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Sample records for suspicious primary malignant

  1. Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy.

  2. Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

    Science.gov (United States)

    McElroy, Jennifer Y.; Gorens, Marsha E.; Jackson, Lisa N.; Stigger, Danielle; Becker, Teresa; Sheiner, Eyal

    2006-01-01

    Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy. PMID:17093351

  3. "Suspicious" salivary gland FNA: Risk of malignancy and interinstitutional variability.

    Science.gov (United States)

    Maleki, Zahra; Miller, James Adam; Arab, Seyedeh Elham; Fadda, Guido; Bo, Ping; Wise, Olga; Rossi, Esther Diana; Jhala, Nirag; Ashish, Chandra; Ali, Syed Z; Wang, He

    2018-02-01

    Fine-needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimally invasive, and cost-effective method for the diagnosis of salivary gland lesions. Salivary gland neoplasms are often difficult to diagnose because of morphologic heterogeneity and a variety of epithelial metaplastic changes. Hence, a number of salivary gland FNA specimens yield indeterminate results. For indeterminate FNA specimens, the suspicious-for-malignancy (SFM) category is used when a specific neoplasm falls short in quantity or quality for the criteria for malignancy. Therefore, the findings are not sufficient for a conclusive diagnosis of malignancy. This study was designed to evaluate the risk of malignancy (ROM) for the SFM group at 5 tertiary medical centers worldwide with the aforementioned criteria. Among 12,606 salivary gland FNA cases between 1997 and 2014, 276 (2.2%) were reported to be SFN. Specifically, 114 suspicious cases (41%) had histological follow-up. Histological follow-up of the 114 suspicious cases showed 95 malignant tumors indicating a risk of malignancy (ROM) of 83.3%. The ROM varied between 74% and 88% for the 5 participating institutions, and a Fisher's exact test with significance set to p<.05 showed no significant difference in ROM among the institutions (p = .78). Overall, 83.3% of SFM salivary gland FNA specimens turned out to be malignant; there was no significant interinstitutional variability in the ROMs. The SFM category for salivary gland FNA is very homogeneous, and the ROMs are quite similar worldwide. Cancer Cytopathol 2018;126:94-100. © 2017 American Cancer Society. © 2017 American Cancer Society.

  4. Cavitary lung lesion suspicious for malignancy reveals Mycobacterium xenopi.

    Science.gov (United States)

    Fogla, Sumit; Pansare, Vaishali M; Camero, Luis G; Syeda, Uzma; Patil, Naveen; Chaudhury, Arun

    2018-01-01

    We report the case of a 68-year-old gentleman who presented with musculoskeletal chest pain which appeared suddenly when he bent over with his dog. The chest pain was localized to the left lower chest and increased with movement and deep breathing. The patient did not complain weight loss, night sweat, fever or chill. He complained of mild cough, with expectoration of whitish mucus. Imaging revealed cavitary chest lesion in the right upper lobe, which was initially suspected to be lung cancer. The patient had a 50-year-old history of smoking 2 packs per day. PET CT imaging did not reveal any specific activity. Needle biopsy and bronchoalveolar lavage, however, did not reveal any malignant cells. Rather, necrotic tissues were observed. A wedge resection of the lung mass was performed. No common organisms or fungi could be grown. However, acid fast bacilli were observed in clumps. The morphology hinted towards non-tuberculous mycobacterial organism(s). Molecular studies revealed infection with Mycobacterium xenopi. The patient was started on an anti-tuberculous regimen of INH, rifampicin, ethambutol and PZA, with pyridoxine. The patient is a Vietnam veteran and complained of exposure to dust from a bird's nest and asbestos exposure in childhood, but no specific exposure to tuberculosis. The patient had an uneventful recovery post-surgery. He complained of some nausea after initiation of the antituberculous medications, but his pain subsided with time. The patient had diabetes, though specific reasons of compromise of immune status could not be pinpointed as causative of his nontuberculous mycobacterial lung infection.

  5. Primary ovarian malignant melanoma

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    Kostov Miloš

    2010-01-01

    Full Text Available Background. Primary ovarian malignant melanoma is extremely rare. It usually appears in the wall of a dermoid cyst or is associated with another teratomatous component. Metastatic primary malignant melanoma to ovary from a primary melanoma elsewhere is well known and has been often reported especially in autopsy studies. Case report. We presented a case of primary ovarian malignant melanoma in a 45- year old woman, with no evidence of extraovarian primary melanoma nor teratomatous component. The tumor was unilateral, macroscopically on section presented as solid mass, dark brown to black color. Microscopically, tumor cells showed positive immunohistochemical reaction for HMB-45, melan-A and S-100 protein, and negative immunoreactivity for estrogen and progesteron receptors. Conclusion. Differentiate metastatic melanoma from rare primary ovarian malignant melanoma, in some of cases may be a histopathological diagnostic problem. Histopathological diagnosis of primary ovarian malignant melanoma should be confirmed by immunohistochemical analyses and detailed clinical search for an occult primary tumor.

  6. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

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    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  7. Thyroid nodules with highly suspicious ultrasonographic features, but with benign cytology on two occasions: is malignancy still possible?

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    Rosario, Pedro Weslley; Calsolari, Maria Regina, E-mail: pedrowsrosario@gmail.com [Santa Casa de Belo Horizonte, MG (Brazil)

    2016-11-01

    There is no information about the frequency of malignancy specifically in the case of thyroid nodules with highly suspicious sonographic features, but with two fine needle aspiration (FNA) showing benign cytology. This was the objective of the study. Subjects and methods: We report the results of 105 patients with thyroid nodules considered 'highly suspicious' according to the ultrasonographic classification of American Thyroid Association, in whom FNA revealed benign cytology on two occasions (interval of 6 months). Results: Thyroidectomy was performed in 11 cases due to desire of the patient or significant growth of the nodule. In these patients, cytology continued to be benign in 9, was non-diagnostic in 1, and suspicious in 1. Histology revealed papillary carcinoma in only one nodule. In patients in whom a third FNA was obtained for this study (n = 94), cytology continued to be benign in 86, became non-diagnostic in 5, indeterminate in 2, and suspicious in 1. The last 8 patients (with non-benign cytology) were submitted to thyroidectomy and histology revealed malignancy in only one nodule. Conclusion: The rate of malignancy found here for nodules with highly suspicious sonographic features, even after two FNA showing benign cytology, was 2%. We believe that in these cases, the continuation of follow-up consisting of ultrasound at intervals of 2 years may still be adequate. (author)

  8. Diagnosis and Treatment of a Neck Node Swelling Suspicious for a Malignancy: An Algorithmic Approach

    Directory of Open Access Journals (Sweden)

    A. J. M. Balm

    2010-01-01

    Full Text Available Aim. To present an up-to-date algorithm incorporating recent advances regarding its diagnosis and treatment. Method. A Medline/Pubmed search was performed to identify relevant studies published in English from 1990 until 2008. Only clinical studies were identified and were used as basis for the diagnostic algorithm. Results. The eligible literature provided only observational evidence. The vast majority of neck nodes from occult primaries (>90% represent SCC with a high incidence among middle aged man. Smoking and alcohol abuse are important risk factors. Asiatic and North African patients with neck node metastases are at risk of harbouring an occult nasopharyngeal carcinoma. The remainder are adenocarcinoma, undifferentiated carcinoma, melanoma, thyroid carcinoma and Merkel cell carcinoma. Fine needle aspiration cytology (FNAC reaches sensitivity and specificity percentages of 81% and 100%, respectively and plays an important role as the second diagnostic step after routine ENT mirror and/or endoscopic examination. FDG-PET/CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases. Conclusion. Although reports on the diagnostic process offer mainly descriptive studies, current information seems sufficient to formulate a diagnostic algorithm to contribute to a more systematic diagnostic approach preventing unnecessary steps.

  9. Diagnosis and treatment of a neck node swelling suspicious for a malignancy: an algorithmic approach.

    Science.gov (United States)

    Balm, A J M; van Velthuysen, M L F; Hoebers, F J P; Vogel, W V; van den Brekel, M W M

    2010-01-01

    Aim. To present an up-to-date algorithm incorporating recent advances regarding its diagnosis and treatment. Method. A Medline/Pubmed search was performed to identify relevant studies published in English from 1990 until 2008. Only clinical studies were identified and were used as basis for the diagnostic algorithm. Results. The eligible literature provided only observational evidence. The vast majority of neck nodes from occult primaries (>90%) represent SCC with a high incidence among middle aged man. Smoking and alcohol abuse are important risk factors. Asiatic and North African patients with neck node metastases are at risk of harbouring an occult nasopharyngeal carcinoma. The remainder are adenocarcinoma, undifferentiated carcinoma, melanoma, thyroid carcinoma and Merkel cell carcinoma. Fine needle aspiration cytology (FNAC) reaches sensitivity and specificity percentages of 81% and 100%, respectively and plays an important role as the second diagnostic step after routine ENT mirror and/or endoscopic examination. FDG-PET/CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases. Conclusion. Although reports on the diagnostic process offer mainly descriptive studies, current information seems sufficient to formulate a diagnostic algorithm to contribute to a more systematic diagnostic approach preventing unnecessary steps.

  10. FDG PET and other imaging modalities in the primary diagnosis of suspicious breast lesions

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    Scheidhauer, K.; Seemann, M.D. [Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Ismaninger Strasse 22, 81675, Munich (Germany); Walter, C. [Department of Diagnostic Radiology, Krankenhaus der Barmherzigen Brueder, Trier (Germany)

    2004-06-01

    Mammography is the primary imaging modality for screening of breast cancer and evaluation of breast lesions (T staging). Ultrasonography is an adjunctive tool for mammographically suspicious lesions, in patients with mastopathy and as guidance for reliable histological diagnosis with percutaneous biopsy. Dynamic enhanced magnetic resonance mammography (MRM) has a high sensitivity for the detection of breast cancer, but also a high false positive diagnosis rate. In the literature, MRM is reported to have a sensitivity of 86-96%, a specificity of 64-91%, an accuracy of 79-93%, a positive predictive value (PPV) of 77-92% and a negative predictive value (NPV) of 75-94%. In unclarified cases, metabolic imaging using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) can be performed. In the literature, FDG PET is reported to have a sensitivity of 64-96%, a specificity of 73-100%, an accuracy of 70-97%, a PPV of 81-100% and an NPV of 52-89%. Furthermore, PET or PET/CT using FDG has an important role in the assessment of N and M staging of breast cancer, the prediction of tumour response in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy, and the differentiation of scar and cancer recurrence. Other functional radionuclide-based diagnostic tools, such as scintimammography with sestamibi, peptide scintigraphy or immunoscintigraphy, have a lower accuracy than FDG PET and, therefore, are appropriate only for exceptional indications. (orig.)

  11. Malignant acanthosis nigricans with occult primary

    Directory of Open Access Journals (Sweden)

    Thomas Moly

    2002-11-01

    Full Text Available A case of generalized malignant acanthosis nigricans of 2 years duration is reported. In spite of the long duration of this cutaneous marker of internal malignancy, the patient was completely asymptamatic and extensive investigations revealed the presence of widespread metastasis of mucin secreting signet cell adenocarcinoma from an unknown primary site. In addition the patient also had acquired hypertrichosis lanuginose and florid cutaneous papillomatosis which are also markers of internal malignancy.

  12. Primary malignant lymphoma of the rectum

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    Hirakata, K.; Nakata, H.; Nakayama, T.; Kajiwara, Y.; Kuroda, Y.

    1989-07-01

    A rare case of a primary malignant lymphoma of the rectum in a 7 year old girl is presented. Although rectal polyps in children are usually benign juvenile polyps, a rare possibility of malignancy should be kept in mind. An adequate histological examination is essential. (orig.).

  13. MULTIPLE PRIMARY MALIGNANCIES IN PATIENTS.cdr

    African Journals Online (AJOL)

    RICHY

    Two patients had cancers of the colon followed by ovarian malignancy in one and a rectal malignancy in the other. Of the other patients, one had cancer of the cervix and later she developed None Hodgkin's lymphoma. ..... primary cancer after treatment of the first with radiotherapy or chemotherapy is well documented.

  14. Primary Malignant Melanoma of the Female Genital Tract

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    Tayfun Gungor

    2009-06-01

    Conclusion: Although malignant melanoma of the female genital tract is uncommon, elderly women should undergo regular gynecologic examinations and suspicious pigmented lesions should be biopsied. The use of immunohistochemical assays could markedly improve diagnosis. However, the prognosis for these tumors is poor, regardless of the treatment delivered, and they are associated with a high rate of recurrence and low long-term survival. Surgery is the best available treatment for controlling and potentially curing malignant melanomas.

  15. Pediatric second primary malignancies after retinoblastoma treatment.

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    Temming, Petra; Viehmann, Anja; Arendt, Marina; Eisele, Lewin; Spix, Claudia; Bornfeld, Norbert; Sauerwein, Wolfgang; Jöckel, Karl-Heinz; Lohmann, Dietmar R

    2015-10-01

    Children with retinoblastoma carry a high risk to develop second primary malignancies in childhood and adolescence. This study characterizes the type of pediatric second primary malignancies after retinoblastoma treatment and investigates the impact of different treatment strategies and prognostic factors at presentation. All national patients treated for retinoblastoma at the German referral center with a current age of 6-27 years were invited to participate in a study to characterize late effects. Data on pediatric second primary malignancies were recorded from 488 patients. Ten developed a malignancy before the age of 18 years. For children with heterozygous oncogenic RB1 alteration (heritable retinoblastoma), the cumulative incidence to develop a second malignancy at the age of 10 years was 5.2% (95% CI 1.7; 8.7%). This results in an elevated risk for sarcoma (n = 4) (SIR 147.98; 95% CI 39.81; 378.87) and leukemia (n = 4) (SIR 41.38; 95% CI 11.13; 105.95). Neither the functional type of the RB1 alteration nor its origin showed a significant impact. Treatment modality influenced incidence, latency, and type of malignancy. Previous radiotherapy increased the risk for solid tumors and 3 of 91 children developed acute leukemia after chemotherapy. However, 2 of 10 malignancies were diagnosed in patients with heritable retinoblastoma but without previous chemotherapy or external beam radiotherapy. Screening for second primary malignancy is an important part of pediatric oncological follow-up in patients with heritable retinoblastoma. For patients with sporadic unilateral retinoblastoma, genetic information influences treatment decisions and allows tailoring of follow-up schedules. © 2015 Wiley Periodicals, Inc.

  16. [Three cases of primary pulmonary malignant lymphoma].

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    Sakuraba, M; Onuki, T; Mae, M; Yoshida, T; Nitta, S

    2000-09-01

    Primary pulmonary malignant lymphoma is a rare disease that is thought to belong to a category of malignant lymphomas arising from mucosa- or bronchus-associated lymphoid tissue (MALT or BALT). We encountered 3 cases of primary pulmonary malignant lymphoma, Case 1: In a 51-year-old male, an abnormal shadow was detected in chest radiography in the right S9 after an operation for thyroid carcinoma. A right lower lobectomy was performed. The diagnosis was malignant lymphoma (marginal zone B-cell lymphoma). Immunohistochemical staining for IgM gave a positive result. Case 2: Multiple nodular shadows were noted in both lungs of a 55-year-old man after a bout of pneumonia. Video-assisted thoracoscopic surgery was performed, and the diagnosis was malignant lymphoma (marginal zone B-cell lymphoma). Gene analysis revealed rearrangement of a heavy chain gene. Case 3: An abnormal shadow was seen in the chest radiograph of a 60-year-old man. He was treated by right upper and middle lobectomy. The diagnosis was Hodgkin's disease, nodular sclerosing type. Chemotherapy was given after surgery and the patient is now alive without recurrence. As the pulmonary malignant lymphoma was difficult to diagnosepreoperatively, it was necessary to resect the mass for diagnostic purposes. The prognosis of a resected solitary lesion in the lobe was good. Therefore lobectomy was performed as the treatment of choice. Systemic chemotherapy is performed for the diffuse type of pulmonary lymphoma.

  17. Primary Oral Malignancy Imitating Peri-Implantitis.

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    Raiser, Vadim; Abu-El Naaj, Immad; Shlomi, Benjamin; Fliss, Dan M; Kaplan, Ilana

    2016-07-01

    To describe new cases of primary malignancy arising around dental implants. Three patients presented with asymptomatic lesions around longstanding dental implants that resembled peri-implantitis. One case was primary large B-cell lymphoma and the remaining cases were primary squamous cell carcinoma in patients with oral lichen planus. The literature was reviewed for cases mimicking peri-implantitis. Of 42 implant-associated malignancies reported from 2000 through 2014, 85.7% were squamous cell carcinoma (69% primary and 9.4% metastatic). Most patients presented with pre-existing risk factors for oral cancer. Lymphoma was not associated with dental implants. Primary and metastatic malignancies can occur in peri-implant mucosa, often with clinical and radiographic features resembling peri-implantitis. Clinicians should have a high index of suspicion for changes in peri-implant mucosa in patients with existing risk factors; however, rare cases such as lymphoma might present outside this risk population. Histopathologic analysis should be included in the management of selected peri-implant lesions to avoid delayed diagnosis of malignancy. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    National Research Council Canada - National Science Library

    Dobrosavljević, Aleksandar; Rakić, Snezana; Nikoli, Branka; Raznatović, Svetlana Janković; Dikić, Svetlana Dragojević; Milosević, Zorica; Jurisić, Aleksandar; Skrobić, Milica

    2016-01-01

    Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant...

  19. PRIMARY MALIGNANT MELANOMA OF ARYEPIGLOTTIC FOLD

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... This can be helpful in development of effective adjuvant immunotherapy for the treatment of melano- mas.1,3. Patients with primary malignant melanoma of the lar- ynx usually present with complaints of hoarseness of voice and sore throat. If the size of tumor increases and obstructs the lumen of larynx, ...

  20. SUSPICIOUS POST

    CERN Multimedia

    Relations with the Host States Service

    2001-01-01

    If you receive a suspicious letter or package in the post, please do not open it and contact the Fire Brigade Tel. 74444. They will contact the CERN Medical Service. This is especially important in today's current situation with regard to the Anthrax scare. For further information, the Permanent Mission of Switzerland to the International Organisations in Geneva recommends the following web sites:   http://www.admin.ch/ch/f/cf/brennpunkt/03.html http://www.who.int/emc-documents/zoonoses/whoemczdi986c.html

  1. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    Directory of Open Access Journals (Sweden)

    Dobrosavljević Aleksandar

    2016-01-01

    Full Text Available Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%, fibroadenoma (26.7%, fibrocystic dysplasia with/without atypia (10%, lipoma (3.3% and intramammary lymph node (3.3%. Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05. All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05. Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C and BI-RADS 5 lesions should be worked-up with biopsy.

  2. Primary malignant melanoma of aryepiglottic fold | Chhabra | Ghana ...

    African Journals Online (AJOL)

    Background: Primary malignant melanoma rarely arises from noncutaneous tissues that contain melanocytes. Head and neck mucosal melanomas account for 0.7% to 3.8% of all melanomas. Here we report a case of primary malignant melanoma of aryepiglottic fold. Result: Here we reported a case of primary malignant ...

  3. Imaging Findings of Primary Tubal Malignancy

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    Nam, Sang Been; Park, Jun Young; Park, Dong Hee; Kim, Kie Hwan [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Cho, Kyoung Sik [Dept. of Radiology and Research Institute of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2012-02-15

    To describe the radiologic findings of primary tubal malignancy. This study described the imaging findings of 27 patients with 28 cases of primary tubal malignancy. Of the 27 patients examined, 23 underwent CT, 3 underwent MRI and 4 underwent ultrasonography. Image findings were analyzed according to size, proportion of cyst, shape, and associated findings of tumor. The mean tumor diameter was 5.3 cm (range 2.0-13.1 cm). According to proportion of cyst within the tumor, each case was categorized in one of the four types: 10 cases (35.7%) of type I ({>=} 75 of cystic portion), 2 cases (7.1%) of type II (50-75%), 3 cases (10.7%) of type III (25-50%) and 13 cases (46.4%) of type IV ({<=} 25%). According to the shape of the tumor, 7 cases (25%) were round, 12 cases (42.9%) were lobular, and 9 cases (32.1%) were tubular. Moreover, septa were observed in 8 cases (28.6%), wall thickening was observed in 13 cases (46.4%), and hydrosalpinx was observed in 11 cases (39.3%). The imaging findings of tubal cancer manifests from a solid to a cystic mass. It is a challenge to differentiate primary tubal cancer from ovarian cancer, but when it is associated with hydrosalpinx or the shape of the tumor is lobular or tubular, primary tubal cancer can be suggested as part of the differential diagnosis.

  4. [Primary Malignant Cardiac Tumors: Surgical results].

    Science.gov (United States)

    Saraiva, Joana; Antunes, Pedro Engrácia; Carvalho, Lina; Antunes, Manuel Jesus

    2016-04-01

    To characterize primary malignant cardiac tumors operated on in our center and to analyze patient survival. Between January 1994 and August 2014, 123 patients with cardiac tumors underwent surgery, of which 12 (9.8%) were primary malignant tumors - eight sarcomas (67%), three B-cell lymphomas (25%) and one epithelioid hemangioendothelioma (8.3%). The tumor affected the left atrium in five cases (42%), the right atrium in four (33%), the right ventricle in two (17%) and the pulmonary valve in one (8%). Patients' mean age was 55.4 ± 16.9 years, 67% were female and 75% presented in New York Heart Association class III-IV. Resection was complete (negative margins) in five cases and partial in seven (five sarcomas and two lymphomas), and 11 patients needed adjuvant therapy, surgery alone being curative in only one (epithelioid hemangioendothelioma). Mean follow-up was 41.7 ± 61.3 months: 24.8 ± 30.0 months (3.8-95.7) for sarcomas, 70.1 ± 118.0 months (1-206.3) for lymphomas and 91.9 months for the epithelioid hemangioendothelioma. During follow-up, 10 patients died (83%) and two were alive (17%). Overall survival at 30 days, six months, one year and two years was 91.7%, 66.7%, 58.3% and 41.7%, respectively. In the sarcoma group, 1-year and 2-year survival were 62.5% and 37.5%, respectively. Resection of primary malignant cardiac tumors, even partial, is safe, provides relief of obstructive symptoms and improves quality of life, but is rarely curative and has a low survival rate. Due to the rarity of such tumors, a multicenter database could improve knowledge and help clarify the indications for cardiac surgery as a treatment option. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  5. Complete regression of primary malignant melanoma.

    Science.gov (United States)

    Emanuel, Patrick O; Mannion, Meghan; Phelps, Robert G

    2008-04-01

    Over the years, histopathologic studies to determine the nature and significance of regression in malignant melanoma have yielded different results. At least in part, this most likely reflects differences in the definition of what constitutes regression. Although partial regression is relatively common, complete regression is rare. It has been said that complete regression of a primary lesion is associated with metastatic disease, but the evidence for this is largely anecdotal-the literature contains only case reports and small series. We found 2 cases of complete regression in our dermatopathology database. Metastatic disease was identified in both cases; in 1 case, the suspicion of melanoma was raised on the initial biopsy and subsequent workup revealed lymph node metastasis. These cases illustrate the histologic features of a completely regressed primary melanoma and add credence to the theory that completely regressed melanoma is associated with a poor outcome.

  6. Primary Malignant Neuroendocrine Tumour of Pleura: First Case Report

    Directory of Open Access Journals (Sweden)

    Anirban Das

    2016-01-01

    Full Text Available Metastatic tumours of pleura are the most common malignant tumours causing malignant pleural effusion. Lungs are the most common primary sites. Primary pleural tumours are rarely seen and diffuse malignant mesothelioma is the most common malignant tumour of pleura. Primary malignant neuroendocrine tumour of pleura is not reported in the literature. Here, we report a rare case of primary malignant neuroendocrine tumour of pleura in a fifty-two-year-old, nonsmoker female who presented with right-sided pleural effusion and ipsilateral, dull aching chest pain. Clinical presentations of inflammatory lesions like tuberculous pleuritis and benign and malignant neoplasms of pleura are indistinguishable; hence, fluid cytology, pleural biopsy, and immunohistochemistry are necessary for exact tissue diagnosis of the tumours, which is mandatory for correct treatment and prognostic assessment.

  7. Primary Malignant Amelanotic Melanoma Arising From a Vitiligo ...

    African Journals Online (AJOL)

    Skin cancer is rare in people of African origin while vitiligo occurs worldwide. The occurrence of primary malignant melanoma and vitiligo together is very rare. We present a rare case of primary malignant amelanotic melanoma arising from a depigmented patch of a patient with vitiligo. It was completely excised and followed ...

  8. Pattern of second primary malignancies in thyroid cancer patients ...

    African Journals Online (AJOL)

    Nigerian Journal of Clinical Practice ... thyroid malignancies were the second primary cancers, they usually follow radiotherapy to the head and neck region for treatment of the first primary tumor and tend to be of aggressive histologic types than the ... Key words: Radiation, radiotherapy, second malignancies, thyroid cancer ...

  9. Primary malignant bone tumour in a tropical African University ...

    African Journals Online (AJOL)

    Osteogenic sarcoma was the most common primary malignant bone tumour while the mandible was the most commonly affected bone. In contrast to previous studies, Burkitt's lymphoma affected the mandible more commonly than the maxilla. The relative frequency of primary malignant bone tumours is low in our ...

  10. RB1 mutations and second primary malignancies after hereditary retinoblastoma

    NARCIS (Netherlands)

    Dommering, Charlotte J.; Marees, Tamara; van der Hout, Annemarie H.; Imhof, Saskia M.; Meijers-Heijboer, Hanne; Ringens, Peter J.; van Leeuwen, Flora E.; Moll, Annette C.

    Survivors of hereditary retinoblastoma have a high risk of second primary malignancies, but it has not been investigated whether specific RB1 germline mutations are associated with greater risk of second primary malignancies in a large cohort. We conducted a retrospective cohort study of 199

  11. RB1 mutations and second primary malignancies after hereditary retinoblastoma

    NARCIS (Netherlands)

    Dommering, Charlotte J.; Marees, Tamara; van der Hout, Annemarie H.; Imhof, Saskia M.; Meijers-Heijboer, Hanne; Ringens, Peter J.; van Leeuwen, Flora E.; Moll, Annette C.

    2012-01-01

    Survivors of hereditary retinoblastoma have a high risk of second primary malignancies, but it has not been investigated whether specific RB1 germline mutations are associated with greater risk of second primary malignancies in a large cohort. We conducted a retrospective cohort study of 199

  12. Primary oral malignant melanoma - A case report | Kumar | Nigerian ...

    African Journals Online (AJOL)

    This paper reports a case of a 42year old woman with primary malignant melanoma at a rare site, the left retromolar region involving the left side of the mandible, up to level IV ipsilateral cervical lymph nodes. The patient was treated ... should be biopsied. Keywords: Malignant melanoma, palate, maxilla, gingiva, oral cavity ...

  13. Pattern of second primary malignancies in thyroid cancer patients

    African Journals Online (AJOL)

    2012-07-02

    Jul 2, 2012 ... to institutional protocols. Pattern of second primary malignancies in thyroid ... leukemia (CML), about 16.7% of malignancies occurred in the region of the head and neck, specifically one each for ... tumors and that the risk of leukemia following radiation is considerably smaller than after chemotherapy.

  14. Biphasic Malignant Pleural Mesothelioma Masquerading as a Primary Skeletal Tumor

    Directory of Open Access Journals (Sweden)

    James Benjamin Gleason

    2016-01-01

    Full Text Available Biphasic malignant pleural mesothelioma is a rare malignant tumor, usually presenting as a pleural-based mass in a patient with history of chronic asbestos exposure. We herein report a case of a 41-year-old man who presented with chest pain and had a chest computed tomography (CT scan suggestive of a primary skeletal tumor originating from the ribs (chondrosarcoma or osteosarcoma, with no history of asbestos exposure. CT-guided core needle biopsies were diagnosed as malignant sarcomatoid mesothelioma. Surgical resection and chest wall reconstruction were performed, confirming the diagnosis and revealing a secondary histologic component (epithelioid, supporting the diagnosis of biphasic malignant mesothelioma.

  15. primary malignant amelanotic melanoma arising from a vitiligo patch ...

    African Journals Online (AJOL)

    2014-05-05

    May 5, 2014 ... nevus, achromic patches on melanoma scars, depigmentation of injection site after immunotherapy and depigmentation associated with regressing malignant melanoma. The association of vitiligo with regressing melanoma has been widely reported in literature, however primary melanoma presenting.

  16. Primary malignant bone tumours in Ibadan, Nigeria: an update.

    Science.gov (United States)

    Omololu, A B; Okolo, C A; Ogunlade, S O; Oyebadejo, T Y; Adeoye, A O; Ogunbiyi, J O; Akang, E E; Gopaldasani, V K

    2009-03-01

    Bone tumours are relatively rare compared to tumours of other sites. The frequency of primary malignant bone tumours is low in our environment, as was observed in an earlier study. The aim of this study is to update the information available on the pattern of primary malignant bone tumours at the University College Hospital (UCH), Ibadan, Nigeria. The medical records of 49 patients with malignant bone tumours documented in the Cancer Registry of UCH, Ibadan between January 2001 and September 2007 were reviewed retrospectively. The results were then added to those of the previous study published in 2002. This brought the number of cases of primary malignant bone tumours to 163 from January 1977 to September 2007. Primary malignant bone tumours represented 0.53% of the 30462 cases of cancer seen in the hospital in the period studied. The male female ratio was 1.5:1. About 44% of the tumours occurred among patients less than 20 years of age. Osteogenic sarcoma was the commonest malignant bone tumour. Important changes recorded in the seven years since the last review from this centre include; a rise in the prevalence rate of primary malignant bone tumours (49 new cases in the last seven years as compared to 114 cases over 23 years), the male-female ratio of Osteogenic sarcoma showed a decline (1.5:1 as compared to 1.6:1), and there was an increase in the prevalence of primary malignant bone tumours in the 0-9 years and > 60 years age groups. The significance of these findings will need to be determined by further studies.

  17. Primary malignant melanoma of the vagina: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young; Kim, Do Kang; Lee, Eun Hee [College of Medicine, Catholic Univ., Seoul (Korea, Republic of); Kim, Jun Sang [College of Medicine, Chungnam National Univ., Daejeon (Korea, Republic of)

    2003-09-01

    A primary malignant melanoma of the vagina is a very rare gynecological malignant tumor. Its clinical behavior is more aggressive than that of cutaneous and vulvar melanomas. We present a case of a large sized primary melanoma of the lower third of the vagina, with a cervical lesion, in a 58-year-old postmenopausal woman. The patient was treated with conventional external radiation therapy and intracavitary radiotherapy (lCR), without surgical treatment. Although the primary lesion showed a partial response, the patient died of extensive metastases, which were found 4.5 months after the initial diagnosis. We suggest that shortening the treatment period, such as hypofractionated radiation therapy and surgical removal, and various systemic therapies for preventing early distant metastasis, are appropriate treatments for a primary malignant melanoma of the vagina, with a large tumor size.

  18. Primary Malignant Fibrous Histiocytoma: A Rare Case

    Directory of Open Access Journals (Sweden)

    Anastasios Katsourakis

    2011-01-01

    Full Text Available Malignant fibrous histiocytoma (MFH of the small intestine is an extremely rare condition. It occurs most commonly in the extremities and the trunk. We report a case of a 67-year-old woman who admitted with fever, myalgia, and altered status. After thorough investigation, a tumor of the jejunum was found. The patient underwent complete surgical removal of the tumor. A diagnosis of MFN (undifferentiated high-grade pleomorphic sarcoma was made. The patient received adjuvant chemotherapy with Gemcitabine. Two years after the operation, the patient died due to recurrence of the disease. MFH of the small intestine is an extremely rare neoplasm with an aggressive biological behaviour. In this paper, pathogenesis, natural history, and treatment are reviewed.

  19. Glioblastoma multiforme and papillary thyroid carcinoma - A rare combination of multiple primary malignancies

    Directory of Open Access Journals (Sweden)

    Swaroopa Pulivarthi

    2015-01-01

    Full Text Available We are describing a 19-year-old white woman who presented with two synchronous primary cancers, namely glioblastoma multiforme and papillary thyroid cancer. The patient was admitted with dizziness, headache, and vomiting. CT head revealed acute intraparenchymal hematoma in the right cingulate gyrus and the splenium of the corpus callosum. Carotid and cerebral angiogram were unremarkable. MRI of the brain demonstrated a non-enhancing and non-hemorrhagic component of the lesion along the lateral margin of the hemorrhage just medial to the atrium of the right lateral ventricle that was suspicious for a tumor or metastasis. Brain biopsy confirmed it as glioblastoma mutiforme. CT chest was done to rule out primary cancer that revealed a 11 mm hypodense lesion in the left lobe of the thyroid and ultrasound-guided fine-needle aspiration biopsy confirmed it as papillary thyroid carcinoma. We should evaluate for multiple primary malignancies in young patients who are found to have primary index cancer.

  20. Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features.

    Science.gov (United States)

    Delfim, Ricardo Luiz Costantin; Veiga, Leticia Carrasco Garcez da; Vidal, Ana Paula Aguiar; Lopes, Flávia Paiva Proença Lobo; Vaisman, Mário; Teixeira, Patrícia de Fatima Dos Santos

    2017-01-01

    The aim of this study was to describe the ultrasound features of benign and malignant thyroid nodules and evaluate the likelihood of malignancy associated with each feature according to the Bethesda System for Reporting Thyroid Cytopathology and histopathology. With this analysis, we propose a new TI-RADS classification system. The likelihood of malignancy from ultrasound features were assessed in 1413 thyroid nodules according to the Bethesda System for Reporting Thyroid Cytopathology and histopathological findings. A score was established by attributing different weights to each ultrasound feature evaluated. Features positively associated with malignancy in bivariate analysis received a score weight of +1. We attributed a weight of +2 to features which were independently associated with malignancy in a multivariate analysis and +3 for those associated with the highest odds ratio for malignancy (> 10.0). Hence, hypoechogenicity (graded as mild, moderate or marked, according to a comparison with the overlying strap muscle), microcalcification and irregular/microlobulated margin received the highest weights in our scoring system. Features that were negatively associated with malignancy received weights of -2 or -1. In the proposed system a cutoff score of 2 (sensitivity 97.4% and specificity 51.6%) was adopted as a transition between probably benign (TI-RADS 3) and TI-RADS 4a nodules. Overall, the frequency of malignancy in thyroid nodules according to the categories was 1.0% for TI-RADS 3, 7.8% for TI-RADS 4a, 35.3% for TI-RADS 4b, and 84.7% for TI-RADS 5. A newly proposed TI-RADS classification adequately assessed the likelihood of malignancy in thyroid nodules.

  1. Vaginal Primary Malignant Melanoma: A Rare and Aggressive Tumor

    Directory of Open Access Journals (Sweden)

    Georgios Androutsopoulos

    2013-01-01

    Full Text Available Vaginal primary malignant melanoma is a rare and very aggressive tumor. It most commonly occurs in postmenopausal women, with a mean age of 57 years. Our patient is an 80-year-old, postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. On gynecologic examination there was a pigmented, raised, ulcerated, and irregular lesion  cm in the upper third of anterior vaginal wall. She underwent a wide local excision of the lesion. The histopathology revealed vaginal primary malignant melanoma with ulceration and no clear surgical margins. She denied any additional surgical interventions and underwent to postoperative adjuvant radiotherapy. Follow up 5 months after initial diagnosis revealed no evidence of local recurrence or distant metastasis. The prognosis of vaginal primary malignant melanoma is very poor despite treatment modality, because most of the cases are diagnosed at advanced stage. Particularly patients with no clear surgical margins and tumor size >3 cm needed postoperative adjuvant radiotherapy.

  2. Malignancy risk prediction for primary jejunum-ileal tumors

    Directory of Open Access Journals (Sweden)

    MARQUES Ruy Garcia

    2000-01-01

    Full Text Available This work is aimed at identifying factors associated with primary jejunum-ileal tumors malignancy, defining a prediction model with sensitivity, specificity and accuracy to distinguish malign from benign neoplasms. These tumors are rare, have highly unspecific presentation and, frequently, are diagnosed late. We reviewed the charts of 42 patients with primary jejunum-ileal tumors treated in the Department of General Surgery of Rio de Janeiro State University Hospital, Rio de Janeiro, RJ, Brazil, from 1969 to 1998. We performed bivariate analyses, based on chi² test, searching associations between tumors malignancy and demographic and clinical variables. Then logistic regression was employed to consider the independent effect of variables previously identified on malignancy risk. The malign tumors included 11 adenocarcinomas, 7 leiomyosarcomas, 5 carcinoids and 4 lymphomas; the benign tumors included 10 leiomyomas, 2 hamartomas, and single cases of adenoma, multiple neurilemoma and choristoma. The bivariate analyses indicated the association between malignancy and palpable abdominal mass (P = 0.003, period from signs and symptoms onset to diagnosis (P = 0.016, anemia (P = 0.020, anorexia (P = 0.003, abdominal pain (P = 0.031, weight loss (P = 0.001, nausea and vomit (P = 0.094, and intestinal obstruction (P = 0.066; no association with patients demographic characteristics were found. In the final logistic regression model, weight loss, anemia and intestinal obstruction were statistically associated with the dependent variable of interest. Based only on three variables -- weight loss, anemia and intestinal obstruction -- the model defined was able to predict primary jejunum-ileal tumors malignancy with sensitivity of 85.2%, specificity of 80.0%, and accuracy of 83.3%.

  3. Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

    National Research Council Canada - National Science Library

    Kılıçkaya, M. Mustafa; Aynali, Giray; Ceyhan, Ali Murat; Çiriş, Metin

    2016-01-01

    .... Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously...

  4. Reconstruction of Lower Extremity Primary Malignant and Metastatic ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... Introduction: This study is aimed to assess the functional results of cases with lower extremity malignant and metastatic bone tumours that were treated with modular tumour resection prostheses. Materials and Methods: 49 patients were retrospectively examined. 27 (55.1%) patients had a primary bone ...

  5. Reconstruction of Lower Extremity Primary Malignant and Metastatic ...

    African Journals Online (AJOL)

    Introduction: This study is aimed to assess the functional results of cases with lower extremity malignant and metastatic bone tumours that were treated with modular tumour resection prostheses. Materials and Methods: 49 patients were retrospectively examined. 27 (55.1%) patients had a primary bone tumour, and 22 ...

  6. Primary malignant skin tumours in Ghanaians: a prospective study of ...

    African Journals Online (AJOL)

    A four year (2003 to 2007) prospective study of patients presenting at a Plastic and Reconstructive Surgical clinic in Ghana with malignant primary skin tumours was undertaken. The patients were examined clinically; the diagnosis was confirmed by biopsy. The patients had wide excision of their lesions with either direct ...

  7. Multiple Primary Malignancies in Patients: Case Reports of Five ...

    African Journals Online (AJOL)

    Occurrences of multiple discrete synchronous or metachronous primary neoplasms in a single patient though reported are not a common occurrence. In the last the last ten years five patients presented to Nchanga South Hospital in Chingola, Zambia with multiple discrete malignancies. The mean age of our patients was ...

  8. 4. Primary Malignant Bone Tumours at the University Teaching ...

    African Journals Online (AJOL)

    46987.2

    The highest number of patients, 39 (25.5%) was recorded in 2012 and the lowest number 20 (13%) was recorded in 2011. Based on National Cancer Registry data, from 2008 to 2011, the overall proportion of patients with primary malignant bone tumours compared to all the other cancers recorded at UTH ranged between ...

  9. Primary malignant gastric PEComa - Diagnostic and technical dilemmas.

    Science.gov (United States)

    Waters, Peadar S; Mitchell, David P; Murphy, Ruth; McKenna, Michael; Waldron, Ronan P

    2012-01-01

    The World Health Organisation defines PEComa's as "a mesenchymal tumour composed of histologically and immunohistochemically distinctive perivascular cells".(1) These ubiquitous tumours show distinctive perivascular epithelioid cell differentiation and arise most commonly at visceral and abdominopelvic sites. We present a case of a forty-two year old man presenting to accident and emergency department with upper gastro-intestinal bleeding. He had a palpable epigatric mass on examination. He underwent a CT Scan Abdomen which displayed a tumour arising from the gastric wall. Upper GI endoscopy and biopsy was carried out and biopsied were taken for histological analysis. A primary gastric PEComa was diagnosed and the patient underwent distal polya gastrectomy and gastrojejunostomy. This is believed to be the first reported case of a Primary malignant gastric PEComa. Perivascular epithelioid carcinomas were first described in 1943 as an abnormal myoblast in a case of renal angiomyolipoma. PEComas display a strong female predominance with a typical benign course. There are approximately 100 reported cases of PEComa to date, with 55 of which were malignant. PEComa's may be subdivided into benign, uncertain malignant potential and malignant. Their natural history can be very aggressive leading to multiple metastases and death as expected with a high-grade sarcoma. This case depicts the aggressive nature of malignant gastric PEComa's. The majority of PEComa's are benign in nature and have a better prognosis. We display here the challenges in ascertaining a definitive diagnosis and management of such patients due to limited clinical studies.

  10. Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Ekram Ullah

    2012-01-01

    Full Text Available Primary hyperparathyroidism is a disease characterized by excessive secretion of parathormone. During the course of this disease, bone loss occurs, particularly depending on resorption of the skeletal system. One of the complications of primary hyperparathyroidism is fibrotic, cystic bony changes which is called Brown tumor. Skeletal manifestations in the form of Brown tumors are rare and according to literature occur in less than 2% of patients suffering from any form of hyperparathyroidism. Such rare and multiple benign lesions may simulate a malignant neoplasm and pose a real challenge for the clinician in its differential diagnosis. We present a case of a 23-year-old Indian woman who was evaluated for multiple lytic expansile lesions with a strong suspicion of malignancy and fibrous dysplasia but turned out to be a case of primary hyperparathyroidism.

  11. Evaluation of the MoleMateTM training program for assessment of suspicious pigmented lesions in primary care

    Directory of Open Access Journals (Sweden)

    Annabel Wood

    2008-05-01

    Conclusion The MoleMateTM training program is a potentially effective and acceptable informatics tool to teach practitioners to recognise the features of SPLs identified by the MoleMateTM system. It will be used as part of the intervention in a randomised controlled trial to compare the diagnostic accuracy and appropriate referral rates of practitioners using the MoleMateTM system with best practice in primary care.

  12. Multiple Primary Malignancies in Patients with Multiple Early Gastric Cancer.

    Science.gov (United States)

    Kim, Dae Hoon; Kim, Su Mi; Choi, Min Gew; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung

    2017-06-01

    This study aimed to investigate the correlation between multiple early gastric cancer (MEGC) and multiple primary malignancies during the follow-up of patients with gastrectomy. The number of primary tumors detected in other organs after gastrectomy for early gastric cancer (EGC) has been increasing because of improved survival and surveillance programs. A total of 3,129 patients underwent radical gastrectomy for treatment of EGC at Samsung Medical Center from January 2000 to December 2005. Of these, 3,057 patients were selected and their medical records were retrospectively analyzed. Among the 3,057 patients, 148 (4.8%) had MEGC, 84.5% were male, 57.4% were over 60 years old, 42.6% had a macroscopic type EGC IIb main lesion, and 68.9% had well-differentiated tumors with a significantly high incidence of MEGC. There were no differences between patients with solitary early gastric cancer (SEGC) and those with MEGC with regard to overall survival or recurrence-free survival, but MEGC was an independent risk factor for metachronous primary malignancies in other organs (P=0.004, hazard ratio [HR]=2.444). MEGC is not a risk factor for poor prognosis after curative gastrectomy, but it is a risk factor for metachronous primary malignancies in other organs during postoperative follow-up; therefore, careful surveillance is needed.

  13. Malignant priapism: Penile metastasis originating on a primary prostate adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sandro Roberto da Silva Gaspar

    2015-01-01

    Full Text Available Malignant priapism is a definition invented in 1938 by Peacock, defined as a persistent erection, not related with sexual activity, caused by cavernous sinus and associated venous systems invasion with malignant cells. Penile secondary lesions are rare entities. Primary locations are usually the pelvic cavity organs, namely the prostate and the bladder as the most common ones. Priapism as a first manifestation of these kinds of lesions is even rarer. The aim was to present a 52-year-old patient harboring a penile metastasis that originated in the primary prostate adenocarcinoma, manifesting itself as a "common" priapism. The patient referred to the emergency room presenting with a priapism and nodules at the coronal sulcus, without previous similar episodes. His evolution until properly diagnosed was catastrophic with multiple lymph nodes, bone and organ involvement, and with his demise soon after from serious bleeding and congestive heart failure, almost 2 months after he first came to the emergency room. We review the literature concerning malignant priapism, diagnosis, and current treatment and survival perspectives.

  14. Unexpected second primary malignancies detected by f-18 FDG PET/CT during follow-up for primary malignancy: Two case report

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Ji In; Lee, Eun Seong; Kim, Tae Sung; Kim, Seok Ki [Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2015-03-15

    As the survival rate of cancer patients has increased over the last few decades, the risk of cancer survivors developing second primary malignancies has gained attention. We report two rare cases of second primary hematologic malignancy detected by 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) during follow-up for primary solid malignancies. Acute lymphoblastic leukemia developed in a breast cancer patient and non-Hodgkin lymphoma in an anal cancer patient. F-18 FDG PET/CT findings led to the diagnosis of unexpected second primary hematologic malignancy in cancer survivors in these two cases.

  15. "Burned out" testicular seminoma presenting as a primary gastric malignancy.

    Science.gov (United States)

    Mesa, Hector; Rawal, Ajay; Rezcallah, Anthony; Iwamoto, Carlos; Niehans, Gloria A; Druck, Paul; Gupta, Pankaj

    2009-02-01

    In contrast to primary gastric adenocarcinomas, germ cell tumors are potentially curable even when metastatic. It is therefore essential for clinicians and pathologists to be aware of the spectrum of unusual manifestations of germ cell malignancies. Here we report on a 55-year-old man who presented with clinical and endoscopic features indicative of a primary gastric carcinoma. Surprisingly, the ulcerative mucosal lesion was found to be due to a metastasis from an occult, "burned-out" testicular seminoma. This case describes the radiological and pathological features that helped differentiate this rare situation from the much more common gastric adenocarcinoma, and extends the diagnostic possibilities that must be considered in patients presenting with gastric ulcers.

  16. Primary Non-Hodgkin's Malignant Lymphoma of the Sinonasal Tract

    Directory of Open Access Journals (Sweden)

    Nitin Gupta

    2009-09-01

    Full Text Available Primary non-Hodgkin’s lymphomas (NHL of the sinonasal tract are rather uncommon entities. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non- neoplastic processes. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and invasive fungal infection respectively. We report a case of primary NHL involving sinonasal tract in elderly female, which was clinically and radiologically mimicking as sinonasal malignany and was proven as NHL on histological examination and confirmed by immunohistochemistry. A high index of suspicion, appropriate histopathological examination and immunohistochemistry is necessary to differentiate sinonasal lymphomas from other possibilities. Failure to do so may miss the diagnosis and delay appropriate treatment

  17. Primary malignant pericardial sarcomatoid mesothelioma: An autopsy report.

    Science.gov (United States)

    Muta, Hiroko; Sugita, Yasuo; Ohshima, Koichi; Otsubo, Hitoshi

    2017-06-01

    Primary malignant pericardial sarcomatoid mesothelioma (PMPSM) is an extremely rare tumor with poor prognosis. We present an autopsy case in an 80-year-old man admitted for heart failure after one month of treatment at an outpatient clinic. He died three months after symptom onset. A complete autopsy revealed localization of the tumor to the pericardium without other lesions. Histologically, mainly spindle-shaped atypical cells with hyperchromatic nuclei and nucleoli were observed. Immunohistochemical markers for mesothelioma were positive for calretinin, cytokeratin AE1/AE3, and cytokeratin CAM5.2. Thus, we diagnosed primary sarcomatoid malignant mesothelioma of the pericardium. To our knowledge, only four PMPSM cases have been reported in the English literature in the past 30 years. Although PMPSM is rare, clinicians and pathologists should recognize it as a possible diagnosis of pericardial tumors. It is necessary to accumulate clinical and pathological diagnostic findings to establish early detection methods for this extremely rare disease. © 2017 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  18. Primary gastric melanoma: case report of a rare malignancy

    Directory of Open Access Journals (Sweden)

    Alexander Augustyn

    2015-03-01

    Full Text Available We report the case of a 64-year-old white male who presented to his primary care physician with complaints of fatigue. Physical exam was unremarkable and laboratory studies revealed profound anemia, for which the patient received a transfusion. Esophagogastroduodenoscopy revealed a bleeding mass in the proximal stomach that was histologically determined to be malignant melanoma, with immunohistochemical staining demonstrating positivity for SOX10, S100, MART-1, and HMG-45. After an extensive dermatological exam no other primary lesion was identified. Whole body positron emission tomography (18-FDG-PET/CT demonstrated pathologic uptake only in the area of the proximal stomach. For this reason, primary gastric melanoma was suspected in this patient. The patient underwent subtotal gastrectomy with mass excision followed by Roux-en-Y reconstruction. Very few cases of primary gastric melanoma have been reported. We report this case and present diagnostic criteria for primary non-cutaneous melanoma and discuss potential non-surgical therapies.

  19. Primary Malignant Melanoma of the Lung: A Case Report

    Directory of Open Access Journals (Sweden)

    Karagianni Evangelia

    2003-11-01

    Full Text Available Abstract Background Primary melanoma of the lung is an extremely rare pathological entity and sparsely reported in the literature. Case presentation A case of primary malignant melanoma of the lung in a 41-year-old female is reported. The clinical, radiological and histopathological features are discussed. The initial symptom was cough, whereas the chest radiography showed a round opacity of the right lung. The computed tomography of the chest revealed a well-demarcated mass lesion in the right upper lobe. Endobronchial mass causing obstruction of the upper lobar bronchus was the bronchoscopic finding. Patient underwent pneumonectomy. A diagnosis of melanoma was confirmed postoperatively after the immunohistochemistry. Primary nature of the tumour in the lung results from the demonstration of characteristic junctional pattern of melanoma cells beneath the bronchial epithelium on histopathology, and from exclusion of other potential primary sites in the clinical, paraclinical and laboratory examination. Conclusions Primary melanoma of the lung represents a rare pathological entity. Careful interpretation of histopathological information in correlation with all other findings from clinical and paraclinical studies can establish a diagnosis. Follow-up is necessary in order to diagnose potential dissemination or secondary sites of the disease. Due to the small number of cases reported in the literature, there is no experience on the management and the prognosis of the disease, but surgical resection remains the cornerstone of the treatment.

  20. Experience with surgical treatment for primary malignant adrenal tumors

    Directory of Open Access Journals (Sweden)

    V. R. Latypov

    2016-01-01

    Full Text Available Background. Adrenal tumors occur in 3–10 % of the population and are mostly benign adrenal cortical tumors. Adrenocortical carcinoma is a very rare tumor and has an annual incidence of 1–2 cases per million people. The U.S. National Cancer Data Base registered 4275 patients with adrenocortical carcinoma in 1985 to 2007. It is extremely difficult to assess Russia’s epidemiological data, as reports on adrenocortical carcinoma are not presented separately.Materials and methods. A total of 133 patients (49 men and 84 women (1:1.7 with adrenal tumors were operated on at the clinics of the Siberian State Medical University in the period December 1998 to March 2015. The patients’ mean age was 51.3 (16–80 years (median age 51.0 years. The right and left adrenal glands were affected in 49 (36.9 % and 77 (57.9 % patients, respectively; both adrenal glands were involved in 7 (5.3 %. A group of 21 (15.8 % people with primary malignant adrenal tumors was identified among all the patients. The clinical manifestations of the disease were evaluated from the presence of hormonal activity, gastrointestinal symptoms, pain syndrome, and hypertension. All the patients were operated on under endotracheal anesthesia. The data were statistically processed using the program package Statistica 6.0. Survival rates were analyzed by the Kaplan–Meier method. The Gehan–Wilcoxon test was used to compare the groups.Results. The investigation analyzed treatment results in 21 (15.8 % patients with primary malignant adrenal lesions (Group 1. The most common morphological form was adrenocortical carcinoma in 15 (11.3 % patients (5 men and 10 women (1:2; their mean age was 48.1 years. The right, left, and both adrenal glands were affected in 4, 9, and 2 cases, respectively. In Group 2, other malignant adrenal involvements were identified from 1 case of rare malignant adrenal tumors: malignant pheochromocytoma, sarcoma, melanoma, squamous cell

  1. [Primary renal manifestation in malignant lymphomas and leukemia].

    Science.gov (United States)

    Nizze, H; Prall, F; Wigger, M; Eggers, G; Knieling, K; Parwaresch, R

    2003-10-01

    Primary manifestation of malignant lymphoma and/or leukaemia rarely occurs in the kidney. It can be the cause of a hitherto unexplained acute renal failure or it is incidentally detected as shown in the three cases under report.1.A 68-year-old man was operated on because of a symptomatic tumour in his right kidney. At nephrectomy, a conventional (clear cell) renal cell carcinoma was found simultaneously with an occult mantle cell lymphoma infiltrating the adjacent renal and extrarenal tissue. Clinical follow-up uncovered nodal and bone marrow involvement, so that a primary renal manifestation of mantle cell lymphoma was apparent.2.A 69-year-old man with suspected vertebral metastasis underwent partial renal resection because of a mass in his left kidney. Histologically and immunohistochemically, the renal infiltration was diagnosed as a precursor B-lymphoblastic lymphoma. After chemotherapy and irradiation, leukaemic blood cell counts with 50% lymphoblasts proved a primary renal manifestation of precursor B-lymphoblastic leukaemia/lymphoma.3.A 13-year-old boy presented clinically with renal failure, enlarged kidneys, and normal urinalysis. Renal biopsy showed a diffuse interstitial infiltration with atypical T-lymphoblasts compressing tubules and surrounding preserved glomeruli. Subsequent clinical bone marrow smears presented 60% T-lymphoblasts, so that the final diagnosis of a primary renal manifestation of acute T-lymphoblastic leukaemia of mature thymic cortex type was made. Immediate chemotherapy resulted in total recovery of renal function and bone marrow findings.

  2. PRIMARY PREVENTION OF MALIGNANT SKIN TUMORS – PHOTOPROTECTION

    Directory of Open Access Journals (Sweden)

    Ana Benedičič - Pilih

    2001-12-01

    Full Text Available Background. The incidence of skin cancer is increasing in the world as well as in our country. Decades of research have increased the understanding of the ethiopathogenetic influences and risk factors for development of malignant skin tumors and stimulated efforts to promote their prevention. There are successes of prevention programs in some places in the world expressing with the reduction of mortality because of the cutaneous malignant melanoma. A primary prevention of a skin cancer attempts to change population knowledge, attitudes and beliefs about sunlight, leading to reduce of sunlight exposure.Conclusions. In this article we are discussing guidelines for photoprevention. The best approach to it is a reduction in the overall exposure to sunlight. The natural protection with the use of shade, clothing and hats is promoted as the best protection. Sunscreens are assumed as an important component of adjuvant photoprotection based on their convenience of use and also on their widespread promotion. While it has been argued that all tanning is a manifestation of skin injury, avoiding of artificial tanning devices is proposed also.

  3. Surgical treatment of primary malignant tumors of the sacrum.

    Science.gov (United States)

    Varga, Peter Paul; Szövérfi, Zsolt; Lazary, Aron

    2014-06-01

    The objective of the authors was to provide an up-to-date review about the epidemiology, diagnosis, and surgical management of the malignant primary sacral tumors. A PubMed search was conducted using a combination of the following items: (('Spinal Neoplasms'[Mesh]) AND 'Sacrum'[Mesh]) NOT ('Metastasis' OR 'Metastases' OR 'Benign'). The literature review and the author's own surgical experiences were used to assess the current treatment strategies of the malignant sacral tumors. Twenty case series were identified, which studies discuss in detail the surgical strategies, the postoperative complications, the functional and oncologic outcome, and the recurrence-free and disease-specific survival of this rare patient category. Sacral tumors are rare pathologies. Their management generates a complex medical problem, as they usually are diagnosed in advanced stages with extended dimensions involving the sacral nerves and surrounding organs. The evaluation and complex treatment of these rare tumors require a multidisciplinary approach, optimally at institutions with comprehensive care and experience. Although conventional oncologic therapeutic methods should be used as neoadjuvant or adjuvant therapies in certain histological types, en bloc resection with wide surgical margins is essential for long-term local oncologic control. This is often technically difficult to achieve, as just a few centers in the world perform sacral tumor surgeries on a regular basis, and have enough wide experience. Therefore international cooperation and organization of multicenter tumor registries are essential to develop evidence based treatment protocols.

  4. Primary malignant lymphoma of the maxillary sinus: CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yasumoto, M.; Shibuya, H. [Department of Radiology, Tokyo Medical and Dental University (Japan); Taura, S.; Honda, M. [Department of Radiology, Saiseikai Utsunomiya Hospital, Tokyo (Japan)

    2000-04-01

    We reviewed the CT and MRI of seven patients with primary malignant lymphoma of the maxillary sinus to find if there are characteristic imaging findings suggestive of the disease. The images were analysed for appearance, size, signal, internal characteristics, extent of tumour, bone change and lymph node enlargement. In two patients, the tumour first presented with mucosal thickening. In the remaining five, the tumours were an expansile mass 4-6 cm in diameter at the time of detection. Although it was difficult to distinguish tumour from mucosa or obstructed fluid on CT, T2-weighted MRI enabled us to separate tumour from normal mucosa or fluid. In two patients, the tumours were heterogeneous. Calcification and haemorrhage were observed in one patient. Periantral soft-tissue infiltration was always present, even when tumour appeared as slight mucosal thickening. Posterior extension was seen in all patients. Permeative and lytic bone destruction accompanied most cases of periantral soft-tissue infiltration; mixed destruction and sclerosis was also observed. Mucosal thickening with periantral soft-tissue infiltration may suggest malignant lymphoma of the maxillary sinus in its early form. Various types of bone change may accompany the periantral soft-tissue infiltration. (orig.)

  5. CT in primary malignant germ cell tumors of the retroperitoneum

    Energy Technology Data Exchange (ETDEWEB)

    Blomlie, V.; Lien, H.H.; Fossaa, S.D.; Jacobsen, A.B.; Stenwig, A.E. (Norske Radiumhospital, Oslo (Norway). Dept. of Diagnostic Radiology Norske Radiumhospital, Oslo (Norway). Dept. of Medical Oncology Norske Radiumhospital, Oslo (Norway). Dept. of Radiotherapy Norske Radiumhospital, Oslo (Norway). Dept. of Pathology)

    1991-03-01

    Malignant germ cell tumors may exist as a primary entity in the retroperitoneum. In a CT study of 14 males with this condition (2 seminomas and 12 non-seminomatous tumors) all masses were large, lobulated and of mixed density. Fat plane obliteration against adjacent structures was frequent. The aorta was embedded in 9 patients and the inferior vena cava was affected in 7, 2 of whom had signs of compromised caval blood flow. Distant metastases were found in the lungs (7 patients), liver (n=4), posterior mediastinum (n=3), and in brain and supraclavicular lymph nodes in one patient each. Serum biomarkers were elevated in 11 patients. An extragonadal germ cell tumor should be considered when CT of the abdomen reveals a large retroperitoneal mass with mixed density. (orig.).

  6. Primary retroperitoneal melanoma presented in a rare extracutaneous site for malignant melanoma

    Directory of Open Access Journals (Sweden)

    Mohamed Alsharedi

    2016-10-01

    Full Text Available Malignant melanoma, as the name implies, is a malignant tumor of melanocytes, found in the skin, eyes, meningeal lining and the mucosal epithelium of the aero-digestive and genitourinary tracts. Malignant melanoma is typically skin malignancy, which rarely presents at extracutaneous site. Here we present a rare case of primary retroperitoneal melanoma and review the findings in comparison with other cases described in literature.

  7. Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

    Directory of Open Access Journals (Sweden)

    M. Mustafa Kılıçkaya

    2016-01-01

    Full Text Available Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient’s old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions.

  8. Impact of hypothyroidism on primary anal malignant melanoma: A rare entity

    Directory of Open Access Journals (Sweden)

    Siddharth Singh

    2014-01-01

    Full Text Available Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  9. Occurrence of second primary malignancies in patients with neuroendocrine tumors of the digestive tract and pancreas

    NARCIS (Netherlands)

    K. Kamp (Kimberly); R.A. Damhuis (Ronald); R.A. Feelders (Richard); W.W. de Herder (Wouter)

    2012-01-01

    textabstractAn increased association between neuroendocrine tumors of the gastrointestinal tract and pancreas (GEP-NET) and other second primary malignancies has been suggested. We determined whether there is indeed an increased risk for second primary malignancies in GEP-NET patients compared with

  10. Secondary Primary Malignancies in Multiple Myeloma: An Old Nemesis Revisited

    Directory of Open Access Journals (Sweden)

    Jay Yang

    2012-01-01

    Full Text Available The treatment of myeloma has undergone extraordinary improvements in the past half century. These advances have been accompanied by a concern for secondary primary malignancies (SPMs. It has been known for decades that extended therapy with alkylating chemotherapy agents, such as melphalan, carries an increased risk of therapy-related myelodysplastic syndrome and/or acute myeloid leukemia (t-MDS/AML, with a cumulative risk as high as 10–15%. High-dose chemotherapy with autologous stem cell support became widely accepted for myeloma in the 1990s. Despite the use of high doses of melphalan, the risk of t-MDS/AML with this procedure is estimated to be less than 5%, with much of this risk attributable to pretransplant therapy. Recently, lenalidomide has come under scrutiny for its possible association with SPMs. It is too soon to declare a causal relationship at this time, but there appears to be an increased number of SPMs in reports from several studies using lenalidomide maintenance. Current studies should be amended and future studies planned to better define the risk of SPMs and the risk factors and mechanisms for its development. Patients should be educated regarding this potential concern but the current use of lenalidomide should not generally be altered until further data are available.

  11. Secondary primary malignancies in multiple myeloma: an old NEMESIS revisited.

    Science.gov (United States)

    Yang, Jay; Terebelo, Howard R; Zonder, Jeffrey A

    2012-01-01

    The treatment of myeloma has undergone extraordinary improvements in the past half century. These advances have been accompanied by a concern for secondary primary malignancies (SPMs). It has been known for decades that extended therapy with alkylating chemotherapy agents, such as melphalan, carries an increased risk of therapy-related myelodysplastic syndrome and/or acute myeloid leukemia (t-MDS/AML), with a cumulative risk as high as 10-15%. High-dose chemotherapy with autologous stem cell support became widely accepted for myeloma in the 1990s. Despite the use of high doses of melphalan, the risk of t-MDS/AML with this procedure is estimated to be less than 5%, with much of this risk attributable to pretransplant therapy. Recently, lenalidomide has come under scrutiny for its possible association with SPMs. It is too soon to declare a causal relationship at this time, but there appears to be an increased number of SPMs in reports from several studies using lenalidomide maintenance. Current studies should be amended and future studies planned to better define the risk of SPMs and the risk factors and mechanisms for its development. Patients should be educated regarding this potential concern but the current use of lenalidomide should not generally be altered until further data are available.

  12. Fine-needle aspiration of the thyroid: correlating suspicious cytology results with histological outcomes.

    Science.gov (United States)

    Baynes, Andrea L; Del Rio, Andres; McLean, Catriona; Grodski, Simon; Yeung, Meei J; Johnson, William R; Serpell, Jonathan W

    2014-05-01

    Fine-needle aspiration cytology (FNAC) assists the diagnosis of thyroid malignancy. A 'suspicious for malignancy' on FNAC creates a management dilemma. The aims of this study were to investigate the malignancy rate for patients with suspicious cytology, and to describe a management approach for those with a suspicious result. A retrospective review of prospectively collected data in an endocrine surgery database was undertaken. Patients undergoing thyroidectomy with preoperative FNAC from 1992 to 2012 were analysed. Preoperative FNAC was undertaken in 2,692 patients, and the FNAC result was 'suspicious for malignancy' in 94 (3.5 %) patients. Of these, 53 (56.4 %) were malignant, with the majority 44 (83.0 %) being papillary thyroid cancer. 48 patients went straight to total thyroidectomy, 40 patients had an initial diagnostic hemithyroidectomy, and 1 patient had a diagnostic isthmusectomy. 5 patients required reoperative total thyroidectomy as an initial procedure. Of the 94 suspicious cases, 55 were reported by an unknown, presumably non-expert, thyroid cytopathologist. 38 of these cases were available for review and re-reporting by an experienced cytopathologist. On review, 28 (73.7 %) were reclassified as cytologically malignant, and all of these were confirmed as malignant on subsequent histopathology. Suspicious cytology has a high risk of malignancy. Expert thyroid cytopathology can improve diagnostic accuracy and a preoperative malignant diagnosis should be pursued to enable one-stage surgery where possible.

  13. Primary malignant skin tumours in Ghanaians: a prospective study of ...

    African Journals Online (AJOL)

    squamous cell carcinoma one (3%) had basal cell carcinoma and four (13%) had sarcomas comprising two cases of Kaposi sarcoma, one synovial sarcoma, and another of unknown origin. Patients with malignant melanoma had a mean age of 73.4 years while those with non-melanoma malignancies had a mean age of ...

  14. Unusual occurrence of primary malignant melanoma of the nasal cavity

    Directory of Open Access Journals (Sweden)

    Madhu Kumar

    2016-01-01

    Full Text Available Malignant melanoma of nasal cavity is an extremely rare tumor with an incidence rate of 0.67% among all malignant melanomas. Melanomas are tumors arising from melanocytes that are neuroectodermal cells located in the basal layers of skin, skin adnexa, uveal tract, and occasionally in mucosal membranes. We report a case of malignant melanoma of nasal cavity in a 60-year-old female for its rare occurrence. These tumors have poor prognosis owing to high rates of locoregional recurrence and distant metastasis. We report this case without the symptom of epistaxis because of its rarity.

  15. Second Primary Malignancies in Hepatocellular Cancer - A US Population-based Study.

    Science.gov (United States)

    Shah, Binay K; Kandel, Pujan; Khanal, Amit

    2016-07-01

    A second primary malignancy is a serious long-term complication in cancer survivors. The aim of this study was to evaluate the risk of second primary malignancies in patients with hepatocellular carcinoma (HCC). We selected adult patients (≥18 years) diagnosed with HCC from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We calculated the risk of second primary malignancies in these patients using multiple primary standardized incidence ratio (MP-SIR) session of SEER* stat software. Second primary malignancy was defined as a metachronous malignancy diagnosed 6 months or more after an index HCC. A total of 15,296 patients with a diagnosis of primary HCC were reported in the SEER 13 registry during January 1992 to December 2011. A total of 446 (2.83%) developed 466 second primary malignancies with an observed/expected ratio of 10.07 (95% confidence interval=0.97-1.17, p=0.16) and absolute risk of 7.17 per 10,000 population. Risk of stomach and of thyroid cancer were significantly increased among older patients. Risk of lung cancer and of hepatobiliary cancer were significantly higher compared to that of the general population after two years of latency. Risk of specific second primary malignancies in adult patients with HCC depends on age of the patient and latency. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  16. Second Primary Malignancy in Anal Carcinoma--A US Population-based Study.

    Science.gov (United States)

    Shah, Binay Kumar; Budhathoki, Nibash

    2015-07-01

    To our knowledge, there are no data on second primary malignancies in anal cancer. This study was conducted to evaluate the risk of second primary malignancies in patients with anal carcinoma. We selected adult patients diagnosed with anal cancer from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We calculated the risk of second primary malignancies in these patients using multiple primary standardized incidence ratio (MP-SIR) session of SEER statistical software. Among 7,661 patients, 675 (9.07%) developed 747 second primary malignancies, with an observed/expected ratio of 1.41 (95% confidence interval=1.32-1.52, p<0.001), and an absolute excess risk of ~55 per 10,000 population. Significant excess risks were observed for tumors of the oral cavity and pharynx, rectum and anal canal, larynx, lung and bronchus, ovary, vagina, and vulva, and Kaposi's sarcoma and hematological malignancies. The risk of specific second primary malignancies was related to the age of patients, exposure to radiotherapy and latency period. The risk of second primary malignancies in adult patients with anal cancer is significantly increased compared to the general population. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Comparison of the clinical and prognostic features of primary breast sarcomas and malignant phyllodes tumor.

    Science.gov (United States)

    Wang, Fang; Jia, Yan; Tong, Zhongsheng

    2015-02-01

    Primary breast sarcoma is a kind of extremely rare disease. Malignant phyllodes tumor represents a specific subset of breast soft tissue tumors. So till now, the classification and clinical management of primary breast sarcoma and malignant phyllodes tumor are controversial. The aim of this study is to explore the differences in clinical features, treatment, disease-free survival and overall survival between primary breast sarcoma and malignant phyllodes tumor group. A retrospective review of 35 cases with primary breast sarcoma and 70 cases with malignant phyllodes tumor registered from 1995 to 2010 was carried out in Tianjin Medical University Cancer Institute and Hospital. Prognosis in terms of disease-free survival and overall survival was evaluated. In primary breast sarcoma group, the result of univariate analysis demonstrated that surgical type, histopathological nodal status and local recurrence were significantly correlated with disease-free survival and overall survival. While, the result of monofactorial analysis showed the tumor size was significant prognostic indicator of disease-free survival and overall survival in malignant phyllodes tumor group. The Kaplan-Meier curves for 5-year disease-free survival rates and overall survival rates demonstrated that no significant difference was found between the primary breast sarcoma and malignant phyllodes tumor group (P = 0.702 and 0.772, respectively). The primary breast sarcoma patients had identical disease-free survival and overall survival compared with the malignant phyllodes tumor patients, which indicated that primary breast sarcoma and malignant phyllodes tumor patients should be treated with the same strategies. Surgical management is important for both the primary breast sarcoma and malignant phyllodes tumor patients. The role of the adjuvant radiotherapy and chemotherapy remains uncertain. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email

  18. Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma

    Directory of Open Access Journals (Sweden)

    Bortolotto Luiz Aparecido

    2003-01-01

    Full Text Available Two cases are reported as follows: 1 1 female patient with accelerated-malignant hypertension secondary to an aldosterone-producing adrenal adenoma; and 2 1 female patient with adrenal adenoma, severe hypertension, and hypertensive encephalopathy. This association is a rare clinical finding, and malignant hypertension may modify the hormonal characteristic of primary aldosteronism, making its diagnosis more difficult. The diagnosis of primary aldosteronism should be considered in patients with malignant hypertension or hypertensive encephalopathy if persistent hypokalemia occurs. Identification of primary aldosteronism is of paramount importance for the patient's evolution, because the surgical treatment makes the prognosis more favorable.

  19. Astroglial c-Myc overexpression predisposes mice to primary malignant gliomas

    DEFF Research Database (Denmark)

    Jensen, Niels Aagaard; Pedersen, Karen-Marie; Lihme, Frederikke

    2003-01-01

    Malignant astrocytomas are common human primary brain tumors that result from neoplastic transformation of astroglia or their progenitors. Here we show that deregulation of the c-Myc pathway in developing astroglia predisposes mice to malignant astrocytomas within 2-3 weeks of age. The genetically...

  20. Malignant Melanoma Presenting as Superior Mediastinal Mass without Extrathoracic Primary Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    You, Myung Won; Sung, Dong Wook; Lee, Young Kyung [Dept. of Diagnostic Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2013-03-15

    Malignant melanoma most commonly occurs in the skin, and other organs are secondarily involved. Malignant melanoma presenting in the mediastinum without an extrathoracic primary is very rare. Authors report a case of malignant melanoma of the superior mediastinum without clinical history of extrathoracic malignant melanoma primarily and discuss its radiologic findings. CT shows lobulated heterogenous enhanced mass. Magnetic resonance shows mild hyperintense mass on T1 and T2-weighted images contained focal hemorrhage and necrosis, and invasion to neural foramen. In addition, positron emission tomography/computed tomography shows high standard uptake values uptake of the mass.

  1. Primary cutaneous malignancies in the Northern Cape Province of ...

    African Journals Online (AJOL)

    Cutaneous malignant melanoma. 135 (3.1). Basosquamous carcinoma. 43 (1.0). Dermatofibrosarcoma protuberans. 13 (0.3). Mycosis fungoides. 3 (0.07). Sebaceous adenocarcinoma. 3 (0.07). Trichilemmal carcinoma. 3 (0.07). Angiocentric T-cell lymphoma. 2 (0.05). Merkel cell carcinoma. 1 (0.02). Mucinous carcinoma.

  2. Insitu analysis of the mononuclear cell infiltrate in primary malignant-melanoma of the skin

    NARCIS (Netherlands)

    Poppema, S.; Brocker, E. B.; de Leij, L; ter Brack, D; Visscher, T.; Macher, E; The, T. Hauw; Sorg, C

    Monoclonal antibodies, directed against functionally different lymphocyte subsets, were applied on frozen sections of primary malignant melanomas and benign nevi. Positive reaction was identified by means of an immunoperoxidase method. It was found that lymphocytic infiltrate underneath and in

  3. [Pain as the primary symptom of a malignant parotid tumour].

    Science.gov (United States)

    van der Kamp, M F; Leusink, F K J; Al-Mamgani, A; Lohuis, P J F M; van den Brekel, M W M

    2016-12-01

    The differential diagnosis of peri-auricular pain is comprehensive and arriving at a correct diagnosis is not always easy, which may result in a delay of treatment or even malpractice. Two patients presented themselves with facial peri-auricular pain. After a period of follow-up and control this pain turned out to be related to a malignant tumor in the glandula parotidea. These two cases show the importance for the dentist to refer patients with peri-auricular pain, with or without concomitant facial nerve palsy, to a specialist in a timely manner.

  4. Primary malignant esophageal melanoma arising from localized benign melanocytosis.

    Science.gov (United States)

    Maroy, Bernard; Baylac, Francois

    2013-04-01

    A heavy drinker and smoker had a normal UGI-endoscopy in 1996. In 1999, a repeat examination disclosed distal esophageal benign melanocytosis, typical, macro- and microscopically. Endoscopic and microscopic features were stable in 2002 and 2004. In 2007, dysphagia prompted an endoscopy, which disclosed a poorly differentiated epidermoid carcinoma at 19 cm and black nodules of the cardia with a microscopy typical of malignant melanoma, uT3N1 at EUS. Radiochemotherapy led to an 8-month improvement, which did not prevent death one year after diagnosis. Copyright © 2012. Published by Elsevier Masson SAS.

  5. Primary leptomeningeal malignant melanoma in posterior fossa and upper cervical canal: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kyu Ran; Kim, Jung Hyuk; Shin, Bong Kyung; Lee, Nam Joon [Korea Univ. Hospital, Seoul (Korea, Republic of)

    2001-11-01

    The term 'primary melanocytic neoplasm' covers a wide disease spectrum, from well differentiated meningeal melanocytoma to malignant melanoma, its most aggressive malignant counterpart. Previous reports have shown that due to the paramagnetic effect of melanin, melanocytic neoplasms show high signal intensity on T1-weighted images and very low signal intensity on T2-weighted images, with relatively homogeneous contrast enhancement. The differentiation of leptomeningeal malignant melanoma from benign melanocytoma is important because of their different prognosis but on the basis of imaging findings alone is difficult. Ultrastructural immunohistochemical analysis is a possible alternative. We report the imaging findings of rare primary malignant melanoma, revealed by noncontrast-enhanced CT as a high-density mass, and demonstrating high signal intensity on T1-weighted images, and very low signal intensity on T2WI, with relatively good contrast enhancement.

  6. Primary malignant peripheral nerve sheath tumor at unusual location

    Directory of Open Access Journals (Sweden)

    Souvagya Panigrahi

    2013-01-01

    Full Text Available Malignant peripheral nerve sheath tumor (MPNST is a rare soft tissue sarcoma. Most arise in association with major nerve trunks. Their most common anatomical sites are the proximal portions of the upper and lower extremities and the trunk. MPNSTs have rarely been reported in literature to occur in other unusual body parts. We review all such cases reported till now in terms of site of origin, surgical treatment, adjuvant therapy and outcome and shortly describe our experience with two of these cases. Both of our case presented with lump at unusual sites resembling neurofibroma, one at orbitotemporal area and other in the paraspinal region with characteristic feature of neurofibroma with the exception that both had very short history of progression. They underwent gross total removal of the tumor with adjuvant radiotherapy postoperatively. At 6-month follow-up both are doing well with no evidence of recurrence.

  7. Chromophobe Renal Cell Carcinoma and the Synchronous Presence of Primary Colon Malignancies. Is There a Relation?

    Directory of Open Access Journals (Sweden)

    Georgios Sahsamanis

    2017-09-01

    Full Text Available While the presence of multiple primary malignancies in the same patient is a well described phenomenon, there is no clear association between various histological subtypes of renal cell carcinoma (RCC and the synchronous presence of colon malignancies. We present the rare case of an 81-year-old female patient suffering from chromophobe renal cell carcinoma (chRCC and an angiomyolipoma of her left kidney, synchronous with an adenocarcinoma of the caecum. While there is an established connection between RCC and colon cancer, a literature review is performed to specify this association in regard to chRCC and the synchronous presence of colon malignancies.

  8. Second Primary Malignancy in Bladder Carcinoma - A Population-based Study.

    Science.gov (United States)

    Khanal, Amit; Budhathoki, Nibash; Singh, Vijay Pal; Shah, Binay K

    2017-04-01

    A second primary malignancy is a serious long-term complication in cancer survivors. The aim of this study was to evaluate the risk of second primary malignancies (SPM) in adult patients with bladder cancer. We selected patients ≥18 years diagnosed with bladder cancer from National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We calculated the risk of second primary malignancies in the bladder cancer patients using the MP-SIR session of SEER*stat software. A total of 103,516 cases of bladder cancer was included in the study. Among them, 17,004 (16.4%) developed 19,318 second primary malignancies. The risk of development of SPM was significantly higher compared to the general population with O/E ratio of 1.42 (95% CI=1.4-1.44, AER=89.22 and p-value of <0.001). Prostate cancer, lung and bronchial cancer and urinary bladder cancer were the three commonest SPMs. There is significant increased risk of second primary malignancies in adult patients with bladder cancer to general population. Bladder cancer survivors may benefit from life-long follow-up for development of SPM. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  9. The miRNA machinery in primary cutaneous malignant melanoma, cutaneous malignant melanoma metastases and benign melanocytic nevi.

    Science.gov (United States)

    Sand, Michael; Skrygan, Marina; Georgas, Dimitrios; Sand, Daniel; Gambichler, Thilo; Altmeyer, Peter; Bechara, Falk G

    2012-10-01

    Although several studies have shown a dysregulation of microRNA (miRNA) expression profiles in cutaneous melanoma, there has been little research on the miRNA machinery itself. In this study, we investigated the mRNA expression profiles of different miRNA machinery components in primary cutaneous malignant melanoma (PCMM), cutaneous malignant melanoma metastases (CMMM) and benign melanocytic nevi (BMN). Patients with PCMM (n = 7), CMMM (n = 6) and BMN (n = 7) were included in the study. Punch biopsies were harvested from the centers of tumors (lesional) and from BMN (control). In contrast to previous reports exploring specific clusters of miRNAs in PCMM, the present study investigates mRNA expression levels of Dicer, Drosha, Exp5, DGCR8 and the RISC components PACT, argonaute-1, argonaute-2, TARBP1, TARBP2, MTDH and SND1, which were detected by TaqMan real-time reverse transcription polymerase chain reaction (RT-PCR). Argonaute-1, TARBP2 and SND1 expression levels were significantly higher in BMN compared to PCMM (p  0.05). The results of this study show that the miRNA machinery components argonaute-1, TARBP2 and SND1 are dysregulated in PCMM and CMMM compared to BMN and may play a role in the process of malignant transformation.

  10. [Primary malignant melanoma of the central nervous system: A diagnostic challenge].

    Science.gov (United States)

    Quillo-Olvera, Javier; Uribe-Olalde, Juan Salvador; Alcántara-Gómez, Leopoldo Alberto; Rejón-Pérez, Jorge Dax; Palomera-Gómez, Héctor Guillermo

    2015-01-01

    The rare incidence of primary malignant melanoma of the central nervous system and its ability to mimic other melanocytic tumors on images makes it a diagnostic challenge for the neurosurgeon. A 51-year-old patient, with a tumor located in the right forniceal callosum area. Total surgical excision was performed. Histopathological result was consistent with the diagnosis of primary malignant melanoma of the central nervous system, after ruling out extra cranial and extra spinal melanocytic lesions. The primary malignant melanoma of the central nervous system is extremely rare. There are features in magnetic resonance imaging that increase the diagnostic suspicion; nevertheless there are other tumors with more prevalence that share some of these features through image. Since there is not an established therapeutic standard its prognosis is discouraging. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  11. Primary malignant bone tumour in a tropical African University teaching hospital.

    Science.gov (United States)

    Omololu, A B; Ogunbiyi, J O; Ogunlade, S O; Alonge, T O; Adebisi, A; Akang, E E

    2002-01-01

    Bone tumours are relatively rare tumours as compared with all other tumours. The relative frequency has not been well documented in this environment. The aim of the study was to define the frequency of primary malignant bone tumours in an African University teaching hospital in Ibadan. The medical records of 114 patients with malignant bone tumours recorded in the Cancer Registry of the University College Hospital, Ibadan, Nigeria between January 1977 and December 2000 were reviewed retrospectively. Primary malignant bone tumours represented 0.53% of all the 21390 cancers seen in the teaching hospital in the period studied, with a male female ratio of 1.4:1. About 45% oftumours occurred among patients < 20 years of age. Osteogenic sarcoma was the most common primary malignant bone tumour while the mandible was the most commonly affected bone. In contrast to previous studies, Burkitt's lymphoma affected the mandible more commonly than the maxilla. The relative frequency of primary malignant bone tumours is low in our environment as observed in other developing countries.

  12. Radiculopathy due to malignant melanoma in the sacrum with unknown primary site.

    Science.gov (United States)

    Kakutani, Kenichiro; Doita, Minoru; Nishida, Kotaro; Miyamoto, Hiroshi; Kurosaka, Masahiro

    2008-09-01

    Melanoma is an interesting tumor, showing the appearance of metastasis without any trace of its primary lesion. To report a very rare case of malignant melanoma in the sacrum with unknown primary origin. The authors present a case of a 52-year-old man who was admitted with increasing lower back, left buttock, and left lower extremity pain, and dysuria. Plain radiograph, computed tomography scan, and magnetic resonance imaging revealed a destructive lesion in the sacrum and left ilium, which infiltrated the spinal canal and sacroiliac joint. The tumor cells were immunoreactive for HMB-45. The pathological diagnosis was malignant melanoma. No obvious primary malignant melanoma was detected on the skin surface, on the oral or anal mucosa, or in the fundus oculi. Following radiotherapy and chemotherapy, the severe buttock pain disappeared and the patient was able to walk without impediment. However the patient died nine months after initial diagnosis. Malignant melanoma in the sacrum with an unknown primary site, showing S1 radiculopathy is reported for the first time. The melanoma could have been a metastatic tumor of the sacrum, although the primary site was not detected. The incidence of primary melanoma is increasing faster than any other cancer. Thus treatment of patients with spinal metastasis of melanoma is an important challenge for orthopedic surgeons.

  13. Primary breast actinomyces simulating malignancy: A case diagnosed by fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Renu Thambi

    2012-01-01

    Full Text Available We report a case of primary actinomycosis of breast diagnosed by fine needle aspiration cytology (FNAC in a postmenopausal lady who presented with a clinical impression of malignancy. Resolution of infection while conserving the breast was achieved by timely diagnosis and effective antibiotic therapy. The literature reports that primary actinomycosis of the breast is very rare after menopause, with only very few cases found after extensive search. It is imperative that this condition should be considered in the differential diagnosis of malignancy. The effectiveness of cell block sections in the final diagnosis is also highlighted.

  14. Primary Retroperitoneal Mucinous Cystic Tumors with Borderline Malignancy: A Case Report and Literature Review

    Science.gov (United States)

    Manrai, Megumi; Takesita, Naoki; Ishida, Hiroaki; Takashima, Akiko; Adachi, Tomohiro; Sasaki, Izumi; Yokokawa, Kei; Tokuyama, Wataru; Hiruta, Nobuyuki; Kinoshita, Toshihiko

    2015-01-01

    Primary retroperitoneal mucinous cystic tumors with borderline malignancy are rarely encountered. To date, only 12 cases have been reported in the literature. In this report, we present an additional case. A 65-year-old nulliparous woman complained of abdominal fullness. Her medical history included a hysterectomy and a single salpingo-oophorectomy performed 25 years prior to the present event. Physical examination revealed a large cystic mass in the abdomen and pelvis. During laparotomy, a cystic tumor measuring 21×14 cm in size was observed in the left retroperitoneal space. The tumor was resected, and the final diagnosis was primary retroperitoneal mucinous cystic cancer with borderline malignancy. PMID:25918634

  15. Dark sputum: An atypical presentation of primary pulmonary malignant melanoma

    Directory of Open Access Journals (Sweden)

    Alida Filippini

    2015-01-01

    Primary lung melanoma is an uncommon neoplasm that may be confused with more conventional types of lung cancer. Careful interpretation of histopathological information in correlation with all other clinical, laboratory and imaging studies may be needed to establish a diagnosis. Evaluation for metastases should include looking at the eyes, brain, skin. Due to the small number of cases reported in literature, there is no experience on the management and the prognosis of the disease.

  16. Second primary malignancies in adult acute myeloid leukemia--A US population-based study.

    Science.gov (United States)

    Ghimire, Krishna Bilas; Shah, Binay Kumar

    2014-07-01

    Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Long-term survivors from AML may be at higher risk of second primary malignancies. We selected adult patients with AML aged≥18 years from the National Cancer Institute's Surveillance, Epidemiology and End RESULTS (SEER 13) database. We used the multiple primary standardized incidence ratio session of SEER*stat software to calculate the risk of second primary malignancies in patients with AML. Among 5,091 patients, 148 patients developed a total of 160 second primary malignancies, with an observed/expected (O/E) ratio of 1.17, (95% confidence interval=0.99-1.36), and an excess risk of 15.47 per 10,000 population. The risk of all-site cancer, cancer of gastrointestinal system, and oral and pharyngeal cancer in different age groups was found to be significantly higher among patients with AML compared to that of general US population. Adult patients with AML have a significantly higher risk of second primary malignancies compared to the general population. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Clinical characteristics and survival of lung cancer patients associated with multiple primary malignancies.

    Directory of Open Access Journals (Sweden)

    Shan Shan

    Full Text Available To investigate the characteristics and survival of lung cancer patients with additional malignant primary cancers.Records of lung cancer patients newly diagnosed in Shanghai Pulmonary Hospital between January 2000 and January 2010 were retrospectively reviewed. Patients with second primary lung cancer and those with lung cancer only were included for detailed analysis.Of 27642 newly diagnosed lung cancer patients, 283 patients (1.02% suffered previous additional primary cancers. Compared with single primary lung cancer, patients with secondary lung cancer associated other primary cancers were more often women (female to male ratio 1:1.72 vs 1:2.58, P = 0.018, older (64.2 vs 60.5 years old, P<0.001, more squamous cell type (30.7% vs 20.5%, P = 0.004, less small cell (3.9% vs 15.5%, P<0.001 type, at earlier stages (17.7% vs 11.0% for stage I, P = 0.014, and more frequently with family history of cancers (7.8% vs 3.9%, P = 0.038. The most common previous primary cancers observed were colorectal (22.0%, breast (18.4%, gastric (14.4% and larynx cancers (11.9%. Approximately 42.9% of patients were diagnosed with lung cancer 2 to 6 years after diagnosis of initial primary cancers. The survival of patients with secondary lung cancer associated other malignancies was not significantly different from those with single lung cancer (P = 0.491, while synchronous multiple primary malignancies showed worse prognosis compared with those with metachronous ones or single lung cancer (p = 0.012.The possibility of second primary lung cancer should always be considered during the follow-up of related cancer types, especially those with family history of cancers. Patients with secondary lung cancer associated other primary malignancies have non-inferior survival than those with single lung cancer.

  18. Primary Malignant B-cell Lymphoma of the Epididymis

    Directory of Open Access Journals (Sweden)

    Jungyo Suh

    2016-01-01

    Full Text Available Primary epididymal lymphomas are very rare condition, only 6 case report was published. In 4 of them, initial presentation was non-tender, continuous growth of testis. It can be misdiagnosed with epididymitis, 5 of them was treated by antibiotics before surgery. One patients treated by surgery another 5 makes neoadjuvant therapy, 2 of radiotherapy 3 of chemotherapy. Only one man died after treatment. This case is about 54-year male patients, diagnosed by diffuse large B-cell lymphoma, who treated by surgery and neoadjuvant chemotherapy combined with radiotherapy.

  19. Primary Benign Intraosseous Meningioma on {sup 18}F-FDG PET/CT Mimicking Malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ho Seong; Kim, Seok Hwi; Kim, Hyung Jin; Kang, Se Woong; Kim, Soo Jeong; Lee, Joo Hee; Hong, Sun Pyo; Cho, Young Seok; Choi, Joon Young [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    We present a case of primary benign intraosseous meningioma in the sphenoid bone mimicking malignancy. A 44-year-old female patient who had a protruding right eye and headache came to our hospital. MRI showed a large, destructive, heterogeneously well-enhancing soft tissue mass in the right sphenoid bone suggesting malignancy. {sup 18}F-FDG PET/CT showed a hypermetabolic mass in the same site with an SUV{sub max} of 9.1 The pathological diagnosis by surgery revealed that this tumor was a WHO grade I transitional meningioma. This case suggests that primary benign intraosseous meningioma may show high {sup 18}F-FDG uptake mimicking a malignancy.

  20. [Establishment of nude mice liver metastatic model of human primary malignant melanoma of the small intestine].

    Science.gov (United States)

    Tuo, Shuai; Zhang, Ning; Liu, Qiu-Zhen

    2008-07-01

    To provide ideal animal models for exploring pathogenesis and experimental therapy of primary malignant melanoma of the small intestine. The histologically intact primary and liver metastatic fragments derived from surgical specimens of one patient with metastatic malignant melanoma of the small intestine were orthotopically implanted in the small intestinal mucous layer of nude mice. The take rate, invasion and liver metastasis were observed. Morphology (light microscopy, electron microscopy), immunophenotype analysis, flow cytometry and karyotype analysis were applied for the original human tumors and the transplanted tumors. The primary and liver metastatic fragments of malignant melanoma of the small intestine were successfully implanted in nude mice. After continuous passages in nude mice,an orthotopic model of human primary malignant melanoma of the small intestine(from the primary focus)in nude mice (termed HSIM-0501) and a liver metastatic model of human primary malignant melanoma of the small intestine (from the liver metastatic focus) in nude mice (termed HSIM-0502) were established. Histological examination of transplanted tumors revealed high-grade melanoma. S-100 protein and HMB45 were positive. Massive melanin granules and melanin complex were seen in cytoplasm of tumor cells.Chromosomal modal number was between 55 and 59. DNA index (DI) was 1.49-1.61, representing heteroploid. HSIM-0501 and HSIM-0502 were maintained for 25 and 27 passages in nude mice respectively. Three hundred and seventeen nude mice were used for transplantation. Both the take rate after transplantation and resuscitation rate of liquid nitrogen cryopreservation were 100%. HSIM-0501 exhibited 46.2% liver metastasis and 36.7% lymph node metastases. In HSIM-0502, both liver and lymph node metastases were 100%.The transplanted tumors autonomically and invasively grew in the small intestines of nude mice and hematogenous metastasis, lymph node metastasis and celiac planting metastasis

  1. Radiologic findings following Y90 radioembolization for primary liver malignancies.

    Science.gov (United States)

    Ibrahim, Saad M; Nikolaidis, Paul; Miller, Frank H; Lewandowski, Robert J; Ryu, Robert K; Sato, Kent T; Senthilnathan, Sean; Riaz, Ahsun; Kulik, Laura; Mulcahy, Mary F; Omary, Reed A; Salem, Riad

    2009-01-01

    A therapy gaining rapid clinical adoption involves radioembolization with the use of Yttrium-90 (90Y) microspheres. The 20-60 microm-sized microspheres are injected trans-arterially and flow to hepatic tumors given their preferential blood supply from the hepatic artery. Once they lodge in the arterioles, they impart a very intense local radiotherapeutic effect. Given the combined radiation and embolic effect, the imaging findings imparted by this mode of action differ significantly from other treatments. This work represents a comprehensive review of the imaging findings following radioembolization in patients with primary liver tumors. The report discusses imaging response, benign secondary effects, and complications. This should help educate the radiologist on imaging findings that should be expected following radioembolization and therefore aid in the proper image interpretation.

  2. Metastatic Malignant Melanoma of the Inguinal Lymph Node with Unknown Primary Lesion

    Directory of Open Access Journals (Sweden)

    Sherif Ali Eltawansy

    2015-01-01

    Full Text Available Background. Malignant melanoma could present with metastasis with unknown primary (MUP and this happens in 2-3% according to the studies. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. Case Report. We report a 58-year-old Caucasian male who presented with a right sided swelling in the inguinal region. Surgery was performed and biopsy showed metastatic malignant melanoma. No cutaneous lesions were identified by history or physical examination. Work up could not detect the primary lesion and patient was started on radiotherapy and immunotherapy. Conclusion. We present a case of malignant melanoma of unknown primary presenting in an unusual place which is the inguinal lymph node. Theories try to explain the pathway of development of such tumors and one of the theories mentions that it could be a spontaneous regression of the primary cutaneous lesion. Another theory is that it could be from transformation of aberrant melanocyte within the lymph node. Prognosis is postulated to be better in this case than in melanoma with a known primary.

  3. Primary melanoma of testis

    Directory of Open Access Journals (Sweden)

    Katiyar R

    2008-01-01

    Full Text Available Primary melanoma of testis is extremely rare and even the existence of such an entity is questioned. We present the case of a 60-year-old man with primary malignant melanoma in the testis. We report this case to emphasize the need for awareness of the possibility of the testis being the primary site in the patient with a melanoma and to underline the necessity of meticulous investigation of suspicious lesions of the testis in patients with or without a past history of malignant melanoma.

  4. Primary retroperitoneal mucinous tumor of low malignant potential in a Persian woman.

    Directory of Open Access Journals (Sweden)

    Hayedeh Haeri

    2014-09-01

    Full Text Available Primary retroperitoneal mucinous tumor (PRMT of low malignant potential (border line is an uncommon neoplasm with fewer than 50 reported cases. Uncertain diagnostic imaging results make diagnosis of its origin difficult, preoperatively. Later treatment planning and prognosis would be affected by exact diagnosis of the tumor origin. This study presents a case of Persian woman with diagnostic, histological and immunohistochemical specifications.

  5. Primary Sclerosing Cholangitis as a Pre-malignant Biliary Tract Disease: Surveillance and Management

    Science.gov (United States)

    Rizvi, Sumera; Eaton, John E.; Gores, Gregory J.

    2015-01-01

    Primary sclerosing cholangitis (PSC) is a pre-malignant biliary tract disease that confers a significant risk for the development of cholangiocarcinoma (CCA). The chronic biliary tract inflammation of PSC promotes pro-oncogenic processes such as cellular proliferation, induction of DNA damage, alterations of the extracellular matrix and cholestasis. The diagnosis of malignancy in PSC can be challenging as inflammation-related changes in PSC may produce dominant biliary tract strictures mimicking CCA. Biomarkers such as detection of methylated genes in biliary specimens represent non-invasive techniques which may discriminate malignant biliary ductal changes from PSC strictures. However, conventional cytology and advanced cytologic techniques such as fluorescence in situ hybridization (FISH) for polysomy remain the practice standard for diagnosing CCA in PSC. Curative treatment options of malignancy arising in PSC are limited. For a subset of patients selected using stringent criteria, liver transplantation following neoadjuvant chemoradiation is a potential curative therapy. However, most patients have advanced malignancy at the time of diagnosis. Advances directed at identifying high risk patients, early cancer detection, and development of chemopreventive strategies will be essential to better manage the cancer risk in this pre-malignant disease. A better understanding of dysplasia definition and especially its natural history is also needed in this disease. Herein, we review recent developments in our understanding of the risk factors, pathogenic mechanisms of PSC associated with CCA, as well as advances in early detection and therapies. PMID:26051390

  6. Radiculopathy due to malignant melanoma in the sacrum with unknown primary site

    OpenAIRE

    Kakutani, Kenichiro; Doita, Minoru; Nishida, Kotaro; Miyamoto, Hiroshi; Kurosaka, Masahiro

    2007-01-01

    Melanoma is an interesting tumor, showing the appearance of metastasis without any trace of its primary lesion. To report a very rare case of malignant melanoma in the sacrum with unknown primary origin. The authors present a case of a 52-year-old man who was admitted with increasing lower back, left buttock, and left lower extremity pain, and dysuria. Plain radiograph, computed tomography scan, and magnetic resonance imaging revealed a destructive lesion in the sacrum and left ilium, which i...

  7. Second primary malignancies in adults with gastric cancer – A US population-based study

    Directory of Open Access Journals (Sweden)

    Binay Kumar Shah

    2016-04-01

    Full Text Available Background: Multiple studies have examined the incidence of secondary primary malignancies (SPM in gastric cancer patients in Europe and Asia. This retrospective review was conducted to analyze risk of SPM in patients with gastric cancer diagnosed in the United States (US.Methods: We included adult patients diagnosed with gastric cancer from the Surveillance, Epidemiology and End Result (SEER 13 database. We calculated the risk of secondary primary malignancies in these patients using the multiple primary standardized incidence ratio (MP-SIR session of SEER*stat software and performed subset analyses of SPM with regard to age, sex, radiotherapy used, and latency period.Results: Among 33,720 patients, 1838 (5.45% developed 2019 secondary primary malignancies with an observed/expected (O/E ratio of 1.11 (95% confidence interval (CI = 1.06-1.16, p<.001 and an absolute excess risk (AER of 18.16 per 10,000 population. The median time to first SPM from the time of diagnosis of gastric cancer was 46.9 months (range 6-239 months. Significant excess risk was observed for gastrointestinal malignancies [O/E ratio 1.71 (CI = 1.59-1.84, p<.001], thyroid [O/E ratio 2.00 (CI = 1.37-2.8, p<.001] and pancreatic cancer [O/E ratio 1.60 (CI = 1.29-21.96, p<.001]. Risk of secondary melanoma, breast cancer and prostate cancer was lower than in the general population.Conclusions: The risk for secondary primary malignancies is significantly increased in adults with gastric cancer compared to the general population.

  8. Diffusion-weighted magnetic resonance imaging in the assessment of ovarian masses with suspicious features: Strengths and challen

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2015-12-01

    Conclusion: DWI supported by conventional MRI data can confirm or exclude malignancy in suspicious ovarian masses. The combined analysis of quantitative and qualitative criteria and knowledge of the sequence pitfalls are required.

  9. Primary malignant mesothelioma of the tunica vaginalis of the testis. Immunohistochemistry and electron microscopy.

    Science.gov (United States)

    Berti, E; Schiaffino, E; Minervini, M S; Longo, G; Schmid, C

    1997-02-01

    A case of primary malignant mesothelioma of the tunica vaginalis of the testis in a 75 year old man is here presented. Anamnesis for asbestos exposure was negative. Recurrent left hydrocele was the main symptom. Echography revealed a nodular mass in the caudal aspect of the epididymis and papillary projection on the surface of the tunica vaginalis of the testis. An inguinal left orchiectomy was performed. The tumor both in the solid area and in the papillary projections was identified as a malignant mesothelioma of epithelial type. The role of immunohistochemistry and ultrastructure for a correct definition of the tumor is underlined.

  10. DNA-index and stereological estimation of nuclear volume in primary and metastatic malignant melanomas

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Kristensen, I B; Grymer, F

    1990-01-01

    The aim of this study was to investigate the relationship between physical nuclear volume and ploidy level in malignant melanomas, and to analyse the heterogeneity of these two parameters among primary and corresponding secondary tumours. Unbiased stereological estimates of nuclear volume can...... be obtained objectively by point-sampled intercepts. Using this approach, the volume-weighted mean nuclear volume, nuclear vv, was estimated in ordinary histological sections from 34 primary cutaneous malignant melanomas and their corresponding 62 metastatic lesions. For comparison, DNA-indices (DI) were...... determined by flow cytometry in adjacent sections from the same paraffin-embedded tumours. Only a poor correlation was found between nuclear vv and DI (Kendall's tau = +0.21). The variability of nuclear vv among metastatic lesions was increased as compared to primary melanomas, whereas averaged mean values...

  11. The role of imaging for the surgeon in primary malignant bone tumors of the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Rocca, M., E-mail: michele.rocca@ior.it [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Salone, M. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Galletti, S. [Ultrasound Unit, The Rizzoli Orthopaedic Institute, Bologna (Italy); Balladelli, A. [Laboratory of Experimental Oncology, The Rizzoli Orthopaedic Institute, Bologna (Italy); Vanel, D. [Research in Imaging Musculo Skeletal Tumors, The Rizzoli Orthopaedic Institute, Bologna (Italy); Briccoli, A. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy)

    2013-12-01

    Primary malignant chest wall tumors are rare. The most frequent primary malignant tumor of the chest wall is chondrosarcoma, less common are primary bone tumors belonging to the Ewing Family Bone Tumors (EFBT), or even rarer are osteosarcomas. They represent a challenging clinical entities for surgeons as the treatment of choice for these neoplasms is surgical resection, excluding EFBT which are normally treated by a multidisciplinary approach. Positive margins after surgical procedure are the principal risk factor of local recurrence, therefore to perform adequate surgery a correct preoperative staging is mandatory. Imaging techniques are used for diagnosis, to determine anatomic site and extension, to perform a guided biopsy, for local and general staging, to evaluate chemotherapy response, to detect the presence of a recurrence. This article will focus on the role of imaging in guiding this often difficult surgery and the different technical possibilities adopted in our department to restore the mechanics of the thoracic cage after wide resections.

  12. Solitary Pulmonary Lesion in Patients with History of Malignancy: Primary Lung Cancer or Metastatic Cancer?

    Science.gov (United States)

    Jin, Ke; Wang, Kexi; Zhang, Huizhong; Pan, Yuejiang; Cao, Dexiong; Wang, Minghui; Chen, Ju; Wu, Duoguang; Chen, Boshen; Xie, Xuan

    2018-02-07

    Defining the status of solitary pulmonary lesion (SPL) in patients with history of malignancy is important because primary lung cancer (PLC) or intrapulmonary metastasis might indicate different surgical strategies. The aim of this study is to identify factors related to the status of these lesions and construct a clinical model to estimate the pretest probability of PLC. From January 2005 to January 2016, 104 patients with previous malignancy and suitable for surgery were retrospectively studied. Univariate and multivariate analyses were performed to identify possible factors related to SPLs. A nomogram was constructed to differentiate PLC from intrapulmonary metastasis. Ninety-seven (93.3%) patients were diagnosed as malignant postoperatively, including 61 patients with intrapulmonary metastasis and 36 patients with PLC. Multivariate analysis showed that site of primary tumor [head and neck squamous cell cancer: odds ratio (OR) = 28.509, P = 0.006; genitourinary cancer: OR = 23.928, P = 0.012], negative lymph node status of primary tumor (OR = 3.154, P = 0.038), spiculation of SPL (OR = 3.972, P = 0.022), and central location of SPL (OR = 4.679, P = 0.026) were four independent factors differentiating PLC from intrapulmonary metastasis. All of these were included in the nomogram. The C-index of the nomogram for predicting probability was 0.82. Incidence of malignant SPLs was fairly high in patients with history of malignancy. A nomogram including site and lymph node status of primary tumor, and spiculation and location of SPL might be a good tool for differentiating PLC from intrapulmonary metastasis preoperatively and guiding treatment.

  13. Second Primary Malignancies in Mantle Cell Lymphoma: A US Population-based Study.

    Science.gov (United States)

    Shah, Binay Kumar; Khanal, Amit

    2015-06-01

    The risk of second primary malignancy (SPM) in mantle cell lymphoma (MCL) is not well-known. In this population-based study, we analyzed rates of SPM in adult patients with MCL. We selected adult (≥18 years) patients with MCL as first primary malignancy diagnosed during January 1992 to December 2011 from National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We used multiple standardized incidence ratio (MP-SIR) session of SEER(*) stat software to calculate the risk of second primary malignancies. Among 3,149 patients, 261 (8.29%) developed 287 second primary malignancies with observed/expected (O/E) ratio of 1.32 (95% confidence interval (CI=1.17-1.48, p<0.001). The median time to SPM from the time of diagnosis was 47 months (range=6 months to 17.91 years). The significant excess risks were observed for skin, excluding basal and squamous cancer, (N=22, O/E=2.24, CI=1.4-3.39, p<0.001), thyroid malignancy (O/E=3, CI=1.1-6.52, p<0.01), acute myeloid leukemia (O/E=7.74, CI=4.54-13.94, p<0.001), chronic lymphocytic leukemia (O/E=7.27, CI=4.44-11.23, p<0.001) and Non-Hodgkin's lymphoma (NHL) (O/E=3.79, CI=2.64-5.27, p<0.001). The risk of malignancies of brain, thyroid, rectum and anal canal were higher within the first two years of diagnosis of MCL. Risk of skin cancer, excluding basal and squamous cancer, was higher after two years of latency. There is significantly higher risk of second primary malignancies in patients with mantle cell lymphoma compared to the general population. Patients may benefit from cancer-specific screening during follow-up. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  14. Primary malignant melanoma of uterine cervix with probable origin from benign cervical melanosis.

    Science.gov (United States)

    Singh, Nilanchali; Tripathi, Reva; Mala, Yedla Manikya

    2013-06-03

    We report a case of primary malignant melanoma of cervix which is a rare malignancy with only around 60 cases being reported. This patient presented with bleeding per vaginum. A large exophytic growth from cervix with black discolouration was seen. International Federation of Gynaecology and Obsterics (FIGO) staging was stage IIa. Histoimmunocytology confirmed the diagnosis of malignant melanoma of cervix. S-100 and HMB-45 are reliable markers for cervical melanomas. We attempted Wertheim's hysterectomy; but, due to extensive disease, paravescical and pararectal fossae could not be dissected and we had to perform type I hysterectomy. The patient was started on adjuvant chemotherapy with dacarbazine. Despite counselling, she refused a complete course of chemotherapy and died after 6 months. Radical surgery, chemotherapy and immunotherapy are the therapeutic modalities used. In bulky disease, neoadjuvant chemotherapy should be considered to reduce the tumour bulk and facilitate required surgery. Prognosis is poor and unpredictable.

  15. CT findings of primary retroperitoneal cystic tumors. Special emphasis on the distinction benignancy from malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Nobusawa, Hiroshi; Hashimoto, Touji; Munechika, Hirotsugu [Showa Univ., Tokyo (Japan). School of Medicine] [and others

    1995-10-01

    We describe the CT findings of primary retroperitoneal cystic tumors in 20 patients (cystic lymphangioma, 9; cystic teratoma, 3; cystic neurinoma, 4; mucinous cystadenocarcinoma, 3; synovial sarcoma, 1). CT findings were retrospectively reviewed and the findings correlated with the pathological findings to determine malignant or benign cystic tumors. Definite criteria for malignancy were invasion to surrounding organ and the presence of distant metastasis. However, the sensitivity of these criteria was very low (25%). Enhancement of an intracystic solid component was a reliable criterion (p<0.05) for malignancy (sensitivity 75%, specificity 81%, accuracy 80%). Either unilocular cystic appearance or the presence of a `neck` (between the cystic mass and paraaortic region) strongly suggested the possibility of benignancy (specificity 100%). The `neck` was thought to be morphologically specific for cystic lymphangioma. (author).

  16. Second primary malignancies in renal cortical neoplasms: an updated evaluation from a single institution.

    Science.gov (United States)

    Murray, Katie S; Zabor, Emily C; Spaliviero, Massimiliano; Russo, Paul; Bazzi, Wassim M; Musser, John E; Ari Hakimi, A; Bernstein, Melanie L; Dalbagni, Guido; Coleman, Jonathan A; Furberg, Helena

    2016-12-01

    To examine the incidence of secondary primary malignancies in patients with renal cortical neoplasms. Between January 1989 and July 2010, 3647 patients underwent surgery at our institution for a renal cortical neoplasm and were followed through 2012. Occurrence of other malignancies was classified as antecedent, synchronous, or subsequent. All patients with antecedent malignancies (n = 498) and a randomly selected half of those with synchronous malignancies (n = 83) were excluded. The expected number of second primaries was calculated by multiplying Surveillance, Epidemiology, and End Results Program incidence rates of renal cortical neoplasms by person-years at risk within categories of age, sex, and year of diagnosis. The standardized incidence ratio (SIR) was calculated as observed cancers divided by expected incidence of the cancer, with approximation to the exact Poisson test used to obtain confidence intervals (CI) and p values. Of 3066 patients with renal cortical neoplasms, 267 had a second primary cancer; the five most common in men were prostate, colorectal, bladder, lung, and non-Hodgkin's lymphoma; the five most common in women were breast, colorectal, lung, endometrium, and thyroid. Men demonstrated higher than expected thyroid cancer rate (SIR 5.0; 95 % CI 1.83-10.88, p = 0.002), and women had higher than expected rates of stomach cancer (SIR 5.0; 95 % CI 1.61-11.67, p = 0.004) and thyroid cancer (SIR 4.62; 95 % CI 1.69-10.05, p = 0.003). The incidence of certain types of second malignancies may be higher in patients after diagnosis of renal cortical neoplasms compared to the general population. These observations can inform clinical follow-up in kidney cancer survivorship and future research studies.

  17. Primary Malignant Lymphoma of the Uterus: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Margriet Samama

    2011-12-01

    Full Text Available Primary malignant lymphomas in the female genital tract are rare. Most cases are non-Hodgkin lymphomas of which diffuse large B-cell lymphomas are most commonly seen. Symptoms are associated with other, more common diseases; therefore, a doctors’ delay can be expected. In this case a woman presented with complaints of urinary obstruction due to a large tumour in the pelvic area. A laparotomy was performed. A very large tumour of the uterus was found with adherence to the pelvic wall and urinary bladder. Diagnostic histological examination showed a diffuse large B-cell lymphoma. Treatment with R-CHOP chemotherapy was started shortly after the operation. The treatment of patients with a primary malignant lymphoma of the uterus should be individualized with the following options: surgery, radiotherapy and/or chemotherapy.

  18. Primary intraosseous smooth muscle tumor of uncertain malignant potential: original report and molecular characterization

    Directory of Open Access Journals (Sweden)

    Lauren Kropp

    2016-11-01

    Full Text Available We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel. Molecular characterization and ultrastructural analysis was consistent with smooth muscle origin, and amplification of unmutated chromosome 12p and 12q segments appears to be the major genomic driver of this tumor. Primary intraosseous STUMP is thought to be genetically related to leiomyosarcoma of bone, but likely representing an earlier stage of carcinogenesis. Wide excision and aggressive followup is warranted for this potentially life-threatening neoplasm.

  19. Primary malignant tumours of the bony pelvis: US-guided high intensity focused ultrasound ablation.

    Science.gov (United States)

    Wang, Yang; Wang, Wei; Tang, Jie

    2013-11-01

    The aim of this review is to evaluate the value of ultrasound (US)-guided high intensity focused ultrasound (HIFU) ablation in the treatment of primary malignant tumours of the bony pelvis. Eleven patients with primary malignant tumours of the bony pelvis received US-guided HIFU ablation. The maximum tumour size ranged from 5.6 to 25.0 cm (median 10.5 cm). Treatment was curative in four patients and palliative in seven patients. During follow-up, the effectiveness of HIFU ablation was assessed by contrast-enhanced magnetic resonance (MR). Significant coagulative necrosis was obtained in all patients after scheduled HIFU ablations; the volume ablation ratio was 86.7% ± 12.5% (range 65-100%). Complete tumour necrosis was achieved in all patients receiving curative HIFU ablation. No major complications were encountered. No patients died of local tumour progression during follow-up. US-guided HIFU ablation may be a safe and effective minimally invasive technique for the local treatment of primary malignant tumours of the bony pelvis.

  20. Immunosuppression and Multiple Primary Malignancies in Kidney-Transplanted Patients: A Single-Institute Study.

    Science.gov (United States)

    Santangelo, Michele L; Criscitiello, Carmen; Renda, Andrea; Federico, Stefano; Curigliano, Giuseppe; Dodaro, Concetta; Scotti, Alessandro; Tammaro, Vincenzo; Calogero, Armando; Riccio, Eleonora; Pisani, Antonio; Carlomagno, Nicola

    2015-01-01

    Immunodeficiency is associated with higher cancer incidence. However, it is unknown whether there is a link between immunodeficiency and development of multiple primary malignancies. In the present study we analyse this link focusing on kidney-transplanted patients, as they are at higher risk of developing cancer due to the chronic assumption of immunosuppressants. We followed up 1200 patients who underwent kidney transplantation between 1980 and 2012. A total of 77/1200 kidney-transplanted patients developed cancer and 24 of them developed multiple cancers. Most multiple cancers were synchronous with a nonsignificant association between cancer and rejection episodes. In the general cancer population, one-ninth of patients are at higher risk of developing a second tumor over a lifetime; hence it would be reasonable to conclude that, from a merely theoretical and statistical viewpoint, long-term transplanted patients potentially have a higher risk of developing MPMs. However, data did not confirm this assumption, probably because these patients die before a second primary malignancy appears. Despite many observations on the increased incidence of different tumor types in immunodeficient patients and despite immunosuppression certainly being a predisposing factor for the multicancer syndrome, data so far are not robust enough to justify a correlation between immunodeficiency and multiple primary malignancies in transplanted patients.

  1. Immunosuppression and Multiple Primary Malignancies in Kidney-Transplanted Patients: A Single-Institute Study

    Directory of Open Access Journals (Sweden)

    Michele L. Santangelo

    2015-01-01

    Full Text Available Immunodeficiency is associated with higher cancer incidence. However, it is unknown whether there is a link between immunodeficiency and development of multiple primary malignancies. In the present study we analyse this link focusing on kidney-transplanted patients, as they are at higher risk of developing cancer due to the chronic assumption of immunosuppressants. We followed up 1200 patients who underwent kidney transplantation between 1980 and 2012. A total of 77/1200 kidney-transplanted patients developed cancer and 24 of them developed multiple cancers. Most multiple cancers were synchronous with a nonsignificant association between cancer and rejection episodes. In the general cancer population, one-ninth of patients are at higher risk of developing a second tumor over a lifetime; hence it would be reasonable to conclude that, from a merely theoretical and statistical viewpoint, long-term transplanted patients potentially have a higher risk of developing MPMs. However, data did not confirm this assumption, probably because these patients die before a second primary malignancy appears. Despite many observations on the increased incidence of different tumor types in immunodeficient patients and despite immunosuppression certainly being a predisposing factor for the multicancer syndrome, data so far are not robust enough to justify a correlation between immunodeficiency and multiple primary malignancies in transplanted patients.

  2. Primary malignant mixed Müllerian tumour (MMMT) of the vagina and review of the literature.

    Science.gov (United States)

    Visvalingam, Geetha; Lee, Wai Kheong Ryan; Wong, Chin Fong; Lim, Yong Kuei

    2016-04-25

    Primary malignant mixed Müllerian tumour (MMMT) of the vagina is a rare entity. We report a case of a 62-year-old woman who presented with a fixed and hard anterior vaginal wall mass with contact bleeding. She proceeded to have an anterior infralevator pelvic exenteration with urethrectomy and anterior vaginectomy, creation of an ileal conduit and bilateral lymph node dissection. Histopathological examination and immunohistochemistry confirmed the diagnosis of primary MMMT of the vagina. The patient was stage IVA at diagnosis. Despite chemotherapy and radiotherapy, she had progressive disease and eventually passed away at the age of 65 years. 2016 BMJ Publishing Group Ltd.

  3. Sonographic scoring of solid thyroid nodules: effects of nodule size and suspicious cervical lymph node.

    Science.gov (United States)

    Unsal, Ozlem; Akpinar, Meltem; Turk, Bilge; Ucak, Irmak; Ozel, Alper; Kayaoglu, Semra; Uslu Coskun, Berna

    Ultrasound is the most frequently used imaging method to evaluate thyroid nodules. Sonographic characteristics of thyroid nodules which are concerning for malignancy are important to define the need for fine needle aspiration biopsy or open surgery. To evaluate malignancy risk of solid thyroid nodules through sonographic scoring. The effects of nodule size ≥2cm and associated pathologic cervical lymph node in scoring were examined in addition to generally excepted suspicious features. Medical data of 123 patients underwent thyroid surgery were reviewed, and 89 patients (58 females, 31 males) were included in the study. The presence and absence of each suspicious sonographic feature of thyroid nodules were scored as 1 and 0, respectively. Total ultrasound score was obtained by adding the positive ultrasound findings. Differently from the literature, nodule size ≥2cm and associated pathologic cervical node were added in scoring criteria. The diagnostic performance of nodule characteristics for malignancy and the effect of total US score to discriminate malignant and benign disease were calculated. A significant relationship was found between malignancy and hypoechogenity, border irregularity, intranodular vascularity, and microcalcification (p<0.05). Pathologic cervical node was observed predominantly in association with malignant nodules. Positive predictive value of suspicious cervical node for malignancy was 67%, similar to microcalcification. Nodule size ≥2cm was not distinctive for diagnosis of malignancy. The number of suspicious sonographic features obtained with receiver operating characteristic analysis to discriminate between malignant and benign disease was three. Sonographic scoring of thyroid nodules is an effective method for predicting malignancy. The authors suggest including associated pathologic node in the scoring criteria. Further studies with larger cohorts will provide more evidence about its importance in sonographic scoring. Copyright

  4. Secondary Malignant Peritoneal Mesothelioma of the Greater Omentum after Therapy for Primary Pleural Mesothelioma

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    Andreas Gutzeit

    2013-04-01

    Full Text Available Mesothelioma is the most common malignant primary tumor of the pleura and usually associated with inhalation of asbestos fibers. In contrast, peritoneal mesothelioma is a rare entity whose pathomechanism is not yet fully understood. The coexistence of pleural mesothelioma with secondary involvement of the abdominal cavity has not been addressed in the literature. In this case report, we describe secondary malignant mesothelioma of the greater omentum. A 69-year-old man with histologically proven pleural mesothelioma on the right side and no past medical history of asbestos exposure received palliative treatment consisting of a talc pleurodesis. After a 6-month interval of stable disease, a local progressive tumor of the right pleura was seen on a CT scan. Eleven months later, during follow-up, the patient presented at our emergency department with a sudden onset of diffuse abdominal pain. Abdominal ultrasound revealed a mass within the greater omentum and the coexistence of free fluid. Subsequent abdominal CT scans demonstrated tumor infiltration from the right pleura by a transdiaphragmatic route into the abdomen, where diffuse infiltration of the greater omentum was observed. Aspiration of the ascites and the biopsy of the greater omentum confirmed the diagnosis of secondary malignant mesothelioma of the peritoneum. In conclusion, we present the extremely rare diagnosis of secondary malignant mesothelioma of the abdomen, which arose as a result of local progression from the right pleura into the abdomen.

  5. Endoscopic Ultrasound Fine-Needle Aspiration Characteristics of Primary Adenocarcinoma versus Other Malignant Neoplasms of The Pancreas

    Directory of Open Access Journals (Sweden)

    Veronika Gagovic

    2012-01-01

    Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA is often used to assist in the evaluation of pancreatic lesions and may help to diagnose benign versus malignant neoplasms. However, there is a paucity of literature regarding comparative EUS characteristics of various malignant pancreatic neoplasms (primary and metastatic.

  6. Normal mammary fibroblasts induce reversion of the malignant phenotype in human primary breast cancer.

    Science.gov (United States)

    Römer, Anna-Maria; Lühr, Inke; Klein, Andreas; Friedl, Andreas; Sebens, Susanne; Rösel, Frank; Arnold, Norbert; Strauss, Alexander; Jonat, Walter; Bauer, Maret

    2013-04-01

    The tumor microenvironment plays a major role in tumor growth and progression. Its manipulation can lead to a reversion of the malignant phenotype. Here we explored the ability of normal mammary fibroblasts (HMFs) to induce reversion of the malignant phenotype of primary breast carcinoma cells (PBCs) in a three-dimensional (3D) context. PBCs were isolated from 13 primary breast carcinomas and cultured in 3D collagen-I gels as mono- or co-culture with HMFs. In five co-cultures, PBCs exhibited reversion of their malignant phenotype, whereas PBCs in matched monocultures exhibited disorganized growth. Reversion, defined as the restoration of the complete baso-apical polarity axis, was confirmed with established polarity markers. Secretion of the tissue-specific glycoprotein MAM-6 into the acinar lumens and deposition of basement membrane indicated functional differentiation. Gene expression analysis revealed a set of differentially regulated genes which possibly affect the reversion process. These included MAL, ELF5, MAP6, ZMYND11 and SQLE. These findings highlight the significant role of fibroblasts in regulating the carcinoma phenotype.

  7. Outcome of patients with malignant glioma and synchronous or metachronous non-central nervous system primary neoplasms.

    Science.gov (United States)

    Hamza, Mohamed A; Kamiya-Matsuoka, Carlos; Liu, Diane; Yuan, Ying; Puduvalli, Vinay K

    2016-02-01

    Patients with malignant glioma who are also diagnosed with one or more primary neoplasms of other organs present a unique challenge in both determining prognosis and clinical management. The overlapping impact of the malignancies and their treatment result in confounding variables that may adversely affect optimal management of such patients. Additionally, the glioma-related characteristics and survival outcome of these patients is not well-defined. In this retrospective chart and data review from our longitudinal database, we identified patients with malignant glioma including anaplastic glioma and glioblastoma, diagnosed between January 2005 and June 2011, who were also diagnosed with other non-CNS primary neoplasms. Patients with known genetic syndromes were excluded. The data was analyzed to determine the clinical characteristics and glioma-related survival. A total of 204 patients with malignant glioma (165 glioblastoma and 39 anaplastic glioma) were identified. There was no significant difference in the overall survival or progression-free survival between patients with malignant glioma plus non-CNS primary neoplasm when compared with patients with malignant glioma only. In patients with glioblastoma and non-CNS malignancy, the duration between diagnosis of glioblastoma and non-CNS neoplasms did not significantly alter glioma-related survival. Patients with malignant glioma who were diagnosed with other non-CNS malignancy have survival outcome comparable to those with malignant glioma only. The duration between diagnosis of glioblastoma and diagnosis of non-CNS neoplasms did not affect survival. Further prospective studies specifically addressing survival and molecular characteristics of patients with malignant glioma plus non-CNS cancers are recommended.

  8. Malignant amelanotic melanoma of the pleura without primary skin lesion:an autopsy case report.

    Science.gov (United States)

    Ohata, Yuichiro; Haga, Takayuki; Ogata, Sho; Nakanishi, Kuniaki; Kawai, Toshiaki

    2009-12-01

    Melanoma metastasizing to the lungs is common, but primary pulmonary or pleural melanoma is extremely rare. We present an autopsy case of malignant melanoma of the pleura without primary skin lesion in a 49-year-old man. A mass found in the right chest was diagnosed as spindle cell sarcoma by antemortem fine-needle aspiration cytology. At autopsy, a yellow-white tumor located primarily in the right visceral pleura (diagnosed as an amelanotic melanoma) was found to have invaded into the right lung, right parietal pleura, and right diaphragm, and to have metastasized into the left lung and visceral pleura, thyroid, and left adrenal gland. No primary site was found. The tumor cells were positive for S100 and focally positive for HMB-45, but negative for other markers. Immuno-histochemical examination for S100 and HMB-45 would thus appear to be useful for the diagnosis of an amelanotic melanoma.

  9. Mammalian models of chemically induced primary malignancies exploitable for imaging-based preclinical theragnostic research.

    Science.gov (United States)

    Liu, Yewei; Yin, Ting; Feng, Yuanbo; Cona, Marlein Miranda; Huang, Gang; Liu, Jianjun; Song, Shaoli; Jiang, Yansheng; Xia, Qian; Swinnen, Johannes V; Bormans, Guy; Himmelreich, Uwe; Oyen, Raymond; Ni, Yicheng

    2015-10-01

    Compared with transplanted tumor models or genetically engineered cancer models, chemically induced primary malignancies in experimental animals can mimic the clinical cancer progress from the early stage on. Cancer caused by chemical carcinogens generally develops through three phases namely initiation, promotion and progression. Based on different mechanisms, chemical carcinogens can be divided into genotoxic and non-genotoxic ones, or complete and incomplete ones, usually with an organ-specific property. Chemical carcinogens can be classified upon their origins such as environmental pollutants, cooked meat derived carcinogens, N-nitroso compounds, food additives, antineoplastic agents, naturally occurring substances and synthetic carcinogens, etc. Carcinogen-induced models of primary cancers can be used to evaluate the diagnostic/therapeutic effects of candidate drugs, investigate the biological influential factors, explore preventive measures for carcinogenicity, and better understand molecular mechanisms involved in tumor initiation, promotion and progression. Among commonly adopted cancer models, chemically induced primary malignancies in mammals have several advantages including the easy procedures, fruitful tumor generation and high analogy to clinical human primary cancers. However, in addition to the time-consuming process, the major drawback of chemical carcinogenesis for translational research is the difficulty in noninvasive tumor burden assessment in small animals. Like human cancers, tumors occur unpredictably also among animals in terms of timing, location and the number of lesions. Thanks to the availability of magnetic resonance imaging (MRI) with various advantages such as ionizing-free scanning, superb soft tissue contrast, multi-parametric information, and utility of diverse contrast agents, now a workable solution to this bottleneck problem is to apply MRI for noninvasive detection, diagnosis and therapeutic monitoring on those otherwise

  10. [Primary malignant melanoma of the vagina and treatment options: a case report].

    Science.gov (United States)

    Tsvetkov, Ch; Gorchev, G; Tomov, S; Hinkova, N; Nikolova, M; Veselinova, T

    2014-01-01

    To present and analyze the clinical characteristics, treatment, and treatment options for a patient with primary malignant melanoma of the vagina and review of literature. A 71-year-old patient with a history of vaginal bleeding caused by four tumor growths located in the vagina is presented. The size of each formation was about 2 cm. Three of them were located in the proximal two-thirds of the anterior wall of the vagina and one in the distal third. Excisional biopsy was performed of the lesion located near the entrance of the vagina. Histopathological examination revealed that it was a malignant melanoma of the vagina, which was confirmed immunohistochemically. After ruling out a tumor of an unknown primary site, the patient underwent radical hysterectomy type IV total vaginectomy and pelvic lymph node dissection. Hystological examination proved a clinically asymptomatic melanoma lesion of the uterine cervix. After surgery, the patient was given chemotherapy with Dacarbasine and monthly immunotherapy with BCG vaccine. The patient survived 21 months after surgery without developing a local relapse and died of distant metastases in the spine. Radical surgery for primary melanoma of the vagina is a secure way of achieving locoregional control of multifocal disease. The wide local excision can be used in unifocal lesions with security in achieving clean surgical margins.

  11. Primary localized malignant biphasic mesothelioma of the liver in a patient with asbestosis

    Science.gov (United States)

    Sasaki, Motoko; Araki, Ichiro; Yasui, Toshiaki; Kinoshita, Masaru; Itatsu, Keita; Nojima, Takayuki; Nakanuma, Yasuni

    2009-01-01

    We report a case of primary localized malignant biphasic mesothelioma of the liver in a 66-year-old man associated with asbestosis. The tumor was detected as a hepatic nodule, 4 cm in diameter, in the right lobe (S8 segment) on CT scan. Histopathological examination demonstrated an intrahepatic tumor with central necrosis consisting of a papillary epithelioid pattern on the surface of the liver, microcystic (microglandular or adenomatoid) pattern mainly in the subcapsular area and sarcomatoid pattern intermingled with microcystic pattern in the major part of the hepatic nodular tumor. Tumor cells, especially of epithelioid type, showed distinct immunoreactivity for mesothelial markers (WT-1, calretinin, D2-40, CK5/6, mesothelin, thrombomodulin) and no immunoreactivity for epithelial (adenocarcinoma) markers (CEA, CD15, BerEP4, BG8, MOC31). P53 immunoreactivity was detected focally in papillary epithelioid tumor cells and extensively in microcystic and sarcomatoid components, suggesting that the papillary epithelioid mesothelioma arose on the surface of the liver, and tumor cells showing microcystic and sarcomatoid patterns invaded and grew into the liver. To date, this is the first case of primary localized malignant biphasic mesothelioma of the liver, since all three primary hepatic mesotheliomas reported so far were epithelioid type. PMID:19195066

  12. A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy

    Directory of Open Access Journals (Sweden)

    Lindfay Laura Lau

    2015-01-01

    Full Text Available A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.

  13. Primary malignant mixed mesenchymal tumour of the heart in a dog.

    Science.gov (United States)

    Machida, N; Kobayashi, M; Tanaka, R; Katsuda, S; Mitsumori, K

    2003-01-01

    A case of primary malignant mixed mesenchymal tumour of the heart in an 8-year-old golden retriever is described. The cardiac tumour, measuring 2.5 x 3 x 5 cm, was located in the posterior part of the atrial septum, extending into the surrounding region. Histologically, the tumour was composed of multiple mesenchymal elements of fibrosarcoma, rhabdomyosarcoma, liposarcoma and chondrosarcoma. No previous reports of such a tumour occurring in the heart of the dog were found in the literature. Copyright 2002 Elsevier Science Ltd.

  14. A Case Report of Primary Pericardial Malignant Mesothelioma Treated with Pemetrexed and Cisplatin.

    Science.gov (United States)

    Kim, Jung Sun; Lim, Sang Yup; Hwang, Jinwook; Kang, Eun Joo; Choi, Yoon Ji

    2017-11-01

    Primary pericardial malignant mesothelioma (PPM) is a very rare malignancy, with an incidence of less than 0.002% and represents less than 5% of all mesotheliomas. The cause of pericardial mesothelioma is uncertain that differ from pleural mesothelioma which is associated with asbestos exposure. This malignancy is terribly aggressive and has very poor prognosis with less than six months of overall survival. We present a case of a 71-year-old woman who was diagnosed with cardiac tamponade caused by PPM and received chemotherapy with pemetrexed and cisplatin for six months. During two years she was alive without disease progression. To better understand the clinical, pathologic features and treatment outcome of this entity, we reviewed 23 cases described in the English literature from 2009, together with our case, provided a total of 24 cases. Based on this review, we suggest that PPM must be considered in patients who have unexplained massive pericardial effusion and recommend chemotherapy with pemetrexed and cisplatin for the better outcome of PPM. © 2017 The Korean Academy of Medical Sciences.

  15. The association between primary hyperparathyroidism and malignancy: nationwide cohort analysis on cancer incidence after parathyroidectomy.

    Science.gov (United States)

    Nilsson, Inga-Lena; Zedenius, Jan; Yin, Li; Ekbom, Anders

    2007-03-01

    In order to evaluate the link between primary hyperparathyroidism (pHPT) and malignancies, cases subjected to parathyroid adenomectomy (PTX) during 1958-1997 in Sweden were identified by analyzing the National Swedish Cancer Registry. To minimize the influence of confounding by detection, cases with malignant disease diagnosed before or at the same time as pHPT or during the first year after PTX were excluded. Altogether 9782 cases (7642 female) were included and followed for up to 40 years. Thus, the study comprises 89,571 person-years of observation. The incidence of malignancies was compared with that in the Swedish population standardized for age, sex, and calendar year. An increased overall incidence of cancer was demonstrated in both genders (standardized incidence ratio (SIR) 1.43, 95% confidence interval (CI) 1.35-1.52). This remain unchanged beyond 15 years after PTX. Breast cancer contributed a quarter of the cancer incidence in women (SIR 1.44, 95% CI 1.25-1.62). An increased risk of kidney (SIR 2.40, 95% CI 1.72-3.25), colonic (SIR 1.46, 95% CI 1.19-1.77), and squamous cell skin cancer (SIR 2.79, 95% CI 2.25-3.43) was found in both genders. The risk of endocrine and pancreas cancer was increased in the minority of patients who had their PTX before the age of 40. We conclude that pHPT is associated with an increased risk of developing malignancies that persists even after PTX. This suggests a causal disassociation with the biochemical derangements caused by parathyroid adenoma, while potentially common etiological mechanisms may include genetic predisposition or acquired disability to withstand environmental influence.

  16. Primary Malignant Fibrous Histiocytoma of the Lung: A Report of 20 Cases

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    Daliang QI

    2011-05-01

    Full Text Available Background and objective Primary malignant fibrous histiocytoma (MFH of the lung is a type of rare sarcoma which showed a lack of detailed guidance about treatment and prognosis. The clinical features, treatment methods and prognosis of primary MFH of the lung were analyzed by this study to reveal some information of this disease. Methods The clinical data and survival state of 20 patients with primary pulmonary MFH treated in Cancer Institute and Hospital of Tianjin Medical University were collected. SPSS 16.0 software was used for statistical analysis. Kaplan-Meier method was applied to figure out whether gender, size, site and post-operative chemotherapy correlated to prognosis. COX regression was employed for multivariate prognostic analysis to find the unattached prognostic factors. Statistical significance was considered at P<0.05. Results The clinical manifestations of primary pulmonary MFH mainly included cough, blood-stained sputum, chest pain, fever and chest distress. The one-year and two-year overall survival rates were 55.0% and 25.0%, respectively. Most cases died of local recurrence and distant metastasis. Multivariate COX regression analysis showed tumor size and location type were unattached prognostic factors. The patients with tumors smaller than 5 cm had a median survival of 27 months, while larger than 5 cm group’s median survival was 8 months. The median survival of central tumor and the peripheral tumor were 6 months and 23 months respectively. Conclusion Primary pulmonary MFH was a type of highly malignant sarcoma which had poor prognosis. The main effective treatment was surgery, yet the role of postoperative adjuvant chemotherapy in the whole course of treatment was undefined. Small mass size and peripheral type might be correlated to relatively better prognosis.

  17. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

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    Visser, Roelant; Schuur, Klaas H. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Veldkamp, Wouter J.H.; Bun, Petra A.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Centre/Mid-West, Utrecht (Netherlands); Imhof-Tas, Mechli W.; Snoeren, Miranda M.; Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Academical Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands)

    2012-04-15

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV). All cases had digitised previous mammograms. For both algorithms, the probability of malignancy of each finding was scored independently by six screening radiologists. Perceived case suspiciousness was defined as the highest probability of malignancy of all findings of a radiologist within a case. Differences in diagnostic accuracy of the processing algorithms were analysed by comparing the areas under the receiver operating characteristic curves (A{sub z}). Differences in perceived case suspiciousness were analysed using sign tests. There was no significant difference in A{sub z} (TE: 0.909, PV 0.917, P = 0.46). For all radiologists, perceived case suspiciousness using PV was higher than using TE more often than vice versa (ratio: 1.14-2.12). This was significant (P <0.0083) for four radiologists. Optimisation of local contrast by image processing may increase perceived case suspiciousness, while diagnostic accuracy may remain similar. (orig.)

  18. Primary biliary tract malignancies: MRI spectrum and mimics with histopathological correlation.

    Science.gov (United States)

    Mittal, Pardeep K; Moreno, Courtney Coursey; Kalb, Bobby; Mittal, Ankush; Camacho, Juan C; Maddu, Kiran; Kitajima, Hiroumi D; Quigley, Brian C; Kokabi, Nima; Small, William C

    2015-08-01

    Contrast-enhanced magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRCP), due to their excellent soft tissue contrasts, have become first-line noninvasive tests in the characterization and detection of both hepatic and pancreaticobiliary pathologies. MRCP is also helpful in detecting the level and cause of obstruction in patients presenting with jaundice. Cholangiocarcinoma (CCA) is the most common primary malignant tumor arising from the bile duct epithelium, with extrahepatic tumors presenting more often than with intrahepatic ones. However, the diagnosis and management of CCA is made more complex by a variety of malignant and benign conditions that resemble CCA, including hepatocellular carcinoma variants such as the fibrolamellar variant of hepatocellular carcinoma, cholangiocellular carcinoma, biliary metastases, hepatic inflammatory pseudotumor, lymphoepithelioma-like carcinoma, confluent fibrosis, primary sclerosis cholangitis, and the secondary sclerosing cholangitis complex. Consequently, knowledge of the underlying risk factors and imaging characteristics of these conditions is important in differentiating between neoplastic and non-neoplastic conditions in order to reach a definite diagnosis. Endoscopic retrograde cholangiopancreatography should be reserved for those patients who require intervention or biopsy for histopathological diagnosis.

  19. Primary Malignant Lymphoma of the Trigeminal Nerve: Case Report and Literature Review.

    Science.gov (United States)

    Ogiwara, Toshihiro; Horiuchi, Tetsuyoshi; Sekiguchi, Nodoka; Kakizawa, Yukinari; Hongo, Kazuhiro

    2015-08-01

    Primary lymphomas of the cranial nerves are extremely rare except for optic nerve lymphoma, and it is difficult to make a correct diagnosis in the initial stage. Here, we report a case of primary malignant lymphoma of the left trigeminal nerve that presented as trigeminal nerve disorder. A 47-year-old man presented with aggravating left facial pain and hypesthesia within all three divisions of the trigeminal nerve. Magnetic resonance imaging (MRI) revealed a swollen left trigeminal nerve with gadolinium homogenous enhancement. An open biopsy had to be taken from two different locations of the tumor via the lateral suboccipital approach followed by subtemporal approach because adequate specimen volume was not obtained for definitive diagnosis at the first surgery. Histopathological examinations with flow cytometric analysis revealed diffuse large B cell lymphoma. Chemotherapy followed by whole-brain radiation therapy was effective. No recurrence was observed during a 15-month follow-up period. This is a rare clinical presentation of malignant lymphoma of the trigeminal nerve. It is difficult to establish a correct diagnosis of trigeminal nerve lesions during the initial stages without biopsy. Therefore it is important that a sufficient specimen should be taken for biopsy without hesitation in order to diagnose and treat rapidly. The most suitable operative approach must be selected in trigeminal nerve lesions considering functional preservation, operative difficulty, preference of each surgeon, and quantity of specimen to be removed. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. TUMOR CONTAMINATION IN THE BIOPSY PATH OF PRIMARY MALIGNANT BONE TUMORS

    Science.gov (United States)

    Oliveira, Marcelo Parente; Lima, Pablo Moura de Andrade; de Mello, Roberto José Vieira

    2015-01-01

    Objective: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. Method: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. Results: Among the 35 patients studied, four cases of contamination occurred (11.43%): one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65). There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06). On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01) and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02). Conclusion: Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery. PMID:27047877

  1. Reconstruction of lower extremity primary malignant and metastatic bone tumours with modular endoprosthesis.

    Science.gov (United States)

    Sezgin, H; Çıraklı, A; Göçer, H; Dabak, N

    2017-09-01

    This study is aimed to assess the functional results of cases with lower extremity malignant and metastatic bone tumours that were treated with modular tumour resection prostheses. 49 patients were retrospectively examined. 27 (55.1%) patients had a primary bone tumour, and 22 (44.9%) had a metastatic bone tumour. Although most tumours located in the proximal femur were metastatic, tumours located around the knee were mostly primary malignant bone tumours. The functional assessments of our patients were made according to the Musculoskeletal Tumour Society (MSTS) scoring system. The Student's t-test and the Chi-square test were used for statistical analyses. 30 (61.2%) of the patients were men, and 19 (38.8%) were women. The average age was 46.2 ± 1.9 years. Tumours were located in the proximal femur in 27 (55.1%) patients, distal femur in 16 (32.7%) patients and proximal tibia in 6 (12.2%) patients. 14 (28.6%) patients had a pathological fracture on admission. The average follow-up period of our patients was 27.4 ± 3.4 months, and the average MSTS score was 74.3 ± 13%. Complications developed at any time in 34.7% of the patients, and the most common symptoms were aseptic loosening (8.2%) and prosthesis infection (8.2%). Local relapse was found in one (2%) patient. The 5-year survival rate was 68.3% in patients with a primary tumour and 30% in patients with a metastatic tumour. Although endoprosthesis reconstruction had advantages of giving very good functional results in the early phases, it was found to cause mechanical complications, especially in patients with primary bone tumours during the mid and late phases.

  2. Efficacy of 18F-FDG PET/CT in investigation of elevated CEA without known primary malignancy

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    Simon Sin-man Wong

    2016-01-01

    Full Text Available Aim: To evaluate the efficacy of 18flurodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT in investigating patients with elevated carcinoembryonic antigen (CEA and without known primary malignancy, and the impact of PET/CT findings on patient management. Setting and Design: PET/CT scans done in a tertiary hospital between December 2007 and February 2012 for elevated CEA in patients without known primary malignancy were retrospectively reviewed. Materials and Methods: The PET/CT findings, patients' clinical information, level of CEA, histological diagnosis, and subsequent management were retrieved by the electronic patient record for analysis. Statistical Analysis: Data were analyzed using SPSS version 19. Results: One hundred and one PET/CT scans were performed for patients with elevated CEA. Fifty-eight of these were performed for patients with known primary malignancy and were excluded; 43 PET/CT scans were performed for patients without known primary malignancy and were included. Thirty-three (77% had a positive PET/CT. Among the 32 patients with malignancy, 15 (47% suffered from lung cancer and 8 (25% suffered from colorectal cancer. The sensitivity (97%, specificity (82%, positive predictive value (94%, negative predictive value (90%, and accuracy (93% were calculated. Thirty (91% patients had resultant change in management. The mean CEA level for patients with malignancy (46.1 ng/ml was significantly higher than those without malignancy (3.82 ng/ml (P < 0.05. In predicting the presence of malignancy, a CEA cutoff at 7.55 ng/ml will achieve a sensitivity of 91% and a specificity of 73%. Conclusion: PET/CT, in our study population, appears to be sensitive, specific, and accurate in investigating patients with elevated CEA and without known primary malignancy. In addition to diagnosis of underlying primary malignancy, PET/CT also reveals occult metastases which would affect patient treatment options.Its role in

  3. Efficacy of 18F-FDG PET/CT in investigation of elevated CEA without known primary malignancy

    Science.gov (United States)

    Wong, Simon Sin-man; Yu, Wong L; Wang, Ki; Ahuja, Anil T

    2016-01-01

    Aim: To evaluate the efficacy of 18flurodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) in investigating patients with elevated carcinoembryonic antigen (CEA) and without known primary malignancy, and the impact of PET/CT findings on patient management. Setting and Design: PET/CT scans done in a tertiary hospital between December 2007 and February 2012 for elevated CEA in patients without known primary malignancy were retrospectively reviewed. Materials and Methods: The PET/CT findings, patients' clinical information, level of CEA, histological diagnosis, and subsequent management were retrieved by the electronic patient record for analysis. Statistical Analysis: Data were analyzed using SPSS version 19. Results: One hundred and one PET/CT scans were performed for patients with elevated CEA. Fifty-eight of these were performed for patients with known primary malignancy and were excluded; 43 PET/CT scans were performed for patients without known primary malignancy and were included. Thirty-three (77%) had a positive PET/CT. Among the 32 patients with malignancy, 15 (47%) suffered from lung cancer and 8 (25%) suffered from colorectal cancer. The sensitivity (97%), specificity (82%), positive predictive value (94%), negative predictive value (90%), and accuracy (93%) were calculated. Thirty (91%) patients had resultant change in management. The mean CEA level for patients with malignancy (46.1 ng/ml) was significantly higher than those without malignancy (3.82 ng/ml) (P < 0.05). In predicting the presence of malignancy, a CEA cutoff at 7.55 ng/ml will achieve a sensitivity of 91% and a specificity of 73%. Conclusion: PET/CT, in our study population, appears to be sensitive, specific, and accurate in investigating patients with elevated CEA and without known primary malignancy. In addition to diagnosis of underlying primary malignancy, PET/CT also reveals occult metastases which would affect patient treatment options. Its role in

  4. Secondary malignant neoplasms following radiotherapy for primary cancer in children and young adults.

    Science.gov (United States)

    Harbron, Richard W; Feltbower, Richard G; Glaser, Adam; Lilley, John; Pearce, Mark S

    2014-04-01

    A study was conducted to investigate secondary malignant neoplasm (SMN) occurrence following radiotherapy (RT) for cancer in children and young adults, to examine the spatial distribution of SMNs in relation to the irradiated field, and to evaluate a possible role of bystander effects in SMN distribution. Forty-two SMNs were identified among 7257 subjects diagnosed with cancer while living in Yorkshire, UK. Thirty-two of these occurred in patients receiving RT. Distances between SMN locations and RT field edge were estimated along with dose at SMN site. Expected radiation-induced SMN frequency in remote tissues receiving less than 0.1 Gy was predicted using risk estimates based on atomic bombing data. After a median follow-up period of 7.58 years, patients treated with RT were at a nearly five-fold increased risk of developing a subsequent primary neoplasm than the general population in the 0-29 years age range. The most common type of secondary malignancy associated with RT was of the central nervous system (28%), followed by sarcoma (25%) and leukemia (19%). Considering only solid SMNs developing 5 years or more from treatment, the spatial distribution showed a strong pattern of proximity to the irradiated field, with 68% occurring in-field or within 8 cm of the field edge. The SMN frequency in distant tissues receiving doses of less than 0.1 Gy was low but compatible with local absorbed dose.

  5. Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated?

    Science.gov (United States)

    Candelaria, Rosalind P; Hansakul, Palita; Thompson, Alastair M; Le-Petross, Huong; Valero, Vicente; Bassett, Roland; Huang, Monica L; Santiago, Lumarie; Adrada, Beatriz E

    2017-07-01

    To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Retrospective review of stereotactic biopsies performed during 2009-2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6-20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. A case report of an extremely rare and aggressive tumor: primary malignant pericardial mesothelioma

    Directory of Open Access Journals (Sweden)

    Vanessa Krause

    2012-04-01

    Full Text Available Primary pericardial malignant mesothelioma (PMPM is extremely rare with an incidence less than 0.0022%. It comprises 0.7% of all mesothelioma cases. To date, approximately 350 cases of pericardial mesothelioma have been reported in the literature. Its typical presentation is insidious, with nonspecific signs and symptoms, and usually results in constrictive pericarditis, cardiac tamponade and congestive heart failure either by a serous effusion or by direct tumorous constriction of the heart. With the exception of several case reports, the outcome is uniformly fatal, and patients typically die within six months of diagnosis. Here we report a 72-year-old Caucasian male with persistent pericardial and pleural effusion. He was diagnosed with PMPM after pericardectomy. He had only one cycle of chemotherapy with cisplatin and pemetrexed. He developed acute kidney injury as result of chemotherapy. He died 1 month after diagnosis and 6 months after the first symptoms.

  7. Other primary malignancies in breast cancer patients treated with breast conserving surgery and radiation therapy.

    Science.gov (United States)

    Yi, Min; Cormier, Janice N; Xing, Yan; Giordano, Sharon Hermes; Chai, Christy; Meric-Bernstam, Funda; Vlastos, Georges; Kuerer, Henry M; Mirza, Nadeem Q; Buchholz, Thomas A; Hunt, Kelly K

    2013-05-01

    Our purpose was to examine the incidence and impact on survival of other primary malignancies (OPM) outside of the breast in breast cancer patients and to identify risk factors associated with OPM. Patients with stage 0-III breast cancer treated with breast conserving therapy at our center from 1979 to 2007 were included. Risk factors were compared between patients with/without OPM. Logistic regression was used to identify factors that were associated with OPM. Standardized incidence ratios (SIRs) were calculated. Among 4,198 patients in this study, 276 (6.6 %) developed an OPM after breast cancer treatment. Patients with OPM were older and had a higher proportion of stage 0/I disease and contralateral breast cancer compared with those without OPM. In a multivariate analysis, older patients, those with contralateral breast cancer, and those who did not receive chemotherapy or hormone therapy were more likely to develop OPM after breast cancer. Patients without OPM had better overall survival. The SIR for all OPM sites combined after a first primary breast cancer was 2.91 (95 % confidence interval: 2.57-3.24). Significantly elevated risks were seen for numerous cancer sites, with SIRs ranging from 1.84 for lung cancer to 5.69 for ovarian cancer. Our study shows that breast cancer patients have an increased risk of developing OPM over the general population. The use of systemic therapy was not associated with increased risk of OPM. In addition to screening for a contralateral breast cancer and recurrences, breast cancer survivors should undergo screening for other malignancies.

  8. Clinical characteristics of the primary hepatic malignant fibrous histiocytoma in China: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Yao Dianbo

    2012-01-01

    Full Text Available Abstract Background A malignant fibrous histiocytoma is a soft tissue tumor that most commonly occurs in the extremities, but rarely involves the liver. The clinical characteristics and therapeutic experiences of primary hepatic malignant fibrous histiocytoma are still limited. Methods Two cases of primary hepatic malignant fibrous histiocytoma were analyzed retrospectively, and all the literature concerning primary hepatic malignant fibrous histiocytoma was analyzed. Results In China, a total of 76 cases had been reported, among which 50 were men, with a male to female ratio of 1.9:1. Mean age of the patients was 51.0 years old, and more than 85 percent were older than 40 years. 82.9 percent (63/76 of hepatic MFH were solitary lesions, with tumor size ranging from 2.5 to 23.5 cm (average 10.3 cm. Major clinical presentation (78.4% was abdominal pain or discomfort, accompanied with some other non-specific symptoms such as malaise, anorexia, weight loss, jaundice and fever, and small cases (14.9% were asymptomatic. Computed tomography and ultrasound usually revealed the location of lesions. The rate of pre-operative misdiagnosis was extremely high, and 14.9 percent of patients were even misdiagnosed as a benign liver cyst, liver abscess or hematoma. Integrated resection was performed among the most cases (49/68, among which only a few ones (12 cases were introduced to have no recurrence or metastasis or be still alive with no detail information provided, while among the cases with palliative operation or only a biopsy, the cases that were followed-up all died. Conclusions Hepatic malignant fibrous histiocytoma is a rare malignant mesenchymal tumor. The variable features of clinical presentations and images make the diagnosis difficult. Though the prognosis of primary hepatic malignant fibrous histiocytoma was rather poor, integrated resection might provide a few cases a good opportunity for surviving, suggesting that surgery might be an effective

  9. Metachronous and Synchronous Occurrence of 5 Primary Malignancies in a Female Patient between 1997 and 2013: A Case Report with Germline and Somatic Genetic Analysis

    OpenAIRE

    Jenny Nyqvist; Fredrik Persson; Toshima Z. Parris; Khalil Helou; Elisabeth Kenne Sarenmalm; Zakaria Einbeigi; Åke Borg; Per Karlsson; Anikó Kovács

    2017-01-01

    The number of patients with multiple primary malignancies has been increasing steadily in recent years. In the present study, we describe a unique case of an 81-year-old woman with 5 metachronous and synchronous primary malignant neoplasms. The patient was first diagnosed with an endometrium adenocarcinoma in 1997 and a colon adenocarcinoma in 2002. Eleven years after her colon surgery, in 2013, the patient presented with 3 other primary malignancies within a 4-month time span: an invasive ma...

  10. Natural History of Pathologically Benign Cancer Suspicious Regions on Multiparametric Magnetic Resonance Imaging Following Targeted Biopsy.

    Science.gov (United States)

    Bryk, Darren J; Llukani, Elton; Huang, William C; Lepor, Herbert

    2015-11-01

    We determined the natural history of pathologically benign cancer suspicious regions on multiparametric magnetic resonance imaging following targeted biopsy. Between January 2012 and September 2014, 330 men underwent prostate multiparametric magnetic resonance imaging. A total of 533 cancer suspicious regions were identified and scored on a Likert scale of 1 to 5 based on suspicion for malignancy with 5 indicating the highest suspicion level. Following multiparametric magnetic resonance imaging all men underwent magnetic resonance imaging-ultrasound fusion targeted prostate biopsy using ProFuse software and the ei-Nav|Artemis system (innoMedicus, Cham, Switzerland), and a computer generated 12-core random biopsy. We analyzed a cohort of 34 men with a total of 51 cancer suspicious regions who had benign prostate biopsies and underwent repeat multiparametric magnetic resonance imaging and prostate specific antigen testing at 1 year. Changes in the greatest linear measurement, the suspicion score and serum prostate specific antigen were ascertained. During 1 year the suspicion score distribution and the mean greatest linear measurement of the cancer suspicious regions decreased significantly (p resonance imaging at 1 year in men with pathologically benign cancer suspicious regions should be discouraged since it is unlikely to influence management decisions. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. Clinical Outcomes of Patients with Resected Oral Cavity Cancer and Simultaneous Second Primary Malignancies.

    Directory of Open Access Journals (Sweden)

    Chun-Ta Liao

    Full Text Available Simultaneous second primary tumors (SSPT are not uncommon in patients with oral cavity squamous cell carcinoma (OSCC living in areas where the habit of betel quid chewing is widespread. We sought to identify the main prognostic factors in OSCC patients with SSPT and incorporate them into a risk stratification scheme.A total of 1822 consecutive patients with primary OSCC treated between January 1996 and February 2014 were analyzed for the presence of SSPT. The 18-month and 5-year overall survival (OS rates served as the main outcome measures.Of the 1822 patients, 77 (4% were found to have SSPT (i.e, two malignancies identified within one month of each other. The 18-month and 5-year OS rates in patients without SSPT and with SSPT were 82% and 69%, and 72% and 53%, respectively (p = 0.0063. Patients with SSPT were further divided into patients with either esophageal cancer or hepatocellular carcinoma (eso-HCC subgroup, n = 8 and other tumors (NO eso-HCC subgroup, n = 69. After multivariate analysis, neck nodal extracapsular spread (ECS, n = 18 and the presence of eso-HCC were identified as independent adverse prognostic factors. The 18-month OS rates of SSPT patients with both eso-HCC and ECS (n = 5 vs. the remaining patients (n = 72 were 0% and 78%, respectively (p < 0.0001.OSCC patients with neck nodal ECS and esophageal cancer or hepatocellular carcinoma as SSPT have a dismal short-term prognosis.

  12. Malignant melanoma in Chile: an unusual distribution of primary sites in men from low socioeconomic strata.

    Science.gov (United States)

    Zemelman, V; Roa, J; Tagle, S Ruiz; Valenzuela, C Y

    2006-05-01

    Mortality from malignant melanoma (MM) has increased in Chile in the past decade. The location of MM lesions on the body has been correlated with prognosis and survival. To review body site and gender relationships with histopathologically confirmed primary MM in Chile. Records of 575 cases presenting to 5 state hospitals from 1992 to 2001 were analysed. There were 360 women and 215 men. Women showed a significantly higher number of MM on the legs, cheeks and arms, and in the genital area, whereas men showed a significantly higher number on the ears, backs of the hands, soles and feet. Men had a predilection for MM with a poor prognosis. The different body site distribution of primary MM in men and women may be explained by a different pattern of sun exposure. Ethnic and genetic factors may also be involved. The predominant location of MM in women in Chile is similar to white populations, whereas the location in men is similar to that observed in black and Asian populations. These observations may be relevant to the high mortality of MM in Chilean men.

  13. Primary malignant melanoma of the uterine cervix treated with ultraradical surgery: a case report.

    Science.gov (United States)

    Calderón-Salazar, Luz; Cantú de Leon, David; Perez Montiel, Delia; Almogabar-Villagrán, Erika; Villavicencio, Verónica; Cetina, Lucely

    2011-01-01

    Primary melanomas of the uterine cervix are rare tumors with no more than 60 cases reported in the world literature. Poor prognosis is considered for the neoplasia itself as well as for diagnostic tardiness. There is no standard treatment; however, radical surgery is the treatment cornerstone. Our aim was to present the case of a 34-year-old woman with a primary malignant melanoma in the uterine cervix with affectation of the posterior face of the vagina without metastasis. Total infraelevator pelvic exenteration and adjuvant radiotherapy was performed. The patient was under surveillance for 8 years of followup without evidence of local or distant disease. The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients. Notwithstanding this, survival is very short when patients are treated in this manner. Based on our results and on those reported in the literature, we propose initial treatment with total pelvic exenteration as optimal management for this neoplasia in its initial form.

  14. (aspiration cytology and mammography) of clinically suspicious ...

    African Journals Online (AJOL)

    Combined assessment. (aspiration cytology and mammography) of clinically suspicious breast masses. W. F. van Wyk, D. M. Dent, E. Anne Hacking,. Genevieve Learmonth, R. E. Kottler,. C. Anne Gudgeon, A. Tiltman. We examined the safety and utility of the combined assessment of aspiration cytology and mammography ...

  15. Secondary Primary Malignancy Risk in Patients With Cervical Cancer in Taiwan

    Science.gov (United States)

    Teng, Chung-Jen; Huon, Leh-Kiong; Hu, Yu-Wen; Yeh, Chiu-Mei; Chao, Yee; Yang, Muh-Hwa; Chen, Tzeng-Ji; Hung, Yi-Ping; Liu, Chia-Jen

    2015-01-01

    Abstract To evaluate the risk of secondary primary malignancy (SPM) in patients with cervical cancer using a nationwide population-based dataset. Patients newly diagnosed with cervical cancer between 1997 and 2011 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated by comparing with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models. During the 14-year study period (follow-up of 223,062 person-years), 2004 cancers developed in 35,175 patients with cervical cancer. The SIR for all cancers was 1.56 (95% confidence interval, 1.50–1.63, P 10, 5 to 10, 1 to 5, and cervical cancer diagnosis, SIRs were significantly higher for cancers of the esophagus (2.05), stomach (1.38), colon, rectum, and anus (1.36); lung and mediastinum (2.28), bone and soft tissue (2.23), uterus (3.76), bladder (2.26), and kidneys (1.41). Multivariate analysis showed that age ≥60 was a significant SPM risk factor (hazard ratio [HR] 1.59). Different treatments for cervical cancer, including radiotherapy (HR 1.41) and chemotherapy (HR 1.27), had different impacts on SPM risk. Carboplatin and fluorouracil independently increased SPM risk in cervical cancer patients. Patients with cervical cancer are at increased risk of SPM development. Age ≥60 years, chemotherapy, and radiotherapy are independent risk factors. Carboplatin and fluorouracil also increased SPM risk independently. Close surveillance of patients at high risk should be considered for the early detection of SPMs. PMID:26512575

  16. The multidimensional burden of informal caregivers in primary malignant brain tumor.

    Science.gov (United States)

    Bayen, Eléonore; Laigle-Donadey, Florence; Prouté, Myrtille; Hoang-Xuan, Khê; Joël, Marie-Eve; Delattre, Jean-Yves

    2017-01-01

    Informal caregivers (ICs) provide care and improve the quality of life of patients with malignant brain tumor. We analyze the impact of their involvement on themselves from a triple perspective. Home-dwelling patients with primary malignant brain tumor underwent a medical examination. ICs burden was evaluated by a self-administered postal questionnaire. Objective burden (Informal Care Time, ICT), subjective burden (Zarit Burden Inventory, ZBI), and financial burden (valuation of lost earnings using the Replacement and Opportunity Cost Methods, RCM, OCM) were evaluated. ICs (N = 84) were principally women (87 %) and spouses (64 %), of mean age 55 years, who assisted patients of mean age 53 years and with a mean KPS score of 61 (range = 30-90, med = 60). Subjective burden was moderate (mean ZBI = 30). Objective burden was high (mean ICT = 11.7 h/day), mostly consisting of supervision time. Higher subjective and objective burden were associated with poorer functional status (KPS) but not with a higher level of cognitive disorders in multivariate analyses. Other independent associated factors were bladder dysfunction and co-residency for objective burden and working and a poor social network for subjective burden. The 56 working ICs made work arrangements (75 %) that impacted their wages (36 %) and careers (30 %). Financial burden due to uncompensated caregiving hours for Activities of Daily Living had a mean monetary value from Є677(RCM) to Є1683(OCM) per month (i.e., ranging from Є8124 to Є20196 per year). IC burden is multidimensional. Greater provision of formal care, more IC support programs, and economic interventions targeting IC employment and finances are needed.

  17. A case report of gastric lymphocytic phlebitis, a rare mimic for malignancy

    Directory of Open Access Journals (Sweden)

    Daniel L. Chan

    2017-01-01

    Conclusion: If clinical history and endoscopic findings are suspicious for malignancy, despite normal biopsies, an aggressive surgical resection remains reasonable given the rarity gastric lymphocytic phlebitis.

  18. Frequency and clinical implications of incidental new primary cancers detected on true whole-body 18F-FDG PET/CT studies.

    Science.gov (United States)

    Sebro, Ronnie; Aparici, Carina Mari; Pampaloni, Miguel Hernandez

    2013-04-01

    To determine the frequency of additional primary malignancies in patients undergoing staging/restaging with PET/computed tomography (CT) and to determine the frequency with which these unsuspected findings change clinical management. This is a retrospective review of 556 patients who had undergone a total of 804 PET/CTs for staging/restaging. Lesions that were at an atypical location for a metastasis from the primary malignancy (indication for the study) and had a maximum standardized uptake value greater than 2.5 were considered suspicious. Suspicious lesions were followed up by a combination of clinical examination, biopsy, and additional and/or follow-up imaging. Forty-three (7.7%) patients had lesions that were suspicious for a newly discovered primary malignancy that was different from the known/suspected malignancy (indication for study). Eight (1.4% of 556) of these patients had biopsy confirmation of an additional synchronous or metachronous primary malignancy. However, these suspicious lesions changed the clinical management for 18 (3.2% of 556) patients. Patients with early-stage disease (stages 1 and 2) based on the malignancy for which the study was conducted were three times more likely to have these suspicious lesions biopsied, evaluated by clinical examination or by additional immediate imaging than were patients with advanced-stage disease (stages 3 and 4); however, this difference was not statistically significant (P=0.08). Unsuspected additional primary malignancies are rarely identified in patients undergoing staging/restaging with PET/CT but have the potential to significantly impact clinical management.

  19. Second Primary Malignant Neoplasms and Survival in Adolescent and Young Adult Cancer Survivors.

    Science.gov (United States)

    Keegan, Theresa H M; Bleyer, Archie; Rosenberg, Aaron S; Li, Qian; Goldfarb, Melanie

    2017-11-01

    Although the increased incidence of second primary malignant neoplasms (SPMs) is a well-known late effect after cancer, few studies have compared survival after an SPM to survival of the same cancer occurring as first primary malignant neoplasm (PM) by age. To assess the survival impact of SPMs in adolescents and young adults (AYAs) (15-39 years) compared with that of pediatric (cancer in 13 Surveillance, Epidemiology and End Results regions in the United States diagnosed from 1992 to 2008 and followed through 2013. Data analysis was performed between June 2016 and January 2017. Five-year relative survival was calculated overall and for each cancer occurring as a PM or SPM by age at diagnosis. The impact of SPM status on cancer-specific death was examined using multivariable Cox proportional hazards regression. A total of 15 954 pediatric, 125 750 AYAs, and 878 370 older adult patients diagnosed as having 14 cancers occurring as a PM or SPM were included. Overall, 5-year survival after an SPM was 33.1% lower for children, 20.2% lower for AYAs, and 8.3% lower for older adults compared with a PM at the same age. For the most common SPMs in AYAs, the absolute difference in 5-year survival was 42% lower for secondary non-Hodgkin lymphoma, 19% for secondary breast carcinoma, 15% for secondary thyroid carcinoma, and 13% for secondary soft-tissue sarcoma. Survival by SPM status was significantly worse in younger vs older patients for thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, soft-tissue sarcoma, and central nervous system cancer. Adolescents and young adults with secondary Hodgkin lymphoma (hazard ratio [95% CI], 3.5 [1.7-7.1]); soft-tissue sarcoma (2.8 [2.1-3.9]); breast carcinoma (2.1 [1.8-2.4]); acute myeloid leukemia (1.9 [1.5-2.4]); and central nervous system cancer (1.8 [1.2-2.8]) experienced worse survival compared with AYAs with the same PMs. The adverse impact of SPMs on survival is substantial for AYAs and may partially

  20. Unattended Monitoring of Suspicious Behaviour for Route Surveillance

    NARCIS (Netherlands)

    Schoemaker, R.M.; Sandbrink, R.D.J.; Voorthuijsen, G.P. van

    2010-01-01

    A priori information on suspicious behaviour is extremely valuable for countering threats involving improvised explosive devices (IEDs). Suspicious activities along routes during expeditionary operations can be monitored by unattended networks using simple sensing nodes that can gather data for

  1. Clinical Outcomes of Surgical Treatments for Primary Malignant Bone Tumors Arising in the Acetabulum

    Directory of Open Access Journals (Sweden)

    Tomohiro Fujiwara

    2015-01-01

    Full Text Available The functional and oncologic results of eighteen patients with primary malignant periacetabular tumors were reviewed to determine the impact of surgical treatment. The reconstruction procedures were endoprosthesis (11, hip transposition (4, iliofemoral arthrodesis (2, and frozen bone autograft (1. After a mean follow-up of 62 months, 13 patients were alive and 5 had died of their disease; the 5-year overall survival rate was 67.2%. The corresponding mean MSTS scores of patients with endoprosthesis (11 and other reconstructions (7 were 42% and 55% (49%, 68%, and 50%, respectively. Overall, postoperative complications including deep infection or dislocation markedly worsened the functional outcome. Iliofemoral arthrodesis provided better function than the other procedures, whereas endoprosthetic reconstruction demonstrated poor functional outcome except for patients who were reconstructed with the adequate soft tissue coverage. Avoiding postoperative complications is highly important for achieving better function, suggesting that surgical procedures with adequate soft tissue coverage or without the massive use of nonbiological materials are preferable. Appropriate selection of the reconstructive procedures for individual patients, considering the amount of remaining bone and soft tissues, would lead to better clinical outcomes.

  2. Pericardial Effusion due to Primary Malignant Pericardial Mesothelioma: A Common Finding but an Uncommon Cause

    Directory of Open Access Journals (Sweden)

    Valery Istomin

    2016-01-01

    Full Text Available This case report describes a 37-year-old female who was admitted to our Emergency Department because of shortness of breath. On physical examination, she had dyspnea and tachycardia and blood pressure was 80/50 mmHg with a pulsus paradoxus of 22 mmHg. Neck veins were distended, heart sounds were distant, and dullness was found on both lung bases. Her chest X-ray revealed bilateral pleural effusion and cardiomegaly. On both computed tomography and echocardiography the heart was of normal size and a large pericardial effusion was noted. The echocardiogram showed signs of impending tamponade, so the patient underwent an emergent pericardiocentesis. No infectious etiology was found and she was assumed to have viral pericarditis and was treated accordingly. However, when the pericardial effusion recurred and empirical therapy for tuberculosis failed, a pericardial window was performed. A typical staining pattern for mesothelioma was found on her pericardial biopsy specimen. Since no other mesodermal tissue was affected, a diagnosis of primary malignant pericardial mesothelioma was made. Chemotherapy was not effective and she passed away a year after the diagnosis was made. This case highlights the difficulties in diagnosing this uncommon disease in patients that present with the common finding of pericardial effusion.

  3. Double primary malignancies associated with colon cancer in patients with situs inversus totalis: two case reports

    Directory of Open Access Journals (Sweden)

    Kim Dae

    2011-09-01

    Full Text Available Abstract Situs inversus totalis (SIT is not itself a premalignant condition, however, rare synchronous or metachronous multiple primary malignancies have been reported. Herein we present a case of synchronous transverse and sigmoid colon cancers and a case of metachronous rectosigmoid colon and gastric cancers in patients with SIT. A 66-year-old male with SIT was referred for a two-month history of hematochezia. Synchronous colonic tumors were found on the proximal transverse and sigmoid colon. The patient underwent open total colectomy and was discharged without incident. A 71-year-old female with rectosigmoid colon cancer and SIT underwent laparoscopy-assisted low anterior resection. Fourteen months after the surgery, the patient developed a single hepatic metastasis and underwent hepatic segmentectomy (S6. Forty-six months after laparoscopy-assisted low anterior resection, the patient developed metachronous early gastric cancer on the antrum and underwent radical subtotal gastrectomy with gastroduodenostomy. The patient is doing well without recurrence for 28 months.

  4. Subsequent primary malignancies after diffuse large B-cell lymphoma in the modern treatment era.

    Science.gov (United States)

    Tao, Li; Clarke, Christina A; Rosenberg, Aaron S; Advani, Ranjana H; Jonas, Brian A; Flowers, Christopher R; Keegan, Theresa H M

    2017-07-01

    With the addition of rituximab and other treatment advances, survival after diffuse large B-cell lymphoma (DLBCL) has improved, but subsequent primary malignancies (SPMs) have emerged as an important challenge for DLBCL survivorship. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPMs among 23 879 patients who survived at least 1 year after a first primary DLBCL diagnosed during 1989-2012, compared to the general population in California. Cumulative incidence (CMI) of SPMs, accounting for the competing risk of death, also was calculated. We found that the incidence of acute myeloid leukaemia (AML) nearly doubled in the post-rituximab era [SIR (95% CI) 4·39 (2·51-7·13) pre- (1989-2000) and 8·70 (6·62-11·22) post-rituximab (2001-2012)]. Subsequent thyroid cancer was rare pre-rituximab, but increased substantially after 2001 [0·66 (0·08-2·37) vs. 2·27(1·44-3·41)]. The 5-year CMI for all SPMs (4·77% pre- vs. 5·41% post-rituximab, P = 0·047), AML (0·15% vs. 0·41%, P = 0·003), thyroid cancer (0·03% vs. 0·15%, P = 0·003) and melanoma (0·25% vs. 0·42%, P = 0·020) were greater in DLBCL patients diagnosed in the post- versus pre-rituximab period. This study provides insight into the changing pattern of SPM occurrence after the introduction of rituximab, which may elucidate the aetiology of SPMs and should guide future cancer surveillance efforts among DLBCL patients. © 2017 John Wiley & Sons Ltd.

  5. Metachronous Second Primary Malignancies after Head and Neck Cancer in a Korean Cohort (1993-2010.

    Directory of Open Access Journals (Sweden)

    Yuh-S Jung

    Full Text Available Second primary malignancy (SPM is the major long-term cause of patient mortality with head and neck squamous cell carcinoma (HNSCC. As the incidence of high-risk human papillomavirus (HPV-related HNSCC is increasing globally, we analyzed the patterns of SPM occurrence, the effect of the index tumor site along with attributes to HPV, and the effect of SPM on survival in South Korean patients with head and neck cancer (HNC. Data were retrieved from the Korea Central Cancer Registry, a nationwide population-based cancer registry, from 1993 to 2010. Standardized incidence ratios were analyzed and compared between index tumor sites, particularly oropharyngeal vs. non-oropharyngeal sites. After adjustment for competing risks, 3- and 5-year SPM rates were calculated using the cumulative incidence function. The effects of SPM occurrence on overall survival (OS were then analyzed. SPM rates were significantly lower for HPV-attributable oropharyngeal sites than for non-oropharyngeal sites, such as the larynx and hypopharynx (p<0.001. SPM rates were also lower for oral cavity first primary sites than for non-oropharyngeal first primary sites (p<0.001. SPMs typically occurred in the esophagus, lungs and the head and neck. Uterine cervical cancers occurred significantly more frequently after index oropharyngeal cancer in women. The 5-year and 10-year OS rates were 57.8 and 45.7% in all HNC patients, respectively. The OS after SPM occurrence was poor (5-year, 31.8%; 10-year, 20.8% compared to after index HNC occurrence (5-year, 68.4%; 10-year, 41.2%. SPM occurrence in the esophagus and lung/bronchus showed a worse OS than SPM localized to the head and neck. South Korean HNC patient, the first primary cancer site affected SPM risk and distribution. The 5- and 10-year OS rates deteriorated after SPM occurrence, particularly in the esophagus and lungs. Further optimization of follow-up strategies for effective surveillance of SPM, particularly in the esophagus

  6. Bayesian pretest probability estimation for primary malignant bone tumors based on the Surveillance, Epidemiology and End Results Program (SEER) database.

    Science.gov (United States)

    Benndorf, Matthias; Neubauer, Jakob; Langer, Mathias; Kotter, Elmar

    2017-03-01

    In the diagnostic process of primary bone tumors, patient age, tumor localization and to a lesser extent sex affect the differential diagnosis. We therefore aim to develop a pretest probability calculator for primary malignant bone tumors based on population data taking these variables into account. We access the SEER (Surveillance, Epidemiology and End Results Program of the National Cancer Institute, 2015 release) database and analyze data of all primary malignant bone tumors diagnosed between 1973 and 2012. We record age at diagnosis, tumor localization according to the International Classification of Diseases (ICD-O-3) and sex. We take relative probability of the single tumor entity as a surrogate parameter for unadjusted pretest probability. We build a probabilistic (naïve Bayes) classifier to calculate pretest probabilities adjusted for age, tumor localization and sex. We analyze data from 12,931 patients (647 chondroblastic osteosarcomas, 3659 chondrosarcomas, 1080 chordomas, 185 dedifferentiated chondrosarcomas, 2006 Ewing's sarcomas, 281 fibroblastic osteosarcomas, 129 fibrosarcomas, 291 fibrous malignant histiocytomas, 289 malignant giant cell tumors, 238 myxoid chondrosarcomas, 3730 osteosarcomas, 252 parosteal osteosarcomas, 144 telangiectatic osteosarcomas). We make our probability calculator accessible at http://ebm-radiology.com/bayesbone/index.html . We provide exhaustive tables for age and localization data. Results from tenfold cross-validation show that in 79.8 % of cases the pretest probability is correctly raised. Our approach employs population data to calculate relative pretest probabilities for primary malignant bone tumors. The calculator is not diagnostic in nature. However, resulting probabilities might serve as an initial evaluation of probabilities of tumors on the differential diagnosis list.

  7. Primary malignant oro-facial lesions: a review of cases in a tertiary ...

    African Journals Online (AJOL)

    Background: Oro-facial malignancies are among major causes of morbidity and mortality the world over with varying incidence in different geographical locations. Aim: To review oro-facial malignancies seen at the University of Port Harcourt Teaching Hospital (UPTH) and to compare results with reports from other centres.

  8. Alveolar soft part sarcoma: the new primary intracranial malignancy : A case report and review of the literature.

    Science.gov (United States)

    Kumar, Aditaya; Alrohmain, B; Taylor, W; Bhattathiri, P

    2017-07-26

    The purpose of this paper is to serve as a reference to aid in the management of this poorly understood intracranial malignancy. The authors report their experience treating the eighth ostensible case of a primary intracranial alveolar soft part sarcoma (ASPS). A 21-year-old man presented to hospital after collapsing. He gave a 1-year history of headache, a 2-month history of reduced visual acuity and on examination had left facial paraesthesia with left-sided incoordination. MRI of the brain revealed a large left posterior fossa mass. The patient underwent resection of the tumour with good recovery in function. Immunohistochemical analysis of the tumour specimen confirmed an ASPS, and multimodal imaging in search of an extra-cranial disease primary was negative. A review of the literature yielded only seven other cases of primary intracranial ASPS. A variety of diagnostic imaging modalities were employed in search of a disease primary, as were various combinations of surgical resection, chemotherapy and radiotherapy as treatment. Half of the cases documented delayed disease recurrence. The authors discuss the following: the unique radiological and immunohistological characteristics of this disease including the potential for its misdiagnosis; the investigations required to diagnose a primary intracranial ASPS; the efficacy of current medical and surgical treatment options and the factors that will aid in prognostication. This is the first review of this new primary intracranial malignancy. From our analysis, we offer a joint radiological and immunohistochemical algorithm for the diagnosis of primary intracranial ASPS and specific operative considerations prior to resection.

  9. Primary malignant melanoma of the vagina with repeated local recurrences and brain metastasis

    Directory of Open Access Journals (Sweden)

    Li-Te Lin

    2011-08-01

    Full Text Available Malignant melanoma of the vagina, a very rare malignancy, has a notoriously aggressive behavior associated with a high risk of local recurrence and distant metastasis. At present, there are various treatment options for this disease but no standard guideline. We describe a case of a 54-year-old woman with a locally advanced melanoma of the vagina, who underwent radical surgery, biochemotherapy with interferon-α-2b, chemotherapy, radiotherapy, and repeat excision of local recurrent lesions and brain metastasis. In conclusion, malignant melanoma of the vagina has a high risk for local recurrence. Repeated local excision followed by biochemotherapy is a tolerable treatment.

  10. Is thyroid gland only a "land" for primary malignancies? role of morphology and immunocytochemistry.

    Science.gov (United States)

    Rossi, Esther Diana; Martini, Maurizio; Straccia, Patrizia; Gerhard, Rene; Evangelista, Antonella; Pontecorvi, Alfredo; Fadda, Guido; Maria Larocca, Luigi; Schmitt, Fernando

    2015-05-01

    Thyroid Metastases (TM) represent a rare entity with an estimated variability ranging between 0 and 24%. Fine needle aspiration cytology (FNAC) might be useful in discriminating between primary and TM nodules especially when ancillary techniques (i.e., immunocytochemistry-ICC) are carried out. We herein appraised a series of 20 TM on FNAC analyzed between 2000 and 2013. We included eight male and 12 female patients. The cytological cases were processed with both liquid based (LBC) and conventional cytology. We reported 2.2% TM out of 910 malignancies. Our TM cases resulted as: six lung (LG), five gastro-intestinal (GI), five breast (B), three larynx (LX), and one clear cell renal carcinoma (CCRC) metastases. All the patients had a previous known cancer history. Although the cytological features were likely to suspect a TM, the application of ICC panels was contributive in 100% cases. None of TMs resulted as a unique localization whereby two cases underwent total thyroidectomy (including one B and one CCRC) and 18 TM were treated with radio-chemotherapy approaches. FNAC empowered the diagnostic workup of patients with TM avoiding useless surgical approach. The low sensitivity of cytology might be reinforced by the application of ancillary techniques. In contrast with the reported predominant rate of kidney metastatic carcinomas, our findings underlined that intestinal cancer as well as lung and breast are the most common TM. TM are frequently multifocal and in a contest of a systemic disease so that a tailored therapy seems to be the best treatment. © 2014 Wiley Periodicals, Inc.

  11. Rare multiple primary malignancies among surgical patients-a single surgical unit experience.

    Science.gov (United States)

    Carlomagno, Nicola; Santangelo, Michele L; Mastromarino, Rossella; Calogero, Armando; Dodaro, Concetta; Renda, Andrea

    2014-01-01

    A remarkable number of patients presents with multiple primary malignancies (MPM) over their lifetimes. In most cases inherited syndromes, iatrogenic, or viral factors are implicated, while in some cases it is not possible to ascertain a clear aetiopathogenesis. Starting from a series of 315 patients with MPM, we focused our attention on those with extremely infrequent combinations of tumours. We retrospectively analysed patients' characteristics, type of first and second tumour and the interval between the two tumours. We made a comparison between our own data and data from surveillance, epidemiology, and end results cancer registries, the largest global series on this topic. Six patients presented with unusual associations, namely, central nervous system (CNS)/colon, testis/stomach, colon/CNS, CNS/kidney, uterus/soft tissue, and bone/breast. The median age was 50.5 years at the diagnosis of second neoplasm and the male:female ratio was 1:1. All six patients underwent surgery for both tumours. The median interval between the first and the second tumour was 11.3 years (range 1-36 years). Five patients were given chemotherapy as adjuvant systemic treatment, and two of them with CNS tumours also received radiotherapy. We analysed the behaviour of these rare tumours as first and second neoplasms. More frequent combinations and possible aetiological factors were evaluated. Follow-up for patients recovering from a first tumour must be strict, as there is the risk of developing MPM, even after a long time period. Advancement in biomolecular knowledge and cooperation among different specialists are strongly needed to reduce mortality related to MPM and to foresee their occurrence.

  12. Rare multiple primary malignancies among surgical patients—a single surgical unit experience

    Science.gov (United States)

    Carlomagno, Nicola; Santangelo, Michele L; Mastromarino, Rossella; Calogero, Armando; Dodaro, Concetta; Renda, Andrea

    2014-01-01

    Background A remarkable number of patients presents with multiple primary malignancies (MPM) over their lifetimes. In most cases inherited syndromes, iatrogenic, or viral factors are implicated, while in some cases it is not possible to ascertain a clear aetiopathogenesis. Methods Starting from a series of 315 patients with MPM, we focused our attention on those with extremely infrequent combinations of tumours. We retrospectively analysed patients’ characteristics, type of first and second tumour and the interval between the two tumours. We made a comparison between our own data and data from surveillance, epidemiology, and end results cancer registries, the largest global series on this topic. Results Six patients presented with unusual associations, namely, central nervous system (CNS)/colon, testis/stomach, colon/CNS, CNS/kidney, uterus/soft tissue, and bone/breast. The median age was 50.5 years at the diagnosis of second neoplasm and the male:female ratio was 1:1. All six patients underwent surgery for both tumours. The median interval between the first and the second tumour was 11.3 years (range 1–36 years). Five patients were given chemotherapy as adjuvant systemic treatment, and two of them with CNS tumours also received radiotherapy. Discussion We analysed the behaviour of these rare tumours as first and second neoplasms. More frequent combinations and possible aetiological factors were evaluated. Conclusions Follow-up for patients recovering from a first tumour must be strict, as there is the risk of developing MPM, even after a long time period. Advancement in biomolecular knowledge and cooperation among different specialists are strongly needed to reduce mortality related to MPM and to foresee their occurrence. PMID:24966890

  13. Primary Malignant Peritoneal Mesothelioma Mimicking Peritoneal Carcinomatosis on F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-08-15

    Malignant mesothelioma of the peritoneum is a rare neoplasm with a rapidly fatal course. The tumour arises from the mesothelial cells lining the pleura and peritoneum or, rarely, in the pericardium or tunica vaginalis. This neoplasm is characterized by being difficult to diagnose, having a rapid evolution and a poor response to therapy. Mesothelioma is very glucose avid, and malignant pleural mesothelioma has been reported concerning the utility of F-18 FDG PET or PET/CT. But little has been known about the imaging finding of malignant peritoneal mesothelioma on F-18 FDG PET/CT. We report a case of malignant peritoneal mesothelioma mimicking peritoneal carcinomatosis of F-18 FDG PET/CT.

  14. Sleep Loss and Its Effects on Health of Family Caregivers of Individuals with Primary Malignant Brain Tumors

    OpenAIRE

    Pawl, Jean D.; Lee, Shih-Yu; Clark, Patricia C.; Sherwood, Paula R.

    2013-01-01

    Sleep loss places caregivers at risk for poor health. Understanding correlates of sleep loss and relationships to health may enable improvement of health of caregivers of individuals with primary malignant brain tumors (PMBT). In this cross-sectional, descriptive study of 133 caregivers, relationships were examined between sleep loss and physical, mental, emotional, and social health at time of patient diagnosis. Sleep loss was not related to physical health. Shorter total sleep time was asso...

  15. Primary malignant peripheral nerve sheath tumor of the lung in a young child without neurofibromatosis type 1.

    Science.gov (United States)

    Muwakkit, Samar A; Rodriguez-Galindo, Carlos; El Samra, Ahmad I; Khoury, Ruby; Akel, Samir R; Mroueh, Salman; Razzouk, Bassem; Abboud, Miguel R

    2006-10-15

    Malignant peripheral nerve sheath tumors (MPNST) are uncommon in children and almost half of the cases occur in patients with neurofibromatosis 1 (NF1). We report a child with a primary MPNST of the lung without NF1. MPNST of the lung has similar clinical and radiologic characteristics as pleuropulmonary blastoma. We suggest to include MPNST of the lung in the differential diagnosis of intrapulmonary masses in children. Copyright (c) 2006 Wiley-Liss, Inc.

  16. Incidence of second primary malignancies in patients with treated head and neck cancer: a comprehensive review of literature.

    Science.gov (United States)

    Atienza, Jonessa Ann S; Dasanu, Constantin A

    2012-12-01

    Increased incidence of a second primary aero-digestive malignancy after an index head and neck cancer (HNC) is well-documented. Furthermore, a clear set of surveillance strategies for second primary aero-digestive cancers in these patients exists. The goal of this article is to review the published literature on risk of second primary malignancies (SPMs) (including aero-digestive malignancies) after a treated index HNC as well as its associated predictors, prognosis and surveillance. Most relevant publications were identified through searching the PubMed database for articles published up to July 2012; epidemiologic evidence was synthesized and thoroughly analyzed. Data from randomized controlled trials, meta-analyses, population-based and cohort group studies, prior reviews, and case reports indicate an increased incidence of various SPMs after occurrence of a HNC. These cancers are not limited to upper aero-digestive sites. Common risk factors including environmental, genetic and immune factors may explain the increased incidence of second cancers in this patient population. In addition, site of the index HNC may predict the site of a future SPM. As a general rule, oral cavity and oropharyngeal squamous cell cancers are associated more with head and neck region SPM, while laryngeal and hypopharyngeal cancers - with that of the lung. As these cancers confer dismal prognosis and shorter survival in patients with HNCs, several literature sources recommend close surveillance for and an aggressive therapy of SPM. Notwithstanding, their optimal management and follow-up schedule remains to be established.

  17. Correspondence of cytological and histopathological diagnoses in diagnostic category V of the Bethesda system: “suspicious for malignancy”

    Directory of Open Access Journals (Sweden)

    Agata Stanek-Widera

    2016-05-01

    Full Text Available The progress in imaging methods enables fine needle aspiration (FNA biopsy to be performed on smaller and smaller lesions, including malignant ones (papillary microcarcinomas. The follicular variant predominates in this group, with cytological features often not permitting an unbiased interpretation. The aim of the study was to determine the degree of reliability of the “suspicious for malignancy” (SM diagnosis in material from the Institute of Oncology in Gliwice (IO. 290 primary SM diagnoses were established from 2010 to 2015 in the IO, including the consultations. None of the patients was treated surgically after the first FNA resulting in diagnostic category V (DC V. After the second FNA 80 patients underwent surgery, after the third 58, and after subsequent FNA 10. Together, 148 surgical resections were performed. Among 148 patients treated surgically, 111 were diagnosed with malignant lesions, which constitutes 75%. Predominantly – in 91 cases – the histopathological outcome was papillary carcinoma. The others were: 16 medullary carcinomas, 2 follicular carcinomas, and 2 poorly differentiated carcinoma cases. Moreover, 8 follicular adenomas and 28 nonneoplastic lesions were found. The high positive predictive value (PPV = 75% of SM diagnosis established in the IO testifies to the high reliability of this test. Diagnostic category V in FNA should be an indication for surgical treatment.

  18. Advance care planning in patients with primary malignant brain tumours: a systematic review

    Directory of Open Access Journals (Sweden)

    Krystal Song

    2016-10-01

    Full Text Available Advance care planning (ACP is a process of reflection and communication of a person’s future health care preferences, and has been shown to improve end-of-life care for patients. The aim of this systematic review is to present an evidence-based overview of ACP in patients with primary malignant brain tumours (pmBT. A comprehensive literature search was conducted using medical and health science electronic databases (PubMed, Cochrane, Embase, MEDLINE, ProQuest, Social Care Online, Scopus and Web of Science up to July 2016. Manual search of bibliographies of articles and grey literature search were also conducted. Two independent reviewers selected studies, extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program’s appraisal tools. All studies were included irrespective of the study design. A meta-analysis was not possible due to heterogeneity amongst included studies; therefore, a narrative analysis was performed for best evidence synthesis. Overall, 19 studies were included (1 RCT, 17 cohort studies, 1 qualitative study with 4686 participants. All studies scored low to moderate on the methodological quality assessment, implying high risk of bias. A single RCT evaluating a video decision support tool in facilitating ACP in pmBT patients showed a beneficial effect in promoting comfort care and gaining confidence in decision–making. However, the effect of the intervention on quality of life and care at the end-of-life were unclear. There was a low rate of use of ACP discussions at the end-of-life. Advance Directive completion rates and place of death varied between different studies. Positive effects of ACP included lower hospital readmission rates, and intensive care unit utilization. None of the studies assessed mortality outcomes associated with ACP. In conclusion, this review found some beneficial effects of ACP in pmBT. The literature still remains limited in this area, with lack of

  19. Primary, orbital, malignant extra-renal, non-cerebral rhabdoid tumour.

    Science.gov (United States)

    Mulay, Kaustubh; Honavar, Santosh G

    2014-08-01

    Malignant rhabdoid tumour is a rare tumour outside the kidney and central nervous system. Orbital and intraocular malignant rhabdoid tumour is particularly rare with very few reports in published literature. Given the aggressiveness of this tumour and resistance to conventional chemotherapy, it is important to differentiate this tumour from other, less aggressive tumours that may have similar clinicoradiological or light microscopic features. We report one such case in a 6-week-old male child with its clinicoradiological and histopathologic features, differential diagnosis and also review the literature on the same.

  20. Comparative microarray analysis of microRNA expression profiles in primary cutaneous malignant melanoma, cutaneous malignant melanoma metastases, and benign melanocytic nevi.

    Science.gov (United States)

    Sand, Michael; Skrygan, Marina; Sand, Daniel; Georgas, Dimitrios; Gambichler, Thilo; Hahn, Stephan A; Altmeyer, Peter; Bechara, Falk G

    2013-01-01

    Perturbations in microRNA (miRNA) expression profiles have been reported for cutaneous malignant melanoma (CMM) predominantly when examined in cell lines. Despite the rapidly growing number of newly discovered human miRNA sequences, the availability of up-to-date miRNA expression profiles for clinical samples of primary cutaneous malignant melanoma (PCMM), cutaneous malignant melanoma metastases (CMMM), and benign melanocytic nevi (BMN) is limited. Specimens excised from the center of tumors (lesional) from patients with PCMM (n=9), CMMM (n=4), or BMN (n=8) were obtained during surgery. An exploratory microarray analysis was performed by miRNA expression profiling based on Agilent platform screening for 1205 human miRNAs. The results from the microarray analysis were validated by TaqMan quantitative real-time polymerase chain reaction. In addition to several miRNAs previously known to be associated with CMM, 19 unidentified miRNA candidates were found to be dysregulated in CMM patient samples. Among the 19 novel miRNA candidates, the genes hsa-miR-22, hsa-miR-130b, hsa-miR-146b-5p, hsa-miR-223, hsa-miR-301a, hsa-miR-484, hsa-miR-663, hsa-miR-720, hsa-miR-1260, hsa-miR-1274a, hsa-miR-1274b, hsa-miR-3663-3p, hsa-miR-4281, and hsa-miR-4286 were upregulated, and the genes hsa-miR-24-1*, hsa-miR-26a, hsa-miR-4291, hsa-miR-4317, and hsa-miR-4324 were downregulated. The results of this study partially confirm previous CMM miRNA profiling studies identifying miRNAs that are dysregulated in CMM. However, we report several novel miRNA candidates in CMM tumors; these miRNA sequences require further validation and functional analysis to evaluate whether they play a role in the pathogenesis of CMM.

  1. Metachronous and Synchronous Occurrence of 5 Primary Malignancies in a Female Patient between 1997 and 2013: A Case Report with Germline and Somatic Genetic Analysis.

    Science.gov (United States)

    Nyqvist, Jenny; Persson, Fredrik; Parris, Toshima Z; Helou, Khalil; Kenne Sarenmalm, Elisabeth; Einbeigi, Zakaria; Borg, Åke; Karlsson, Per; Kovács, Anikó

    2017-01-01

    The number of patients with multiple primary malignancies has been increasing steadily in recent years. In the present study, we describe a unique case of an 81-year-old woman with 5 metachronous and synchronous primary malignant neoplasms. The patient was first diagnosed with an endometrium adenocarcinoma in 1997 and a colon adenocarcinoma in 2002. Eleven years after her colon surgery, in 2013, the patient presented with 3 other primary malignancies within a 4-month time span: an invasive malignant melanoma on the lower leg, an invasive mucinous breast carcinoma in the right breast, and a pleomorphic spindle cell sarcoma on the left upper arm. Subsequent routine medical checkups in 2013-2017 revealed no metastases of the primary malignancies. The patient mentioned a familial aggregation of malignant tumors, including 2 sisters with breast cancer and a brother with lung cancer. Interestingly, next-generation sequencing analysis of the patient's blood sample detected no mutations in the BRCA1, BRCA2, TP53, PTEN, CDH1, PALB2, RAD51C, RAD51D, MLH1, MSH2, MSH6, PMS2, EPCAM, APC, MUTYH, STK11, BMPR1A, SMAD4, PTEN, POLE, POLD1, GREM1, and GALNT12 genes. Therefore, whole genome sequencing is warranted to identify cancer-related genetic alterations in this patient with quintuple primary malignancies.

  2. Metachronous and Synchronous Occurrence of 5 Primary Malignancies in a Female Patient between 1997 and 2013: A Case Report with Germline and Somatic Genetic Analysis

    Directory of Open Access Journals (Sweden)

    Jenny Nyqvist

    2017-11-01

    Full Text Available The number of patients with multiple primary malignancies has been increasing steadily in recent years. In the present study, we describe a unique case of an 81-year-old woman with 5 metachronous and synchronous primary malignant neoplasms. The patient was first diagnosed with an endometrium adenocarcinoma in 1997 and a colon adenocarcinoma in 2002. Eleven years after her colon surgery, in 2013, the patient presented with 3 other primary malignancies within a 4-month time span: an invasive malignant melanoma on the lower leg, an invasive mucinous breast carcinoma in the right breast, and a pleomorphic spindle cell sarcoma on the left upper arm. Subsequent routine medical checkups in 2013–2017 revealed no metastases of the primary malignancies. The patient mentioned a familial aggregation of malignant tumors, including 2 sisters with breast cancer and a brother with lung cancer. Interestingly, next-generation sequencing analysis of the patient’s blood sample detected no mutations in the BRCA1, BRCA2, TP53, PTEN, CDH1, PALB2, RAD51C, RAD51D, MLH1, MSH2, MSH6, PMS2, EPCAM, APC, MUTYH, STK11, BMPR1A, SMAD4, PTEN, POLE, POLD1, GREM1, and GALNT12 genes. Therefore, whole genome sequencing is warranted to identify cancer-related genetic alterations in this patient with quintuple primary malignancies.

  3. Primary malignant head and neck tumours in Ghana: a survey of ...

    African Journals Online (AJOL)

    McRoy

    Received: 16.11.12; Accepted: 02.02.13. INTRODUCTION. Malignant neoplasms of the head and neck. [ICD-10 (International Classification of. Diseases 10th Revision) categories C00-. C14 (cancer of the lip, oral cavity and pharynx) and C32 (larynx)][1] are a cause of mortality and morbidity in several parts of the world.[2].

  4. Treatment of malignant fibrous histiocytoma of bone. A plea for primary chemotherapy

    NARCIS (Netherlands)

    den Heeten, G. J.; Schraffordt Koops, H.; Kamps, W. A.; Oosterhuis, J. W.; Sleijfer, D. T.; Oldhoff, J.

    1985-01-01

    Seven patients have been treated for malignant fibrous histiocytoma (MFH) of bone since the end of 1977. One patient received no chemotherapy, and one did not complete attempted chemotherapy. Both died, 7 and 51 months after diagnosis, respectively. The remaining five patients completed

  5. Triple synchronous primary malignancies of the colon, endometrium and kidney in a patient with Lynch syndrome treated via minimally invasive techniques

    Directory of Open Access Journals (Sweden)

    Luis E. Mendez

    2016-08-01

    It is important to consider hereditary cancer syndromes in women with a strong family history presenting with synchronous multiple primary malignancies. A multidisciplinary surgical approach is key to best practices and optimal patient outcomes.

  6. Pleural malignancies.

    Science.gov (United States)

    Friedberg, Joseph S; Cengel, Keith A

    2010-07-01

    Pleural malignancies, primary or metastatic, portend a grim prognosis. In addition to the serious oncologic implications of a pleural malignancy, these tumors can be highly symptomatic. A malignant pleural effusion can cause dyspnea, secondary to lung compression, or even tension physiology from a hydrothorax under pressure. The need to palliate these effusions is a seemingly straightforward clinical scenario, but with nuances that can result in disastrous complications for the patient if not attended to appropriately. Solid pleural malignancies can cause great pain from chest wall invasion or can cause a myriad of morbid symptoms because of the invasion of thoracic structures, such as the heart, lungs, or esophagus. This article reviews pleural malignancies, the purely palliative treatments, and the treatments that are performed with definitive (curative) intent. Copyright 2010 Elsevier Inc. All rights reserved.

  7. [Rotationplasty in the surgical treatment plan of primary malignant bone tumors. Possibilities and limits].

    Science.gov (United States)

    Hardes, J; Gebert, C; Hillmann, A; Winkelmann, W; Gosheger, G

    2003-11-01

    Long-term survival of patients with a malignant bone tumor increased with a combined therapeutic approach using chemotherapy and possibly radiation therapy. Today up to 80% of patients with an osteosarcoma or Ewing's sarcoma survive. Therefore, it is important that the functional outcome and the quality of life are good after resection of the tumor. Before the era of endoprosthetic devices, rotationplasty, which was introduced in 1974 by Salzer for surgery of malignant bone tumors and modified by Winkelmann, protected many patients from an amputation. Although many authors favor limb-saving procedures today, rotationplasty obtained excellent functional and psychosocial results. Rotationplasty can be recommended in tumors with a large soft tissue component, in tumors located in the proximal femur and proximal tibia, and in children under 10 years of age. Furthermore, rotationplasty can be used in patients in whom a limb-salvage procedure failed because of infection or repeated changes of the endoprosthesis.

  8. Clinical outcomes of an endoscopic transclival and transpetrosal approach for primary skull base malignancies involving the clivus.

    Science.gov (United States)

    Kim, Yong Hwy; Jeon, Chiman; Se, Young-Bem; Hong, Sang Duk; Seol, Ho Jun; Lee, Jung-Ii; Park, Chul-Kee; Kim, Dong Gyu; Jung, Hee-Won; Han, Doo Hee; Nam, Do-Hyun; Kong, Doo-Sik

    2017-06-02

    OBJECTIVE The endoscopic endonasal approach for treating primary skull base malignancies involving the clivus is a formidable task. The authors hypothesized that tumor involvement of nearby critical anatomical structures creates hurdles to endoscopic gross-total resection (GTR). The aim of this study was to retrospectively review the clinical outcomes of patients who underwent an endoscopic endonasal approach to treat primary malignancies involving the clivus and to analyze prognostic factors for GTR. METHODS Between January 2009 and November 2015, 42 patients underwent the endoscopic endonasal approach for resection of primary skull base malignancies involving the clivus at 2 independent institutions. Clinical data; tumor locations within the clivus; and anatomical involvement of the cavernous or paraclival internal carotid artery, cisternal trigeminal nerve, hypoglossal canal, and dura mater were investigated to assess the extent of resection. Possible prognostic factors affecting GTR were also analyzed. RESULTS Of the 42 patients, 37 were diagnosed with chordomas and 5 were diagnosed with chondrosarcomas. The mean (± SD) preoperative tumor volume was 25.2 ± 30.5 cm3 (range 0.8-166.7 cm3). GTR was achieved in 28 patients (66.7%) and subtotal resection in 14 patients (33.3%). All tumors were classified as upper (n = 17), middle (n = 17), or lower (n = 8) clival tumors based on clival involvement, and as central (24 [57.1%]) or paramedian (18 [42.9%]) based on laterality of the tumor. Univariate analysis identified the tumor laterality (OR 6.25, 95% CI 1.51-25.86; p = 0.011) as significantly predictive of GTR. In addition, the laterality of the tumor was found to be a statistically significant predictor in multivariate analysis (OR 41.16, 95% CI 1.12-1512.65; p = 0.043). CONCLUSIONS An endoscopic endonasal approach can provide favorable clinical and surgical outcomes. However, the tumor laterality should be considered as a potential obstacle to total removal.

  9. Epithelial to mesenchymal transition of a primary prostate cell line with switches of cell adhesion modules but without malignant transformation.

    Directory of Open Access Journals (Sweden)

    Xi-Song Ke

    Full Text Available BACKGROUND: Epithelial to mesenchymal transition (EMT has been connected with cancer progression in vivo and the generation of more aggressive cancer cell lines in vitro. EMT has been induced in prostate cancer cell lines, but has previously not been shown in primary prostate cells. The role of EMT in malignant transformation has not been clarified. METHODOLOGY/PRINCIPAL FINDINGS: In a transformation experiment when selecting for cells with loss of contact inhibition, the immortalized prostate primary epithelial cell line, EP156T, was observed to undergo EMT accompanied by loss of contact inhibition after about 12 weeks in continuous culture. The changed new cells were named EPT1. EMT of EPT1 was characterized by striking morphological changes and increased invasion and migration compared with the original EP156T cells. Gene expression profiling showed extensively decreased epithelial markers and increased mesenchymal markers in EPT1 cells, as well as pronounced switches of gene expression modules involved in cell adhesion and attachment. Transformation assays showed that EPT1 cells were sensitive to serum or growth factor withdrawal. Most importantly, EPT1 cells were not able to grow in an anchorage-independent way in soft agar, which is considered a critical feature of malignant transformation. CONCLUSIONS/SIGNIFICANCE: This work for the first time established an EMT model from primary prostate cells. The results show that EMT can be activated as a coordinated gene expression program in association with early steps of transformation. The model allows a clearer identification of the molecular mechanisms of EMT and its potential role in malignant transformation.

  10. Mucosal surface nodularity on upper gastrointestinal series (UGIS) : prospective analysis of its primary cause and prevalence of gastric malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Youn; Kim, Sun Mi; Kim, Ah Young; Kim, Tae Kyoung; Kim, Pyo Nyun; Ha, Hyun Kwon [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2001-10-01

    Mucosal surface nodularity was defined as present at UGIS when multiple nodular defects larger than 5 mm were scattered in the gastric mucosa in an area greater than 5 x 5 cm. The purpose of this study was to determine the primary causes of this radiographic finding and to assess the incidence of gastric malignancy in these patients. During a one-year period were prospectively collected among patients who underwent UGIS, data for 51 [aged 30-78 (mean, 51) years] above who met the criteria of mucosal surface nodularity. Whether or not this was present was decided by two radiologists who in reaching a consensus excluded the possibility of erosive gastritis, indicated by central barium collection in the nodular defects. The primary causes of mucosal nodularity and associated gastric pathologies were determined by the histopathological results obtained from the specimens after surgery (n=18) or endoscopic biopsy (n=33). Pathological examinations revealed that the primary causes of the mucosal nodularity in these 51 patients were intestinal metaplasia in 28 (54.9%), MALT lymphoma in seven (13.7%), early gastric cancer in six (11.8%), chronic gastritis in five (9.8%), low grade dysplasia in four (7.8%), and gastritis cystica profunda in one (2%). Gastric malignancy was present either in or outside the area of mucosal nodularity in 34 (66/7%) of the 51 (27 carcinomas and 7 MALT lymphomas). No different patterns of mucosal surface nodularity were noted between the groups of each disease entity. Mucosal surface nodularity is observed at UGIS in various gastric pathologies. Because of the high incidence of gastric malignancy in these patients, close follow-up or gastrofiberscopic biopsy is mandatory.

  11. Neuroimaging findings of the post-treatment effects of radiation and chemotherapy of malignant primary glial neoplasms.

    Science.gov (United States)

    Mamlouk, M D; Handwerker, J; Ospina, J; Hasso, A N

    2013-08-01

    Post-treatment radiation and chemotherapy of malignant primary glial neoplasms present a wide spectrum of tumor appearances and treatment-related entities. Radiologic findings of these post-treatment effects overlap, making it difficult to distinguish treatment response and failure. The purposes of this article are to illustrate and contrast the imaging appearances of recurrent tumor from necrosis and to discuss other radiologic effects of cancer treatments. It is critical for radiologists to recognize these treatment-related effects to help direct clinical management.

  12. Differential diagnosis of cervical malignant lymphadenopathy among Iranian patients.

    Science.gov (United States)

    Naeimi, Mohammad; Sharifi, Amin; Erfanian, Youssef; Velayati, Arash; Izadian, Shahla; Golparvar, Sadegh

    2009-03-01

    To investigate the differential diagnosis in cases referred with neck lumps suspicious to malignant nodal masses and its relation to demographic variants. Individuals who entered in this cross-sectional study conducted at the Department of Otolaryngology, Ghaem Medical Center, Mashdad, Iran from May 1995 to April 2005 were re-evaluated by history taking, physical examination and imaging studies. Fine needle aspiration was applied to obtain tissue sampling. Among the patients, 232 cases had malignant disease confirmed by pathology reports. Cases with unknown primary tumor underwent investigations including pan-endoscopy, and further imaging studies were carried out to determine the primary tumor site. Demographic data as gender, age, location, size, and pathology of tumor were considered. The results of this study showed that 50% of patients which were referred with neck masses had malignant neoplasm. The most common pathology in patients younger than 40 years were lymphoma (55%) and thyroid cancer (26%), whereas, in patients older than 40 years squamous cell carcinoma (67%) was more common. The most involved lymph nodes were jugulodigastric chain. Larynx and hypopharynx are the most common sources of aerodigestive tract metastatic. According to high incidence malignancy (50%) among neck lesions, an asymmetrical neck mass in adults should be considered malignant until proven otherwise. It seems that age is an important predictor of tumor pathology, and determination of further diagnostic investigations would be helpful.

  13. Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Joon Ho; Kim, Eun-Kyung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Lee, Hye Sun [Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Moon, Hee Jung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kwak, Jin Young, E-mail: docjin@yuhs.ac [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

    2013-01-15

    Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and {sup 99m}Tc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and {sup 99m}Tc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8%) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1% and 92.2%, 90.4% and 89.5%, and 96.9% and 96.9% by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9%), and 7 patients (7/107, 6.5%) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and {sup 99m}Tc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules.

  14. Autopsied case of primary malignant lymphoma of the central nervous system presenting an unusual clinical course and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Kazuya; Kobayashi, Shotai; Yamaguchi, Shuhei and others

    1987-08-01

    A case of primary malignant lymphoma of the central nervous system was reported. A 58-year-old man was admitted because of diplopia in March, 1986. Last year in June he lost consciousness, accompanied by headache, vertigo, a floating sensation, and tinnitus, though his symptoms disappeared the next day. Last year in October and November, he complained of weakness of the left hand, but it soon disappeared. A neurological examination on admission revealed left trochlear nerve palsy, a decreased sensitivity to pain on the left side of the face and the opposite side of the body, and a mild left-side lack of coordination. A head CT scan and angiography showed no abnormalities. An examination of the CSF revealed increased protein with mild pleocytosis and IgG, but cytology was negative. After admission, he complained of left trigeminal neuralgia, but it disappeared upon steroid pulse therapy. When the steroids were tapered off, however, peripheral facialnerve palsy developed. Therefore, a second course of steroid pulse therapy was done, with some effect. In June, however, the patient became unconscious while the orally administered steroid was being tapered off. A head CT scan showed isodensity masses in the basal ganglia, the thalamus, and the periventricular white matter on a plain scan, and homogeneous masses with ring enhancement and edema on the use of a contrast medium. A histopathological examination showed primary cerebral malignant lymphoma (large-cell type).

  15. Long-term outcome of primary Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) including PUNLMP with inverted growth.

    Science.gov (United States)

    Maxwell, Jay P; Wang, Cheng; Wiebe, Nicholas; Yilmaz, Asli; Trpkov, Kiril

    2015-03-13

    Few larger studies have evaluated the long-term outcome after a diagnosis of papillary urothelial neoplasm of low malignant potential (PUNLMP), demonstrating a broad range of recurrence and progression rates. Additionally, no study has addressed the outcome of PUNLMP exhibiting inverted growth. We evaluated the long term clinical outcome of primary papillary urothelial neoplasm of low malignant potential (PUNLMP), including PUNLMP with inverted growth in a large single center study. We evaluated 189 primary PUNLMP (177 exophytic, 12 inverted), diagnosed from January 1, 2000 to December 31, 2009, in a centralized uropathology practice. We excluded PUNLMP diagnosed after a previous or with a concurrent urothelial neoplasm. Recurrence was defined as any subsequent urothelial neoplasm, regardless of the grade. Progression was defined as any subsequent higher-grade or invasive urothelial neoplasm. Recurrence and progression were established only if documented on a subsequent biopsy. Descriptive statistical analysis was performed using Microsof Excel software package. The location of PUNLMP included bladder (187) and renal pelvis and ureter (1 each). After a median follow-up of 61 months (range, 9-128 months), 20.1% patients developed a recurrence. Recurrence with PUNLMP only was found in 9% of patients. Subsequent low-grade urothelial carcinoma was documented in 9.5% of patients. Progression to high-grade urothelial carcinoma was found in 1.6% patients (1% with muscle invasion). No patients with recurrent PUNLMP or subsequent low-grade carcinoma demonstrated invasion. All patients with PUNLMP exhibiting an inverted growth had no recurrence or progression on follow-up. In this study, primary PUNLMP recurred primarily either as PUNLMP or low grade urothelial carcinoma. Primary PUNLMP rarely progressed to high grade or invasive carcinoma on long term follow-up. No recurrence or progression was documented on follow-up for PUNLMP that demonstrated exclusively inverted

  16. Congenital Giant Melanocytic Nevus with Malignant Melanoma of the Pleura: Do Primary Pleural Melanomas Exist?

    Directory of Open Access Journals (Sweden)

    Brijesh Sharma

    2017-09-01

    Full Text Available Cases of primary pleural and bronchial melanoma have been described in the literature in the absence of melanocytic cells in the pleura and bronchi. We described a case of congenital giant melanocytic nevus that had a presentation suggestive of primary pleural melanoma. However, biopsy of a chest wall lesion confirmed the presence of another melanoma deposit in a subcutaneous swelling concealed within the congenital giant melanocytic nevus. Histopathology with immunohistochemistry results showed that the pleural and chest wall swelling were similar. The difficult clinical detection of the primary tumor contributes to the fact that 24% of cases of congenital giant melanocytic nevus receive a diagnosis of metastatic melanoma without identification of the primary site. We propose that it is probable that the entity “primary pleural melanoma” may, in fact, not exist. Instead, all such reported tumors in the pleura may actually be metastatic from an unknown, regressed, or missed primary site.

  17. Malignant melanoma and breast carcinoma: a bidirectional correlation.

    LENUS (Irish Health Repository)

    Ho, W L

    2009-03-05

    BACKGROUND: Epidemiologic and genetic studies have suggested a bidirectional association between breast carcinoma (BC) and malignant melanoma (MM). OBSERVATION: We present a series of patients with MM and BC detected in our department within a span of 6 months, raising concerns for the high associations between the two malignancies. This led us to match the concordance of the two tumours in the National Irish Cancer Registry. CONCLUSION: The national figures provide evidence of a link between BC and MM. We recommend increased awareness among clinicians leading to more detailed surveillance of both second primary tumours. All MM patients with a family history of BC should be referred to a breast clinic. Women above the age of 40 with MM should undergo annual mammography and those less than 40 may be better evaluated with a breast MRI. All breast cancer patients should be made aware of the significance of changing moles and those with suspicious lesions referred to a dermatologist for evaluation.

  18. Malignant melanoma and breast carcinoma: a bidirectional correlation.

    LENUS (Irish Health Repository)

    Ho, W L

    2012-02-01

    BACKGROUND: Epidemiologic and genetic studies have suggested a bidirectional association between breast carcinoma (BC) and malignant melanoma (MM). OBSERVATION: We present a series of patients with MM and BC detected in our department within a span of 6 months, raising concerns for the high associations between the two malignancies. This led us to match the concordance of the two tumours in the National Irish Cancer Registry. CONCLUSION: The national figures provide evidence of a link between BC and MM. We recommend increased awareness among clinicians leading to more detailed surveillance of both second primary tumours. All MM patients with a family history of BC should be referred to a breast clinic. Women above the age of 40 with MM should undergo annual mammography and those less than 40 may be better evaluated with a breast MRI. All breast cancer patients should be made aware of the significance of changing moles and those with suspicious lesions referred to a dermatologist for evaluation.

  19. Evaluation of primary cutaneous malignant melanoma according to Breslow and Clarke pathological indices

    Directory of Open Access Journals (Sweden)

    Z. Safaii Naraghi

    2006-07-01

    Full Text Available Background: Malignant melanoma is one of the fatal cutaneous neoplasms which are curable by early diagnosis. This neoplasm is diagnosed by the biopsy of the suspected lesion. It is essential to classify the tumor based on its histology, thickness, phase of growth, level of invasion, mitotic rate, presence of regression, inflammatory infiltration and ulceration. These descriptions yield some knowledge about the progression of disease and suggest an estimate of the status of the screening system for early diagnosis. Methods: This is a cross-sectional retrospective descriptive study. Pathological slides with diagnosis of malignant melanoma from 1377 to 1379 that present in the pathology department were assessed according to mentioned pathological indices and the 10-year survival calculated in this regard. Results: We assessed 47 cases with mean age of 57.38 (SD=5.85 and the gender distribution was 51.1% male and 42.2% female. More than 42% of cases were in Clarke level I, 2.1% Clarke level II, 6.4% Clarke level III, 40.4% Clarke level IV and 8.5% Clarke level V. Fifty three percent of patients were breslow thickness equal to or less than 0.75 millimeter(mm , 8.5% between 0.76 to 1.69 mm , 27.7% between 1.7 to 3.6 mm and 10.6% greater than 3.61 mm. Mean breslow thickness show no significant difference between males and females but there is a significant relation between thickness and age of the patients. Mean 10-year survivals of patients were 75% and were greater in females than males. We found a linear relation between patient age and breslow thickness that is calculated by the following equation: Log Breslow thickness (mm = - 0.625 + 0.016×age (year Conclusion: Complete recording of clinical and pathological data of patients with malignant melanoma make a proper stream to reach a surveillance system.

  20. [Primary Intracranial Malignant Lymphoma Associated with Acquired Immunodeficiency Syndrome(AIDS):A Case Report].

    Science.gov (United States)

    Inaka, Yasufumi; Otani, Naoki; Nishida, Sho; Fujii, Kazuya; Ueno, Hideaki; Tomura, Satoshi; Tomiyama, Arata; Osada, Hideo; Wada, Kojiro; Maeda, Takuya; Mori, Kentaro

    2017-11-01

    The spread of human immunodeficiency virus(HIV)infection may result in an increased likelihood of surgery in patients with HIV infection. We treated a patient with intracranial malignant lymphoma associated with acquired immunodeficiency syndrome(AIDS)caused by HIV infection. The recommendations of the countermeasure manual for AIDS were followed. Only surgical staff without finger injury or inflammation were permitted to be involved in the operation. All staff were dressed in a waterproof, full-body surgical gown, and wore double gloves, double foot covers, and an N95 mask. The surgery could be performed safely with such infection control measures. Histological examination revealed a diffuse large B-cell lymphoma. The patient was referred to the Division of Infectious Diseases and Respiratory Medicine for chemotherapy.

  1. Primary Oral Malignant Melanoma - A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    R Sathawane

    2005-01-01

    Malignant melanoma (MM is a neoplasm of melanocytic origin that arises from a benign melanocytic lesion or de novo from melanocytes within otherwise normal mucosa or skin. It is one of most biologically unpredictable and deadly of all human neoplasms. It is third most common skin cancer, and accounts for 5% of all tumours. Although it comprises 1.3% of all cancers, MM of oral cavity accounts for only 0.2 to 8% of all reported melanomas. The mucosal melanoma tends to appear at a higher stage and is much aggressive than its cutaneous counterpart. The prognosis of oral melanoma is extremely poor, until recently less than 29% of affected patients survived for 5 years or more.

  2. Primary Dermal Melanoma in a Patient with a History of Multiple Malignancies: A Case Report with Molecular Characterization

    Directory of Open Access Journals (Sweden)

    Germana Sini

    2013-07-01

    Full Text Available Introduction: Primary dermal melanoma (PDM is a recently described clinical entity accounting for less than 1% of all melanomas. Histologically, it is located in the dermis or subcutaneous tissue, and it shows no connections with the overlying epidermis. The differential diagnosis is principally made along with that of metastatic cutaneous melanoma. Case Report: A 72-year-old Caucasian woman with a history of multiple cancers (metachronous bilateral breast cancer, meningioma, clear cell renal cell carcinoma, uterine fibromatosis and intestinal adenomatous polyposis, came to our attention with a nodular lesion on her back. After removal of the lesion, the histology report indicated malignant PDM or metastatic malignant melanoma. The clinical and instrumental evaluation of the patient did not reveal any other primary tumour, suggesting the primitive nature of the lesion. The absence of an epithelial component argued for a histological diagnosis of PDM. Subsequently, the patient underwent a wide surgical excision with sentinel node biopsy, which was positive for metastatic melanoma. Finally, the mutational status was studied in the main genes that regulate proliferation, apoptosis and cellular senescence. No pathogenetic mutations in CDKN2A, BRAF, NRAS, KRAS, cKIT, TP53 and PTEN genes were observed. This suggests that alternative pathways and low-frequency alterations may be involved. Conclusions: The differential diagnosis between PDM and isolated metastatic melanoma depends on the negativity of imaging studies and clinical findings for other primary lesions. This distinction is important because 5-year survival rates in such cases are higher than in metastatic cases (80-100 vs. 5-20%, respectively.

  3. Tumour Endoprosthetic Reconstruction for Primary Aggressive and Malignant Bone Tumours of the Distal Femur

    Directory of Open Access Journals (Sweden)

    DA Rubio

    2013-11-01

    Full Text Available At the Philippine General Hospital, tumour endoprostheses have become an option for reconstruction after limb saving surgery for primary bone tumors. We performed a retrospective review of patients with primary bone tumors of the distal femur who underwent tumor excision and reconstruction using tumor endoprostheses. Outcome measures included prosthetic survival, functional outcome and complications. Twenty-two patients were evaluated; 14 males and 8 females, with a mean age of 18 years and a mean follow-up of 56 months. The overall 2-year endoprosthetic survival rate was 86%. Mean MSTS was 23/30. There were a total of 6 revisions. Failure modes included 3 infections, 3 aseptic loosening, 4 structural failures, 2 soft tissue failures and 3 tumor progression. Our early results show that tumor endoprosthesis reconstruction is an acceptable option for patients with primary bone tumor of the distal femur. Survival rates, failure modes and functional outcomes are comparable to other reported studies.

  4. Sleep loss and its effects on health of family caregivers of individuals with primary malignant brain tumors.

    Science.gov (United States)

    Pawl, Jean D; Lee, Shih-Yu; Clark, Patricia C; Sherwood, Paula R

    2013-08-01

    Sleep loss places caregivers at risk for poor health. Understanding correlates of sleep loss and relationships to health may enable improvement of health of caregivers of individuals with primary malignant brain tumors (PMBT). In this cross-sectional, descriptive study of 133 caregivers, relationships were examined between sleep loss and physical, mental, emotional, and social health at time of patient diagnosis. Sleep loss was not related to physical health. Shorter total sleep time was associated with greater fatigue and social support. Sleep quality was positively associated with quality of life. Further study is needed of the role of sleep loss in the PMBT caregiving trajectory and its long-term relationship with health outcomes. Copyright © 2013 Wiley Periodicals, Inc.

  5. Venous thromboembolism and intracranial hemorrhage after craniotomy for primary malignant brain tumors: a National Surgical Quality Improvement Program analysis.

    Science.gov (United States)

    Senders, Joeky T; Goldhaber, Nicole H; Cote, David J; Muskens, Ivo S; Dawood, Hassan Y; De Vos, Filip Y F L; Gormley, William B; Smith, Timothy R; Broekman, Marike L D

    2018-01-01

    Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), frequently complicates the postoperative course of primary malignant brain tumor patients. Thromboprophylactic anticoagulation is commonly used to prevent VTE at the risk of intracranial hemorrhage (ICH). We extracted all patients who underwent craniotomy for a primary malignant brain tumor from the National Surgical Quality Improvement Program (NSQIP) registry (2005-2015) to perform a time-to-event analysis and identify relevant predictors of DVT, PE, and ICH within 30 days after surgery. Among the 7376 identified patients, the complication rates were 2.6, 1.5, and 1.3% for DVT, PE, and ICH, respectively. VTE was the second-most common major complication and third-most common reason for readmission. ICH was the most common reason for reoperation. The increased risk of VTE extends beyond the period of hospitalization, especially for PE, whereas ICH occurred predominantly within the first days after surgery. Older age and higher BMI were overall predictors of VTE. Dependent functional status and longer operative times were predictive for VTE during hospitalization, but not for post-discharge events. Admission two or more days before surgery was predictive for DVT, but not for PE. Preoperative steroid usage and male gender were predictive for post-discharge DVT and PE, respectively. ICH was associated with various comorbidities and longer operative times. This multicenter study demonstrates distinct critical time periods for the development of thrombotic and hemorrhagic events after craniotomy. Furthermore, the VTE risk profile depends on the type of VTE (DVT vs. PE) and clinical setting (hospitalized vs. post-discharge patients).

  6. DNA-index and stereological estimation of nuclear volume in primary and metastatic malignant melanomas

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Kristensen, I B; Grymer, F

    1990-01-01

    of nuclear vv did not differ significantly between the two types of neoplasms. Aneuploidy was not significantly associated with increased nuclear vv. Pronounced intra-patient heterogeneity of nuclear vv was disclosed among metastases and between the primary melanoma and the metastatic lesions. Likewise...

  7. In vitro growth characteristics of human lymphoid malignancies in primary cell culture

    NARCIS (Netherlands)

    I.P. Touw (Ivo)

    1986-01-01

    textabstractThe experimental work presented in this thesis deals with the analysis of the in vitro growth and differentiation characteristics of acute lymphoblastic leukemia ( T end non-T), T cell non Hodgkin's lymphoma and B cell chronic lymphocytic leukemia in primary cell culture. For

  8. The Association between Primary Endometrioid Carcinoma of the Ovary and Synchronous Malignancy of the Endometrium

    Directory of Open Access Journals (Sweden)

    Catharina C. van Niekerk

    2010-01-01

    Among 460 ovarian endometrioid carcinoma patients 53 cases showed a second primary endometrial cancer; 40 out of these 53 cases (75.5% showed at both organ sites an endometrioid adenocarcinoma. Conclusion. These findings suggest an important role for the endometrioid subtype and prompt to mechanism-based studies incorporating molecular techniques.

  9. Primary and malignant cholangiocytes undergo CD40 mediated Fas dependent apoptosis, but are insensitive to direct activation with exogenous Fas ligand.

    Directory of Open Access Journals (Sweden)

    Elizabeth H Humphreys

    2010-11-01

    Full Text Available Cholangiocarcinoma is a rare malignancy of the biliary tract, the incidence of which is rising, but the pathogenesis of which remains uncertain. No common genetic defects have been described but it is accepted that chronic inflammation is an important contributing factor. We have shown that primary human cholangiocyte and hepatocyte survival is tightly regulated via co-operative interactions between two tumour necrosis family (TNF receptor family members; CD40 and Fas (CD95. Functional deficiency of CD154, the ligand for CD40, leads to a failure of clearance of biliary tract infections and a predisposition to cholangiocarcinoma implying a direct link between TNF receptor-mediated apoptosis and the development of cholangiocarcinoma.To determine whether malignant cholangiocytes display defects in CD40 mediated apoptosis. By comparing CD40 and Fas-mediated apoptosis and intracellular signalling in primary human cholangiocytes and three cholangiocyte cell lines.Primary cholangiocytes and cholangiocyte cell lines were relatively insensitive to direct Fas-mediated killing with exogenous FasL when compared with Jurkat cells, which readily underwent Fas-mediated apoptosis, but were extremely sensitive to CD154 stimulation. The sensitivity of cells to CD40 activation was similar in magnitude in both primary and malignant cells and was STAT-3 and AP-1 dependent in both.1 Both primary and malignant cholangiocytes are relatively resistant to Fas-mediated killing but show exquisite sensitivity to CD154, suggesting that the CD40 pathway is intact and fully functional in both primary and malignant cholangiocytes 2 The relative insensitivity of cholangiocytes to Fas activation demonstrates the importance of CD40 augmentation of Fas dependent death in these cells. Agonistic therapies which target CD40 and associated intracellular signalling pathways may be effective in promoting apoptosis of malignant cholangiocytes.

  10. Primary malignant lymphoma of the uterus and broad ligament: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Chen R

    2015-01-01

    Full Text Available Runzhe Chen, Zhengping Yu, Hongming Zhang, Jiahua Ding, Baoan Chen Department of Hematology and Oncology (Key Department of Jiangsu Medicine, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China Abstract: Primary malignant lymphoma of the uterus and broad ligament is rare. Here, we present a rare case of primary diffuse large B-cell lymphoma (DLBCL of uterus and broad ligament in a 63-year-old female. The patient presenting with lower abdominal distention was referred to our hospital. Subsequent abdominal and pelvic ultrasound revealed the presence of a large mass, which was highly suspected as subserosal uterine leiomyoma. A large tumor was found with unclear boundary with right posterior wall, broad ligament and bilateral adnexa during surgery. Her uterus and the tumor of a broad ligament and bilateral adnexa were all excised as a result. Postoperative pathological examination showed DLBCL in uterus and broad ligament. Further examinations excluded metastatic diseases, which supported the diagnosis of primary DLBCL of the uterus and broad ligament. The patient received six cycles of R-CHOP (21 days regimen. During the 8 months follow-up, no evidence of disease recurrence was identified. As the prevalence of primary extranodal lymphoma is increasing, the details of this rare case may highlight the importance and facilitate treatment of similar diseases. A summary focusing on the presentation and prognosis as well as a review of current management is also discussed. Keywords: diffuse large B-cell lymphoma, primary uterine and broad ligament lymphoma, extranodal lymphoma, diagnosis, therapy

  11. [A case report: a patient with paralysis of the lower half of the body being diagnosed with prostate cancer and primary spinal malignant lymphoma].

    Science.gov (United States)

    Koizumi, Koji; Nakayama, Tsuyoshi; Oba, Hiroki; Fujiwara, Masayuki

    2014-07-01

    The patient was an 81-year-old man who visited our hospital for paralysis of the lower half of the body. He was suspected as having a spinal tumor by computed tomography and magetic resonance imaging, and also as having prostate cancer based on a high prostate specific antingen level. A prostate needle biopsy, thoracic spinal fusion and posterior decompression were performed. The patient was diagnosed as having prostate cancer and primary spinal malignant lymphoma. Hormone therapy and chemotherapy were started for the prostate cancer and primary spinal malignant lymphoma, respectively. However, the patient died of a complication from chemotherapy.

  12. Primary malignant mixed müllerian tumor of the peritoneum a case report with review of the literature

    DEFF Research Database (Denmark)

    Kurshumliu, Fisnik; Rung-Hansen, Helle; Skovlund, Vibeke Ravn

    2011-01-01

    Malignant mixed Müllerian tumor is a rare malignancy of the genital tract and extremely uncommon in extragenital sites. This report describes a case of malignant mixed Müllerian tumor arising in the lower peritoneum of a 72-year-old female patient. The patient presented with ascites, lower abdomi...

  13. En Bloc Resection of Primary Malignant Bone Tumor in the Cervical Spine Based on 3-Dimensional Printing Technology.

    Science.gov (United States)

    Xiao, Jian-Ru; Huang, Wen-Ding; Yang, Xing-Hai; Yan, Wang-Jun; Song, Dian-Wen; Wei, Hai-Feng; Liu, Tie-Long; Wu, Zhi-Peng; Yang, Cheng

    2016-05-01

    To investigate the feasibility and safety of en bloc resection of cervical primary malignant bone tumors by a combined anterior and posterior approach based on a three-dimensional (3-D) printing model. Five patients with primary malignant bone tumors of the cervical spine underwent en bloc resection via a one-stage combined anteroposterior approach in our hospital from March 2013 to June 2014. They comprised three men and two women of mean age 47.2 years (range, 26-67 years). Three of the tumors were chondrosarcomas and two chordomas. Preoperative 3-D printing models were created by 3-D printing technology. Sagittal en bloc resections were planned based on these models and successfully performed. A 360° reconstruction was performed by spinal instrumentation in all cases. Surgical margins, perioperative complications, local control rate and survival rate were assessed. All patients underwent en bloc excision via a combined posterior and anterior approach in one stage. Mean operative time and estimated blood loss were 465 minutes and 1290 mL, respectively. Mean follow-up was 21 months. Wide surgical margins were achieved in two patients and marginal resection in three; these three patients underwent postoperative adjuvant radiation therapy. One vertebral artery was ligated and sacrificed in each of three patients. Nerve root involved by tumor was sacrificed in three patients with preoperative upper extremity weakness. One patient (Case 3) had significant transient radiculopathy with paresis postoperatively. Another (Case 4) with C 4 and C 5 chordoma had respiratory difficulties and pneumonia after surgery postoperatively. He recovered completely after 2 weeks' management with a tracheotomy tube and antibiotics in the intensive care unit. No cerebrovascular complications and wound infection were observed. No local recurrence or instrumentation failure were detected during follow-up. Though technically challenging, it is feasible and safe to perform en

  14. [Primary Pituitary Malignant Lymphoma that was Difficult to Differentiate from Nonfunctioning Pituitary Adenoma:A Case Report].

    Science.gov (United States)

    Murakami, Yuta; Sato, Taku; Jinguji, Shinya; Kishida, Yugo; Watanabe, Tadashi; Suzuki, Osamu; Ikeda, Kazuhiko; Homma, Miyuki; Midorikawa, Sanae; Saito, Kiyoshi

    2016-09-01

    We report a rare case of primary pituitary lymphoma in a 75-year-old immunocompetent woman. The patient was blind in the right eye and presented with visual disturbance in the left eye that started 2 months previously. She also exhibited right third and fifth cranial nerve palsy. Magnetic resonance imaging(MRI)revealed an intrasellar mass lesion with right cavernous sinus invasion and suprasellar extension with compression of the optic chiasm. The mass lesion was isointense on both T1WI and T2WI, and showed less enhancement than a normal pituitary gland on gadolinium-enhanced T1WI. We therefore suspected the tumor to be a nonfunctioning pituitary adenoma. The patient underwent endoscopic endonasal transsphenoidal surgery. The tumor was firm and grayish, and had an ill-defined border along the normal pituitary gland. Histological examination revealed a malignant CD5-positive diffuse large B-cell lymphoma. After surgery, the patient received both chemotherapy and radiotherapy. Although the visual acuity of the right eye did not improved, other symptoms improved. At the 34-month follow-up, no recurrence was detected on serial MRI. Patients with primary pituitary lymphoma often exhibit ophthalmoplegia and/or panhypopituitarism more frequently than expected from radiological findings. In cases of pituitary tumors with atypical symptoms, a biopsy and general physical examination should be performed immediately to determine the diagnosis and perform adjuvant therapy even when the tumor is assumed as nonfunctioning pituitary adenoma from the image findings.

  15. Secondary Primary Malignancy Risk in Patients With Ovarian Cancer in Taiwan: A Nationwide Population-Based Study.

    Science.gov (United States)

    Hung, Yi-Ping; Liu, Chia-Jen; Hu, Yu-Wen; Chen, Min-Huang; Li, Chun-Pin; Yeh, Chiu-Mei; Chiou, Tzeon-Jye; Chen, Tzeng-Ji; Yang, Muh-Hwa; Chao, Yee

    2015-09-01

    To evaluate the incidence of secondary primary malignancy (SPM) in patients with ovarian cancer using a nationwide retrospective population-based dataset. Patients newly diagnosed with ovarian cancer between 1997 and 2010 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated and compared with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models. Effects of surgery, chemotherapy, and radiotherapy after ovarian cancer diagnosis were regarded as time-dependent variables to prevent immortal time bias. During the 14-year study period (follow-up of 56,214 person-years), 707 cancers developed in 12,127 patients with ovarian cancer. The SIR for all cancers was 2.78 (95% confidence interval 2.58-3.00). SIRs for follow-up periods of >5, 1-5, and cancer diagnosis, SIRs were significantly higher for cancers of the colon, rectum, and anus (2.14); lung and mediastinum (1.58); breast (1.68); cervix (1.65); uterus (7.96); bladder (3.17), and thyroid (2.23); as well as for leukemia (3.98) and others (3.83). Multivariate analysis showed that age ≥ 50 years was a significant SPM risk factor (hazard ratio [HR] 1.60). Different treatments for ovarian cancer, including radiotherapy (HR 2.07) and chemotherapy (HR 1.27), had different impacts on SPM risk. Patients with ovarian cancer are at increased risk of SPM development. Age ≥ 50 years, radiotherapy, and chemotherapy are independent risk factors. Close surveillance of patients at high risk should be considered for the early detection of SPM.

  16. Long-term results of primary transpupillary thermal therapy for the treatment of choroidal malignant melanoma.

    Science.gov (United States)

    Aaberg, T M; Bergstrom, C S; Hickner, Z J; Lynn, M J

    2008-06-01

    This is a long-term follow-up report investigating primary transpupillary thermal therapy (TTT) for choroidal melanoma. Retrospective case series of 135 patients harbouring choroidal melanoma treated with primary TTT. Patient demographics, tumour characteristics, treatment responses and complications, visual acuity outcomes and mortality data were captured and reported. A statistical analysis was performed for predictors of treatment failure. Successful tumour regression was achieved in 76% of patients. Of the 32 patients who failed, 12 had enucleation, and 20 had irradiation. Metastatic disease has occurred in three patients, and two patients have died (3/135, or 2%). Multivariate analysis determined that tumour diameter, tumour thickness greater than 3 mm and tumours exhibiting high-risk characteristics were significant predictors of failure. Patient age, gender, number of treatments and proximity of the tumour to the disc or fovea were not predictive of failure. Kaplan-Meier cumulative probability predicted a 19% 5-year treatment failure and 33% 10-year treatment failure. Treatment failure occurred as late as 99 months. Final visual acuity was 20/40 or better in 50% of patients; 32% had a final visual acuity of 20/200 or worse. Thirty-two per cent of patients developed one or more complications as a result of the TTT, the most concerning of which was intra- or extrascleral extension of tumour (occurring in 11 patients). Though not as successful as radiation therapy, TTT successfully induced regression in 76% of patients. TTT may still have a role in our treatment paradigm but should probably be reserved for specific cases, such as monocular patients with tumours near critical visual structures, surgically unstable patients or patients with advanced diabetic retinopathy. All patients considering TTT as monotherapy for choroidal melanoma must be selected, counselled and followed appropriately.

  17. Malignant hyperechoic breast lesions at ultrasound: A pictorial essay.

    Science.gov (United States)

    Tiang, Stephen; Metcalf, Cecily; Dissanayake, Deepthi; Wylie, Elizabeth

    2016-08-01

    Malignant breast lesions are typically hypoechoic at sonography. However, a small subgroup of hyperechoic malignant breast lesions is encountered in clinical practice. We present a pictorial essay of a number of different hyperechoic breast malignancies with mammographic, sonographic and histopathologic correlation. Suspicious sonographic features in a hyperechoic lesion include inhomogeneity in echogenic pattern, an irregular margin, posterior acoustic shadowing and internal vascularity. A hyperechoic lesion at ultrasound does not discount the need to undertake histological assessment of a mammographically suspicious lesion. © 2016 The Royal Australian and New Zealand College of Radiologists.

  18. Metastatic malignant melanoma affecting stomach

    Directory of Open Access Journals (Sweden)

    Jamal Eivazi-Ziaei

    2014-01-01

    Full Text Available Malignant melanoma has been reported to affect all organs of the human body with the metastasis. Stomach metastases are quite rare in cases of the most commonly reported primaries including, melanoma and breast, and lung carcinomas. This report involves, a 56-year-old man suffering from melanoma of the lower extremity that developed into gastric, pulmonary, and brain metastases. The patient who experienced epigastric pain with suspicious melanoma was referred to undergo endoscopy. A black and white ulcer with dimensions of 1 × 1.5 cm and a mass of 1 × 2 cm mass were found at D1 and lesser curvature. Physical examination revealed a 2 × 3 cm black lesion at his right heel. Pathologic examination provided multiple pieces of creamy soft-tissue measuring 0.3 × 0.2 × 0.1 cm showing pigmented tumor cells in lamina propria. Staining biopsy samples with anti-HMB-45 and Fontana demonstrated a higher degree of positivity in tumor cells. The patient was admitted to the hospital, but unfortunately his general conditions were deteriorated and he developed convulsion and deceased four days after admission.

  19. Multiple primary malignant neoplasms of the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in a Japanese male patient: a case report.

    Science.gov (United States)

    Mukaiyama, Yoshihiro; Suzuki, Motofumi; Morikawa, Teppei; Mori, Yoshiyuki; Takeshima, Yuta; Fujimura, Tetsuya; Fukuhara, Hiroshi; Nakagawa, Tohru; Nishimatsu, Hiroaki; Kume, Haruki; Homma, Yukio

    2014-09-22

    Owing to recent advances in diagnostic and surgical techniques for cancer, a patient diagnosed with two or more neoplasms is not rare. We report on the case of a 58-year-old male with multiple primary malignant neoplasms, who suffered from three histological types of malignant neoplasm in six organs, namely the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in chronological order. The first neoplasm was a squamous cell carcinoma of the glottis diagnosed in 2006. The second and third neoplasms were urothelial carcinomas of the right renal pelvis and urinary bladder, respectively, diagnosed in 2008. The remaining three neoplasms were diagnosed in 2010, namely a squamous cell carcinoma of the oral floor, an adenocarcinoma of the prostate, and a squamous cell carcinoma of the esophagus. The glottic cancer and esophageal cancer were treated by external radiation therapy. The malignant neoplasms of the oral floor and those which originated in the urinary tract were surgically resected. All neoplasms except the malignant neoplasm of the oral floor were well controlled. The patient died of cervical lymph node metastasis from the squamous cell carcinoma of the oral floor in January 2011. As far as we know, the present report is the first one on this combination of primary malignant neoplasms.

  20. Clinical experience of the use of voriconazole, caspofungin or the combination in primary and salvage therapy of invasive aspergillosis in haematological malignancies.

    Science.gov (United States)

    Raad, Issam I; Zakhem, Aline El; Helou, Gilbert El; Jiang, Ying; Kontoyiannis, Dimitrios P; Hachem, Ray

    2015-03-01

    Invasive aspergillosis (IA) is a life-threatening infection in severely immunocompromised haematological malignancy patients. In this study, the efficacy and safety of caspofungin, voriconazole or the combination as primary and salvage therapy in patients with IA were compared. The study included 181 patients with haematological malignancies and IA who received primary or salvage therapy with caspofungin, voriconazole or the combination. In total, 138 patients who received treatment for ≥7 days were analysed; 86 underwent primary antifungal therapy (15 with caspofungin, 38 with voriconazole and 33 with both). Among the salvage therapy patients, 17 received caspofungin, 24 received voriconazole and 35 received both. In the primary therapy group, no difference in therapy response was found, but caspofungin was associated with higher IA mortality rates. A multivariate competing risk analysis of primary antifungal therapy revealed that voriconazole was independently associated with lower IA-associated mortality rates than caspofungin (hazard ratio=0.2, 95% confidence interval 0.06-0.96; P=0.04). In the salvage therapy group, the three treatment groups had similar responses and IA-associated mortality rates. The combination of voriconazole and caspofungin did not result in better outcomes compared with voriconazole alone, as primary or salvage therapy, in haematological malignancy patients. However, voriconazole was associated with a lower Aspergillus-associated mortality rate compared with caspofungin monotherapy. Copyright © 2014. Published by Elsevier B.V.

  1. A comparisonof lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Sang Yu; Shin, Jung Hee; Ko, Eun Young; Hahn, Soo Yeon [Dept. of Radiology, Samsung Medicine Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy. We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNAC were excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors. For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years. LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in this condition.

  2. Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer

    Directory of Open Access Journals (Sweden)

    Milazzo Francesca

    2011-08-01

    Full Text Available Abstract Background Many studies have reported an increased risk of developing a second primary malignancy (SPM of the breast in women treated for thyroid cancer. In this study, we investigated several potential risk factors for this association. The aim of this retrospective cohort study was to identify a subgroup of women surgically treated for papillary thyroid cancer that may benefit from more careful breast cancer screening. Methods A total of 101 women surgically treated for papillary thyroid cancer from 1996 to 2009 with subsequent follow-up were interviewed by phone regarding personal risk factors and lifestyle habits. Only 75 questionnaires could be evaluated due to a 25.7% rate of patients not retrieved or refusing the interview. Data analysis was performed using a multivariate logistic model. Results The standardised incidence ratio (SIR for breast cancer was 3.58 (95% IC 1.14 - 8.37. Our data suggest a protective effect of multiparity on the development of a SPM of the breast (O.R. 0.15; 95% IC 0.25 - 0.86. Significant associations were not found with other known risk factors including Body Mass Index (BMI, age at first tumour, concurrent metabolic diseases, smoking, physical activity and familiarity. Conclusions This study confirms that a higher incidence of SPM of the breast is observed in women treated for papillary thyroid cancer. Additionally, this risk is increased by nulliparity, thus a strict breast screening program for nulliparous women treated for thyroid cancer may be advisable.

  3. Effect of first-line treatment on second primary malignancies and Richter's transformation in patients with CLL.

    Science.gov (United States)

    Maurer, C; Langerbeins, P; Bahlo, J; Cramer, P; Fink, A M; Pflug, N; Engelke, A; von Tresckow, J; Kovacs, G; Stilgenbauer, S; Wendtner, C-M; Müller, L; Ritgen, M; Seiler, T; Fischer, K; Hallek, M; Eichhorst, B

    2016-10-01

    This study aimed to assess the frequency of and the contributing factors for second primary malignancies (SPMs) and Richter's transformations (RTs) following first-line treatment of chronic lymphocytic leukemia within four phase II/III trials of the GCLLSG evaluating fludarabine (F) vs F+cyclophosphamide (FC), chlorambucil vs F, FC without or with rituximab, and bendamustine+R (BR). Among 1458 patients, 239 (16.4%) experienced either an SPM (N=191) or a RT (N=75). Solid tumors (N=115; 43.2% of all second neoplasias) appeared most frequently, followed by RTs (N=75; 28.2%). Patients showed a 1.23-fold increased risk of solid tumors in comparison to the age-matched general population from the German cancer registry. Age>65 (hazard ratio (HR) 2.1; PHR 1.7; P=0.01), co-morbidities (HR 1.6; P=0.01) and number of subsequent treatments⩾1 (HR 12.1; P10 U/l at trial enrollment (HR 3.9; P=0.02), non-response to first-line treatment (HR 3.6; PHR 30.2; P<0.001) were independently associated with increased risk for RT.

  4. Understanding the challenges to improve transition to palliative care: An issue for the primary malignant brain tumour population.

    Science.gov (United States)

    Sabo, Brenda; Johnston, Grace

    2016-01-01

    Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care. An exploration of extant literature over the past 10 years. The current literature demonstrates that timely referrals to palliative care consult teams and access to community-based resources have been associated with fewer hospitalizations and visits to emergency departments and a decrease in the initiation of invasive, aggressive treatment at end of life. Timely referral to palliative care has also been shown to reduce distress, enhance quality of life and, in some cases, increase life expectancy. Earlier referral to palliative care has yet to become a reality for many patients diagnosed with life-limiting illnesses and, in particular, those with a PMBT. More research is needed to uncover and challenge the barriers to early transition including communication issues among professionals, patients and families around palliative care.

  5. Computer-Aided Diagnosis of Malignant Mammograms using Zernike Moments and SVM

    National Research Council Canada - National Science Library

    Sharma, Shubhi; Khanna, Pritee

    This work is directed toward the development of a computer-aided diagnosis (CAD) system to detect abnormalities or suspicious areas in digital mammograms and classify them as malignant or nonmalignant...

  6. Diagnostic Value of Nucleolar Organizer Regions (AgNORs in Brush Biopsies of Suspicious Lesions of the Oral Cavity

    Directory of Open Access Journals (Sweden)

    Torsten W. Remmerbach

    2003-01-01

    Full Text Available Objective: The aim of this retrospective study was to report on the diagnostic accuracy of AgNOR‐analysis as an adjunctive diagnostic tool of conventional oral exfoliative cytology taken from suspicious lesions in our clinic. Study design: Cytological diagnoses obtained from brush biopsies of macroscopically suspicious lesions of the oral mucosa from 75 patients (final diagnoses: 53 histologically proven squamous cell carcinomas, 11 leukoplakias and other inflammatory oral lesions and from 11 patients with normal mucosa as a negative control group were compared with histological and/or clinical follow‐ups. Five smears were doubtful and seven suspicious for tumor cells in the cytologic report. Number of AgNOR's were counted in 100 squamous epithelial cell‐nuclei per slide after silver‐restaining. Results: Sensitivity of our cytological diagnosis alone on oral smears for the detection of squamous carcinomas was 92.5%, specificity 100%, positive predictive value was 100% and negative 84.6%. The best cut‐off value of the mean number of AgNOR dots per nucleus distinguishing benign from malignant cells was 4.8. The percentage of nuclei with more than three AgNORs had a cut‐off level of 70%. Applying these methods to twelve doubtful or suspicious cytological diagnoses we were able to correctly establish the diagnosis of malignancy in ten cases of histologically proven cancers and to reveal benignity in two histologically proven cases. Thus we achieved a positive and negative predictive value of 100% each. Conclusions: Smears from brushings of visible oral lesions, if clinically considered as suspicious for cancer, are an easily practicable, non‐invasive, painless, safe and accurate screening method for detection of oral cancerous lesions. We conclude that AgNOR‐analysis may be a useful adjunct to other methods in routine cytological diagnosis of oral cancer that can help to solve cytologically suspicious or doubtful cases. Colour

  7. Management of malignant pleural effusions.

    LENUS (Irish Health Repository)

    Uzbeck, Mateen H

    2010-06-01

    Malignant pleural effusions are a common clinical problem in patients with primary thoracic malignancy and metastatic malignancy to the thorax. Symptoms can be debilitating and can impair tolerance of anticancer therapy. This article presents a comprehensive review of pharmaceutical and nonpharmaceutical approaches to the management of malignant pleural effusion, and a novel algorithm for management based on patients\\' performance status.

  8. Visualization of suspicious lesions in breast MRI based on intelligent neural systems

    Science.gov (United States)

    Twellmann, Thorsten; Lange, Oliver; Nattkemper, Tim Wilhelm; Meyer-Bäse, Anke

    2006-05-01

    Intelligent medical systems based on supervised and unsupervised artificial neural networks are applied to the automatic visualization and classification of suspicious lesions in breast MRI. These systems represent an important component of future sophisticated computer-aided diagnosis systems and enable the extraction of spatial and temporal features of dynamic MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogenity of the cancerous tissue, these techniques reveal the malignant, benign and normal kinetic signals and and provide a regional subclassification of pathological breast tissue. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging.

  9. "I'm just waiting…": an exploration of the experience of living and dying with primary malignant glioma.

    Science.gov (United States)

    Philip, Jennifer; Collins, Anna; Brand, Caroline A; Moore, Gaye; Lethborg, Carrie; Sundararajan, Vijaya; Murphy, Michael A; Gold, Michelle

    2014-02-01

    Referral to supportive and palliative care services for people with high-grade primary malignant glioma (PMG) often occurs late in the illness course, despite significant care needs and overall poor prognosis. This study aimed to understand patient experience at the end of life and document supportive and palliative care needs. A qualitative study was conducted involving ten PMG patients who were at different stages in the illness course including the end of life and had varying levels of physical and cognitive function. Consecutive, eligible patients attending neurosurgery, oncology, and palliative care services of two metropolitan hospitals were recruited. In-depth interviews explored supportive and palliative care needs across the disease trajectory. Interviews were analysed independently by three investigators consistent with a grounded theory approach, and emerging ideas were compared and refined to define key patient experiences. Despite the medical treatment and supportive care available, there remains a gap in services addressing complex existential and psychosocial needs that were markedly valued by patients. Patient experience was characterised by a pervasive loss of all that encompassed their former sense of self and a focus on immediate needs. Patients in this study had substantial needs, which were often not shared and not addressed by the current medical system of care. An improved multidisciplinary care model is indicated, which proactively (1) engages care coordination and advocacy; (2) minimises patients' sense of waiting and uncertainty through mapping out a plan, including involvement of palliative care in a timely fashion; and (3) actively invites discussion around goals and preferences for care to promote patients' sense of self.

  10. Health care professionals' perspectives of living and dying with primary malignant glioma: Implications for a unique cancer trajectory.

    Science.gov (United States)

    Philip, Jennifer; Collins, Anna; Brand, Caroline A; Gold, Michelle; Moore, Gaye; Sundararajan, Vijaya; Murphy, Michael A; Lethborg, Carrie

    2015-12-01

    Health care professionals (HCPs) caring for people with primary malignant glioma (PMG) and their carers see many of the profound challenges facing this group, yet their perspectives are not documented. This study aimed to understand and document the unique perspective of HCPs in relation to the supportive and palliative care needs of patients with PMG and their carers, with a view to developing a model of care. Qualitative study involving semi-structured focus groups and interviews with 35 medical, nursing and allied health staff actively engaged in providing care for this patient group. Purposive and theoretical sampling from two major metropolitan hospitals and one community palliative care service in Australia was utilised to seek perspectives from a variety of disciplines and health care settings. Thematic analysis was conducted by three independent researchers, using a constant comparative method influenced by grounded theory. Key themes relating to the needs of people with PMG which were apparent from the HCPs included: The difference in the illness course of glioma compared to other cancers; Limitations of current medical care; Challenges in balancing hope with reality of the illness; and Recommendations to improve care, including recognising the role of family and moving from a model where services are offered in response to demonstrated needs. Significance of the results: Current models of care based upon the classic cancer trajectory are unresponsive to the needs of people with PMG. Care may be enhanced by moving towards a proactive approach, extending the goals of care beyond medical needs and broadening the focus of care to include family needs.

  11. Subsequent primary malignancies and acute myelogenous leukemia transformation among myelodysplastic syndrome patients treated with or without lenalidomide.

    Science.gov (United States)

    Rollison, Dana E; Shain, Kenneth H; Lee, Ji-Hyun; Hampras, Shalaka S; Fulp, William; Fisher, Kate; Al Ali, Najla H; Padron, Eric; Lancet, Jeffrey; Xu, Qiang; Olesnyckyj, Martha; Kenvin, Laurie; Knight, Robert; Dalton, William; List, Alan; Komrokji, Rami S

    2016-07-01

    The few studies that have examined rates of acute myeloid leukemia (AML) transformation in lenalidomide-treated myelodysplastic syndrome (MDS) patients have been limited to deletion 5q MDS. The association between lenalidomide and subsequent primary malignancies (SPMs) in MDS patients has not been evaluated previously. We conducted a retrospective cohort study to evaluate the risk of both SPM and AML in association with lenalidomide. A cohort of MDS patients (n = 1248) treated between 2004 and 2012 at Moffitt Cancer Center were identified, and incident cases of SPM and AML transformation were ascertained. Using a nested case-control design, MDS controls were 1:1 matched to SPM (n = 41) and AML (n = 150) cases, on age and date of MDS diagnosis, gender, follow-up time, IPSS, and del (5q). Associations between lenalidomide and (1) SPM incidence and (2) AML transformation were estimated with hazards ratios (HR) and 95% confidence intervals (CIs) in the cohort and odds ratios (OR) in the case-control analysis. SPM incidence did not differ significantly between cohort MDS patients treated with (0.7 per 100 person-years) or without lenalidomide (1.4 per 100 person-years) (HR = 1.04, 95% CI = 0.40-2.74), whereas a significantly reduced SPM risk was observed in the case-control sample (OR = 0.03, 95% CI = transformation in the cohort analysis (HR = 0.75, 95% CI = 0.44-1.27) or in the case-control analyses (OR = 1.16, 95% CI = 0.52-2.56), after adjustment for potential confounders. Lenalidomide was not associated with increased risk of SPM or AML transformation in a large cohort of MDS patients mostly including nondeletion 5q MDS. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  12. Incidence trends in the anatomic location of primary malignant brain tumors in the United States: 1992-2006.

    Science.gov (United States)

    Zada, Gabriel; Bond, Aaron E; Wang, Ya-Ping; Giannotta, Steven L; Deapen, Dennis

    2012-01-01

    This study sought to determine incidence trends of the anatomical origin of primary malignant brain tumors. Incidence data for histologically confirmed brain tumors were obtained from the Los Angeles County Cancer Surveillance Program (LAC), the California Cancer Registry (CCR), and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program for 1992 to 2006. Age-adjusted incidence rates (AAIR) and annual percent changes (APC) were calculated by histologic subtypes and anatomic subsites. Statistical analyses were performed using the SEER*Stat analytic software and SAS statistical software. Increased AAIRs of frontal (APC +2.4% to +3.0%, P ≤ 0.001) and temporal (APC +1.3% to +2.3%, P ≤ 0.027) lobe glioblastoma multiforme (GBM) tumors were observed across all registries, accompanied by decreased AAIRs in overlapping region GBMs (-2.0% to -2.8% APC, P ≤ 0.015). The AAIRs of GBMs in the parietal and occipital lobes remained stable. The AAIR of cerebellar GBMs increased according to CCR (APC +11.9%, P AAIR of all gliomas, which includes all anatomical subsites, decreased (-0.5% to -0.8% APC, P ≤ 0.034). Low-grade and anaplastic astrocytomas demonstrated decreased AAIRs in the majority of brain regions. Data from 3 major cancer registries demonstrate increased incidences of GBMs in the frontal lobe, temporal lobe, and cerebellum, despite decreased incidences in other brain regions. Although this may represent an effect of diagnostic bias, the incidence of both large and small tumors increased in these regions. The cause of these observed trends is unknown. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Typing the atypical: Diagnostic issues and predictive markers in suspicious prostate lesions.

    Science.gov (United States)

    Sanguedolce, Francesca; Cormio, Antonella; Musci, Giovanni; Troiano, Francesco; Carrieri, Giuseppe; Bufo, Pantaleo; Cormio, Luigi

    2017-08-01

    As much as 5% of prostate biopsies yield findings equivocal for malignancy even for skilled uropathologist; such "grey zone" lesions have been addressed in many ways, although the acronym ASAP (atypical small acinar proliferation) is the most widely used when referring to an atypical focus suspicious, but not diagnostic, for malignancy. Since the introduction of this diagnostic category more than 20 years ago, debate has ensued over its histological characterization and clinical significance. Pathology reporting of ASAP, commonly based on strict morphological criteria and traditional immunohistochemical markers such as basal cell antibodies, has been improved by recent availability of novel immunohistochemical markers such as AMACR and ERG. Further pathological issues, such as the role of pre-analytical variables, number of tissue levels, interobserver variability, and association with prostatic intraepithelial neoplasia also play a role in the optimal assessment of ASAP. Apart from diagnostic issues, a major issue is ASAP predictive value for prostate cancer on repeat biopsy. Therefore, attempts have been made to identify clinical and biological parameters that could predict subsequent diagnosis of malignancy as well as define time and modality of repeat biopsy. Finally, pathological features of cancers detected after a previous ASAP diagnosis are compared with those diagnosed at first prostate biopsy.

  14. An integrated framework for detecting suspicious behaviors in video surveillance

    Science.gov (United States)

    Zin, Thi Thi; Tin, Pyke; Hama, Hiromitsu; Toriu, Takashi

    2014-03-01

    In this paper, we propose an integrated framework for detecting suspicious behaviors in video surveillance systems which are established in public places such as railway stations, airports, shopping malls and etc. Especially, people loitering in suspicion, unattended objects left behind and exchanging suspicious objects between persons are common security concerns in airports and other transit scenarios. These involve understanding scene/event, analyzing human movements, recognizing controllable objects, and observing the effect of the human movement on those objects. In the proposed framework, multiple background modeling technique, high level motion feature extraction method and embedded Markov chain models are integrated for detecting suspicious behaviors in real time video surveillance systems. Specifically, the proposed framework employs probability based multiple backgrounds modeling technique to detect moving objects. Then the velocity and distance measures are computed as the high level motion features of the interests. By using an integration of the computed features and the first passage time probabilities of the embedded Markov chain, the suspicious behaviors in video surveillance are analyzed for detecting loitering persons, objects left behind and human interactions such as fighting. The proposed framework has been tested by using standard public datasets and our own video surveillance scenarios.

  15. 75 FR 75586 - Confidentiality of Suspicious Activity Reports

    Science.gov (United States)

    2010-12-03

    ... FinCEN and the OCC, the OTS proposed to modify the general introduction in its rules to state that....'' The introduction also would indicate that SAR information may not be disclosed, except as authorized... ordinary course of the banks' business, on which the report of suspicious activity was based''); Cotton v...

  16. Interpersonal hostility and suspicious thinking in obsessive-compulsive disorder.

    Science.gov (United States)

    Tellawi, Ghazel; Williams, Monnica T; Chasson, Gregory S

    2016-09-30

    Individuals with obsessive-compulsive disorder (OCD) may struggle with hostility and suspicious thinking, but this has not been the subject of much research. The purpose of this study is to examine the relationship between hostility, suspicious thinking, and OCD severity. Participants included 66 outpatients in treatment for OCD, 27 in treatment for other disorders, and 68 students (n=161). All completed the Inventory of Hostility and Suspicious Thinking (IHS), a measure of psychotic thinking/paranoia, the Obsessive Compulsive Inventory-Revised (OCI-R), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). As expected, the IHS was significantly positively correlated with the BAI and BDI-II. Additionally, regression analyses revealed that individuals with OCD have higher levels of hostility than students. Hostility was also significantly positively associated with increased OCD severity. Hostility and suspicious thoughts are prominent in anxiety disorders in general, and thus necessitate continued research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Money laundering: correlation between risk assessment and suspicious transactions

    Directory of Open Access Journals (Sweden)

    Sonja Cindori

    2013-06-01

    Full Text Available The risk assessment system was introduced in the Republic of Croatia in 2009, as a result of harmonization with international standards, especially the Directive 2005/60/EC on the prevention of the use of the financial system for the purpose of money laundering and terrorist financing. Risk assessment is an extensive concept which requires not only a legislative framework, but also the application of numerous criteria for its effective implementation in practice. Among these criteria are suspicious transactions, closely related to the assessment of the customer, transaction, product or service.The undeniable contribution of suspicious transactions to the quality of the risk assessment system will be confirmed by a statistical analysis of a number of West and East European countries. A combination of strict, but sufficiently flexible legal provisions governing the system for prevention of money laundering and terrorist financing and a statistical analysis of reported suspicious transactions will lead to conclusions that either support or represent criticism of the efficiency of application of the risk assessment system in practice.The aforementioned statistical analysis will show whether suspicious transactions are a reliable criterion for the risk assessment analysis, and whether they can be considered the only such criterion. There is a possibility that the findings of the analysis will be contradictory to those of some international studies.

  18. {sup 99m}Tc sestamibi scintimammography. Screening mammographic non-palpable suspicious breast lesions: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, R.; Derebek, E.; Degirmenci, B.; Durak, H. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Nuclear Medicine; Balci, P. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Radiology; Kocdor, M.A. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Surgery; Canda, T. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Pathology

    2004-02-01

    Aim: Investigation of the diagnostic role of technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc estamibi) scintimammography in non-palpable, suspicious breast lesions described as microcalcification, mass and increased density using mammography. Patients, method: 35 women with non-palpable breast lesions were enrolled in the study. Anterior, left and right lateral, ipsilateral posterior oblique images were obtained 15 min after the injection of 740 MBq of {sup 99m}Tc sestamibi. All scintigraphic images were evaluated visually and focal increased {sup 99m}Tc sestamibi uptake was accepted as malignant lesion. Breast lesions were classified as microcalcification (13 women), mammographic mass (16 women) and increased density (6 women). Excisional biopsy was performed in all of them irrespective of the scintigraphic results: Results: The focally increased {sup 99m}Tc sestamibi uptake was seen in 11 breast lesions with malignant lesions and in 4 breast lesions with benign lesions. The diffuse uptake of {sup 99m}Tc sestamibi was seen in 18 breast lesions with benign lesions and 2 breast lesions with malignant lesions. There was no false positive result of {sup 99m}Tc sestamibi in microcalcification group and three was no false negative result of the mammographic mass and increased density groups. Conclusion: Scintimammography might be a complementary method in decision making for the non-palpable, suspicious breast lesions that were evaluated as microcalcification, mass and increased density mammograpically. (orig.)

  19. Can positron emission mammography help to identify clinically significant breast cancer in women with suspicious calcifications on mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir G.V.; Lima, Eduardo N.P.; Macedo, Bruna R.C.; Conrado, Jorge L.F.A.; Marques, Elvira F.; Chojniak, Rubens [A C Camargo Cancer Center-Department of Imaging, Sao Paulo, SP (Brazil)

    2017-05-15

    To evaluate the diagnostic accuracy of positron emission mammography (PEM) for identifying malignant lesions in patients with suspicious microcalcifications detected on mammography. A prospective, single-centre study that evaluated 40 patients with suspicious calcifications at mammography and indication for percutaneous or surgical biopsy, with mean age of 56.4 years (range: 28-81 years). Patients who agreed to participate in the study underwent PEM with 18F-fluorodeoxyglucose before the final histological evaluation. PEM findings were compared with mammography and histological findings. Most calcifications (n = 34; 85.0 %) were classified as BIRADS 4. On histology, there were 25 (62.5 %) benign and 15 (37.5 %) malignant lesions, including 11 (27.5 %) ductal carcinoma in situ (DCIS) and 4 (10 %) invasive carcinomas. On subjective analysis, PEM was positive in 15 cases (37.5 %) and most of these cases (n = 14; 93.3 %) were confirmed as malignant on histology. There was one false-positive result, which corresponded to a fibroadenoma, and one false negative, which corresponded to an intermediate-grade DCIS. PEM had a sensitivity of 93.3 %, specificity of 96.0 % and accuracy of 95 %. PEM was able to identify all invasive carcinomas and high-grade DCIS (nuclear grade 3) in the presented sample, suggesting that this method may be useful for further evaluation of patients with suspected microcalcifications. (orig.)

  20. Differential Findings of Tc 99m Sestamibi Dual Phase Parathyroid Scintigraphy Between Benign and Malignant Parathyroid Lesions in Patients with Primary Hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Miju; Choi, Joon Young; Chung, Jae Hoon; Lee, Ji Young; Cho, Sook Kyung; Yoo, Jang; Park, Soo Bin; Lee, Kyung Han; Kim, Byung Tae [Sungkyunkwan, Univ. School of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    This study aimed to investigate the differential findings in clinical and biochemical features, and Tc 99m sestamibi (MIBI) dual phase parathyroid lesions in patients with primary hyperparathyroidism. Subjects were 102 parathyroid lesions from 91 patients with primary hyperparathyroidism. Scintigraphic findings included radioactivity grade, uptake pattern, uptake contour lesion size on early and delayed images, and degree of washout. Clinical and biochemical features were also evaluated. Histopathology confirmed the final diagnosis for all the patients. Final diagnoses were 94 benign parathyroid lesions and 8 parathyroid carcinomas. The patients with parathyroid carcinoma were significantly older (p=0.002) and had significantly higher serum parathyroid hormone concentrations than those with benign parathyroid lesions (p<0.001). All malignant parathyroid lesions showed intense radioactivity similar to or greater than the submandibular gland activity on delayed images (p=0.007), and little radioactivity difference between early and delayed images (p=0.012). The cancer incidence for parathyroid lesions with both intense radioactivity and no washout was 17.0% (8/47). When parathyroid lesions with all of the above mentioned findings were regarded as malignant, the cancer incidence significantly increased from 17.0% to 33.3% (8/24, p<0.001). For Tc 99m MIBI dual phase parathyroid scintigraphy, uptake grade on delayed images and washout were significantly useful diagnostic criteria for differentiating benign from malignant parathyroid lesions, along with age and parathyroid hormone serum concentration.

  1. Residual tumor after the salvage surgery is the major risk factors for primary treatment failure in malignant ovarian germ cell tumors: A retrospective study of single institution

    Directory of Open Access Journals (Sweden)

    Park Jong Sup

    2011-10-01

    Full Text Available Abstract Background Malignant ovarian germ cell tumors are rare, and knowledge of their prognostic factors is limited, with little available randomized data. This study was conducted to evaluate the clinicopathologic characteristics of malignant ovarian germ cell tumors and to determine the association of their prognostic factors to primary treatment failure. Methods The medical records of 57 patients with stages I to IV malignant ovarian germ cell tumor were retrospectively reviewed, and their clinicopathologic and treatment-related data were collected and analyzed. Results The median age at the diagnosis was 23.3 years (range: 8-65 years, and the median follow-up period was 108 months (range: 48-205 months. The histological types of the tumors were immature teratoma (n = 24, dysgerminoma (n = 20, endodermal sinus tumor (n = 8, mixed germ cell tumor (n = 4, and choriocarcinoma (n = 1. 66.7% of the patients had stage I disease; 5.2%, stage II; 26.3%, stage III; and 1.8%, stage IV. After the initial surgery, 49 patients (86% received cisplatin-based chemotherapy. The five-year survival rate was 96.5%. There were six primary treatment failures, with two of the patients dying of the disease, and the median time to the recurrence was 8 months. The histological diagnosis (P P = 0.0052, elevation of beta-hCG (P = 0.0134, operation methods (P = 0.0006, and residual tumor after the salvage surgery (P P = 0.0011, Hazard ratio = 29.046, 95% Confidence interval 3.832-220.181. Conclusion Most malignant ovarian germ cell tumors have excellent prognoses with primary treatment, and good reproductive outcomes can be expected. Because primary treatment failure is associated with the residual disease after the salvage surgery, knowledge of the presence or absence of this risk factor may be helpful in risk stratification and individualization of adjuvant therapy in malignant ovarian germ cell tumors. Further large-scale prospective studies to confirm these results

  2. Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators

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    Elena Antonova

    2016-09-01

    Full Text Available Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males from the Buddhist tradition (meditators and 24 meditation-naïve individuals (all males. Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males. All participants completed the Schizotypal Personality Questionnaire (Raine, 1991, a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness. Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe, describing (Describe, acting with awareness (Awareness, non-judging of (Non-judgment and non-reactivity to inner experience (Non-reactivity facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

  3. Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.

    Science.gov (United States)

    Antonova, Elena; Amaratunga, Kavitha; Wright, Bernice; Ettinger, Ulrich; Kumari, Veena

    2016-09-01

    Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

  4. Neural Correlates of Suspiciousness and Interactions with Anxiety during Emotional and Neutral Word Processing

    Directory of Open Access Journals (Sweden)

    Joscelyn E Fisher

    2014-06-01

    Full Text Available Suspiciousness is usually classified as a symptom of psychosis, but it also occurs in depression and anxiety disorders. Though how suspiciousness overlaps with depression is not obvious, suspiciousness does seem to overlap with anxious apprehension and anxious arousal (e.g., verbal iterative processes and vigilance about environmental threat. However, suspiciousness also has unique characteristics (e.g., concern about harm from others and vigilance about social threat. Given that both anxiety and suspiciousness have been associated with abnormalities in emotion processing, it is unclear whether it is the unique characteristics of suspiciousness or the overlap with anxiety that drive abnormalities in emotion processing.. Event-related brain potentials were obtained during an emotion-word Stroop task. Results indicated that suspiciousness interacts with anxious apprehension to modulate initial stimulus perception processes. Suspiciousness is associated with attention to all stimuli regardless of emotion content. In contrast, anxious arousal is associated with a later response to emotion stimuli only. These results suggest that suspiciousness and anxious apprehension share overlapping processes, but suspiciousness alone is associated with a hyperactive early vigilance response. Depression did not interact with suspiciousness to predict response to emotion stimuli. These findings suggest that it may be informative to assess suspiciousness in conjunction with anxiety in order to better understand how these symptoms interact and contribute to dysfunctional emotion processing.

  5. Diagnostic accuracy of risk of malignancy index in predicting complete tumor removal at primary debulking surgery for ovarian cancer patients

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Håkansson, Fanny; Antonsen, Sofie L

    2013-01-01

    to investigate whether the risk of malignancy index (RMI) was a useful marker for this evaluation. RMI and surgical outcome were investigated in 164 patients, 49 of whom had no residual tumor after PDS. The receiver operating characteristic curve showed an area under the curve of 0.72 (confidence interval: 0...

  6. Primary malignant mixed müllerian tumor of the peritoneum a case report with review of the literature

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    Gashi-Luci Lumturije

    2011-02-01

    Full Text Available Abstract Malignant mixed Müllerian tumor is a rare malignancy of the genital tract and extremely uncommon in extragenital sites. This report describes a case of malignant mixed Müllerian tumor arising in the lower peritoneum of a 72-year-old female patient. The patient presented with ascites, lower abdominal mass and pleural effusion. The serum level of CA125 was elevated. At operation a diffuse carcinosis associated with tumor mass measuring 20 × 15 × 10 cm in the vesicouterine and Duglas' pouch were found. The uterus and the adnexa were unremarkable. Histopathology revealed a typical malignant mixed Müllerian tumor, heterologous type. The epithelial component was positive for cytokeratin 7 and vimentin whereas the mesenchymal component was positive for Vimentin, S100 and focally for CK7. The histogenesis of this tumor arising from the peritoneum is still speculative. Based on the previous reports and the immunohistochemical analysis of our case, we believe that this is a monoclonal tumor with carcinoma being the "precursor" element. Nevertheless, further molecular and genetic evidence is needed to support such a conclusion.

  7. Thyroid cyst wall atypia in a patient with a history of malignant melanoma: a pitfall in fine-needle aspiration cytology.

    Science.gov (United States)

    Johnson, Rebecca L; Hasteh, Farnaz

    2013-08-01

    We present an interesting case report from a patient with a history of desmoplastic malignant melanoma (MM), who presented with a thyroid nodule. The patient's clinical diagnosis included a benign thyroid nodule versus a primary thyroid malignancy or metastatic MM. Fine-needle aspiration biopsy showed highly atypical spindle cells suspicious for metastatic MM. The acellular cell block prevented further studies such as immunohistochemical analysis. The patient underwent surgical excision of the mass, which showed a benign cystic thyroid nodule with an atypical cyst lining. Here, we report the presence of atypical cyst-lining cells in a patient with diagnosis of MM. The atypical cytology of the cyst-lining cells has been reported in the English literature; however, presence of significant cytological atypia, especially in a patient with a history of another malignancy, can be problematic. The cytopathologist should be aware of this entity and its diagnostic pitfalls. Copyright © 2011 Wiley Periodicals, Inc., a Wiley company.

  8. Phishing suspiciousness in older and younger adults: The role of executive functioning.

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    Brandon E Gavett

    Full Text Available Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger, sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3] accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27 and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12 and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07. Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid

  9. Phishing suspiciousness in older and younger adults: The role of executive functioning

    Science.gov (United States)

    Zhao, Rui; John, Samantha E.; Bussell, Cara A.; Roberts, Jennifer R.; Yue, Chuan

    2017-01-01

    Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger), sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3]) accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27) and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12) and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07). Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid tools in

  10. Effectiveness of autofluorescence to identify suspicious oral lesions--a prospective, blinded clinical trial.

    Science.gov (United States)

    Koch, Felix Peter; Kaemmerer, Peer W; Biesterfeld, Stefan; Kunkel, Martin; Wagner, Wilfried

    2011-12-01

    Regular screening through white light inspection of the entire oral mucosa is the most important examination method to identify precancerous lesions and early oral carcinoma. Additionally, the physiologic autofluorescence of the oral mucosa has been described as a novel screening method for the detection of mucosal lesions that are not visible by white light. This study aimed to evaluate the sensitivity and specificity of the autofluorescence examination. Seventy-eight patients were examined in this study. All of them suffered from suspicious oral mucosal lesions. Two different investigation methods were applied: the standard examination by white light and an examination by a novel light source of 400 nm that evoked a green light emission (>500 nm) in normal mucosa. It was proposed that malignant oral mucosal lesions show different autofluorescence characteristics than the green autofluorescence of healthy mucosa. Red autofluorescence indicated SCC with a sensitivity of 20% and a specificity of 98%. The results showed that dysplasia and carcinoma could be identified with a sensitivity of 96% and a specificity of 18% by using the autofluorescence method. The sensitivity decreased according to the grade of mucosal keratosis and was influenced by the localisation of the lesion. In conclusion, benign as well as malignant oral lesions could not be distinguished by a diminished autofluorescence signal. A red autofluorescence signal, however, could indicate cancerous processes of the oral mucosa.

  11. Primary hepatic actinomycosis mimicking hepatic malignancy with metastatic lymph nodes by F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung [Yeungnam Univ. Medical School and Hospital, Daegu (Korea, Republic of)

    2016-03-15

    Hepatic involvement is usually secondary to abdominal actinomycosis infection. Symptom onset is typically subscute and the disease follows a chronic and indolent course. These lesions are called inflammatory pseudotumors and cannot be differentiated from malignant tumors by radiological examination alone. Laboratory tests showed mild anemia; hemoglobin 119 g/L, elevated white blood cell count of 23,060/mm{sup 3}, AST 33 U/L, ALT 45 U/L, and γ-GT 155 U/L.

  12. Primary penile melanoma with an incidental renal oncocytoma.

    Science.gov (United States)

    McLoughlin, Louise Catherine; Davis, Niall F; Cham, Adrian; Mohan, Ponnusamy

    2013-09-12

    A 57-year-old man presented with a pigmented lesion on the ventral aspect of his glans penis. A punch biopsy showed features consistent with malignant melanoma. Preoperative staging was initiated with CT of the thorax, abdomen and pelvis. A mass in the lower pole of the left kidney was found and given the presence of a primary melanoma, was highly suspicious for a metastatic deposit or a primary renal cell carcinoma. A biopsy of this mass failed to give a definitive diagnosis. The patient proceeded to have a partial penectomy and a left radical nephrectomy. The penile lesion was a 2.5 mm malignant melanoma with nodular and superficial spreading components. The renal mass turned out to be a benign oncocytoma. The final clinical stage of the penile melanoma was pT3a N0 M0. The patient received adjuvant interferon therapy. He is well and free of disease recurrence at 1-year postsurgery.

  13. Diagnostic value of whole-body diffusion-weighted magnetic resonance imaging for detection of primary and metastatic malignancies: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Li, Bin, E-mail: lllb146@163.com [Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003 (China); Li, Qiong [Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003 (China); Nie, Wei [Department of Respiratory Disease, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003 (China); Liu, Shiyuan, E-mail: lsy20112077@163.com [Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003 (China)

    2014-02-15

    Purpose: To perform a meta-analysis to evaluate the diagnostic performance of whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) technique in detection of primary and metastatic malignancies compared with that of whole-body positron emission tomography/computed tomography (WB-PET/CT). Materials and methods: Search Pubmed, MEDLINE, EMBASE and Cochrane Library database from January 1984 to July 2013 for studies comparing WB-DWI with WB-PET/CT for detection of primary and metastatic malignancies. Methodological quality was assessed by the quality assessment of diagnostic studies (QUADAS) instrument. Sensitivities, specificities, predictive values, diagnostic odds ratio (DOR) and areas under the summary receiver operator characteristic curve (AUC) were calculated. Potential threshold effect, heterogeneity and publication bias were investigated. Result: Thirteen eligible studies were included, with a total of 1067 patients. There was no significant threshold effect. WB-DWI had a similar AUC (0.966 (95% CI, 0.940–0.992) versus 0.984 (95% CI, 0.965–0.999)) with WB-PET/CT. No significant difference was detected between AUC of WB-DWI and WB-PET/CT. WB-DWI had a pooled sensitivity of 0.897 (95% CI, 0.876–0.916) and a pooled specificity of 0.954 (95% CI, 0.944–0.962). WB-PET/CT had a pooled sensitivity of 0.895 (95% CI, 0.865–0.920) and a pooled specificity of 0.975 (95% CI, 0.966–0.981). Heterogeneity was found to stem primarily from data type (per lesion versus per patient), MR sequence (DWIBS only and DWIBS with other sequence), and primary lesion type (single type and multiple type). The Deeks's funnel plots suggested the absence of publication bias. Conclusion: WB-DWI has similar, good diagnostic performance for the detection of primary and metastatic malignancies compared with WB-PET/CT. DWIBS with other MR sequences could further improve the diagnostic performance. More high-quality studies regarding comparison of WB-DWI and WB

  14. Association of thyroid diseases with primary extra-thyroidal malignancies in women: results of a cross-sectional study of 6,386 patients.

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    Natalie Prinzi

    Full Text Available We here analyzed the prevalence of extra-thyroidal malignancies (EM in 6,386 female patients affected by different thyroid disease (TD. At first, an age-matched analysis of EM in all patients was performed. We then evaluated EM prevalence in four TD diagnostic categories: non-nodular TD (n = 2,159; solitary nodule (n = 905; multinodular TD (n = 2,871; differentiated thyroid cancers (n = 451. Finally, patients were grouped based on the absence (n = 3,820 or presence of anti-thyroglobulin (TgAb and/or anti-thyroperoxidase (TPOAb (n = 2,369, or anti-Thyroid Stmulating Hormone (TSH receptor autoantibodies (n = 197. A total of 673 EM were recorded. EM prevalence in TD patients was higher compared to the general population (Odds Ratio, OR 3.21 and the most frequent EM was breast cancer (OR 3.94, followed by colorectal (OR 2.18, melanoma (OR 6.71, hematological (OR 8.57, uterus (OR 2.52, kidney (OR 3.40 and ovary (OR 2.62 neoplasms. Age-matched analysis demonstrated that the risk of EM was maximal at age 0-44 yr (OR 11.28, remaining lower, but significantly higher that in the general population, in the 45-59 and 60-74 year age range. Breast and hematological malignancies showed an increased OR in all TD, while other cancers associated with specific TD. An increased OR for melanoma, breast and hematological malignancies was observed in both TPOAb and/or TgAb autoantibody negative and positive patients, while colorectal, uterus, kidney and ovary cancers showed an increased OR only in thyroid autoantibody negative patients. In conclusions, women affected by both benign and malignant TD, especially at a younger age and in absence of thyroid autoimmunity, have an increased risk of developing primary EM, thus requiring a careful follow-up and surveillance.

  15. Malignant hyperthermia resolving with discontinuation of sevoflurane alone

    Directory of Open Access Journals (Sweden)

    Abdullah Abolkhair

    2011-01-01

    Full Text Available An otherwise healthy 13 year old developed hypercarbia and increased temperature during anesthesia with sevoflurane. Discontinuation of sevoflurane, surface cooling, and hyperventilation resulted in prompt resolution. However, hyperkalemia continued to raise the suspicion for malignant hyperthermia, which was ultimately confirmed by ryanodine receptor gene sequencing. The case underlines the importance of intraoperative monitoring of end-tidal CO2 and temperature and the potential benefits of early discontinuation of inhalational anesthetics in the presence of signs and symptoms suspicious for malignant hyperthermia. The severe hyperkalemia suggests that standard guidelines for diagnosis and treatment of malignant hyperthermia, including dantrolene treatment, should be followed whenever malignant hyperthermia is suspected.

  16. Dexmedetomidine as the primary anesthetic agent during cardiac surgery in an infant with a family history of malignant hyperthermia

    Directory of Open Access Journals (Sweden)

    Aymen Naguib

    2011-01-01

    Full Text Available Malignant hyperthermia (MH is an acute hypermetabolic crisis triggered in susceptible patients by the administration of succinylcholine or a volatile anesthetic agent. When providing anesthetic care for MH-susceptible agents, a total intravenous anesthetic (TIVA technique is frequently chosen. When choosing the components for TIVA, several options exist including the combination of propofol or dexmedetomidine with an opioid. We present our experience with the use of dexmedetomidine as a key component of the anesthetic regimen in a 5-month-old infant with a family history of MH. Previous reports of the use of dexmedetomidine in MH-susceptible patients are reviewed and its benefits in such patients discussed.

  17. Palliative Care in Improving Quality of Life in Patients With High Risk Primary or Recurrent Gynecologic Malignancies

    Science.gov (United States)

    2015-10-15

    Cervical Carcinoma; Ovarian Carcinoma; Primary Peritoneal Carcinoma; Recurrent Cervical Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Vulvar Carcinoma; Uterine Corpus Cancer; Vulvar Carcinoma; Peritoneal Neoplasms

  18. Survival after Resection of a Primary Malignant Melanoma of the Small Intestine in a Young Patient: Report of a Case

    Directory of Open Access Journals (Sweden)

    T.K. Timmers

    2013-05-01

    Full Text Available The occurrence of primary melanoma of the small intestine is rare. We describe the case of a 25-year-old man found to have a primary melanoma of the ileum. The patient presented with gradual onset of abdominal pain, fever, diarrhea, weight loss and fatigue. A preoperative diagnosis of a small intestinal tumor was based on the findings of computed tomography scanning. This diagnosis was confirmed at laparotomy and a partial small bowel resection was performed. Histopathological examination of the resected specimen clarified the exact nature of the lesion, confirming the diagnosis of melanoma. Thorough postoperative investigation did not reveal a primary lesion in the skin, gastrointestinal tract, oculus or brain. Thus, we diagnosed this tumor as a primary lesion. One year after his operation, the patient remains well without any evidence of recurrence. Thus, we diagnosed this small bowel tumor as a primary melanoma of the small intestine.

  19. Survival after resection of a primary malignant melanoma of the small intestine in a young patient: report of a case.

    Science.gov (United States)

    Timmers, T K; Schadd, E M; Monkelbaan, J F; Meij, V

    2013-05-01

    The occurrence of primary melanoma of the small intestine is rare. We describe the case of a 25-year-old man found to have a primary melanoma of the ileum. The patient presented with gradual onset of abdominal pain, fever, diarrhea, weight loss and fatigue. A preoperative diagnosis of a small intestinal tumor was based on the findings of computed tomography scanning. This diagnosis was confirmed at laparoto-my and a partial small bowel resection was performed. Histopathological examination of the resected specimen clarified the exact nature of the lesion, confirming the diagnosis of melanoma. Thorough postoperative investigation did not reveal a primary lesion in the skin, gastrointestinal tract, oculus or brain. Thus, we diagnosed this tumor as a primary lesion. One year after his operation, the patient remains well without any evidence of recurrence. Thus, we diagnosed this small bowel tumor as a primary melanoma of the small intestine.

  20. Positron emission tomography-computed tomography and 4-hydroxynonenal-histidine immunohistochemistry reveal differential onset of lipid peroxidation in primary lung cancer and in pulmonary metastasis of remote malignancies.

    Science.gov (United States)

    Živković, Nevenka Piskač; Petrovečki, Mladen; Lončarić, Čedna Tomasović; Nikolić, Igor; Waeg, Georg; Jaganjac, Morana; Žarković, Kamelija; Žarković, Neven

    2017-04-01

    The Aim of the study was to reveal if PET-CT analysis of primary and of secondary lung cancer could be related to the onset of lipid peroxidation in cancer and in surrounding non-malignant lung tissue. Nineteen patients with primary lung cancer and seventeen patients with pulmonary metastasis were involved in the study. Their lungs were analyzed by PET-CT scanning before radical surgical removal of the cancer. Specific immunohistochemistry for the major bioactive marker of lipid peroxidation, 4-hydroxynonenal (HNE), was done for the malignant and surrounding non-malignant lung tissue using genuine monoclonal antibody specific for the HNE-histidine adducts. Both the intensity of the PET-CT analysis and the HNE-immunohistochemistry were in correlation with the size of the tumors analyzed, while primary lung carcinomas were larger than the metastatic tumors. The intensity of the HNE-immunohistochemistry in the surrounding lung tissue was more pronounced in the metastatic than in the primary tumors, but it was negatively correlated with the cancer volume determined by PET-CT. The appearance of HNE was more pronounced in non-malignant surrounding tissue than in cancer or stromal cells, both in case of primary and metastatic tumors. Both PET-CT and HNE-immunohistochemistry reflect the size of the malignant tissue. However, lipid peroxidation of non-malignant lung tissue in the vicinity of cancer is more pronounced in metastatic than in primary malignancies and might represent the mechanism of defense against cancer, as was recently revealed also in case of human liver cancer. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Asymptomatic Primary Fallopian Tube Cancer: An Unusual Cause of Axillary Lymphadenopathy

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    N. A. Healy

    2011-01-01

    Full Text Available Primary Fallopian tube malignancy is considered a rare disease and is often mistaken histologically and clinically for ovarian cancer. The etiology is poorly understood, and it typically presents at an advanced disease stage, as symptoms are often absent in the initial period. As a result, primary fallopian tube cancer is generally associated with a poor prognosis. We present the case of a 45-year-old female who presents with a 5-day history of left axillary swelling and a normal breast examination. Mammogram and biopsy of a lesion in the left breast revealed a fibroadenoma but no other abnormalities. Initial sampling of the axillary node was suspicious for a primary breast malignancy, but histology of the excised node refuted this. PET-CT showed an area of high uptake in the right pelvis, and a laparoscopy identified a tumor of the left fallopian tube which was subsequently excised and confirmed as a serous adenocarcinoma.

  2. Primary Immature Teratoma of the Uterus Relapsing as Malignant Neuroepithelioma: Case Report and Review of the Literature

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    Meryam Ben Ameur El Youbi

    2013-01-01

    Full Text Available Background. Although some mature cases of teratomas have recently been described in the cervix, they are not commonly found in the uterus, especially in immature forms. An immature uterine teratoma relapsing after surgery as malignant neuroepithelioma has never been reported in the literature. Case Presentation. We describe a case of immature teratoma which occurred primarily in the uterus in a 56-year-old female. Treatment consisted of total simple hysterectomy. Three months after surgery, the patient relapsed with voluminous pelvic mass and was treated with bleomycin, etoposide, and cisplatin-containing chemotherapy regimen. Conclusion. In this report and according to the pertinent literature, clinical and pathological features and management of uterine immature teratomas are discussed. The mainstay of treatment is surgery. The prognosis of this unusual disease remains uncertain.

  3. Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database

    Directory of Open Access Journals (Sweden)

    Ma K

    2017-12-01

    Full Text Available Ke Ma,* Fenghao Sun,* Xiaodong Yang, Shuai Wang, Lin Wang, Yulin Jin, Yu Shi, Wei Jiang, Cheng Zhan, Qun Wang Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to identify risk factors for patients with malignant main stem bronchial tumors (MBTs and to develop a nomogram for predicting prognosis in those patients using data from the Surveillance, Epidemiology, and End Results (SEER database.Method: A process was used for case screening from the SEER database. The effect of prognostic factors on survival was evaluated using the Kaplan–Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. A nomogram was established for predicting 1-, 3-, and 5-year overall survival (OS in patients with MBTs.Results: A total of 7,418 cases were included in this study. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were identified as independent risk factors by univariate and multivariate analyses. A nomogram was established based on the results of the Cox model, which was validated by a C-index of 0.672 (95% CI, 0.664–0.680, and a group of calibration plots.Conclusion: Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were independent risk factors for OS of patients with MBTs. A nomogram was formulated to predict 1-, 3-, and 5-year OS in patients with MBTs based on individual clinical characteristics. Keywords: malignant main stem bronchial tumor, nomogram, prognosis, risk factors

  4. CD40 ligand is necessary and sufficient to support primary diffuse large B-cell lymphoma cells in culture: a tool for in vitro preclinical studies with primary B-cell malignancies.

    Science.gov (United States)

    Ito, Daisuke; Frantz, Aric M; Williams, Christina; Thomas, Rachael; Burnett, Robert C; Avery, Anne C; Breen, Matthew; Mason, Nicola J; O'Brien, Timothy D; Modiano, Jaime F

    2012-07-01

    Established cell lines are utilized extensively to study tumor biology and preclinical therapeutic development. However, they may not accurately recapitulate the heterogeneity of their corresponding primary disease. B-cell tumor cells are especially difficult to maintain under conventional culture conditions, limiting access to samples that faithfully represent this disease for preclinical studies. Here, we used primary canine diffuse large B-cell lymphoma to establish a culture system that reliably supports the growth of these cells. CD40 ligand, either expressed by feeder cells or provided as a soluble two-trimeric form, was sufficient to support primary lymphoma cells in vitro. The tumor cells retained their original phenotype, clonality and known karyotypic abnormalities after extended expansion in culture. Finally, we illustrate the utility of the feeder cell-free culture system for comparable assessment of cytotoxicity using dog and human B-cell malignancies. We conclude that this system has broad applications for in vitro preclinical development for B-cell malignancies.

  5. Transnasal Flexible Fiberoptic in-office Laryngeal Biopsies—Our Experience with 117 Patients with Suspicious Lesions

    Directory of Open Access Journals (Sweden)

    Jacob T. Cohen

    2014-04-01

    Full Text Available Objective: To compare pathologic results obtained via in-office transnasal fiberoptic laryngoscopy (TFL to those of subsequent direct laryngoscopy in order to assess the accuracy of TFL as a diagnostic tool. Patients: One hundred and seventeen patients with suspicious laryngeal lesions. Methods: All patients underwent in-office biopsies. All patients with malignant diagnosis were referred to treatment. All patients with benign diagnosis or carcinoma in situ were referred to direct laryngoscopy for definitive diagnosis. The pathological results of the specimens from both procedures were compared. Results: Adequate tissue for diagnostic purposes was obtained in 110 of 117 in-office transnasal fiberoptic laryngoscopy biopsies (94.0%. The biopsy results revealed invasive carcinoma in 42 patients (38.2%, carcinoma in situ (CIS in 17 patients (15.4%, and benign lesions in 51 patients (46.4%. All patients with benign pathologies and carcinoma in situ were referred to biopsy under direct laryngoscopy (five patients refused and were removed from the statistics. The final pathologies identified from the biopsies on direct laryngoscopy revealed that there was an underestimation of the transnasal fiberoptic laryngoscopy results in 33 patients (a false negative rate of 31.4%, 33/105 and an overestimation in one patient. The sensitivity of transnasal fiberoptic laryngoscopy biopsy compared with direct laryngoscopy biopsy was 70.6% and the specificity was 96.7%. Conclusions: TFL with biopsy is easy, safe, and cost-effective but raises serious doubts about its clinical value due to its low sensitivity rate for diagnosing suspicious lesions of the larynx. As such, it is recommended that all patients with a suspicious lesion diagnosed by TFL biopsy as being benign or CIS should be referred to direct laryngoscopy for verification of the findings.

  6. Predictive performance of BI-RADS magnetic resonance imaging descriptors in the context of suspicious (category 4 findings

    Directory of Open Access Journals (Sweden)

    João Ricardo Maltez de Almeida

    2016-06-01

    Full Text Available Abstract Objective: To determine the positive predictive value (PPV and likelihood ratio for magnetic resonance imaging (MRI characteristics of category 4 lesions, as described in the Breast Imaging Reporting and Data System (BI-RADS® lexicon, as well as to test the predictive performance of the descriptors using multivariate analysis and the area under the curve derived from a receiver operating characteristic (ROC curve. Materials and Methods: This was a double-blind review study of 121 suspicious findings from 98 women examined between 2009 and 2013. The terminology was based on the 2013 edition of the BI-RADS. Results: Of the 121 suspicious findings, 53 (43.8% were proven to be malignant lesions, with no significant difference between mass and non-mass enhancement (p = 0.846. The PPVs were highest for masses with a spiculated margin (71% and round shape (63%, whereas segmental distribution achieved a high PPV (80% for non-mass enhancement. Kinetic analyses performed poorly, except for type 3 curves applied to masses (PPV of 73%. Logistic regression models were significant for both patterns, although the results were better for masses, particularly when kinetic assessments were included (p = 0.015; pseudo R2 = 0.48; area under the curve = 90%. Conclusion: Some BI-RADS MRI descriptors have high PPV and good predictive performance-as demonstrated by ROC curve and multivariate analysis-when applied to BI-RADS category 4 findings. This may allow future stratification of this category.

  7. Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database.

    Science.gov (United States)

    Ma, Ke; Sun, Fenghao; Yang, Xiaodong; Wang, Shuai; Wang, Lin; Jin, Yulin; Shi, Yu; Jiang, Wei; Zhan, Cheng; Wang, Qun

    2018-01-01

    The aim of this study was to identify risk factors for patients with malignant main stem bronchial tumors (MBTs) and to develop a nomogram for predicting prognosis in those patients using data from the Surveillance, Epidemiology, and End Results (SEER) database. A process was used for case screening from the SEER database. The effect of prognostic factors on survival was evaluated using the Kaplan-Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. A nomogram was established for predicting 1-, 3-, and 5-year overall survival (OS) in patients with MBTs. A total of 7,418 cases were included in this study. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were identified as independent risk factors by univariate and multivariate analyses. A nomogram was established based on the results of the Cox model, which was validated by a C-index of 0.672 (95% CI, 0.664-0.680), and a group of calibration plots. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were independent risk factors for OS of patients with MBTs. A nomogram was formulated to predict 1-, 3-, and 5-year OS in patients with MBTs based on individual clinical characteristics.

  8. Identifying family members who are likely to perceive benefits from providing care to a person with a primary malignant brain tumor.

    Science.gov (United States)

    Newberry, Alyssa; Kuo, Jean; Donovan, Heidi; Given, Barbara; Given, Charles W; Schulz, Richard; Sherwood, Paula

    2012-05-01

    To identify changes in positive aspects of care (PAC) from the time of diagnosis to four months following the diagnosis in family caregivers of care recipients with primary malignant brain tumors. Longitudinal. Dyads were recruited from neurosurgery clinics in Pittsburgh, PA, at the time of care recipients' diagnosis with a primary malignant brain tumor. A second data collection took place four months following the diagnosis. 89 caregiver and care recipient dyads. Paired t tests were used to examine change in PAC, univariate analyses were used to determine predictors of PAC at four months, Mann-Whitney U tests and t tests were used to examine associations between categorical predictor variables and PAC at four months, and univariate linear regressions were used to examine associations between continuous predictors and PAC at four months. The impact of sociodemographic factors, caregiver-perceived social support, mastery, neuroticism, and marital satisfaction on PAC. Caregivers' PAC scores during the first four months following diagnosis appeared to remain stable over time. Significant differences were found between the care recipient reasoning domain group at diagnosis and PAC score. Care recipients who scored below average were associated with caregivers with higher PAC scores. Caregiver PAC at four months following diagnosis was significantly predicted by care recipient reasoning and caregiver social support. PAC scores appear to remain stable over time, although levels of PAC may be related to care recipients' level of functioning. Future research should focus on the development of interventions for caregivers who report low levels of PAC at the time of diagnosis in an attempt to help these individuals identify PAC in their caregiving situation. Findings have clinical and research implications. Clinicians may be able to better identify caregivers who are at risk for negative outcomes by understanding the risks faced by caregivers of patients with milder symptoms

  9. The genomic profile of human malignant glioma is altered early in primary cell culture and preserved in spheroids

    NARCIS (Netherlands)

    de Witt Hamer, P. C.; van Tilborg, A. A. G.; Eijk, P. P.; Sminia, P.; Troost, D.; van Noorden, C. J. F.; Ylstra, B.; Leenstra, S.

    2008-01-01

    Screening of therapeutics relies on representative cancer models. The representation of human glioblastoma by in vitro cell culture models is questionable. We obtained genomic profiles by array comparative genomic hybridization of both short-and long-term primary cell and spheroid cultures, derived

  10. Is primary Sjögren's syndrome a risk factor for malignancies different from lymphomas? What does the literature highlight about it?

    Science.gov (United States)

    Manzo, Ciro; Kechida, Melek

    2017-01-01

    Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease with an elevated risk of developing lymphoproliferative malignancies (LM). Whether pSS is a risk factor or not for non-lymphoma malignancies (NLM) has been scarcely evaluated in the literature. Age is per se a risk factor for malignancies: patients over 70 years old have 4 times higher risk for cancers than adults. Even if the mean age of pSS onset usually is in the 4th and 5th decade, its onset in patients aged over 65 years (Elderly Onset pSS - EOpSS) is not uncommon. To evaluate pSS as a risk factor for NLM we performed a systematic electronic search on PubMed in the period 2006-2016 to identify all the publications on this topic. The studies were eligible for inclusion if they reported specific Standardized Incidence Ratio (SIR) with 95% CI. Studies that did not report sufficient published and/or original data were excluded. Only 7 articles of 494 that we found in PubMed fulfilled the inclusion criterion. In the vast majority of these, SIR values were not statistically significant for NLM. The occurrence of NLM after LM was statistically significant in some studies and a NLM represented the most frequent cause of death. The possibility that NLM may represent a paraneoplastic syndrome seems much more frequent than LM, the risk of which increases with time after the diagnosis. Data regarding the neoplastic weight of EOpSS are mainly pointed out by case reports. Primary Sjögren's syndrome is not associated with an increased risk for NLM. However the possibility that NLM may appear after recovery from lymphoma should be carefully considered because it could be cause of the patient's death. Similarly the possibility that NLM may represent a paraneoplastic syndrome must be highlighted. The relationship between EOpSS and SIRs for NLM should be deepened with studies on ad hoc cohorts.

  11. Hybrid ANN optimized artificial fish swarm algorithm based classifier for classification of suspicious lesions in breast DCE-MRI

    Science.gov (United States)

    Janaki Sathya, D.; Geetha, K.

    2017-12-01

    Automatic mass or lesion classification systems are developed to aid in distinguishing between malignant and benign lesions present in the breast DCE-MR images, the systems need to improve both the sensitivity and specificity of DCE-MR image interpretation in order to be successful for clinical use. A new classifier (a set of features together with a classification method) based on artificial neural networks trained using artificial fish swarm optimization (AFSO) algorithm is proposed in this paper. The basic idea behind the proposed classifier is to use AFSO algorithm for searching the best combination of synaptic weights for the neural network. An optimal set of features based on the statistical textural features is presented. The investigational outcomes of the proposed suspicious lesion classifier algorithm therefore confirm that the resulting classifier performs better than other such classifiers reported in the literature. Therefore this classifier demonstrates that the improvement in both the sensitivity and specificity are possible through automated image analysis.

  12. Molecular characterization of permanent cell lines from primary, metastatic and recurrent malignant peripheral nerve sheath tumors (MPNST) with underlying neurofibromatosis-1.

    Science.gov (United States)

    Fang, Yuqiang; Elahi, Abul; Denley, Ryan C; Rao, Pulivarthi H; Brennan, Murray F; Jhanwar, Suresh C

    2009-04-01

    Malignant peripheral nerve sheath tumors (MPNSTs) develop in patients with underlying NF1, and usually arise as a result of malignant transformation of a pre-existing plexiform neurofibroma. The clonal cytogenetic abnormalities reported in primary MPNST include complex karyotypes with chromosome numbers in the triploid or tetraploid range with recurrent abnormalities of several chromosomes including losses or imbalances. As a prelude to cell biological, pharmacological, and functional studies to investigate pathways and gene(s) associated with multistep tumorigenesis, which includes progression, metastasis and resistance to therapy in MPNST, detailed molecular cytogenetic and genetic analyses of cell lines from primary, metastatic and recurrent MPNST with underlying NF1 disorder have been performed. The clonal cytogenetic abnormalities detected in the primary tumor cell line were similar to those observed in primary cultures of this tumor. Due to the complexity of the rearrangements seen by G-banded karyotype analysis, further characterization of the clonal abnormalities in these three cell lines was performed by molecular cytogenetic techniques, including CGH and SKY. CGH analysis detected recurrent deletions of 9p, 12q21-q32, complete losses of the X-chromosome, and gains of the chromosomal segment 17q25 in all three cell lines. SKY analysis detected extensive clonal abnormalities in these cell lines. The nature and the alterations of the cell cycle regulators, particularly those associated with G1-S checkpoints and known to be deregulated in MPNST, were studied. These cell cycle regulators included those associated with Rb1-cyclin D1 and the p53 pathways. The findings are consistent with the argument that an imbalance between the cyclin activators of CDKs and inhibitory proteins such as p16 result in uncontrollable proliferation in the cell lines, associated with progression of the disease. LOH and expression of the p53 gene in metastatic and recurrent cell

  13. SU-F-R-25: Automatic Identification of Suspicious Recurrent/residual Disease Regions After Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Parra, N A; Abramowitz, M; Pollack, A; Stoyanova, R [University of Miami, Miami, FL (United States)

    2016-06-15

    Purpose: To automatically identify and outline suspicious regions of recurrent or residual disease in the prostate bed using Dynamic Contrast Enhanced-MRI (DCE-MRI) in patients after prostatectomy. Methods: Twenty-two patients presenting for salvage radiotherapy and with identified Gross Tumor Volume (GTV) in the prostate bed were retrospectively analyzed. The MRI data consisted of Axial T2weighted-MRI (T2w) of the pelvis: resolution 1.25×1.25×2.5 mm; Field of View (FOV): 320×320 mm; slice thickness=2.5mm; 72 slices; and Dynamic Contrast Enhanced MRI (DCE-MRI)–12 series of T1w with identical spatial resolution to T2w and at 30–34s temporal resolution. Unsupervised pattern recognition was used to decompose the 4D DCE data as the product W.H of weights W of k patterns H. A well-perfused pattern Hwp was identified and the weight map Wwp associated to Hwp was used to delineate suspicious volumes. Threshold of Wwp set at mean(Wwp)+S*std(Wwp), S=1,1.5,2 and 2.5 defined four volumes labeled as DCE1.0 to DCE2.5. These volumes were displayed on T2w and, along with GTV, were correlated with the highest pre-treatment PSA values, and with pharmacokinetic analysis constants. Results: GTV was significantly correlated with DCE2.0(ρ= 0.60, p<0.003), and DCE 2.5 (ρ=0.58, p=0.004)). Significant correlation was found between highest pre-treatment PSA and GTV(ρ=0.42, p<0.049), DCE2.0(ρ= 0.52, p<0.012), and DCE 2.5 (ρ=0.67, p<<0.01)). Kruskal-Wallis analysis showed that Ktrans median value was statistically different between non-specific prostate bed tissue NSPBT and both GTV (p<<0.001) and DCE2.5 (p<<0.001), but while median Ve was statistically different between DCE2.5 and NSPBT (p=0.002), it was not statistically different between GTV and NSPBT (p=0.054), suggesting that automatic volumes capture more accurately the area of malignancy. Conclusion: Software developed for identification and visualization of suspicions regions in DCE-MRI from post-prostatectomy patients has

  14. Glioma stem cells are more aggressive in recurrent tumors with malignant progression than in the primary tumor, and both can be maintained long-term in vitro

    Directory of Open Access Journals (Sweden)

    Diao Yi

    2008-10-01

    Full Text Available Abstract Background Despite the advances made during decades of research, the mechanisms by which glioma is initiated and established remain elusive. The discovery of glioma stem cells (GSCs may help to elucidate the processes of gliomagenesis with respect to their phenotype, differentiation and tumorigenic capacity during initiation and progression. Research on GSCs is still in its infancy, so no definitive conclusions about their role can yet be drawn. To understand the biology of GSCs fully, it is highly desirable to establish permanent and biologically stable GSC lines. Methods In the current study, GSCs were isolated from surgical specimens of primary and recurrent glioma in a patient whose malignancy had progressed during the previous six months. The GSCs were cryopreserved and resuscitated periodically during long-term maintenance to establish glioma stem/progenitor cell (GSPC lines, which were characterized by immunofluorescence, flow cytometry and transmission electronic microscopy. The primary and recurrent GSPC lines were also compared in terms of in vivo tumorigenicity and invasiveness. Molecular genetic differences between the two lines were identified by array-based comparative genomic hybridization and further validated by real-time PCR. Results Two GSPC lines, SU-1 (primary and SU-2 (recurrent, were maintained in vitro for more than 44 months and 38 months respectively. Generally, the potentials for proliferation, self-renewal and multi-differentiation remained relatively stable even after a prolonged series of alternating episodes of cryopreservation and resuscitation. Intracranial transplantation of SU-1 cells produced relatively less invasive tumor mass in athymic nude mice, while SU-2 cells led to much more diffuse and aggressive lesions strikingly recapitulated their original tumors. Neither SU-1 nor SU-2 cells reached the terminal differentiation stage under conditions that would induce terminal differentiation in neural

  15. Glioma stem cells are more aggressive in recurrent tumors with malignant progression than in the primary tumor, and both can be maintained long-term in vitro.

    Science.gov (United States)

    Huang, Qiang; Zhang, Quan-Bin; Dong, Jun; Wu, Yin-Yan; Shen, Yun-Tian; Zhao, Yao-Dong; Zhu, Yu-De; Diao, Yi; Wang, Ai-Dong; Lan, Qing

    2008-10-22

    Despite the advances made during decades of research, the mechanisms by which glioma is initiated and established remain elusive. The discovery of glioma stem cells (GSCs) may help to elucidate the processes of gliomagenesis with respect to their phenotype, differentiation and tumorigenic capacity during initiation and progression. Research on GSCs is still in its infancy, so no definitive conclusions about their role can yet be drawn. To understand the biology of GSCs fully, it is highly desirable to establish permanent and biologically stable GSC lines. In the current study, GSCs were isolated from surgical specimens of primary and recurrent glioma in a patient whose malignancy had progressed during the previous six months. The GSCs were cryopreserved and resuscitated periodically during long-term maintenance to establish glioma stem/progenitor cell (GSPC) lines, which were characterized by immunofluorescence, flow cytometry and transmission electronic microscopy. The primary and recurrent GSPC lines were also compared in terms of in vivo tumorigenicity and invasiveness. Molecular genetic differences between the two lines were identified by array-based comparative genomic hybridization and further validated by real-time PCR. Two GSPC lines, SU-1 (primary) and SU-2 (recurrent), were maintained in vitro for more than 44 months and 38 months respectively. Generally, the potentials for proliferation, self-renewal and multi-differentiation remained relatively stable even after a prolonged series of alternating episodes of cryopreservation and resuscitation. Intracranial transplantation of SU-1 cells produced relatively less invasive tumor mass in athymic nude mice, while SU-2 cells led to much more diffuse and aggressive lesions strikingly recapitulated their original tumors. Neither SU-1 nor SU-2 cells reached the terminal differentiation stage under conditions that would induce terminal differentiation in neural stem cells. The differentiation of most of the tumor

  16. Expression analysis of the autosomal recessive primary microcephaly genes MCPH1 (microcephalin) and MCPH5 (ASPM, abnormal spindle-like, microcephaly associated) in human malignant gliomas.

    Science.gov (United States)

    Hagemann, Carsten; Anacker, Jelena; Gerngras, Stefanie; Kühnel, Siglinde; Said, Harun M; Patel, Rajnikant; Kämmerer, Ulrike; Vordermark, Dirk; Roosen, Klaus; Vince, Giles Hamilton

    2008-08-01

    Patients with autosomal recessive primary microcephaly have a small but architecturally normal brain containing a reduced number of neurons. Microcephalin and ASPM are two of the genes causing this disease. Both are centrosomal proteins involved in cell cycle regulation. Whereas microcephalin is a component of the DNA damage response and a repressor of telomerase function, ASPM is required for the proper formation of a central mitotic spindle and ensures symmetric, proliferative divisions of neuro-epithelial cells. Both proteins are also involved in the regulation of tumor growth. Microcephalin expression is reduced in breast cancer cell lines and human tumors of the ovary and prostate. Reduction in microcephalin mRNA expression correlates with increased chromosomal instability. ASPM mRNA is overexpressed in transformed human cell lines and tumors, and its increased expression is positively associated with proliferation of glioblastoma cells. Glioblastomas are the most prevalent malignant brain tumors in adults, characterized by increased invasiveness, an aggressive local growth pattern and short survival periods of patients. In this study, we analysed the expression of microcephalin mRNA and ASPM mRNA and protein in a panel of 15 glioblastomas and 15 astrocytoma WHO grade II by semi-quantitative RT-PCR, Western blotting and immunohistochemistry. Whereas microcephalin expression did not seem to be altered during glioma development, there was a clear increase in ASPM mRNA and protein expression that corresponded with the WHO grade of the tumor. Our findings are significant as the expression of ASPM may be used as a marker for glioma malignancy and represents a potential therapeutic target.

  17. Is radioactive iodine-{sup 131} treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Marcelo Cruzick de; Momesso, Denise P.; Vieira Neto, Leonardo; Vaisman, Mario, E-mail: dmomesso@terra.com.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, (Brazil). Servico de Endocrinologia; Vaisman, Fernanda; Corbo, Rossana [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia; Martins, Rosangela Aparecida Gomes [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil). Divisao de Pesquisa

    2016-02-15

    Objective: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Materials and methods: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. Results: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. Conclusion: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. (author)

  18. Minimising bias in the forensic evaluation of suspicious paediatric injury.

    Science.gov (United States)

    Skellern, Catherine

    2015-08-01

    In the rules of evidence in all legal jurisdictions, medical experts are required to maintain objectivity when providing opinions. When interpreting medical evidence, doctors must recognise, acknowledge and manage uncertainties to ensure their evidence is reliable to legal decision-makers. Even in the forensic sciences such as DNA analysis, implicit bias has been shown to influence how results are interpreted from cognitive and contextual biases unconsciously operating. In cases involving allegations of child abuse there has been significant exposure in the media, popular magazines, legal journals and in the published medical literature debating the reliability of medical evidence given in these proceedings. In these cases judges have historically been critical of experts they perceived had sacrificed objectivity for advocacy by having an investment in a 'side'. This paper firstly discusses the issue of bias then describes types of cognitive biases identified from psychological research applied to forensic evidence including adversarial bias, context bias, confirmation bias and explains how terminology can influence the communication of opinion. It follows with previously published guidelines of how to reduce the risk of bias compromising objectivity in forensic practices then concludes with my own recommendations of practices that can be used by child protection paediatricians and within an organisation when conducting forensic evaluations of suspicious childhood injury to improve objectivity in formulation of opinion evidence. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  19. A comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesions.

    Science.gov (United States)

    Garg, Shailja; Mohan, Harsh; Bal, Amanjit; Attri, A K; Kochhar, Suman

    2007-11-01

    The present study was undertaken to compare the efficacy of needle core biopsy (NCB) of the breast with fine-needle aspiration cytology (FNAC) in breast lesions (palpable and non-palpable) in the Indian set-up, along with the assessment of tumor grading with both the techniques. Fifty patients with suspicious breast lesions were subjected to simultaneous FNAC and ultrasound-guided NCB following an initial mammographic evaluation. Cases were categorized into benign, benign with atypia, suspicious and malignant groups. In cases of infiltrating duct carcinomas, grading was performed on cytological smears as well as on NCB specimens. Both the techniques were compared, and findings were correlated with radiological and excision findings. Out of 50 cases, 18 were found to be benign and 32 malignant on final pathological diagnosis. Maximum number of patients with benign diagnosis was in the fourth decade (42.11%) and malignant diagnosis in the fourth as well as fifth decade (35.48% each). Sensitivity and specificity of mammography for the diagnosis of malignancy was 84.37% and 83.33%, respectively. Sensitivity and specificity of FNAC for malignant diagnosis was 78.15% and 94.44%, respectively, and of NCB was 96.5% and 100%, respectively. But NCB had a slightly higher specimen inadequacy rate (8%). NCB improved diagnostic categorization over FNAC by 18%. Tumor grading in cases of IDC showed high concordance rate between NCB and subsequent excision biopsy (94.44%) but low concordance rate between NCB and FNAC (59.1%). NCB is superior to FNAC in the diagnosis of breast lesions in terms of sensitivity, specificity, correct histological categorization of the lesions as well as tumor grading. (c) 2007 Wiley-Liss, Inc.

  20. Suspiciousness and low self-esteem as predictors of misattributions of anger in schizophrenia spectrum disorders.

    Science.gov (United States)

    Lysaker, Paul Henry; Davis, Louanne Whitman; Tsai, Jack

    2009-04-30

    While it is widely recognized that many with schizophrenia have significant difficulties in correctly identifying the emotions of others, less is known about the causes and correlates of particular forms of misattribution, including mistakenly seeing anger in others. One possibility is that persons with high levels of suspiciousness and low levels of self-esteem are at risk to attribute their poor feelings about themselves to the malice of others. To explore this possibility, we identified 52 persons with a schizophrenia spectrum disorder who made significant numbers of errors on the Bell-Lysaker Emotional Recognition Test. We then performed a cluster analysis based on measures of suspiciousness from the Positive and Negative Syndrome Scale and self-esteem from the Rosenberg Self-Esteem Schedule, and found the following four groups: a) High Suspiciousness/High Self-Esteem; b) Mild Suspiciousness/High Self-Esteem; c) High Suspiciousness/Low Self-Esteem; and d) Minimal Suspiciousness/Low Self-Esteem. Comparisons between groups revealed that as predicted the High Suspiciousness/Low Self-Esteem group made significantly more misattributions of anger than other groups, even when levels of depression were controlled for statistically. Implications for addressing the misattributions of anger in schizophrenia are discussed.

  1. Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

    Science.gov (United States)

    Vigneswaran, Nadarajah

    2011-03-01

    Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

  2. Revaluation of breast cytology with pathologist on-site of lesions with suspicious sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Capalbo, Emanuela, E-mail: emanuelacapalbo@tiscalinet.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Sajadidehkordi, Farideh, E-mail: faridehit@yahoo.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Colombi, Claudio; Ticha, Vladimira; Moretti, Angela, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy); Peli, Michela, E-mail: peli.michela@gmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Cosentino, Maria, E-mail: maria-cosentino@tiscali.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Lovisatti, Maria, E-mail: marialovisatti@hotmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Berti, Elisabetta, E-mail: eliberti@hotmail.it [Dipartimento di Scienze Diagnostiche, UOC di Anatomia Patologica, A.O San Carlo Borromeo. Via Pio II, 3, Milano 20153 (Italy); Cariati, Maurizio, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy)

    2013-09-15

    Objective: Evaluating correlation estimation between diagnostic ultrasound (U.S.) of breast lesions and fine needle aspiration cytology (FNAC), and the correlation between cytology and histology (I) of these lesions undergo surgery. Materials and methods: In 2010 we performed 1589 ultrasound breast. We identified 210 suspicious lesions to be subjected to FNAC, which was performed with pathologist on site, and extemporaneous analysis of the sample to assess their appropriateness. We classified the lesions in 5 ultrasound (U) classes according to the criteria defined by Echographic BIRADS Lexicon. The results of cytology were classified in 5 classes (C) according to the guidelines of F.O.N.Ca.M. Then we evaluated the diagnostic correlation between U.S. and FNAC, and between FNAC and Histology. Results: The distribution of lesions in U classes was: 57U2, 55U3, 36U4 and 62U5. The diagnostic concordance between U and FNAC was 96.7%, with a sensitivity of 98%, specificity 93%, negative and positive predictive value respectively of 94.9% and 97.3%, and diagnostic accuracy of 96.6%. The 98 patients with C4-C5 lesions were subjected to surgery and the histology confirmed high-grade malignancy of lesions with a concordance of 99.7%. Conclusions: Having achieved high diagnostic concordance between U and FNAC, and then between FNAC and histology, we may say that the FNAC, less invasive and traumatic for the patient than needle biopsy (CB), may be still a valid method when performed with pathologist on-site to assess the adequacy of the sample taken.

  3. Malignant priapism: a case report.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-12-01

    Metastatic involvement of the penis is most commonly from a primary malignant genitourinary tumour. It is a rare phenomenon usually reflecting disseminated malignancy associated with a poor prognosis. Metastasis to the penis mimicking priapism is extremely rare, particularly in the absence of disseminated disease.

  4. Malignant ameloblastoma or ameloblastic carcinoma

    NARCIS (Netherlands)

    Slootweg, P.J.; Müller, H.

    1984-01-01

    The World Health Organization defines malignant ameloblastoma as a lesion exhibiting features of an ameloblastoma in primary and metastatic growths. To cases collected from the literature we have added two of our own cases in which features of an ameloblastoma were coupled with malignant behavior.

  5. [Initial evaluation, diagnosis, staging, treatment, and follow-up of patients with primary cutaneous malignant melanoma. Consensus statement of the Network of Catalan and Balearic Melanoma Centers].

    Science.gov (United States)

    Mangas, C; Paradelo, C; Puig, S; Gallardo, F; Marcoval, J; Azon, A; Bartralot, R; Bel, S; Bigatà, X; Curcó, N; Dalmau, J; del Pozo, L J; Ferrándiz, C; Formigón, M; González, A; Just, M; Llambrich, A; Llistosella, E; Malvehy, J; Martí, R M; Nogués, M E; Pedragosa, R; Rocamora, V; Sàbat, M; Salleras, M

    2010-03-01

    The consensus statement on the management of primary cutaneous melanoma that we present here was based on selection, discussion, review, and comparison of recent literature (including national and international guidelines). The protocols for the diagnosis, treatment, and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered. The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time. As such, the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients, and neither can it nor should it be used for this purpose. Professionals reading the statement should not therefore consider it binding on their practice, and in no case can this text be used to guarantee or seek responsibility for a given medical opinion. The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor, which, in comparison with other types of cancer, we believe does not receive sufficient attention in Spain. In addition, the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological, clinical, and basic applied research projects on the subject of malignant melanoma in our society.

  6. Pulmonary Nodule Detection in Patients with a Primary Malignancy Using Hybrid PET/MRI: Is There Value in Adding Contrast-Enhanced MR Imaging?

    Science.gov (United States)

    Lee, Kyung Hee; Park, Chang Min; Lee, Sang Min; Lee, Jeong Min; Cho, Jeong Yeon; Paeng, Jin Chul; Ahn, Su Yeon; Goo, Jin Mo

    2015-01-01

    Purpose To investigate the added value of post-contrast VIBE (volumetric-interpolated breath-hold examination) to PET/MR imaging for pulmonary nodule detection in patients with primary malignancies. Materials and Methods This retrospective institutional review board–approved study, with waiver of informed consent, included 51 consecutive patients who underwent 18F-fluorodeoxyglucose (FDG) PET/MR followed by PET/CT for cancer staging. In all patients, the thorax was examined with pre-and post-contrast VIBE MR with simultaneous PET acquisition. Two readers blinded to the patients’ data independently recorded their level of suspicion for pulmonary nodules based on PET, pre-contrast VIBE, and fused PET/MR images (first session), and reassessed them 4-weeks later after addition of post-contrast VIBE (second session). Jackknife alternative free-response receiver-operating-characteristic (JAFROC) analysis was performed, with PET/CT as the reference standard. Results A total of 151 pulmonary nodules (44 FDG-avid, 107 non-FDG-avid nodules) were detected on PET/CT, including 62 nodules≥5mm in diameter and 89 nodulesPET/MR imaging provided no additional value in the detection of pulmonary nodules. PMID:26065695

  7. The challenges and suffering of caring for people with primary malignant glioma: qualitative perspectives on improving current supportive and palliative care practices.

    Science.gov (United States)

    Collins, Anna; Lethborg, Carrie; Brand, Caroline; Gold, Michelle; Moore, Gaye; Sundararajan, Vijaya; Murphy, Michael; Philip, Jennifer

    2014-03-01

    Carers of patients with high-grade primary malignant glioma (PMG) are known to face extraordinary challenges, as they care for patients with multiple profound and often devastating physical, cognitive and behavioural changes. This study aimed to understand the supportive and palliative care needs in this setting, with a particular focus upon care at the end-of-life, which has hitherto been neglected. This prospective qualitative study undertook in-depth interviews with 23 current and bereaved carers of adults with PMG. Carers were recruited from outpatient and inpatient services of two Australian metropolitan hospitals, including neurosurgery, oncology and palliative care. Thematic analysis was conducted by three independent researchers, using methods informed by grounded theory. Carers described significant needs in relation to three distinct domains: the challenge of caring; the lack of support available to carers and the suffering of caring. The need for care coordination was highlighted as it may enable a series of recommendations for improved care, including: navigation between health providers, individualised, staged information; routine, proactive telephone needs-assessment and emotional support; and early routine integration of palliative care services. The results of this study shed new light on providing timely information and palliative care to support carers. We call for health services to reconsider the current medical model for this patient group, where patients are the centre of care, information and support, towards a more collaborative model which places carers and patients into a partnership.

  8. Mesothelioma - malignant

    Science.gov (United States)

    ... 2016:chap 82. National Cancer Institute. PDQ malignant mesothelioma treatment. Updated August 5, 2015. www.cancer.gov/types/mesothelioma/hp/mesothelioma-treatment-pdq#section/29 . Accessed July 8, 2016. National ...

  9. Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care.

    Science.gov (United States)

    Epstein, Jonathan I; Herawi, Mehsati

    2006-03-01

    to confirm whether routine repeat biopsies should be performed several years following a HGPIN diagnosis on needle biopsy. There were certain results concerning atypical glands suspicious for carcinoma. 1) An average of 5% of needle biopsy pathology reports are diagnosed as atypical glands suspicious for carcinoma. 2) Cases diagnosed as atypical have the highest likelihood of being changed upon expert review and urologists should consider sending such cases for consultation in an attempt to resolve the diagnosis as definitively benign or malignant before subjecting the patient to repeat biopsy. 3) Ancillary techniques using basal cell markers and AMACR (alpha-methyl-acyl-coenzyme A racemase) can decrease the number of atypical diagnoses, and yet one must use these techniques with caution since there are numerous false-positive and false-negative results. 4) The average risk of cancer following an atypical diagnosis is approximately 40%. 5) Clinical and pathological parameters do not help predict which men with an atypical diagnosis have cancer on repeat biopsy. 6) Repeat biopsy should include increased sampling of the initial atypical site, and adjacent ipsilateral and contralateral sites with routine sampling of all sextant sites. Therefore, it is critical for urologists to submit needle biopsy specimens in a manner in which the sextant location of each core can be determined. 7) All men with an atypical diagnosis need re-biopsy within 3 to 6 months. It is critical for urologists to distinguish between a diagnosis of HGPIN and that of atypical foci suspicious for cancer on needle biopsy. These 2 entities indicate different risks of carcinoma on re-biopsy and different recommendations for followup.

  10. Malignant Catatonia

    Directory of Open Access Journals (Sweden)

    Ayca Ozkul

    2010-12-01

    Full Text Available Catatonia is a syndrome characterized by mutism, immobility, negativism, stereotypy, mannerisms, echophenomena, perseveration and passive obedience. The underlying causes can be psychiatric or may be associated with general medical status or neurological diseases. Additionally catatonia has two subtypes as malignant and nonmalignant catatonia. Main symptoms of malignant catatonia are hyperthermia and autonomic symptoms such as tachycardia, tachypnea and hyperhidrosis. It is important to make the diagnosis as early as possible for an appropriate medical treatment. Clinicians should be aware of the fatal outcome of the disease.

  11. Ultrasound surveillance for thyroid malignancies in survivors of childhood cancer following radiotherapy: a single institutional experience.

    Science.gov (United States)

    Li, Zhe; Franklin, Jason; Zelcer, Shayna; Sexton, Tracy; Husein, Murad

    2014-12-01

    Survivors of childhood cancer (SCC) who have received radiotherapy to the head, neck, and upper thorax are at higher risk of developing subsequent thyroid malignancies. As part of the post treatment long-term follow-up protocol, the current Children's Oncology Group guideline recommends surveillance by annual palpation; however, thyroid nodules are difficult to detect by physical examinations alone, and potentially malignancy-harboring nodules may be undetected. Since thyroid ultrasound is a sensitive and noninvasive procedure, it was incorporated in our institutional follow-up protocol. The aim of this study was to examine the outcome of ultrasound screening in this high-risk population. The following describes our experience from 2007 to 2013. A retrospective chart review was conducted on survivors enrolled in our follow-up program. SCC who have received direct or scattered radiation to the thyroid gland, and who were ≥10 years from the diagnosis of primary childhood cancer were considered to be at-risk. Seventy-eight survivors met the inclusion criteria and were screened. Thyroid ultrasound detected thyroid nodule(s) in 46 patients (59%), 17 of which had nodule(s) between 5 and 10 mm (22%), and 15 patients had nodules ≥10 mm (19%). Fourteen patients (18%) underwent fine-needle aspiration biopsy. Six patients (8%) underwent surgery, and 5 (6%) had confirmed papillary carcinoma. At the time of the first ultrasound, thyroid nodules of various sizes were found. However, over time, these nodules demonstrated slow growth rates. Incorporation of thyroid ultrasound into routine follow-up of high-risk SCC may aid in the detection of thyroid malignancies that are not clinically apparent. The use of ultrasound allows detailed characterization of the thyroid nodule and reliable monitoring of nodule progression. In SCC without suspicious nodule(s), it may be reasonable to perform screening ultrasounds less frequently due to the slow growth rate of thyroid nodules

  12. Targeted ultra-deep sequencing unveils a lack of driver-gene mutations linking non-hereditary gastrointestinal stromal tumors and highly prevalent second primary malignancies: random or nonrandom, that is the question

    OpenAIRE

    Lai, Bo-Ru; Wu, Yu-Tung; Kuo, Yung-Chia; Hsu, Hung-Chih; Chen, Jen-Shi; Chen, Tse-Ching; Wu, Ren-Chin; Chiu, Cheng-Tang; Yeh, Chun-Nan; Yeh, Ta-Sen

    2016-01-01

    The association of non-hereditary (sporadic) gastrointestinal stromal tumors (GISTs) and second primary malignancies is known to be nonrandom, although the underlying molecular mechanisms remain unknown. In this study, 136 of 749 (18.1%) patients with sporadic GISTs were found to have additional associated cancers, with gastrointestinal and genitourinary/gynecologic/breast cancers being the most prevalent. Gene mutations in GISTs and their associated colorectal cancers (CRCs) (n=9) were analy...

  13. Heterotopic pancreas presenting as suspicious mass in the gallbladder.

    Science.gov (United States)

    Foucault, Amélie; Veilleux, Hubert; Martel, Guillaume; Lapointe, Réal; Vandenbroucke-Menu, Franck

    2012-11-10

    Heterotopic pancreas is a rare entity. Thirty-three cases in the gallbladder have been reported. We describe the first case of heterotopic pancreas mimicking a gallbladder cancer, identified within a calcified lesion in the thickened posterior wall of the gallbladder. A 72-year-old woman with right upper quadrant pain was referred with a suspicion of gallbladder neoplasia. A CT scan demonstrated a 1 cm thickened posterior wall of the gallbladder with a 2 mm punctate calcification. An open cholecystectomy was carried out without complication. The frozen section demonstrated pancreatic tissue. Heterotopic pancreas of the gallbladder is highly uncommon. It can mimic a neoplastic process in the gallbladder, particularly in the context of calcification. Its malignant potential in the gallbladder is unknown, in contrast to previously described neoplastic transformation with gastric heterotopic pancreas.

  14. A rare case of malignant paraganglioma of urinary bladder.

    Science.gov (United States)

    Shah, Vinaya B; Bhandare, Amit T

    2015-01-01

    Paraganglioma of the urinary bladder is a rare pathologic entity with no definitive histological, immunohistochemical or molecular features to determine its malignant potential. Malignancy is essentially determined by the presence of deep local invasion, invasion of adjacent structures and lymph node or distant metastases. So far, up to 180 cases of paraganglioma have been reported, with bladder mass was given as invasive urothelial carcinoma. Patient underwent radical cystectomy with pelvic lymphadenectomy. The gross morphological brown discoloration of mass on formalin fixation was suspicious of paraganglioma and was confirmed on immunohistochemistry. The diagnosis of malignant paraganglioma was made based on regional lymph node metastases. We describe a rare case of a patient with malignant urinary bladder paraganglioma with main differential diagnostic considerations on the histomorphology.

  15. Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis.

    Science.gov (United States)

    Campanella, Paolo; Ianni, Francesca; Rota, Carlo Antonio; Corsello, Salvatore Maria; Pontecorvi, Alfredo

    2014-05-01

    In order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies. We did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes. The meta-analysis included 41 studies, for a total of 29678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size ≥4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22). Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas. The current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.

  16. Passive Smoking and Breast Cancer - a Suspicious Link.

    Science.gov (United States)

    Malik, Abhidha; Jeyaraj, Pamela Alice; Shankar, Abhishek; Rath, Goura Kishore; Mukhopadhyay, Sandip; Kamal, Vineet Kumar

    2015-01-01

    Breast cancer is the most common malignancy of women in the world. The disease is caused by infectious and non-infectious, environmental and lifestyle factors. Tobacco smoke has been one of the most widely studied environmental factors with possible relevance to breast cancer. The purpose of this study was to assess the impact of tobacco smoking in breast cancer patients in a hospital based cohort and to establish prognostic implications if any. A retrospective audit of 100 women with pathological diagnosis of invasive breast cancer was included in this study. The verbal questionnaire elicited information on current and previous history of exposure to smoking in addition to active smoking. All analyses were adjusted for potential confounders, including stage at presentation, alcohol intake, hormonal replacement therapy, oral contraceptive intake, obesity and menopausal status. The mean age at presentation of breast cancer was 51.4 ± 10.86 years. Mean age of presentation was 53.1±11.5 and 45.7±11.9 years in never smokers and passive smokers, respectively. Age at presentation varied widely in patients exposed to tobacco smoke for >10 years in childhood from 40.3± 12.0 years to 47.7± 13.9 in patients exposed for > 20 years as adults. Among passive smokers, 60.9% were premenopausal and 39.1% of patients were postmenopausal. In never smokers, 71.4% were post menopausal. Expression of receptors in non-smokers vs passive smokers was comparable with no significant differences. Metastatic potential in lung parenchyma was slightly elevated in passive smokers as compared to never smokers although statistically non-significant. An inverse relationship exists between the intensity and duration of smoking and the age at presentation and poor prognostic factors. The results strongly suggest efforts should be taken to prevent smoking, encourage quitting and restrict exposure to second hand smoke in India.

  17. RARE METASTASES OF MALIGNANT MELANOMA

    Directory of Open Access Journals (Sweden)

    Marija Trenkić-Božinović

    2014-09-01

    Full Text Available Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 μm thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S - 100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S - 100 protein ( markers of malignant melanoma , as well as mucins: MUC5AC, MUC2 and CDX2 ( markers of different types of primary gastric carcinoma.

  18. A novel statistical approach for detection of suspicious regions in digital mammogram

    Directory of Open Access Journals (Sweden)

    Z.A. Abo-Eleneen

    2013-07-01

    Full Text Available In this paper, we propose a novel algorithm to detect the suspicious regions on digital mammograms that based on the Fisher information measure. The proposed algorithm is tested different types and categories of mammograms (fatty, fatty-glandular and dense glandular within mini-MIAS database (Mammogram Image Analysis Society database (UK. The proposed method is compared with a different segmentation based information theoretical methods to demonstrate their effectiveness. The experimental results on mammography images showed the effectiveness in the detection of suspicious regions. This study can be a part of developing a computer-aided decision (CAD system for early detection of breast cancer.

  19. Tattoo pigment mimicking metastatic malignant melanoma.

    Science.gov (United States)

    Anderson, L L; Cardone, J S; McCollough, M L; Grabski, W J

    1996-01-01

    The benefits of elective lymph node dissection (ELND) in the treatment of melanoma remain controversial, however, it may be beneficial in some patients. Tattoo pigment from decorative tattoos may migrate to the regional lymph nodes. In patients who develop malignant melanoma and who have been tattooed, this pigment may clinically mimic metastatic disease. We wish to alert clinicians that pigment from tattoos may migrate to the regional lymph nodes. In the unusual instance of a tattooed patient who develops malignant melanoma, when undergoing ELND, surgeons should rely on histologic confirmation of metastatic disease before altering operative plans. ELND for malignant melanoma, in a patient with a history of decorative tattoos that had been removed by dermabrasion, was performed. Black lymph nodes that clinically resembled metastatic disease were identified. Subsequent histologic examination revealed normal lymph node architecture with a heavy collection of black pigment. Mass spectrophotometry showed this pigment to be consistent with tattoo dye. A patient who had undergone dermabrasion for removal of decorative tattoos developed malignant melanoma in the same extremity. Clinically suspicious black lymph nodes were identified during ELND. Histologic examination did not reveal metastatic disease. Additional therapy was not considered intra- or postoperatively even though the clinical suspicion of metastatic disease was high. The patient was not subjected to any unnecessary emotional or physical distress pending histologic confirmation. Tattoo pigment in the lymph nodes may clinically mimic metastatic melanoma. Histologic confirmation of metastatic disease should always be obtained before additional therapy is considered.

  20. 31 CFR 103.20 - Reports by money services businesses of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... immediate attention, such as ongoing money laundering schemes, the money services business shall immediately... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reports by money services businesses of suspicious transactions. 103.20 Section 103.20 Money and Finance: Treasury Regulations Relating to...

  1. 31 CFR 103.15 - Reports by mutual funds of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... FINANCIAL RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS Reports Required To Be Made § 103.15 Reports by mutual funds of suspicious transactions. (a) General. (1) Every investment company (as... pursuant to that Act (for purposes of this section, a “mutual fund”), shall file with the Financial Crimes...

  2. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

    NARCIS (Netherlands)

    Visser, Roelant; Veldkamp, Wouter J. H.; Beijerinck, David; Bun, Petra A. M.; Deurenberg, Jan J. M.; Imhof-Tas, Mechli W.; Schuur, Klaas H.; Snoeren, Miranda M.; den Heeten, Gerard J.; Karssemeijer, Nico; Broeders, Mireille J. M.

    2012-01-01

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was

  3. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography.

    NARCIS (Netherlands)

    Visser, R.; Veldkamp, W.J.H.; Beijerinck, D.; Bun, P.A.; Deurenberg, J.J.; Imhof-Tas, M.W.; Schuur, K.H.; Snoeren, M.M.; Heeten, G.J. den; Karssemeijer, N.; Broeders, M.J.M.

    2012-01-01

    OBJECTIVES: To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. METHODS: Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal).

  4. Anomaly detection driven active learning for identifying suspicious tracks and events in WAMI video

    Science.gov (United States)

    Miller, David J.; Natraj, Aditya; Hockenbury, Ryler; Dunn, Katherine; Sheffler, Michael; Sullivan, Kevin

    2012-06-01

    We describe a comprehensive system for learning to identify suspicious vehicle tracks from wide-area motion (WAMI) video. First, since the road network for the scene of interest is assumed unknown, agglomerative hierarchical clustering is applied to all spatial vehicle measurements, resulting in spatial cells that largely capture individual road segments. Next, for each track, both at the cell (speed, acceleration, azimuth) and track (range, total distance, duration) levels, extreme value feature statistics are both computed and aggregated, to form summary (p-value based) anomaly statistics for each track. Here, to fairly evaluate tracks that travel across different numbers of spatial cells, for each cell-level feature type, a single (most extreme) statistic is chosen, over all cells traveled. Finally, a novel active learning paradigm, applied to a (logistic regression) track classifier, is invoked to learn to distinguish suspicious from merely anomalous tracks, starting from anomaly-ranked track prioritization, with ground-truth labeling by a human operator. This system has been applied to WAMI video data (ARGUS), with the tracks automatically extracted by a system developed in-house at Toyon Research Corporation. Our system gives promising preliminary results in highly ranking as suspicious aerial vehicles, dismounts, and traffic violators, and in learning which features are most indicative of suspicious tracks.

  5. Clinical experiences with photoacoustic breast imaging: the appearance of suspicious lesions

    NARCIS (Netherlands)

    Heijblom, M.

    2014-01-01

    This thesis describes photoacoustic (PA) imaging of suspicious breast lesions. In PA imaging, the tissue of interest is illuminated by short pulses of laser light, usually in the near infrared (NIR) regime. Upon absorption by primarily the tumor vasculature, the light causes a small temperature

  6. 75 FR 63545 - Proposed Collection; Comment Request; Bank Secrecy Act Suspicious Activity Report Database...

    Science.gov (United States)

    2010-10-15

    ... derived through third party data as enhanced data if not provided and Country is US, Mexico or Canada and... corruption (domestic) h. Suspected public/private corruption (foreign) i. Suspicious use of informal value... Country is US, Mexico or Canada and ZIP/Postal Code is provided * 57. ZIP/Postal Code a. (check if...

  7. Methylene Blue as a Diagnostic Aid in the Early Detection of Potentially Malignant and Malignant Lesions of Oral Mucosa.

    Science.gov (United States)

    Lejoy, Abraham; Arpita, Rai; Krishna, Burde; Venkatesh, Naikmasur

    2016-05-01

    In vivo stains are the prompt resources, which have emerged in recent years to aid as clinical diagnostic tools in detecting early potentially malignant and malignant lesions. Toluidine blue, by its property of retaining in the increased DNA and RNA cellular activity areas, aids in delineating the suspicious areas. However, it is hazardous if swallowed, and has been shown to have toxicity to fibroblasts. Methylene blue has a similar chemical structure and exhibits similar physicochemical properties as toluidine blue. It is less toxic to the human body and has recently been proposed for screening some gastrointestinal or prostate tumors. The application of this material in detecting oral lesions has so far not been addressed. The objective of this study was to evaluate the sensitivity and reliability of in vivo staining with methylene blue as a diagnostic adjunct in screening for oral malignant or potentially malignant lesions. The present study involved the examination of 75 patients suspected of having oral malignant or potentially malignant lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions. The overall sensitivity was 95% (100% for malignancy and 92% for potentially malignant lesions) and specificity was 70%. The positive predictive value was 91% and negative predictive value of 80% was observed in the study. We consider that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.

  8. Interstitial brachytherapy with 192-IR in treatment of recurrent malignant primary brain tumors. Braquiterapia intersticial con iridio-192 en el tratamiento de recidivas de tumores cerebrales tras cirugia y radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Cardenes, R.; Martinez, R.; Victoria, C.; Nuez, L.; Clavo, B.; Sancedo, G. (Clinica Puerta de Hierro. Madrid (Spain))

    1994-01-01

    Seven patients with recurrent malignant primary brain tumors after surgery and radiation therapy were treated at the Clinica Puerta de Hierro (Madrid) by interstitial brachytherapy with 192-Ir sources. Implantations were performed using computerized tomography and dose prescription were determined following the Paris system rules for interstitial implants. The means dose deliberated was 50 to 65 Gy to the reference isodoses. At the last follow-up all patients except for one are alive and without evidence of progression of the disease. (Author) 35 refs.

  9. {sup 131}I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kuan-Yin [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); Kao, Chia-Hung [China Medical University, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, Taichung (China); China Medical University Hospital, Department of Nuclear Medicine and PET Center, Taichung (China); Lin, Cheng-Li [China Medical University Hospital, Management Office for Health Data, Taichung (China); China Medical University, College of Medicine, Taichung (China); Huang, Wen-Sheng [Changhua Christian Hospital, Department of Nuclear Medicine, Changhua (China); Yen, Ruoh-Fang [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); National Taiwan University College of Medicine, Department of Radiology, Taipei (China)

    2015-07-15

    The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with {sup 131}I therapy and 1,834 controls (thyroid cancer without {sup 131}I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative {sup 131}I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the {sup 131}I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95 % confidence intervals (CIs). In patients treated with {sup 131}I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95 % CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95 % CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95 % CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95 % CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. {sup 131}I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between {sup 131}I treatment and KCS development. (orig.)

  10. Malignant mesothelioma after radiation treatment for Hodgkin lymphoma

    NARCIS (Netherlands)

    de Bruin, Marie L.; Burgers, Jacobus A.; Baas, Paul; van 't Veer, Mars B.; Noordijk, Evert M.; Louwman, Marieke W. J.; Zijlstra, Josée M.; van den Berg, Hendrik; Aleman, Berthe M. P.; van Leeuwen, Flora E.

    2009-01-01

    Malignant mesothelioma is a relatively uncommon malignancy. Although the pathogenesis is primarily related to asbestos, the disease may be associated with radiation exposure. Recently, increased risks for second primary mesothelioma after radiation for lymphoma have been reported. Because these

  11. Hematuria and urologic malignancies

    National Research Council Canada - National Science Library

    Lien, Yeong-Hau H

    2014-01-01

    ...% of total malignancies and 3.7% of malignancy-related mortality. Asymptomatic microscopic hematuria is the most common presenting sign of urologic malignancies that may lead to early diagnosis and cure of these cancers...

  12. Development of primary malignant melanoma during treatment with a TNF-α antagonist for severe Crohn’s disease: a case report and review of the hypothetical association between TNF-α blockers and cancer

    Directory of Open Access Journals (Sweden)

    Kouklakis G

    2013-03-01

    Full Text Available George Kouklakis,1 Eleni I Efremidou,2 Michael Pitiakoudis,3 Nikolaos Liratzopoulos,2 Alexandros Ch Polychronidis2 1Endoscopy Unit, 2First Surgical Department, 3Second Surgical Department, Medical School, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece Abstract: It is recognized that immunosuppression may lead to reduced immune surveillance and tumor formation. Because of the immunosuppressive properties of tumor necrosis factor (TNF-alpha (TNF-α antagonists, it is plausible that these biologics may increase the risk of the occurrence of malignancies or the reactivation of latent malignancies. TNF-α antagonists have gained momentum in the field of dermatology for treating rheumatoid arthritis and psoriasis, and they have revolutionized the treatment of other inflammatory autoimmune diseases such as refractory Crohn's disease. However, there is accumulating evidence that TNF-α inhibitors slightly increase the risk of cancer, including malignant melanoma (MM. The authors herein report the case of a 54-year-old female patient who developed a primary MM during treatment with adalimumab for severe Crohn’s disease resistant to successive medical therapies. The patient had been receiving this TNF-α blocker therapy for 3 years before the occurrence of MM. After wide surgical excision of the lesion and staging (based on Breslow thickness and Clark level, evaluation with a whole-body computed tomography scan was negative for metastatic disease. The long duration of the adalimumab therapy and the patient's lack of a predisposition to skin cancer suggest an association between anti-TNF-α drugs and melanocytic proliferation. The authors also review the literature on the potential association between anti-TNF regimens and the occurrence of malignancies such as melanocytic proliferations. There is a substantial hypothetical link between anti-TNF-α regimens such as adalimumab and the potential for cancers

  13. Secondary ovarian malignancies: frequency, origin, and characteristics.

    NARCIS (Netherlands)

    Waal, Y.R. de; Thomas, C.M.G.; Oei, A.L.M.; Sweep, F.C.; Massuger, L.F.A.G.

    2009-01-01

    OBJECTIVE: To evaluate the frequency of metastatic tumors among malignant ovarian neoplasms, the site distribution of the primary malignancies that give rise to ovarian metastasis and the clinicopathologic features of metastatic tumors. METHODS: We analyzed a total number of 116 patients diagnosed

  14. Isolated Pancreatic Metastasis from Malignant Melanoma: Is ...

    African Journals Online (AJOL)

    Pancreatic metastatic tumors are uncommon and account for less than 2% of all pancreatic carcinomas.[1] Renal-cell cancer, colorectal cancer, melanoma and sarcoma are the most common sites of primary malignancy.[1] Around one-third of patients with malignant melanoma develop metastases.[2] Metastatic melanoma ...

  15. Malignant hypercalcemia.

    Science.gov (United States)

    Basso, U; Maruzzo, M; Roma, A; Camozzi, V; Luisetto, G; Lumachi, F

    2011-01-01

    Malignancy-associated hypercalcemia (MAH) is one of the clinical emergencies in medical oncology, arising early or, more often, during the late phases of disease. Prevalence cannot be estimated accurately because previous figures of 5-30% of all cancer patients have progressively reduced thanks to the widespread use of bisphosphonates for the prevention of skeletal events. The classic distinction of humoral vs. osteolytic hypercalcemia is still relevant from an etiological point of view, but should not be considered as a rigid alternative since both mechanisms may be active in the same patients and the activation of the RANKL pathway is a common pathogenetic mechanism. Parathyroid hormone-related protein mimics the effects of PTH on the bone and kidney (tubular calcium resorption) and may represent an attractive druggable target, but additional agents (cytokines or other mediators) as well as ectopic production of 1,25(OH)₂D₃ may give an important contribution to humoral hypercalcemia. Conversely, bone invasion by cancer cells determines massive bone reabsorption due to the release of proteolytic enzymes and pro-osteolytic agents with paracrine activity on adjacent bone and stromal cells. When cancer patients develop headache, confusion, de-hydration and tremors hypercalcemia should be suspected although slow rise of calcium levels may produce more indolent symptoms. Bisphosphonates (with or without hydration and diuretics) may efficiently control MAH but only if an active treatment for the underlying cancer is promptly started. The anti-RANKL monoclonal antibody denosumab represents a novel agent able to revert the vicious cycle of bone metastases and data from phase III studies are currently showing promising activity in reverting bone resorption with manageable toxicity.

  16. Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.

    Science.gov (United States)

    Addison, Naa Okaikor; Pfau, Stefanie; Koka, Eric; Aboagye, Samuel Yaw; Kpeli, Grace; Pluschke, Gerd; Yeboah-Manu, Dorothy; Junghanss, Thomas

    2017-02-01

    Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier. Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC) center and a municipal hospital, secondary health care (SHC) center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance. 53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7%) compared to 40% at the SHC center, where the majority required split-skin grafting (75%) or excision (12.5%). Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma) and at the SHC center (malignant ulceration, chronic lymphedema) in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7%) of analyzed wounds were

  17. Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.

    Directory of Open Access Journals (Sweden)

    Naa Okaikor Addison

    2017-02-01

    Full Text Available Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier.Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC center and a municipal hospital, secondary health care (SHC center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance.53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7% compared to 40% at the SHC center, where the majority required split-skin grafting (75% or excision (12.5%. Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma and at the SHC center (malignant ulceration, chronic lymphedema in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7% of analyzed

  18. Punch 'scoring': a technique that facilitates melanoma diagnosis of clinically suspicious pigmented lesions.

    Science.gov (United States)

    Grogan, Judith; Cooper, Caroline L; Dodds, Tristan J; Guitera, Pascale; Menzies, Scott W; Scolyer, Richard A

    2017-08-10

    Early recognition and accurate diagnosis underpins melanoma survival. Identifying early melanomas arising in association with pre-existing lesions is often challenging. Clinically suspicious foci, however small, must be identified and examined histologically. This study assessed the accuracy of punch biopsy 'scoring' of suspicious foci in excised atypical pigmented skin lesions to identify early melanomas. Forty-one excised pigmented skin lesions with a clinically/dermoscopically focal area of concern for melanoma, with the suspicious focus marked prior to excision with a punch biopsy 'score' (a partial incision into the skin surface), were analysed. Melanoma was diagnosed in nine of 41 cases (22%). In eight of nine cases (89%) the melanoma was associated with a naevus, and in seven of nine (88%) cases the melanoma was identified preferentially by the scored focus. In six of nine cases (67%), the melanoma was entirely encompassed by the scored focus. In one case of melanoma in situ, the diagnostic material was identified only on further levelling through the scored focus. In 28 of 32 of non-melanoma cases (88%), the scored focus identified either diagnostic features of a particular lesion or pathological features that correlated with the clinical impression of change/atypia including altered architecture or distribution of pigmentation, features of irritation or regression. The 'punch scoring technique' allows direct clinicopathological correlation and facilitates early melanoma diagnosis by focusing attention on clinically suspicious areas. Furthermore, it does not require special expertise in ex-vivo clinical techniques for implementation. Nevertheless, in some cases examination of the lesion beyond the scored focus is also necessary to make a diagnosis of melanoma. © 2017 John Wiley & Sons Ltd.

  19. Utilizing Social Media to Further the Nationwide Suspicious Activity Reporting Initiative

    Science.gov (United States)

    2012-09-01

    Initiative NYPD New York Police Department OSINT Open Source Intelligence P2P Peer to Patent SAR Suspicious Activity Report SMS Short Message (or...Media as an Open-Source Intelligence Tool Several government documents outline the use of social media as an Open Source intelligence tool ( OSINT ...social media to be an OSINT tool that federal, state, and local law enforcement agencies should use to develop timely, relevant, and actionable

  20. Metastases and primary tumors around dental implants: A literature review and case report of peri-implant pulmonary metastasis.

    Science.gov (United States)

    Pfammatter, Chantal; Lindenmüller, Irène Hitz; Lugli, Alessandro; Filippi, Andreas; Kühl, Sebastian

    2012-01-01

    To perform a literature review on peri-implant metastases and primary malignoma and report a case of a pulmonary metastasis around dental implants of the anterior mandibular jaw that mimicked peri-implantitis. A literature search of publications from June 1980 to June 2011 in the PubMed/Medline database was performed to collect information about the type, incidence, and localization of malignant primary tumors and metastases around dental implants and to evaluate potential risk factors. A descriptive statistic was performed based on the collected data with regard to the type and/or origin of tumor, its localization, and the patient's age and sex. A total of 1,795 articles were considered for evaluation. Peri-implant metastases are described in three articles, and peri-implant primary tumors were found in 14 publications. Of all peri-implant metastases, no associated risk factors are mentioned. Those of the peri-implant tumors are alterations of the peri-implant mucosa (such as oral lichen planus, verrucous leukoplakia, and ulcer). Most of the primary tumors are squamous cell carcinoma. The mean age of the patients with peri-implant metastases was 68 years; for the peri-implant primary tumors, it was 71 years. Peri-implant metastases and primary tumors are rare. Every untypical or refractory reaction to the treatment of peri-implantitis is suspicious for malignancy as long as the contrary remains unproven.

  1. Segmental neurofibromatosis and malignancy.

    Science.gov (United States)

    Dang, Julie D; Cohen, Philip R

    2010-01-01

    Segmental neurofibromatosis is an uncommon variant of neurofibromatosis type I characterized by neurofibromas and/or café-au-lait macules localized to one sector of the body. Although patients with neurofibromatosis type I have an associated increased risk of certain malignancies, malignancy has only occasionally been reported in patients with segmental neurofibromatosis. The published reports of patients with segmental neurofibromatosis who developed malignancy were reviewed and the characteristics of these patients and their cancers were summarized. Ten individuals (6 women and 4 men) with segmental neurofibromatosis and malignancy have been reported. The malignancies include malignant peripheral nerve sheath tumor (3), malignant melanoma (2), breast cancer (1), colon cancer (1), gastric cancer (1), lung cancer (1), and Hodgkin lymphoma (1). The most common malignancies in patients with segmental neurofibromatosis are derived from neural crest cells: malignant peripheral nerve sheath tumor and malignant melanoma. The incidence of malignancy in patients with segmental neurofibromatosis may approach that of patients with neurofibromatosis type I.

  2. Separating Facts from Fiction: Linguistic Models to Classify Suspicious and Trusted News Posts on Twitter

    Energy Technology Data Exchange (ETDEWEB)

    Volkova, Svitlana; Shaffer, Kyle J.; Jang, Jin Yea; Hodas, Nathan O.

    2017-07-30

    Pew research polls report 62 percent of U.S. adults get news on social media (Gottfried and Shearer, 2016). In a December poll, 64 percent of U.S. adults said that “made-up news” has caused a “great deal of confusion” about the facts of current events (Barthel et al., 2016). Fabricated stories spread in social media, ranging from deliberate propaganda to hoaxes and satire, contributes to this confusion in addition to having serious effects on global stability. In this work we build predictive models to classify 130 thousand news tweets as suspicious or verified, and predict four subtypes of suspicious news – satire, hoaxes, clickbait and propaganda. We demonstrate that neural network models trained on tweet content and social network interactions outperform lexical models. Unlike previous work on deception detection, we find that adding syntax and grammar features to our models decreases performance. Incorporating linguistic features, including bias and subjectivity, improves classification results, however social interaction features are most informative for finer-grained separation between our four types of suspicious news posts.

  3. Malignant hyperthermia

    Directory of Open Access Journals (Sweden)

    Pollock Neil

    2007-04-01

    Full Text Available Abstract Malignant hyperthermia (MH is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stresses such as vigorous exercise and heat. The incidence of MH reactions ranges from 1:5,000 to 1:50,000–100,000 anesthesias. However, the prevalence of the genetic abnormalities may be as great as one in 3,000 individuals. MH affects humans, certain pig breeds, dogs, horses, and probably other animals. The classic signs of MH include hyperthermia to marked degree, tachycardia, tachypnea, increased carbon dioxide production, increased oxygen consumption, acidosis, muscle rigidity, and rhabdomyolysis, all related to a hypermetabolic response. The syndrome is likely to be fatal if untreated. Early recognition of the signs of MH, specifically elevation of end-expired carbon dioxide, provides the clinical diagnostic clues. In humans the syndrome is inherited in autosomal dominant pattern, while in pigs in autosomal recessive. The pathophysiologic changes of MH are due to uncontrolled rise of myoplasmic calcium, which activates biochemical processes related to muscle activation. Due to ATP depletion, the muscle membrane integrity is compromised leading to hyperkalemia and rhabdomyolysis. In most cases, the syndrome is caused by a defect in the ryanodine receptor. Over 90 mutations have been identified in the RYR-1 gene located on chromosome 19q13.1, and at least 25 are causal for MH. Diagnostic testing relies on assessing the in vitro contracture response of biopsied muscle to halothane, caffeine, and other drugs. Elucidation of the genetic changes has led to the introduction, on a limited basis so far, of genetic testing for susceptibility to MH. As the sensitivity of genetic testing increases, molecular genetics will be used for identifying those at risk with

  4. Malignant Nodular Hidradenoma of Face

    Directory of Open Access Journals (Sweden)

    Bansal N

    2014-10-01

    Full Text Available We report a case of malignant nodular hidradenoma in an old woman, who presented with a nodular swelling in the right side of nose near the medial canthus of the right eye. Wide excision of the nodular mass with a clear margin of healthy surrounding tissue was performed along with primary closure. Post operatively, adjuvant radiation therapy was given on a telecobalt machine due to the presence of high risk features. In general, malignant forms of hidradenomas are not usual and treatment strategies should be individualized.

  5. Is there any additional benefit of contrast-enhanced CT as part of routine PET/CT protocols for the differentiation of suspicious incidental gastrointestinal 2-deoxy-{sup 18}F-FDG uptake?

    Energy Technology Data Exchange (ETDEWEB)

    Brendle, Cornelia Bettina; Aschoff, Phillip; Kratt, Thomas; Schraml, Christina; Reimold, Matthias; Claussen, Claus Detlef; Pfannenberg, Christina Anna [University Hospital Tuebingen, Tuebingen (Germany)

    2013-12-15

    Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.

  6. The clinical impact of 18F-FDG PET/CT to detect suspicious recurred thyroid cancer with differentiated type before high dose radioactive iodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chang, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    The purpose of this study was to evaluate the usefulness of 18F-FDG PET/CT (PET/CT) in suspicious recurred thyroid cancer before high dose of radioactive iodine therapy (RAI therapy). PET/CT was performed after injecting 370-555MBq of 18F-FDG in 23 patients prior to RAI therapy. RAI therapy (212 58 mCi) was performed, and thyroglobulin (Tg) and anti-thyroglobulin antibody (anti-TG ab) during TSH stimulation was measured. The interval between PET/CT and RAI scan was 41 50 day. 15 patients were confirmed as recurred thyroid cancer (pathologic diagnosis: 10), whereas 8 patients were diagnosed as remission status (pathologic diagnosis: 3). PET/CT had 80.0% (12/15) of sensitivity and 75.0% (6/8) of specificity. TG and RAI scan had 80.0% (12/15) and 75% (6/8), 80% (12/15) and 37.5% (3/8) of sensitivity and specificity, respectively. Combination of PET/CT and TG increased the sensitivity (93.3%; 14/15) and specificity (87.5%; 7/8). There was 25 suspicious lesions (19 malignant lesion, 6 benign lesion) in lesion-based study. PET/CT had 84.5% and 83.3% of sensitivity and specificity but RAI scan had 89.5% and 16.7%, respectively. Five false positive sites of RAI scan were diagnosed as fungus ball of lung, calcified mediastinal LN, and post op induced change such as suture granuloma. PET/CT revealed 80% (3/5) of them as benign lesions. Even though PET/CT had similar sensitivity with high dose of RAI scan, it had a better discriminating nature to detect benign lesion. We could diminish the unnecessary high dose of RAI therapy using FDG PET/CT.

  7. Clinical and Imaging Follow-up Practices after Transarterial Therapy for Primary and Secondary Hepatic Malignancies: Results of an Online Survey.

    Science.gov (United States)

    Gaba, Ron C; Baerlocher, Mark O; Nikolic, Boris; Venkatesan, Aradhana M; Lewandowski, Robert J

    2015-12-01

    To characterize practices and quantify variation in longitudinal follow-up approaches among interventional radiologists (IRs) after liver transarterial locoregional therapy (LRT) in contemporary Interventional Oncology practice. In November/December 2014, Society of Interventional Radiology members were invited to participate in a survey regarding clinical and imaging follow-up of liver cancer patients treated with transarterial LRT. On survey closure, responses were compiled and analyzed. The 30-item survey response rate was 11% (361 of 3290). Respondents were predominantly American IRs (311 of 355, 88%) who perform 1-5 LRTs monthly (196 of 354, 55%). Most (305 of 336, 91%) IRs reported longitudinal follow-up, with patient encounters within 1-month (73%, 211 of 290) postprocedure and every 3 months (68%, 196 of 287) thereafter and involvement in imaging (up to 80%, 235 of 290) ordering and evaluation. Preferred timing of first follow-up imaging (1 month vs. 3 months) and response criteria used (mRECIST favored) varied. Although IRs are actively involved in clinical and imaging follow-up of patients with liver malignancies treated with transarterial LRTs, there are differences in imaging frequency and response assessment. These data may serve as a starting point for standardization of LRT follow-up. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  8. Pulmonary Endogenous Fluorescence Allows the Distinction of Primary Lung Cancer from the Perilesional Lung Parenchyma.

    Directory of Open Access Journals (Sweden)

    Lucile Gust

    Full Text Available Pre-therapeutic pathological diagnosis is a crucial step of the management of pulmonary nodules suspected of being non small cell lung cancer (NSCLC, especially in the frame of currently implemented lung cancer screening programs in high-risk patients. Based on a human ex vivo model, we hypothesized that an embedded device measuring endogenous fluorescence would be able to distinguish pulmonary malignant lesions from the perilesional lung tissue.Consecutive patients who underwent surgical resection of pulmonary lesions were included in this prospective and observational study over an 8-month period. Measurements were performed back table on surgical specimens in the operative room, both on suspicious lesions and the perilesional healthy parenchyma. Endogenous fluorescence signal was characterized according to three criteria: maximal intensity (Imax, wavelength, and shape of the signal (missing, stable, instable, photobleaching.Ninety-six patients with 111 suspicious lesions were included. Final pathological diagnoses were: primary lung cancers (n = 60, lung metastases of extra-thoracic malignancies (n = 27 and non-tumoral lesions (n = 24. Mean Imax was significantly higher in NSCLC targeted lesions when compared to the perilesional lung parenchyma (p<0,0001 or non-tumoral lesions (p<0,0001. Similarly, photobleaching was more frequently found in NSCLC than in perilesional lung (p<0,0001, or in non-tumoral lesions (p<0,001. Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions. Considering lung metastases, both mean Imax and wavelength of the targeted lesions were not different from those of the perilesional lung tissue. In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01.Our results demonstrate that endogenous fluorescence applied to the diagnosis of lung nodules allows

  9. Risk of second primary malignancies in women with breast cancer : Results from the European prospective investigation into cancer and nutrition (EPIC)

    NARCIS (Netherlands)

    Ricceri, Fulvio; Fasanelli, Francesca; Giraudo, Maria Teresa; Sieri, Sabina; Tumino, Rosario; Mattiello, Amalia; Vagliano, Liliana; Masala, Giovanna; Quirõs, J. Ramõn; Travier, Noemie; Sánchez, María José; Larranaga, Nerea; Chirlaque, María Dolores; Ardanaz, Eva; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Chang-Claude, Jenny; Kaaks, Rudolf; Boeing, Heiner; Clavel-Chapelon, Françoise; Kvaskoff, Marina; Dossus, Laure; Trichopoulou, Antonia; Benetou, Vassiliki; Adarakis, George; Bueno-De-Mesquita, H. Bas|info:eu-repo/dai/nl/06929528X; Peeters, Petra H.|info:eu-repo/dai/nl/074099655; Sund, Malin; Andersson, Anne; Borgquist, Signe; Butt, Salma; Weiderpass, Elisabete; Skeie, Guri; Khaw, Kay Tee; Travis, Ruth C.; Rinaldi, Sabina; Romieu, Isabelle; Gunter, Marc; Kadi, Mai; Riboli, Elio; Vineis, Paolo; Sacerdote, Carlotta

    2015-01-01

    Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second

  10. Primary Gallbladder Small Lymphocytic Lymphoma as a Rare Postcholecystectomy Finding

    Directory of Open Access Journals (Sweden)

    Kyriakos Psarras

    2014-01-01

    Full Text Available Introduction. Primary lymphoma of the gallbladder is an extremely rare entity with approximately 50 cases reported so far. In many of these cases the presenting symptoms were mimicking symptomatic gallstone disease and the diagnosis was made postoperatively, especially when the preoperative imaging results were far from suspicious for malignant disease. Patients and Methods. We report a case of primary lymphoma of the gallbladder in an 85-year-old man with gallstone disease, who was admitted for elective cholecystectomy 2 months after an episode of acute cholecystitis and pancreatitis. Histological evaluation of the specimen revealed a small lymphocytic lymphoma of the gallbladder. This type of primary gallbladder lymphoma has not been previously reported. Discussion. The most common primary lymphomas of the gallbladder are MALT lymphomas and diffuse large B-cell lymphomas, although a variety of other histological types have been reported. The association of these lesions with chronic inflammation is the most convincing theory for their pathogenesis. For lesions confined to the gallbladder, cholecystectomy is considered to be sufficient, while supplementary chemotherapy significantly improves prognosis in more advanced disease.

  11. Oral non-squamous malignant tumors; diagnosis and treatment.

    Science.gov (United States)

    van der Waal, Rutger; van der Waal, Isaäc

    2007-11-01

    Some 90% of oral cancers consist of squamous cell carcinomas that arise from the oral mucosa. The remaining 10% of malignancies consist of malignant melanomas, carcinomas of the intraoral salivary glands, sarcomas of the soft tissues and the bones, malignant odontogenic tumors, non-Hodgkin's lymphomas and metastases from primary tumors located elsewhere in the body. These malignancies will be briefly reviewed and discussed. The emphasis is on diagnosis and management.

  12. Enterobiasis-related inflammatory caecal polyp masquerading as a malignancy

    Science.gov (United States)

    Elsaid, Nada; Mahmood, Humza; Tekkis, Paris; Tan, Emile

    2014-01-01

    Summary A 55 -year-old Asian man was seen in the emergency department with bleeding per rectum. He was a teetotaller and had no previous abdominal surgery. He did, however, report a change in bowel habit towards constipation. He underwent colonoscopy which revealed a lesion, highly suspicious of malignancy, in the caecum. On review by two consultants, a decision to completely resect this lesion was made. Histological analysis of the polypoidal growth showed it to be a consequence of chronic infection with the helminth Enterobius vermicularis. Importantly, there was no evidence of dysplastic or malignant cells. The patient was subsequently discharged with a 3-day course of antihelminthic mebendazole and reassured that his per rectal bleeding was most likely due to haemorrhoids discovered at rectal examination. PMID:24429050

  13. Typically atypical: histiocytoid Sweet syndrome, associated with malignancy.

    Science.gov (United States)

    Hünermund, Anika; Wendel, Ana-Maria; Geissinger, Eva; Bröcker, Eva-Bettina; Stoevesandt, Johanna

    2011-09-01

    Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by a dramatic onset of high fever, neutrophilia and typical skin lesions. About 20 % of patients have an associated malignancy, most commonly hematologic diseases. Chronic and paucisymptomatic manifestations of Sweet syndrome may be misdiagnosed or misinterpreted as harmless, resulting in delayed diagnosis. "Atypical" manifestations are especially suspicious for associated malignancies. This is demonstrated by a 39-year old patient with chronic and afebrile disease who was referred to our clinic only after symptoms had persisted for several months. By that point, an underlying nodular lymphocyte predominant Hodgkin's lymphoma had already reached an advanced stage. Skin biopsies revealed dermal infiltrates of histiocytoid cells of myelogenous origin, supporting a diagnosis of histiocytoid Sweet syndrome. Specific cutaneous infiltrates associated with myelogenous leukemia were ruled out. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

  14. Temozolomide in malignant glioma

    Directory of Open Access Journals (Sweden)

    Gregor Dresemann

    2010-07-01

    Full Text Available Gregor DresemannCenter for Neurooncology at Aerztehaus Velen, Velen, GermanyAbstract: Glioblastoma multiforme WHO grade IV (GBM is the most aggressive ­malignant glioma and the most frequent primary tumor of the central nervous system. The median ­survival of newly diagnosed GBM patients was between 9 to 12 months prior to treatment with ­temozolomide being introduced. Primary resection that is as complete as possible is recommended for malignant glioma. Conventional fractionated irradiation 55 to 60 gy with concomitant temozolomide followed by standard temozolomide 6 cycles (5/28 (EORTC/NCIC-regime published by R Stupp in 2005 is the standard of care for newly diagnosed GBM after surgery, independent of the methylation status of the MGM-T gene promoter. Age is no ­contraindication for treatment with temozolomide, although comorbidity and performance status have to be ­considered. For temozolomide naive GBM and astrocytoma grade III patients with disease progression, temozolomide is still the treatment of choice outside of clinical studies. A ­general consensus regarding the schedule of choice has not yet been achieved; so far the 5 out of 28 days regimen (5/28 is the standard of care in most countries. Patients with disease progression after standard temozolomide (5/28 are candidates for clinical studies. Outside of clinical ­studies, dose-dense (7/7, prolonged (21/28, or metronomic (28/28 temozolomide, or alternatively a nitrosourea-based regimen can be an option. The excellent toxicity profile of ­temozolomide allows for various combinations with antitumor agents. None of these ­combinations, however, have been demonstrated to be statistically significantly superior compared to temozolomide alone. The role of lower dosed, dose-dense, or continuous regimen with or without drug combination and the role of temozolomide for newly diagnosed astrocytoma grade III and low grade glioma still has to be determined.Keywords: glioblastoma

  15. Targeted ultra-deep sequencing unveils a lack of driver-gene mutations linking non-hereditary gastrointestinal stromal tumors and highly prevalent second primary malignancies: random or nonrandom, that is the question.

    Science.gov (United States)

    Lai, Bo-Ru; Wu, Yu-Tung; Kuo, Yung-Chia; Hsu, Hung-Chih; Chen, Jen-Shi; Chen, Tse-Ching; Wu, Ren-Chin; Chiu, Cheng-Tang; Yeh, Chun-Nan; Yeh, Ta-Sen

    2016-12-13

    The association of non-hereditary (sporadic) gastrointestinal stromal tumors (GISTs) and second primary malignancies is known to be nonrandom, although the underlying molecular mechanisms remain unknown. In this study, 136 of 749 (18.1%) patients with sporadic GISTs were found to have additional associated cancers, with gastrointestinal and genitourinary/gynecologic/breast cancers being the most prevalent. Gene mutations in GISTs and their associated colorectal cancers (CRCs) (n=9) were analyzed using a panel of 409 cancer-related genes, while a separate group of 40 sporadic CRCs not associated with GISTs served as controls. All 9 of the GISTs had either KIT (8 of 9) or PDGFRA (1 of 9) mutations that were not present in their associated CRCs. Conversely, all but one of the 9 GIST-associated CRCs exhibited an APC mutation, a TP53 mutation or both, while none of their corresponding GISTs harbored either APC or TP53 mutations. The genetic profile of CRCs with and without associated GISTs did not differ. Although population-based studies and case series worldwide, including ours, have unanimously indicated that the GIST-CRC association is nonrandom, our targeted ultra-deep sequencing unveiled a lack of driver-gene mutations linking sporadic GISTs to highly prevalent second primaries. Further studies are needed to elucidate other genetic alterations that may be responsible for this puzzling contradiction.

  16. Overview of hypercalcemia of malignancy.

    Science.gov (United States)

    Solimando, D A

    2001-11-15

    The etiology, pathophysiology, and diagnosis of hypercalcemia associated with malignant diseases are discussed. In humans, calcium is controlled by three mechanisms: parathyroid hormone, which regulates bone resorption and renal reabsorption of calcium; calcitonin, an antagonist of parathyroid hormone; and cholecalciferol, which regulates calcium absorption from the gastrointestinal tract. Hypercalcemia of malignancy (HCM) results primarily from increased bone resorption by osteoclasts and, to a lesser extent, from increased renal tubular reabsorption. In most tumors, parathyroid hormone-related protein (PTHrP) is the primary mediator of calcium. PTHrP stimulates increased bone resorption by osteoclasts. This stimulation also activates transforming growth factor-beta (TGF-beta), which stimulates tumor cells, thus perpetuating the cycle. Hypercalcemia is usually defined as a serum calcium concentration greater than 12 mg/dL, corrected for the serum albumin concentration. In diagnosing HCM, it is important to rule out other causes of hypercalcemia, such as primary hyperparathyroidism.

  17. Informing cancer patient based on his type of personality: the suspicious (paranoid) patient.

    Science.gov (United States)

    Kallergis, G

    2013-01-01

    Imparting bad news had always been an unpleasant task for the physician, as shown from ancient years to our days. In the healthcare sector and as far as the cancer patient is concerned, the imparting of bad news is performed by the patient's doctor within a therapeutic relationship of course. The fundamental question is how a therapist could tailor the information to any patient and if "Is it possible to determine who should be told what, when and how ?". The aim of this paper was to describe the suspicious character or type of personality thoroughly so that any physician can make a diagnosis and tailor the information strategy to the patient's needs. As method of research was used the qualitative method through groups with doctors and nurses, while research within groups lasted for 5 years. The degree of informing of the suspicious personality in the range "minimal - small - medium - large - very large" is : the degree of denial varies between large and very large. The degree of informing varies between medium and small and sometimes minimal. Informing the Family: The hardest family to deal with. Pay attention to litigious mania. Avoid confrontation or be drawn into agreeing with the family views.

  18. Automated linking of suspicious findings between automated 3D breast ultrasound volumes

    Science.gov (United States)

    Gubern-Mérida, Albert; Tan, Tao; van Zelst, Jan; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    Automated breast ultrasound (ABUS) is a 3D imaging technique which is rapidly emerging as a safe and relatively inexpensive modality for screening of women with dense breasts. However, reading ABUS examinations is very time consuming task since radiologists need to manually identify suspicious findings in all the different ABUS volumes available for each patient. Image analysis techniques to automatically link findings across volumes are required to speed up clinical workflow and make ABUS screening more efficient. In this study, we propose an automated system to, given the location in the ABUS volume being inspected (source), find the corresponding location in a target volume. The target volume can be a different view of the same study or the same view from a prior examination. The algorithm was evaluated using 118 linkages between suspicious abnormalities annotated in a dataset of ABUS images of 27 patients participating in a high risk screening program. The distance between the predicted location and the center of the annotated lesion in the target volume was computed for evaluation. The mean ± stdev and median distance error achieved by the presented algorithm for linkages between volumes of the same study was 7.75±6.71 mm and 5.16 mm, respectively. The performance was 9.54±7.87 and 8.00 mm (mean ± stdev and median) for linkages between volumes from current and prior examinations. The proposed approach has the potential to minimize user interaction for finding correspondences among ABUS volumes.

  19. Validation of the EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis.

    Science.gov (United States)

    Burgers, Leonie E; Siljehult, Filip; Ten Brinck, Robin M; van Steenbergen, Hanna W; Landewé, Robert B M; Rantapää-Dahlqvist, Solbritt; van der Helm-van Mil, Annette H M

    2017-12-01

    Recently a EULAR-taskforce defined arthralgia suspicious for progression to RA, in order to allow inclusion of homogeneous sets of arthralgia patients in clinical studies. This longitudinal study aimed (i) to validate this definition in arthralgia patients in whom rheumatologists felt that imminent RA was more likely than other arthralgias [clinically suspect arthralgia (CSA)], that is, the target population fulfilling the entry criterion, and (ii) to explore the performance in arthralgia patients who were referred to secondary care prior to rheumatological evaluation, hence ignoring the entry criterion. The definition was assessed in 241 Dutch patients identified with CSA by rheumatologists and 113 patients referred to the Umeå university hospital with recent-onset arthralgia in small joints. The external reference was arthritis development definition (⩾3/7 parameters present) had an increased risk for developing arthritis compared with definition-negative CSA patients (hazard ratio = 2.1, 95% CI: 0.9, 4.7). The sensitivity was 84% and the positive predictive value 30%. In arthralgia patients in whom the definition was applied before rheumatological evaluation, a positive definition was neither sensitive (10%) nor predictive (positive predictive value 3%). The EULAR definition of arthralgia suspicious for progression to RA is sensitive when used to support the rheumatologist's opinion on imminent RA. This validation study shows that the definition, when used as designed, further homogenizes patients that rheumatologists consider at risk for RA. To arrive at a high specificity, the clinical definition needs to be combined with biomarkers.

  20. [Chemotherapy of malignant bone tumors].

    Science.gov (United States)

    Höffken, K; Seeber, S; Gallmeier, W M; Bruntsch, U; Hossfeld, D K; Schmidt, C G

    1977-04-01

    In several primary malignant tumors significant improvement of formely bad prognosis has been achieved by the introduction of new cytostatic compounds and the study of new cytostatic combination regimens. Adjuvant chemotherapy in osteosarcoma and Ewing's sarcoma led to remarkable increase in survival rates. Leaning on natural history and on remission rates reached by cytostatic treatment in metastasizing stages of disease, proposals for adjuvant chemotherapy are made and chemotherapy regimen appliable on out-patient basis is described.

  1. Malignant endobronchial lesions of adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Bellah, R.D. (Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States)); Mahboubi, S. (Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States)); Berdon, W.E. (Dept. of Radiology, Babies Hospital/Columbia Presbyterian Medical Center, New York, NY (United States))

    1992-12-01

    Rare primary endobronchial malignancies were diagnosed in four adolescents: atypical bronchial carcinoid, mucoepidermoid carcinoma, bronchogenic (squamous cell) carcinoma, and non-Hodgkin's lymphoma. Metastatic disease was evident in each case. Three of the four patients died within one year of diagnosis. This paper describes each of these entities, illustrates their plain film and CT abnormalities (bronchial 'cut-off', hilar mass, local congestive edema, lobar collapse, hyperinflation), and discusses the utility of CT in their diagnosis. (orig.)

  2. Malignant phyllodes breast tumor

    OpenAIRE

    Lisa R. Shah-Patel, MD

    2017-01-01

    Malignant phyllodes tumor is a rare tumor of the breast occurring in females usually between the ages of 35 and 55 years. It is often difficult to distinguish benign from malignant phyllodes tumors from other benign entities such as fibroadenomas. This case presentation demonstrates a woman with malignant phyllodes tumor treated with mastectomy with abdominal skin flap reconstruction.

  3. Malignant phyllodes breast tumor

    Directory of Open Access Journals (Sweden)

    Lisa R. Shah-Patel, MD

    2017-12-01

    Full Text Available Malignant phyllodes tumor is a rare tumor of the breast occurring in females usually between the ages of 35 and 55 years. It is often difficult to distinguish benign from malignant phyllodes tumors from other benign entities such as fibroadenomas. This case presentation demonstrates a woman with malignant phyllodes tumor treated with mastectomy with abdominal skin flap reconstruction.

  4. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

    Directory of Open Access Journals (Sweden)

    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  5. Primary chemotherapy and pre surgical radiation therapy in patients with stage II, locally-advanced, non inflammatory breast malignancies measuring more than 3 cm in diameter; Chimiotherapie et radiotherapie a dose pre-operatoire des cancers du sein stade II de plus de 3 cm de diametre et localement avances, non inflammatoires

    Energy Technology Data Exchange (ETDEWEB)

    Buffat, L.; Touboul, E.; Deniaud, E.; Belkacemi, Y.; Benmiloud, M.; Laugier, A.; Schlienger, M.; Housset, M. [Hopital Tenon, 75 - Paris (France); Lefranc, J.P.; Blondon, J. [Hopital Pitie-Salpetriere, 75 - Paris (France)

    1997-09-01

    Our data suggest that the response to primary chemotherapy followed by pre surgical radiation therapy of locally-advanced non inflammatory or stage II breast malignancies measuring more than 3 cm in diameter can be used to select patients eligible for breast conservation therapy. The impact of this treatment modality on survival requires further studies. (N.C.). 52 refs.

  6. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy.

  7. Diagnostic efficiency of toluidine blue with Lugol′s iodine in oral premalignant and malignant lesions

    Directory of Open Access Journals (Sweden)

    Nagaraju Kamarthi

    2010-01-01

    Full Text Available Background and Objectives: In vivo stains are prompt resources, which have emerged, in the recent years, to aid as clinical diagnostic tools in detecting early premalignant and malignant lesions. The aim of the study was to determine the diagnostic efficiency of toluidine blue with Lugol′s iodine in oral premalignancies and malignancies and to evaluate the reliability of in vivo staining with toluidine blue and Lugol′s iodine in the lesions at risk of malignancy. Materials and Methods: The study group comprised 30 subjects with clinically suspicious premalignant lesions and 30 subjects with clinically suspicious malignant lesions. All the lesions were stained consecutively with toluidine blue and Lugol′s iodine and the dye retention were recorded with photographs. Depending on the retention of the dyes, the biopsy site was determined. The biopsy specimens were sent for histological confirmation and results were statistically analyzed. Results: The overall diagnostic accuracy of Lugol′s iodine when used consecutively with toluidine blue stain in distinguishing premalignant lesions and malignant lesions was 90%. As the degree of differentiation of malignant lesions progressed toward more severity, they failed to show the retention of Lugol′s iodine and the result was highly significant statistically, with a P value < 0.001. Interpretation and Conclusion: Lugol′s iodine when used with toluidine blue helped in delineating the inflammatory lesions and was the mean source in determining clinically the degrees of differentiation of malignant lesions as the poorly differentiated malignant lesions without glycogen content failed to show Lugol′s iodine retention. Toluidine blue with Lugol′s iodine can be used as a pretherapeutic assessment of the biologic aggressiveness of the disease.

  8. Malignant fibrous histiocytoma arising on chronic osteomyelitis.

    Science.gov (United States)

    Foti, C; Giannelli, G; Berloco, A; Mascolo, V; Ingravallo, G; Giardina, C

    2002-07-01

    We present a case of a primary malignant fibrous histiocytoma of the skin (MFH) arising on chronic osteomyelitis in a 67-year-old woman. Although this condition seems to be a predisposing factor for the onset of the malignancy, MFH complicating chronic osteomyelitis is generally localized at the level of the bone tissue. In the case we report the neoplasm was primitively localized at the dermal and subcutaneous level and presented as a rapidly growing mass.

  9. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  10. Digital epiluminescence dermoscopy for pigmented cutaneous lesions, primary care physicians, and telediagnosis: a useful tool?

    Science.gov (United States)

    Grimaldi, Luca; Silvestri, Alessandro; Brandi, Cesare; Nisi, Giuseppe; Brafa, Anna; Calabrò, Massimiliano; Campa, Alessandra; D'Aniello, Carlo

    2009-08-01

    Digital epiluminescence dermoscopy is a relatively recent tool, based on the acquisition of high-definition digital images, for the diagnosis of pigmented cutaneous lesions. To verify the usefulness of digital dermoscopy in detecting pigmented lesions with features which may lead to suspicion of malignancy, when the examination is carried out by primary care physicians (PCP), not expert in that kind of diagnosis. Another target was an appraisal of the effectiveness and safety of telediagnosis based on epiluminescence digital dermoscopy on pigmented lesions. Digital images from some peripheral centres (235 lesions) have been forwarded in real time to the reference centre (Unit of Plastic Surgery, University of Siena, Italy), with a double judgement by each primary care physician ('benign' or 'suspicious of malignancy') on the basis of anamnesis and clinical examination at first step, and dermoscopy as second step. The image analysis carried out from the reference centre identified every lesion examined as 'to be controlled' (219 lesions) or 'to be removed' (16 lesions). Regarding the patients with dermoscopic examination (197 subjects, 235 lesions), the investigation reduced the number of lesions suspected of malignancy from 68 to 29 after the first dermoscopy, and from 29 to 16 after the re-examination of the image by the central unit researchers. Fourteen lesions suspected of malignancy when examined in the peripheral centres were then evaluated as benign by the central unit researchers, while one lesion, judged as benign at first (always labelled as 'benign' by the PCP), was then revealed as a dysplastic naevus. Digital dermoscopy can be enhanced by telediagnosis, which provides a better control of cutaneous pigmented lesions in the peripheral areas, thus reducing the number of consultations in specialised centres.

  11. Student Perceptions of Auditor Responses to Evidence of Suspicious Activities: An Experimental Assessment

    Directory of Open Access Journals (Sweden)

    David S Murphy

    2015-12-01

    Full Text Available This study assessed student perceptions of auditor responses to evidence that a client failed to respond appropriately to suspicious activities that could indicate money laundering. Subjects were presented with a series of randomized cases in which partner type (new vs. experienced, firm type (regional vs. international and audit fee materiality (not material, material to the local office only, material to the firm were manipulated asked to indicate their perceptions of the likelihood that an audit partner would discuss such evidence with the client, and the likelihood that the issue would be disclosed by the auditor. Both partner type and audit fee materiality was found to have significant effects on perceived likelihoods.

  12. Prevalence and Outcomes of Head and Neck versus Non-Head and Neck Second Primary Malignancies in Head and Neck Squamous Cell Carcinoma: An Analysis of the Surveillance, Epidemiology, and End Results Database.

    Science.gov (United States)

    Birkeland, Andrew C; Rosko, Andrew J; Chinn, Steven B; Prince, Mark E; Sun, Gordon H; Spector, Matthew E

    2016-01-01

    Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for second primary malignancies (SPMs). The prevalence, distribution, and patient survival in head and neck versus non-head and neck SPMs are not fully elucidated. The objective of this study was to quantify the rate of SPMs in patients with HNSCC. This is a population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. Prevalence and location of SPMs, and survival data were analyzed. There were 58,363 HNSCC patients, and the prevalence of HNSCC and non-HNSCC SPMs was 3.0% (1,746) and 8.8% (5,109), respectively. Overall survival (OS) was higher in patients with HNSCC SPMs compared to non-HNSCC SPMs (p < 0.001), with no difference in disease-specific survival. Patients with SPMs in the lung and esophagus had a worse OS (p < 0.001), and patients with SPMs in the prostate and breast had a better OS (p < 0.001). In HNSCC patients who develop SPMs, nearly 75% are non-HNSCC SPMs. Patients with non-HNSCC SPMs have a lower OS. Future clinical practice guidelines should take the risks and locations of SPM development into consideration for screening. © 2016 S. Karger AG, Basel.

  13. Theobromine, the primary methylxanthine found in Theobroma cacao, prevents malignant glioblastoma proliferation by negatively regulating phosphodiesterase-4, extracellular signal-regulated kinase, Akt/mammalian target of rapamycin kinase, and nuclear factor-kappa B.

    Science.gov (United States)

    Sugimoto, Naotoshi; Miwa, Shinji; Hitomi, Yoshiaki; Nakamura, Hiroyuki; Tsuchiya, Hiroyuki; Yachie, Akihiro

    2014-01-01

    Theobromine, a caffeine derivative, is the primary methylxanthine produced by Theobroma cacao. We previously showed that methylxanthines, including caffeine and theophylline, have antitumor and antiinflammatory effects, which are in part mediated by their inhibition of phosphodiesterase (PDE). A member of the PDE family, PDE4, is widely expressed in and promotes the growth of glioblastoma, the most common type of brain tumor. The purpose of this study was to determine whether theobromine could exert growth inhibitory effects on U87-MG, a cell line derived from human malignant glioma. We show that theobromine treatment elevates intracellular cAMP levels and increases the activity of p38 mitogen-activated protein kinase and c-Jun N-terminal kinase, whereas it attenuates p44/42 extracellular signal-regulated kinase activity and the Akt/mammalian target of rapamycin kinase and nuclear factor-kappa B signal pathways. It also inhibits cell proliferation. These results suggest that foods and beverages containing cocoa bean extracts, including theobromine, might be extremely effective in preventing human glioblastoma.

  14. Introducing a Model for Suspicious Behaviors Detection in Electronic Banking by Using Decision Tree Algorithms

    Directory of Open Access Journals (Sweden)

    Rohulla Kosari Langari

    2014-02-01

    Full Text Available Change the world through information technology and Internet development, has created competitive knowledge in the field of electronic commerce, lead to increasing in competitive potential among organizations. In this condition The increasing rate of commercial deals developing guaranteed with speed and light quality is due to provide dynamic system of electronic banking until by using modern technology to facilitate electronic business process. Internet banking is enumerate as a potential opportunity the fundamental pillars and determinates of e-banking that in cyber space has been faced with various obstacles and threats. One of this challenge is complete uncertainty in security guarantee of financial transactions also exist of suspicious and unusual behavior with mail fraud for financial abuse. Now various systems because of intelligence mechanical methods and data mining technique has been designed for fraud detection in users’ behaviors and applied in various industrial such as insurance, medicine and banking. Main of article has been recognizing of unusual users behaviors in e-banking system. Therefore, detection behavior user and categories of emerged patterns to paper the conditions for predicting unauthorized penetration and detection of suspicious behavior. Since detection behavior user in internet system has been uncertainty and records of transactions can be useful to understand these movement and therefore among machine method, decision tree technique is considered common tool for classification and prediction, therefore in this research at first has determinate banking effective variable and weight of everything in internet behaviors production and in continuation combining of various behaviors manner draw out such as the model of inductive rules to provide ability recognizing of different behaviors. At least trend of four algorithm Chaid, ex_Chaid, C4.5, C5.0 has compared and evaluated for classification and detection of exist

  15. Diagnostic Accuracy of Radiologic Scoring System for Evaluation of Suspicious Hirschsprung Disease in Children

    Science.gov (United States)

    Alehossein, Mehdi; Roohi, Ahad; Pourgholami, Masoud; Mollaeian, Mansour; Salamati, Payman

    2015-01-01

    Background: In 1996, Donovan and colleagues represented a scoring system for better prediction of Hirschsprung disease (HD). Objectives: Our objective was to devise another scoring system that uses a checklist of radiologic and clinical signs to determine the probability of HD in suspicious patients. Patients and Methods: In a diagnostic accuracy study, 55 children with clinical manifestations of HD that referred to a training hospital from 1998 to 2011 were assessed. A checklist was used to evaluate the items proposed by contrast enema (CE), based on six subscales, including transitional zone, rectosigmoid index (RSI), irregular contractions in aganglionic region, cobblestone appearance, filling defect due to fecaloid materials and lack of meconium defecation during the first 48 hours after birth. The patients were classified as high score and low score. Sensitivity, specificity, positive predictive value and negative predictive value of our scoring system were calculated for identifying HD, in comparison with pathologically proved or ruled out HD. Results: Of the 55 patients, 36 (65.4%) cases had HD and 19 (34.6%) cases were without HD. In the HD group, 32 patients showed high scores and four patients had low scores. The sensitivity and specificity of our diagnostic scoring system were 88.9% (95% CI: 78.6% - 99.1%) and 84.2% (95% CI: 68.7% - 100%), respectively. Moreover, positive predictive value (PPV) and negative predictive value (NPV) were 91.4% (95% CI: 82.1% - 100%) and 80% (95% CI: 62.5% - 97.5%), respectively. Conclusions: Our new scoring system of CE is a useful diagnostic method in HD. If a patient’s score is high, that patient is highly suspicious to HD and reversely, when one’s score is low, the patient presents a reduced probability to be diagnosed with HD. PMID:25901256

  16. Differentiation of malignant melanoma from benign nevus using a novel genomic microarray with low specimen requirements.

    Science.gov (United States)

    Chandler, Wells M; Rowe, Leslie R; Florell, Scott R; Jahromi, Mona S; Schiffman, Joshua D; South, Sarah T

    2012-08-01

    Histologic examination of clinically suspicious melanocytic lesions is very sensitive and specific for the detection of malignant melanoma. Yet, the malignant potential of a small percentage of melanocytic lesions remains histologically uncertain. Molecular testing offers the potential to detect the genetic alterations that lead to malignant behavior without overt histologic evidence of malignancy. To differentiate benign melanocytic nevi from malignant melanoma and to predict the clinical course of melanocytic lesions with ambiguous histology using a novel genomic microarray. We applied a newly developed single-nucleotide polymorphism genomic microarray to formalin-fixed, paraffin-embedded melanocytic lesions to differentiate benign nevi (n  =  23) from malignant melanoma (n  =  30) and to predict the clinical course of a set of histologically ambiguous melanocytic lesions (n  =  11). For cases with unambiguous histology, there was excellent sensitivity and specificity for identifying malignant melanoma with this genomic microarray (89% sensitivity, 100% specificity). For cases with ambiguous histology, the performance of this genomic microarray was less impressive. Without microdissection and with quantities of DNA one-tenth what is required for more commonly used microarrays, this microarray can differentiate between malignant melanoma and benign melanocytic nevi. For histologically ambiguous lesions, longer clinical follow-up is needed to confidently determine the sensitivity and specificity of this microarray. Some of the previous technical hurdles to the clinical application of genomic microarray technology are being overcome, and the advantages over targeted fluorescence in situ hybridization assays currently in clinical use are becoming apparent.

  17. Malignant Phyllodes Tumor with Chondrosarcomatous Differentiation: Radiological-Pathological Correlation

    Directory of Open Access Journals (Sweden)

    Kathyayini Paidipati Gopalkishna Murthy

    2014-01-01

    Full Text Available We present a case of a 63-year-old woman with malignant phyllodes tumor in her left breast. On imaging, a large, dumbbell-shaped, predominantly cystic mass with thin peripheral enhancement was noted. The lesion was causing rib destruction, chest wall invasion, and intrathoracic extension. These aggressive imaging features were considered highly suspicious of a malignant chest wall tumor. Subsequent chest wall resection of the tumor showed breast tissue with a biphasic lesion composed of proliferated spindle cells in loose sheets with extensive islands of atypical cartilage and a scanty epithelial component, including compressed ducts in the periphery of the lesion. A diagnosis of a malignant phyllodes tumor with stromal overgrowth and chondrosarcomatous differentiation was made in view of the presence of a benign epithelial component and negative reaction of the stromal component with a pancytokeratin. To the best of our knowledge, a phyllodes tumor with the radiological features of chest wall invasion and intrathoracic extension has not been described in the literature until now. Malignant phyllodes should be included in the list of differentials along with sarcomas on encountering lesions with such aggressive imaging features.

  18. Malignant melanoma (non-metastatic).

    Science.gov (United States)

    Savage, Philip

    2007-06-01

    The incidence of malignant melanoma has increased over the past 25 years in the UK, but death rates have remained fairly constant. Five-year survival ranges from 20% to 95% depending on disease stage. Risks are greater in white populations and in people with higher numbers of skin naevi. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent malignant melanoma? Is there an optimal surgical margin for the primary excision of melanoma? What are the effects of elective lymph node dissection in people with malignant melanoma with clinically uninvolved lymph nodes? What are the effects of sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes? What are the effects of adjuvant treatment for malignant melanoma? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 30 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: adjuvant vaccines; elective lymph node dissection; low-, intermediate-, and high-dose adjuvant interferon alfa; sentinel lymph node biopsy; suncreens; surveillance for early recurrence; and wide excisions.

  19. Aggressive malignant phyllodes tumor

    OpenAIRE

    Nathan Roberts; Dianne M. Runk

    2015-01-01

    Introduction: Originally described in 1838 by Muller, phyllodes tumor is a rare fibroepithelial neoplasm which represents roughly 0.3–0.9% of all breast cancers. Phyllodes tumor are divided into benign, borderline and malignant histologic categories. Malignant phyllodes tumor represent anywhere from 10–30% of all phyllodes tumors. This group has both the potential to recur locally and metastasize, however not all malignant phyllodes behave this way. The challenge lays in predicting which tumo...

  20. Computer-aided detection (CADe) and diagnosis (CADx) system for lung cancer with likelihood of malignancy.

    Science.gov (United States)

    Firmino, Macedo; Angelo, Giovani; Morais, Higor; Dantas, Marcel R; Valentim, Ricardo

    2016-01-06

    CADe and CADx systems for the detection and diagnosis of lung cancer have been important areas of research in recent decades. However, these areas are being worked on separately. CADe systems do not present the radiological characteristics of tumors, and CADx systems do not detect nodules and do not have good levels of automation. As a result, these systems are not yet widely used in clinical settings. The purpose of this article is to develop a new system for detection and diagnosis of pulmonary nodules on CT images, grouping them into a single system for the identification and characterization of the nodules to improve the level of automation. The article also presents as contributions: the use of Watershed and Histogram of oriented Gradients (HOG) techniques for distinguishing the possible nodules from other structures and feature extraction for pulmonary nodules, respectively. For the diagnosis, it is based on the likelihood of malignancy allowing more aid in the decision making by the radiologists. A rule-based classifier and Support Vector Machine (SVM) have been used to eliminate false positives. The database used in this research consisted of 420 cases obtained randomly from LIDC-IDRI. The segmentation method achieved an accuracy of 97 % and the detection system showed a sensitivity of 94.4 % with 7.04 false positives per case. Different types of nodules (isolated, juxtapleural, juxtavascular and ground-glass) with diameters between 3 mm and 30 mm have been detected. For the diagnosis of malignancy our system presented ROC curves with areas of: 0.91 for nodules highly unlikely of being malignant, 0.80 for nodules moderately unlikely of being malignant, 0.72 for nodules with indeterminate malignancy, 0.67 for nodules moderately suspicious of being malignant and 0.83 for nodules highly suspicious of being malignant. From our preliminary results, we believe that our system is promising for clinical applications assisting radiologists in the detection and

  1. Impact of dermoscopy and short-term sequential digital dermoscopy imaging for the management of pigmented lesions in primary care: a sequential intervention trial.

    Science.gov (United States)

    Menzies, S W; Emery, J; Staples, M; Davies, S; McAvoy, B; Fletcher, J; Shahid, K R; Reid, G; Avramidis, M; Ward, A M; Burton, R C; Elwood, J M

    2009-12-01

    Studies have shown the benign to malignant ratio of excised pigmented skin lesions is suboptimal in primary care. To assess the impact of dermoscopy and short-term sequential digital dermoscopy imaging (SDDI) on the management of suspicious pigmented skin lesions by primary care physicians. A total of 63 primary care physicians were trained in the use of dermoscopy and SDDI (interventions) and then recruited pigmented lesions requiring biopsy or referral in routine care by naked eye examination. They were then given a dermatoscope and the option of a SDDI instrument, and change of diagnosis and management was assessed. Following the use of the interventions on 374 lesions a total of 163 lesions (43.6%) were excised or referred, representing a reduction of 56.4%. Of the 323 lesions confirmed to be benign, 118 (36.5%) were excised or referred, leading to a reduction of 63.5% (P melanoma ratio was 9.5 : 1 which decreased to 3.5 : 1 after the diagnostic interventions (P melanoma, six pigmented basal cell carcinoma and two Bowen disease) only one in situ melanoma was incorrectly managed (patient to return if changes occur) resulting in the correct management of 97.6% and 97.1% of malignant pigmented lesions and melanoma, respectively. In a primary care setting the combination of dermoscopy and short-term SDDI reduces the excision or referral of benign pigmented lesions by more than half while nearly doubling the sensitivity for the diagnosis of melanoma.

  2. The Role of Conventional Bronchoscopy in the Workup of Suspicious CT Scan Screen-Detected Pulmonary Nodules

    NARCIS (Netherlands)

    van't Westeinde, Susan C.; Horeweg, Nanda; Vernhout, Rene M.; Groen, Harry J. M.; Lammers, Jan-Willem J.; Weenink, Carla; Nackaerts, Kristiaan; Oudkerk, Matthijs; Mali, Willem; Thunnissen, Frederik B.; de Koning, Harry J.; van Klaveren, Rob J.

    Background: Up to 50% of the participants in CT scan lung cancer screening trials have at least one pulmonary nodule. To date, the role of conventional bronchoscopy in the workup of suspicious screen-detected pulmonary nodules is unknown. If a bronchoscopic evaluation could be eliminated, the

  3. The role of conventional bronchoscopy in the workup of suspicious CT scan screen-detected pulmonary nodules

    NARCIS (Netherlands)

    S.C. van 't Westeinde (Susan); N. Horeweg (Nanda); R. Vernhout (Rene); H.J.M. Groen (Henk); J.-W.J. Lammers (Jan-Willem); C. Weenink (Carla); K. Nackaerts (Kristiaan); M. Oudkerk (Matthijs); W.P. Mali (Willem); F.B.J.M. Thunnissen (Frederik); H.J. de Koning (Harry); R.J. van Klaveren (Rob)

    2012-01-01

    textabstractBackground: Up to 50% of the participants in CT scan lung cancer screening trials have at least one pulmonary nodule. To date, the role of conventional bronchoscopy in the workup of suspicious screen-detected pulmonary nodules is unknown. If a bronchoscopic evaluation could be

  4. Primary Angiitis Of The Central Nervous System

    Directory of Open Access Journals (Sweden)

    Sundaram Meenakshi

    2001-01-01

    Full Text Available An unusual case of primary angiitis of central nervous system (PACNS presenting with headache, seizures and focal deficits is presented. Despite multiple lesions noted on brain MRI, definitive diagnosis required a brain biopsy. A high index of clinical suspicious and the utility of brain biopsy for diagnosis are emphasized.

  5. PRIMARY MALIGNANT MELANOMA OF ARYEPIGLOTTIC FOLD

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... examination, direct and indirect laryngoscopy revealed a pigmented and ulcerated lesion involving the aryepi- glottic folds. Computed tomography (CT) scan of the neck confirmed aryepiglottic lesion. Biopsy of the ulcerated lesion revealed sheets of ma- lignant melanin containing cells involving the overly-.

  6. Malignant vasovagal syndrome?

    Science.gov (United States)

    Kala, G K; Lee, C; Coatesworth, A P

    2004-01-01

    We present the management of a patient with nasopharyngeal carcinoma with a history of recurrent syncopal attacks diagnosed as malignant vasovagal syndrome. We discuss clinical presentation as well as the resolution of disease symptoms. The importance of metastatic nasopharyngeal malignancy in relation to syncope is discussed.

  7. The role of argyrophilic nucleolar organizer region (AgNoR) study in cytological evalution of fluids, especially for detection of malignancy.

    Science.gov (United States)

    Karki, S; Jha, A; Sayami, G

    2012-01-01

    Serous effusion smears reported as (suspicious for malignancy) pose problems in clinical management. Silver staining for argyrophilic nucleolar organizer regions (AgNOR) has proved useful in making a cytopathologic differential diagnosis between benign and malignant cells. Nucleolar organizer regions(NORs) are loops of DNA located in acrocentric chromosomes. These NORs are visualized by silver staining technique that recognizes these argyrophilia associated proteins which are increased in malignancy. This study aimed to distinguish reactive mesothelial cells from malignant cells in serous effusions using these NORs. A total of 174 serous effusions received at the Department of Pathology, TUTH, during a period of one year were included in the study. Smears were studied by conventional Papanicolaou and Giemsa stains. AgNOR counts, variation in size and dispersion of AgNOR dots in smears were graded and compared in malignant and non-malignant effusions. Mean AgNOR counts of 10.43+\\-0.73 and 10.21+\\-0.51 in malignant peritoneal and pleural effusions, respectively, were significantly (p < 0.0001) greater as compared with counts of 2.12 +\\- 0.54 and 2.11 +\\- 0.54 in non-malignant effusions. The AgNORs were irregular in shape in malignant effusions whereas they were comparatively larger, single dots in benign effusions. AgNOR size and dispersion were of higher grade in significantly greater proportion of malignant as compared with non malignant effusions (p < 0.0001). Of the cytologically suspicious samples, nine were in the malignant range and one was in the benign range. AgNOR study appears to be clinically useful as an additional diagnostic tool for use in serous effusion when the cytologic diagnosis is difficult.

  8. Resection for secondary malignancy of the pancreas.

    Science.gov (United States)

    Hung, Jui-Hsia; Wang, Shin-E; Shyr, Yi-Ming; Su, Cheng-Hsi; Chen, Tien-Hua; Wu, Chew-Wun

    2012-01-01

    This study tried to clarify the role of pancreatic resection in the treatment of secondary malignancy with metastasis or local invasion to the pancreas in terms of surgical risk and survival benefit. Data of secondary malignancy of the pancreas from our 19 patients and cases reported in the English literature were pooled together for analysis. There were 329 cases of resected secondary malignancy of the pancreas, including 241 cases of metastasis and 88 cases of local invasion. The most common primary tumor metastatic to the pancreas and amenable to resection was renal cell carcinoma (RCC) (73.9%). More than half (52.3%) of the primary cancers with local invasion to the pancreas were colon cancer, and nearly half (40.9%) were stomach cancer. The median metastatic interval was 84 months (7 years) for overall primary tumors and 108 months (9 years) for RCC. The 5-year survival for secondary malignancy of the pancreas after resection was 61.1% for metastasis and 58.9% for local invasion, with 72.8% for RCC metastasis, 69.0% for colon cancer, and 43.8% for stomach cancer with local invasion to the pancreas. Pancreatic resection should not be precluded for secondary malignancy of the pancreas because long-term survival could be achieved with acceptable surgical risk in selected patients.

  9. Comparison of the Formula of PSA, Age, Prostate Volume and Race Versus PSA Density and the Detection of Primary Malignant Circulating Prostate Cells in Predicting a Positive Initial Prostate Biopsy in Chilean Men with Suspicion of Prostate Cancer.

    Science.gov (United States)

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Orellana, Nelson; Morales, Francisca; Jacob, Omar

    2015-01-01

    Combining risk factors for prostate cancer into a predictive tool may improve the detection of prostate cancer while decreasing the number of benign biopsies. We compare one such tool, age multiplied by prostate volume divided by total serum PSA (PSA-AV) with PSA density and detection of primary malignant circulating prostate cells (CPCs) in a Chilean prostate cancer screening program. The objectives were not only to determine the predictive values of each, but to determine the number of clinically significant cancers that would have been detected or missed. A prospective study was conducted of all men undergoing 12 core ultrasound guided prostate biopsy for suspicion of cancer attending the Hospital DIPRECA and Hospital de Carabineros de Chile. Total serum PSA was registered, prostate volumecalculated at the moment of biopsy, and an 8 ml blood simple taken immediately before the biopsy procedure. Mononuclear cells were obtained from the blood simple using differential gel centrifugation and CPCs identified using immunocytchemistry with anti- PSA and anti-P504S. Biopsy results were classed as positive or negative for cancer and if positive the Gleason score, number of positive cores and percent infiltration recorded. A total of 664 men participated, of whom 234 (35.2%) had cancer detected. They were older, had higher mean PSA, PSA density and lower PSA-AV. Detection of CPCs had high predictive score, sensitivity, sensibility and positive and negative predictive values, PSA-AV was not significantly different from PSA density in this population. The use of CPC detection avoided more biopsies and missed fewer significant cancers. In this screening population the use of CPC detection predicted the presence of clinically significant prostate cancer better than the other parameters. The high negative predictive value would allow men CPC negative to avoid biopsy but remain in follow up. The formula PSA-AV did not add to the predictive performance using PSA density.

  10. Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety.

    Science.gov (United States)

    Beddis, H P; Davies, S J; Budenberg, A; Horner, K; Pemberton, M N

    2014-10-01

    Trismus is a restriction in the ability to open the mouth. Trismus can occur following trauma, surgery, radiation therapy, infection, inflammatory diseases, temporomandibular disorders (TMD) or less commonly as a result of malignancy. Following two cases of delayed diagnosis of carcinoma presenting with features of TMD to a specialist clinic, a checklist was developed for completion in cases of trismus, to alert the clinician to suspicious features suggesting a possible non-TMD cause. The use of this checklist, together with an increased awareness, has improved early recognition of atypical features in patients presenting with trismus and has contributed to the early diagnosis of a further case of malignancy presenting to this clinic. This article discusses the presentation of malignancy with trismus, the relevance of imaging in these cases, and the implementation of a checklist to reduce the risk of future misdiagnosis.

  11. Treatment and follow-up of malignant struma ovarii: Regarding two cases

    Directory of Open Access Journals (Sweden)

    Aurore Oudoux

    2016-08-01

    Full Text Available Malignant struma ovarii (SO is a rare tumor, and as a consequence, treatments and follow-up procedures are not clearly established. Presented in this study are two cases of suspicious ovarian masses, resected and corresponding to malignant SO on histopathology. Similar to thyroid cancer, we proposed complementary radioiodine therapy (131I after total thyroidectomy (no malignancy was observed at this level in our two patients. Patients underwent treatment with 3.7 GBq 131I followed by post-therapy whole-body scintigraphy, which can detect residual disease or occult metastases. Thyroid remnant ablation increases the sensitivity and specificity of follow-up testing using serum thyroglobulin levels as a tumor marker. Our two patients remained disease-free for 3 and 5 years, respectively, after treatment.

  12. A case of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection.

    Science.gov (United States)

    Das, Joyutpal; Layton, Benjamin; Lamb, Harriet; Sinnott, Nicola; Leahy, Bernard C

    2015-11-01

    Serratia marcescens is a saprophytic gram-negative bacillus capable of causing a wide range of infections. A 57-year-old female was admitted to our hospital for four weeks with community acquired pneumonia. A chest x-ray, six weeks after discharge, demonstrated multiple, bilateral 'cannon ball'-like opacities and mediastinal lymphadenopathy which were highly suspicious of disseminated malignancy or tuberculosis. The only symptom that this patient had was a productive cough. She had multiple commodities, but no specific immunodeficiency disorder. Interestingly, her sputum and bronchial washing samples grew S. marcescens. The computed tomography-guided lung biopsy demonstrated necrotic granulomatous changes. There was no pathological evidence of tuberculosis or fungal infection, malignancy or vasculitis. There are only a handful of reported cases of Serratia granulomas. Thus, we are reporting a rare instance of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection. © The Author(s) 2015.

  13. Primary malignant tumors of the neck in the material of the ENT Dept. of the Babinski Regional Hospital in Wroclaw in the years 1988-1992; Pierwotne, zlosliwe guzy szyi w materiale Oddzialu Laryngologicznego Wojewodzkiego Szpitala Zespolonego im. J. Babinskiego we Wroclawiu w latach 1988-1992

    Energy Technology Data Exchange (ETDEWEB)

    Piechnik-Resler, D.; Wardega-Lasek, E.; Gul, E.; Jachowicz, B. [Wojewodzki Szpital Zespolony im. J. Babinskiego, Wroclaw (Poland)

    1994-12-31

    In this paper the authors discussed 10 patients with primary malignant tumors of the neck. These cases were selected from the group of 275 patients with tumors of the neck treated during that time. Malignant tumors of the salivary glands and metastatic tumors coming from the known primary focus have been excluded from the analysis. The occurrence of tumors has been analyzed according to sex, age social and economic conditions and the morbidity in each year. Attention has been called to the stage of the tumor advancement and to the time that passed between occurrence of the change and the patient report for treatment. Attention has been also called to the difficulties in making the final diagnosis (repeated histopathological examination). (author)

  14. Unusual malignant solid neoplasms of the kidney: Cross-sectional imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Karaosmanoglu, Ali Devrim; Hahn, Peter F. [Dept. of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (United States); Shirkhoda, Ali [Dept. of Radiology, University of California School of Medicine, Irvine (United States); Onur, Mehmet Ruhi; Ozmen, Mustafa [Dept. of Radiology, University of Hacettepe School of Medicine, Ankara (Turkmenistan)

    2015-08-15

    Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma.

  15. A panel of markers for identification of malignant and non-malignant cells in culture from effusions.

    Science.gov (United States)

    Carneiro, Fabiana Pirani; Muniz-Junqueira, Maria Imaculada; Pittella-Silva, Fabio; Carneiro, Marcos de Vasconcelos; Takano, Gustavo Henrique Soares; Vianna, Leonora Maciel de Sousa; De Andrade, Luciano Barbosa; De Castro, Tercia Maria Mendes Lousa; Peres, Isabela; Dos Santos Borges, Tatiana Karla; Ferreira, Vânia Moraes; Motoyama, Andrea Barretto

    2017-12-01

    The aim of the present study was to identify cell types in primary culture from malignant and non-malignant effusions. Effusion samples were subjected to cytology and culture. Immunocytochemistry was performed in cytological slides to evaluate malignancy (positivity for malignancy markers) and in culture slides for identification of cell types in growth. A total of 143 effusion samples (pleural n=76; peritoneal n=37; pericardial n=4; and peritoneal lavage n=26) were analyzed. Cell growth was observed in 34.9% of all samples and immunocytochemistry for identification of cell types in culture slides was conclusive in 90% of them. In non-malignant samples (n=28), growth of mesothelial cells, macrophages and of both cell types was identified in 82.14, 10.71 and 7.14%, respectively. In malignant samples (n=17, all carcinomas), growth of malignant epithelial cells and of both malignant epithelial and mesothelial cells was identified in 41.17 and 23.52%, respectively. In the remaining 35.29% of malignant samples, the only cells in growth were mesothelial and/or macrophages instead of malignant epithelial cells. In conclusion, in culture of malignant effusions, mesothelial cells may be simultaneously identified with malignant epithelial cells. Besides, mesothelial cells and macrophages may be the only cells identified in malignant effusion culture. Therefore, a broad panel of cell markers should be used for unmistakable identification of cells in studies of effusion primary culture. The ideal malignant effusion sample to obtain culture of neoplastic cells should be that without the presence of mesothelial cells and macrophages.

  16. Automatic detection of suspicious behavior of pickpockets with track-based features in a shopping mall

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; Burghouts, Gertjan J.; Eendebak, Pieter T.; van Huis, Jasper R.; Dijk, Judith; van Rest, Jeroen H. C.

    2014-10-01

    Proactive detection of incidents is required to decrease the cost of security incidents. This paper focusses on the automatic early detection of suspicious behavior of pickpockets with track-based features in a crowded shopping mall. Our method consists of several steps: pedestrian tracking, feature computation and pickpocket recognition. This is challenging because the environment is crowded, people move freely through areas which cannot be covered by a single camera, because the actual snatch is a subtle action, and because collaboration is complex social behavior. We carried out an experiment with more than 20 validated pickpocket incidents. We used a top-down approach to translate expert knowledge in features and rules, and a bottom-up approach to learn discriminating patterns with a classifier. The classifier was used to separate the pickpockets from normal passers-by who are shopping in the mall. We performed a cross validation to train and evaluate our system. In this paper, we describe our method, identify the most valuable features, and analyze the results that were obtained in the experiment. We estimate the quality of these features and the performance of automatic detection of (collaborating) pickpockets. The results show that many of the pickpockets can be detected at a low false alarm rate.

  17. [Establishment of confirmatory test for suspicious hepatitis B surface antigen positive samples].

    Science.gov (United States)

    Chen, Lin; Rong, Yang; Liu, Jia; Xu, Jun; Guo, Jing-Xia; Song, Yong-Ji; Zhao, Jing; Liu, Ai-Xia; Yang, Li-Hua; Li, Bo-An; Mao, Yuan-Li

    2012-08-01

    Establish a confirmatory test based on ELISA, and use to verify the authenticity of HBsAg weak positive samples, pick and get rid of the false result, and avoid the mistake diagnosis. The particles (reagent A) coated by streptavidin and biotinylated HBsAb (reagent B) were mixed in different proportions, then neutralized with serum whose the COI of HBsAg > 20 by ELISA in order to identify the activity of HBsAb in confirmatory reagent. 30 pieces of HBsAg weak positive serum neutralized with the confirmatory reagent, the serum were considered to be positive if rate of decline of HBsAg COI > 50%. The results were compared to Roche confirmatory Kit. Confirmatory reagent was able to neutralized with HBsAg. 24 of 30 pieces of HBsAg weak positive samples were judged to be positive, while 6 poeces were negative. The ELISA comfirm method is fully consistent with Roche confirmatory Kit. The ELISA confirmatory test for suspicious HBsAg positive samples is a simple, accurate and low cost initial validation method, After further clinical trials, should be widely applied.

  18. Adaptive Suspicious Prevention for Defending DoS Attacks in SDN-Based Convergent Networks.

    Science.gov (United States)

    Dao, Nhu-Ngoc; Kim, Joongheon; Park, Minho; Cho, Sungrae

    2016-01-01

    The convergent communication network will play an important role as a single platform to unify heterogeneous networks and integrate emerging technologies and existing legacy networks. Although there have been proposed many feasible solutions, they could not become convergent frameworks since they mainly focused on converting functions between various protocols and interfaces in edge networks, and handling functions for multiple services in core networks, e.g., the Multi-protocol Label Switching (MPLS) technique. Software-defined networking (SDN), on the other hand, is expected to be the ideal future for the convergent network since it can provide a controllable, dynamic, and cost-effective network. However, SDN has an original structural vulnerability behind a lot of advantages, which is the centralized control plane. As the brains of the network, a controller manages the whole network, which is attractive to attackers. In this context, we proposes a novel solution called adaptive suspicious prevention (ASP) mechanism to protect the controller from the Denial of Service (DoS) attacks that could incapacitate an SDN. The ASP is integrated with OpenFlow protocol to detect and prevent DoS attacks effectively. Our comprehensive experimental results show that the ASP enhances the resilience of an SDN network against DoS attacks by up to 38%.

  19. Adaptive Suspicious Prevention for Defending DoS Attacks in SDN-Based Convergent Networks.

    Directory of Open Access Journals (Sweden)

    Nhu-Ngoc Dao

    Full Text Available The convergent communication network will play an important role as a single platform to unify heterogeneous networks and integrate emerging technologies and existing legacy networks. Although there have been proposed many feasible solutions, they could not become convergent frameworks since they mainly focused on converting functions between various protocols and interfaces in edge networks, and handling functions for multiple services in core networks, e.g., the Multi-protocol Label Switching (MPLS technique. Software-defined networking (SDN, on the other hand, is expected to be the ideal future for the convergent network since it can provide a controllable, dynamic, and cost-effective network. However, SDN has an original structural vulnerability behind a lot of advantages, which is the centralized control plane. As the brains of the network, a controller manages the whole network, which is attractive to attackers. In this context, we proposes a novel solution called adaptive suspicious prevention (ASP mechanism to protect the controller from the Denial of Service (DoS attacks that could incapacitate an SDN. The ASP is integrated with OpenFlow protocol to detect and prevent DoS attacks effectively. Our comprehensive experimental results show that the ASP enhances the resilience of an SDN network against DoS attacks by up to 38%.

  20. Anomaly and signature filtering improve classifier performance for detection of suspicious access to EHRs.

    Science.gov (United States)

    Kim, Jihoon; Grillo, Janice M; Boxwala, Aziz A; Jiang, Xiaoqian; Mandelbaum, Rose B; Patel, Bhakti A; Mikels, Debra; Vinterbo, Staal A; Ohno-Machado, Lucila

    2011-01-01

    Our objective is to facilitate semi-automated detection of suspicious access to EHRs. Previously we have shown that a machine learning method can play a role in identifying potentially inappropriate access to EHRs. However, the problem of sampling informative instances to build a classifier still remained. We developed an integrated filtering method leveraging both anomaly detection based on symbolic clustering and signature detection, a rule-based technique. We applied the integrated filtering to 25.5 million access records in an intervention arm, and compared this with 8.6 million access records in a control arm where no filtering was applied. On the training set with cross-validation, the AUC was 0.960 in the control arm and 0.998 in the intervention arm. The difference in false negative rates on the independent test set was significant, P=1.6×10(-6). Our study suggests that utilization of integrated filtering strategies to facilitate the construction of classifiers can be helpful.

  1. Oral malignant melanoma: a rare case with unusual clinical ...

    African Journals Online (AJOL)

    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. Pan African ...

  2. Cytology of Pericardial Effusion due to Malignancy

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-09-01

    Full Text Available Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare.

  3. Delirium followed by neuroleptic malignant syndrome in ...

    African Journals Online (AJOL)

    Delirium and neuroleptic malignant syndrome (NMS) are two uncommon syndromes that are often unrecognized or misdiagnosed by the primary physicians as functional psychiatric disorders. The infrequency and the heterogeneity of clinical manifestation, progression and outcome with which those diagnoses are ...

  4. Intraoral malignant melanoma | Babburi | Nigerian Medical Journal

    African Journals Online (AJOL)

    Primary oral mucosal melanoma is a rare aggressive neoplasm and accounts for only 0.2‑8% of all reported melanomas. It is a malignant neoplasm of melanocytes that may arise from a benign melanocytic lesion or de novo from melanocytes within normal skin or mucosa. It is considered to be the most deadly and ...

  5. Angiogenic and Metastatic Determinants of Malignant Melanoma

    NARCIS (Netherlands)

    A. Mooppilmadham Das (Asha)

    2015-01-01

    markdownabstractCutaneous melanoma or malignant melanoma of the skin is a highly metastatic disease, with an increasing rate of incidence, poor prognosis and high resistance to therapeutic intervention. Although early diagnosis and surgical resection of the primary lesion could significantly improve

  6. High-grade microscopic hematuria in adult men can predict urothelial malignancy.

    Science.gov (United States)

    Kotb, Ahmed Fouad; Attia, Doaa

    2014-07-01

    Microscopic hematuria in men younger than 40 is a confusing issue to urologists, especially when these men have normal radiological findings. We report our experience in looking for urologic malignancy in this group of patients. We conducted a prospective study for men with vague urological symptoms. We included men under 40 years old, men with microscopic hematuria greater than 25 red blood cells/high power field in 2 properly collected mid-stream urine samples, and men with free urine culture and normal multiphasic computed tomography abdomen and pelvis studies. All patients underwent diagnostic cystoscurethroscopy. If there were no lesions, multiple random biopsies were taken. In cases of apparently normal cystoscopic findings and associated renal colic, uretroscopy was done to the suspected side. Only 20 patients fulfilled our inclusion criteria. The mean age of the patients were 34; 2 patients presented with pain. The other 18 patients were presenting with mild recurrent lower urinary tract symptoms. Cystoscopy showed small papillary low-grade tumour in 3 patients. All random biopsies were free of malignancy. Unilateral uretroscopy for the 2 cases presented with pain detected carcinoma in situ in one of them. Cystoscopy is highly recommended for young adult men, with significant levels of microscopic hematuria, due to the 20% incidence rate of associated urological malignancy. Random bladder biopsies, in the absence of suspicious lesions, have no diagnostic role, and should not be done. Uretroscopy is advised for patients with microscopic hematuria and loin pain, even in the absence of suspicious radiological findings.

  7. Nonurological malignancies in children

    Directory of Open Access Journals (Sweden)

    Lalit Parida

    2014-01-01

    Full Text Available Context: Nonurological malignancies in children include a wide variety of tumors. These tumors include primary tumors of the liver, thyroid, lung, gastrointestinal tract (GIT, and adrenals; soft tissue sarcomas (STSs like rhabdomyosarcoma (RMS and non-RMS; and finally extragonadal germ cell tumors (GCT. Aims: This article aims at describing the current thinking in the management of these childhood solid tumors. This is critical in view of the recent advances in the elucidation of the molecular, genetic, and biologic behavior of these tumors and how these factors are getting integrated not only in the staging but also in developing a risk-based approach towards the management of these tumors. Materials and Methods: Reference was made to recently published literature from the leading pediatric cancer centers of the world to make a sense of things of the most current thinking in this rapidly expanding field. This will provide surgeons and physicians taking care of these children with a working knowledge in this somewhat challenging field. Conclusions: Treatment results vary from center to center depending on access to resources and following different management protocols. Results have improved for these tumors with the advent of newer chemotherapeutic agents, novel delivery methods of radiation therapy (RT, and improvement in surgical technique. Due to the limited number of patients presenting with these tumors, national and international collaboration of data is critical for all and beneficial to individual treatment centers. This has resulted in better results in the past and will definitely result in still better results in the future.

  8. A PRELIMARY APPROACH FOR THE AUTOMATED RECOGNITION OF MALIGNANT MELANOMA

    Directory of Open Access Journals (Sweden)

    Ezzeddine Zagrouba

    2011-05-01

    Full Text Available In this work, we are motivated by the desire to classify skin lesions as malignants or benigns from color photographic slides of the lesions. Thus, we use color images of skin lesions, image processing techniques and artificial neural network classifier to distinguish melanoma from benign pigmented lesions. As the first step of the data set analysis, a preprocessing sequence is implemented to remove noise and undesired structures from the color image. Second, an automated segmentation approach localizes suspicious lesion regions by region growing after a preliminary step based on fuzzy sets. Then, we rely on quantitative image analysis to measure a series of candidate attributes hoped to contain enough information to differentiate melanomas from benign lesions. At last, the selected features are supplied to an artificial neural network for classification of tumor lesion as malignant or benign. For a preliminary balanced training/testing set, our approach is able to obtain 79.1% of correct classification of malignant and benign lesions on real skin lesion images.

  9. The radiological excision of high risk and malignant lesions using the INTACT breast lesion excision system. A case series with an imaging follow up of at least 5 years.

    Science.gov (United States)

    Allen, S D; Osin, P; Nerurkar, A

    2014-07-01

    To evaluate the efficacy of a BLES procedure as a primary excisional biopsy rather than a surgical wide local excision for treatment of a high risk or a malignant lesion. 41 patients underwent a BLES procedure in order to attempt to remove a small breast lesion using a 15 mm or 20 mm wand from August 2007 to January 2009. The lesions were either proven on prior core biopsy to show high risk or malignant pathology or were considered to be indeterminate or suspicious on ultrasound or mammography. The pathology was reviewed to include the final status of lesion excision. If margin involvement was demonstrated then a formal surgical excision was subsequently recommended. Follow up mammography or ultrasound was performed annually in patients following the final pathological diagnosis. 9 patients had a primary diagnosis of atypia (columnar cell change with atypia or atypical ductal hyperplasia (ADH)), 23 patients had ductal carcinoma in situ (DCIS) and 9 had an invasive carcinoma (IC) at the original BLES pathology. Clear BLES margins of >1 mm were obtained in 3/9 atypia lesions, 15/23 DCIS and 0/9 IC. 12/13 low grade DCIS were completely excised. Subsequent surgical margin excisions were undertaken in 20 patients. After at least 5 years of follow up (mean 66 months), 1 lesion had recurred on imaging. A BLES excision has potential as an alternative technique to traditional surgical wide local excision in the management of certain small breast lesions with high risk and low grade malignant potential. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Large fibroadenoma mimicking malignancy

    African Journals Online (AJOL)

    Enrique

    looking features that can mimic malignancy. ... breast. Due to the fact that there was a positive family history of breast carci- noma and the mass ... Histological diagnosis confirmed a fibroadenoma. ... texture with regular, lobulated or irregular ...

  11. Stages of Malignant Mesothelioma

    Science.gov (United States)

    ... malignant mesothelioma, and may also be used as palliative therapy to relieve symptoms and improve quality of life . ... and decortication , with or without radiation therapy , as palliative therapy to relieve symptoms and improve quality of life . ...

  12. The use of light-based (optical) detection systems as adjuncts in the detection of oral cancer and oral potentially malignant disorders: a systematic review.

    Science.gov (United States)

    Rashid, A; Warnakulasuriya, S

    2015-05-01

    In recent decades, optical techniques utilising the principles of chemiluminescence and tissue autofluorescence have emerged to facilitate the early detection of any oral mucosal changes suspicious of cancer. To evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of oral cancer and oral potentially malignant disorders (OPMDs). A systematic review of the published literature to evaluate the effectiveness of the ViziLite(®) and ViziLite(®) Plus with toluidine blue, MicroLux™/DL and the VELscope™ as aids in the detection of oral cancer and OPMDs. Twenty-five primary studies published between 2004 and 2013 satisfied our criteria for selection - 13 utilised chemiluminescence and 12 tissue autofluorescence. Some had utilised both study methods on the same population. Chemiluminescence shows good sensitivity at detecting any OPMDs and oral cancer. However, it preferentially detects leukoplakia and may fail to spot red patches. The additive use of toluidine blue may improve specificity. Tissue autofluorescence is sensitive at detecting white, red and white and red patches, and the area of fluorescence visualisation loss (FVL) often extends beyond the clinically visible lesion. However, in addition to OPMDs, VELScope may detect erythematous lesions of benign inflammation resulting in false-positive test results. There is limited evidence for their use in primary care, and these tools are better suited to specialist clinics in which there is a higher prevalence of disease and where experienced clinicians may better discriminate between benign and malignant lesions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Error in laboratory report data for platelet count assessment in patients suspicious for dengue: a note from observation

    Directory of Open Access Journals (Sweden)

    Somsri Wiwanitkit

    2016-08-01

    Full Text Available Dengue is a common tropical infection that is still a global health threat. An important laboratory parameter for the management of dengue is platelet count. Platelet count is an useful test for diagnosis and following up on dengue. However, errors in laboratory reports can occur. This study is a retrospective analysis on laboratory report data of complete blood count in cases with suspicious dengue in a medical center within 1 month period during the outbreak season on October, 2015. According to the studied period, there were 184 requests for complete blood count for cases suspected for dengue. From those 184 laboratory report records, errors can be seen in 12 reports (6.5%. This study demonstrates that there are considerable high rate of post-analytical errors in laboratory reports. Interestingly, the platelet count in those erroneous reports can be unreliable and ineffective or problematic when it is used for the management of dengue suspicious patients.

  14. Utility of commercial DNA analysis in detecting malignancy within pancreatic cysts.

    Science.gov (United States)

    Lee, Linda S; Wu, Bechien U; Banks, Peter A; Kadiyala, Vivek; Mehta, Shivani; Saltzman, John R; Thompson, Christopher C; Bellizzi, Andrew M

    2013-03-10

    Pancreatic cysts raise concern because of their malignant potential. Our aims were to assess accuracy of DNA analysis in detecting malignant pancreatic cysts at EUS-FNA and to determine whether DNA analysis added to imaging and cyst fluid studies enhanced International Association of Pancreatology (IAP) guidelines for resection of pancreatic cysts. This is a retrospective study including pancreatic cysts undergoing EUS-FNA and DNA analysis with k-ras and loss of heterozygosity testing. Diagnostic models of 2006 and 2012 IAP guidelines, DNA analysis alone, and DNA combined with 2012 IAP guidelines were developed, and area under receiver operator characteristic curves (AUC) compared to determine the added value of DNA for detecting malignant cysts at the time of EUS-FNA. Two-hundreds and fifty-seven patients were included with 8 (3.1%) malignant cysts. Solid component (P<0.001), main pancreatic duct dilation (P=0.012), suspicious or malignant cytology (P=0.001), and high DNA quantity (P<0.001) were associated with malignancy. Concurrent high amplitude k-ras with loss of heterozygosity mutations was highly specific (98.4%) though insensitive (12.5%) for malignancy. The 2012 IAP guideline (AUC=0.87; 95% CI: 0.82-0.91) was superior to 2006 IAP guideline (AUC=0.54; 95% CI: 0.47-0.60) and DNA analysis alone (AUC=0.60; 95% CI: 0.53-0.66) for detecting malignant cysts (P=0.004 and P=0.002, respectively). Addition of DNA did not improve performance of the 2012 IAP guideline (AUC=0.84; 95% CI: 0.79-0.88). Commercial DNA analysis does not add useful information beyond imaging and cytology for detection of malignant pancreatic cysts. The 2012 IAP guideline better predicted malignant cysts than the 2006 IAP guideline.

  15. The use of clinical guidelines for referral of patients with lesions suspicious for oral cancer may ease early diagnosis and improve education of healthcare professionals.

    Science.gov (United States)

    Seoane, Juan; Corral-Lizana, Cesar; González-Mosquera, Antonio; Cerero, Rocío; Esparza, Germán; Sanz-Cuesta, Teresa; Varela-Centelles, Pablo

    2011-11-01

    Early diagnosis and referral of oral cancer is essential. Successful implementation of clinical guidelines must include current practitioners and students. To evaluate the diagnostic accuracy of students at oral cancer screening and to assess the effectiveness of clinical referral guidelines. Fifth year dental students were randomly allocated to either control (n=19) or experimental groups (n = 18). Both received the customary training in oral diagnosis. The experimental group underwent a 2 hour workshop where the guidelines for the referral of suspicious lesions were discussed. Three months later, a set of 51 clinical cases including benign, malignant, and precancerous conditions/lesions were used to assess the screening ability of each subject. All 37 students entered the study. Sensitivity (control group) ranged from 16.7% to 66.7%; the experimental group scored from 16.7% to 83.3%. Fifty percent of the experimental students reached sensitivity values ≥ 62.5% (p = 0.01). Diagnostic specificity (control group) spanned from 80% to 93.3% (median = 50%); amongst experimental group it ranged from 82.2% to 97.8% (median = 92.8%); (p = 0.003). Concordance -control group- was X = 82.5 (SD = 3.2), and X = 88.2 (SD = 4.3) for the experimental, (p > 0.001). Cohen's kappa test was poor (K cancers urgently (p = 0.002) and left less unreferred cancers (0.04). This group also referred more precancerous lesions/conditions urgently (p = 0.02). The implementation of a clinical referral guideline at undergraduate level has proved valuable, under experimental conditions, to significantly increase diagnostic abilities of the examiners and thus to improve screening for oral cancer.

  16. Complicated Thyroglossal Duct Cyst Mimicking Malignancy on Ultrasound: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In Joong; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    A Thyroglossal Duct Cyst (TGDC) is the most common cause of midline neck masses and is characterized in sonography as an anechoic or hypoechoic well-cir- cumscribed cyst with posterior enhancement. TGDCs mostly occur in children and are easy to spot in them, but the sonographic appearance of TGDCs in adults is variable, ranging from a typical anechoic to a pseudosolid appearance. The presence of a solid component should alert the radiologist to the possibility of a cancer arising from the thyroglossal duct. We report here on our experience with a 58-year-old woman who had a complicated TGDC with a suspicious sonographic appearance of malignancy

  17. Aggressive malignant phyllodes tumor.

    Science.gov (United States)

    Roberts, Nathan; Runk, Dianne M

    2015-01-01

    Originally described in 1838 by Muller, phyllodes tumor is a rare fibroepithelial neoplasm which represents roughly 0.3-0.9% of all breast cancers. Phyllodes tumor are divided into benign, borderline and malignant histologic categories. Malignant phyllodes tumor represent anywhere from 10-30% of all phyllodes tumors. This group has both the potential to recur locally and metastasize, however not all malignant phyllodes behave this way. The challenge lays in predicting which tumor will recur locally or metastasize. Distinguishing this subset of malignant phyllodes tumor is paramount. We present a case of malignant phyllodes which presented with metastatic disease. What is fascinating about this case is not only the initial presentation but also the aggressiveness of this variation of phyllodes tumor. The patient initially presented with a large mass which encompassed her whole right breast. On surgical pathology the mass measured roughly 31cm in diameter and weighed over 10kg. Within 5 weeks from surgery the patient had suffered brain metastases and also 6 local recurrent tumors. The patient passed roughly 11 weeks after her first visit to our office. Despite biopsy proven malignant phyllodes tumor, it was near impossible to predict such a rapid course of disease progression in our patient. Our case illustrates the unpredictable nature of this disease in general and it possibly sheds light on a variant of the disease which had undergone an aggressive transformation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Renal malignancies with normal excretory urograms

    Energy Technology Data Exchange (ETDEWEB)

    Kass, D.A. (Univ. of California, San Francisco); Hricak, H.; Davidson, A.J.

    1983-10-01

    Four patients with malignant renal masses showed no abnormality of excretory urograms with tomography. Of the four lesions, two were primary renal cell carcinomas, one was a metastatic focus from a contralateral renal cell carcinoma, and one was a metastatic lesion from rectal adenocarcinoma. A normal excretory urogram should not be considered sufficient to exclude a clinically suspected malignant renal mass. In such an instance, diagnostic evaluation should be pursued using a method capable of topographic anatomic display, such as computed tomography or sonography.

  19. Efficacy of two fluorescence in situ hybridization (FISH) probes for diagnosing malignant pleural effusions.

    Science.gov (United States)

    Rosolen, Débora C B; Kulikowski, Leslie D; Bottura, Giorgio; Nascimento, Amon M; Acencio, Milena; Teixeira, Lisete; Vargas, Francisco S; Sales, Roberta K; Antonangelo, Leila

    2013-06-01

    It is difficult to differentiate tumor cells in pleural fluid from reactive benign mesothelium. Fluorescence in situ hybridization (FISH) can increase diagnostic accuracy. Two hundred pleural fluid samples were analyzed by using FISH probes for chromosomes 11 and 17. Histological analysis was used to diagnose cancer. Clinical, radiological, and histological data were used to exclude malignancy. Eighty-two pleural effusion samples had positive cytology, 51 were benign, and 67 were atypical, but inconclusive. The 82 positive cases were confirmed to be malignant. Among the 51 negative cytology cases, videothoracoscopy-guided pleural biopsy revealed malignancy in three; aneuploid cells were detected by FISH in all cases. In 43 of the 67 cases with inconclusive cytology, malignancy was confirmed based on histology and fluorescence in situ hybridization. One case of parapneumonic effusion with no evidence of cancer during clinical follow-up had a suspicious cytology and positive fluorescence in situ hybridization result. The remaining 23 cases had no histological, radiological, clinical, or genetic evidence of malignancy. This study demonstrated that cytogenetic analysis of fresh pleural fluid samples using only two FISH probes is a valuable ancillary method for the identification of malignant pleural effusion, particularly in cases in which oncotic cytology is inconclusive. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Malignancies after liver transplantation: Value of contrast-enhanced ultrasound (CEUS).

    Science.gov (United States)

    Rübenthaler, J; Paprottka, K J; Hameister, E; Hoffmann, K; Joiko, N; Reiser, M; Clevert, D A

    2016-01-01

    To evaluate the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and computed tomography (CT) in the diagnosis of malignancies after liver transplantation. A total of 23 patients with suspicious liver masses after liver transplantation with initial imaging series between September 2006 and September 2015 were statistically analysed. CEUS and CT were compared in their diagnosis of malignancy with CT being the gold standard. Out of 23 patients 9 patients showed malignant masses in CT, which could also be detected in 7 out 9 of cases using CEUS. CEUS showed a sensitivity of 77.8%, a specificity of 100.0%, a positive predictive value (PPV) of 100.0% and a negative predictive value (NPV) of 87,5% in comparison with CT being the gold standard. In 2 cases CT showed a malignancy, contrary to the CEUS examination that was reported as normal. CEUS seems to be an alternative option for the evaluation of malignant masses in liver transplant patients. CEUS shows a high specificity and PPV in the detection of malignant liver masses.

  1. Assessment of Feasibility to Use Computer Aided Texture Analysis Based Tool for Parametric Images of Suspicious Lesions in DCE-MR Mammography

    Directory of Open Access Journals (Sweden)

    Mehmet Cemil Kale

    2013-01-01

    Full Text Available Our aim was to analyze the feasibility of computer aided malignant tumor detection using the traditional texture analysis applied on two-compartment-based parameter pseudoimages of dynamic contrast-enhanced magnetic resonance (DCE-MR breast image data. A major contribution of this research will be the through-plane assessment capability. Texture analysis was performed on two-compartment-based pseudo images of DCE-MRI datasets of breast data of eight subjects. The resulting texture parameter pseudo images were inputted to a feedforward neural network classification system which uses the manual segmentations of a primary radiologist as a gold standard, and each voxel was assigned as malignant or nonmalignant. The classification results were compared with the lesions manually segmented by a second radiologist. Results show that the mean true positive fraction (TPF and false positive fraction (FPF performance of the classifier vs. primary radiologist is statistically as good as the mean TPF and FPF performance of the second radiologist vs. primary radiologist with a confidence interval of 95% using a one-sample -test with . In the experiment implemented on all of the eight subjects, all malignant tumors marked by the primary radiologist were classified to be malignant by the computer classifier. Our results have shown that neural network classification using the textural parameters for automated screening of two-compartment-based parameter pseudo images of DCE-MRI as input data can be a supportive tool for the radiologists in the preassessment stage to show the possible cancerous regions and in the postassessment stage to review the segmentations especially in analyzing complex DCE-MRI cases.

  2. Polymer Nanoparticle-Based Chemotherapy for Spinal Malignancies

    OpenAIRE

    Ma, Hongyun; Jiang, Weiqian; Ding, Jianxun; Li, Mingqiang; Cheng, Yilong; Sun, Shuo; Fu, Changfeng; Liu, Yi

    2016-01-01

    Malignant spinal tumors, categorized into primary and metastatic ones, are one of the most serious diseases due to their high morbidity and mortality rates. Common primary spinal tumors include chordoma, chondrosarcoma, osteosarcoma, Ewing’s sarcoma, and multiple myeloma. Spinal malignancies are not only locally invasive and destructive to adjacent structures, such as bone, neural, and vascular structures, but also disruptive to distant organs (e.g., lung). Current treatments for spinal malig...

  3. A prospective randomised study of dense Infinity cytological brush versus regularly used brush in pancreaticobiliary malignancy.

    Science.gov (United States)

    Kylänpää, Leena; Boyd, Sonja; Ristimäki, Ari; Lindström, Outi; Udd, Marianne; Halttunen, Jorma

    2016-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) with a cytological sample is a valuable tool in the diagnosis of the aetiology of biliary stricture. Our aim was to evaluate whether a more dense Infinity® cytological brush is more sensitive in diagnosing malignancy than the regularly used brush. We recruited 60 patients with a biliary stricture suspicious for malignancy for a randomised controlled trial. Patients were randomly assigned to an Infinity® brush group (n = 30) and a regularly used cytology brush group (n = 30). All the patients had verified cancer during follow-up. Crossing the brush over the stricture was possible in each case without dilatation of the biliary duct. Brush cytology yield was good or excellent in 86.7% of cases with the Infinity® brush and 96.7% with the regular brush (p = 0.161). The cytological sample showed clear malignancy in three patients (10.0%) in the Infinity® group and in 12 (40.0%) patients of the regular brush group (p = 0.007). The cytological diagnosis was highly suspicious for malignancy or malignant in 14 patients (46.7%) in the Infinity® group and in 23 patients (76.7%) in the regular brush group (p = 0.017). The result was benign in 10 patients (33.3%) in the Infinity® group and in four patients (13.6%) in the regular brush group (p = 0.067). With the standardised technique, the sensitivity of brush cytology is fairly good. The dense Infinity® brush does not show any advantage regarding sensitivity compared with the conventional cytology brush.

  4. Contaminação tumoral em trajeto de biópsia de tumores ósseos malignos primários Tumor contamination in the biopsy path of primary malignant bone tumors

    Directory of Open Access Journals (Sweden)

    Marcelo Parente Oliveira

    2012-10-01

    Full Text Available OBJETIVO: Estudar os fatores possivelmente associados à contaminação tumoral do trajeto de biópsia de tumores ósseos malignos primários. MÉTODO: Foram estudados, retrospectivamente, 35 pacientes submetidos a tratamento cirúrgico com diagnóstico de osteossarcoma, tumor de Ewing e condrossarcoma. A amostra foi analisada para caracterização quanto à técnica de biópsia empregada, tipo histológico do tumor, realização de quimioterapia neoadjuvante, ocorrência de recidiva local e contaminação tumoral no trajeto da biópsia. RESULTADOS: Nos 35 pacientes avaliados ocorreram quatro contaminações (11,43%. Um caso era de osteossarcoma, dois casos de tumor de Ewing e um caso de condrossarcoma, não se observando associação entre o tipo de tumor e a presença de contaminação tumoral no trajeto da biópsia (p = 0,65. Também não se observou associação entre a presença de contaminação tumoral e a técnica de biópsia (p = 0,06. Por outro lado, observou-se associação entre a presença de contaminação tumoral e a ocorrência de recidiva local (p = 0,01 e entre a presença de contaminação e a não realização de quimioterapia neoadjuvante (p = 0,02. CONCLUSÃO: A contaminação tumoral no trajeto de biópsia de tumores ósseos malignos primários esteve associada à ocorrência de recidiva local. Por outro lado, não mostrou ser influenciada pelo tipo de biópsia realizada e pelo tipo histológico de tumor estudado. A quimioterapia neoadjuvante mostrou um efeito protetor contra esta complicação. A despeito desses achados, a contaminação tumoral é uma complicação que deve sempre ser considerada, sendo recomendada a remoção do trajeto da biópsia na cirurgia de ressecção do tumor.OBJECTIVE: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. METHOD: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and

  5. Simulants of malignant melanoma

    Directory of Open Access Journals (Sweden)

    Gérald E. Piérard

    2015-08-01

    Full Text Available During the recent period, dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN of the skin. Beyond this clinical procedure, AMN histopathology remains mandatory for establishing their precise diagnosis. Of note, panels of experts in AMN merely report moderate agreement in various puzzling cases. Divergences in opinion and misdiagnosis are likely increased when histopathological criteria are not fine-tuned and when facing a diversity of AMN types. Furthermore, some AMN have been differently named in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus, pigmented epithelioid melanocytoma or animal-type melanoma. Some acronyms have been further suggested such as MELTUMP (after melanocytic tumor of uncertain malignant potential and STUMP (after Spitzoid melanocytic tumor of uncertain malignant potential. In this review, such AMN at the exclusion of cutaneous malignant melanoma (MM variants, are grouped under the tentative broad heading skin melanocytoma. Such set of AMN frequently follows an indolent course, although they exhibit atypical and sometimes worrisome patterns or cytological atypia. Rare cases of skin melanocytomas progress to loco regional clusters of lesions (agminate melanocytomas, and even to regional lymph nodes. At times, the distinction between a skin melanocytoma and MM remains puzzling. However, multipronged immunohistochemistry and emerging molecular biology help profiling any malignancy risk if present.

  6. Malignancy following kidney transplantation.

    Science.gov (United States)

    Arichi, N; Kishikawa, H; Nishimura, K; Mitsui, Y; Namba, Y; Tokugawa, S; Ichikawa, Y

    2008-09-01

    A cohort of 429 patients who received kidney grafts between 1973 and 2007 at our hospital was studied for the incidence and sites of malignancy. Sixty-two malignant diseases developed in 57 of 429 patients (13.3%). The cumulative incidences of malignancy increased markedly in the second and third posttransplantation decades. The overall rates were 1.8% at 5 years, 6.7% at 10 years, 12.5% at 15 years, 17.3% at 20 years, and 25.6% at 25 years. In the second and third posttransplantation decades, patients without malignancy showed significantly superior survival versus than those with cancer (P = .0002). Their survival rates were 83.4% versus 86.9% at 10 years and 63.1% versus 80.3% at 20 years, respectively. Skin cancer, renal cell carcinoma of the native kidney, hepatocellular carcinoma, posttransplantation lymphoproliferative disease, uterine cancer, and colorectal cancer were common in our series. The 5-year survival rates after the treatment of malignancy were better for skin cancer and renal cell carcinoma of the native kidney. Concerning the effects of immunosuppression, the tacrolimus-based group displayed a higher incidence among 3 groups (P = .0044).

  7. Immunotherapy of Genitourinary Malignancies

    Directory of Open Access Journals (Sweden)

    Teruo Inamoto

    2012-01-01

    Full Text Available Most cancer patients are treated with some combination of surgery, radiation, and chemotherapy. Despite recent advances in local therapy with curative intent, chemotherapeutic treatments for metastatic disease often remain unsatisfying due to severe side effects and incomplete long-term remission. Therefore, the evaluation of novel therapeutic options is of great interest. Conventional, along with newer treatment strategies target the immune system that suppresses genitourinary (GU malignancies. Metastatic renal cell carcinoma and non-muscle-invasive bladder caner represent the most immune-responsive types of all human cancer. This review examines the rationale and emerging evidence supporting the anticancer activity of immunotherapy, against GU malignancies.

  8. Rheumatologic Manifestations of Malignancy.

    Science.gov (United States)

    Hashefi, Mandana

    2017-02-01

    A variety of conditions mimicking rheumatologic syndromes may be associated with an underlying malignancy. Therefore, distinguishing these syndromes from more common, nonparaneoplastic rheumatologic conditions can be perplexing. Some autoimmune conditions and the medications used for their management can be associated with increased future risk of malignancy. Some cancers can directly involve the musculoskeletal structures, whereas others present with systemic manifestations at sites away from the tumor and its metastases. Better awareness and timely recognition of these associations may lead to earlier cancer detection and hopefully better long-term survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Accuracy of intraoperative gross examination of surgical margin status in women undergoing partial mastectomy for breast malignancy.

    Science.gov (United States)

    Balch, Glen C; Mithani, Suhail K; Simpson, Jean F; Kelley, Mark C

    2005-01-01

    Margin status is an important prognostic factor for local recurrence after partial mastectomy for breast malignancy. Options for intraoperative evaluation of margin status include gross examination of the specimen, frozen section, and "touch preparation" cytology. This study evaluates the accuracy of gross examination without other intraoperative pathological analysis as a method of determining margin status. Records of 254 consecutive patients undergoing partial mastectomy for 255 breast malignancies (199 invasive, 56 DCIS) over 6 years were analyzed retrospectively. All women underwent en bloc excision of the primary lesion with gross examination of margin status by the surgeon and pathologist. All suspicious areas were reexcised, and the specimen was inked, serially sectioned at 2-3 mm intervals and examined with hematoxylin and eosin (H&E) stains. Specimens with tumor margin were considered margin-positive and those with all tumor > or =2 mm from the margin were designated margin-negative. One hundred fourteen (45%) of the 255 segmental resections were considered to have grossly tumor-free margins, and intraoperative reexcision was not performed. Ninety-six (84%) of these specimens had histologically negative margins. Gross examination prompted intraoperative reexcision in 141 (55%) cases. Ninety-five (67%) of these 141 resections had tumor-free margins on histopathology. Overall, the final margin was involved in 64 of the 255 partial mastectomies. Seventeen (27%) women with initially margin-positive resections underwent mastectomy, while 46 (72%) underwent reexcision, which was margin-negative in 41 (89%). After a median follow-up of 42 months, there have been eight (3.5%) local recurrences. The initial margin-positive rate was similar in ductal carcinoma in situ (DCIS) (30%) and invasive carcinoma (24%). Margin status was correlated with nodal status; there was no correlation with age, tumor size, grade hormone receptor status, or type of diagnostic biopsy

  10. Thigmotropism of Malignant Melanoma Cells

    Directory of Open Access Journals (Sweden)

    Pascale Quatresooz

    2012-01-01

    Full Text Available During malignant melanoma (MM progression including incipient metastasis, neoplastic cells follow some specific migration paths inside the skin. In particular, they progress along the dermoepidermal basement membrane, the hair follicles, the sweat gland apparatus, nerves, and the near perivascular space. These features evoke the thigmotropism phenomenon defined as a contact-sensing growth of cells. This process is likely connected to modulation in cell tensegrity (control of the cell shape. These specifically located paucicellular aggregates of MM cells do not appear to be involved in the tumorigenic growth phase, but rather they participate in the so-called “accretive” growth model. These MM cell collections are often part of the primary neoplasm, but they may, however, correspond to MM micrometastases and predict further local overt metastasis spread.

  11. Angiogenesis in malignant lymphoma.

    NARCIS (Netherlands)

    Koster, A.; Raemaekers, J.M.M.

    2005-01-01

    PURPOSE OF REVIEW: Angiogenesis plays an important role in the pathophysiology of both solid tumors and hematologic malignancies. Angiogenesis-associated parameters are important prognosticators, and tumor blood vessels are an emerging target for therapy. This review addresses the evidence of the

  12. Aggressive malignant phyllodes tumor

    Directory of Open Access Journals (Sweden)

    Nathan Roberts

    2015-01-01

    Conclusion: Despite biopsy proven malignant phyllodes tumor, it was near impossible to predict such a rapid course of disease progression in our patient. Our case illustrates the unpredictable nature of this disease in general and it possibly sheds light on a variant of the disease which had undergone an aggressive transformation.

  13. Susceptibility to malignant hyperthermia

    NARCIS (Netherlands)

    Snoeck, Marcus Matheus Johannes

    2004-01-01

    In this thesis the author studied the diagnostic procedures for susceptibility to malignant hyperthermia (MH), with special emphasis upon refining the biological diagnostic test and improving protocols and guidelines for investigation of MH susceptibility. MH is a pharmacogenetic disease of skeletal

  14. [Pregnancy and malignant melanoma].

    Science.gov (United States)

    Pankova, T; Stoikov, S; Nikolova, M

    2010-01-01

    The authors review on a rare pregnancy accompanying disease--Melanoma malignum. After the definition are presented the epidemiology, etiology, pathogenesis, pathomorphology, clinical forms, diagnosis, differential diagnosis, treatment and prevention. Described are the effects of the pregnancy on this malignant disease and the impact of it during the pregnancy.

  15. Trauma - the malignant epidemic

    African Journals Online (AJOL)

    life are lost annually from trauma than malignant disease, heart disease, and AIDS combined, and by the ... diffused and rapidly spreading condition affecting many people in anyone region at the same time and tending ... upon inadequate and overcrowded methods of transportation. TABLE I. INTERPERSONAL VIOLENCE ...

  16. Homologous Type of Malignant Mixed Mullerian Tumor of the Uterus Presenting as a Cervical Mass

    Directory of Open Access Journals (Sweden)

    Umur Kuyumcuoğlu

    2009-10-01

    Full Text Available Malignant mixed Mullerian tumors are composed of a mixture of sarcoma and carcinoma. The carcinomatous element is usually glandular, whereas the sarcomatous element may resemble normal endometrial stroma (homologous or so-called carcinosarcoma. Here, we present a homologous type of malignant mixed Mullerian tumor of the uterus that presented as a cervical mass. We describe a 55-year-old patient who had a cervical mass arising from the uterus. We performed total abdominal hysterectomy and bilateral salpingo-oophorectomy and surgical staging (including (peritoneal washings, suspicious areas or peritoneal surfaces sampled, infracolic omental sampling, pelvic and paraaortic lymph node sampling, and appendectomy. Carcinosarcomas of the uterine cervix are extremely rare, and when a post-menopausal woman with a cervical mass is admitted to the gynecology clinic, the physician should keep in mind that the mass might be a carcinosarcoma. [J Chin Med Assoc 2009;72(10:533–535

  17. [Skin cancer in primary care: frequency, need to further education and subjective diagnostic certainty. A cross sectional survey among general practitioners in Canton of Zurich

    NARCIS (Netherlands)

    Badertscher, N.; Senn, O.; Rossi, P.O.; Wensing, M.; Rosemann, T.; Tandjung, R.

    2013-01-01

    BACKGROUND: Incidence of malignant skin lesions is rising in Switzerland. We wanted to assess the frequency of patients with suspicious skin lesions in daily practice. Furthermore, we asked for diagnostic certainty and the need of further education in skin cancer. METHODS: Survey with 1212 GPs in

  18. Oral potentially malignant disorders: is malignant transformation predictable and preventable?

    NARCIS (Netherlands)

    van der Waal, I.

    2014-01-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that

  19. Nevus of the Eyelid Margin Mimicking a Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    A. Echchaoui

    2016-06-01

    Full Text Available Nevi are a benign skin lesions commonly found on the eyelid margin, these tumors are usually pigmented and have thickness. Nevi are not typically visible at birth; they appear during childhood and often exhibit a more rapid increase in pigmentation about the time of puberty. Most eyelid nevi can be diagnosed by clinical examination; suspicious lesions should be biopsied when rapid growth, loss of eyelashes or discoloration of the nevus is noted. Eyelid nevi require treatment if malignant transformation and/or cosmetically bothersome to the patient. We report a case of a 37-year-old female patient exhibited a single cutaneous tumor at the free margin of the lower left eyelid, she noticed a dark spot on their eyelid since childhood. It was a brown, fleshy, thickened, and nodular well-circumscribed exophytic mass, measuring 6 mm in diameter; its clinical appearance argued for a possible nodular melanoma. Excisional-biopsy was performed using a full-thickness pentagonal wedge excision technique. Histopathology showed that the lesion was a benign melanocytic nevocellular nevus. The post-operative courses were uneventful with excellent cosmetic and functional result. Preventive measures (cap, sunglasses... and regular monitoring of the lesion by assessing ABCDE criteria (asymmetry, irregular borders, multiple colors, diameter ≥ 6 mm, and enlargement remain necessary to detect and rule out a possible risk of malignant melanoma.

  20. Prevalence of potentially malignant oral mucosal lesions among tobacco users in Jeddah, Saudi Arabia.

    Science.gov (United States)

    Al-Attas, Safia Ali; Ibrahim, Suzan Seif; Amer, Hala Abbas; Darwish, Zeinab El-Said; Hassan, Mona Hassan

    2014-01-01

    Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions , those suspicious for malignancy being linked with chewable forms, indicating serious effects.

  1. Malignant mesenchymoma of the scrotum

    DEFF Research Database (Denmark)

    Møller, P; Bernstein, Inge Thomsen; Brynitz, S

    1991-01-01

    Paratesticular sarcomas are rare, especially the malignant mesenchymoma. To our knowledge only four cases of paratesticular malignant mesenchymoma have been described previously. All were localized to the spermatic cord. We present a case of malignant mesenchymoma in the scrotum free of the sperm...

  2. [Malignant cartilage tumors].

    Science.gov (United States)

    Geirnaerdt, M J; Hogendoorn, P C; Taminiau, A H; Bloem, J L

    1998-06-01

    Malignant cartilaginous tumors (chondrosarcomas) are, with a relative frequency of 20%, the second most common malignant tumors of bone after osteosarcoma. The diagnosis of chondrosarcoma can usually be made confidently based on combination of clinical information, radiographs, Gd-enhanced MR imaging, and histologic examination of a biopsy sample. The combination of these parameters is important because accuracy of histologic diagnosis is adversely affected by unrepresentative sampling of these usually large tumors. The prognosis of patients with chondrosarcoma becomes poorer with more axial location, higher histologic grade, larger tumor size and inadequate resection. By careful analysis of radiographs and Gd-enhanced MR imaging the radiologist has the ability to improve the management of patients with chondrosarcoma.

  3. Telomerase in hematologic malignancies.

    Science.gov (United States)

    Bruedigam, Claudia; Lane, Steven W

    2016-07-01

    The activation of telomere maintenance pathways has long been regarded as a key hallmark of cancer and this has propelled the development of novel inhibitors of telomerase. In this review, we detail the background biology on telomere maintenance in health and disease, then concentrate on the recent preclinical and clinical development behind targeting telomerase in blood cancers. Preclinical and clinical studies have shown that imetelstat, a competitive inhibitor of telomerase, has activity in certain hematologic malignancies, in particular the myeloproliferative neoplasms and acute myeloid leukemia. Telomerase inhibition has shown remarkable efficacy in myeloid malignancies, and current and future preclinical and clinical studies are necessary to comprehensively investigate its underlying mechanism of action. Future work should identify the potential genetic susceptibilities to telomerase inhibition therapy, and evaluate rational combinations of telomerase inhibitors with chemotherapy and other novel agents. Robust preclinical evaluation is essential to best translate these new agents successfully into our clinical treatment algorithm for myeloid and other blood cancers.

  4. Intravascular malignant lymphomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Martin-Duverneuil, N.; Lafitte, F.; Chiras, J. [Service de Neuroradiologie Charcot, Batiment Babinski, Hopital de la Salpetriere, 75013 Paris (France); Mokhtari, K. [Service de Neuropathologie, Hopital de la Salpetriere, 75013 Paris (France); Behin, A.; Hoang-Xuan, K. [Departement de Neurologie, Hopital de la Salpetriere, 75013 Paris (France)

    2002-09-01

    Intravascular malignant lymphomatosis is a rare and probably often overlooked disease characterised by massive intravascular proliferation of lymphoid cells, usually with a poor prognosis. CT and MRI appearances are nonspecific; the most suggestive finding being both asymmetrical, bilateral, contrast enhancing high-signal areas on T2 weighting and infarct-like lesions of the cortex and basal ganglia. We report two patients with previously unreported dural and spinal cord involvement. (orig.)

  5. Candidiasis in Malignancy

    OpenAIRE

    Taher, Diany N; Syam, Ari Fahrial; Abdullah, Murdani; Atmakusuma, Jumhana; Chen, Khie

    2006-01-01

    Esophageal candidiasis presents with a range of clinical findings and is rarely found among immunocompetent patient without predisposing factors. Between 20-50% of patient may be asymptomatic. One of predisposing factor of candidiasis is immunocompromised condition due to Malignancy. Dysphagia is the most frequently presented feature of esophageal carcinoma. We demonstrated a case of esophageal candidiasis as one of early clinical presentation in patient with esophageal carcinoma.

  6. Lymphoscintigraphy in gynecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Bloomer, W.D.

    1983-01-01

    Lymphoscintigraphy is an easily performed noninvasive procedure that offers the potential to detect small numbers of ascitic tumor cells and early diaphragmatic tumor involvement. Moreover, it can be used to delineate and define abnormalities in lymph nodes that are not routinely visualized by bipedal contrast lymphangiography, ultrasound or computed tomography. Lymphoscintigraphy is recommended as an important investigative and adjunctive procedure in diagnosing gynecologic malignancies; there does not appear to be sufficient sensitivity and specificity to justify its routine clinical use.

  7. Malignant histiocytosis. Case report

    OpenAIRE

    Ruiz, Oscar; Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM, y Hospital Nacional Dos de Mayo; QUIÑONES, WILLY; Servicio Hematologia Clínica, Hospital Dos de Mayo; MISAD, OSCAR; Laboratorio de Anatomia Patológica “Oscar Misad; DELGADO, CARLOS; Instituto de Investigaciones Clínicas, UNMSM; Servicio Hematologia Clínica, Hospital Dos de Mayo; Ronceros, Sergio; Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.; Marangoni, Manuela; Departamento de Enfermería, Hospital Nacional Dos de Mayo. Lima, Perú; BARDALES, LUZ; Servicio Hematologia Clínica, Hospital Dos de Mayo; REYES, RAFAEL; Servicio Hematologia Clínica, Hospital Dos de Mayo; CASTILLO, ALFREDO; Servicio Hematologia Clínica, Hospital Dos de Mayo; URRUTIA, KATIA; Servicio Hematologia Clínica, Hospital Dos de Mayo

    2013-01-01

    Fourteen year-old male patient referred from Huancayo who presented one month gastric intolerance, jaundice, fever and a lymph proliferative syndrome. Laboratory tests revealed severe pancytopenia due to phagocytosis. Haematologic and anatomy-pathology diagnosis was human malignant histiocytosis. We present this case due to its low frequency and the emergency character of the disease. Paciente varón de 14 años, procedente de Huancayo, que presenta un mes antes de su hospitalización intoler...

  8. Immunotherapy for gastrointestinal malignancies.

    Science.gov (United States)

    Toomey, Paul G; Vohra, Nasreen A; Ghansah, Tomar; Sarnaik, Amod A; Pilon-Thomas, Shari A

    2013-01-01

    Gastrointestinal (GI) cancers are the most common human tumors encountered worldwide. The majority of GI cancers are unresectable at the time of diagnosis, and in the subset of patients undergoing resection, few are cured. There is only a modest improvement in survival with the addition of modalities such as chemotherapy and radiation therapy. Due to an increasing global cancer burden, it is imperative to integrate alternative strategies to improve outcomes. It is well known that cancers possess diverse strategies to evade immune detection and destruction. This has led to the incorporation of various immunotherapeutic strategies, which enable reprogramming of the immune system to allow effective recognition and killing of GI tumors. A review was conducted of the results of published clinical trials employing immunotherapy for esophageal, gastroesophageal, gastric, hepatocellular, pancreatic, and colorectal cancers. Monoclonal antibody therapy has come to the forefront in the past decade for the treatment of colorectal cancer. Immunotherapeutic successes in solid cancers such as melanoma and prostate cancer have led to the active investigation of immunotherapy for GI malignancies, with some promising results. To date, monoclonal antibody therapy is the only immunotherapy approved by the US Food and Drug Administration for GI cancers. Initial trials validating new immunotherapeutic approaches, including vaccination-based and adoptive cell therapy strategies, for GI malignancies have demonstrated safety and the induction of antitumor immune responses. Therefore, immunotherapy is at the forefront of neoadjuvant as well as adjuvant therapies for the treatment and eradication of GI malignancies.

  9. Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

    Directory of Open Access Journals (Sweden)

    Jan Kornafel

    2011-10-01

    Full Text Available The aim of this study was to compare the imaging symptoms and microscopic findings in females with lobular neoplasia (LN found on biopsy. 1,478 women who underwent primary open biopsy or surgical excision after percutaneous biopsy were reviewed. In 24 of them (1.6%, LN was found. In four patients, excisional biopsy with hook-wire localization was done primarily due to the radial scar. In 20 females, surgical excision of BIRADS 4 lesion was performed because of the presence of LN in specimens from the vacuum-assisted or core-needle percutaneous biopsy. Postoperative pathologic findings were compared to the radiological symptoms. In 13 women, LN did not produce any radiological symptoms and was an additional histologic finding existing near the other lesion: fibroadenoma and radial scar. In none of these lesions was an invasive cancer noticed. In one single patient, ductal carcinoma in situ was observed in the other segment of the breast. Invasive ductal cancer developed in the contralateral breast in one patient. In 11 patients, LN was diagnosed due to radiological symptoms produced by itself. In this group, the invasive lobular cancer was found in seven lesions (64%. Our finding suggests that LN producing suspicious radiological symptoms can be a different biologic type of this lesion when compared asymptomatic LN diagnosed which is usually found on biopsy as additional microscopic pathology. Symptomatic LN is probably associated with a higher potential of malignant transformation. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 417–424

  10. The pattern of head and neck malignant tumours in Jos. | Adoga ...

    African Journals Online (AJOL)

    Background: Head and neck tumours are not uncommon in our environment with only a few publications focusing on primary head and neck malignancies. Aim: This study evaluated the histopathological types and anatomic sites of primary head and neck malignancies that were managed and the challenges encountered ...

  11. Advance of Therapeutic Methods for Malignant Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Tao-tao XU

    2016-06-01

    Full Text Available Malignant pleural effusion (MPE is a condition caused by primary malignant tumors in the pleura or other malignant tumors metastasis to the pleura. It is also one of common serious complications of middle-late malignant tumor, which has severe impact on the quality of life, even threatening the life of the patients. The selection of treatments for MPE depends on many factors, including the symptoms, performance status, primary tumor types, response to systemic therapy, and degree of lung recruitment maneuvers (LRM after drainage of pleural effusion. Generally, the treatment methods include thoracentesis, indwelling pleural catheter, pleurodesis, intrapleural injection of drugs, chemotherapy, radiotherapy, anti-angiogenesis therapy, surgery, and thermotherapy. With the in-depth study on pathogenesis of MPE, the treatments of MPE have continuous improvements. This study mainly reviewed the treatment methods for MPE so as to provide the basis for clinical practice in the future.

  12. {sup 99m}Tc-MDP and {sup 99m}Tc-MIBI scintimammography in patients with clinically suspicious breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Kim, Su Zy; Yoon, Suk Nam; Park, Hee Boong [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    {sup 99m}Tc-MDP scintimammography(SM) was performed at the time of the preoperative bone scan in patients with suspicious breast cancer. These patients also had {sup 99m}Tc-MIBI scintimammography before or after the bone scan. The purpose of this report is to compare {sup 99m}Tc-MDP SM and {sup 99m}Tc-MIBI SM with the surgical results. Scintimammography with {sup 99m}Tc-MDP was performed in 20 patients with palpable mass and radiologic suspicion or proven diagnosis of breast cancer preoperatively. Patients ranged in age from 34 to 72. No male patient was included. Both prone lateral and supine anterior views were obtained for 10 min each 10-15min after IV administration of 740 MBq of {sup 99m}Tc-MDP. The {sup 99m}Tc-MIBI scintimammography was also performed before surgery. {sup 99m}Tc-MIBI SM began in 5 min. postinjection of 740MBq of {sup 99m}Tc-MIBI with prone lateral views for 10 min. Scintimammography was evaluated as positive or negative for presence or absence of focal localization of the tracers and the results were compared to histological findings. Breast cancer was histologically diagnosed in all patients ( 16 infiltrating ductal carcinoma, 2 comedocarcinoma, 1 phyllodes tumor, 1 paget disease). The size of tumor mass ranged 1.5-3 cm. Lymph node metastasis was found in 4 patients by the histologic examination. The uptake of {sup 99m}Tc-MDP in breast cancer was noted in all patients except two. One of the two patients was in post excisional biopsy state and the other was also negative in the MIBI scan. There was MDP axillary node uptake in 5 patients. Two of 5 patients with axillary lymph node uptake were false positive but they were all positive with {sup 99m}Tc-MIBI scintimammography. Two masses found in MIBI scan of a patients cannot be separated o the MDP scan. It showed more diffuse uptake than MIBI scan. The concordance between MDP-SM with MIBI-SM(similar pattern of uptake) was 45% and the remaining cases showed not focal but more diffuse uptake

  13. Yttrium-90 radioembolization in the management of liver malignancies.

    Science.gov (United States)

    Riaz, Ahsun; Kulik, Laura M; Mulcahy, Mary F; Lewandowski, Robert J; Salem, Riad

    2010-04-01

    Primary and secondary liver tumors are common. Locoregional therapies are establishing a role in the management of liver tumors due to the limited roles of surgical and systemic therapies. Our review presents some general concepts associated with yttrium-90 radioembolization and its specific utilization in various primary and secondary liver malignancies. Copyright 2010. Published by Elsevier Inc.

  14. Synchronous Occurrence of Primary Breast Carcinoma and Primary Colon Adenocarcinoma.

    Science.gov (United States)

    Yetkin, Gurkan; Celayir, Fevzi; Akgun, Ismail Ethem; Ucak, Ramazan

    2017-01-01

    A 65-year-old female patient presented to the emergency clinic with abdominal pain, meteorism, and intermittent rectal bleeding. Colonoscopy was performed, and a hepatic flexure tumor was detected. Histopathological examination of biopsy revealed adenocarcinoma. Thoracoabdominal CT was performed for staging, and a spiculated contour mass was found incidentally on the left breast. Mammography and ultrasonography were performed for the cause of these findings, and suspicious lesions of malignancy were seen in the left breast. Invasive ductal carcinoma was detected in core needle biopsy samples from lesions. In the multidisciplinary council consisting of oncologist, pathologist, radiologist, and general surgery specialist, it was decided to perform breast operation first and then colon operation, followed by adjuvant chemotherapy. In the first operation, left total mastectomy and sentinel lymph node biopsy were performed. One week after her initial operation, the patient underwent right hemicolectomy. After operations, the patient did not develop postoperative complications and was sent to medical oncology department for adjuvant chemotherapy.

  15. Malignant mesothelioma after radiation treatment for Hodgkin lymphoma

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Burgers, Jacobus A; Baas, Paul

    2009-01-01

    Malignant mesothelioma is a relatively uncommon malignancy. Although the pathogenesis is primarily related to asbestos, the disease may be associated with radiation exposure. Recently, increased risks for second primary mesothelioma after radiation for lymphoma have been reported. Because...... and survival of the mesothelioma cases were comparable with cases from the general population, asbestos exposure and the proportion of males were lower than expected. The evidence for radiotherapy as cause for mesothelioma independent of exposure to asbestos is expanding, and the diagnosis of mesothelioma...

  16. Evaluation of a simulation procedure designed to recognize shape and contour of suspicious masses in mammography

    Science.gov (United States)

    Sousa, Maria A. Z.; Siqueira, Paula N.; Schiabel, Homero

    2015-03-01

    A large number of breast phantoms have been developed for conducting quality tests, characterization of imaging systems and computer aided diagnosis schemes, dosimetry and image perception. The realism of these phantoms is important for ensuring the accuracy of results and a greater range of applications. In this work, a developed phantom is considered proposing the use of PVC films for simulation of nodules inserted in the breast parenchyma designed for classification between malignant and benign signals according to the BI-RADS® standard. The investigation includes analysis of radiographic density, mass shape and its corresponding contour outlined by experienced radiologists. The material was cut based on lesions margins found in 44 clinical cases, which were divided between circumscribed and spiculated structures. Tests were performed to check the ability of the specialists in distinguishing the contour compared to actual cases while the shapes accuracy was determined quantitatively by evaluation metrics. Results showed the applicability of the chosen material creating image radiological patterns very similar to the actual ones.

  17. Malignant Transformation of Endometrioma in a Woman with a History of Ovulation Induction and In Vitro Fertilization

    Directory of Open Access Journals (Sweden)

    Terri L. Woodard

    2012-01-01

    Full Text Available Our aim is to document a case of endometrioid adenocarcinoma of the ovary found in an endometriotic cyst that was suspected on pelvic ultrasound in a patient with polycystic ovary syndrome, normal Ca125, and a recent history of ovulation induction for IVF. She underwent an exploratory laparotomy with left salpingo-oophorectomy and omental biopsies followed by reexploration, complete staging, and modified radical abdominal hysterectomy and right salpingo-oophorectomy. An endometrioma described as suspicious for malignancy by an experienced ultrasound examiner should prompt immediate referral to a gynecological oncologist irrespective of Ca125 levels especially in women with a history of ovulation induction and endometriosis.

  18. Meningioma maligno Malignant meningioma

    Directory of Open Access Journals (Sweden)

    Yvei González Orlandi

    2011-03-01

    Full Text Available Los meningiomas intracraneales son tumores por lo general benignos, de crecimiento lento, y se originan en la capa de células aracnoideas, especialmente en las granulaciones aracnoideas. Los meningiomas anaplásicos o malignos representen solo el 1-3 %. En ocasiones simulan lesiones tumorales neuroepiteliales malignas, por su crecimiento rápido y la frecuente invasión al tejido cerebral vecino; suelen recidivar con mayor frecuencia y muchas veces requieren terapia coadyuvante. Las imágenes topográficas de este tipo de tumores suelen ser hiperdensas, con muy buena captación del contraste, regulares y bien delimitadas con poco o ningún edema asociado, todo lo contrario a lo visto en el caso que se presenta, en el cual las imágenes parecían corresponder a las de un glioma maligno (glioblastoma multiforme.The intracranial meningiomas are tumors in general of benign type of a slow growth originating in the arachnoid cells layer, especially in arachnoid granulations. The anaplastic or malignant meningiomas accounted for only the 1-3%. Sometimes they simulate malignant neuroepithelial lesions due to its fast growth and the frequent invasion of surrounding cerebral tissue with very frequent relapses and many times they required adjuvant therapy. The topographic images of this type of tumor are hyper-denses with a good contrast capture, regular and well defined with not much or not associated edema, quite the contrary that observed in present case where images seems to correspond with those of a malignant glioma (multiforme glioblastoma.

  19. Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications.

    Science.gov (United States)

    Scaperrotta, Gianfranco; Ferranti, Claudio; Capalbo, Emanuela; Paolini, Biagio; Marchesini, Monica; Suman, Laura; Folini, Cristina; Mariani, Luigi; Panizza, Pietro

    2016-01-01

    To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤ 1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture. Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤ 1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576). The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. [Malignant tumors of thyroid gland].

    Science.gov (United States)

    Uhliarová, B; Bugová, G; Hajtman, A

    2015-01-01

    The incidence of thyroid cancer has been increasing. The aim of this work was to determine risk factors, diagnostic methods and extent of surgical treatment of malignant goiter. The authors retrospectively analyzed patients who were surgically treated for thyroid disease at the Department of Otorhinolaryngology, Head and Neck Surgery, Comenius University, Jessenius Faculty of Medicine, Teaching Hospital in Martin, Slovakia, from the January 1st, 2006 to December 31st, 2013, for thyroid disease. The incidence, risk factors of malignant thyroid tumors, indication for surgery and its complications were evaluated. A total of 1,620 adult patients were surgically treated for thyroid disease at the Department of ENT, Head and Neck Surgery, CU JMF, UH in Martin, Slovakia, between 2006- 2013. Malignant tumors were identified in 238 patients (15%). Microcarcinoma (incidentally detected malignant tumor 1 cm) occurred in 78 cases (5%). Malignant thyroid tumor was more common in younger patients (p = 0.002). Newly created and larger nodules positively correlated with the occurrence of malignancy (p = 0.003, p = 0.041, resp.). Gender, family history of thyroid disorder, previous radiation therapy, and previous malignancy did not affect the incidence of malignant tumor of thyroid gland. High sensitivity and specificity in the dia-gnosis of malignant thyroid nodule was observed using aspiration cytology (75%, 97%, resp.) and intraoperative histopathological examination (88%, 100%, resp.). Malignant tumor of thyroid gland is more common in younger patients with newly developed nodule. The risk factors of malignancy increase with the size of the thyroid nodule. Aspiration cytology and peroperative histopathology have high sensitivity and specificity in the dia-gnosis of malignant thyroid tumor; therefore, they should be a standard method in the dia-gnosis of nodular goiter. The method of choice in the treatment of thyroid malignancy is total thyroidectomy.

  1. Oral potentially malignant disorders: is malignant transformation predictable and preventable?

    OpenAIRE

    Van der Waal, Isaäc

    2014-01-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in ...

  2. Helminths and malignancy

    DEFF Research Database (Denmark)

    Vennervald, Birgitte J; Polman, K.

    2009-01-01

    It has been estimated that chronic infections with viruses, bacteria and parasites contribute to 17.8% of the global burden of cancer, although only a relatively small proportion of the infection-related cancers can be attributed to helminth infections. These are important because of the high...... oxidize and damage DNA and lead to genetic instabilities and malignant transformation. Physical damage caused by the parasites, their eggs or secreted products leads to restorative hyperplasia of the damaged tissue. This may promote the propagation of cells, in which genotoxic damage and pre...

  3. Maligne adnekstumorer i huden

    DEFF Research Database (Denmark)

    Klit, Anders; Hærskjold, Ann; Lei, Ulrikke

    2016-01-01

    types entirely on their clinical appearance. The histologic diagnosis is troublesome, and the lesions are often mistaken for their benign counterpart, basal cell carcinoma or squamous cell carcinoma. The lesions are treated with surgery. Radiotherapy and chemotherapy may play a role in treatment......Malignant adnexal carcinomas of the skin are rare but associated with high propensity for local recurrence, and for some of the distinct subgroups they are known to metastasize regionally or distant. Biopsy is necessary for correct diagnosis, as the lesions cannot be separated from other tumour...

  4. Neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Bino Rajamani

    2016-01-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a life-threatening emergency that is often seen as a complication of antipsychotic agents. It is characterized by a tetrad of motor, behavioral, autonomic, and laboratory abnormalities. We report a case of a 34-year-old man with a history of newly diagnosed Type 2 diabetes mellitus, mental retardation, and behavioral abnormalities who developed NMS after starting on antipsychotic agents. He presented with high temperature, muscle rigidity, tachycardia, and elevated blood pressure. After a week of hospital treatment in the general ward of a secondary care unit, he was discharged in a hemodynamically and mentally stable state.

  5. CURRENT APPROACHES TO CHEMORADIOTHERAPY FOR MALIGNANT GLIOMAS

    Directory of Open Access Journals (Sweden)

    Ye. L. Choinzonov

    2014-01-01

    Full Text Available High-grade malignant gliomas (WHO grade G III–IV account for more than 50% of all primary brain tumors. Despite aggressive treatment, survival rates are still very low with a median reported survival of no more than 1.5 years.Radiation therapy is an integral part of the combined treatment, but often does not influence lethally on resistant tumor cells. Thereby, in recent decades there has been an active search for novel approaches to the treatment of malignant gliomas (chemotherapeutic drugs, biological modifiers, local hyperthermia. Experimental data showed that the effect of high temperatures has both a direct damaging effect on tumor cells and a sensitizing effect. Significant advantages are achieved when the complex treatment of different malignant tumorsincludes local hyperthermia. However data on the treatment of patients with primary and recurrent gliomas G III–IV using local hyperthermia are scarce.The literature review is given in the article provides an overview of the existing treatment methods for brain tumors.

  6. Malignancy estimation of Lung-RADS criteria for subsolid nodules on CT. Accuracy of low and high risk spectrum when using NLST nodules

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kaman; Jacobs, Colin; Scholten, Ernst T.; Dekker, Irma; Prokop, Mathias; Ginneken, Bram van [Radboud University Medical Centre, Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Mets, Onno M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Schaefer-Prokop, Cornelia M. [Radboud University Medical Centre, Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Meander Medical Center, Department of Radiology, Amersfoort (Netherlands)

    2017-11-15

    Lung-RADS proposes malignancy probabilities for categories 2 (<1%) and 4B (>15%). The purpose of this study was to quantify and compare malignancy rates for Lung-RADS 2 and 4B subsolid nodules (SSNs) on a nodule base. We identified all baseline SSNs eligible for Lung-RADS 2 and 4B in the National Lung Screening Trial (NLST) database. Solid cores and nodule locations were annotated using in-house software. Malignant SSNs were identified by an experienced radiologist using NLST information. Malignancy rates and percentages of persistence were calculated. Of the Lung-RADS 2SSNs, 94.3% (1790/1897) could be located on chest CTs. Likewise, 95.1% (331/348) of part-solid nodules ≥6 mm in diameter could be located. Of these, 120 had a solid core ≥8 mm, corresponding to category 4B. Category 2 SSNs showed a malignancy rate of 2.5%, exceeding slightly the proposed rate of <1%. Category 4B SSNs showed a malignancy rate of 23.9%. In both categories one third of benign lesions were transient. Malignancy probabilities for Lung-RADS 2 and 4B generally match malignancy rates in SSNs. An option to include also category 2 SSNs for upgrade to 4X designed for suspicious nodules might be useful in the future. Integration of short-term follow-up to confirm persistence would prevent unnecessary invasive work-up in 4B SSNs. (orig.)

  7. Pulmonary talc granulomatosis mimicking malignant disease 30 years after last exposure: a case report

    Directory of Open Access Journals (Sweden)

    Krimsky William S

    2008-07-01

    Full Text Available Abstract Introduction Pulmonary talc granulomatosis is a rare disorder characterized by the development of foreign body granuloma secondary to talc exposure. Previous case reports have documented the illness in current intravenous drug users who inject medications intended for oral use. We present a rare case of the disease in a patient with a distant history of heroin abuse who presented initially with history and imaging findings highly suggestive of malignancy. Case presentation A 53-year-old man reported a 4-month history of increasing dyspnea and weight loss. He had a long history of smoking and admission chest X-ray revealed a density in the right hemithorax. Computed tomography confirmed a probable mass with further speculated opacities in both lung fields suspicious for malignant spread. Biopsies obtained using endobronchial ultrasound-guided aspiration returned negative for malignancy and showed bronchial epithelial cells with foreign body giant cell reaction and polarizable birefringent talc crystals. Conclusion This case demonstrates a rare presentation of talc granulomatosis three decades after the last likely exposure. The history and imaging findings in a chronic smoker were initially strongly suggestive of malignant disease, and we recommend that talc-induced lung disease is considered in any patient with multiple scattered pulmonary lesions and a history of intravenous drug use. Confirmation of the disease by biopsy is essential, but unfortunately there are few successful proven management options for patients with worsening disease.

  8. Technetium-99m scintimammography in the diagnosis of malignant breast tumors

    Directory of Open Access Journals (Sweden)

    Jauković Ljiljana

    2004-01-01

    Full Text Available Background. Technetium-99m (99mTc tetrofosmin scintigraphy is a new imaging method for the diagnosis of various malignancies, such as lung, thyroid, and most frequently breast neoplasms. The aim of this study was to evaluate the diagnostic reliability of 99mTc-Tetrofosmin breast scintigraphy in the detection of malignant breast disease. Methods. 99mTc -Tetrofosmin scintimammography (SMM was performed in 28 patients with 30 breast lesions suspicious for malignancy. Standard mammography (MM was also done. After surgery, the results of SMM and MM were compared to definitive histopathological findings as the "gold standard". After intravenous injection of radiotracer, SMM was performed in prone and supine views of the thorax, using large field-of-view Gamma camera. Results. The results of SMM were interpreted visually and semiquantitatively, and evaluated as positive or negative. Sensitivity, specificity and accuracy, positive (PPV and negative predictive value (NPV were obtained in relation to histopathology. After comparing the results of SMM and MM, SMM was proved more sensitive (95% for SMM vs. 80% for MM, while the specificity of both methods was similar. Conclusion. The results of this study indicate that the contribution of SMM as a nuclear medicine procedure has its place in the diagnostic protocol for patients suspected of malignant breast cancer.

  9. Fourier component imaging of water resonance in the human breast provides markers for malignancy

    Science.gov (United States)

    Medved, Milica; Newstead, Gillian M.; Fan, Xiaobing; Du, Yiping P.; Olopade, Olufunmilayo I.; Shimauchi, Akiko; Zamora, Marta A.; Karczmar, Gregory S.

    2009-10-01

    The purpose of this paper is to demonstrate that voxels with inhomogeneously broadened water resonances, as revealed by high spectral and spatial resolution (HiSS) MRI, correlate with underlying tumor pathology findings, and thus carry diagnostically useful information. Thirty-four women with mammographically suspicious breast lesions were imaged at 1.5 T, using high-resolution echo-planar spectroscopic imaging. Fourier component images (FCIs) of the off-peak spectral signal were generated, and clusters of voxels with significant inhomogeneous broadening (broadened clusters) were identified and correlated to biopsy results. Inhomogeneously broadened clusters were found significantly more frequently in malignant than in benign lesions. A larger percentage of broadened cluster voxels were found inside the malignant versus benign lesions. The high statistical significance for separation of benign and malignant lesions was robust over a large range of post-processing parameters, with a maximum ROC area under curve of 0.83. In the human breast, an inhomogeneously broadened water resonance can serve as a correlate marker for malignancy and is likely to reflect the underlying anatomy or physiology.

  10. Malignant fibrous histiocytoma of the spleen: An extremely rare entity

    Directory of Open Access Journals (Sweden)

    Leelavathi Dawson

    2012-01-01

    Full Text Available Primary malignant fibrous histiocytoma (MFH of the spleen is extremely rare. Since the first description of primary splenic MFH reported by Govoni et al in 1982, to the best of our knowledge, only twelve cases of MFH of the spleen have been reported in the literature. We herein report a rare case of primary splenic MFH in a 30-year-old Indian male who presented with abdominal pain with a history of recurrent hydatid cyst of liver and spleen. A computed tomography (CT scan was performed and a diagnosis of splenic hydatid cyst was made. Splenectomy was done. On histopathological examination, a diagnosis of malignant mesenchymal tumor, possibly storiform variant of malignant fibrous histiocytoma, was made. On immunohistochemistry, the tumor was positive for vimentin and CD68. The post operative period was uneventful. Compared with the twelve previously cases of MFH of the spleen, our patient is the youngest case reported so far.

  11. Primary pulmonary lymphoepithelioma-like carcinoma on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Aktas, Gul Ege; Can, Nuray; Demir, Selin Soyluglu; Sarika, Ali [Trakya University Medical Faculty, Edirne (Turkmenistan)

    2017-03-15

    A 69-year-old male smoker was referred to 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) with the indication of a suspicious solitary pulmonary nodule. FDG PET/CT determined a 2.5 × 2-cm soft-tissue lesion (SUV{sub ma{sub x}}, 16.2) with spiculated margins in the hilum of the right lung. A 1-cm diameter lymphadenopathy on the right hilum with an SUV{sub max} of 3.2 was also determined. Transbronchial biopsy of the right hilar lymphadenopathy did not reveal any malignant features in histopathologic examination, and it was determined to be reactive. The patient underwent a right upper lobe segmentectomy, and the histopathologic evaluation revealed that the tumor was a primary lymphoepithelioma-like carcinoma (LELC) of the lung with negative Epstein-Barr virus (EBV) on in situ hybridization studies. In this case report, we mainly focus on the FDG avidity of this very rare kind of tumor comparatively with previous reports and possible explanations of discordancy in FDG avidity in relation to histopathologic characteristics.

  12. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

    Directory of Open Access Journals (Sweden)

    Diogo Turiani Hourneaux De Moura

    2016-12-01

    Full Text Available Abstract Background When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. Case presentation A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL. Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm, localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. Conclusions To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has

  13. Oral potentially malignant disorders: Is malignant transformation predictable and preventable?

    Science.gov (United States)

    van der Waal, Isaäc

    2014-01-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract. The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant transformation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value. It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed. Key words:Oral potentially malignant disorders, oral leukoplakia, oral lichen planus. PMID:24905952

  14. Gastric malignancies and associated pre-malignant lesions in a ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-07-04

    Jul 4, 2008 ... lesions like chronic gastritis, glandular atrophy, intestinal metaplasia, H. pylori infection play some role in the pathogenesis of gastric malignancies. The aims of this investigation were to study the histological type of gastric malignancies seen in the. Department of Morbid Anatomy and Forensic Medicine,.

  15. Malignant tumors of the heart.

    Science.gov (United States)

    Hudzik, Bartosz; Miszalski-Jamka, Karol; Glowacki, Jan; Lekston, Andrzej; Gierlotka, Marek; Zembala, Marian; Polonski, Lech; Gasior, Mariusz

    2015-10-01

    Primary malignant cardiac tumors are rare, and mostly manifest as sarcomas in various types. As non-invasive diagnostic modalities, e.g. echocardiography and magnetic resonance imaging, have become more sensitive, there is a marked increase in the number of patients diagnosed. Nevertheless, most patients die within one year of initial diagnosis, either because of the often asymptomatic presentation of cardiac tumors until advanced disease, or a low index of suspicion on the part of the physician. The presenting symptoms, treatment options and, indeed, prognosis are largely controlled by the tumor's anatomic location. Cardiac sarcomas may present with a variety of symptoms and are known to be great mimickers. A quick diagnosis facilitates the initiation of a proper treatment (surgical resection, adjuvant chemotherapy), which may in turn improve the prognosis. Metastases to the heart are far more common, unfortunately, clinical manifestations are mainly dominated by generalized tumor spread. The article summarizes epidemiology, symptoms, diagnostic modalities, and possible treatment options. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Survival and Prognosis for Malignant Tumors of Odontogenic Origin.

    Science.gov (United States)

    Agarwal, Sunil; Mark, Jonathan; Xie, Changchun; Ghulam, Enas; Patil, Yash

    2016-07-01

    Determine survival and factors affecting survival for patients with malignant tumors of odontogenic origin. Retrospective analysis of the National Cancer Institute's SEER database (Surveillance, Epidemiology, and End Results). Tertiary medical center. All cases of malignant tumors of odontogenic origin were extracted from the SEER database for the period of 1973 to 2011. Demographic, tumor-specific, and survival data were tabulated and Kaplan-Meier survival analysis conducted according to histopathologic results. Cox regression analysis stratified for histopathology was conducted to determine factors that influenced survival. A total of 308 cases of malignant tumors with odontogenic origin were analyzed. Malignant ameloblastoma accounted for 59.7% of cases, followed by malignant odontogenic tumor (35.4%; including odontogenic carcinoma, odontogenic sarcoma, primary intraosseous carcinoma, and ameloblastic carcinoma) and ameloblastic fibrosarcoma (2.9%). The overall mean and median were 229 and 227 months, respectively, while the 5-year survival rate was 81% for the entire cohort. Malignant ameloblastoma exhibited the best mean survival (237 months), whereas malignant odontogenic tumor (139 months) and ameloblastic fibrosarcoma (42 months) had lower mean survival rates. Younger age, surgery with adjuvant radiation, and smaller tumor size were found to improve survival. Significantly different survival can be expected depending on individual tumor histopathology, tumor size, age at diagnosis, and treatment modality. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  17. Malignant pleural effusion

    OpenAIRE

    Teixeira, Lisete Ribeiro; Pinto, José Antonio de Figueiredo; Marchi, Evaldo

    2006-01-01

    O derrame pleural neoplásico é uma complicação freqüente nos pacientes portadores de tumores avançados. A presença de células malignas no líquido pleural ou na biópsia da pleura é indicativa de disseminação da doença primária, com conseqüente redução da expectativa de vida. O diagnóstico e tratamento precoce do derrame pleural maligno são fundamentais para promover uma melhor qualidade de vida aos pacientes portadores de câncer avançado.The malignant pleural effusion is a frequent complicatio...

  18. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  19. Gastric ulcers: malignancy yield and risk stratification for follow-up endoscopy.

    Science.gov (United States)

    Selinger, Christian P; Cochrane, Rebecca; Thanaraj, Sangeetha; Sainsbury, Anita; Subramanian, Venkat; Everett, Simon

    2016-06-01

    Malignant change can occur in gastric ulcer but guideline recommendations for follow-endoscopy (FU-OGD) are conflicting. This study aims to determine rate of malignancy and need for follow-up for gastric ulcers. Patients with a first diagnosis of gastric ulcer between January 2012 and September 2013 were studied by analyzing endoscopic assessments, dysplasia, and malignancy yield and the influence of risk factors on the likelihood of benign disease. In a cohort of 432 patients with gastric ulcer (53 % male, mean age 65 years) dysplasia or neoplasia were found in 27 (19 adenocarcinomas, 2 cases of dysplasia, 5 lymphomas, 1 melanoma; malignancy yield 6 %). Twenty-five (93 %) cases were diagnosed on first biopsy. The cancer yield of FU-OGD after initially benign biopsy was 0.9 %. Binary logistic regression analysis revealed that endoscopically benign appearance (odds ratio 0.004 95 % CI 0 - 0.576; P = 0.029), benign histology on first biopsy (odds ratio 0 95 % CI 0 - 0.39; P = 0.011) and lower number of ulcers (odds ratio 0.22 (95 % CI 0.05 - 0.99); P = 0.049) were independent predictors of benign disease. All dysplastic and neoplastic cases would have been identified by a combination of initial biopsies plus repeat endoscopy with further biopsies for endoscopically suspicious appearances. In this large cohort 6 % of gastric ulcers were found to be malignant, highlighting the need for all gastric ulcers to be biopsied. The cancer yield of FU-OGD after benign biopsies was low. We have demonstrated that the combination of benign index histology and no endoscopic suspicion of malignancy can predict benign disease. We recommend that all gastric ulcers to be biopsied. Risk stratification could potentially reduce need for FU-OGD.

  20. Anxiety/Depression and Hostility/Suspiciousness in Adolescent Boys: Testing Adherence to Honor Code as Mediator of Callousness and Attachment Insecurity

    Science.gov (United States)

    Somech, Lior Y.; Elizur, Yoel

    2012-01-01

    Research of psychological distress (PD) needs to differentiate between anxiety/depression and hostility/suspiciousness, which are associated with different motivational systems. In this study, structural equation modeling was used to test two hypothesized models for the prediction of each facet of PD. Hypotheses were proposed about the effects of…

  1. Rapid identification of bacillus anthracis spores in suspicious powder samples by using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)

    NARCIS (Netherlands)

    Dybwad, M.; Laaken, A.L. van der; Blatny, J.M.; Paauw, A.

    2013-01-01

    Rapid and reliable identification of Bacillus anthracis spores in suspicious powders is important to mitigate the safety risks and economic burdens associated with such incidents. The aim of this study was to develop and validate a rapid and reliable laboratory- based matrix-assisted laser

  2. Malign katatoni, et neuropsykiatrisk syndrom

    DEFF Research Database (Denmark)

    Moltke, Katinka; Lublin, Henrik

    2010-01-01

    This case report describes a 36-year-old schizophrenic man who developed malignant catatonia during a hospital stay. He was treated with benzodiazepines (BZD) and 26 sessions of electroconvulsive therapy (ECT). After the therapy his condition normalised. Malignant catatonia is a rare condition...

  3. Malignant Melanoma of the Foot

    Science.gov (United States)

    ... page. Please enable Javascript in your browser. Malignant Melanoma of the Foot What Is Malignant Melanoma? Melanoma is a cancer that begins in the ... people of all age groups, even the young. Melanoma in the Foot Melanoma that occurs in the ...

  4. Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression

    Energy Technology Data Exchange (ETDEWEB)

    Moretti, J.L. [Medicine Nucleaire, CHU Bobigny, Paris (France); Azaloux, H. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Boisseron, D. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Kouyoumdjian, J.C. [Service de Biochemie, Hopital Henri Mondor, Creteil (France); Vilcoq, J. [Service de Cancerologie-Radiotherapie, Inst. Curie, Paris (France)

    1996-08-01

    The aim of this preliminary study was to evaluate retrospectively sestamibi scintigraphy in relation to the presence of the 170-kDa P-glycoprotein (Pgp), which represents an expression of multidrug resistance in patients with primary breast cancer. Fifteen women (age range 37-76 years) were referred for technetium-99m sestamibi scintigraphy because of suspicious breast lesions detected by mammography and ultrasonography, and subsequently assessed by fine-needle aspiration. Scintigraphy was performed 30 min following the injection of 500 MBq {sup 99m}Tc-sestamibi. Three planar anterior and oblique images were obtained with the patient in the supine position. Excised tumours were assessed for cytosolic CA 15.3, oestrogen (OR) and progesterone (PR) receptors and c-erb B2 neu oncogene. Pathology revealed that only 13 of the 15 patients had malignant tumours. The two benign tumours were sestamibi-negative and Pgp-positive. Sestamibi scintigraphy was positive in 10 of the 13 malignant lesions (including nine of ten infiltrating ductal carcinomas). Two of the three lesions with false-negative scintigraphy were Pgp-negative; in one of these cases histology revealed an invasive lobular carcinoma and in the other, mucinous adenocarcinoma. The third false-negative lesion was a Pgp-positive infiltrating ductal carcinoma which was c-erb B2 neu-negative but CA 15.3-, OR- and PR-positive. This preliminary study confirms that the resistance to chemotherapy which may occur in patients with primary breast cancer can be a cause of negative sestamibi scintigraphy. (orig.)

  5. Oral potentially malignant disorders: is malignant transformation predictable and preventable?

    Science.gov (United States)

    van der Waal, Isaäc

    2014-07-01

    Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract. The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant transformation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value. It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed.

  6. Metastatic lung malignancy to mandibular gingiva

    Directory of Open Access Journals (Sweden)

    Moharil Rohit

    2010-01-01

    Full Text Available Metastatic tumors of oral cavity are uncommon and may occur in oral soft tissues or jaw bones. Because of their rarity, metastasis to oral cavity are challenging to diagnose and difficult to treat. They often have vague symptoms that mimic dental infections. These lesions generally show poorly differentiated histopathologic picture and have poor prognosis. We reported a case of a 40-year-old male patient of metastatic lesion to the oral cavity and brain with primary tumor, diagnosed as an undifferentiated epithelial malignancy of lung.

  7. Malignant mental nerve neuropathy: systematic review.

    Science.gov (United States)

    Galán Gil, Sónnica; Peñarrocha Diago, Maria; Peñarrocha Diago, Miguel

    2008-10-01

    Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs, 9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affected region was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months.

  8. Radiologic findings of malignant retroperitoneal fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yu Jin; Lee, Hae Kyung; Kim, Hyung Hwan; Cha, Jang Gyu; Hong, Hyun Sook; Kwon, Gui Hyang; Choi, Deuk Lin [Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To evaluate the radiologic findings of malignant retroperitoneal fibrosis. Post-contrast CT (n=9) and urographic (n=7) findings of nine patients with malignant retroperitoneal fibrosis were retrospectively analyzed. Primary tumors were found to be advanced gastric cancer (n=6), early gastric cancer (n=1), breast cancer (n=1), and cervical cancer (n=1). We analyzed CT findings with regard to the site of soft tissue lesion, ureteral involvement, the presence or absence of hydronephrosis, and distant metastasis. The level and length of ureteral involvement, presence or absence of ureteral stenosis, and ureteral displacement as seen on urography, were analyzed. On CT scans, enhanced soft tissue lesions (mass, 5 cases ; plaque, 4 cases) encircling the abdominal aorta and IVC were noted in all cases. Thickening of the ureteral wall (n=8), hydronephrosis (n=9), and enlarged lymph node (n=5) were also seen. On urography, irregular stenosis and medial displacement of ureters from level L2 to S2 were noted in all cases. The length of ureteral involvement was 4 - 6.5cm. The common CT findings of malignant retroperitoneal fibrosis were enhanced soft tissue lesion encircling the abdominal aorta and IVC, hydronephrosis, and thickening of the ureteral wall. On urography, ureteral stenosis and medial displacement were seen.

  9. Radiologists' performance in the detection of benign and malignant masses with 3D automated breast ultrasound (ABUS)

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@radcom.snu.ac.kr [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Cho, Nariya [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Park, Jeong Seon [Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital (Korea, Republic of); Kim, Seung Ja [Department of Radiology, Seoul National Universtiy Boramea Hospital (Korea, Republic of)

    2011-04-15

    Objectives: To retrospectively evaluate the detection performance of benign and malignant breast masses using 3D volume data obtained by ABUS and to determine lesion variables which affect detectability. Methods: Between November and December of 2007, bilateral whole breast US images were obtained using ABUS in 67 consecutive women who were scheduled to undergo US-guided needle biopsy due to suspicious breast masses. Twenty-four invasive ductal cancers in 23 breasts, 46 benign breast lesions in 44 breasts and 38 normal breasts were included. Three breast radiologists (experience range, 8-16 years) who did not perform the examinations and were blinded to the histology independently reviewed the ABUS data of the 105 breasts to detect suspicious solid masses with pathology as the standard of reference. Sensitivity and specificity in detecting benign and malignant masses were calculated, and lesion characteristics affecting detectability were analyzed. Results: Sensitivities for benign and malignant mass detections were 65.2% (30/46), 95.8% (23/24) for reader 1 (p = 0.007), 66.7% (31/46), 87.5% (21/24) for reader 2 (p = 0.087), and 56.3% (24/46), 91.7% (22/24), for reader 3 (p = 0.001), respectively. Logistic analysis showed that mass size (odds ratio, 95% CI; 1.12, 1.02-1.24), surrounding tissue changes (odds ratio, 95% CI; 0.11, 0.02-0.47), and shape of the mass (odds ratio, 95% CI; 3.12, 1.02-9.55) were the variables associated with detectability at ABUS. Conclusion: In reader studies using ABUS data, significantly higher sensitivity was noted for malignant breast masses than for benign masses.

  10. Female Urethral Malignant Melanoma With Vesical Invasion: A Case Report

    Directory of Open Access Journals (Sweden)

    Alpaslan Akbas

    2010-02-01

    Full Text Available We report a 75-year-old female with a primary urethral malignant melanoma. A mass protruding from inside the urethra was detected on physical examination. Abdominopelvic magnetic resonance imaging revealed a mass extending from the urethra with dimensions of 4 × 2 cm, and periurethral heterogenous fatty planes consistent with infiltration. The histopathologic examination was consistent with HMB45(+ malignant melanoma. We performed cystourethrectomy and bilateral inguinal and pelvic lymphadenectomy in one session. The pathology report revealed primary malignant melanoma of the urethra invading the inferior bladder wall. The patient received no adjuvant therapy because of cardiopulmonary morbidities and the presence of multiple pulmonary metastases. The patient eventually died 13 months after surgery.

  11. Ocular metastasis of cutaneous malignant melanoma.

    Science.gov (United States)

    Ullah, Tehseena; Gurwood, Andrew S; Myers, Marc D

    2009-10-01

    Metastatic melanoma to the eye and orbit are rare. Patients at greatest risk often have disseminated metastases in the setting of advanced disease. Because the prognosis for orbital metastatic disease is poor, emphasis must be placed on early detection and prevention. Although cutaneous malignancies include basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma, the majority of cases that result in metastasis, ocular morbidity, and mortality are from sebaceous cell carcinoma and malignant melanoma. A 72-year-old white woman presented emergently with a chief complaint of sudden, painless vision loss in her left eye of 2 weeks' duration. Her best-corrected visual acuities measured 20/30 in the right eye and 20/400 in the left eye with no improvement on refraction. Her systemic medical history was significant for the diagnosis of a cutaneous malignant melanoma. Examination of the left eye found grade II disc edema with all other posterior pole and peripheral structures intact and unremarkable. Magnetic resonance imaging confirmed the diagnosis of metastatic lesions involving structures of the left orbit ultimately causing reduced visual ability. The patient opted to avoid aggressive care and "hope for the best." Denying significant medical intervention, the woman lived in hospice where she died 6 months later. The primary care optometric setting, by the way a patient's visual symptoms present or the appearance of fundus abnormalities, can offer the capability of first detection and referral for the discovery of metastatic lesions. Although orbital metastasis is considered a terminal finding in these cases, timely diagnosis enables, while limited, the best options for management.

  12. Metastatic malignant melanoma of the gastrointestinal tract.

    Science.gov (United States)

    Liang, Kelly V; Sanderson, Schuyler O; Nowakowski, Grzegorz S; Arora, Amindra S

    2006-04-01

    Malignant melanoma is one of the most common malignancies to metastasize to the gastrointestinal (GI) tract. Metastases to the GI tract can present at the time of primary diagnosis or decades later as the first sign of recurrence. Symptoms may include abdominal pain, dysphagia, small bowel obstruction, hematemesis, and melena. We report 2 cases of malignant melanoma metastatic to the GI tract, followed by a review of the literature. The first case is a 72-year-old man who underwent resection of superficial spreading melanoma on his back 13 years previously who presented with dysphagia. A biopsy specimen of a mucosal fold in a gastric fundus noted during endoscopy was taken and revealed metastatic malignant melanoma, which was resected 1 month later. Three weeks later, the patient was found to have an ulcerated jejunal metastatic melanoma mass, which was also resected. The second case is a 63-year-old man with an ocular melanoma involving the chorold of the left eye that had been diagnosed 4 years previously, which had been excised several times, who presented with anorexia, dizziness, and fatigue. He was found to have cerebellar and stomach metastases. He underwent adjuvant radiation therapy, chemotherapy, and surgical resection of the gastric melanoma metastasis. In patients with a history of melanoma, a high index of suspicion for metastasis must be maintained if they present with seemingly unrelated symptoms. Diagnosis requires careful inspection of the mucosa for metastatic lesions and biopsy with special immunohistochemical stains. Management may include surgical resection, chemotherapy, immunotherapy, observation, or enrollment in clinical trials. Prognosis is poor, with a median survival of 4 to 6 months.

  13. Immunotherapy in genitourinary malignancies

    Directory of Open Access Journals (Sweden)

    Kathan Mehta

    2017-04-01

    Full Text Available Abstract Treatment of cancer patients involves a multidisciplinary approach including surgery, radiotherapy, and chemotherapy. Traditionally, patients with metastatic disease are treated with combination chemotherapies or targeted agents. These cytotoxic agents have good response rates and achieve palliation; however, complete responses are rarely seen. The field of cancer immunology has made rapid advances in the past 20 years. Recently, a number of agents and vaccines, which modulate the immune system to allow it to detect and target cancer cells, are being developed. The benefit of these agents is twofold, it enhances the ability the body’s own immune system to fight cancer, thus has a lower incidence of side effects compared to conventional cytotoxic chemotherapy. Secondly, a small but substantial number of patients with metastatic disease are cured by immunotherapy or achieve durable responses lasting for a number of years. In this article, we review the FDA-approved immunotherapy agents in the field of genitourinary malignancies. We also summarize new immunotherapy agents being evaluated in clinical studies either as single agents or as a combination.

  14. [Malignant melanoma : Current status].

    Science.gov (United States)

    Winkler, J K; Buder-Bakhaya, K; Dimitrakopoulou-Strauss, A; Enk, A; Hassel, J C

    2017-10-01

    The incidence of malignant melanoma is continuously increasing. The prognosis of metastatic disease is still limited. Until a few years ago palliative chemotherapy with a limited response rate was the standard treatment for metastatic melanoma. Immunotherapy and targeted therapy provide new treatment options. Immune checkpoint inhibitors have significantly improved the prognosis. Regional lymph node sonography, computed tomography (CT) of the neck, chest and abdomen and brain magnetic resonance imaging (MRI) are routinely used. As an alternative to CT scans 18 F fluorodeoxyglucose positron emission tomography (FDG-PET) may be used. Immunotherapy provides the chance of long-term disease control in metastatic melanoma. Ipilimumab may provide long-term tumor control in approximately 20% of patients. Median overall survival of approximately 2 years is achieved during therapy with anti-programmed cell death (PD) 1 antibodies. For combined therapy of ipilimumab and nivolumab a response rate of almost 60% is achieved and 2‑year survival is also approximately 60%. The range of immune-mediated side effects demands particular consideration. For response evaluation immune-related response criteria were defined. Furthermore, immunotherapeutic approaches, such as talimogene laherparepvec (T-VEC), which is a modified herpes virus can be used for intralesional injection. An individual definition of the appropriate therapy for each patient is of particular importance. In the context of modern therapy regimens close patient monitoring is crucial.

  15. Malignancy and chronic renal failure.

    Science.gov (United States)

    Peces, Ramon

    2003-01-01

    Increased incidence of cancer at various sites is observed in patients with end-stage renal disease (ESRD). Certain malignant diseases, such as lymphomas and carcinomas of the kidney, prostate, liver and uterus, show an enhanced prevalence compared with the general population. In particular, renal cell carcinoma (RCC) shows an excess incidence in ESRD patients. A multitude of factors, directly or indirectly associated with the renal disease and the treatment regimens, may contribute to the increased tumor formation in these patients. Patients undergoing renal replacement therapy (RRT) are prone to develop acquired cystic kidney disease (ACKD), which may subsequently lead to the development of RCC. In pre-dialysis patients with coexistent renal disease, as in dialysis and transplant patients, the presence of ACKD may predispose to RCC. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse, are additional risk factors for malignancy. Malignancy following renal transplantation is an important medical problem during the follow-up. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). Another important confounder for risk of malignancy after renal transplantation is the type of immunosuppression. The type of malignancy is different in various countries and dependent on genetic and environmental factors. Finally, previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and post-malignancy screening.

  16. Ewing's Sarcoma and Second Malignancies

    Directory of Open Access Journals (Sweden)

    Joshua D. Schiffman

    2011-01-01

    Full Text Available Ewing's sarcoma (ES is a rare tumor that is most common in children and young adults. Late effects of ES therapy include second cancers, a tragic outcome for survivors of such a young age. This paper will explore the frequencies and types of malignancies that occur after ES. Additionally, it will review how second malignancies have changed with the shift in treatment from high-dose radiation to chemotherapy regimens including alkylators and epipodophyllotoxins. The risk of additional cancers in ES survivors will also be compared to survivors of other childhood cancers. Finally, the possible genetic contribution to ES and second malignancies will be discussed.

  17. Primary pulmonary leiomyosarcoma

    OpenAIRE

    Shen, Wang; Chen, Jun; Wei, Sen; Xinyun WANG; LI, Xin; Qinghua ZHOU

    2014-01-01

    Primary pulmonary leiomyosarcoma (PPL) is an extremely rare malignant tumor. In the case presented here, a 52-year-old Chinese female with a lung mass underwent a right upper-middle lobectomy with pulmonary artery sleeve resection and reconstruction, and was thereafter diagnosed with PPL. After 28 months, the patient was well and without local recurrence or distant metastasis.

  18. Primary pulmonary leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Wang Shen

    2014-01-01

    Full Text Available Primary pulmonary leiomyosarcoma (PPL is an extremely rare malignant tumor. In the case presented here, a 52-year-old Chinese female with a lung mass underwent a right upper-middle lobectomy with pulmonary artery sleeve resection and reconstruction, and was thereafter diagnosed with PPL. After 28 months, the patient was well and without local recurrence or distant metastasis.

  19. Eosinophilia in routine blood samples and the subsequent risk of hematological malignancies and death

    DEFF Research Database (Denmark)

    Andersen, Christen Bertel L; Siersma, Volkert Dirk; Hasselbalch, HC

    2013-01-01

    Eosinophilia may represent an early paraclinical sign of hematological malignant disease, but no reports exist on its predictive value for hematological malignancies. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356,196 individuals with at least one...

  20. Malignant melanoma of the vagina: a report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Bae; Kim, Jin Hee; Jung, Young Yeon; Cho, Chi Heum; Choi, Tae Jin [Dongsan Medical Center, School of Medicine, Keimyung University, Daegu (Korea, Republic of)

    2005-06-15

    Primary malignant melanoma of the vagina is an extremely rare genital neoplasm occurring mainly in postmenopausal women. It has a worse prognosis than cutaneous melanomas, because of the high rate of locoregional recurrences and rapid systemic dissemination. In the past, radical surgical extirpation as the primary management had been recommended to improve loco-regional control, and possibly overall survival. However, the prognosis was poor in spite of such a radical approach. Recently, more conservative treatment such as wide local excision combined with adjuvant high-dose fraction radiotherapy seems to have promising results. Primary radiation therapy could be served as an alternative to surgery for patients with lesion less than 3 cm in diameter. We report 2 cases of primary vaginal malignant melanoma treated with radiotherapy.

  1. Malignant Giant Cell Tumour of Bone with Axillary Metastasis

    African Journals Online (AJOL)

    2002-06-06

    Jun 6, 2002 ... patients with benign GCT in a Mayo Clinic series. [1]. •. Pulmonary nodules in these patients may demonstrate peripheral ossification at both radiology and pathologic analysis but otherwise have a nonspecific imaging appearance. The five primary malignant GCTs in the Mayo Clinic series demonstrated ...

  2. Modeling of Malignant Glioma and Investigations into Novel Treatments

    NARCIS (Netherlands)

    R.K. Balvers (Rutger)

    2015-01-01

    markdownabstractAbstract With the advent of personalized medicine and large omics-based profiling studies into multiple diseases, new opportunities rise for the treatment of Malignant Glioma. This primary brain tumor remains unvariantly fatal and therefore urgently requires novel treatment

  3. Spinal cord disease in children with malignancies: Clinical cases ...

    African Journals Online (AJOL)

    Corresponding author: K Rautenbach (RautenbachK.MD@ufs.ac.za). Spinal cord disease in children with malignancies: Clinical cases and literature review. Case presentations. Case 1. A 32-month-old boy presented to a remote primary health care clinic with a 20-month history of progressive lower limb dysfunction. He.

  4. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    Energy Technology Data Exchange (ETDEWEB)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A. [Heidelberg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Akbar, M. [Heidelberg Univ. (Germany). Dept. of Orthopaedic Surgery and Rehabilitation Medicine

    2016-12-15

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  5. Primary Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified: A Rapidly Progressive Variant of Cutaneous T-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Kimberly Aderhold

    2015-01-01

    Full Text Available Primary Cutaneous Peripheral T-Cell Lymphoma NOS (PTL-NOS is a rare, progressive, fatal dermatologic disease that presents with features similar to many common benign plaque-like skin conditions, making recognition of its distinguishing features critical for early diagnosis and treatment (Bolognia et al., 2008. A 78-year-old woman presented to ambulatory care with a single 5 cm nodule on her shoulder that had developed rapidly over 1-2 weeks. Examination was suspicious for malignancy and a biopsy was performed. Biopsy results demonstrated CD4 positivity, consistent with Mycosis Fungoides with coexpression of CD5, CD47, and CD7. Within three months her cancer had progressed into diffuse lesions spanning her entire body. As rapid progression is usually uncharacteristic of Mycosis Fungoides, her diagnosis was amended to PTL-NOS. Cutaneous T-Cell Lymphoma (CTCL should be suspected in patients with patches, plaques, erythroderma, or papules that persist or multiply despite conservative treatment. Singular biopsies are often nondiagnostic, requiring a high degree of suspicion if there is deviation from the anticipated clinical course. Multiple biopsies are often necessary to make the diagnosis. Physicians caring for patients with rapidly progressive, nonspecific dermatoses with features described above should keep more uncommon forms of CTCL in mind and refer for early biopsy.

  6. Metastatic choriocarcinoma as initial presentation of small bowel perforation in absence of primary uterine lesion: a case report.

    Science.gov (United States)

    Cho, En Bee; Byun, Jung Mi; Jeong, Dae Hoon; Yoon, Hye Kyoung; Kim, Young Nam; Sung, Moon Su; Lee, Kyung Bok; Kim, Ki Tae

    2016-11-11

    Choriocarcinoma is a highly malignant tumor of gestational trophoblastic neoplasia that characteristically spreads via the bloodstream. Small bowel metastasis is very rare, and a small number of cases of choriocarcinoma metastasis to small bowel have been reported. We report a case of a 40-year-old woman presenting with acute abdominal pain and vaginal bleeding due to small bowel perforation secondary to jejunal metastasis. In our case, metastatic choriocarcinoma was present in the small bowel, lung, and liver, but no primary lesion was apparent. After resection and anastomosis of the perforated small bowel, chemotherapy was performed. The patient began chemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO) for 9 cycles. When the 4th cycle of chemotherapy was finished, β-human chorionic gonadotropin (hCG) level was normalized and follow-up computed tomography scans showed regression of the liver metastasis and small bowel lesion and significantly decreased lung metastasis. After 9 cycles of chemotherapy were completed, the patient showed complete response. If patients have high β-hCG of unknown origin and suspected panperitonitis, which are suspicious of choriocarcinoma metastasis to small bowel, the pathologic findings are important. It is essential to confirm the histopathologic diagnosis postoperatively. Choriocarcinoma can spread to various organs and show aggressive manifestations. Therefore, we should be aware of possible metastatic sites and remain alert to its diagnosis.

  7. Primary glandular melanoma of male breast with nodal metastasis

    OpenAIRE

    Jayabal Pandiaraja

    2016-01-01

    Malignant melanoma is a malignancy that develops from melanocytes. Breast is an uncommon site for malignant melanoma. Melanoma of the breast occurs in various situations such as primary melanoma of breast skin, metastatic melanoma of breast, in-transit metastasis to the breast, and primary glandular breast melanoma. Most of the melanoma breast either cutaneous melanoma or metastatic melanoma. Primary glandular melanoma of male breast with nodal involvement is rarely reported compared to prima...

  8. Budget impact analysis of a novel gene expression assay for the diagnosis of malignant melanoma.

    Science.gov (United States)

    Cassarino, David S; Lewine, Nicolas; Cole, Doria; Wade, Brandon; Gustavsen, Gary

    2014-11-01

    Traditional pathology techniques alone can be insufficient to reliably distinguish between malignant melanoma, dysplastic nevi, and benign nevi in biopsies of suspicious pigmented lesions. Numerous studies have shown high rates of ambiguity when assessing such samples. A novel gene expression assay has been developed to objectively differentiate malignant melanoma from benign nevi. The purpose of this study was to quantify the economic impact of the gene expression assay on a US commercial health plan. The clinical paradigm of care was modeled for a hypothetical cohort of patients with suspicious pigmented lesions that are difficult-to-diagnose. Costs were assigned to each unit of care provided based on 2013 Medicare fee-for-service rates. Patients were followed for 10 years and were modeled to progress according to the natural history of their disease. The total cost of care was calculated for two scenarios: a Reference Scenario, representing current clinical practice, and a Test Scenario, in which each lesion was tested with the gene expression assay and diagnosed. Total cost of care was compared between the two scenarios to determine overall budget impact. Sensitivity analyses were performed to test the robustness of the model. The gene expression assay reduces costs by $1268 per patient tested over 10 years, a decrease of 8.3%, after accounting for the cost of the assay. For a health plan with 10 million members, this would translate to over $8 million in savings. The largest portion of this saving comes from reducing the number of missed melanomas, which would otherwise progress to advanced disease. In sensitivity analyses, no single model input changed within a reasonable range of values caused the model to show that the assay was not cost-saving. In addition to improving the diagnosis of melanoma, this gene expression assay would likely reduce costs for health plans that choose to cover it.

  9. AMG 319 Lymphoid Malignancy FIH

    Science.gov (United States)

    2017-02-08

    Cancer; Chronic Lymphocytic Leukemia; Diffuse Large Cell Lymphoma; Hematologic Malignancies; Hematology; Leukemia; Low Grade Lymphoma; Lymphoma; Mantle Cell Lymphoma; Non-Hodgkin's Lymphoma; Oncology; Oncology Patients; T Cell Lymphoma; Tumors

  10. Drugs Approved for Malignant Mesothelioma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for malignant mesothelioma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  11. Urologic malignancies in kidney transplantation.

    Science.gov (United States)

    Hickman, Laura A; Sawinski, Deirdre; Guzzo, Thomas; Locke, Jayme E

    2018-01-01

    With advances in immunosuppression, graft and patient outcomes after kidney transplantation have improved considerably. As a result, long-term complications of transplantation, such as urologic malignancies, have become increasingly important. Kidney transplant recipients, for example, have a 7-fold risk of renal cell carcinoma (RCC) and 3-fold risk of urothelial carcinoma (UC) compared with the general population. While extrapolation of data from the general population suggest that routine cancer screening in transplant recipients would allow for earlier diagnosis and management of these potentially lethal malignancies, currently there is no consensus for posttransplantation RCC or UC screening as supporting data are limited. Further understanding of risk factors, presentation, optimal management of, and screening for urologic malignancies in kidney transplant patients is warranted, and as such, this review will focus on the incidence, surveillance, and treatment of urologic malignancies in kidney transplant recipients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  12. Multiple Cutaneous (pre)-Malignancies

    NARCIS (Netherlands)

    R.J.T. van der Leest (Robert)

    2015-01-01

    markdownabstract__Abstract__ The three most common cutaneous malignancies are derived from melanocytes and keratinocytes (ordered in decreasing aggressiveness): melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). This thesis focuses only on these three types of cancer and

  13. General Information about Malignant Mesothelioma

    Science.gov (United States)

    ... malignant mesothelioma, and may also be used as palliative therapy to relieve symptoms and improve quality of life . ... and decortication , with or without radiation therapy , as palliative therapy to relieve symptoms and improve quality of life . ...

  14. Treatment Option Overview (Malignant Mesothelioma)

    Science.gov (United States)

    ... malignant mesothelioma, and may also be used as palliative therapy to relieve symptoms and improve quality of life . ... and decortication , with or without radiation therapy , as palliative therapy to relieve symptoms and improve quality of life . ...

  15. Treatment Options for Malignant Mesothelioma

    Science.gov (United States)

    ... malignant mesothelioma, and may also be used as palliative therapy to relieve symptoms and improve quality of life . ... and decortication , with or without radiation therapy , as palliative therapy to relieve symptoms and improve quality of life . ...

  16. Polymer Nanoparticle-Based Chemotherapy for Spinal Malignancies

    Directory of Open Access Journals (Sweden)

    Hongyun Ma

    2016-01-01

    Full Text Available Malignant spinal tumors, categorized into primary and metastatic ones, are one of the most serious diseases due to their high morbidity and mortality rates. Common primary spinal tumors include chordoma, chondrosarcoma, osteosarcoma, Ewing’s sarcoma, and multiple myeloma. Spinal malignancies are not only locally invasive and destructive to adjacent structures, such as bone, neural, and vascular structures, but also disruptive to distant organs (e.g., lung. Current treatments for spinal malignancies, including wide resection, radiotherapy, and chemotherapy, have made significant progress like improving patients’ quality of life. Among them, chemotherapy plays an important role, but its potential for clinical application is limited by severe side effects and drug resistance. To ameliorate the current situation, various polymer nanoparticles have been developed as promising excipients to facilitate the effective treatment of spinal malignancies by utilizing their potent advantages, for example, targeting, stimuli response, and synergetic effect. This review overviews the development of polymer nanoparticles for antineoplastic delivery in the treatment of spinal malignancies and discusses future prospects of polymer nanoparticle-based treatment methods.

  17. Superficial Fungal Infections in Patients with Hematologic Malignancies: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Berna Ülgen Altay

    2011-06-01

    Full Text Available Background and Design: Dermatophytes, yeasts and some moulds settle on the skin and mucosal surfaces in immunocompetent individuals as commensals. Patients with diabetes mellitus, HIV-positive patients, organ transplant recipients and the patients with malignancies are predisposed to develop superficial fungal infections. We aimed to determine the prevalence, clinical and mycological features of superficial fungal infections in patients with hematologic malignancies in this case-control study.Material and Method: Eighty patients with hematologic malignancies (49 men, 31 women and 50 healthy individuals (22 men, 28 women randomly selected at our clinical department as controls were included to this study between 2003 and 2004. The mean age was 52±1.85 years in patients and 41.56±2.04 years in controls. All patients were inspected for superficial fungal infections. Skin scrapings and mucosal swabs were obtained from the toe web, inguinal region, any suspicious lesion and oral mucosa. Nail samples were also collected. All samples were examined by direct microscopy and cultured in Sabouraud dextrose agar (SDA. The yeasts were established in germ-tube production. Results: Fifty-six (70% of 80 patients with hematologic malignancies had fungal colonization, whereas 21 (42% of 50 controls had. For both groups, oral mucosa was the predominant area that fungus was mostly isolated from. A rising number of non-dermatophyte moulds (26% was observed. Candida albicans was the predominant agent isolated from the culture.Conclusion: The prevalence of superficial fungal infection was higher in patients with hematologic malignancies (being immunosuppressed than in the normal population. Candida albicans was the predominant isolated agent that was found in our study. We observed oral mucosa candidal infection mostly. The rising number of non-dermatophyte moulds is attributed to long-term use of antibiotics, cytotoxic chemotherapies and antifungals.

  18. Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Su Min [Dept. of Radiology, Research Institute of Radiology, Chung Ang University Hospital, Seoul(Korea, Republic of); Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung [Dept. of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

  19. Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

    Directory of Open Access Journals (Sweden)

    Kalofonos Haralabos P

    2011-07-01

    Full Text Available Abstract Background Mammographic density (MD and malignant-appearing microcalcifications (MAMCs represent the earliest mammographic findings of non-palpable breast carcinomas. Matrix proteoglycans versican and decorin are frequently over-expressed in various malignancies and are differently involved in the progression of cancer. In the present study, we have evaluated the expression of versican and decorin in non-palpable breast carcinomas and their association with high risk mammographic findings and tumor characteristics. Methods Three hundred and ten patients with non-palpable suspicious breast lesions, detected during screening mammography, were studied. Histological examination was carried out and the expression of decorin, versican, estrogen receptor α (ERα, progesterone receptor (PR and c-erbB2 (HER-2/neu was assessed by immunohistochemistry. Results Histological examination showed 83 out of 310 (26.8% carcinomas of various subtypes. Immunohistochemistry was carried out in 62/83 carcinomas. Decorin was accumulated in breast tissues with MD and MAMCs independently of the presence of malignancy. In contrast, versican was significantly increased only in carcinomas with MAMCs (median ± SE: 42.0 ± 9.1 and MD (22.5 ± 10.1 as compared to normal breast tissue with MAMCs (14.0 ± 5.8, MD (11.0 ± 4.4 and normal breast tissue without mammographic findings (10.0 ± 2.0. Elevated levels of versican were correlated with higher tumor grade and invasiveness in carcinomas with MD and MAMCs, whereas increased amounts of decorin were associated with in situ carcinomas in MAMCs. Stromal deposition of both proteoglycans was related to higher expression of ERα and PR in tumor cells only in MAMCs. Conclusions The specific accumulation of versican in breast tissue with high MD and MAMCs only in the presence of malignant transformation and its association with the aggressiveness of the tumor suggests its possible use as molecular marker in non

  20. Håndens maligne tumorer

    DEFF Research Database (Denmark)

    Knudsen, Britt Mejer; Svabo Rasmussen, Per Joen; Lausten, Gunnar Schwarz

    2011-01-01

    Malignant tumours of the hand are rare and are often misdiagnosed. A painful swelling of the hand or digits are often diagnosed with an infection, benign tumours such as ganglion cysts, or arthritis. Wounds that do not heal despite adequate treatment should be biopsied to rule out malignancy. A c....... A correct diagnosis without delay is important because the life expectancy, due to a metastasis on the hand or fingers is approximately six months....