-01

    Introduction: Metastatic lesions of the oral cavity are extremely rare, accounting for approximately 1% of all malignant oral tumors. The most common primary sources of metastatic tumors in the oral region are, from the most to the least common, the breast, lung, kidney, bone, and colon. Renal cell carcinoma accounts for nearly 3% of all adult malignancies. It usually metastasizes to the lungs, bone, adrenal glands, and regional lymph nodes. The incidence of metastasis from renal cell carcino...

  17. A 76 year old male with an unusual presentation of merkel cell carcinoma

    Directory of Open Access Journals (Sweden)

    Joel C. Acab

    2016-01-01

    Conclusion: With initial unsuccessful treatment, his lesion was excised and pathological evaluation reported Merkel Cell Carcinoma (MCC. Despite further surgical excision and adjuvant chemotherapy, increased hyper metabolism was found in the left descending colon and left prostate of unknown etiology. There have been reports of metastasis of primary MCC to the small bowel mesentery; therefore new focal hyper metabolism cannot be delineated precisely as unrelated to MCC until biopsy and histochemical staining are performed.

  18. Intussusception due to caecal carcinoma in a young man: unusual cause of presentation a case report

    Directory of Open Access Journals (Sweden)

    Ajay Ashok Gujar

    2015-12-01

    Full Text Available A young 26 year male patient admitted with colicky pain in right iliac fossa with well palpable tender lump. After radiological investigation lump was diagnosed as ileocaecal intussusception. Patient underwent laparoscopy which diagnosed as intussusception due to caecal carcinoma. Laparoscopy again proved to be useful diagnostic tool over imaging techniques in this case. Laparoscopic assisted surgery of right radical hemicolectomy done successfully. [Int J Res Med Sci 2015; 3(12.000: 3901-3903

  19. Cytokeratin-positive interstitial reticulum cell sarcoma: Extranodal presentations mimicking carcinoma

    Directory of Open Access Journals (Sweden)

    Shirley Sundersingh

    2013-01-01

    Full Text Available Cytokeratin-positive interstitial reticulum cell (CIRC sarcoma is a rare type of dendritic cell tumor derived from a subset of fibroblastic reticular cells. Expression of cytokeratins and extranodal location of these tumors can lead to a misdiagnosis of carcinoma. We report two cases of CIRC sarcomas primarily involving the scalp and breast. Patients were referred with an initial diagnosis of carcinoma. Case 1 underwent wide local excision of the scalp tumor with left posterolateral neck dissection. Case 2 had modified radical mastectomy for the tumor in left breast. Histopathological examination of both specimens showed an epithelioid to spindle cell malignant tumor that co-expressed CK 8, CK 18, vimentin, and smooth muscle actin. A diagnosis of CIRC sarcoma was made. Pathologists should be aware of this subset of dendritic cell sarcoma. Carcinomas, other sarcomas of the accessory dendritic cell family, and poorly differentiated malignant tumors have to be ruled out by combination of morphology, immunohistochemistry, and electron microscopic studies.

  20. Cutis verticis gyrata in a patient with multiple basal cell carcinomas; case presentation and review of the literature

    OpenAIRE

    Simona-Roxana Georgescu; Maria Isabela Sârbu; Cristina-Iulia Mitran; Mădălina-Irina Mitran; Alice Rusu; Vasile Benea; Mircea Tampa

    2016-01-01

    Cutis verticis gyrata is a rare disease characterized by convoluted folds and deep furrows of the scalp, resembling the gyri and sulci of the cerebral cortex. Basal cell carcinoma is the most frequent cancer in Caucasians, patients frequently presenting multiple tumors. We report the case of a 62 year old male, Caucasian patient, from the urban area, who addressed the dermatology department of our hospital for multiple tumors located on the face and upper trunk. A careful examination revealed...

  1. Clinical analysis of post-irradiation sensorineural hearing loss in patients suffering from nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the incidence of post-irradiation sensorineural hearing loss (SNHL) in patients suffering from nasopharyngeal carcinoma and to evaluate its potentially contributing factors. Methods: Pure tonetest and impedance audiography were carried out in patients suffering from nasopharyngeal carcinoma with a post-irradiation follow-up time over 1 year. Additionally, the test results were combined with clinical data and analyzed retrospectively. Results: The follow-up time of all patients ranged from 12 to 94 months (median 53 months). The incidences of SNHL at low and high frequencies were 8% and 42% respectively. Univariate analysis showed that patient's age and follow-up time affected the incidence of SNHL at high frequencies (t=2.051, P=0.0269; t=2.978, P=0.0011), but sex, preirradiation subjective hearing loss, irradiation dose and chemotherapy including cisplatin had no significance. Multivariate analysis by Binary Logistic Regression revealed that the risk of SNHL was correlated with patient's age and follow-up time (P=0.02; P=0.009). Conclusion: Post-irradiation SNHL at high frequencies in patients suffering from nasopharyngeal carcinoma is more common than that at low frequencies. The independent prognostic factors for development of SNHL at high frequencies are patient's age and follow-up time. But the role of preirradiation hearing level ,irradiation dose and chemotherapy including cisplatin are not conclusive and further research is needed. (authors)

  2. DNA COPY PROFILE IN NASOPHARYNGEAL CARCINOMA AND ITS CORRELATION WITH CLINICAL STAGING

    Institute of Scientific and Technical Information of China (English)

    鄢践; 方嬿; 梁启万; 曾益新

    2001-01-01

    To detect genetic alterations in nasopharyngeal carcinoma (NPC) in Cantonese, the population with the highest incidence of NPC, and to correlate the findings with clinical staging. Methods: Comparative genomic hybridization (CGH) was performed on 35 primary nasopharyngeal carcinomas and a nonparametric χ2 test was used to analyze relationship between chromosome changes and clinical staging. Results: The identified common chromosomal alterations in NPC included gain of chromosomes 12q (21 cases, 60%), 4q (19cases, 43%), 3q (18 cases, 51%), 1q (15 cases, 43%),8q (14 cases, 40%), and 2q (12 cases, 30%). The most frequently detected loss of chromosomal materials involved chromosome 1p (24 cases, 69%), chromosome 3p (21 cases, 60%), 11q (20 cases, 57%), 14q (18 cases, 51%), 16q (14 cases, 40%), 13(12 cases, 34%), and 9p(11 cases, 31%). The high frequency (>50%) 4q gain and 1p loss were novel findings. Compared by nonparametric χ2 test, gains on 12q and 8q were found mainly in stages Ⅲ/Ⅳ and there were significant differences between two clinical stage groups ( stagesⅠ/Ⅱvs stages Ⅲ/Ⅳ). Conclusions: Current analysis has revealed a comprehensive profile of the chromosomal regions showing DNA copy number changes, which may harbor oncogenes or tumor suppressor genes involved in the development of primary NPC.

  3. Clinical Presentation of Mucopolysaccharidosis Type II (Hunter's Syndrome)

    OpenAIRE

    Chinawa, JM; Adimora, GN; Obu, HA; Tagbo, B; Ujunwa, F; Onubogu, I

    2012-01-01

    We present a rare case of mucopolysaccharidosis (MPS) with a typical presentation of mental retardation and absence of corneal clouding. The purpose of presenting this case report is to highlight the distinctive manifestation of MPS (Hunter's disease) and to provide a concise report of Hunter's disease for medical practitioners with the hope that such information will help identify boys earlier in the course of their disease. This report is of a 7-year-old boy who presented to the children ou...

  4. Comparison of the clinical and pathological features between patients with recurrent metastatic breast carcinoma and patients with initially metastatic breast carcinoma

    International Nuclear Information System (INIS)

    Objective was to compare initial metastatic breast carcinoma (MBC) with recurrent MBC and assess their biologic phenotypes and clinical behaviors. A comparison of clinical and biological characteristics and median overall survival times were assessed in the 251 patients with MBC at the Division of Medical Oncology, Ege University School of Medicine and the Division of radiation Oncology, Tepecik Government Hospital, Izmir, Turkey between 1995 and 2004. Hormone receptors, c-erb B-2,ki-67 and p53 expressions were performed by immunohistochemistry. Out of 251 MBC patients, 206 patients had recurrent MBC and 45 had initial MBC. Regarding survival there was no difference between the recurrent MBC group and the initial MBC group. The initial MBC group had a higher proportion of T4 tumors (46% versus 27%), a lower proportion of T-1-2 tumors (31% versus 55%; p=0.01), and higher percentage of patients with high Ki-67 expression (64% versus 49%; p=0.05). Multivariate analysis showed that T stage was an independent prognostic factor (p=0.02). Patients with initial MBC tended to present with larger tumors. This relationship can be explained by delayed diagnosis. The potential for reducing death rates from breast cancer is contingent on educational improvement and increased screening rates. (author)

  5. Clinical significance of erythropoietin receptor expression in oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Hypoxic tumors are refractory to radiation and chemotherapy. High expression of biomarkers related to hypoxia in head and neck cancer is associated with a poorer prognosis. The present study aimed to evaluate the clinicopathological significance of erythropoietin receptor (EPOR) expression in oral squamous cell carcinoma (OSCC). The study included 256 patients who underwent primary surgical resection between October 1996 and August 2005 for treatment of OSCC without previous radiotherapy and/or chemotherapy. Clinicopathological information including gender, age, T classification, N classification, and TNM stage was obtained from clinical records and pathology reports. The mRNA and protein expression levels of EPOR in OSCC specimens were evaluated by Q-RT-PCR, Western blotting and immunohistochemistry assays. We found that EPOR were overexpressed in OSCC tissues. The study included 17 women and 239 men with an average age of 50.9 years (range, 26–87 years). The mean follow-up period was 67 months (range, 2–171 months). High EPOR expression was significantly correlated with advanced T classification (p < 0.001), advanced TNM stage (p < 0.001), and positive N classification (p = 0.001). Furthermore, the univariate analysis revealed that patients with high tumor EPOR expression had a lower 5-year overall survival rate (p = 0.0011) and 5-year disease-specific survival rate (p = 0.0017) than patients who had low tumor levels of EPOR. However, the multivariate analysis using Cox’s regression model revealed that only the T and N classifications were independent prognostic factors for the 5-year overall survival and 5-year disease-specific survival rates. High EPOR expression in OSCC is associated with an aggressive tumor behavior and poorer prognosis in the univariate analysis among patients with OSCC. Thus, EPOR expression may serve as a treatment target for OSCC in the future

  6. Clinical features and prognostic factors in patients with bone metastases from hepatocellular carcinoma after liver transplantation

    Directory of Open Access Journals (Sweden)

    He Jian

    2011-11-01

    Full Text Available Abstract Background Little is known about the clinical features and prognostic factors of bone metastases of hepatocellular carcinoma (HCC following liver transplantation (LT. Methods All adult patients undergoing LT from 2001 to 2010 were reviewed. Patients with HCC bone metastases after LT received external beam radiotherapy(EBRT during this period. Demographic variables, laboratory values, and tumor characteristics were determined before LT and EBRT. Total radiation dose ranged from 8 to 60 Gy(median dose 40.0 Gy. Results The trunk was the most common site of bone metastases with finding of expansile soft-tissue masses in 23.3% of patients. Overall pain relief from EBRT occurred in 96.7% (29/30. No consistent dose-response relationship was found for palliation of with doses between 30 and 56 Gy (P = 0.670. The median survivals from the time of bone metastases was 8.6 months. On univariate and multivariate analyses, better survival was significantly associated with a better Karnofsky performance status (KPS and well-controlled intrahepatic tumor, but not with lower alpha-fetoprotein levels. The median time from LT to bone metastases was 7.1 months. Patients exceeding the Shanghai criteria presented with bone metastases earlier than those within the Fudan criteria. Patients with soft-tissue extension always had later bone metastases. The majority of deaths were caused by liver failure due to hepatic decompensation or tumor progression. Conclusion The prognostic factors of bone metastases of HCC following LT are KPS and well-controlled intrahepatic. Even though survival is shorter for these patients, EBRT provides effective palliation of pain.

  7. Digital Device in Postextraction Implantology: A Clinical Case Presentation

    OpenAIRE

    A E Borgonovo; F. Rigaldo; Battaglia, D.; Re, D.(INFN Sezione di Roma, Roma, Italy); A.B. Giannì

    2014-01-01

    Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of t...

  8. Most lobular carcinoma in situ and atypical lobular hyperplasia diagnosed on core needle biopsy can be managed clinically with radiologic follow-up in a multidisciplinary setting

    OpenAIRE

    Middleton, Lavinia P.; Sneige, Nour; Coyne, Robin; Shen, Yu; Dong, Wenli; Dempsey, Peter; Bevers, Therese B.

    2014-01-01

    We evaluated the efficacy of using standard radiologic and histologic criteria to guide the follow-up of patients with lobular carcinoma in situ (LCIS), lobular neoplasia (LN), or atypical lobular hyperplasia (ALH). Patients with high-risk benign lesions diagnosed on biopsy were presented and reviewed in a multidisciplinary clinical management conference from 1 November 2003 through September 2011. Associations between patient characteristics and rates of upgrade were determined by univariate...

  9. Patient with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV: epidemiological, clinical and therapeutic results after 14 years of follow-up

    OpenAIRE

    Casanovas-Taltavull, Teresa; Ribes, Josepa; Berrozpe, Ana; Jordan, Sara; Casanova, Aurora; Sancho, Concha; Valls, Carles; Bosch, F. Xavier

    2006-01-01

    Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus (HBV) infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood. In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived wit...

  10. Clinical presentation, allergens, and management of wheat allergy.

    Science.gov (United States)

    Quirce, Santiago; Boyano-Martínez, Teresa; Díaz-Perales, Araceli

    2016-05-01

    IgE-mediated allergy to wheat proteins can be caused by exposure through ingestion, inhalation, or skin/mucosal contact, and can affect various populations and age groups. Respiratory allergy to wheat proteins is commonly observed in adult patients occupationally exposed to flour, whereas wheat food allergy is more common in children. Wheat allergy is of growing importance for patients with recurrent anaphylaxis, especially when exercise related. The diagnosis of wheat allergy relies on a consistent clinical history, skin prick testing with well-characterized extracts and specific IgE tests. The accuracy of wheat allergy diagnosis may be improved by measuring IgE responses to several wheat components. However, a high degree of heterogeneity has been found in the recognition pattern of allergens among patient groups with different clinical profiles, as well as within each group. Thus, oral provocation with wheat or the implicated cereal is the reference test for the definitive diagnosis of ingested wheat/cereal allergy. PMID:26800201

  11. Giant intracranial aneurysms: development, clinical presentation and treatment

    International Nuclear Information System (INIS)

    The natural history of giant intracranial aneurysms are grave. More than 50% of patients suffer from rupture of these aneurysms and mortality is >60% in 2 years. Modern technology and advancement of knowledge in neurosurgery and interventional neuroradiology have altered its natural course for the better. As many reports have shown, the majority of these aneurysms can be treated either by surgery or by endovascular approach, even though morbidity is higher than when treating smaller aneurysms. Certain aneurysms are more suitable to direct surgical clipping and others may have better chances of good clinical outcome by endovascular treatment. It is imperative to analyse the location, morphology, hemodynamics and circulation of normal brain of each aneurysm before the mode of treatment is decided. Needless to say, the individual patient's age, neurological and medical condition should be considered. For endovascular treatment, application of each technique, endosaccular occlusion or parent artery occlusion depends on the aneurysm location and geometry as well as its pathology. Several reports indicated that clinical outcome is better in patients treated by parent artery occlusion since it eliminates any blood flow to the aneurysm and it provides a more effective reduction of the mass effect. However, not all parent arteries can be sacrificed. In addition, endosaccular treatment is effective in preventing haemorrhage if the aneurysm is not re-canalised. It is also demonstrated that symptoms of mass effect can be reversed by endosaccular coiling. The patients who are treated this way should be closely monitored for re-canalisation

  12. Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sarag Aboujafar Boukhar

    2015-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.

  13. Cryotherapy is associated with improved clinical outcomes of sorafenib for the treatment of advanced hepatocellular carcinoma

    OpenAIRE

    Yang, Yongping; LU, YINYING; Wang, Chunping; Bai, Wenlin; Qu, Jianhui; Chen, Yan; Chang, Xiujuan; An, Linjing; Zhou, Lin; Zeng, Zhen; Lou, Min; LV, JIYUN

    2011-01-01

    Sorafenib may prolong survival in patients with advanced hepatocellular carcinoma (HCC), but with limited efficacy. The present study aimed to assess the safety and efficacy of sorafenib combined with cryotherapy (cryoRx) for the treatment of advanced HCC. A total of 104 patients met the following criteria: advanced HCC without distant metastasis, presence of portal vein thrombosis, Child-Pugh class A or B and life expectancy of at least 12 weeks. All patients were randomly assigned to sorafe...

  14. Clinical relevance of the tumor microenvironment and immune escape of oral squamous cell carcinoma

    OpenAIRE

    Eckert, Alexander W.; Wickenhauser, Claudia; Salins, Paul C.; Kappler, Matthias; Bukur, Juergen; Seliger, Barbara

    2016-01-01

    Background Changes in the tumor microenvironment and immune surveillance represent crucial hallmarks of various kinds of cancer, including oral squamous cell carcinoma (OSCC), and a close crosstalk of hypoxia regulating genes, an activation of chemokines and immune cells has been described. Methods A review about the pivotal role of HIF-1, its crosstalk to various cornerstones in OSCC tumorigenesis is presented. Results Hypoxia is a frequent event in OSCC and leads to a reprogramming of the c...

  15. Development of uterine neoplasms following radiotherapy for carcinoma of uterine cervix: a clinical evaluation of 47 patients

    International Nuclear Information System (INIS)

    Objective: To analysis the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods: The clinical data of 47 patients of uterine neoplasm developed following radiotherapy for uterine cervical carcinoma were retrospectively reviewed. Results: The median age on diagnosis of uterine neoplasms was 62 years (range 38-77), and the median latency from the initial therapy to the development of uterine neoplasm was 14 years (range 5-35). Thirty of 47 patients had endometrial carcinoma, of which 3 were uterine papillary serous carcinoma(UPSC). Seventeen of 47 patients had uterine sarcoma, all of which were carcinosarcoma. The distribution by stage, grade, and histology of 30 patients with endometrial carcinoma was: stage Ib, 1 patient; stage Ic, 2 patients; stage II, 6; stage III a, 4; stage III b, 2; stage III c, 11; stage IV, 4; grade 1, 2 patients; grade 2, 9; grade 3 (include 3 UPSC patients), 17; unknown grade, 2; endometriod, 27; UPSC, 3. Seven of 30 patients with en- dometrial carcinoma deleloped recurrence, at median time of 24 months. Their median survival time was 26 m. The overall 3- and 5-year survival rate was 60% and 38%, respectively. Of the 17 patients with uterine sarcoma, the median survival was 10 months. Six patients developed recurrence, at a median time of 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rate was 12% and 0, respectively. Conclnsions: The main uterine neoplasm developed after radiotherapy for uterine cervical carcinoma is endometrial carcinoma, of which there is a preponderance of high-risk histological subtype and poor prognosis. Most of the uterine sarcoma which occur following radiation therapy for uterine cervical carcinoma is carcinosarcoma and its prognosis is very poor. (authors)

  16. Clinical presentation of pertussis in fully immunized children in Lithuania

    Directory of Open Access Journals (Sweden)

    Bernatoniene Genovaite

    2005-05-01

    Full Text Available Abstract Background In Lithuania, the vaccination coverage against pertussis is high. Nevertheless, there is a significant increase in pertussis cases in fully immunized children. The aim of our study was to determine the frequency of classical symptoms of laboratory confirmed pertussis and describe its epidemiology in children fully vaccinated against pertussis. Methods From May to December 2001, 70 children aged 1 month to 15 years, suffering from prolonged cough were investigated in the Centre of Paediatrics, Vilnius University Children's Hospital. The collected information included personal data, vaccination history, clinical symptoms of the current illness, and treatment before hospitalization. At the admission to the hospital blood samples were taken from all studied children for Bordetella pertussis IgM and IgA. Results A total of 53 (75.7% of the 70 recruited patients with prolonged cough showed laboratory evidence of pertussis. 32 of them were fully vaccinated with whole cell pertussis vaccine (DTP. The age of fully vaccinated patients varied from 4 to 15 years (average 10.9 ± 3.1; median 11. The time period between the last vaccination dose (fourth and the clinical manifestation of pertussis was 2.6–13 years (average 8.9 ± 3.0; median 9. More than half of the children before the beginning of pertussis were in contact with persons suffering from long lasting cough illness in the family, school or day-care center. The mean duration from onset of pertussis symptoms until hospitalization was 61.4 ± 68.3 days (range, 7 to 270 days; median 30. For 11 patients who had had two episodes (waves of coughing, the median duration of cough was 90 days, and for 21 with one episode 30 days (p Conclusion Fully vaccinated children fell ill with pertussis at the median of 11 years old, 9 years following pertussis vaccination. More than half of the children could catch pertussis at home, at school or day-care center. Clinical picture of pertussis in

  17. Large bowel obstruction resulting from bladder transitional cell carcinoma metastasis: a common cancer presenting in an uncommon manner.

    Science.gov (United States)

    Rohloff, Matthew; VandenBerg, Todd; MacMath, Terry

    2015-01-01

    Transitional cell carcinoma (TCC) and large bowel obstructions are both common disease processes typically considered unrelated. Presented below is the case of a 49-year-old male with a large bowel obstruction caused by a bladder TCC metastasis. One year prior to large bowel obstruction presentation, the patient had a T2, Grade III TCC of the bladder with no nodal involvement or metastasis, which was removed via radical cystoprostatectomy. This case serves as a reminder that cancer, despite common pathogenesis patterns, can present in atypical ways. PMID:26197806

  18. Sinonasal carcinoma presenting as chronic sinusitis and sequential bilateral visual loss

    Directory of Open Access Journals (Sweden)

    Wei-Yu Chiang

    2015-01-01

    Full Text Available Sinonasal undifferentiated carcinoma-related rhinogenic optic neuropathy is rare and may lead to visual loss. To the best of our knowledge, this is the first report of bilateral sequential visual loss induced by this etiology. It is important to differentiate between chronic sinusitis and malignancy on the basis of specific findings on magnetic resonance images. Surgical decompression with multidisciplinary therapy, including steroids, chemotherapy, and radiotherapy, is indicated. However, no visual improvement was noted in this case, emphasizing the rapid disease progression and importance of early diagnosis and treatment.

  19. CNS Cavernous Hemangioma; Imaging, Clinical Presentation and Related Anatomophysiology

    Directory of Open Access Journals (Sweden)

    Jalal Jalal Shokouhi

    2009-01-01

    Full Text Available "nClinical and imaging judgement or decision: "n- Is it a CH “CM, CA“? "n- Is it solitary, multiple or familial? "n- Is there an associated venous malformation? "n- Are there risks and consequences of hemorrhage? "n- Is the anatomic location critical and life threatening? "nCavernous malformation is a low pressure, slow flowing malformation and composes 10 – 15 % of vascular malformations. Cavernous angioma consists of enlarged sinusoidal vascular spaces, a compact mass in the brain and spinal cord, the endothelial lining is weak and blood element leakage is frequent.Calcification is possible "X – ray CT ". 75% located in the brain and 25 % in the posterior fossa and brain stem. "nAll 50% of cases are multiple and this form is familial in 80 % of cases “possibility combined with cord cavernoma“. "nExtra – medullary and extra – paranchymal forms are rare. "n- 40-60 % of the patients demonstrate seizure because of hemorrhage inside the cavernoma. "n10 – 15 % of complicated patients show significant clinical signs especially in the brain stem."n Imaging: "n1- X-ray CT: Isodense or hyperdense with frequent and heavy calcification . "nEnhanced CT may show the degree of enhancement. "n2 – By MRI: T1 may be isointense but in case of hemorrhage there is bright methemoglobin inside. By T2 and flair a thin capsule and a rim of hemosiderin – ferritin "popcorn or mulberries" and shows enhancement "GD-GRE-MRI pulse". "nCompanion of venous angioma and cavernoma is possible. "nBleeding is more likely from cavernous malformations during pregnancy. "nConclusion: CT and MRI demonstrate all forms and sites of brain and spinal cord cavernomas. "nAttention is necessary for brain stem lesions especially during pregnancy."n Treatment: 1- Medial and serial MRI controls. "n2- Radiosurgery "Gama-knife", rare. "n3- Microsurgery, very rare Multiple forms of these lesions are demonstratable in 55 patients.  

  20. Present status of clinical deployment of glucokinase activators.

    Science.gov (United States)

    Nakamura, Akinobu; Terauchi, Yasuo

    2015-03-01

    Glucokinase is one of four members of the hexokinase family of enzymes. Its expression is limited to the major organs (such as the pancreas, liver, brain and the gastrointestinal tract) that are thought to have an integrated role in glucose sensing. In the liver, phosphorylation of glucose by glucokinase promotes glycogen synthesis, whereas in the β-cells, it results in insulin release. Studies of glucokinase-linked genetically-modified mice and mutations in humans have illustrated the important roles played by glucokinase in whole-body glucose homeostasis, and suggest that the use of pharmacological agents that augment glucokinase activity could represent a viable treatment strategy in patients with type 2 diabetes. Since 2003, many glucokinase activators (GKAs) have been developed, and their ability to lower the blood glucose has been shown in several animal models of type 2 diabetes. Also, we and others have shown in mouse models that GKAs also have the effect of stimulating the proliferation of β-cells. However, the results of recent phase II trials have shown that GKAs lose their efficacy within several months of use, and that their use is associated with a high incidence of hypoglycemia; furthermore, patients treated with GKAs frequently developed dyslipidemia. A better understanding of the role of glucokinase in metabolic effects is required to resolve several issues identified in clinical trials. PMID:25802718

  1. [Cutaneous leishmaniasis as travelers' disease. Clinical presentation, diagnostics and therapy].

    Science.gov (United States)

    von Stebut, E; Schleicher, U; Bogdan, C

    2012-03-01

    Leishmaniasis is a disease with worldwide increasing incidence, which in Germany is almost exclusively observed in patients who have travelled to classical endemic regions such as the Mediterranean basin. Cause of the disease is an infection with protozoan parasites of the genus Leishmania, which are transmitted by sand flies and replicate intracellularly within mammalian hosts. Depending on the inoculated parasite (sub-) species and the immune status of the host, a local cutaneous, diffuse cutaneous, mucocutaneous or visceral form of leishmaniasis will develop. Cutaneous leishmaniasis, which frequently appears only weeks after the bite of a sand fly, starts with the formation of a papule, which subsequently can turn into a skin ulcer. The latter may heal spontaneously after months leaving behind a scar or persist as chronic, non-healing cutaneous leishmaniasis. If cutaneous leishmaniasis is suspected, a sterile skin biopsy followed by appropriate diagnostic measures in a specialized laboratory to identify the pathogen should be performed. For the decision on the type of therapy, several clinical parameters (e.g. number and localization of lesions, immune status) and, most importantly, the underlying parasite (sub-) species need to be considered. Therapy can consist of a variety of topical measures or systemic drug treatment. A modern and safe vaccine does not yet exist. PMID:22422121

  2. Diabetic polyneuropathy: pathogenesis, classification, clinical presentation, and treatment

    Directory of Open Access Journals (Sweden)

    Marina Valentinovna Nesterova

    2013-11-01

    Full Text Available Diabetes mellitus (DM is a global epidemic followed by late complications as diabetic polyneuropathy (DPN and diabetic foot syndrome, leading to appreciable social and economic consequences. Virtually all patients with DM develop DPN in different periods. There is a clear correlation between the presence and magnitude of painful DPN and the duration of DM and the level of glycosylated hemoglobin and the severity of DPN. In spite of the abundance of theories of the development of DPN, its main identified pathogenetic factor is hyperglycemia. The literature gives no universal classification due to the variability of clinical symptoms. The main goals of treatment are to affect the pathogenesis of the disease and to prescribe symptomatic medications. The pathogenetic treatment of DPN includes compensation for carbohydrate metabolism and use of neurometabolic drugs. Pain from DPN may be controlled with antidepressants, anticonvulsants, local anesthetics and opioid analgesics. Although much evidence for the pathogenesis of peripheral nervous system injury has been recently accumulated, a universal standard for the effective therapy of DPN and the follow-up of these patients has not yet been developed.

  3. Pertussis in young infants: clinical presentation, course and prevention.

    Science.gov (United States)

    O'Riordan, A; Cleary, J; Cunney, R; Nicholson, A J

    2014-01-01

    Pertussis is a highly contagious disease caused by the Gram negative aerobic coccobacillus, Bordetella pertussis. It may present with severe symptoms and complications in infants and can pose a diagnostic challenge. This is a vaccine preventable illness covered by the Irish Childhood Immunisation Schedule. In 2011, a retrospective review was conducted of the records of infants, under six months, with a confirmed diagnosis of pertussis, presenting to Temple Street Children's University Hospital (TSCUH). A summery of notifications of pertussis nationally, from 2001 to 2012, was also examined as part of the study. This found that the rate of reported cases of pertussis has been increasing in Ireland. This national increase corresponds with a rising number of cases identified at TSCUH. Patients commonly presented severely ill with cyanosis and apnoea, on a background of prolonged cough. We found that pertussis was diagnosed rapidly in most cases however in all cases there was a delay to commencement of appropriate macrolide therapy. PMID:25226721

  4. Molecular biology of anal squamous cell carcinoma: implications for future research and clinical intervention.

    Science.gov (United States)

    Bernardi, Maria-Pia; Ngan, Samuel Y; Michael, Michael; Lynch, A Craig; Heriot, Alexander G; Ramsay, Robert G; Phillips, Wayne A

    2015-12-01

    Anal squamous cell carcinoma is a human papillomavirus-related disease, in which no substantial advances in treatment have been made in over 40 years, especially for those patients who develop disease relapse and for whom no surgical options exist. HPV can evade the immune system and its role in disease progression can be exploited in novel immunotherapy platforms. Although several studies have investigated the expression and inactivation (through loss of heterozygosity) of tumour suppressor genes in the pathways to cancer, no clinically valuable biomarkers have emerged. Regulators of apoptosis, including survivin, and agents targeting the PI3K/AKT pathway, offer opportunities for targeted therapy, although robust data are scarce. Additionally, antibody therapy targeting EGFR may prove effective, although its safety profile in combination with standard chemoradiotherapy has proven to be suboptimal. Finally, progress in the treatment of anal cancer has remained stagnant due to a lack of preclinical models, including cell lines and mouse models. In this Review, we discuss the molecular biology of anal squamous cell carcinoma, clinical trials in progress, and implications for novel therapeutic targets. Future work should focus on preclinical models to provide a resource for investigation of new molecular pathways and for testing novel targets. PMID:26678214

  5. Guidelines on radioiodine therapy for differentiated thyroid carcinoma. Impact on clinical practice

    International Nuclear Information System (INIS)

    Aim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing multicenter study differentiated thyroid carcinoma (MSDS) were analyzed. Patients, methods: patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pNO/1/x MO/x (UICC, 5th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4-6 weeks), in 33% and 84% with regard to 131I activity for RIT (1-3 vs. 1-4 GBq; ±10%), and in 16% and 60% with regard to 131I activity for WBS (100-300 vs. 100-400 MBq; ±10%). Conclusions: the 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes. (orig.)

  6. EEC syndrome sans clefting: Variable clinical presentations in a family

    Directory of Open Access Journals (Sweden)

    Thakkar Sejal

    2007-01-01

    Full Text Available Ectrodactyly, ectodermal dysplasia and cleft palate/lip syndrome (EEC is a rare autosomal dominant syndrome with varied presentation and is actually a multiple congenital anomaly syndrome leading to intra- and interfamilial differences in severity because of its variable expression and reduced penetrance. The cardinal features include ectrodactyly, sparse, wiry, hypopigmented hair, peg-shaped teeth with defective enamel and cleft palate/lip. A family comprising father, daughter and son presented to us with split hand-split foot deformity (ectrodactyly, epiphora, hair changes and deafness with variable involvement in each family member.

  7. AMELANOTIC MELANOMA WITH ATYPICAL CLINICAL PRESENTATION AND MULTIPLE METASTASIS

    Directory of Open Access Journals (Sweden)

    Revathy

    2014-11-01

    Full Text Available A 52 year old woman presented with a history of asymptomatic skin lesions over left leg for the past 4 months. On examination she had multiple skin coloured papules and plaques over left leg. Oedema was also seen over left leg. Histopathology and immunohistochemistry proved the diagnosis of malignant melanoma. Radiological investigation showed metastasis to lung, liver and brain. The patient was asymptomatic at the time of admission but she developed rapid metastasis within a very short span of time. This case is reported for the rare atypical presentation of malignant melanoma.

  8. Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy

    International Nuclear Information System (INIS)

    To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. 210 patients with locally advanced rectal carcinoma (cT3-4 or cN+) treated with neo-CRT followed by total mesorectal excision. Treatment outcomes were compared according to clinical and pathological stage. Overall survival (OS), disease free survival (DFS) among patients with different clinical stage and pathological stage after neo-CRT. The median follow-up time was 47 months (range, 14–98 months). Clinical T stage was associated with 5 year OS (p = 0.042) and 5 year DFS (p = 0.014) while clinical N stage was not associated with 5 year OS (p = 0.440), 5 year DFS (p = 0.711). Pathological T stage was associate with 5 year OS (p = 0.001) and 5 year DFS (p = 0.046); and N stage was associated with 5 year OS (p = 0.001), 5 year DFS (p = 0.002). The pathological stage was further classified into three groups: ypT0–2N0 in 91 patients (43.3 %), ypT3–4N0 in 69 patients (32.9 %) and ypT0–4N+ in 50 patients (23.8 %). While pathological stage (ypT0–2 vs ypT3–4N0 vs ypT0–4N+) was associated with 5 year OS (87.9 %, 75.5 %, 56.7 %, p = 0.000), 5 year DFS (74.5 %, 77.4 %, 50.5 %, p = 0.003). Multivariate analysis showed that ypN stage was an independent prognostic factor for patients 5 year DFS. Pathological stage is strongly associated with treatment outcomes in patients with locally advanced rectal carcinoma treated with neo-CRT followed by total mesorectal excision, which may be used as guidance for further individualized treatment

  9. Small bronchioloalveolar carcinoma of the lung. High resolution CT analysis and clinical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Eiji; Kuriyama, Keiko; Kido, Shoji [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan)] [and others

    1999-01-01

    Since 1986, we have experienced 52 cases of resected small bronchioloalveolar carcinomas (BACs) less than 2 cm in diameter. All cases were compatible with type A or type B, using the histologic classification based on tumor growth patterns reported by Noguchi et al. We retrospectively reviewed their high-resolution CT findings. The characteristics of type A tumors (localized BACs) include well-defined margin, little air-bronchogram, little vascular indentation and marked areas of ground-glass opacities (GGO). Those of type B tumors (localized BACs with foci of collapse of alveolar structure) include ill-defined margin, marked air-bronchogram, marked vascular indentation and fewer areas of GGO than type A. Patients with localized BACs exhibit no significant differences in clinical aspects between type A and type B. The common clinical aspects include no gander dominance, lack of symptoms, few lymph node metastasis and no remote metastasis. (author)

  10. Small bronchioloalveolar carcinoma of the lung. High resolution CT analysis and clinical aspects

    International Nuclear Information System (INIS)

    Since 1986, we have experienced 52 cases of resected small bronchioloalveolar carcinomas (BACs) less than 2 cm in diameter. All cases were compatible with type A or type B, using the histologic classification based on tumor growth patterns reported by Noguchi et al. We retrospectively reviewed their high-resolution CT findings. The characteristics of type A tumors (localized BACs) include well-defined margin, little air-bronchogram, little vascular indentation and marked areas of ground-glass opacities (GGO). Those of type B tumors (localized BACs with foci of collapse of alveolar structure) include ill-defined margin, marked air-bronchogram, marked vascular indentation and fewer areas of GGO than type A. Patients with localized BACs exhibit no significant differences in clinical aspects between type A and type B. The common clinical aspects include no gander dominance, lack of symptoms, few lymph node metastasis and no remote metastasis. (author)

  11. Intracranial actinomycosis: Varied clinical and radiologic presentations in two cases

    Directory of Open Access Journals (Sweden)

    Sandeep Mohindra

    2012-01-01

    Full Text Available Two patients with primary actinomycotic brain infection are presented here. The first case had 2 predisposing factors, cardiac septal defect and chronic mastoiditis, whereas the second patient was a chronic smoker, belonging to a desert region. Both the patients were successfully managed with surgical debridement and prolonged administration of antibiotics.

  12. PET, Positron emission tomography: Presentation of a clinical case

    International Nuclear Information System (INIS)

    A patient with a solitary pulmonary nodule is presented. She was studied with PET using F-18 FDG. The metabolic images demonstrated increased uptake in the nodule and 2 additional areas suggestive of extension, not seen in anatomic diagnostic procedures. These findings were compatible with a malignant tumour with metastasis (au)

  13. Primary biliary cirrhosis: Pathophysiology, clinical presentation and therapy.

    Science.gov (United States)

    Purohit, Treta; Cappell, Mitchell S

    2015-05-01

    Primary biliary cirrhosis (PBC) is an autoimmune, slowly progressive, cholestatic, liver disease characterized by a triad of chronic cholestasis, circulating anti-mitochondrial antibodies (AMA), and characteristic liver biopsy findings of nonsuppurative destructive cholangitis and interlobular bile duct destruction. About 10% of PBC patients, however, lack AMA. A variant, called PBC-autoimmune hepatitis (AIH) overlap, is characterized by the above findings of PBC together with findings of elevated serum alanine aminotransferase, elevated serum immunoglobulin G, and circulating anti-smooth muscle antibodies, with liver biopsy demonstrating periportal or periseptal, lymphocytic, piecemeal necrosis. PBC is hypothesized to be related to environmental exposure in genetically vulnerable individuals. It typically occurs in middle-aged females. Prominent clinical features include fatigue, pruritis, jaundice, xanthomas, osteoporosis, and dyslipidemia. The Mayo Risk score is the most widely used and best prognostic system. Ursodeoxycholic acid is the primary therapy. It works partly by reducing the concentration and injury from relatively toxic bile acids. PBC-AIH overlap syndrome is treated with ursodeoxycholic acid and corticosteroids, especially budesonide. Obeticholic acid and fibrate are promising new, but incompletely tested, therapies. Liver transplantation is the definitive therapy for advanced disease, with about 70% 10-year survival after transplantation. Management of pruritis includes local skin care, dermatologist referral, avoiding potential pruritogens, cholestyramine, and possibly opioid antagonists, sertraline, or rifaximin. Management of osteoporosis includes life-style modifications, administration of calcium and vitamin D, and alendronate. Statins are relatively safe to treat the osteopenia associated with PBC. Associated Sjogren's syndrome is treated by artificial tears, cyclosporine ophthalmic emulsion to stimulate tear production; and saliva

  14. Squamous Cell Lung Carcinoma Presenting With Refractory Status Epilepticus: A Case Report of Paraneoplastic Limbic Encephalitis.

    Science.gov (United States)

    Hurley, Killian; Herron, Malcolm; McDermott, Sean; Farrell, Terence; O'Riordan, Deirdre

    2015-08-01

    Lung cancer-associated paraneoplastic syndromes affecting the central nervous system present significant diagnostic and treatment challenges. In this case, the patient presented with personality change, cognitive impairment, complex partial seizures, ataxia, dyspraxia, and dysphasia. Shortly after admission, the patient suffered refractory generalized tonic-clonic seizures and a decreased level of consciousness and required intubation, ventilation, and admission to the ICU. He was subsequently diagnosed with paraneoplastic limbic encephalitis based on recognized criteria, including a compatible clinical picture, elevated protein content in his cerebrospinal fluid with negative cytology, a positive positron emission tomography-computed tomography scan showing a right upper lobe tumor, and the exclusion of other neuro-oncological complications. Histopathology confirmed the tissue diagnosis as squamous cell cancer. Initial immunotherapy with steroids and intravenous immunoglobulin and subsequent lobectomy and adjuvant chemotherapy were partially successful, leading to partial resolution of his cognitive impairment. This report highlights the diagnostic and therapeutic challenges of lung-related paraneoplastic syndromes. In addition, it illustrates the poor outcomes for patients and identifies squamous cell cancer as an extremely rare cause of paraneoplastic limbic encephalitis. PMID:25784771

  15. An unusual cause of a fall: an unusual presentation of lung carcinoma.

    Science.gov (United States)

    Kowa, Xin-Ying; Hyams, Catherine; Farrugia, Mark; Lightowlers, Sara

    2014-01-01

    An 80-year-old gentleman presented with a fall and subtle symptoms suggestive of a cerebellar lesion, on a background of hemiparesis due to a previous cerebral vascular accident. On admission it was thought that changes on a chest radiograph were consistent with a community-acquired pneumonia. A CT of the head showed a space-occupying lesion in the right cerebellum with surrounding oedema. A previous MRI of the brain performed 8 months earlier for investigation of dementia showed evidence of this lesion although it was significantly smaller and without midline shift; however, this had not been discussed on the MRI report. A subsequent CT of the thorax confirmed a thick-walled cavitating mass in the left upper lobe, with biopsy of this lesion and bronchial washings showing metaplastic and atypical cells suggestive of adenocarcinoma. This report highlights both the importance of accurate imaging reporting, even of incidental findings, and the insidious nature of lung malignancy and its broad clinical presentation. PMID:24811107

  16. Adenocarcinoma of the uncinate process of the pancreas: MDCT patterns of local invasion and clinical features at presentation

    Energy Technology Data Exchange (ETDEWEB)

    Padilla-Thornton, Amie E.; Willmann, Juergen K.; Jeffrey, R.B. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2012-05-15

    To compare the multidetector CT (MDCT) patterns of local invasion and clinical findings at presentation in patients with adenocarcinoma of the uncinate process of the pancreas to patients with adenocarcinomas in the non-uncinate head of the pancreas. We evaluated the two cohorts for common duct and pancreatic duct dilatation, mesenteric vascular encasement, root of mesentery invasion, perineural invasion and duodenal invasion. In addition, we compared the clinical findings at presentation in both groups. Common duct (P < 0.001) and pancreatic duct dilatation (P = 0.001) were significantly less common in uncinate process adenocarcinomas than in the non-uncinate head of the pancreas. Clinical findings of jaundice (P = 0.01) and pruritis (P = 0.004) were significantly more common in patients with lesions in the non-uncinate head of the pancreas. Superior mesenteric artery encasement (P = 0.02) and perineural invasion (P = 0.001) were significantly more common with uncinate process adenocarcinomas. Owing to its unique anatomic location, adenocarcinomas within the uncinate process of the pancreas have significantly different patterns of both local invasion and clinical presentation compared to patients with carcinomas in the non-uncinate head of the pancreas. (orig.)

  17. Initial Presentation of Renal Cell Carcinoma as a Metastatic Mass within the Masseter Muscle: A Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Eun; Lee, Han Bee; Cho, Woo Ho; Kim, Jae Hyung; Lee, Ji Hae; Kang, Min Jin [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kim, Hyun Jung [Dept. of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Renal cell carcinoma (RCC) is often concomitant with distant metastasis, and these metastases are the first sign of an otherwise occult primary. Whereas metastasis of RCC to the head and neck has been reported, metastasis to the masseter muscle, which is composed of skeletal muscle, is quite rare. We now report the case of a 66-year-old man who had a past history of pulmonary tuberculosis, with RCC metastasis of a well-defined intensely enhancing hypervascular mass in the masseter muscle as the initial presentation. We present the imaging findings of this case and a literature review about radiologic differential diagnosis of intramasseteric masses.

  18. EEC syndrome sans clefting: Variable clinical presentations in a family

    OpenAIRE

    Thakkar Sejal; Marfatia Yogesh

    2007-01-01

    Ectrodactyly, ectodermal dysplasia and cleft palate/lip syndrome (EEC) is a rare autosomal dominant syndrome with varied presentation and is actually a multiple congenital anomaly syndrome leading to intra- and interfamilial differences in severity because of its variable expression and reduced penetrance. The cardinal features include ectrodactyly, sparse, wiry, hypopigmented hair, peg-shaped teeth with defective enamel and cleft palate/lip. A family comprising father, daughter and son prese...

  19. Cowden Syndrome Presenting as Breast Cancer: Imaging and Clinical Features

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mirinae [Dept. of Radiology, Graduate School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Cho, Nariya; Moon, Hyeong Gon [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ahn, Hye Shin [Dept. of Radiology, Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2014-10-15

    Cowden syndrome is an uncommon, autosomal dominant disease which is characterized by multiple hamartomas of the skin, mucous membrane, brain, breast, thyroid, and gastrointestinal tract. The diagnosis of Cowden syndrome implicates an increased risk of developing breast cancer. We report a case of a 22-year-old woman with Cowden syndrome that presented as breast cancer with concomitant bilateral exuberant benign masses in both breasts.

  20. AN UNUSUAL CLINICAL PRESENTATION OF GROUP A STREPTOCOCCAL INFECTION

    OpenAIRE

    H.V., Prashanth; R.M, Saldanha Dominic; Shenoy, Shalini; Baliga, Shrikala

    2011-01-01

    After two decades of decline of Group A streptococcal infections, the recent years are witnessing a resurgence in the incidence and severity of infections caused by Group A Streptococcus including necrotizing fasciitis and streptococcal toxic shock syndrome sometimes with fatal outcomes. We present an unusual case of Group A streptococcal infection in a 4-year-old boy who did not have any predisposing factors for Group A streptococcal infection.

  1. Digital device in postextraction implantology: a clinical case presentation.

    Science.gov (United States)

    Borgonovo, A E; Rigaldo, F; Battaglia, D; Re, D; Giannì, A B

    2014-01-01

    Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient's discomfort. However, it is still necessary for scientific

  2. Digital Device in Postextraction Implantology: A Clinical Case Presentation

    Directory of Open Access Journals (Sweden)

    A. E. Borgonovo

    2014-01-01

    Full Text Available Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy. Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy. The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient’s discomfort. However, it is still necessary

  3. Renal cell carcinoma in childhood

    International Nuclear Information System (INIS)

    The authors present five cases of renal cell carcinoma in children, describing its aspects on excretory urography, ultra-sonography and computerized tomography. The clinical, pathological and radiological features are compared with those of the literature. (author)

  4. Clinical and histopathological profile of basal cell carcinoma in a population from Criciúma, Santa Catarina, Brazil Perfil clínico e histopatológico do carcinoma basocelular em amostra populacional de Criciúma, SC, Brasil

    OpenAIRE

    Letícia Pangendler Peres; Joana Zulian Fiorentin; Tamise da Silva Baptista; Deborah Grisolia Fuzina; Luiz Felipe de Oliveira Blanco

    2012-01-01

    Basal cell carcinoma is a local, invasive epidermal neoplasia, the most common type of which is nodular basal cell carcinoma. The objective of the present study was to evaluate the occurrence of basal cell carcinoma, characterizing its distribution in accordance with patients' age, gender, the site of the lesion and its histopathological characteristics. Anatomopathology reports of cases of basal cell carcinoma diagnosed in Criciúma, Santa Catarina, Brazil between June 2005 and June 2007 were...

  5. comparison of clinical features and CT findings between atypical thymoma and thymic carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the differences and the similarities of clinical presentations and CT features between type B3 thymoma (atypical thymoma) and type C thymoma (thymic carcinoma) in the WHO classification of thymic epithelial tumors. Methods: Complete CT findings of thirty cases of type B3 and seventeen cases of type C thymic epithelial tumors confirmed by histopathology according to WHO 2004 Classification System and clinical features including the prognosis of each case were reviewed retrospectively. Statistical analyses of the data for the age and the long diameter were performed with Independent-Samples t test between the two groups. Statistical analysis for gender, association with myasthenia gravis, method of the operation, contours, shapes, calcification,necrosis, enhancement pattern of the tumors on CT, presence of mediastinal lymphadenopathy, invasion of mediastinal fat, chest wall, pericardium, great vessel, pleural mediastinum, metastasis to the plural, pleural effusion, distant metastasis were performed with Fisher exact test. Kaplan-Meier method was employed for survival analysis. Results: Clinical data: the average age of type B3 group was significantly younger (t=-2.905, P=0.006). 90.0% (27/30) of patients in type B3 group were complicated by myasthenia gravis, while only 5.9% (1/17) of patients in type C group were complicated by myasthenia gravis. The difference between the two groups was statistically significant (P=0.000). The ratio of complete resection of type B3 group (80.0%) was significantly higher than that in type C group (P=0.001), 70.6% (12/17) of patients in type C group died within 2 years after surgical resection, while only 20.0% (6/30) of patients in type B3 group died within one to nine years after surgical resection. Three years' survival ratio of C group was 29.4%, and five years' survival ratio of C group was lower than 14.7%, which was significantly lower than B3 group five years' survival ratio was 94.7%), which was

  6. Periampullar y carcinoma presenting as duodenojejunal intussusception:a diagnostic and therapeutic dilemma

    Institute of Scientific and Technical Information of China (English)

    Mansoor Ahmed Madanur; Viswanath Reddy Mula; Dave Patel; Arunachalam Rathinaswamy; Ahmed Ali Madanur

    2008-01-01

    BACKGROUND: An intussusception is the invagination of one segment of the intestine into another. It is more common in children, but a rare clinical entity in adults, where the condition is almost always caused by tumors. METHODS: A 51-year-old female presented with symptoms of gastric outlet obstruction associated with signiifcant weight loss, but no jaundice. Routine hematological and biochemical investigation, including tumor markers, were normal. Abdominal ultrasound revealed duodenojejunal intussusception, and subsequent CT of the abdomen conifrmed it. RESULTS: She underwent a laparotomy, which conifrmed duodenojejunal intussusception. On reducing the intussusception and performing a duodenotomy, a periampullary mass was conifrmed. Hence, she underwent a pylorus-preserving pancreaticoduodenectomy. Histology conifrmed periampullary adenocarcinoma. CONCLUSIONS: Adult intussusceptions are mostly caused by tumors. Contrast CT is the investigation of choice, although ultrasound can be used. One should have a low threshold for suspecting malignancy, obtain frozen section histology, and seek appropriate help at an early stage.

  7. Cardiac asthma in elderly patients: incidence, clinical presentation and outcome

    Directory of Open Access Journals (Sweden)

    Ray Patrick

    2007-05-01

    Full Text Available Abstract Background Cardiac asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of cardiac asthma with that of classical congestive heart failure (CHF in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years were included. Findings of cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137 and the cardiac asthma group (n = 75, differed for tobacco use (34% vs. 59%, p 2 (47 ± 15 vs. 41 ± 11 mmHg, p Conclusion Patients with cardiac asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  8. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kimonis, V.E.; Yang, M.L.; Bale, S.J. [National Institute of Arthritis and Musculoskeletal and Skin Disease, Bethesda, MD (United States)] [and others

    1997-03-31

    Nevoid basal cell carcinoma syndrome (NBCC; Gorlin syndrome), an autosomal dominant disorder linked to 9q22.3-q31, and caused by mutations in PTC, the human homologue of the Drosophila patched gene, comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies and calcification of the falx cerebri. We reviewed the findings on 105 affected individuals examined at the NIH since 1985. The data included 48 males and 57 females ranging in age from 4 months to 87 years. Eighty percent of whites (71/90) and 38% (5/13) of African-Americans had at least one basal cell carcinoma (BCC), with the first tumor occurring at a mean age of 23 (median 20) years and 21 (median 20) years, respectively. Excluding individuals exposed to radiation therapy, the number of BCCs ranged from 1 to >1,000 (median 8) and 1 to 3 (median 2), respectively, in the 2 groups. Jaw cysts occurred in 78/105 (74%) with the first tumor occurring in 80% by the age of 20 years. The number of total jaw cysts ranged from 1 to 28 (median 3). Palmar pits and plantar pits were seen in 87%. Ovarian fibromas were diagnosed by ultrasound in 9/52 (17%) at a mean age of 30 years. Medulloblastoma occurred in 4 patients at a mean age of 2.3 years. Three patients had cleft lip or palate. Physical findings include {open_quotes}coarse face{close_quotes} in 54%, relative macrocephaly in 50%, hypertelorism in 42%, frontal bossing in 27%, pectus deformity in 13%, and Sprengel deformity in 11%. This study delineates the frequency of the clinical and radiological anomalies in NBCC in a large population of US patients and discusses guidelines for diagnosis and management. 48 refs., 3 figs., 5 tabs.

  9. The impact of smoking on the clinical outcome of locoregionally advanced nasopharyngeal carcinoma after chemoradiotherapy

    International Nuclear Information System (INIS)

    Cigarette smoking is a common risk factor for developing nasopharyngeal carcinoma. However, the relationship between smoking and clinical outcomes remains uncertain. The patients who participated in this study were drawn from a randomized clinical trial, for which the purpose was to compare the efficacy of induction chemotherapy plus concurrent chemoradiotherapy with that of induction chemotherapy plus radiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. The patients who ever smoked were divided into the following categories of cumulative smoking exposure based on the duration of smoking and the quantity of cigarettes smoked: light, short-term smokers; light, long-term smokers; heavy, short-term smokers; and heavy, long-term smokers. A log-rank test and Cox models were used to assess the association between smoking and the clinical outcomes of overall survival (OS), failure-free survival (FFS), locoregional recurrence failure-free survival (LRFFS) and distant failure-free survival (DFFS). We found that ever-smokers experienced significantly shorter LRFFS times than never-smokers (5-year LRFFS rates: 85.8% vs. 88.5%, P = 0.022). The amount of smoking was significantly associated with FFS (P = 0.046) and LRFFS (P = 0.001) in the different ever-smoker groups. The amount of smoking was associated with LRFFS [P = 0.002, HR = 2.069 (95% confident interval (CI), 1.298-3.299)] even after a multivariable adjustment. Smoking increases the risk of locoregional recurrence. Furthermore, the amount of smoking influences the prognosis of smokers, and these effects are dose-dependent

  10. The potential clinical value of FDG-PET for recurrent renal cell carcinoma

    International Nuclear Information System (INIS)

    Purpose: The clinical value of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. Methods: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. Results: Recurrence of renal carcinoma was histologically (n = 15) or clinically (n = 6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p = 0.17). Conclusions: FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.

  11. The potential clinical value of FDG-PET for recurrent renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, Koya, E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan); Nakamoto, Yuji, E-mail: 9709.ynakamo1@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan); Saga, Tsuneo, E-mail: saga@nirs.go.jp [Department of Diagnostic Imaging Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba 263-8555 (Japan); Higashi, Tatsuya, E-mail: higashi@shigamed.jp [Research Institute, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama City, Shiga 524-8524 Japan (Japan); Togashi, Kaori, E-mail: ktogashi@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan)

    2011-07-15

    Purpose: The clinical value of positron emission tomography (PET) using {sup 18}F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. Methods: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. Results: Recurrence of renal carcinoma was histologically (n = 15) or clinically (n = 6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p = 0.17). Conclusions: FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.

  12. Role of microRNAs in hepatocellular carcinoma: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Callegari E

    2013-09-01

    Full Text Available Elisa Callegari,1 Bahaeldin K Elamin,1,2 Silvia Sabbioni,3,5 Laura Gramantieri,4 Massimo Negrini1,5 1Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, Università di Ferrara, Ferrara, Italy; 2Department of Microbiology, Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan; 3Dipartimento di Scienze della Vita e Biotecnologie, Università di Ferrara, Ferrara, 4Centro di Ricerca Biomedica Applicata e Dipartimento di Medicina Interna, Policlinico S Orsola-Malpighi e Università di Bologna, Bologna, 5Tecnopolo "Laboratorio per le Tecnologie delle Terapie Avanzate", Università di Ferrara, Ferrara, Italy Abstract: Hepatocellular carcinoma (HCC is one of the most deadly tumors, and current treatments for the disease are often ineffective. The discovery of the involvement of microRNAs (miRNAs in hepatocarcinogenesis represents an important area of investigation for the development of their clinical applications. These molecules may act as oncogenes or tumor suppressors by directly or indirectly controlling the expression of key proteins involved in cancer-associated pathways. On the clinical side, because of their tumor-specific expression and stability in tissues and in the circulation, miRNAs have been proposed as novel diagnostic tools for classification and prognostic stratification of HCC. In recent years, the therapeutic potential of miRNAs has been demonstrated in various preclinical studies. Anti-miRNA oligonucleotides and miRNA mimics have been found to have antitumor activity. Moreover, by exploiting tumor-specific expression of miRNA, efforts have been aimed at improving targeting of tumor cells by replicative oncolytic viruses while sparing normal cells. These areas are expected to be explored further in the upcoming years to assess the clinical value of miRNA-based approaches in HCC and cancer in general. Keywords: hepatocellular carcinoma, microRNA, micromarkers, oncolytic viruses

  13. Human sunlight-induced basal-cell-carcinoma-associated dendritic cells are deficient in T cell co-stimulatory molecules and are impaired as antigen-presenting cells.

    Science.gov (United States)

    Nestle, F O; Burg, G; Fäh, J; Wrone-Smith, T; Nickoloff, B J

    1997-02-01

    Immune surveillance of skin cancer involves the stimulation of effector T cells by tumor-derived antigens and antigen-presenting cells (APCs). An effective APC must not only display processed antigen in the context of MHC molecules but also express co-stimulatory molecules that are required to fully activate T cells. One of the most common cutaneous neoplasms is basal cell carcinoma. To investigate expression of the co-stimulatory molecules CD80 (B7-1) and CD86 (B7-2) on tumor-associated dendritic cells (TADCs), cryosections from basal cell carcinomas were immunostained. In basal cell carcinomas, only 1 to 2% of intratumor and 5 to 10% of peritumor APCs expressed CD80 or CD86. In contrast, biopsies of immunological/inflammatory dermatoses revealed that 38 to 73% of APCs expressed CD80 and CD86. To further evaluate their phenotype and function, TADCs were isolated from tissue samples of basal cell carcinomas; they were non-adherent to plastic, displayed a typical dendritic morphology, and expressed high levels of major histocompatibility class II molecules on their surface. When TADCs were compared with dendritic cells from blood for presentation of superantigens (staphylococcal enterotoxins A and B) to resting autologous T cells, TADCs were consistently weaker stimulators of T cell proliferation than blood dendritic cells. When analyzed by flow cytometry, TADCs expressed high levels of HLA-DR, but only 5 to 10% co-expressed CD80 or CD86. A 3-day culture in granulocyte/macrophage colony-stimulating factor-containing medium partially reconstituted the TADC expression of CD80 and CD86 as well as their immunostimulatory capacity. Thus, in this common skin cancer, although there are prominent collections of HLA-DR-positive APCs in and around tumor cells, the TADCs are deficient in important co-stimulatory molecules as well as being weak stimulators of T cell proliferation. The paucity of co-stimulatory molecule expression and functional activity of TADCs may explain why

  14. Oral acantholytic squamous cell carcinoma shares clinical and histological features with angiosarcoma

    Directory of Open Access Journals (Sweden)

    Kleinheinz Johannes

    2008-07-01

    Full Text Available Abstract Background acantholytic squamous cell carcinomas (ASCC and intraoral angiosarcoma share similar histopathological features. Aim of this study was to find marker for a clear distinction. Methods Four oral acantholytic squamous cell carcinomas and one intraoral angiosarcoma are used to compare the eruptive intraoral growth-pattern, age-peak, unfavourable prognosis and slit-like intratumorous spaces in common histological staining as identical clinical and histopathological features. Immunohistochemical staining for pancytokeratin, cytokeratin, collagen type IV, γ2-chain of laminin-5, endothelial differentiation marker CD31 and CD34, F VIII-associated antigen, Ki 67-antigen, β-catenin, E-cadherin, α-smooth-muscle-actin and Fli-1 were done. Results Cytokeratin-immunoreactive cells can be identified in both lesions. The large vascularization of ASCC complicates the interpretation of vascular differential markers being characteristic for angiosarcoma. Loss of cell-cell-adhesion, monitored by loss of E-cadherin and β-catenin membrane-staining, are indetified as reasons for massive expression of invasion-factor ln-5 in ASCC and considered responsible for unfavourable prognosis of ASCC. Expression of Fli-1 in angiosarcoma and cellular immunoreaction for ln-5 in ASCC are worked out as distinguishing features of both entities. Conclusion Fli-1 in angiosarcoma and ln-5 in ASCC are distinguishing features.

  15. Cryotherapy combined with chemoembolization for the treatment of advanced hepatic carcinoma: a clinical study

    International Nuclear Information System (INIS)

    Objective: To discuss the technique, efficacy and clinical significance of cryoablation combined with transcatheter arterial chemoembolization(TACE) for the treatment of advanced hepatic carcinoma. Methods: One hundred and ninety-two patients, who accorded with the selected criterion, were divided into TACE group (n=100) and combination group (cryotherapy combined with TACE, n=92). Pre-and post-treatment AFP level, recurrence rate and life span between two groups were compared. Results: The complete necrosis rate of the tumor and the recurrence rate in TACE group were 29% and 42%, which were 88.04% and 24% in combination group, respectively. The serum AFP level was significantly decreased after treatment in both groups (P<0.05), and the reduction in AFP level was significantly greater in combination group than that in TACE group (P<0.05). During a follow-up of 30 months the survival rate at each evaluation period of combination group was higher than that of TACE group without exception. Conclusion: As an effective and safe technique, cryoablation combined with chemoembolization is far superior to simple TACE in treating advanced hepatic carcinoma. (authors)

  16. Analysis of Clinical Treatment Efficiency for 179 Geriatric Women with Stage I or II Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    YongwenHuang; MengdaLi; FuyuanLiu; YanfangLi

    2004-01-01

    OBJECTIVE To evaluate the efficiency of surgery plus radiotherapy and chemotherapy versus radiotherapy plus chemotherapy in the treatment of older patients with stage I or II cervical carcinoma and to seek suitable treatment for such patients. METHODS The clinical data of 179 elderly women with stage la or lib cervical cancer were analyzed retrospectively. One hundred and thirty-four cases underwent radical hysterectomy followed by adjuvant radiotherapy and/or chemotherapy (Group 1). Forty-five cases underwent radiation therapy plus adjuvant chemotherapy (Group 2). RESULTS The 5-year survival rates in group 1 and group 2 were 78.3% and 49.1%(P=0.04), respectively. The incidence of complications in group1 was 47.0%. Three patients died of complications after radical hysterectomy. The incidence of complications in group 2 was 75.6%. CONCLUSION Elderly patients with stage I or II cervical carcinoma should receive an operation if possible. In addition they should receive adjuvant treatments according to their personal conditions, and be treated with appropriate adjuvant chemo-and/or radiotherapy.

  17. Incidence and clinical relevance of T(11;19 translocation in salivary gland mucoepidermoid carcinoma

    Directory of Open Access Journals (Sweden)

    Ilić-Dimitrijević Ivana

    2014-01-01

    Full Text Available Mucoepidermoid carcinoma (MEC harbors a recurring t(11;19 translocation with an associated novel fusion oncogene-MECT1-MAML2. The CRTC1-MAML2oncogene disrupts normal cell-cycle and differentiation, contributing to tumor development. The objectives of this study were to establish the incidence of CRTC1-MAML2 fusion in Serbian patients and estimate its relevance as a genetic marker of MEC behavior. In this retrospective study, 20 cases of MEC of salivary glands were tested for the presence of CRTC1-MAML2 fusion using reverse transcriptase-polymerase chain reaction. Clinicopathological parameters and survival data were examined in relation to fusion status. The CRTC1-MAML2 fusion was detected in 40% of MECs and its presence was associated exclusively with low-intermediate grade tumor histology (P = 0.02 and favorable clinical outcome, with 100 % overall survival rate (P=0.046. The study has shown that the presence of the CRTC1-MAML2 fusion can serve as an additional diagnostic and prognostic marker for mucoepidermoid carcinomas.

  18. Clinical relevance of breast cancer-related genes as potential biomarkers for oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Squamous cell carcinoma of the oral cavity (OSCC) is a common cancer form with relatively low 5-year survival rates, due partially to late detection and lack of complementary molecular markers as targets for treatment. Molecular profiling of head and neck cancer has revealed biological similarities with basal-like breast and lung carcinoma. Recently, we showed that 16 genes were consistently altered in invasive breast tumors displaying varying degrees of aggressiveness. To extend our findings from breast cancer to another cancer type with similar characteristics, we performed an integrative analysis of transcriptomic and proteomic data to evaluate the prognostic significance of the 16 putative breast cancer-related biomarkers in OSCC using independent microarray datasets and immunohistochemistry. Predictive models for disease-specific (DSS) and/or overall survival (OS) were calculated for each marker using Cox proportional hazards models. We found that CBX2, SCUBE2, and STK32B protein expression were associated with important clinicopathological features for OSCC (peritumoral inflammatory infiltration, metastatic spread to the cervical lymph nodes, and tumor size). Consequently, SCUBE2 and STK32B are involved in the hedgehog signaling pathway which plays a pivotal role in metastasis and angiogenesis in cancer. In addition, CNTNAP2 and S100A8 protein expression were correlated with DSS and OS, respectively. Taken together, these candidates and the hedgehog signaling pathway may be putative targets for drug development and clinical management of OSCC patients

  19. Clear cell carcinoma of the uterine cervix: clinical characteristics and feasibility of fertility-preserving treatment

    Directory of Open Access Journals (Sweden)

    Jiang X

    2014-01-01

    Full Text Available Xiang Jiang, Ying Jin, Yan Li, Hui-Fang Huang, Ming Wu, Keng Shen, Ling-Ya Pan Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China Abstract: The objective of this retrospective study was to analyze the clinical characteristics and prognosis of clear cell adenocarcinoma (CCA in the post-diethylstilbestrol (DES era and to evaluate the feasibility of fertility-preserving treatment. The records of 32 patients with CCAs who were treated at Peking Union Medical College Hospital from August 1986 to June 2012 were retrospectively reviewed. Three of the patients had undergone fertility-preserving treatment. The incidence of CCA among cervical adenocarcinomas was 15.2%. The median age was 38 years: 11 patients (34.4% were diagnosed before 30 years of age and two (6.3% after 70 years of age. Ten patients (31.2% were nulliparous. No patient had been exposed to DES. Twenty-nine patients (90.6% presented with obvious symptoms, and the cervix appeared abnormal in 26 patients (81.3%. Cervical Papanicolaou (Pap tests were abnormal in all four patients in whom they were performed (three had high-grade squamous intraepithelial lesions and one had atypical squamous cells of undetermined significance. The distribution by stage was 56.3% stage I, 34.4% stage II, 6.3% stage III, and 3.1% stage IV. Treatments mainly included surgery for patients with stage I to IIA CCA and radiochemotherapy for patients with advanced CCA. The overall 5-year progression-free survival was 72.2%. Patients with stage I to IIA CCA had better 5-year progression-free survival than did patients with stage IIB to IV CCA (81.5% versus 40.0%, P=0.003. The three patients who had undergone fertility-preserving treatment had no recurrences. CCA may also affect adolescents and children without prior DES exposure, who are often misdiagnosed as having functional uterine

  20. Intensity-Modulated Radiation Therapy in Oropharyngeal Carcinoma: Effect of Tumor Volume on Clinical Outcomes

    International Nuclear Information System (INIS)

    Purpose: To analyze the effect of primary gross tumor volume (pGTV) and nodal gross tumor volume (nGTV) on treatment outcomes in patients treated with definitive intensity-modulated radiation therapy (IMRT) for oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, a total of 442 patients with squamous cell carcinoma of the oropharynx were treated with IMRT with curative intent at our center. Thirty patients treated postoperatively and 2 additional patients who started treatment more than 6 months after diagnosis were excluded. A total of 340 patients with restorable treatment plans were included in this present study. The majority of the patients underwent concurrent platinum-based chemotherapy. The pGTV and nGTV were calculated using the original clinical treatment plans. Cox proportional hazards models and log-rank tests were used to evaluate the correlation between tumor volumes and overall survival (OS), and competing risks analysis tools were used to evaluate the correlation between local failure (LF), regional failure (RF), distant metastatic failure (DMF) vs. tumor volumes with death as a competing risk. Results: Median follow-up among surviving patients was 34 months (range, 5-67). The 2-year cumulative incidence of LF, RF and DF in this cohort of patients was 6.1%, 5.2%, and 12.2%, respectively. The 2-year OS rate was 88.6%. Univariate analysis determined pGTV and T-stage correlated with LF (p < 0.0001 and p = 0.004, respectively), whereas nGTV was not associated with RF. On multivariate analysis, pGTV and N-stage were independent risk factors for overall survival (p = 0.0003 and p = 0.0073, respectively) and distant control (p = 0.0008 and p = 0.002, respectively). Conclusions: In this cohort of patients with OPC treated with IMRT, pGTV was found to be associated with overall survival, local failure, and distant metastatic failure.

  1. Histopathologic, stereologic, epidemiologic, and clinical parameters in the prognostic evaluation of squamous cell carcinoma of the oral cavity

    DEFF Research Database (Denmark)

    Bundgaard, T; Bentzen, S M; Wildt, J;

    1996-01-01

    BACKGROUND: Prognostic indicators that could assist in a more precise selection of patients with oral cancer for differentiated therapy would be clinically valuable. METHODS: A consecutive series of 161 cases of intraoral squamous cell carcinoma (SCC) occurring during a 5-year period in a...

  2. Solitary Laryngeal Metastasis from Transitional Cell Carcinoma of the Kidney: Clinical Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tarek Assi

    2015-01-01

    Full Text Available The urogenital tract is a rare origin of laryngeal metastasis; transitional cell carcinoma with laryngeal metastases had never been reported previously. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of the first reported case of a laryngeal metastasis of a TCC followed by a brief review of the literature.

  3. Ductal Carcinoma In Situ: What Can We Learn from Clinical Trials?

    Directory of Open Access Journals (Sweden)

    Lucio Fortunato

    2012-01-01

    Full Text Available Ductal Carcinoma in situ has been diagnosed more frequently in the last few years and now accounts for approximately one-fourth of all treated breast cancers. Traditionally, this disease has been treated with total mastectomy, but conservative surgery has become increasingly used in the absence of unfavourable clinical conditions, if a negative excision margin can be achieved. It is controversial whether subgroups of patients with favourable in situ tumors could be managed by conservative surgery alone, without radiation. As the disease is diagnosed more frequently in younger patients, these issues are very relevant, and much research has focused on this topic in the last two decades. We reviewed randomized trials regarding adjuvant radiation after breast-conservative surgery and compared data with available retrospective studies.

  4. Clinical study on external carotid artery infusion (trans-femoral) treatment of recurrent nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect and safety of external carotid artery infusion treatment of recurrent nasopharyngeal carcinoma (NPC). Methods: 20 cases of recurrent NPC (13 male and 7 female, age 36-65 years, mean 50 years) diagnosed by clinical examination (including nasopharyngoscope), serology (VCA-IgA) and imaging (CT, MR) and treated by external carotid artery infusion (trans-femoral) with adriamycin (or epi-adriamycin), cisplatin (or carboplatin), Pingyangmycin and 5-Fluorouracil. Results: Of all the patients, 8 cases (40%) had a complete response (CR), 7 cases (35%) had a partial response (PR). The overall response rate (CR + PR) was 75%. Cumulative survival rates at 1, 3 years were 90% (18/20), 50%(10/20) respectively. No severe side-effects and complications found. Conclusion: External carotid artery infusion (trans-femoral) should be effective and safe in the treatment of recurrent NPC

  5. Anticoagulation control in atrial fibrillation patients present to outpatient clinic of cardiology versus anticoagulant clinics

    Institute of Scientific and Technical Information of China (English)

    DU Xin; MA Chang-sheng; LIU Xiao-hui; DONG Jian-zeng; WANG Jun-nan; CHENG Xiao-jing

    2005-01-01

    @@ Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiac arrhythmia in clinical practice, which if untreated results in a doubling of cardiovascular morbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 times higher than patients in sinus rhythm.1 During recent years, several randomised clinical trials conducted by investigators around the world involving 13 843 participants with NVAF have demonstrated convincingly the value of warfarin therapies for stroke prevention in high risk patients.2-8 However, the dose response of warfarin is complex and its activity is easily altered by concurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice and routine monitoring of the international normalized ratio (INR) is important, because low anticoagulant intensity predisposes the patients to thromboembolic complications and high intensity to haemorrhage. Studies suggested that anticoagulant clinics could improve the quality of anticoagulation control,9 and anticoagulant clinics are common in western countries. However, in China, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, while the quality of anticoagulation control is never investigated. We therefore assessed anticoagulation control in the outpatient clinic of cardiology, and the quality of anticoagulation control since the establishment of anticoagulant clinics.

  6. Omega-3 fatty acid improves the clinical outcome of hepatectomized patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma

    OpenAIRE

    Wu, Zhengshan; Qin, Jianjie; Pu, Liyong

    2012-01-01

    Omega-3 fatty acid supplemented total parenteral nutrition improves the clinical outcome of patients undergoing certain operations; however, its benefits for patients with hepatitis type B virus (HBV)-associated hepatocellular carcinoma (HCC) who have undergone hepatectomy are still not clear. The aim of this study was to evaluate the effect of omega-3 fatty acid supplemented total parenteral nutrition on the clinical outcome of patients with HBV-associated HCC who underwent hepatectomy at ou...

  7. Bacterial brain abscess in patients with nasopharyngeal carcinoma following radiotherapy: microbiology, clinical features and therapeutic outcomes

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    Fang Peng-Hsiang

    2012-09-01

    Full Text Available Abstract Background This study aimed to analyze the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes of bacterial brain abscess in patients with nasopharyngeal carcinoma (NPC following radiotherapy. Methods NPC patients with bacterial brain abscess were evaluated. Their clinical data were collected over a 22-year period. For comparison, the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes between NPC and non-NPC patients were analyzed. Results NPC accounted for 5.7% (12/210 of the predisposing factors, with Viridans streptococci and Staphylococcus aureus as the two most common causative pathogens. Significant statistical analysis between the two groups (NPC and non-NPC patients included chronic otitis media (COM as the underlying disease, post-radiation necrosis by neuro-imaging, and the temporal lobe as the most common site of brain abscesses. The fatality rate in patients with and without NPC was 16.7% and 20.7%, respectively. Conclusions NPC patients with bacterial brain abscess frequently have COM as the underlying disease. Neuro-imaging often reveals both post-radiation necrosis and the temporal lobe as the most common site of brain abscesses, the diagnosis of which is not always a straightforward process. Radiation necrosis can mimic brain abscess on neuro-imaging and pose significant diagnostic challenges. Early diagnosis and treatment is essential for survival.

  8. Adenosquamous cell carcinoma of the cervix — clinical and prognostic characteristics of the disease

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    E. K. Tanriverdieva

    2012-01-01

    Full Text Available Adenosquamous cell carcinoma of the cervix is a rare form of cancer of the cervix. Because of the small number of observations adenosquamous cell carcinoma of the cervix remains poorly understood disease, although the first mention of it dates back to 1956, when A. Glucksmann, and C.D. Cherry first described of mixed carcinoma (adenoacanthoma of the uterine cervix.

  9. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic.

    OpenAIRE

    Cook, L. S.; Koutsky, L A; Holmes, K. K.

    1993-01-01

    INTRODUCTION--A recent study comparing heterosexual men with and without confirmed sexually transmitted diseases (STDs) in an urban STD clinic showed that uncircumcised men were less likely than circumcised men to have genital warts detectable by clinical examination (adjusted odds ratio 0.7, 95% confidence interval 0.4, 0.9). Based on these initial findings we hypothesised that the appearance and anatomic distribution of genital warts, and possibly treatment response, may be different for ci...

  10. A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients

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    Wiwanitkit Viroj

    2002-01-01

    Abstract Background Amebic liver abscess is a tropical disease with a wide spectrum of clinical presentations. Given the often nonspecific nature of the complaints related to amebic abscess, a retrospective review of patients with confirmed disease to recognize the most common patterns of presentation is useful. Here, we study the clinical presentations of 62 Thai patients with amebic liver abscess. We also compare the clinical presentations of Anti HIV seronegative and Anti HIV seropositive ...

  11. Frequência do carcinoma basocelular na população menor de 50 anos: estudo do serviço e revisão de literatura Frequency of basal cell carcinoma in a population younger than 50 years of age: clinical study and literature review

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    Ana Carolina Conde Almeida

    2009-12-01

    Full Text Available O carcinoma basocelular é a neoplasia maligna cutânea mais comum em humanos, que pode ser prevenida e diagnosticada precocemente. O propósito deste estudo é apresentar os achados clínicos e microscópicos do carcinoma basocelular na população menor de 50 anos. Realizaram-se exames microscópicos em múltiplos cortes de lesão de pele e fez-se revisão da literatura pertinente.Basal cell carcinoma is the most common type of malignant cutaneous neoplasm in humans, and it can be prevented and diagnosed early. The purpose of this study is to present clinical and microscopic findings of basal cell carcinoma in a population younger than 50 years of age. Microscopic examinations of multiple sections of skin lesion have been done, as well as a review of relevant literature.

  12. Treatment of the carcinoma of the vulva at the 1st University-Clinic of Gynaecology in Vienna (386 cases)

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    Kucera, H. (Vienna Univ. (Austria). Strahlenabteilung)

    1980-09-01

    In the department of radiotherapy of the 1st University-Clinic of Gynaecology and Obstetrics in Vienna the electroresection and electrocoagulation is practiced with good success in the treatment of carcinoma of the vulva. Of 386 treated cases with vulvar carcinoma, 234 (60,6%) were alive after five years. After surgical treatment the inguinal lymphonodes were irradiated (6000 rad). In comparison with the international statistic of the Annual Report of the results of treatment in gynaecological cancer (1979) the results obtained in Vienna are much better than the international average.

  13. Treatment of the carcinoma of the vulva at the 1st University-Clinic of Gynaecology in Vienna (386 cases)

    International Nuclear Information System (INIS)

    In the department of radiotherapy of the 1st University-Clinic of Gynaecology and Obstetrics in Vienna the electroresection and electrocoagulation is practiced with good success in the treatment of carcinoma of the vulva. Of 386 treated cases with vulvar carcinoma, 234 (60,6%) were alive after five years. After surgical treatment the inguinal lymphonodes were irradiated (6000 rad). In comparison with the international statistic of the Annual Report of the results of treatment in gynaecological cancer (1979) the results obtained in Vienna are much better than the international average. (orig.)

  14. Basaloid squamous cell carcinoma involving floor of the mouth

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    Sah Kunal

    2008-01-01

    Full Text Available Basaloid squamous cell carcinomas of oral mucosa are uncommon. Majority of them can be differentiated from squamous cell carcinoma by their aggressive clinical course and their histopathological features. This case report presents a case of 70-year-old male with basaloid squamous cell carcinoma involving the floor of the mouth.

  15. Metastatic squamous cell carcinoma in the neck presenting with Horner syndrome - a cause of the condition not previously described.

    Science.gov (United States)

    Alam, Peyman; Sloane, James; Koraitim, Mohamed; Brennan, Peter A

    2016-07-01

    Horner syndrome, a combination of pupillary miosis, ptosis and facial anhidrosis, results from damage to the oculosympathetic nerve pathways. It can occur anywhere from the hypothalamus to the eye, but to our knowledge, metastatic disease to a node in the neck from a mucosal squamous cell carcinoma (SCC) of the head and neck has not previously been reported as a primary cause in humans. It is surprising that it does not present more often given the frequency of metastatic disease in the neck. We discuss how it may have occurred, and highlight the importance of a thorough examination and investigation of the head and neck in patients who present with unusual neurological signs. PMID:26689637

  16. Collision tumor of the kidney composed of clear cell carcinoma and collecting duct carcinoma: report of a case with unusual morphology and clinical follow-up

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    Rhonda Burch-Smith

    2014-07-01

    Full Text Available We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional (clear cell renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.

  17. Positron emission tomography scan for predicting clinical outcome of patients with recurrent cervical carcinoma following radiation therapy

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    Daya Nand Sharma

    2012-01-01

    Materials and Methods: Twenty two patients of post irradiated recurrent cervical carcinoma (PIRCC were enrolled in this prospective study. 18-fluorodeoxyglucose (FDG PET imaging was performed in each patient before the salvage therapy. The maximum standardized uptake value (SUVmax and metabolic tumor volume (MTV were measured and correlated with cumulative progression free survival (PFS. Results: Median age of patients was 42 years. Majority of patients had stage III disease at the initial presentation and all 22 patients had received prior definitive RT. The median recurrence free period was 11 months. Salvage therapy consisted of surgical resection or re-irradiation depending upon the various clinical and radiological factors. Median SUVmax was 5.8 (range 1.8-50.6 and median MTV was 43 cm 3 (range 5.8-243. The cumulative PFS for all patients was 20% at 30 months. The one-year PFS was 28% for patients with SUVmax value of >5.8 versus 42% for those with SUVmax value of 43 cm 3 versus 45% for those with MTV value of <43 cm 3 (P value 0.8. Conclusion: Our preliminary experience has suggested that FDG uptake on PET scan can predict the clinical outcome of PIRCC patients. Further randomized studies may be conducted with large sample size and longer follow up to establish its definite predictive value.

  18. Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis

    Science.gov (United States)

    Grassi, Paolo; Doucet, Ludovic; Giglione, Palma; Grünwald, Viktor; Melichar, Bohuslav; Galli, Luca; De Giorgi, Ugo; Sabbatini, Roberto; Ortega, Cinzia; Santoni, Matteo; Bamias, Aristotelis; Verzoni, Elena; Derosa, Lisa; Studentova, Hana; Pacifici, Monica; Coppa, Jorgelina; Mazzaferro, Vincenzo; de Braud, Filippo; Porta, Camillo; Escudier, Bernard; Procopio, Giuseppe

    2016-01-01

    Pancreatic metastases from renal cell carcinoma are uncommon and their prognostic significance is not well defined. In this analysis we evaluated the outcome of patients with pancreatic metastases treated with either targeted therapies or local treatment to the pancreas. Patients with pancreatic metastases from renal cell carcinoma treated between 1993 and 2014 were identified from 11 European centers. Clinical records were retrospectively reviewed. Kaplan-Meier method and log-rank test were used to evaluate progression-free survival and overall survival. Cox’s proportional hazard models were used for survival analysis. In total, 276 PM patients were evaluated, including 77 (28%) patients treated by either surgery or radiotherapy to the pancreas, and 256 (93%) who received systemic therapy. Median time from nephrectomy to diagnosis of pancreatic metastases was 91 months (IQR 54–142). Disease control rate after first-line TTs was 84%, with a median progression-free survival of 12 months (95% CI 10–14). Median overall survival was 73 months (95% CI 61–86) with a 5-year OS of 58%. Median OS of patients treated with local treatment was 106 months (95% CI 78–204) with a 5-year overall survival of 75%. On multivariable analysis, nephrectomy (HR 5.31; 95%CI 2.36–11.92; p<0.0001), Memorial Sloan Kettering/International Metastatic RCC Database Consortium prognostic score (HR 1.45, 95% CI 0.94–2.23 for intermediate vs good vs risk; HR 2.76 95%, CI 1.43–5.35 for poor vs good risk p = 0.0099) and pancreatic local treatment (HR 0.48; 95%CI 0.30–0.78 p = 0.0029) were associated with overall survival. Difference in median OS between patients with PM and that reported in a matched-control group of mRCC patients with extrapancreatic metastases was statistically significant (p < .0001). Pancreatic metastases from renal cell carcinoma usually occur years after nephrectomy, are associated with an indolent behavior and a prolonged survival. Targeted therapies and

  19. Clinical Analysis of Pulmonar y Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    Institute of Scientific and Technical Information of China (English)

    JIANG Wen-jin; WANG Li-gang; SONG Xue-peng; ZHENG Yan-bo; LIU Xiao-gang; SUN Bo-lin

    2015-01-01

    Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE) induced by transcatheter arterial chemoembolization (TACE) so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures of the 9 patients who were accompanied with PLE were observed to analyze the pre-operative hepatic computed tomography (CT) and chest X-ray, intra-operative contrast examination, dosage of lipiodol and chemotherapeutic drugs, clinical manifestation and therapeutic progression as well as the postoperative follow-up. Results:Nine patients accompanied by PLE had different-severity cough, hemoptysis and progressive dyspnea, and chest X-ray and/or CT showed flaky high-density radiography. After treated with oxygen inhalation, bronchus expansion and inlfammation alleviation, 8 patients were improved but 1 died. Of the 8 patients, 2 were given ventilator to assist breath, and the clinical symptoms of 8 patients disappeared within 3~15 d. The re-examined chest X-ray showed normal after 20~60 d follow-up observation. Additionally, 6 patients were with nidus diameter ≥10 cm, 6 with hepatic artery-vein ifstula and 7 with lipiodol dosage≥20 mL. Conclusion:PLE often occurs in patients with giant hepatic carcinoma accompanied by hepatic artery-vein ifstula, whose lipiodol dosage is ≥20 mL. Accurate and correct management during operation can effectively reduce the development of PLE.

  20. Clinical Analysis of Pulmonary Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Wen-jin JIANG

    2015-03-01

    Full Text Available Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE induced by transcatheter arterial chemoembolization (TACE so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures of the 9 patients who were accompanied with PLE were observed to analyze the pre-operative hepatic computed tomography (CT and chest X-ray, intra-operative contrast examination, dosage of lipiodol and chemotherapeutic drugs, clinical manifestation and therapeutic progression as well as the postoperative follow-up.Results: Nine patients accompanied by PLE had different-severity cough, hemoptysis and progressive dyspnea, and chest X-ray and/or CT showed flaky high-density radiography. After treated with oxygen inhalation, bronchus expansion and inflammation alleviation, 8 patients were improved but 1 died. Of the 8 patients, 2 were given ventilator to assist breath, and the clinical symptoms of 8 patients disappeared within 3-15 d. The re-examined chest X-ray showed normal after 20-60 d follow-up observation. Additionally, 6 patients were with nidus diameter ≥10 cm, 6 with hepatic artery-vein fistula and 7 with lipiodol dosage ≥20 mL.Conclusion: PLE often occurs in patients with giant hepatic carcinoma accompanied by hepatic artery-vein fistula, whose lipiodol dosage is ≥20 mL. Accurate and correct management during operation can effectively reduce the development of PLE.

  1. Axillary node metastasis from primary ovarian carcinoma

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    Trupti S Patel

    2014-01-01

    Full Text Available Metastasization and distinction from mammary carcinoma is of great clinical importance because of different treatment modalities. Here, we discuss a case of stage IIIC ovarian serous carcinoma, presenting with bilateral axillary nodes metastasis after 25 months interval of its initial presentation. Increased serum CA-125 level caused clinical suspicion. Computed tomography scan of abdomen and pelvis showed no residual disease or any abdominal lymphadenopathy. Mammography of both breast were normal. Bilateral axillary nodes were noted. Guided fine needle aspiration cytology (FNAC and biopsy of ovarian carcinoma to axillary node is a rare event. Its recogn done. Cytomorphology revealed poorly differentiated carcinoma, compatible to that of primary ovarian tumor. Thus, metastatic carcinoma to axillary node from ovary was confirmed. This case illustrates a rare metastatic presentation of ovarian carcinoma and unequivocal role of FNAC to provide rapid diagnosis and preferred to be first line diagnostic procedure.

  2. Present and future directions of translational research on aflatoxin and hepatocellular carcinoma. A review.

    Science.gov (United States)

    Wogan, Gerald N; Kensler, Thomas W; Groopman, John D

    2012-01-01

    The aflatoxins were discovered in toxic peanut meal causing "turkey X" disease, which killed large numbers of turkey poults, ducklings and chicks in the UK in the early 1960s. Extracts of toxic feed induced the symptoms in experimental animals, and purified metabolites with properties identical to aflatoxins B(1) and G(1) (AFB(1) and AFG(1)) were isolated from Aspergillus flavus cultures. Structure elucidation of aflatoxin B(1) was accomplished and confirmed by total synthesis in 1963. AFB(1) is a potent liver carcinogen in rodents, non-human primates, fish and birds, operating through a genotoxic mechanism involving metabolic activation to an epoxide, formation of DNA adducts and, in humans, modification of the p53 gene. Aflatoxins are unique among environmental carcinogens, in that elucidation of their mechanisms of action combined with molecular epidemiology provides a foundation for quantitative risk assessment; extensive evidence confirms that contamination of the food supply by AFB(1) puts an exposed population at increased risk of developing hepatocellular carcinoma (HCC). Molecular biomarkers to quantify aflatoxin exposure in individuals were essential to link aflatoxin exposure with liver cancer risk. Biomarkers were validated in populations with high HCC incidence in China and The Gambia, West Africa; urinary AFB(1)-N (7)-Guanine excretion was linearly related to aflatoxin intake, and levels of aflatoxin-serum albumin adducts also reflected aflatoxin intake. Two major cohort studies employing aflatoxin biomarkers identified their causative role in HCC etiology. Results of a study in Shanghai men strongly support a causal relationship between HCC risk and the presence of biomarkers for aflatoxin and HBV infection, and also show that the two risk factors act synergistically. Subsequent cohort studies in Taiwan confirm these results. IARC classified aflatoxin as a Group 1 human carcinogen in 1993, based on sufficient evidence in humans and experimental

  3. Clinical and experimental investigation on small intestinal injury following radiation therapy for carcinoma of uterine cervix

    International Nuclear Information System (INIS)

    Radiation injury of the small bowel was observed in 6 of 460 patients with carcinoma of uterine cervix who were treated by radiation between April 1966 and December 1973 at Tokyo Women's Medical College, Department of Radiology. Three of these 6 patients were treated conservatively and the other 3 others underwent surgery but died subsequently. Clinically and surgically these 6 patients showed marked adhesions of intestinal loops, which may be accounted for by the radiation injury of the small bowel. Clinical experience has shown that it is necessary to use a small radiation field to decrease small bowel injury from radiation. An experiment using abdominal radiation in mice confirmed that LD sub(50/30) is larger with a center split, maintaining equal integral doses. In adult dogs, severe small bowel obstruction was observed with over 4000 rad irradiation. Small bowel injury was milder in case with center split, intracavitary irradiation, and small radiation field. It was concluded that center split is one of the methods of preventing radiation injury of the small bowel. (Evans, J.)

  4. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kiminori Uka; Kazuaki Chayama; Hiroshi Aikata; Shintaro Takaki; Hiroo Shirakawa; Soo Cheol Jeong; Keitaro Yamashina; Akira Hiramatsu; Hideaki Kodama; Shoichi Takahashi

    2007-01-01

    AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients.METHODS: After the diagnosis of HCC, all 995consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features,prognosis, and treatment strategies.RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%).The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure.CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly,treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatic tumor stage (T0-T2), and are free of portal venous invasion may improve survival.

  5. Klotho plays a critical role in clear cell renal cell carcinoma progression and clinical outcome.

    Science.gov (United States)

    Kim, Ji-Hee; Hwang, Kyu-Hee; Lkhagvadorj, Sayamaa; Jung, Jae Hung; Chung, Hyun Chul; Park, Kyu-Sang; Kong, In Deok; Eom, Minseob; Cha, Seung-Kuy

    2016-05-01

    Klotho functions as a tumor suppressor predominantly expressed in renal tubular cells, the origin of clear cell renal cell carcinoma (ccRCC). Altered expression and/or activity of growth factor receptor have been implicated in ccRCC development. Although Klotho suppresses a tumor progression through growth factor receptor signaling including insulin-like growth factor-1 receptor (IGF-1R), the role of Klotho acting on IGF-1R in ccRCC and its clinical relevance remains obscure. Here, we show that Klotho is favorable prognostic factor for ccRCC and exerts tumor suppressive role for ccRCC through inhibiting IGF-1R signaling. Our data shows the following key findings. First, in tumor tissues, the level of Klotho and IGF-1R expression are low or high, respectively, compared to that of adjacent non-neoplastic parenchyma. Second, the Klotho expression is clearly low in higher grade of ccRCC and is closely associated with clinical outcomes in tumor progression. Third, Klotho suppresses IGF-1-stimulated cell proliferation and migration by inhibiting PI3K/Akt pathway. These results provide compelling evidence supporting that Klotho acting on IGF-1R signaling functions as tumor suppressor in ccRCC and suggest that Klotho is a potential carcinostatis substance for ccRCC. PMID:27162484

  6. Budd-Chiari syndrome complicated with hepatocellular carcinoma: a clinical analysis of 36 cases

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical characteristics and related factors of Budd-Chinari syndrome (BCS) complicated with hepatocellular carcinoma (HCC), in order to provide theoretical basis for clinical treatment. Methods: A retrospective study was performed to analyze the imaging diagnoses, laboratory tests and follow-up results after surgery of 36 patients of BCS complicated with HCC. The study patients were selected from 1240 patients with BCS who were hospitalized in authors' hospital during the period from June 1994 to July 2010. Results: BCS with HCC mainly occurred in membranous obstruction of inferior vena cava (MOVC) (33/36), the average age of the onset of the disease was 46.6 years old, and the available life span after interventional or surgical operation was 14∼62 months. The average survival time was 32.5 months. Eight cases who developed HCC after BCS operation had an available life span of 18∼62 months (average 37 months). Twenty-two patients with coexisting BCS and HCC before operation had an available life span of 14∼56 months (average 30.8 months). Conclusion: For the treatment of BCS combined with HCC, TACE or TAI followed by interventional therapy of BCS is recommended. (authors)

  7. The Relationship between Apoptosis and the Expression of Proliferating Cell Nuclear Antigen and the Clinical Stages in Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The relationship between the apoptosis and the expression of proliferating cell nuclear antigen (PCNA) and the clinical stages in gastric cancers was studied. By using terminal deoxynucleotidyl transferase-mediated nick end labelling (TUNEL) technique and PCNA immunohistochemical staining, the apoptosis and the expression of PCNA in tissue of gastric carcinoma were assayed in situ, the index of apoptosis (AI), index of PCNA (PI) and the rate of AI/PI were calculated. AI and PI in gastric cancer tissues were (6.5±3.7) % and (49.8±15.9) % respectively, and the rate of AI/PI was 0.13±0.05, which were obviously different from those of normal gastric mucosa in paragastric cancer (P<0.01). With the advanced TNM stages of gastric carcinoma, the AI was decreased, PI was increased and the rate of AI/PI decreased in gastric carcinoma. There was significant difference in them between the gastric cancer tissues and normal gastric mucosa in pericarcinoma in TNM stage Ⅱ to Ⅳ (P<0.05). It was suggested that the decreased apoptotic cells and the increased proliferating cells were obviously related to the tumor genesis and tumor progression in gastric carcinoma. The AI, PI and the rate of AI/PI would become the prognostic factors in advanced gastric carcinoma.

  8. Metastatic renal cell carcinoma presenting as a breast mass in a woman with history of primary breast cancer

    OpenAIRE

    Balliauw, C; Termote, B; Steen, A.; Moerman, P; M. R. Christiaens; Van Ongeval, C

    2011-01-01

    Metastatic extramammary breast tumours are uncommon and differential diagnosis with primary breast carcinoma may prove to be difficult. We report a case of a metastasis of a renal cell cancer in the breast in a woman with a history of primary breast cancer. On follow-up of her breast carcinoma, a lump was detected via mammography and ultrasound. Core needle biopsy revealed a metastatic extramammary lesion originating from an asymptomatic renal cell carcinoma. We conclude that the diagnosis of...

  9. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst

    OpenAIRE

    Serge Ginzburg; Madhu Reddy; Colleen Veloski; Elin Sigurdson; Ridge, John A.; Mikhail Azrilevich; Alexander Kutikov

    2015-01-01

    Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  10. Acute small bowel obstruction: a rare initial presentation for the metastasis of the large-cell carcinoma of the lung

    Directory of Open Access Journals (Sweden)

    Song Yongmao

    2012-01-01

    Full Text Available Abstract We present one case with symptom of paroxysmal abdominal pain for over 20 days. Abdominal computerized tomography (CT scan revealed intestinal obstruction and a mass of 6.0 cm × 6.0 cm in size located at the left adrenal. Chest CT scan showed a lobulated mass of 2.7 cm × 2.7 cm in size at the upper left lung. Core needle biopsy of the lung mass confirmed the diagnosis of large cell carcinoma. The patient underwent an emergency abdominal laparotomy and received a chemotherapy regimen that consisted of pemetrexed and cisplatin postoperatively. In addition, we made a review of the literature of the occurrence, diagnosis and outcome of this manifestation.

  11. An unusual presentation of adenoid cystic carcinoma of the minor salivary glands with cranial nerve palsy: a case study

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    Morris Pierre A

    2007-08-01

    Full Text Available Abstract Background Adenoid Cystic Carcinoma (ACC is a rare tumor entity and comprises about 1% of all malignant tumor of the oral and maxillofacial region. It is slow growing but a highly invasive cancer with a high recurrence rate. Intracranial ACC is even more infrequent and could be primary or secondary occurring either by direct invasion, hematogenous spread, or perineural spread. We report the first case of the 5th and 6th nerve palsy due to cavernous sinus invasion by adenoid cystic carcinoma. Case presentation A 49-year-old African American female presented to the emergency room complaining of severe right-sided headache, photophobia, dizziness and nausea, with diplopia. The patient had a 14 year history migraine headaches, hypertension, and mild intermittent asthma. Physical examination revealed right lateral rectus muscle palsy with esotropia. There was numbness in all three divisions of the right trigeminal nerve. Motor and sensory examination of extremities was normal. An MRI of the brain/brain stem was obtained which showed a large mass in the clivus extending to involve the nasopharynx, pterygoid plate, sphenoid and right cavernous sinuses. Biopsy showed an ACC tumor with a cribriform pattern of the minor salivary glands. The patient underwent total gross surgical resection and radiation therapy. Conclusion This is a case of ACC of the minor salivary glands with intracranial invasion. The patient had long history of headaches which changed in character during the past year, and symptoms of acute 5th and 6th cranial nerve involvement. Our unique case demonstrates direct invasion of cavernous sinus and could explain the 5th and 6th cranial nerve involvement as histopathology revealed no perineural invasion.

  12. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst

    Directory of Open Access Journals (Sweden)

    Serge Ginzburg

    2015-11-01

    Full Text Available Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  13. Squamous Carcinoma of the Lung Presenting as Migraine-Type Headache: A Case Report

    OpenAIRE

    Waran, Eswaran

    2015-01-01

    Introduction Orthostatic hypotension has long been recognised as a paraneoplastic effect of lung cancer. Lung cancer presenting with orthostatic hypotension and migraine-type headaches has not been previously described in the literature. Case Report A 62-year-old Caucasian male presented with headaches, typical of his migraine, after a 30-year migraine-free period. An examination revealed a significant postural drop in BP with reflex tachycardia and no other features of dysautonomia. Investig...

  14. Clinical application of percutanously interventional therapeusis in patients with hepatocellular carcinoma accompanied with bile duct thrombosis

    International Nuclear Information System (INIS)

    Objective: To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis. Methods: Sixteen cases bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed. According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents. Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The patients were followed up within 2 years. Results: The PTBD was successfully performed in 16 cases. Permanent external drainage, temporary internal drainage and imalantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively. TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2 ± 80.5) μmol/L averagely from (261.9 ± 77.2) μmol/L before the treatments. All the patients died before the end of followed-up. The average survival time was 204 days (30 to 391 d) and the median survival time was 200 days. Bleeding and infection were the main complications, which could be controlled successfully by routine treatments. Conclusion: With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis. (authors)

  15. Clinical and survival impact of FDG PET in patients with suspicion of recurrent cervical carcinoma

    International Nuclear Information System (INIS)

    The aim of this retrospective study was to evaluate the contribution of 18F-FDG PET to the clinical management and survival outcome of patients suspected of recurrent cervical carcinoma and in line with the hypothesis that early diagnosis of recurrent cervical cancer may improve overall survival. A total of 40 patients underwent conventional imaging (CI) and FDG PET/CT for suspected cervical cancer. Clinical management decisions were recorded with CI and additional PET/CT. Discordances and concordances between CI and PET/CT results were compared to the final diagnosis as based on histopathology analysis or follow-up considered as the gold standard. The final diagnosis was established pathologically (n=25) or by median clinical follow-up for 48 months after the PET (n=15). The PET/CT was positive in 76% (20/26) of patients compared to 19% (6/26) with CI. Globally PET/CT modified the treatment plan in 55% (22/40) of patients and in 75% (18/24) when the CI was negative prior to PET/CT. These changes led to the use of previously unplanned therapeutic procedures in 37.5% (15/40). When FDG PET was positive for recurrence (>3 foci), the median overall survival was 12 months (2-70) compared to patients with PET findings with ≤1 focus for which the median survival was not attained (p=0.007). A multivariate analysis of prognostic factors demonstrated that abnormal FDG uptake (>3 foci) was the most significant factor (p<0.03) for death from cervical cancer. FDG PET is a valuable tool in the case of suspected recurrence of cervical cancer on account of its impact on treatment planning and especially in predicting patient outcome. (orig.)

  16. Clinical analysis of radiotherapy for nasopharyngeal carcinoma in 145 children and adolescents

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical characteristics, treatment, outcome and complications of child and adolescent nasopharyngeal carcinoma (NPC). Methods: From January 1970 to April 1997, the records of 145 NPC patients younger than 21 years of age were reviewed. The clinical stages according to 92' Chinese NPC Staging System were: stage I in 1, II in 8, III in 79 and IV in 57. All patients were treated with external beam radiotherapy. Before 1988, parallel opposed lateral pre-auricular portals were chiefly used in 75 patients and after 1988, parallel opposed lateral facio-cervical portals were adopted in 70. The radiation dose to the primary tumor ranged 45-80 Gy: 70 Gy in 50 cases and 32 of them also received chemotherapy. Results: Distant metastasis developed in 26 cases, while local and/or regional recurrence in 14. The actuarial overall survival rates of 1-, 3-, 5 , and 10-years were 96.3%, 79.9%, 76.5% and 69.4%, respectively. Among 45 dead cases, 16 did so of metastasis, 11 of local and/or regional recurrence and 18 of other reasons. Univariate analysis suggested that clinical stage, size and site of involved lymph nodes, skull base involvement were significant prognostic factors of survival, whereas sex, age,dose, therapeutic method and chemotherapy were not. Conclusions: 1. Even though the majority of pediatric and adolescent NPC were advanced , it signifies a relatively good survival. 2. As the normal tissue of pediatric and adolescent patients tolerates radiation poorly, prudence should be meticulously practiced in deciding the radiation dose and radiotherapeutic fields

  17. Clinical evaluation of a new serum tumour marker CA 242 in pancreatic carcinoma.

    OpenAIRE

    Pasanen, P. A.; Eskelinen, M.; Partanen, K.; Pikkarainen, P; Penttilä, I.; Alhava, E

    1992-01-01

    The aim of this study was to evaluate the new monoclonal tumour marker CA 242 in the diagnosis of pancreatic carcinoma and to compare it with the established markers CA 50 and CEA. Serum concentrations were determined in 113 patients with jaundice, in 20 patients with laboratory values suggesting cholestasis, and in 60 patients with a suspicion to have chronic pancreatitis. Twenty-four of these 193 patients had pancreatic carcinoma and two patients had carcinoma of papilla of Vater. The sensi...

  18. Sister Mary Joseph nodule as the presenting sign of disseminated prostate carcinoma

    Directory of Open Access Journals (Sweden)

    Deb Prabal

    2009-01-01

    Full Text Available Sister Mary Joseph′s nodule is referred to as metastasis of visceral malignancy to the umbilicus. Most common primaries are in the gastrointestinal or genital tract, while other locations are rare. We recently encountered a 76-year-old male who was referred to the surgery clinic with an erythematous nodule in the umbilicus measuring 6 cm in diameter with complaints of painless profuse hematuria. History revealed severe obstructive voiding symptoms of 2-year duration, along with significant loss of weight and difficulty in walking. A detailed examination showed hard nodular hepatomegaly, along with grade IV prostatomegaly. Serum prostate-specific antigen was 3069 ng/ml. A pelvic radiograph displayed multiple osteolytic lesions, while ultrasonography showed multiple iso- and hypoechoic lesions in both lobes of the liver, suggestive of metastasis. Histopathology of a Tru-cut biopsy of the prostate confirmed an adenocarcinoma (Gleason score 9 with umbilical metastasis. The patient was on regular follow-up and died 3 months later.

  19. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

    Directory of Open Access Journals (Sweden)

    Avradip Santra

    2016-07-01

    Full Text Available Superior vena cava (SVC syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.

  20. Ischemic Posterior Circulation Stroke: A Review of Anatomy, Clinical Presentations, Diagnosis and Current Management

    Directory of Open Access Journals (Sweden)

    Amre eNouh

    2014-04-01

    Full Text Available Posterior circulation (PC strokes represent approximately 20% of all ischemic strokes. In contrast to the anterior circulation (AC several differences in presenting symptoms, clinical evaluation, diagnostic testing and management strategy exist which may present a challenge to the treating physician. This review will discuss the anatomical, etiological and clinical classification of PC strokes, identify diagnostic pitfalls and overview current therapeutic regimens.