Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity

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Liu, Feng-Yuan [Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Department of Nuclear Medicine, Chiayi (China); Liao, Chun-Ta [Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Taoyuan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan County (China)

2011-06-15

Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity (OCSCC) are occasionally encountered. In the current study we tried to evaluate their frequency, detectability by {sup 18}F-fluorodeoxyglucose (FDG) studies, and prognostic factors. A retrospective analysis of patients with primary OCSCC enrolled for {sup 18}F-FDG studies from 2002 to 2008 was performed. The detectability of synchronous second cancers by {sup 18}F-FDG studies was defined by the scoring of two interpreters. Prognostic factors for overall survival in patients receiving curative-intent treatment were assessed using the univariate Kaplan-Mayer analysis and the multivariate Cox regression model. Of 764 patients, 40 (5.2%) had synchronous malignancies. {sup 18}F-FDG studies detected 22 (48%) of 46 synchronous second cancers. For synchronous cancers at the hypopharynx, esophagus, or liver, the median survival of patients was no longer than 1 year, and the detection rates by {sup 18}F-FDG studies were 100, 86, and 25%, respectively. In the 33 patients receiving curative-intent treatment, the site of second cancer, complete surgical resection of all known tumors, and the oral habit of betel quid/areca nut chewing are significant prognostic factors in the univariate analysis, while the site of second cancer is the only significant prognostic factor in the multivariate analysis (p = 0.041). The site of second cancer is the most significant prognostic factor in OCSCC patients with synchronous malignancies receiving curative-intent treatment. {sup 18}F-FDG studies detect synchronous malignancies with poor prognosis in OCSCC patients except for hepatic cancers. In OCSCC patients with synchronous malignancies with poor prognosis, prospective studies comparing different treatment options should be further conducted. (orig.)

Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity

International Nuclear Information System (INIS)

Liu, Feng-Yuan; Liao, Chun-Ta; Yen, Tzu-Chen

2011-01-01

Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity (OCSCC) are occasionally encountered. In the current study we tried to evaluate their frequency, detectability by 18 F-fluorodeoxyglucose (FDG) studies, and prognostic factors. A retrospective analysis of patients with primary OCSCC enrolled for 18 F-FDG studies from 2002 to 2008 was performed. The detectability of synchronous second cancers by 18 F-FDG studies was defined by the scoring of two interpreters. Prognostic factors for overall survival in patients receiving curative-intent treatment were assessed using the univariate Kaplan-Mayer analysis and the multivariate Cox regression model. Of 764 patients, 40 (5.2%) had synchronous malignancies. 18 F-FDG studies detected 22 (48%) of 46 synchronous second cancers. For synchronous cancers at the hypopharynx, esophagus, or liver, the median survival of patients was no longer than 1 year, and the detection rates by 18 F-FDG studies were 100, 86, and 25%, respectively. In the 33 patients receiving curative-intent treatment, the site of second cancer, complete surgical resection of all known tumors, and the oral habit of betel quid/areca nut chewing are significant prognostic factors in the univariate analysis, while the site of second cancer is the only significant prognostic factor in the multivariate analysis (p = 0.041). The site of second cancer is the most significant prognostic factor in OCSCC patients with synchronous malignancies receiving curative-intent treatment. 18 F-FDG studies detect synchronous malignancies with poor prognosis in OCSCC patients except for hepatic cancers. In OCSCC patients with synchronous malignancies with poor prognosis, prospective studies comparing different treatment options should be further conducted. (orig.)

Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy

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Bai H

2016-07-01

Full Text Available Hao Bai,1,* Jianlin Xu,1,* Haitang Yang,2,* Bo Jin,1 Yuqing Lou,1 Dan Wu,3 Baohui Han1 1Department of Pulmonary, 2Department of Pathology, 3Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Introduction: Clinical evidence for patients with synchronous brain oligometastatic non-small-cell lung carcinoma is limited. We aimed to summarize the clinical data of these patients to explore the survival prognostic factors for this population. Methods: From September 1995 to July 2011, patients with 1–3 synchronous brain oligometastases, who were treated with stereotactic radiosurgery (SRS or surgical resection as the primary treatment, were identified at Shanghai Chest Hospital.Results: A total of 76 patients (22 patients underwent brain surgery as primary treatment and 54 patients received SRS were available for survival analysis. The overall survival (OS for patients treated with SRS and brain surgery as the primary treatment were 12.6 months (95% confidence interval [CI] 10.3–14.9 and 16.4 months (95% CI 8.8–24.1, respectively (adjusted hazard ratio =0.59, 95% CI 0.33–1.07, P=0.08. Among 76 patients treated with SRS or brain surgery, 21 patients who underwent primary tumor resection did not experience a significantly improved OS (16.4 months, 95% CI 9.6–23.2, compared with those who did not undergo resection (11.9 months, 95% CI 9.7–14.0; adjusted hazard ratio =0.81, 95% CI 0.46–1.44, P=0.46. Factors associated with survival benefits included stage I–II of primary lung tumor and solitary brain metastasis. Conclusion: There was no significant difference in OS for patients with synchronous brain oligometastasis receiving SRS or surgical resection. Among this population, the number of brain metastases and stage of primary lung disease were the factors associated with a survival benefit. Keywords: non-small-cell lung carcinoma

Synchronous and bilateral oncocytic carcinoma of the breast: A case report and review of the literature

OpenAIRE

Itagaki, Hiroko; Yamamoto, Tomoko; Hiroi, Atsuko; Kawanishi, Kunio; Noguchi, Eiichiro; Ohchi, Tetsuya; Kamio, Takako; Kameoka, Shingo; Oda, Hideaki; Nagashima, Yoji

2017-01-01

Synchronous bilateral breast cancer is rare, and oncocytic carcinoma is an even rarer breast cancer histological subtype. In general, oncocytic tumors are defined as neoplasms with eosinophilic granular cytoplasm and have been reported in various organs. Oncocytic carcinoma of the breast was first documented by G?d?leanu and Craciun in 1987, and 48 cases have since been reported. The present study reports a case of synchronous bilateral breast oncocytic carcinoma. The patient was a 78-year-ol...

Synchronous Parathyroid and Papillary Thyroid Carcinoma

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Shi-Dou Lin

2005-02-01

Full Text Available Concomitant thyroid disease is not unusual among patients with primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid and thyroid carcinoma is extremely rare. We report a 38-year-old man with primary hyperparathyroidism who presented with osteitis fibrosa cystica complicated with pathologic femoral neck fracture. Preoperative investigation for exclusion of multiple endocrine neoplasia did not find evidence of medullary thyroid carcinoma or pheochromocytoma, but imaging studies revealed the presence of nodules in the right lobe and a parathyroid lesion over the left inferior pole of the thyroid gland. Total thyroidectomy, left parathyroidectomy, and bipolar hemiarthroplasty of the left hip were then performed simultaneously. The resected specimens were pathologically identified as papillary thyroid carcinoma and parathyroid carcinoma, respectively. After the operation, 131I ablation therapy was administered at a dose of 120 mCi. Additional doses of 30 mCi were given yearly as serum thyroglobulin level became elevated. Serum calcium level remained normal during yearly follow-up. Although parathyroid carcinoma is an uncommon cause of parathyroid hormone-dependent hypercalcemia, it should nonetheless be given due consideration because its surgical approach differs from that of parathyroid adenoma. As the coexistence of parathyroid and non-medullary thyroid carcinoma has previously been reported, the possibility of both malignancies must also be considered in the setting of primary hyperparathyroidism with thyroid nodules. If confirmed with preoperative parathyroid scintigraphic and other laboratory studies, an optimal outcome may be achieved with complete resection of both tumors at the time of initial operation, followed by adjunctive therapy.

A Rare Case of Metastasis to the Thyroid Gland from Renal Clear Cell Carcinoma 11 Years after Nephrectomy and Concurrent Primary Esophageal Carcinoma

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Mohammad Saud Khan

2018-01-01

Full Text Available Renal cell carcinoma is known to cause metastasis to unusual sites, which can be both synchronous or metachronous. Thyroid gland is a rare site for metastasis, but when it occurs, renal cell carcinoma is the most common primary neoplasm. We report the case of a 81-year-old female patient who had a significant medical history of right clear cell renal carcinoma with adrenal metastasis. She underwent right radical nephrectomy and adrenalectomy followed by radiofrequency ablation of left adrenal metastasis and systemic chemotherapy with sunitinib. Eleven years later, she presented with dysphagia and was found to have distal esophageal adenocarcinoma. On imaging, there was incidental detection of a left renal mass lesion and a right thyroid nodule, which on histopathology and immunohistochemistry were confirmed to be clear cell carcinoma of renal origin.

Podoplanin-positive Cancer-associated Stromal Fibroblasts in Primary Tumor and Synchronous Lymph Node Metastases of HER2-overexpressing Breast Carcinomas.

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Niemiec, Joanna; Adamczyk, Agnieszka; Harazin-Lechowska, Agnieszka; Ambicka, Aleksandra; Grela-Wojewoda, Aleksandra; Majchrzyk, Kaja; Kruczak, Anna; Sas-Korczyńska, Beata; Ryś, Janusz

2018-04-01

We compared the status of stromal podoplanin-positive cancer-associated fibroblasts (ppCAFs) between primary tumors and paired synchronous lymph node metastases (LNMs) and analyzed the prognostic significance of tumoral ppCAFs in 203 patients with human epidermal growth factor receptor 2-positive breast carcinoma. ppCAFs were found in 167/203 and in 35/87 tumors and LNM, respectively. ppCAFs were most frequently found in tumors and corresponding LNM (n=52, 59.8%; p=0.001). However, for all LNMs (n=12) without ppCAFs, their paired tumors also lacked ppCAFs. In both tumors and LNMs, ppCAFs were α-smooth muscle actin-positive and cluster of differentiation 21 protein-negative, suggesting them not to be resident lymph node cells. Moreover, in our series, the presence of ppCAFs in tumors was borderline related to poor disease-free survival (p=0.058). These results speak in favor of a hypothesis suggesting ppCAFs accompany metastatic cancer cells migrating from tumor to LNMs. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Resection of the primary tumour versus no resection prior to systemic therapy in patients with colon cancer and synchronous unresectable metastases (UICC stage IV): SYNCHRONOUS - a randomised controlled multicentre trial (ISRCTN30964555)

International Nuclear Information System (INIS)

Rahbari, Nuh N; Koch, Moritz; Büchler, Markus W; Kieser, Meinhard; Weitz, Jürgen; Lordick, Florian; Fink, Christine; Bork, Ulrich; Stange, Annika; Jäger, Dirk; Luntz, Steffen P; Englert, Stefan; Rossion, Inga

2012-01-01

Currently, it remains unclear, if patients with colon cancer and synchronous unresectable metastases who present without severe symptoms should undergo resection of the primary tumour prior to systemic chemotherapy. Resection of the primary tumour may be associated with significant morbidity and delays the beginning of chemotherapy. However, it may prevent local symptoms and may, moreover, prolong survival as has been demonstrated in patients with metastatic renal cell carcinoma. It is the aim of the present randomised controlled trial to evaluate the efficacy of primary tumour resection prior to systemic chemotherapy to prolong survival in patients with newly diagnosed colon cancer who are not amenable to curative therapy. The SYNCHRONOUS trial is a multicentre, randomised, controlled, superiority trial with a two-group parallel design. Colon cancer patients with synchronous unresectable metastases are eligible for inclusion. Exclusion criteria are primary tumour-related symptoms, inability to tolerate surgery and/or systemic chemotherapy and history of another primary cancer. Resection of the primary tumour as well as systemic chemotherapy is provided according to the standards of the participating institution. The primary endpoint is overall survival that is assessed with a minimum follow-up of 36 months. Furthermore, it is the objective of the trial to assess the safety of both treatment strategies as well as quality of life. The SYNCHRONOUS trial is a multicentre, randomised, controlled trial to assess the efficacy and safety of primary tumour resection before beginning of systemic chemotherapy in patients with metastatic colon cancer not amenable to curative therapy. http://www.controlled-trials.com/ISRCTN30964555

Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy

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Bai, Hao; Xu, Jianlin; Yang, Haitang; Jin, Bo; Lou, Yuqing; Wu, Dan; Han, Baohui

2016-01-01

Introduction Clinical evidence for patients with synchronous brain oligometastatic non-small-cell lung carcinoma is limited. We aimed to summarize the clinical data of these patients to explore the survival prognostic factors for this population. Methods From September 1995 to July 2011, patients with 1–3 synchronous brain oligometastases, who were treated with stereotactic radiosurgery (SRS) or surgical resection as the primary treatment, were identified at Shanghai Chest Hospital. Results A total of 76 patients (22 patients underwent brain surgery as primary treatment and 54 patients received SRS) were available for survival analysis. The overall survival (OS) for patients treated with SRS and brain surgery as the primary treatment were 12.6 months (95% confidence interval [CI] 10.3–14.9) and 16.4 months (95% CI 8.8–24.1), respectively (adjusted hazard ratio =0.59, 95% CI 0.33–1.07, P=0.08). Among 76 patients treated with SRS or brain surgery, 21 patients who underwent primary tumor resection did not experience a significantly improved OS (16.4 months, 95% CI 9.6–23.2), compared with those who did not undergo resection (11.9 months, 95% CI 9.7–14.0; adjusted hazard ratio =0.81, 95% CI 0.46–1.44, P=0.46). Factors associated with survival benefits included stage I–II of primary lung tumor and solitary brain metastasis. Conclusion There was no significant difference in OS for patients with synchronous brain oligometastasis receiving SRS or surgical resection. Among this population, the number of brain metastases and stage of primary lung disease were the factors associated with a survival benefit. PMID:27471395

Thyroglossal Duct Papillary Thyroid Carcinoma and Synchronous Lingual Thyroid Atypia

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Timothy Yoo

2016-01-01

Full Text Available Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.

Primary carcinoma of the duodenum

International Nuclear Information System (INIS)

Steidle, B.; Huetter, B.; Ziegler, F.

1984-01-01

Primary carcinoma of the duodenum represents about 0.35% of all gastrointestinal carcinomas and is thus a rare disease. The radiological diagnosis of a duodenal origin is made more difficult by the close proximity of the pancreas, biliary system, right kidney and transverse colon. Histologically, duodenal malignant tumours are usually adenocarcinomas. Between 1973 and 1983, eight patients with primary duodenal carcinomas were diagnosed at the University of Tuebingen. Average age of the patients was 67 years. There was no sex difference. Average survival was 3.3 years. (orig.) [de

Irradiation of neglected spinocellular carcinomas of the skin following the synchronizing of partial cell division

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Szabo, P.

1979-01-01

The methods of synchronized irradiation as well as the results of the treatment of 20 cases of spinocellular carcinomas have been described. The majority of spinocellular carcinomas were already in the advanced stage. Synchronizing was carried out with a 5-FU in 1000-1000 mg doses twice a week for 12 hour periods in a solution of 1500 ml dissolved in 5 percent dextrose. 8.5 hours after the completion of infusion, irradiation was performed by a Dermopan equipment using 500 R fractions. The total dose reached 4000-5000 R. The conditions of the irradiation were as follows: 50 kV, 25 mA, 5, 10, 15 and 30 cm FB distance. During the treatment the patients were kept under strict clinical control. No toxic side effects were found in the process. It was determined that the patients have tolerated the synchronized ray treatment well. As a direct result of the therapy, 16 out of the 20 spinocellular carcinomas have entirely regressed and four was significantly reduced in size. Patients were kept under a systematic control. Subsequent check-ups revealed only two cases of newly developed tumours. The follow-up control examinations have lasted from six months to four or five years. (author)

[Endoscopic screening for upper gastrointestinal second primary malignancies in patients with hypopharyngeal squamous cell carcinoma].

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Tian, J J; Xu, W; Lyu, Z H; Ma, J K; Cui, P; Sa, N; Cao, H Y

2018-04-07

Objective: To evaluate the usefullness of flexible esophagoscopy and chromoendoscopy with Lugol's solution in the detection of synchronous esophageal neoplasm in patients with hypopharyngeal squamous cell carcinoma (HSCC). Methods: A retrospective review of 96 cases with HSCC that received surgical treatment from March 2016 to March 2017 was accomplished. In these patients, the site of origin were pyriform sinus ( n =75), posterior pharyngeal wall ( n =11) and postcricoid ( n =10). Esophagoscopy was prospectively performed on all patients before treatment for HSCC. All patients underwent conventional white-light endoscopic examination with Lugol chromoendoscopy and narrow band image. Suspicious areas of narrow band image or Lugol-voiding lesions were observed and biopsied. The treatment strategy of primary HSCC was modified according to the presence of synchronous esophageal squamous cell neoplasms by a multidisciplinary approach. Results: Ninety-six patients were enrolled (age ranging from 37-80 years). All patients did not have previous treatment.Histopathological analysis revealed middle to high-grade dysplasia in 5 cases, Tis cancer in 5 cases, cancer in 16 cases and inflammation or normal findings in the others. Four cases were treated with endoscopic submucosal dissection before hypopharygeal surgery, 3 cases with lower esophageal cancers were treated with gastric pull-up combined with free jejunal flap after total circumferential pharyngolaryngectomy (TCPL) and certical esophagectomy, and 14 cases were treated with TCPL, total esophagectomy and gastric pull-up. Conclusions: Esophagoscopy is a feasible and justified procedure in HSCC cases as it enhances the detection of premalignant lesion or second primary cancer. Routine esophagoscopy for detecting synchronous second primary tumor should be recommended for patients with HSCC. The treatment strategy for primary HSCC is modified according to the presence of synchronous second primary tumor.

Synchronous parathyroid adenoma and papillary thyroid carcinoma ...

African Journals Online (AJOL)

Simultaneous existence of parathyroid adenoma and thyroid nonmedullary carcinoma is rarely observed. A 52‑year‑old female was diagnosed approximately 4 years ago with primary hyperparathyroidism (PHPT) on the basis of hypercalcemia and elevated serum parathyroid hormone (PTH) level. Clinically, PHPT ...

High risk Merkel cell carcinoma of the skin treated with synchronous carboplatin/etoposide and radiation: a trans-Tasman radiation oncology group study

International Nuclear Information System (INIS)

Poulsen, M.G.; Rischin, D.; Ainslie, J.; Walpole, E.; Harvey, J.; Mackintosh, J.; Hamilton, C.; Tripcony, L.

2003-01-01

The effectiveness of synchronous carboplatin, etoposide and radiation therapy was prospectively assessed in a group of patients with high risk Merkel Cell Carcinoma of the skin. Patients were eligible if they had disease localised to the primary site and nodes and were required to have at least one of the following high risk features: recurrence after initial therapy, involved nodes, primary size greater than 1 cm, gross residual disease after surgery or occult primary with nodes. Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks and synchronous carboplatin (AUC 4.5) and etoposide 80 mg/M2 intravenously days 1-3 was given in weeks 1, 4, 7 and 10. The median age of the group was 67 [43-86] years and there were 39 males and 14 females. Involved nodes (stageII) were present in 33 (62%) cases. The sites involved in decreasing order were head and neck (22), occult primary (13), upper limb (8), lower limb (8) and trunk (2). Fifty-three patients were entered between 1996 and 2001.The median potential follow up was 48 months. There were no treatment related deaths. The 3 year overall survival, loco-regional control and distant control were 76%, 75% and 76% respectively. Factors that were predictive for local control and survival were tumour site and the presence of nodes. Multivariate analysis indicated that the major factor influencing survival was the presence of nodes. However this was not a significant factor in loco-regional control. High levels of loco-regional control and survival have been achieved with the addition of chemotherapy to radiation treatment for high risk Merkel cell carcinoma of skin. The role of chemo-radiotherapy for high risk MCC warrants further investigation

Primary orbital squamous cell carcinoma

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Ana L. Campos Arbulú

2017-02-01

Full Text Available Primary orbital squamous cell carcinoma is a rare entity. There is little published literature. We report a case of primary squamous cell carcinoma of the orbital soft tissues. Surgical resection offered the best treatment for the patient. Complete resection of the lesion was achieved. The patient received adjuvant radiotherapy due to the proximity of the lesion to the surgical margins. Surgical treatment is feasible and should be considered as part of the surgeon's arsenal. However, therapeutic decisions must be made on a case-by-case basis

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

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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.

Squamous cell carcinoma of the esophagus and multiple primary tumors of the upper aerodigestive tract Carcinoma epidermoide do esôfago e múltiplos tumores primários do trato aerodigestivo alto

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Ulysses RIBEIRO Jr.

1999-12-01

Full Text Available Squamous cell carcinoma of the esophagus is frequently associated with other, synchronous or metachronous tumors, in the upper aerodigestive tract. All 264 patients with squamous cell carcinoma of the esophagus, treated in the Gastrointestinal Surgery, Esophagus section, of the "Hospital das Clínicas" (São Paulo University Medical School, Brazil, between 1979 and 1989 were analyzed retrospectively with regards to the occurrence of multiple primary tumors in the upper aerodigestive tract. Multiple primary tumors were encountered in 10 (3.8% patients. All patients were male and the mean age at the time of the first primary was 52.2 years. Tobacco smoke and alcohol were the principal carcinogens in these patients (n = 10. The sites of the tumors were: larynx (n = 4, tongue (n = 4, lung (n = 2, and oral cavity (n = 1. Two simultaneous, three synchronous and five metachronous multiple primary carcinomas were detected. The esophagus was the second primary tumor in nine patients. The mean overall survival after the diagnosis of the second primary was 2.8 months (SD = 0.89. Inquiry regarding other malignancies, associated with panendoscopy should be carry out prior to the treatment of the first primary to diagnose simultaneous or synchronous primary tumors, and careful follow-up should be performed after treatment of the first primary to detect new tumors in these high-risk patients.Carcinoma epidermóide do esôfago está freqüentemente associado a outros, sincrônicos ou metacrônicos tumores do trato aerodigestivo alto. Foram analisados, retrospectivamente, 264 pacientes com carcinoma de esôfago tratados na Disciplina de Cirurgia do Aparelho Digestivo, Divisão de Cirurgia do Esôfago, do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, entre 1979 e 1989, com o intuito de se observar a ocorrência de múltiplos tumores primários do trato aerodigestivo alto. Observaram-se 10 (3.8% pacientes com múltiplos tumores

Pulmonary squamous cell carcinoma following head and neck squamous cell carcinoma: Metastasis or second primary?

NARCIS (Netherlands)

Geurts, Tom W.; Nederlof, Petra M.; van den Brekel, Michiel W. M.; van't Veer, Laura J.; de Jong, Daphne; Hart, August A. M.; van Zandwijk, Nico; Klomp, Houke; Balm, Alfons J. M.; van Velthuysen, Marie-Louise F.

2005-01-01

Purpose: To distinguish a metastasis from a second primary tumor in patients with a history of head and neck squamous cell carcinoma and subsequent pulmonary squamous cell carcinoma. Experimental Design: For 44 patients with a primary squamous cell carcinoma of the head and neck followed by a

Complete en bloc urinary exenteration for synchronous multicentric transitional cell carcinoma with sarcomatoid features in a hemodialysis patient

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Tiberio M. Siqueira Jr

2006-10-01

Full Text Available The incidence of transitional cell carcinoma (TCC in patients submitted to hemodialysis is low. The presence of TCC with sarcomatoid features in this cohort is even scarcer. Herein, we describe a very rare case of synchronous multicentric muscle invasive bladder carcinoma with prostate invasion in a hemodialysis patient, submitted to complete en bloc urinary exenteration.

Usefulness of analytical CEA doubling time and half-life time for overlooked synchronous metastases in colorectal carcinoma.

Science.gov (United States)

Ito, Katsuki; Hibi, Kenji; Ando, Hideyuki; Hidemura, Kazuhiko; Yamazaki, Taiji; Akiyama, Seiji; Nakao, Akimasa

2002-02-01

Measurement of carcinoembryonic antigen (CEA) has been widely applied to detect recurrence, especially of colorectal carcinoma. The validity however, is still controversial. We investigated serial changes in CEA values to calculate whether the CEA doubling time and half-life time could predict metastatic progression or prognosis in colorectal carcinoma. Pre- and post-operative serial serum CEA contents were determined in 22 cases of colorectal cancer with or without metastasis. CEA values were determined by enzyme immunoassay (EIA). Patients were assigned depending upon survival time (within vs. more than 18 months after primary resection) for assessment of CEA doubling time. From the gradient of the semi-logarithmic CEA graph, the preoperative doubling time was calculated and the postoperative half-life time was estimated according to the diagnosis of metastases within 2 years after primary resection [metastasis (+) or (-)]. In spite of the effect of curative re-operation of metastatic lesions or of postoperative adjuvant chemotherapy, the CEA doubling time of the groups showed a relation with prognosis (p = 0.045, Student's t-test) when the patients were divided into >18 and time. The CEA half-life time of the groups without overlooked metastases was statistically longer than those with (mean +/- SD 8.01 +/- 2.07 and 4.33 +/- 1.11, respectively, p Clearance (k) showed a significant difference between the groups (p time appeared to be a less independent prognostic factor, whereas prolongation of the CEA half-life time might potentially suggest the existence of overlooked synchronous metastases from colorectal carcinoma.

Primary peritoneal clear cell carcinoma versus ovarian carcinoma versus malignant transformation of endometriosis: a vexing issue.

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Insabato, Luigi; Natella, Valentina; Somma, Anna; Persico, Marcello; Camera, Luigi; Losito, Nunzia Simona; Masone, Stefania

2015-05-01

Peritoneum is a site for both primary and secondary tumors. Primary peritoneal tumors are fairly rare. The most common primary tumors of the peritoneum are malignant mesothelioma and serous papillary adenocarcinoma. Clear cell carcinoma of the peritoneum is extremely rare and often misdiagnosed as mesothelioma, serous carcinoma, or metastatic adenocarcinoma, so it represents a diagnostic challenge for both clinicians and pathologists. Up to date, to the best of our knowledge, only 11 cases of primary peritoneal clear cell carcinoma have been reported in the English literature. Distinguishing this tumor of the peritoneum versus ovarian carcinoma can be problematic. Herein, we report a rare case of primary peritoneal clear cell carcinoma occurring in a 49-year-old woman, along with a review of the literature. © The Author(s) 2015.

Primary Fallopian Tube Carcinoma

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Prasad K Shetty

2011-01-01

Full Text Available Primary Fallopian Tube Carcinoma (PFTC is rare and accounts for about 0.3% of all gynecologic cancers. Less than 1500 cases have been reported in the literature. It arises in postmenopausal women and typically presents with abdominal pelvic pain, vaginal bleeding and watery discharge. However, a correct diagnosis is rarely achieved preoperative, and in many cases, the diagnosis is made after incidental surgery for unrelated conditions commonly being ovarian carcinoma . Compared with ovarian carcinoma, PFTC more often presents at early stages, but it has a worse prognosis. PFTC is usually managed in the same manner as ovarian cancer. We report a case of Left PFTC that presented as Left ovarian mass, and we briefly review the literature.

A study of the treatment of oral multiple primary cancers

International Nuclear Information System (INIS)

Sato, Takayuki; Kamata, Shin-etsu; Kawabata, Kazuyoshi

2003-01-01

The subjects were 30 multiple primary cancers (out of 2,169 oral squamous cell carcinoma including lip cancers), which were treated at the Division of Head and Neck, Cancer Institute Hospital. Seven synchronous carcinomas and 23 metachronous cases were seen. The most common site of the primary cancer was the tongue. Surgical treatment was performed for the first treatment in 5 cases of the 7 synchronous cancers. On the other hand, radical treatment was performed in 11 cases of the 23 metachronous cancers. Fourteen of the 18 cases were treated by surgical treatment and controlled. It is suggested that surgical treatment is the most effective for oral multiple primary cancers. (author)

Synchronous colon and gastric advanced carcinomas

International Nuclear Information System (INIS)

Giuliani, A.; Demoro, M.; Corona, M.; Di Bari, M.; Ricciardulli, T.; Galati, G.; Ciardi, A.

2005-01-01

An unusual case of advanced synchronous colon and gastric carcinoma is described. A 36 year old female was admitted to our Department with a stenosing right colon cancer diagnosed at endoscopy which was performed for lower crampy abdominal pain and gross blood in the stool. Multiple colon polyps, distal to the tumor, were also detected. On preoperative abdominal computed tomography, a stenosing right colon cancer, without evidence of abdominal diffusion, was confirmed. At laparotomy, in addition to colon cancer, an antral gastric cancer was incidentally found. En bloc hemi gastrectomy and subtotal colectomy were performed. Digestive continuity was restored by gastrojejunal and ileosigmoid anastomoses. At histology, a poorly differentiated gastric adenocarcinoma with signet ring-cell component (pT2, pN0; stage IB) and a moderately differentiated colon adenocarcinoma with a tubulovillous component (pT3, pN1; stage III, Stage Dukes C) were revealed. Both tumors showed a low expression of p53 and c-erb2 oncoproteins. No genetic defect was identified in the APC and MMR genes. The patient is alive, without recurrence, two years after the operation

Bilateral primary adrenocortical carcinoma complicated by Addisonian crisis: case report

International Nuclear Information System (INIS)

Foster, M.; Nolan, R.L.; Hong, H.H.

2001-01-01

Primary adrenal carcinoma is a rare malignancy. Primary adrenal insufficiency (i.e. Addison's disease) is a rare complication of bilateral infiltration. We report a case of primary bilateral adrenal carcinoma complicated by an episode of primary adrenal insufficiency. (author)

Primary tracheal adenocystic carcinoma and tracheal tumors during pregnancy

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Cem Gundogdu

2011-07-01

Full Text Available Cancer complicates approximately 0.1% of all pregnancies. Primary tracheal carcinoma is one of very rarely seen tumors and the rate of its being seen makes up approximately % 0,2 of all tumors of respiratory tract. The patient, 28 years old, who has 28-weeks-pregnant, was diagnosed with primary tracheal adenocystic carcinoma. Patient was made operation as thoracotomy and tracheal tumor was removed at the 28th week of pregnancy. Patient was delivered with sectio abdominale at the 39th week of pregnancy. Primary tracheal adenocystic carcinoma is very rarely seen tumors and it is the first tracheal ACC with pregnancy case in literature to have been detected and surgically treated during pregnancy. We discussed primary tracheal adenocystic carcinoma and tracheal tumors during pregnancy with literature.

[Expression and clinical significance of KIAA1199 in primary hepatocellular carcinoma].

Science.gov (United States)

Gu, C J; Ni, Q C; Ni, K; Zhang, S; Qian, H X

2018-05-29

Objective: To investigate the expression and clinical significance of KIAA1199 in primary hepatocellular carcinoma. Methods: A total of 136 cases of primary hepatocellular carcinoma tissues and paired adjacent tissues were collected. Immunohistochemistry and Western blot were used to detect the expression of KIAA1199 in primary hepatocellular carcinoma tissues and paired adjacent tissues. The relationship between KIAA1199 and clinicopathological parameter of primary hepatocellular carcinoma was analyzed. Results: The positive rate of KIAA1199 in primary hepatocellular carcinoma was 82.3% (112/136), which was higher than that in paired para-cancerous tissues (14.7%, 20/136). High expression of KIAA1199 was significantly correlated with age, cirrhosis history, tumor size, tumor number, degree of differentiation, TNM staging and microvenous invasion (MVI) ( P 0.05). The Kaplan-Meier survival curves indicated that high KIAA1199 expression was associated with poor survival ( P hepatocellular carcinoma, which is significantly correlated with the clinicopathological features and prognosis, high expression of KIAA1199 increased the risk of death in patients with primary hepatocellular carcinoma.

Triple synchronous cancers. A medical and ethical problem

International Nuclear Information System (INIS)

Debevec, L.; Cesar, R.; Kern, I.

2007-01-01

In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen, and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the ''wait and see'' option can be suitable. (author)

Synchronous lung tumours in a patient with metachronous colorectal carcinoma and a germline MSH2 mutation.

LENUS (Irish Health Repository)

Canney, A

2012-02-01

Mutations of DNA mismatch repair genes are characterised by microsatellite instability and are implicated in carcinogenesis. This mutation susceptible phenotype has been extensively studied in patients with hereditary non-polyposis colon carcinoma, but little is known of the contribution of such mutations in other tumour types, particularly non-small-cell lung carcinoma. This report describes the occurrence of two synchronous lung tumours, one mimicking a metastatic colon carcinoma, in a male patient with a history of metachronous colonic carcinoma. Immunohistochemistry supported a pulmonary origin for both lesions. Mismatch repair protein immunohistochemistry showed loss of MSH2 and MSH6 expression in both colonic tumours and in one lung tumour showing enteric differentiation. Subsequent mutational analysis demonstrated a deleterious germline mutation of the MSH2 mismatch repair gene. The significance of these findings and the practical diagnostic difficulties encountered in this case are discussed.

[Triple synchronous primary gynaecological tumours. A case report].

Science.gov (United States)

Gutiérrez-Palomino, Laura; Romo-de Los Reyes, José María; Pareja-Megía, María Jesús; García-Mejido, José Antonio

2016-01-01

Synchronous multiple primary malignancies in the female genital tract are infrequent. From 50 to 70% of them corresponds to synchronous cancers of the endometrium and ovary. To our knowledge, this is only the third case report in the international literature of three concurrent gynaecological cancers of epithelial origin. A case is presented, as well as a literature review due to the infrequency of its diagnosis and the lack of information on the subject. A 49-year-old woman, with previous gynaecological history of ovarian endometriosis. She underwent a hysterectomy and bilateral oophorectomy, as she had been diagnosed with endometrial hyperplasia with atypia. The final histopathology reported synchronous ovarian, Fallopian tube, and endometrial cancer. An extension study and complete surgical staging was performed, both being negative. She received adjuvant treatment of chemotherapy and radiotherapy. She is currently free of disease. The aetiology is uncertain. There is controversy relating to increased susceptibility of synchronous neoplasms to pelvic endometriosis and inherited genetic syndromes. Its diagnosis needs to differentiate them from metastatic disease. Additionally, they are problematical from a clinical, diagnostic, therapeutic, and prognostic point of view. The presentation of more cases of triple synchronous cancers is necessary for a complete adjuvant and surgical treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Transcriptome analysis of paired primary colorectal carcinoma and liver metastases reveals fusion transcripts and similar gene expression profiles in primary carcinoma and liver metastases

International Nuclear Information System (INIS)

Lee, Ja-Rang; Kwon, Chae Hwa; Choi, Yuri; Park, Hye Ji; Kim, Hyun Sung; Jo, Hong-Jae; Oh, Nahmgun; Park, Do Youn

2016-01-01

Despite the clinical significance of liver metastases, the difference between molecular and cellular changes in primary colorectal cancers (CRC) and matched liver metastases is poorly understood. In order to compare gene expression patterns and identify fusion genes in these two types of tumors, we performed high-throughput transcriptome sequencing of five sets of quadruple-matched tissues (primary CRC, liver metastases, normal colon, and liver). The gene expression patterns in normal colon and liver were successfully distinguished from those in CRCs; however, RNA sequencing revealed that the gene expression between primary CRCs and their matched liver metastases is highly similar. We identified 1895 genes that were differentially expressed in the primary carcinoma and liver metastases, than that in the normal colon tissues. A major proportion of the transcripts, identified by gene expression profiling as significantly enriched in the primary carcinoma and metastases, belonged to gene ontology categories involved in the cell cycle, mitosis, and cell division. Furthermore, we identified gene fusion events in primary carcinoma and metastases, and the fusion transcripts were experimentally confirmed. Among these, a chimeric transcript resulting from the fusion of RNF43 and SUPT4H1 was found to occur frequently in primary colorectal carcinoma. In addition, knockdown of the expression of this RNF43-SUPT4H1 chimeric transcript was found to have a growth-inhibitory effect in colorectal cancer cells. The present study reports a high concordance of gene expression in the primary carcinoma and liver metastases, and reveals potential new targets, such as fusion genes, against primary and metastatic colorectal carcinoma. The online version of this article (doi:10.1186/s12885-016-2596-3) contains supplementary material, which is available to authorized users

Watermelon stomach, hemorrhagic pericarditis, small cell carcinoma of the lung and synchronous squamous cell carcinoma of the tongue base

Directory of Open Access Journals (Sweden)

A. Murinello

2010-07-01

Full Text Available Based on a case of gastric antral vascular ectasia (watermelon stomach that was associated with hemorrhagic pericarditis, small cell lung carcinoma with mediastinal lymph node metastases and a synchronous squamous cell carcinoma of the base of the tongue, the authors made a review of the clinical, endoscopic and histopathological aspects of this type of gastropathy, and its association with other diseases, and of the results of its endoscopic therapy. The causes of hemorrhagic pericarditis are considered, emphasizing the necessity to know if the effusion has a malignant etiology. To the best of our knowledge the association of watermelon stomach to small cell lung carcinoma and squamous cell carcinoma of the base of the tongue has not yet been described. Extensive metastases to mediastal lymph nodes are common to small cell lung carcinoma. Resumo: Baseados num caso de gastropatia antral com ectasia vascular (estômago em melancia associado a pericardite hemorrágica e a um carcinoma de pequenas células do pulmão com metástases ganglionares ao longo do mediastino e a um carcinoma pavimentocelular síncrono da base da língua, os autores fazem uma revisão dos aspectos clínicos, endoscópicos e histopatológicos deste tipo de gastropatia, da sua associação a outras doenças e das possibilidades terapêuticas actuais por via endoscópica. Referem-se igualmente as causas mais frequentes de pericardite hemorrágica, salientando-se a necessidade de esclarecer se o derrame é ou não de origem neoplásica. Não está referida na literatura a associação deste tipo de gastropatia ao carcinoma de pequenas células do pulmão nem ao carcinoma pavimento-celular da base da língua. A invasão extensa dos gânglios mediastínicos pelo carcinoma de pequenas células do pulmão é ocorrência frequente. Key-words: Gastric antral vascular ectasia, watermelon stomach, small cell lung carcinoma, oat cell lung carcinoma, squamous cell carcinoma of the base

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

Directory of Open Access Journals (Sweden)

V. R. Latypov

2014-11-01

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

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

Directory of Open Access Journals (Sweden)

V. R. Latypov

2014-01-01

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

Genetic analysis of an orbital metastasis from a primary hepatic neuroendocrine carcinoma

DEFF Research Database (Denmark)

Rasmussen, Jacob Ø; von Holstein, Sarah L; Prause, Jan U

2014-01-01

and immunohistochemical features, and high-resolution, array-based comparative genomic hybridization demonstrated loss of one copy each of chromosomes 3 and 18, and gain of 1q both in the primary hepatic neuroendocrine carcinoma and in the orbital tumour. The orbital mass was diagnosed as a metastasis from the primary...... hepatic neuroendocrine carcinoma. Primary hepatic neuroendocrine tumours are extremely rare, and the orbit is an extremely rare location for a neuroendocrine carcinoma metastasis. This is the first reported case of an orbital metastasis with origin from a primary hepatic neuroendocrine carcinoma....

Primary Squamous Cell Carcinoma of Stomach: A Rare Entity ...

African Journals Online (AJOL)

Schmidt C, Schmid A, Lüttges JE, Kremer B, Henne-Bruns D. Primary squamous cell carcinoma of the stomach. Report of a case and review of literature. Hepatogastroenterology 2001;48:1033-6. 5. Muto M, Hasebe T, Muro K, Boku N, Ohtsu A, Fujii T, et al. Primary squamous cell carcinoma of the stomach: A case report with ...

Primary and metastatic lobular carcinoma of the breast

International Nuclear Information System (INIS)

Harake, Marie D.J.; Maxwell, Anthony J.; Sukumar, Sathi A.

2001-01-01

Invasive lobular carcinoma of the breast is the second most common type of primary breast cancer, accounting for 8-14% of cases, but is often difficult to diagnose early. It typically shows a diffuse pattern of infiltration within the breast, resulting in a variety of often subtle radiological appearances. A similar infiltrative pattern is seen in its metastatic form, with involvement of the gastrointestinal tract, peritoneum, retroperitoneum, bone marrow, meninges and uterus occurring more frequently than with the more common infiltrating ductal carcinoma of the breast. This pictorial essay illustrates the spectrum of radiological appearances which may be encountered with both primary and secondary lobular carcinoma. Harake, M.D.J., Maxwell, A.J. and Sukumar, S.A. (2001). Clinical Radiology 56, 621-630

Primary and metastatic lobular carcinoma of the breast

Energy Technology Data Exchange (ETDEWEB)

Harake, Marie D.J.; Maxwell, Anthony J.; Sukumar, Sathi A

2001-08-01

Invasive lobular carcinoma of the breast is the second most common type of primary breast cancer, accounting for 8-14% of cases, but is often difficult to diagnose early. It typically shows a diffuse pattern of infiltration within the breast, resulting in a variety of often subtle radiological appearances. A similar infiltrative pattern is seen in its metastatic form, with involvement of the gastrointestinal tract, peritoneum, retroperitoneum, bone marrow, meninges and uterus occurring more frequently than with the more common infiltrating ductal carcinoma of the breast. This pictorial essay illustrates the spectrum of radiological appearances which may be encountered with both primary and secondary lobular carcinoma. Harake, M.D.J., Maxwell, A.J. and Sukumar, S.A. (2001). Clinical Radiology 56, 621-630.

E-cadherin expression in primary carcinomas of the breast and its distant metastases

International Nuclear Information System (INIS)

Kowalski, Paul J; Rubin, Mark A; Kleer, Celina G

2003-01-01

Aberrant expression of E-cadherin has been associated with the development of metastases in patients with breast cancer. Even though the expression of E-cadherin has been studied in primary breast tumors, little is known about its expression at the distant metastatic sites. We investigate the relationship between E-cadherin expression in primary breast carcinoma and their distant, non-nodal metastases. Immunohistochemical analysis of E-cadherin was performed in tissues from 30 patients with primary invasive breast carcinoma and their distant metastases. E-cadherin expression was evaluated as normal or aberrant (decreased when compared with normal internal positive controls, or absent). Twenty-two (73%) invasive carcinomas were ductal, and eight (27%) were lobular. Of the primary invasive ductal carcinomas, 55% (12/22) had normal E-cadherin expression and 45% (10/22) had aberrant expression. All of the metastases expressed E-cadherin with the same intensity as (12 tumors) or with stronger intensity than (10 tumors) the corresponding primaries. Of the invasive lobular carcinomas, one of eight (12%) primary carcinomas and none of the metastases expressed E-cadherin in the cell membranes, but they accumulated the protein in the cytoplasm. Aberrant E-cadherin expression is frequent in invasive ductal carcinomas that progress to develop distant metastases. Distant metastases consistently express E-cadherin, often more strongly than the primary tumor. Invasive lobular carcinomas have a different pattern of E-cadherin expression, suggesting a different role for E-cadherin in this form of breast carcinoma

Urethral carcinoma in women: results of treatment with primary radiotherapy

International Nuclear Information System (INIS)

Milosevic, M.F.; Wards, P.R.; Gospodarowicz, M.K.; McLean, M.; Catton, P.A.; Catton, C.N.; Banerjee, D.

2000-01-01

Urethral carcinoma in women is uncommon. This study was undertaken to evaluate the role of radiotherapy in the treatment of these tumors. The hospital records of 34 women with primary urethral carcinoma were retrospectively reviewed. There were 15 squamous cell carcinomas, 13 transitional cell carcinomas, and six adenocarcinomas. The primary tumor was >4 cm in size in eight patients, involved the proximal urethra in 19 and extended to adjacent organs in 22. Inguinal or iliac lymphadenopathy was present in nine patients. There were eight TNM stage I/II tumors, 11 stage III tumors and 15 stage IV tumors. Radiotherapy was administered only to the primary tumor in 15 patients, and to the primary tumor and regional lymph nodes in the remaining 19 patients. Brachytherapy with or without external radiation was used to treat the primary tumor in 20 patients. Tumor recurred in 21 patients. The 7-year actuarial overall and cause-specific survivals were 41 and 45%, respectively. Large primary tumor bulk and treatment with external beam radiation alone (no brachytherapy) were independent adverse prognostic factors for local tumor recurrence. Brachytherapy reduced the risk of local recurrence by a factor of 4.2. The beneficial effect of brachytherapy was most prominently seen in patients with bulky primary disease. Large tumor size was the only independent adverse predictor of overall disease recurrence and death from cancer. Radiotherapy is an effective treatment for carcinoma of the female urethra and preserves normal anatomy and function. Brachytherapy improves local tumor control, possibly as a result of the higher radiation dose that can safely be delivered. (author)

A Rare Case of Primary Infiltrating Neuroendocrine Carcinoma of the Breast

International Nuclear Information System (INIS)

Nawawi, Ouzreiah; Ying Goh, Keat; Rahmat, Kartini

2012-01-01

Primary neuroendocrine carcinoma of the breast is a very rare malignant tumor. There are not many cases reported in the English literature since it was first documented in 1983. Reports on the imaging features, in particular the ultrasonographic features of this rare tumor are scarce. Herein, we report a case of aggressive primary infiltrating neuroendocrine carcinoma of the breast, masquerading as an inflammatory breast condition in a 22-year-old young lady, perhaps the youngest case ever reported in the English literature. We discuss the imaging features and highlight the Doppler ultrasonographic findings of this rare breast carcinoma. This is the first documentation on Doppler ultrasonographic findings of primary neuroendocrine carcinoma of the breast in the literature

Primary Signet-Ring Carcinoma in the Bladder Presenting as a Hypervascular Luminal Polypoid Mass

International Nuclear Information System (INIS)

Jeong, Min Sun; Choi, Seung A; Jung, Yoon Young; Cho, Young Kwon; Lee, Won Mi; Lee, Seung Wook

2012-01-01

Primary signet-ring carcinoma is a very aggressive and rare variant of a primary urinary bladder cancer, accounting for less than 1% of cases. We reported on a 76-year-old patient with primary signet-ring carcinoma who occurred metastatic lymphadenopathy with extranodal invasion causing intraluminal tumor thrombi in the adjacent vein, and pulmonary metastasis over the course of three months. We demonstrated the computed tomography findings of primary signet-ring carcinoma of the bladder and correlated the imaging findings with the pathologic features. We reviewed the distinguishing imaging findings of the primary signet-ring carcinoma compared with urothelial cell carcinoma, the most common subtype of the bladder cancer.

Primary adenosquamous carcinoma of the stomach: a case report

International Nuclear Information System (INIS)

Kim, Mi Jeong; Kwon, Jung Hyeok; Kim, In Ho; Ryu, Seung Wan; Park, Kyung Sik; Hwang, Jae Seok; Kang, Yu Na

2005-01-01

Adenosquamous carcinoma, a rare malignant tumor of the stomach, is characterized by the presence of two different cell components, one adenomatous and the other squamous. Adenosquamous carcinoma of the stomach tends to more aggressive clinicopathologic features than common adenocarcinoma. There are few reports about radiologic features of adenosquamous carcinoma of the stomach. We experienced a case of a primary adenosquamous carcinoma of the stomach in a 67-year-old man, and report here the ultrasonographic and computed tomographic (CT) findings

Multiple primary cancers: An enigma

Directory of Open Access Journals (Sweden)

Amitabh Jena

2016-01-01

Full Text Available Background: Incidence of multiple primary cancers though uncommon, is being frequently reported now-a-days owing to better diagnostic techniques, the prolonged life span and the increased incidence of long-term survival of cancer patients. Materials and Methods: This is a retrospective study. Cases of multiple malignancies diagnosed histopathologically were retrieved from the archives of department of surgical oncology. Clinical data were obtained from the medical records. They were categorized as synchronous malignancies if the interval between them was less or equal to 6 months and metachronous, if the interval was more than 6 months. Results: A total of 13 cases were encountered in the 5 year study period. Out of them two were in the metachronous category and the rest were synchronous as the 2nd malignancy was detected mostly during clinical evaluation of the patients for the primary malignancy. There was female predominance with age range being 43-68 years. Majority of the cases were in the 7th decade. The most common organ involved was breast, followed by cervix. Apart from bilateral breast malignancies, there were combinations like breast with uterine endometrial carcinoma, cervical carcinoma and even papillary thyroid carcinoma. Conclusion: Detection of multiple primary malignancies is becoming increasingly common in day-to-day practice. Greater awareness of this is required among both cancer patients and their treating clinicians.

Human papillomavirus infection in squamous cell carcinoma of the vulva, in various synchronous epithelial changes and in normal vulvar skin

NARCIS (Netherlands)

Kagie, M. J.; Kenter, G. G.; Zomerdijk-Nooijen, Y.; Hermans, J.; Schuuring, E.; Timmers, P. J.; Trimbos, J. B.; Fleuren, G. J.

1997-01-01

OBJECTIVE: To investigate the prevalence of human papillomavirus (HPV) infection in various vulvar lesions. METHODS: HPV infection using consensus primer-PCR was studied in 66 patients with vulvar carcinoma and in the synchronous epithelial lesions. RESULTS: HPV infection was present in 13/66

Short-Term Outcomes of Simultaneous Laparoscopic Colectomy and Hepatectomy for Primary Colorectal Cancer With Synchronous Liver Metastases

Science.gov (United States)

Inoue, Akira; Uemura, Mamoru; Yamamoto, Hirofumi; Hiraki, Masayuki; Naito, Atsushi; Ogino, Takayuki; Nonaka, Ryoji; Nishimura, Junichi; Wada, Hiroshi; Hata, Taishi; Takemasa, Ichiro; Eguchi, Hidetoshi; Mizushima, Tsunekazu; Nagano, Hiroaki; Doki, Yuichiro; Mori, Masaki

2014-01-01

Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer and synchronous liver metastases with curative intent at our institute. The median operative time was 452 minutes, and the median estimated blood loss was 245 mL. Median times to discharge from the hospital and adjuvant chemotherapy were 13.5 and 44 postoperative days, respectively. Negative resection margins were achieved in all cases, with no postoperative mortality or major morbidity. Simultaneous laparoscopic colectomy and hepatectomy for primary colorectal cancer with synchronous liver metastases appears feasible with low morbidity and favorable outcomes. PMID:25058762

[Surgical Diagnosis and Treatment of Primary Hyperthyroidism Complicated with Occult Thyroid Carcinoma].

Science.gov (United States)

Wu, Xin; Yu, Jian-chun; Kang, Wei-ming; Ma, Zhi-qiang; Ye, Xin

2015-08-01

To evaluate the surgical diagnosis and treatment of primary hyperthyroidism complicated with occult thyroid carcinoma. Data of 51 cases of primary hyperthyroidism complicated with occult thyroid carcinoma admitted during January 2004 to November 2014 were analyzed retrospectively. The incidence of occult thyroid carcinoma was 5.03% in hyperthyroidism,and 47 cases (92.16%) were female. The preoperative diagnosis of all these 51 cases was primary hyperthyroidism and 11 cases were diagnosed thyroid carcinoma at the same time;25 cases were diagnosed thyroid carcinoma by frozen section and the remaining 26 cases were diagnosed by postoperative pathology. Finally,26 cases underwent subtotal thyroidectomy,4 cases underwent total thyroidectomy, and 21 cases underwent total thyroidectomy with lymphadenectomy. The tumor size ranged from 0.1 to 1.0 cm [mean:(0.63 ± 0.35) cm]. The lesions were less than or equal to 0.5 cm in 28 cases (54.9%). The follow-up lasted from 1 to 121 months [mean:(28.6 ± 22.7)months] in 43 patients,and all of them survived. Primary hyperthyroidism complicated with occult thyroid carcinoma is commonly found in female patients. Preoperative diagnosis is difficult. Ultrasound is the major examining method. Frozen section can increase the detection rate. The postoperative prognosis of hyperthyroidism complicated with occult thyroid carcinoma is satisfactory.

Primary Small Cell Neuroendocrine Carcinoma of Vagina: A Rare Case Report

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Jignasa N. Bhalodia

2011-01-01

Full Text Available Primary small cell neuroendocrine carcinoma of vagina is an extremely rare disease. There have been only 26 previously reported cases in literature. Here, we report a case of primary small cell neuroendocrine carcinoma of vagina. Immunohistochemistry (IHC showed tumor cells positive for synaptophysin, chromogranin, and neuron-specific enolase (NSE.

Short-Term Outcomes of Simultaneous Laparoscopic Colectomy and Hepatectomy for Primary Colorectal Cancer With Synchronous Liver Metastases

OpenAIRE

Inoue, Akira; Uemura, Mamoru; Yamamoto, Hirofumi; Hiraki, Masayuki; Naito, Atsushi; Ogino, Takayuki; Nonaka, Ryoji; Nishimura, Junichi; Wada, Hiroshi; Hata, Taishi; Takemasa, Ichiro; Eguchi, Hidetoshi; Mizushima, Tsunekazu; Nagano, Hiroaki; Doki, Yuichiro

2014-01-01

Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer an...

Parathyroid Carcinoma in Patients that Have Undergone Surgery for Primary Hyperparathyroidism.

Science.gov (United States)

Libánský, Petr; Adámek, Svatopluk; Broulík, Petr; Fialová, Martina; Kubinyi, Josef; Lischke, Robert; Naňka, Ondřej; Pafko, Pavel; Šedý, Jiří; Bobek, Vladimír

2017-01-01

Parathyroid carcinoma is a rare clinical entity, which represents one of the main reasons, why surgery should be performed in specialized centres. Preoperatively, it is very difficult to distinguish between benign and malignant hyperparathyroidism. During the years 1996-2016, we performed 2,220 operations in 2,075 patients with a diagnosis of primary hyperparathyroidism. Among these 2,220 operations, there were 16 operations for parathyroid carcinoma. These 16 operations, including reoperations, were performed in four patients. Two patients had no reoperation, but another 2 patients required 14 reoperations in total. Parathyroid carcinoma was described in 0.2% of all patients with a diagnosis of primary hyperparathyroidism. The number of operations was 0.73% of all operations of primary hyperparathyroidism in years 1996-2016. Prognosis of parathyroid carcinoma is quite favourable, patients evidence a long-term survival rate after the primary operation. However, every reoperation increases the number of possible complications, including recurrent laryngeal nerve injury. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Primary intraosseous squamous cell carcinoma in odontogenic keratocyst: A rare entity

Science.gov (United States)

Saxena, Chitrapriya; Aggarwal, Pooja; Wadhwan, Vijay; Bansal, Vishal

2015-01-01

Squamous cell carcinoma (SCC) arising from the wall of an odontogenic cyst (also known as primary intraosseous carcinoma) is a rare tumor which occurs only in jaw bones. This tumor was first described by Loos in 1913 as a central epidermoid carcinoma of the jaw. Primary intraosseous carcinomas (PIOC) may theoretically arise from the lining of an odontogenic cyst or de novo from presumed odontogenic cell rests. According to the new histological classification of tumors of the World Health Organization, odontogenic keratocyst is nowadays considered a specific odontogenic tumor and the PIOC derived from it is considered as a specific entity which is different from other PIOCs derived from the odontogenic cysts. The following report describes a case of such extremely rare entity that is primary intraosseous SCC of the mandible derived from an OKC in a 60-year-old male patient with brief review of literature. PMID:26980976

A Case of Primary Gastric Small-Cell Carcinoma in an Elderly Patient

Directory of Open Access Journals (Sweden)

Fa-Chang Yu

2012-03-01

Full Text Available We report a case of primary small-cell carcinoma of the stomach in a 75-year-old man. The patient was admitted to our hospital with a 1-week history of intermittent tarry stool. An upper gastrointestinal examination revealed a large stage A2 ulcer in the greater curvature of the body of the stomach, and pathological findings from biopsy specimens revealed small-cell carcinoma. The tumor cells were small-sized, composed of hyperchromatic nuclei with scant cytoplasm, and stained positive for cytokeratin, synaptophysin, and chromogranin A. The patient was diagnosed with primary small-cell carcinoma of the stomach. He declined further evaluation and received palliative management. This is a rare carcinoma of the stomach, with aggressive manifestations and a poor prognosis. The mean survival of patients with primary gastric small-cell carcinoma is reported to be 7 months. The choice of treatment for this disease is still controversial. This rare gastric tumor should be listed in the differential diagnosis of gastric carcinoma in the elderly.

Clinical Characteristics of 118 Cases of Chronic Obstructive Pulmonary Disease Complicated with Primary Bronchopulmonary Carcinoma

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Songlin ZHAO

2017-08-01

Full Text Available Background and objective The aim of this study is to investigate the clinical characteristics of patients with primary bronchopulmonary carcinoma complicated with chronic obstructive pulmonary disease (COPD, and to optimize the early diagnoses in the coexistence of COPD and primary bronchopulmonary carcinoma. Methods The clinical data of 118 patients with COPD complicated with primary bronchopulmonary carcinoma were analyzed retrospectively, including age, sex, smoking history, smoking index, clinical symptoms and signs, pathological type, staging, metastasis site and lung function index. 120 patients with simple COPD were selected as control. Results The smoking rate (55.1% and smoking index ≥400 branch /year (90.8% of the patients with COPD complicated with primary bronchopulmonary carcinoma were higher than the simple COPD group (20.8%, 48.0%. The difference between the two groups was statistically significant (P0.05, while the incidence of hemoptysis, weight loss, chest pain, hoarseness, pleural effusion and atelectasis were significantly higher than those in simple COPD group (P0.05, but the diffusing capacity of carbon monoxide (DLCO of COPD patients complicated with primary bronchopulmonary carcinoma was lower than that of simple COPD patients (P<0.05 . In the COPD patients with primary bronchopulmonary carcinoma, squamous cell carcinoma was the most common pathological type (51.7%. Male patients were mainly squamous cell carcinoma (60.7%, while female patients with adenocarcinoma (69.0%. Conclusion COPD combined with primary bronchopulmonary carcinoma occurs in male smokers more. There is higher incidence of squamous cell carcinoma. When they are first diagnosed, most of them are advanced or located late, due to no specific clinical symptoms at the early stages. Periodic chest CT examination for COPD patients can help early diagnoses of primary bronchopulmonary carcinoma.

Primary peritoneal serous carcinoma: A rare case and palliative approach

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Viral M Bhanvadia

2014-01-01

Full Text Available Primary peritoneal serous carcinoma (PPSC is a rare primary malignancy that diffusely involves the peritoneum, indistinguishable clinically and histopathologically from primary serous ovarian carcinoma. The origin of PPSC has not been well characterized. Here we present a case of PPSC diagnosed in ultrasonography-guided fine needle aspiration cytology (FNAC in a 76- old female presenting with ascites, abdominal pain, distension and constipation. PPSC is an unusual tumour but cytomorphology is distinctive enough to diagnose preoperatively. In the case report hereby described PPSC is an inoperable malignancy, hence chemotherapy and palliative care are the only offered treatment.

Primary pulmonary hepatoid carcinoma: Report of a case and review of the literature

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Shiou-Fu Lin

2013-09-01

Full Text Available Hepatoid carcinoma is a rare malignancy defined as extrahepatic primary alpha-fetoprotein-producing carcinoma morphologically resembling hepatocellular carcinoma. It is extremely rare in the lungs, with ambiguous pathological descriptions and variable prognosis. Herein, we present the case of a 66-year-old man with a primary pulmonary hepatoid carcinoma in his right upper lung who received complete curative surgical resection and adjuvant chemotherapy. No signs of recurrence or distant metastasis have been observed for 57 months postoperation. In addition, the literature is reviewed and the pathological diagnostic pitfalls are discussed.

Selective angiography in fifty patients with primary hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Shou-Zhong, Wang; Xing-Rong, Chen; Gong-Xian, Wang

1983-06-01

Selective angiography is of great importance in the diagnosis of primary hepatocellular carcinoma. It offers information on the findings, multicentricity, localisation, extension, and type of growth. This paper discusses angiography from the methodical point of view, the findings to be obtained, the types of hepatocellular carcinoma, and the diagnostic efficiency of selective angiography in the evaluation of this type of tumour.

Primary intraosseous carcinoma occurring in the maxilla

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Kim, Mi Ja [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2004-03-15

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. A 56-year-old patient who complained of delayed healing after extraction of upper left central incisor visited our department. The conventional radiographs showed a bony destructive lesion with ill-defined margin and moth-eaten appearance. On the computed tomographic images, the lesion perforated the labial cortex of alveolar bone, elevated the left nasal floor superiorly, and perforated partially both nasal floor. The magnetic resonance images showed low signal intensity at T2 and T1 weighted images at the area and adjacent soft tissue. Histologically, there were irregular epithelial islands with cell atypia, nuclear hyperchromatism, pleomorphism, atypical mitosis. The final diagnosis was PIOC.

Primary intraosseous carcinoma occurring in the maxilla

International Nuclear Information System (INIS)

Kim, Mi Ja

2004-01-01

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. A 56-year-old patient who complained of delayed healing after extraction of upper left central incisor visited our department. The conventional radiographs showed a bony destructive lesion with ill-defined margin and moth-eaten appearance. On the computed tomographic images, the lesion perforated the labial cortex of alveolar bone, elevated the left nasal floor superiorly, and perforated partially both nasal floor. The magnetic resonance images showed low signal intensity at T2 and T1 weighted images at the area and adjacent soft tissue. Histologically, there were irregular epithelial islands with cell atypia, nuclear hyperchromatism, pleomorphism, atypical mitosis. The final diagnosis was PIOC.

Clonal relatedness between lobular carcinoma in situ and synchronous malignant lesions

Science.gov (United States)

2012-01-01

Introduction Lobular carcinoma in situ (LCIS) has been accepted as a marker of risk for the development of invasive breast cancer, yet modern models of breast carcinogenesis include LCIS as a precursor of low-grade carcinomas. We provide evidence favoring a clonal origin for LCIS and synchronous estrogen receptor-positive malignant lesions of the ductal and lobular phenotype. Methods Patients with prior LCIS undergoing mastectomy were identified preoperatively from 2003 to 2008. Specimens were widely sampled, and frozen blocks were screened for LCIS and co-existing malignant lesions, and were subject to microdissection. Samples from 65 patients were hybridized to the Affymetrix SNP 6.0 array platform. Cases with both an LCIS sample and an associated ductal carcinoma in situ (DCIS) or invasive tumor sample were evaluated for patterns of somatic copy number changes to assess evidence of clonal relatedness. Results LCIS was identified in 44 of the cases, and among these a DCIS and/or invasive lesion was also identified in 21 cases. A total of 17 tumor pairs had adequate DNA/array data for analysis, including nine pairs of LCIS/invasive lobular cancer, four pairs of LCIS/DCIS, and four pairs of LCIS/invasive ductal cancer. Overall, seven pairs (41%) were judged to be clonally related; in five (29%) evidence suggested clonality but was equivocal, and five (29%) were considered independent. Clonal pairs were observed with all matched lesion types and low and high histological grades. We also show anecdotal evidence of clonality between a patient-matched triplet of LCIS, DCIS, and invasive ductal cancer. Conclusion Our results support the role of LCIS as a precursor in the development of both high-grade and low-grade ductal and lobular cancers. PMID:22776144

Results of radiotherapy for primary subglottic squamous cell carcinoma

International Nuclear Information System (INIS)

Paisley, Sonya; Warde, Padraig R.; O'Sullivan, Brian; Waldron, John; Gullane, Patrick J.; Payne, David; Liu, F.-F.; Bayley, Andrew; Ringash, Jolie; Cummings, Bernard J.

2002-01-01

Purpose: To retrospectively evaluate the outcome after radical radiotherapy (RT) and surgical salvage and assess the risk of late toxicity for patients with primary subglottic squamous cell carcinoma treated at our center. Methods and Materials: Between 1971 and 1996, 43 patients with primary squamous cell carcinoma of the subglottis (35 men, 8 women) were treated with radical RT. All received megavoltage irradiation, most commonly to a dose of 50-52 Gy in 20 fractions during 4 weeks (39 patients). The median follow-up was 4.2 years. Results: Local control was achieved with RT alone in 24 (56%) of the 43 patients: 7 of 11 with T1, 8 of 12 with T2, 4 of 8 with T3, and 5 of 12 with T4. The 5-year actuarial local relapse-free rate was 52%. Subsequent local control was achieved in 11 of the 13 patients with failed RT and attempted surgical salvage, for an ultimate local control rate of 81.4% (35 of 43). The 5-year overall and cause-specific actuarial survival rate was 50.3% and 66.9%, respectively. No patients developed Grade 3 or 4 late radiation morbidity. Conclusion: These data support the use of primary RT in the treatment of patients with primary squamous cell carcinoma of the subglottis as an appropriate treatment approach providing an option for laryngeal conservation

Primary intraosseous squamous cell carcinoma of the mandible arising de novo.

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Shamim, Thorakkal

2009-07-01

Primary intraosseous squamous cell carcinoma is an odontogenic tumour with aggressive behaviour usually noticed in 6th to 7th decades of life. The tumour is characterized by progressive swelling of the jaw, pain and loosening of teeth. Microscopically, the lesion is showing foci of keratinising cells separated by collagenous connective tissue stroma. A case of primary intraosseous squamous cell carcinoma of mandible arising de novo in a 40-year-old man is reported.

Primary carcinoma of the Fallopian tubes

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Escalona Veloz, Rafael; Lopez Rodriguez, Caridad; Nunnez Quintana, Adrian; Rizo Reve, Rafael

2010-01-01

The clinical case of a 53 year old patient with history of vaginal bleeding for possible uterine fibroma is described. A total hysterectomy with double ooferectomia was performed. The complementary tests results, including the biopsy, confirmed the presence of a primary carcinoma of the right Fallopian tube. A radiotherapy and follow up were indicated in 'Conrado Benitez' Oncology Hospital from Santiago de Cuba

Weekly Carboplatin Reduces Toxicity During Synchronous Chemoradiotherapy for Merkel Cell Carcinoma of Skin

International Nuclear Information System (INIS)

Poulsen, Michael; Walpole, Euan; Harvey, Jennifer; Dickie, Graeme; O'Brien, Peter; Keller, Jacqui; Tpcony, Lee; Rischin, Danny

2008-01-01

Purpose: The toxicity of radiotherapy (RT) combined with weekly carboplatin and adjuvant carboplatin and etoposide was prospectively assessed in a group of patients with high-risk Stage I and II Merkel cell carcinoma of the skin. This regimen was compared with the Trans-Tasman Radiation Oncology Group 96:07 study, which used identical eligibility criteria but carboplatin and etoposide every 3 weeks during RT. Patients and Methods: Patients were eligible if they had disease localized to the primary site and lymph nodes, with high-risk features. RT was delivered to the primary site and lymph nodes to a dose of 50 Gy and weekly carboplatin (area under the curve of 2) was given during RT. This was followed by three cycles of carboplatin and etoposide. A total of 18 patients were entered into the study, and their data were compared with the data from 53 patients entered into the Trans-Tasman Radiation Oncology Group 96:07 study. Results: Involved lymph nodes (Stage II) were present in 14 patients (77%). Treatment was completed as planned in 16 patients. The weekly carboplatin dose was delivered in 17 patients, and 15 were able to complete all three cycles of adjuvant carboplatin and etoposide. Grade 3 and 4 neutrophil toxicity occurred in 7 patients, but no cases of febrile neutropenia developed. Compared with the Trans-Tasman Radiation Oncology Group 96:07 protocol (19 of 53 cases of febrile neutropenia), the reduction in the febrile neutropenia rate (p = 0.003) and decrease in Grade 3 skin toxicity (p = 0.006) were highly statistically significant. Conclusion: The results of our study have shown that weekly carboplatin at this dosage is a safe way to deliver synchronous chemotherapy during RT for MCC and results in a marked reduction of febrile neutropenia and Grade 3 skin toxicity compared with the three weekly regimen

Primary endometrial squamous cell carcinoma with extensive squamous metaplasia and dysplasia

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Bagga Permeet

2008-04-01

Full Text Available Primary squamous cell carcinoma of endometrium is a rare entity. Only 64 cases have been documented in the literature. We report a case of 60-year-old postmenopausal woman who presented with abdominal distention and blood-stained vaginal discharge for 6-7 months. Clinically, chronic pyometra was considered. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary squamous cell carcinoma of endometrium with extensive squamous metaplasia and dysplasia.

Penile-preserving surgery for primary urothelial carcinoma of male urethra

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Haoping Tai

2015-06-01

Full Text Available Primary urethral carcinoma is a rare cancer, comprising <1% of all malignancies. The location of this lesion presents a certain dilemma of treatment between efficacy and quality of life. We report an 84-year-old male patient, with a history of chronic hepatitis C, hypertension, and transient ischemic accident, who presented with dysuria and acute urinary retention. The intravenous urography showed mild prostatic enlargement, but no stone or filling defect was noted in the upper urinary tract. On urethrocystoscopy, multiple papillary tumors were found at the pendulous urethra, and the pathology of biopsy confirmed urothelial carcinoma. The patient was admitted, and electroresection with fulguration of urethral tumors was performed owing to the patient's old age and poor performance status. Intraurethral and intravesical chemotherapy with mitomycin C was regularly given at the outpatient clinic. Recurrent urothelial carcinomas were noted twice in the first 2 years of follow up, and repeated transurethral resections were done. Unfortunately, liver cirrhosis with hepatocellular carcinoma was diagnosed last June, for which he received transcatheter arterial chemoembolization. No recurrence of urethral cancer has been found on semiannual cystoscopy in the past 3 years. Penile-preserving surgery is a reasonable surgical option for elderly primary urethral carcinoma patients with acceptable oncological outcome and good quality of life.

Primary Neuroendocrine Carcinoma of Breast: A Rare Case Report

African Journals Online (AJOL)

Introduction. Primary neuroendocrine carcinoma (PNEC) of breast ... than 50% neoplastic tumor cells expressing neuroendocrine. (NE) markers .... subtype also concluded that molecular classification helps ... decreased disease free survival.

Carcinoma of Unknown Primary Treatment (PDQ®)—Health Professional Version

Science.gov (United States)

Carcinoma of unknown primary (CUP) treatment depends on the best determination of the primary site, if possible. Treatment options may include surgery, radiation therapy, and systemic treatment. Get detailed information about diagnosis and treatment of CUP in this summary for clinicians.

Primary Follicular Carcinoma Arising in Ectopic Thyroid Tissue of the Lateral Neck: A Case Report

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Oh, Se Won; Park, Dong Woo; Kim, Soo Yeon; Hahm, Chang Kok; Lee, Young Jun; Lee, Seung Ro; Pyo, Ju Yeon; Oh, Young Ha; Park, Yong Wook [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

2010-11-15

Ectopic thyroid tissue in the lateral neck is an uncommon congenital anomaly, and the occurrence of primary follicular carcinoma in this ectopic thyroid tissue is very rare. We report here on such a case of follicular carcinoma arising in ectopic thyroid tissue of the left lateral neck without any evidence of primary carcinoma in the original thyroid gland

Primary Follicular Carcinoma Arising in Ectopic Thyroid Tissue of the Lateral Neck: A Case Report

International Nuclear Information System (INIS)

Oh, Se Won; Park, Dong Woo; Kim, Soo Yeon; Hahm, Chang Kok; Lee, Young Jun; Lee, Seung Ro; Pyo, Ju Yeon; Oh, Young Ha; Park, Yong Wook

2010-01-01

Ectopic thyroid tissue in the lateral neck is an uncommon congenital anomaly, and the occurrence of primary follicular carcinoma in this ectopic thyroid tissue is very rare. We report here on such a case of follicular carcinoma arising in ectopic thyroid tissue of the left lateral neck without any evidence of primary carcinoma in the original thyroid gland

Synchronous papillary carcinoma thyroid with malignant struma ovarii: A management dilemma

International Nuclear Information System (INIS)

Krishnamurthy, Arvind; Ramshankar, Vijayalakshmi; Vaidyalingam, Venkatesh; Majhi, Urmila

2013-01-01

Struma ovarii (SO) is a rare form of ovarian tumor, which is defined by the presence of thyroid tissue comprising more than 50% of the overall tumor volume. The vast majority of the variants of SO are benign; however, malignant tumors have been reported in a small percentage of cases. An aggressive multimodality approach using ovarian cancer staging laparotomy, total thyroidectomy along with radioactive iodine-131 ablation, and thyroxin suppression therapy has been shown to safely treat malignant SO both its initial presentation as well as in the event of any subsequent recurrence with excellent efficacy and possibly better oncological outcomes. The rarity of the disease and the lack of evidence surrounding its management and prognosis continue to remain a challenge to the treating clinician. We present a unique case of malignant SO with an incidental synchronous association of follicular variant of papillary carcinoma of the cervical thyroid gland, this is possibly the second case reported in the English language literature

The impact of surgical resection of the primary tumor on the development of synchronous colorectal liver metastasis: a systematic review.

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Pinson, H; Cosyns, S; Ceelen, Wim P

2018-05-22

In recent years different therapeutic strategies for synchronously liver metastasized colorectal cancer were described. Apart from the classical staged surgical approach, simultaneous and liver-first strategies are now commonly used. One theoretical drawback of the classical approach is, however, the stimulatory effect on liver metastases growth that may result from resection of the primary tumour. This systematic review, therefore, aims to investigate the current insights on the stimulatory effects of colorectal surgery on the growth of synchronous colorectal liver metastases in humans. The systematic review was conducted according to the PRISMA statement. A literature search was performed using PubMed and Embase. Articles investigating the effects of colorectal surgery on synchronous colorectal liver metastases were included. Primary endpoints were metastatic tumor volume, metabolic and proliferative activity and tumour vascularization. Four articles meeting the selection criteria were found involving 200 patients. These studies investigate the effects of resection of the primary tumour on synchronous liver metastases using histological and radiological techniques. These papers support a possible stimulatory effect of resection of the primary tumor. Some limited evidence supports the hypothesis that colorectal surgery might stimulate the growth and development of synchronous colorectal liver metastases.

Carcinoma of Unknown Primary Treatment (PDQ®)—Patient Version

Science.gov (United States)

Carcinoma of unknown primary (CUP), treatment can include surgery, radiation therapy, chemotherapy, or hormone therapy. Get detailed information about the diagnosis and treatment of CUP in this expert-reviewed summary.

Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature

Science.gov (United States)

Marinova, Lena; Vicheva, Snezhinka

2016-01-01

We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment. Prognosis of NECB is not different from that of other invasive breast carcinomas and the most important prognostic factor is tumor grade (G). There is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (not otherwise specified), whose choice of therapy depends on tumor's size, degree of differentiation, clinical stage, and hormonal status. PMID:27840759

Primary signet ring cell carcinoma of the appendix mimicking acute appendicitis

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Mario Fusari

2012-10-01

Full Text Available Primary signet ring cell carcinoma of the appendix is a very rare neoplasm that usually presents with signs and symptoms of acute appendicitis and in particular with a right lower abdominal pain. Preoperative imaging detection of appendiceal adenocarcinoma has an important value because it may result in an appropriate surgical procedure. We report a rare case of primary signet ring cell carcinoma of the vermiform appendix in an 80-year-old man who was misdiagnosed on computed tomography (CT scan as acute appendicitis.

Primary candidiasis and squamous cell carcinoma of the larynx: report of a case.

Science.gov (United States)

Lee, Dong Hoon; Cho, Hyong Ho

2013-02-01

Primary candidiasis is rare and often confused with a pre-cancerous lesion, squamous cell carcinoma, or verrucous carcinoma. We report an extremely rare case of squamous cell carcinoma of the vocal cord following primary candidiasis. A 62-year-old man presented to our department reporting a 1-month history of hoarseness. He underwent laryngeal microscopic surgery for a presumptive diagnosis of glottic carcinoma. Histopathologic examination revealed candidiasis and scattered moderate dysplasia. He was treated with itraconazole for 4 weeks, and followed up without any recurrence of candidiasis. However, the 42-month follow-up examination revealed a focal whitish lesion on the right true vocal cord, and a repeat biopsy of this area revealed squamous cell carcinoma without evidence of candidiasis. The patient was treated with radiotherapy and remains well with no signs of tumor recurrence or candidiasis.

Primary Squamous Cell Carcinoma of the Thyroid: A Population-Based Analysis.

Science.gov (United States)

Au, Joshua K; Alonso, Jose; Kuan, Edward C; Arshi, Armin; St John, Maie A

2017-07-01

Objectives To analyze the epidemiology and describe the prognostic indicators of patients with primary squamous cell carcinoma of the thyroid. Study Design and Setting Retrospective cohort study based on a national database. Methods The US National Cancer Institute's SEER registry (Surveillance, Epidemiology, and End Results) was reviewed for patients with primary squamous cell carcinoma of the thyroid from 1973 to 2012. Study variables included age, sex, race, tumor size, tumor grade, regional and distant metastases, and treatment modality. Survival measures included overall survival (OS) and disease-specific survival (DSS). Results A total of 199 cases of primary squamous cell carcinoma of the thyroid were identified. Mean age at diagnosis was 68.1 years; 58.3% were female; and 79.4% were white. Following diagnosis, 46.3% of patients underwent surgery; 55.7%, radiation therapy; and 45.8%, surgery with radiation therapy. Kaplan-Meier analysis demonstrated OS and DSS of 16% and 21% at 5 years, respectively. Median survival after diagnosis was 9.1 months. Multivariate Cox regression analysis showed that predictors of OS and DSS included age ( P Squamous cell carcinoma of the thyroid is a rare malignancy with a very poor prognosis. Surgical resection confers an overall survival benefit. Age, tumor grade, and tumor size are predictors of OS and DSS.

Synchronous Primary Cancers of the Endometrium and Ovary With the Same Histopathologic Type Versus Endometrial Cancer With Ovarian Metastasis: A Single Institution Review of 72 Cases.

Science.gov (United States)

Bese, Tugan; Sal, Veysel; Kahramanoglu, Ilker; Tokgozoglu, Nedim; Demirkiran, Fuat; Turan, Hasan; Ilvan, Sennur; Arvas, Macit

2016-02-01

The purpose of this study was to evaluate the clinicopathological characteristics and survival outcomes of women with simultaneous endometrial and ovarian carcinomas having the same histopathologic type. A review of medical records from 1997 to 2015 identified 72 patients with simultaneous carcinomas of the endometrium and ovary with the same histopathologic type. Patients with synchronous primary cancers of endometrium and ovary (SCEOs) were compared with patients with primary endometrial cancer with ovarian metastasis (ECOM). Clinical and pathological data were obtained from the patients' medical records. Clinicopathological variables including categorical data were analyzed by χ(2) or Fisher exact test and continuous data by a Student t test. A Kaplan-Meier survival analysis was performed and compared by using the log-rank test. A univariate and multivariate analysis of 72 patients with SCEO with the same histopathologic type revealed that SCEO is an independent prognostic factor of 10-year overall survival. There were 31 patients in the SCEO group and 41 patients in the ECOM group. With a mean follow-up time of 68.2 months, the 10-year overall survival rates were 61.3% and 36.6% in SCEO and ECOM groups, respectively (P = 0.029). Age, menopausal status, stage of ovarian cancer, performing lymphadenectomy, grade of endometrial tumor, omental metastasis, and residual tumor were found to be significant risk factors for recurrence in the synchronous group. The differentiation between SCEO and ECOM is of great clinical importance while our results showed a better prognosis for patients with SCEO compared with patients with ECOM. More aggressive therapeutic approaches may be considered for patients with SCEO who are older, postmenopausal, and/or have advanced grade of endometrial tumor, omental metastasis, and residual tumor. Lymphadenectomy should be performed in every patient with SCEO.

Pure primary small cell carcinoma of urinary bladder: A rare diagnostic entity

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Sonia Gon

2013-01-01

Full Text Available Small cell carcinoma of the bladder is a rare, aggressive, poorly differentiated neuroendocrine neoplasm accounting for only 0.3-0.7% of all bladder tumors. Since the tumor is very rare, pathogenesis is uncertain. Small cell carcinomas of the urinary bladder are mixed with classic urothelial carcinomas or adenocarcinomas of the bladder in 68% cases, making pure primary small cell carcinoma even a rarer entity. The unknown etiology and natural history of small cell carcinoma of the urinary bladder represent a challenge both to the pathologist and urologists for its diagnosis and treatment, respectively.

Synchronous primary ovarian and endometrial cancers: a series of cases and a review of literature

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Sylwia Dębska-Szmich

2014-03-01

Full Text Available Synchronous cancers account for 0.7-1.8% of all gynecologic cancers. Among them, synchronous ovarian and endometrial cancers are predominant (40-53%. Patients with synchronous cancers have better prognosis than those with single disseminated cancer. We present 10 patients with synchronous ovarian and endometrial cancers who were treated at the Chemotherapy Department of the Medical University of Lodz in 2009-2013. The most often reported symptom of the disease was abnormal vaginal bleeding (6 patients. The range of the patients’ age was 48-62 and the median age was 56. Five patients had stage I of ovarian cancer, single patients had stage IIA, IIB and IIIB, 2 patients had stage IIIC. Three patients had I, 5 – II, and 2 – III stage of endometrial cancer. All patients had endometrioid type of endometrial cancer, 7 of them had also the same histological type of ovarian cancer. All patients had adjuvant chemotherapy because of ovarian cancer, none of them had adjuvant radiotherapy. One patient was lost to follow up. For other patients a median follow up was 13 months (range: 3-53 months. One patient experienced relapse, all patients are alive. Synchronous ovarian and endometrial cancers are usually diagnosed at an earlier stage, have lower histological grade and better prognosis than single cancers. The most common histological type of both endometrial and ovarian cancers is endometrioid carcinoma. The first symptoms reported by our patients and the course of the disease were concordant with data from the literature.

Synchronous splenectomy and hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A case-control study

Science.gov (United States)

Zhang, Xiao-Yun; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin; Wang, Wen-Tao; Jiang, Li

2015-01-01

AIM: To investigate whether the use of synchronous hepatectomy and splenectomy (HS) is more effective than hepatectomy alone (HA) for patients with hepatocellular carcinoma (HCC) and hypersplenism. METHODS: From January 2007 to March 2013, 84 consecutive patients with HCC and hypersplenism who underwent synchronous hepatectomy and splenectomy in our center were compared with 84 well-matched patients from a pool of 268 patients who underwent hepatectomy alone. The short-term and long-term outcomes of the two groups were analyzed and compared. RESULTS: The mean time to recurrence was 21.11 ± 12.04 mo in the HS group and 11.23 ± 8.73 mo in the HA group, and these values were significantly different (P = 0.001). The 1-, 3-, 5-, and 7-year disease-free survival rates for the patients in the HS group and the HA group were 86.7%, 70.9%, 52.7%, and 45.9% and 88.1%, 59.4%, 43.3%, and 39.5%, respectively (P = 0.008). Platelet and white blood cell counts in the HS group were significantly increased compared with the HA group one day, one week, one month and one year postoperatively (P Splenectomy and micro-vascular invasion were significant independent prognostic factors for disease-free survival. Gender, tumor number, and recurrence were independent prognostic factors for overall survival. CONCLUSION: Synchronous hepatectomy and hepatectomy potentially improves disease-free survival rates and alleviates hypersplenism without increasing the surgical risks for patients with HCC and hypersplenism. PMID:25741142

Treatment of primary tracheal carcinoma. The role of external and endoluminal radiotherapy

International Nuclear Information System (INIS)

Harms, W.; Wannenmacher, M.; Becker, H.; Herth, F.; Gagel, B.

2000-01-01

Background and Purpose: In a retrospective study the role of radiation therapy for the treatment of primary tracheal carcinoma was investigated. Patients and Methods: Between 1984 and 1997, 25 patients with primary tracheal carcinoma were treated with external beam radiotherapy (17 squamous-cell carcinoma [SCC], 8 adenoid cystic carcinoma [ACC], median dose SCC 60 Gy, ACC 55 Gy). An additional brachytherapy boost was carried out in 10/25 patients (median dose SCC 18 Gy, ACC 15 Gy). Ten patients underwent operative treatment. Results: The median survival (Kaplan-Meier) for patients with SCC was 33 months (ACC 94.2). The 1-, 2- and 5-year survival rates (Kaplan-Meier) for patients with SCC were 64.7% (ACC 85.7%), 64.7% (ACC 85.7%), and 26% (ACC 85.7%). Patients with ACC and patients with a complete remission after treatment had a significantly better survival probability (log rank test, p [de

Intrapericardial primary thymic carcinoma in a 73-year-old man.

Science.gov (United States)

Calderon, Ana Maria; Merchan, Juan Andres; Rozo, Juan Carlos; Guerrero, Cesar Ivan; Treistman, Bernardo; Sulak, Laura E; Cheong, Benjamin Y C; Rodríguez, German; Mesa, Andrés

2008-01-01

Thymic carcinoma is a rare, highly aggressive type of tumor that typically occurs in the anterior mediastinum. We describe the case of a 73-year-old man who presented with weakness, cough, dyspnea, anorexia, and weight loss. An echocardiogram showed an intrapericardial mass that occupied the space around the lateral walls of the left ventricle and distally compressed the right ventricle. Magnetic resonance imaging and a biopsy confirmed the presence of intrapericardial primary thymic carcinoma. The patient underwent surgical excision of the tumor and died of right ventricular rupture during the procedure. This case highlights the importance of considering thymic carcinoma whenever an otherwise unexplained intrapericardial mass is encountered.

Primary infiltrating ductal carcinoma of the axillary breast with metastasis to the contralateral chest wall

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Li-Min Sun

2013-06-01

Full Text Available Primary infiltrating ductal carcinoma of the axillary breast is rare and has a high frequency of lymph node (LN involvement. We report a woman with primary infiltrating ductal carcinoma arising from the right axillary breast with metastasis to the contralateral chest wall. Excisional biopsy of the left chest wall nodule and the right axillary mass was carried out and both showed invasive ductal carcinomas histologically. The lesion of the right axillary mass arose from the breast tissue, rather than the LN. Further surgery proved the right axillary LN metastasis. After further review, a primary infiltrating ductal carcinoma of the right axillary breast with metastasis to axillary LNs and contralateral chest wall was diagnosed. The patient also received chemotherapy and radiation and there was no evidence of tumor recurrence after treatment. The present report demonstrated a rare case with uncommon manifestation. Lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma.

Primary bronchial carcinoma or pulmonary metastases

International Nuclear Information System (INIS)

Hasse, J.

1987-01-01

Operative treatment offers the best chance for long term survival in lung cancer of early stage. In the same way surgery may be the most efficient treatment of lung metastases from tumors of extrapulmonary site. The preoperative investigations have to prove that in case of lung cancer this is restricted to one hemithorax and in lung metastases that these are restricted to the lungs exclusively. They also have to prove that the lung function allows adequate resection. This is mainly lobectomy and pneumonectomy, sometimes sleeve resection and rarely segmentectomy for primary lung cancers. Resection of metastases preferably is by wedge excision or enucleation. In bilateral lesions median sternotomy is the favoured approach to both lungs in a single session. Long term results in primary lung cancer depend on the tumor stage. As a rule of thumb by each step of tumor stage the 5-year-survival rate is cut to half. In regard to histology small cell undifferentiated carcinomas are considered surgical indications only in the very early stage and need to be treated by adjuvant chemotherapy. The operative mortality is correlated to the extent of resection and by average is higher for primary carcinoma of the lung because of the usually higher age level and additional pulmonary damage. Patients operated for pulmonary metastases, however, are in lower age range and due to less functional risks, the operative mortality in most series is between 0 and 3%. Early detection of lung cancer, i.e., immediate and expert exploration of suspicious X-ray findings or respiratory symptoms particularly in smokers and with asbestos exposed individuals will contribute to an increasing efficacy of surgical treatment. (orig.) [de

Carcinomatous Meningitis from Unknown Primary Carcinoma

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L. Favier

2009-10-01

Full Text Available Carcinomatous meningitis (CM occurs in 3 to 8% of cancer patients. Patients present with a focal symptom, and multifocal signs are often found following neurological examination. The gold standard for diagnosis remains the demonstration of carcinomatous cells in the cerebrospinal fluid on cytopathological examination. Despite the poor prognosis, palliative treatment could improve quality of life and, in some cases, overall survival. We report on a patient who presented with vertigo, tinnitus and left-sided hearing loss followed by progressive diffuse facial nerve paralysis. Lumbar cerebrospinal fluid confirmed the diagnosis of CM. However, no primary tumor was discovered, even after multiple invasive investigations. This is the first reported case in the English-language medical literature of CM resulting from a carcinoma of unknown primary origin.

Radiation therapy of primary vaginal carcinoma

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Pirtoli, L; Santoni, R [Florence Univ. (Italy). Ist. di Radiologia

1980-01-01

In a series of 22 patients with primary invasive squamous cell carcinoma of the vagina (stage I through IVa), a radical irradiation was planned in 18 and a palliative in the remaining 4 patients. The 5-year survival rate, in the radically irradiated patients, was 10/18 for all stages, and 8/13 for patients of stage I. A vaginal boost irradiation did not seem to improve the results of external irradiation in patients of stage I. Severe adverse effects did not occur.

Clinical significations of G2-M stage partial synchronization on radiation therapies of uterine cervical carcinomas

International Nuclear Information System (INIS)

Sasaki, Hiroshi

1981-01-01

The present study revealed that irradiation-induced changes of repopulation and redistribution played an important role in radiosensitivity and cure process of human uterine cervical carcinoma. DNA measurements by a microspectrophotometer were made on Feulgen stained biopsy specimens obtained from 20 patients. On the other hand, flow-microfluorometric measurements with Fried's computed cell cycle analysis were made on transplanted human cervical carcinomas. The mean nuclear DNA amount of human cervical carcinoma cells increased according as the irradiation doses increase until 2,000 rad. Moreover, as regards with the mean nuclear diameter of cancer cells the same phenomenon was recognized, and there was an interrelation between the increase of mean nuclear DNA amount and that of mean nuclear diameter. This phenomenon was proved in nuclear DNA analysis by flow-microfluorometric measurements on transplanted human cervical carcinoma in nude mice. Computed cell cycle analysis of F.M.F. data demonstrated that this phenomenon was due to irradiation-induced changes of repopulation and redistribution. That is to say, irradiation induces the increase of cycling cells and then partial synchronization to G2-M stage. Examination of the interrelation between this phenomenon at 500 rad and 5 years survival rate demonstrated that there was more increase of nuclear DNA amount in the good prognosis group than in the poor prognosis group. Estimation of residual cells near the G1 stage at 2,000 rad demonstrated that there were more residual cells near the G1 stage in the poor prognosis group than in the good prognosis group. (author)

Radiation therapy for primary carcinoma of the eyelid. Tumor control and visual function

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Hata, M.; Koike, I.; Odagiri, K.; Kasuya, T.; Minagawa, Y.; Kaizu, H.; Mukai, Y.; Inoue, T. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Radiology; Maegawa, J. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Plastic and Reconstructive Surgery; Kaneko, A. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Ophthalmology

2012-12-15

Background and purpose: Surgical excision remains the standard and most reliable curative treatment for eyelid carcinoma, but frequently causes functional and cosmetic impairment of the eyelid. We therefore investigated the efficacy and safety of radiation therapy in eyelid carcinoma. Patients and methods: Twenty-three patients with primary carcinoma of the eyelid underwent radiation therapy. Sebaceous carcinoma was histologically confirmed in 16 patients, squamous cell carcinoma in 6, and basal cell carcinoma in 1. A total dose of 50-66.6 Gy (median, 60 Gy) was delivered to tumor sites in 18-37 fractions (median, 30 fractions). Results: All but 3 of the 23 patients had survived at a median follow-up period of 49 months. The overall survival and local progression-free rates were 87% and 93% at 2 years, and 80% and 93% at 5 years, respectively. Although radiation-induced cataracts developed in 3 patients, visual acuity in the other patients was relatively well preserved. There were no other therapy-related toxicities of grade 3 or greater. Conclusion: Radiation therapy is safe and effective for patients with primary carcinoma of the eyelid. It appears to contribute to prolonged survival as a result of good tumor control, and it also facilitates functional and cosmetic preservation of the eyelid. (orig.)

Primary intraosseous carcinoma arising from odontogenic keratocyst with parotid lymph node metastasis. A case report

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Siddesh Shenoy

2007-01-01

Full Text Available Squamous cell carcinoma (SCC arising from odontogenic cyst lining is rare. The exact incidence of carcinoma arising in odontogenic cyst is unknown, but it is estimated to vary between 1 and 2/1000. The pathogenesis is unknown, but a long-standing inflammation and continuous intracystic pressure have been suggested as possible causative factors. Metastasis from these lesions is not common (< 20%, and most of the carcinomas are moderately to well differentiated. To qualify as a primary intraosseous carcinoma, there must be no initial connection with the oral mucosa, overlying skin, or antral or nasal mucosa. This paper presents a case of primary intraosseous carcinoma arising from odontogenic keratocyst in the anterior mandible with metastasis to left parotid lymph nodes.

Gene expression profiles of primary colorectal carcinomas, liver metastases, and carcinomatoses

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Myklebost Ola

2007-01-01

Full Text Available Abstract Background Despite the fact that metastases are the leading cause of colorectal cancer deaths, little is known about the underlying molecular changes in these advanced disease stages. Few have studied the overall gene expression levels in metastases from colorectal carcinomas, and so far, none has investigated the peritoneal carcinomatoses by use of DNA microarrays. Therefore, the aim of the present study is to investigate and compare the gene expression patterns of primary carcinomas (n = 18, liver metastases (n = 4, and carcinomatoses (n = 4, relative to normal samples from the large bowel. Results Transcriptome profiles of colorectal cancer metastases independent of tumor site, as well as separate profiles associated with primary carcinomas, liver metastases, or peritoneal carcinomatoses, were assessed by use of Bayesian statistics. Gains of chromosome arm 5p are common in peritoneal carcinomatoses and several candidate genes (including PTGER4, SKP2, and ZNF622 mapping to this region were overexpressed in the tumors. Expression signatures stratified on TP53 mutation status were identified across all tumors regardless of stage. Furthermore, the gene expression levels for the in vivo tumors were compared with an in vitro model consisting of cell lines representing all three tumor stages established from one patient. Conclusion By statistical analysis of gene expression data from primary colorectal carcinomas, liver metastases, and carcinomatoses, we are able to identify genetic patterns associated with the different stages of tumorigenesis.

Primary ureteral carcinoma: MRI diagnosis and comparison with other diagnostic imaging facilities

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An Ningyu; Jiang Bo; Cai Youquan; Liang Yan

2004-01-01

Objective: To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods: Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T 2 WI (water imaging) was performed to show the dilated ureter, then axial T 2 WI and T 1 WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results: MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows: ultrasound (94.3%), IVU (59.8%), CT (52.9%), MRI (40.2%), and RUP (35.6%). The accurate diagnostic rate was as follows :MRI (91.4%), RUP (80.6%), CT (63.0%), ultrasound (47.6%), and IVU (11.5%). Conclusion: Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening

Upper Tract Urothelial Carcinomas Accompanied by Previous or Synchronous Nonmuscle-Invasive Bladder Cancer and Preoperative Hydronephrosis Might Have Worse Oncologic Outcomes After Radical Nephroureterectomy.

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Liang, Chengcai; Chi, Runmin; Huang, Liqun; Wang, Jinliang; Liu, Hailong; Xu, Ding; Qian, Subo; Qian, Xiaoqiang; Qi, Jun

2016-10-01

The purpose of the study was to identify predictors of clinicopathologic features and oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy (RNU). The medical records of 172 patients treated with RNU from January 2001 to September 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology were respectively used to evaluate predictors of clinicopathologic features and oncologic outcomes. Of the enrolled 172 patients, 80 (46.5%) had renal pelvic tumors, 67 (39%) had ureteral tumors, and the remaining 25 (14.5%) patients had multifocal tumors. Compared with patients with renal pelvic tumors, those with ureteral and multifocal tumors were more likely to have previous or synchronous nonmuscle-invasive bladder cancer (NMIBC) and severe hydronephrosis (P = .001 and P hydronephrosis independently predicted worse renal function and positive lymph node or lymphovascular invasion status (P = .001 and P = .007, respectively). Moreover, severe hydronephrosis was an independent risk factor for overall survival and cancer-specific survival in multivariate analysis (P = .025 and P = .045, respectively). Multifocality and previous or synchronous NMIBC were significantly associated with bladder-recurrence-free survival (P = .023 and P = .001, respectively). Upper tract urothelial carcinoma accompanied by previous or synchronous NMIBC and preoperative severe hydronephrosis could have worse oncologic outcomes after RNU. These common accompanied diagnoses could be valuable for guiding preoperative planning and postoperative adjuvant therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Membranoproliferative glomerulonephritis in a carcinoma with unknown primary: An autopsy study

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Gupta Kirti

2008-04-01

Full Text Available Kidney disease frequently complicates malignancy and its treatment. Although many solid and hematologic cancers may involve the renal parenchyma, clinical sequelae are usually not prominent. Published reports cite membranous nephropathy as the most common malignancy-associated glomerulopathy, occurring with many carcinomas and occasionally with leukemia and lymphoma followed by minimal change disease. Rarely membranoproliferative glomerulonephritis (MPGN has been reported in patients with malignancy. The mechanism by which malignancy induces disease remains unproved, but may involve deposition of tumor antigen in the subepithelial space with in situ immune complex formation and subsequent complement activation. Treatment of the underlying malignancy may lead to resolution of nephrotic syndrome, lending indirect support to this theory. We report a rare autopsy case of a patient with metastatic carcinoma (with unknown primary associated with MPGN. The association between MPGN and metastatic carcinoma with unknown primary is uncommon and has not been previously reported in the literature.

Breast Carcinoma Cells in Primary Tumors and Effusions Have Different Gene Array Profiles

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Sophya Konstantinovsky

2010-01-01

Full Text Available The detection of breast carcinoma cells in effusions is associated with rapidly fatal outcome, but these cells are poorly characterized at the molecular level. This study compared the gene array signatures of breast carcinoma cells in primary carcinomas and effusions. The genetic signature of 10 primary tumors and 10 effusions was analyzed using the Array-Ready Oligo set for the Human Genome platform. Results for selected genes were validated using PCR, Western blotting, and immunohistochemistry. Array analysis identified 255 significantly downregulated and 96 upregulated genes in the effusion samples. The majority of differentially expressed genes were part of pathways involved in focal adhesion, extracellular matrix-cell interaction, and the regulation of the actin cytoskeleton. Genes that were upregulated in effusions included KRT8, BCAR1, CLDN4, VIL2, while DCN, CLDN19, ITGA7, and ITGA5 were downregulated at this anatomic site. PCR, Western blotting, and immunohistochemistry confirmed the array findings for BCAR1, CLDN4, VIL2, and DCN. Our data show that breast carcinoma cells in primary carcinomas and effusions have different gene expression signatures, and differentially express a large number of molecules related to adhesion, motility, and metastasis. These differences may have a critical role in designing therapy and in prognostication for patients with metastatic disease localized to the serosal cavities.

Radiation therapy for primary undifferentiated carcinoma of the esophagus

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Ohno, Tatsuya; Yamakawa, Michitaka; Shiojima, Kazumi; Hasegawa, Masatoshi; Akimoto, Tetsuo; Nakayama, Yuko; Kitamoto, Yoshizumi; Mitsuhashi, Norio; Niibe, Hideo

1996-01-01

Eight patients with undifferentiated carcinoma of the esophagus were treated by radiation therapy. Loco-regional control was easily achieved by radiation therapy alone and no loco-regional recurrence was observed for six patients treated with total dose of more than 30 Gy. However four patients developed distant metastases and died of tumor. Median survival was 3.5 months with a range of 0 to 48 months. Only one patient is alive with no evidence of tumor for 48 months. Combination chemotherapy should be recommended for primary undifferentiated carcinoma of the esophagus because of having a high incidence of distant metastases. (author)

Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

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Andrew Austin Gassman

2012-01-01

Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

Metastatic Carcinoma Occurring in a Gastric Hyperplastic Polyp Mimicking Primary Gastric Cancer: The First Reported Case

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Gabriel M. Groisman

2014-01-01

Full Text Available Hyperplastic polyps of the stomach are regarded as benign. However, in rare cases they may contain incipient primary carcinomas. To our knowledge, breast carcinoma metastatic to a gastric hyperplastic polyp has not yet been reported. We describe the case of a 69-year-old woman to whom a gastric polyp was endoscopically excised. The patient had previously undergone a right mastectomy for mixed, invasive ductal and lobular carcinoma 5 years earlier. Histological sections from the gastric lesion showed typical features of hyperplastic polyp with foci of poorly differentiated adenocarcinoma including signet ring cells infiltrating the lamina propria. The histologic findings were consistent with a primary gastric cancer. However, the carcinoma cells were immunopositive for estrogen and progesterone receptors and GATA3 and negative for CDX2, Hep Par 1, and MUC5AC. E-cadherin showed membranous reactivity in some of the carcinoma cells while in others it was negative. Accordingly, metastatic mixed, lobular and ductal breast carcinoma was diagnosed. We conclude that metastatic adenocarcinoma mimicking primary gastric cancer can be rarely encountered in hyperplastic gastric polyps.

Relationship between Ga-67 uptake and radiotherapeutic response of primary lung cancer (squamous cell carcinoma)

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Higashi, Kotaro; Takase, Shuko; Ohguchi, Manabu; Seki, Hiroyasu; Okimura, Tetsuro; Miyamura, Toshio; Yamamoto, Itaru; Rikimaru, Shigeho.

1992-01-01

This investigation was undertaken to evaluate the relationship between Ga-67 uptake and radiotherapeutic response of primary lung cancer (squamous cell carcinoma), Ga-67 uptake of tumor was estimated on 16 patients with untreated primary lung cancer (squamous cell carcinoma). Ga-67 uptake was then compared with the response to radiation therapy (tumor reduction ratio). There was statistically significant inverse correlation between Ga-67 uptake and response to radiation therapy (r=-0.701, p<0.01). The fewer the Ga-67 accumulation in the tumor, the more effective radiotherapy in reducing tumor size. In conclusion, Ga-67 scintigraphy appears to be able to predict the response of primary lung cancer (squamous cell carcinoma) to radiation therapy. (author)

An incidental primary papillary carcinoma arising in a thyroglossal duct cyst: Report of a rare finding

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Mohammad Jaseem Hassan

2016-01-01

Full Text Available The thyroglossal duct cysts (TGDCs are the most common congenital anomaly of the thyroid, usually manifested as painless midline neck mass. Malignancy is very rare and is reported in around 1% of cases as an incidental finding after histopathological evaluation of resected cyst. Papillary carcinoma is the most common carcinoma reported in TGDC. Here, we report a case of 17-year-old-female, who presented with a gradually increasing midline neck mass which moves with swallowing. On imaging a diagnosis of infected TGDC was made. The Sistrunk operation was done and a diagnosis of primary papillary carcinoma arising in a TGDC was rendered histopathologically. The contemporary appearance of papillary carcinoma thyroid was reported in about 20% cases of TGDC carcinoma, thus it is essential to differentiate primary papillary carcinoma arising in a TGDC from those of metastatic papillary carcinoma thyroid by strict diagnostic criteria.

Skeletal metastases from primary hepatocellular carcinoma

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Kim, So Sun; Huh, Jin Do; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duk; Chang, Hee Kyung; Huh, Man Ha

1988-01-01

In order to detect and to evaluate the frequency, the distribution, and the radiological findings of skeletal metastases from hepatocellular carcinoma, the authors retrospectively analyzed radiographic, scintigraphic, and CT findings of 257 patients with hepatocellular carcinoma. The results were as follows: 1. Skeletal metastases were demonstrated in 21 patients (8.2%). 2. Frequent symptoms were pain, limitation of motion, paralysis, and mass. In nine of them the initial symptoms were due to skeletal metastases. 3. The common sites of metastases were spine (13 cases), ribs (8 cases), pelvis (8 cases) and femur (6 cases). Humerus, skull and sternum were also frequently involved. 4. Plain film findings were purely osteolytic in all cases and pathologic fractures were noted in 5 cases. 5. The lesions appear expansible in 7 cases, and 4 of them showed associated soft tissue masses on CT scans. 6. Bone scans were performed in 13 cases of them and showed increased radiotracer uptake in all. 7. Angiographic studies of 3 cases showed hypervascularity of the metastatic lesions as well as the primary hepatic tumor.

Investigation of cervical lymph node metastasis from primary unknown carcinoma

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Sagawa, Kosuke; Terada, Tomonori; Saeki, Nobuo; Uwa, Nobuhiro; Mohri, Takeshi; Sakagami, Masafumi

2012-01-01

We retrospectively evaluated 41 patients with metastatic cervical tumors from unknown primary sites at the Hyogo College of Medicine between 1997 and 2007. The N stage classification of cervical lymph nodes was: N1 in 3 cases, N2a in 10 cases, N2b in 10 cases, N2c in 4 cases, and N3 in 14 cases. The histopathological diagnoses of cervical lymph node were: squamous cell carcinoma in 33 cases, adenocarcinoma in 5 cases, undifferentiated carcinoma in 2 cases, and papillary carcinoma in 1 cases. Primary tumor sites were: tonsil in 5 cases, esophaguses in 2 cases, hypopharynxies in 2 cases, and thyroid, oral floor, submandibular gland, lung, gastric and colon in 1 case each. The useful tests were gastric endoscope, positron emission tomography-computed tomography (PET-CT), and blind biopsy of tonsil. We treated 24 of the 41 patients. Therapies were: neck dissection with postoperative radiation therapy in 11 cases, neck dissection alone in 1 case, only radiation or chemoradiation therapy alone in 8 cases, and chemotherapy alone in 4 cases. The 5-year survival rate was 40.1% in all cases and 81.5% in cases who underwent neck dissection. (author)

Primary Lung Signet Ring Cell Carcinoma Presenting as a Cavitary Pancoast Tumor in a 32-Year-Old Man.

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Corvini, Michael; Koorji, Alysha; Sgroe, Erica; Nguyen, Uyen

2018-06-01

Signet ring cell carcinoma, a subtype of adenocarcinoma, is a rare cause of primary lung cancer. The authors report a case of primary lung signet ring cell carcinoma presenting as a cavitary Pancoast tumor in a 32-year-old male smoker. Beyond the rarity of primary lung signet ring cell carcinoma itself, the youth of the patient, his smoking status, the presence of cavitation, and the location of the tumor in the superior sulcus make it especially atypical.

PD-L1 expression and the immune microenvironment in primary invasive lobular carcinomas of the breast.

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Thompson, Elizabeth D; Taube, Janis M; Asch-Kendrick, Rebecca J; Ogurtsova, Aleksandra; Xu, Haiying; Sharma, Rajni; Meeker, Alan; Argani, Pedram; Emens, Leisha A; Cimino-Mathews, Ashley

2017-11-01

Tumor-infiltrating lymphocytes and immune checkpoint proteins such as PD-L1 are potential prognostic factors and therapeutic targets in breast cancer. Most studies characterizing the breast tumor immune microenvironment have focused on ductal carcinomas. Here we investigate the tumor microenvironment of primary invasive lobular carcinomas. Previously constructed tissue microarrays of 47 lobular carcinomas were labeled by immunohistochemistry for PD-L1, CD8, CD20, and FoxP3. The stromal immune infiltrate density was qualitatively scored as a percentage of tumor area: 1+ (50%). The average immune cell subtype per high-power field was quantitatively scored. The percentage PD-L1 labeling on tumor-infiltrating lymphocytes was scored as none, focal (lobular carcinomas contained PD-L1 + tumor-infiltrating lymphocytes with the majority showing 1+ immune infiltrates with focal-moderate PD-L1 labeling. PD-L1 was expressed by tumor cells in 17% of lobular carcinomas. In contrast to ductal carcinomas, there was no correlation between the immune infiltrate density, the PD-L1 expression by lobular carcinoma cells, tumor grade, or the expression of estrogen receptor or human epidermal growth factor receptor-2. However, both the tumor-infiltrating lymphocyte density and the average CD8 + T-cell counts correlated with immune cell PD-L1 status (P=0.004 and 0.03, respectively). Similar to breast ductal carcinomas, PD-L1 + lobular breast carcinomas had higher numbers of PD-L1 + tumor-infiltrating lymphocytes (63%) than PD-L1 - lobular carcinomas (23%; P=0.04). These data show that a subset of primary breast lobular carcinomas both express PD-L1 on tumor cells and contain PD-L1 + tumor-infiltrating lymphocytes, suggesting the possibility of both constitutive and adaptive PD-L1 expression. Together, these results support immunotherapy as a potential treatment for a subset of patients with primary invasive lobular breast carcinomas.

Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary.

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Shah, Ameer T; Dagher, Walid I; O'Leary, Miriam A; Wein, Richard O

The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass. Squamous cell carcinoma presenting as facial anesthesia and perineural spread, with no primary site is quite rare. Case presentations and review of the literature. Trigeminal anesthesia is an uncommon presentation of head and neck squamous cell carcinoma with unknown primary. We present two interesting cases of invasive squamous cell carcinoma of the trigeminal nerve, with no primary site identified. We will also review the literature of head and neck malignancies with perineural spread and the management techniques for the two different cases presented. Copyright © 2016 Elsevier Inc. All rights reserved.

The role of primary radiotherapy for squamous cell carcinoma of the supraglottic larynx

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Kim, Won Taek; Kim, Dong Won; Kwon, Byung Hyun; Nam, Ji Ho [College of Medicine, Pusan National Univ, Pusan (Korea, Republic of); Hur, Won Joo [College of Medicine, Donga Univ, Pusan (Korea, Republic of)

2000-12-01

was done. Four patients were died from distant metastasis,: three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor (p=0.0215), and radiation dose (more or less than 702 Gy) was an important factor on survival (p=0.0302). The role of radiotherapy in the treatment of supraglottic carcinoma is to improve the survival- val and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supraglottic carcinomas could be successfully treated with either conservative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone. is inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

The role of primary radiotherapy for squamous cell carcinoma of the supraglottic larynx

International Nuclear Information System (INIS)

Kim, Won Taek; Kim, Dong Won; Kwon, Byung Hyun; Nam, Ji Ho; Hur, Won Joo

2000-01-01

was done. Four patients were died from distant metastasis,: three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor (p=0.0215), and radiation dose (more or less than 702 Gy) was an important factor on survival (p=0.0302). The role of radiotherapy in the treatment of supraglottic carcinoma is to improve the survival- val and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supraglottic carcinomas could be successfully treated with either conservative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone. is inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future

Synchronous Pulmonary Malignancies: Atypical Presentation of Mantle Cell Lymphoma Masking a Lung Malignancy.

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Masha, Luke; Zinchuk, Andrey; Boosalis, Valia

2015-09-07

We present a case of a pleural space malignancy masked by an atypical presentation of mantle cell lymphoma. Our patient presented with a large pleural effusion and right sided pleural studding, initially attributed to a new diagnosis of mantle cell lymphoma. Rare atypical epithelial cells were also seen amongst the clonal population of lymphocytes. The patient lacked systemic manifestations of mantle cell lymphoma and did not improve with chemotherapy. A pleural biopsy ultimately revealed the presence of an undifferentiated carcinoma, favoring a lung primary. A discussion of synchronous pleural space malignancies involving lymphomas is given.

Metastatic Signet-Ring Cell Gastric Carcinoma Masquerading as Breast Primary

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Dinesh Chandra Doval

2009-03-01

Full Text Available Metastasis to the breast from an extra-mammary primary is a rare phenomenon; metastasis from gastric carcinoma to the breast is extremely so. We report a case who initially presented as mucin-secreting and signet-ring cell tumor of the ovary, and after an interval of 8 months with breast and chest wall metastatic nodules. The covert gastric primary eluded the oncologists at both presentations.

Axillary node metastatic carcinoma without definitive primary: a case report

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Spencer R. Anderson

2016-01-01

Full Text Available Cancer of unknown primary (CUP is the finding of a metastatic cancerous lesion without an established primary source localized within the body. CUP can be of any cancer cell type, however, adenocarcinoma is most often identified by histology. Up to 5% of all malignant diagnoses are classified as CUP. PET is an imaging modality often utilized to distinguish a primary source in the setting of CUP, yet often a primary is never identified. CUP can be further stratified using specific qualifiers as favorable and unfavorable, indicating the potential therapeutic response to treatment regimens. Treatment approach to CUP relies heavily on the cell type identified by histology, the location of the lesion, and the amount of spread within the body. In the typical setting and presentation, per current literature, CUP arises in the 7th decade of life in patients with multiple comorbidities, and often has a poor prognostic value. This case report identifies an atypical presentation of CUP, a 38-year-old Caucasian female with an axillary mobile mass, and no associated systemic symptoms. Biopsy of the node and immunohistochemical staining showed histology consistent with metastatic carcinoma. Mammography, MRI, and PET scan found no evidence of tumor primary or distant metastasis. Further staining confirmed metastatic carcinoma consistent with breast origin, without an established breast primary. As in this case, CUP may present in an atypical manner, warranting a thorough investigation aiming to identify the tumor primary to aid in identification of a proper treatment regimen and approach.

Analysis of toxicity of Milkier cell carcinoma of the skin treated with synchronous carboplatin/etoposide and radiation: a Trans-Tasman Radiation Oncology Group study

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Poulsen, Michael; Rischin, Danny; Walpole, Evan; Harvey, Jennifer; Macintosh, John; Ainslie, Jill; Hamilton, Chris; Keller, Jacqui B.; Tripcony, Lee B.

2001-01-01

Purpose: The acute and late toxicities of synchronous carboplatin, etoposide, and radiation therapy were prospectively assessed in a group of patients with high-risk Milkier cell carcinoma of the skin. Patients and Methods: Forty patients from six different centers throughout Australia were entered into a Phase II study under the auspices of the Trans-Tasman Radiation Oncology Group. The trial was activated in 1996 and continues to accrue. Patients are eligible if they have disease localized to the primary site and nodes and are required to have at least one of the following high-risk features: recurrence after initial therapy, involved nodes, primary size greater than 1 cm, gross residual disease after surgery, or occult primary with nodes. Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks, and synchronous carboplatin (area under curve [Auc] 4.5) and etoposide (80 mg/M 2 i.v.) were given on days 1-3 during weeks 1, 4, 7, and 10. The median age of the group was 67 years (43-78). Results: The median duration of follow-up was 22 months (2-45). There were no treatment-related deaths. Grade 3 or 4 skin toxicity occurred in 63% of patients (95% CI 48, 78). The most serious acute effect was on neutrophils with Grade 3 or 4 (neutrophils 9 /L), occurring in 60% (95% CI 45, 75) of cases. Complications from neutropenia (fever and sepsis) occurred in 16 patients (40% of cases). The median time for neutropenic complications was 27 days (9-35), and 10/16 (62%) cases of neutropenic fever occurred after the second cycle of chemotherapy. The probability of Grade 3 or 4 late effects on platelets ( 9 /L) and hemoglobin (<8 g/dl) was 10% (95% CI 1, 20) and 6% (95% CI 2, 15), respectively. Of the 40 patients, 35 were able to complete 4 cycles of chemotherapy. There were no factors predictive for neutropenic toxicity at a p value < 0.05. Conclusions: The protocol has acceptable toxicity, and the treatment has been deliverable in a

A Case of Synchronous Bilateral Upper Urinary System Urothelial Carcinoma

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Ibrahim Buldu

2014-12-01

Full Text Available Synchronous bilateral upper urinary tract urothelial cancer (UTUC is a very rare form of urothelial cancer. In patients with high-risk unilateral UTUC, radical nephroureterectomy (RNU is the gold standard treatment. However, there is no consensus on the treatment for synchronous bilateral UTUC. Evaluation of the patient and the tumor is recommended. Bilateral nephron-sparing surgery (NSS was performed on a 53-year-old patient who presented with high-risk synchronous bilateral UTUC, and the outcome was reported.

CT findings of primary squamous cell carcinoma of the stomach: a case report

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Kim, Kyoung Min; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min

2008-01-01

Primary squamous cell carcinoma is a rare tumor of the stomach with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers. We report a case of squamous cell carcinoma in the stomach associated with hypertrophic gastropathy and observed as a huge mass and wall thickening on the greater curvature site by a multidetector CT

A CASE REPORT OF MULTIPLE PRIMARY SQUAMOUS CELL CARCINOMAS OF THE OVARY AND SIGMOID COLON

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A. B. Villert

2016-01-01

Full Text Available Squamous cell ovarian and sigmoid colon carcinomas are extremely rare malignancies. Because of their rarity, it is difficult to investigate the clinical characteristics and prognosis of patients with theses malignancies, and therefore, the increased interest in each clinical case report is highly relevant. Multiple primary squamous cell ovarian and sigmoid colon carcinomas are the subject of discussion and differential diagnosis of sigmoid colon cancer with secondary ovarian cancer. Histopathological and clinical characteristics of the tumors were present and evidences in favor of the multiple primary malignancies were given. The association of squamous cell ovarian and sigmoid colon carcinomas with human papilloma virus type 16 was shown.

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

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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.

Importance of brachytherapy technique in the management of primary carcinoma of the vagina

International Nuclear Information System (INIS)

Stock, R.G.; Mychalczak, B.; Armstrong, J.G.; Hoskins, W.; Harrison, L.B.

1991-01-01

Primary vaginal carcinoma is a rare malignancy. There is little information regarding the optimal treatment. Management has primarily been with external-beam radiation therapy and brachytherapy. This paper examines the importance of brachytherapy and the significance of its techniques in the treatment of this disease. Brachytherapy plays an important part in the management of primary vaginal carcinoma. External-beam radiation therapy alone is not an adequate treatment for this disease. For stages II and III disease, there is a trend toward improved disease-free survival with the use of a temporary interstitial implant compared to an intracavitary application

Combined Primary Neuroendocrine Carcinoma and Hepatocellular Carcinoma of the Liver

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Chii-Shuenn Yang

2009-08-01

Full Text Available We report a unique case of combined primary neuroendocrine carcinoma (NEC and hepatocellular carcinoma (HCC of the liver in a 65-year-old male patient. The patient underwent segmental resection of the liver and regional lymph node dissection for a tumor mass that measured 7.5 cm in diameter in the right lobe, with regional lymphadenopathy. Histologically, the hepatic tumor was composed of predominantly small-cell NEC, but admixed with a small island of moderately differentiated HCC. We speculate that the NEC originated from a poorly differentiated tumor clone of an HCC that underwent neuroendocrine differentiation, and that this tumor was now at the end stage of the transitional period from HCC to NEC, based on the small amount of disappearing HCC. Ki-67 and p53 expression were higher in the NEC than in the HCC, and the lymph nodes showed only metastatic NEC. Therefore, this kind of tumor had a more aggressive clinical course in accordance with being an NEC rather than a conventional HCC. Three months after operation, the patient had multiple recurrent tumor nodules within the liver, spreading the metastasis to the adrenal glands and para-aortic lymph nodes. The patient died 1 year after operation.

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

International Nuclear Information System (INIS)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young

2014-01-01

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

Energy Technology Data Exchange (ETDEWEB)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

2014-12-15

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

Vinorelbine rescue therapy for dogs with primary urinary bladder carcinoma.

Science.gov (United States)

Kaye, M E; Thamm, D H; Weishaar, K; Lawrence, J A

2015-12-01

The goal of this study was to evaluate the anti-tumour activity and toxicoses of vinorelbine as a palliative rescue therapy for dogs with primary urinary bladder carcinoma. Thirteen dogs refractory to prior chemotherapeutics and one dog naïve to chemotherapeutic treatment were enrolled. Vinorelbine (15 mg m(-2) IV) was administered intravenously along with concurrent oral anti-inflammatory drugs, if tolerated. A median of six doses of vinorelbine (range: 1-16) was administered. Two dogs (14%) had partial responses, and eight (57%) experienced stable disease. Subjective improvement in clinical signs was noted in 11 dogs (78%). Adverse events were mild and primarily haematological in nature. Median time to progression was 93 days (range: 20-239 days). Median survival time for all dogs was 187 days; median survival for 13 pre-treated dogs was 207 days. Vinorelbine may have utility in the management of canine primary urinary bladder carcinoma and should be evaluated in a prospective study. © 2013 John Wiley & Sons Ltd.

Latitudinal trends in human primary activities: characterizing the winter day as a synchronizer.

Science.gov (United States)

Martín-Olalla, José María

2018-03-28

This work analyzes time use surveys from 19 countries (17 European and 2 American) in the middle latitude (38-61 degree) accounting for 45% of world population in this range. Time marks for primary activities are contrasted against light/dark conditions. The analysis reveals winter sunrise synchronizes labor start time below 54 degree, occurring within winter civil twilight. Winter sunset is a source of synchronization for labor end times. Winter terminator punctuate meal times in Europe: dinner occurs 3 h after winter sunset time within 1 h; 40% narrower than variability of dinner local times. The sleep-wake cycle of laborers is shown to be related to winter sunrise whereas standard population's appears to be irrespective of latitude. The significance of the winter terminator depends on two competing factors average labor time (~7 h30 m) and the shortest photoperiod. Winter terminator gains significance when both roughly matches. That is within a latitude range from 38 degree to 54 degree. The significance of winter terminator as a source of synchronization is also related to contemporary year round time schedules: the shortest photoperiod represents the worst case scenario the society faces.

Primary hepatocellular carcinoma localised by a radiolabelled monoclonal antibody

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Markham, N; Ritson, A; James, O; Curtin, N; Bassendine, M; Sikora, K

1986-01-01

A rat monoclonal antibody, YPC2/38.8, was selected from a panel of antibodies derived by immunising rats with fresh human colorectal carcinoma. It was found to bind to a 30,000 dalton protein present on the cell surface of normal colon and liver. This protein was increased 10-fold on primary hepatocellular carcinoma (PHC) cells. After labelling with /sup 131/I, YPC2/38.8 was shown to localise human PHCs grown as xenografts in immunosuppressed mice. The authors conclude that YPC2/38.8 may have potential for diagnostic localisation and possibly thence for the selective targeting of drugs or toxins in patients with PHC arising in a liver unaffected by significant parenchymal disease. 16 refs.; 4 figs.; 1 table.

Detection of Metastases of Primary Hepatocellular Carcinoma with {sup 99m}Tc-HIDA Scintigraphy

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Huh, Dae Suk [Seoul National University College of Medicine, Seoul (Korea, Republic of); Hong, Kee Suk; Hong, Seong Woon; Lee, Jhin Oh; Kang, Tae Woong [Cancer Reseach Hospital, Korea Advanced Energy Institute, Seoul (Korea, Republic of)

1983-03-15

{sup 99m}Tc-Sulfur Colloid is concentrated in Kupffer cells of the liver, whereas the new biliary agents such as {sup 99m}Tc-HIDA are processed by hepatic parenchymal cells. The distant metastatic lesions in skull and lung of the primary hepatocellular carcinoma in 38-year old Korean male were detected with {sup 99m}Tc-HIDA scintigraphy. The chest PA, skull bone X-ray and radionuclide scintigraphic studies are illustrated. This observation suggests that {sup 99m}Tc-HIDA scintigraphy is useful for detection of distant metastases of primary hepatocellular carcinoma.

Next Generation Sequencing of Tubal Intraepithelial Carcinomas

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McDaniel, Andrew S.; Stall, Jennifer N.; Hovelson, Daniel H.; Cani, Andi K.; Liu, Chia-Jen; Tomlins, Scott A.; Cho, Kathleen R.

2016-01-01

Importance High-grade serous carcinoma (HGSC) is the most prevalent and lethal form of ovarian cancer. HGSCs frequently arise in the distal fallopian tubes rather than the ovary, developing from small precursor lesions called serous tubal intraepithelial carcinomas (TICs or more specifically STICs). While STICs have been reported to harbor TP53 mutations, detailed molecular characterizations of these lesions are lacking. Observations We performed targeted next generation sequencing (NGS) on formalin-fixed, paraffin- embedded tissue from four women, two with HGSC and two with uterine endometrioid carcinoma (UEC) who were diagnosed with synchronous STICs. We detected concordant mutations in both HGSCs with synchronous STICs, including TP53 mutations as well as assumed germline BRCA1/2 alterations, confirming a clonal relationship between these lesions. NGS confirmed the presence of a STIC clonally unrelated to one case of UEC. NGS of the other tubal lesion diagnosed as a STIC unexpectedly supported the lesion as a micrometastasis from the associated UEC. Conclusions and Relevance We demonstrate that targeted NGS can identify genetic lesions in minute lesions such as TICs, and confirm TP53 mutations as early driving events for HGSC. NGS also demonstrated unexpected relationships between presumed STICs and synchronous carcinomas, suggesting potential diagnostic and translational research applications. PMID:26181193

Next-Generation Sequencing of Tubal Intraepithelial Carcinomas.

Science.gov (United States)

McDaniel, Andrew S; Stall, Jennifer N; Hovelson, Daniel H; Cani, Andi K; Liu, Chia-Jen; Tomlins, Scott A; Cho, Kathleen R

2015-11-01

High-grade serous carcinoma (HGSC) is the most prevalent and lethal form of ovarian cancer. HGSCs frequently arise in the distal fallopian tubes rather than the ovary, developing from small precursor lesions called serous tubal intraepithelial carcinomas (TICs, or more specifically, STICs). While STICs have been reported to harbor TP53 mutations, detailed molecular characterizations of these lesions are lacking. We performed targeted next-generation sequencing (NGS) on formalin-fixed, paraffin-embedded tissue from 4 women, 2 with HGSC and 2 with uterine endometrioid carcinoma (UEC) who were diagnosed as having synchronous STICs. We detected concordant mutations in both HGSCs with synchronous STICs, including TP53 mutations as well as assumed germline BRCA1/2 alterations, confirming a clonal association between these lesions. Next-generation sequencing confirmed the presence of a STIC clonally unrelated to 1 case of UEC, and NGS of the other tubal lesion diagnosed as a STIC unexpectedly supported the lesion as a micrometastasis from the associated UEC. We demonstrate that targeted NGS can identify genetic alterations in minute lesions, such as TICs, and confirm TP53 mutations as early driving events for HGSC. Next-generation sequencing also demonstrated unexpected associations between presumed STICs and synchronous carcinomas, providing evidence that some TICs are actually metastases rather than HGSC precursors.

Synchronous pulmonary malignancies: atypical presentation of mantle cell lymphoma masking a lung malignancy

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Luke Masha

2015-09-01

Full Text Available We present a case of a pleural space malignancy masked by an atypical presentation of mantle cell lymphoma. Our patient presented with a large pleural effusion and right sided pleural studding, initially attributed to a new diagnosis of mantle cell lymphoma. Rare atypical epithelial cells were also seen amongst the clonal population of lymphocytes. The patient lacked systemic manifestations of mantle cell lymphoma and did not improve with chemotherapy. A pleural biopsy ultimately revealed the presence of an undifferentiated carcinoma, favoring a lung primary. A discussion of synchronous pleural space malignancies involving lymphomas is given.

Cryotherapy of employing Argon/Helium assisted with TACE in treating unresectable primary liver carcinoma

International Nuclear Information System (INIS)

Zhang Zhiliang; Yang Xuedong; Cao Yongwei; Lin Xiangyang; Zhang Yongping; Liu Yayuan

2004-01-01

Objective: To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods: 124 cases with primary liver carcinoma were randomly divided into two groups: 60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results: The total effective rates (CR + PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5, 1, 1.5 years survival rate were 81.3%, 62.5%, 43.8% respectively in the control group; 93.3%, 83.3%, 63.3% respectively for the combined group. There was an obvious difference between the two groups of 1, 1.5 years of survival rates. Conclusions: Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time. (authors)

Synchronous primary carcinoid tumor and primary adenocarcinoma arising within mature cystic teratoma of horseshoe kidney: a unique case report and review of the literature

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Perepletchikov Aleksandr M

2009-06-01

Full Text Available Abstract Background Malignant transformation of mature cystic teratoma is a rare complication. While any of the constituent tissues of a teratoma has the potential to undergo malignant transformation, squamous cell carcinoma is the most commonly associated malignancy. Renal carcinoid tumors are rare and frequently associated with horseshoe kidney and renal teratoma. Renal teratoma rarely presents together with carcinoid tumor or adenocarcinoma. To the best of our knowledge, there has never been a report of renal teratoma coexisting with both carcinoid tumor and adenocarcinoma. Methods Here, we present a unique and first case of synchronous primary carcinoid tumor and moderately differentiated adenocarcinoma arising within mature cystic teratoma of horseshoe kidney in a 50-year-old female. Lumbar spine X-ray, done for her complaint of progressive chronic low back pain, accidentally found a large calcification overlying the lower pole of the right kidney. Further radiologic studies revealed horseshoe kidney and a large multiseptated cystic lesion immediately anterior to the right renal pelvis with central calcification and peripheral enhancement. She underwent right partial nephrectomy. Results Macroscopically, the encapsulated complex solid and multiloculated cystic tumor with large calcification, focal thickened walls and filled with yellow-tan gelatinous material. Microscopically, the tumor showed coexistent mature cystic teratoma, moderately differentiated adenocarcinoma and carcinoid tumor. Immunohistochemically, alpha-methylacyl-coenzyme A-racemase, calretinin, CD10 and thyroid transcription factor-1 were negative in all the three components of the tumor. The teratomatous cysts lined by ciliated epithelium showed strong staining for cytokeratin 7 and pancytokeratin, and those lined by colonic-like epithelium showed strong staining for CDX2, cytokeratin 20 and pancytokeratin, but both were negative for calretinin. Additionally, the

Clinical significance of combined determination of serum CA199 and tumor specific growth factor (TSGF) contents in patients with primary hepatic carcinoma

International Nuclear Information System (INIS)

Shen Jiancheng

2005-01-01

Objective: To investigate the clinical significance of the changes of serum TSGF and CA199 contents in patients with primary hepatic carcinoma. Methods: Serum CA199 (with IRMA) and TSGF (with biochemistry method) contents were determined in 33 patients with primary hepatic carcinoma and 35 controls. Results: Serum CA199 and TSGF contents were significantly higher in patients with primary hepatic carcinoma than those in controls (P<0.01) and their levels were significantly positively correlated with those of serum AFP. Conclusion: Determination of serum TSGF and CA199 contents was of clinical diagnostic value in patients with primary hepatic carcinoma. (authors)

Clinical outcome of primary small cell carcinoma of the urinary bladder

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Hou CP

2013-08-01

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

Primary Fallopian Tube Carcinoma: A Case Report and Literature Review.

Science.gov (United States)

Rexhepi, Meral; Trajkovska, Elizabeta; Ismaili, Hysni; Besimi, Florin; Rufati, Nagip

2017-06-15

Primary fallopian tube carcinoma (PFTC) is a rare tumour of the female genital tract with an incidence of 0.1-1.8% of all genital malignancies, and it is very difficult to diagnose preoperatively, because of its non-specific symptomatology. In most cases, it is an intraoperative finding or a histopathological diagnosis. It is a tumour that histologically and clinically resembles epithelial ovarian cancer. We are reporting a case of a 62-year-old, postmenopausal women with primary fallopian tube carcinoma of the right fallopian tube in stage IA. The patient has lower abdominal pain, watery vaginal discharge and repeated episodes of bleeding from the vagina. The clinical and radiological findings suggested a right adnexal tumour with elevated CA-125 levels. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and peritoneal washing were performed. Pathologic confirmation of primary serous cystadenocarcinoma of the right fallopian tube was made. Peritoneal washings were negative for malignancy. FIGO stage was considered as IA, and the patient received no courses of chemotherapy and postoperative radiation because she refused it. Ten months after initial surgery, the patient is alive and in good condition. Cytoreduction surgery followed by adequate cycles of chemotherapy is an important strategy to improve patients' prognosis.

Primary pelvic hydatic cyst mimicking ovarian carcinoma

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Faruk Abike

2011-05-01

Full Text Available Hydatic cyst is an illness that appears in consequence of the cystic form of small strap-shaped worm Echinococcus granulosis. Frequently, cysts exist in the lungs and liver. Peritoneal involvement is rare, and generally occurs as a result of second inoculation from rupture of a liver-located hydatic cyst. Primary ovarian hydatic cyst is very rare. A 56-year-old female patient was admitted to Emergency Service with the complaint of stomachache and swollen abdomen. From ultrasonographic examination, a right ovarian 52 × 45-mm heterogeneous semi-solid cystic mass and right hydronephrosis were detected. As a result of the tomographic examination, the right ovarian growth was judged to be a 60 × 45-mm lobule contoured, septal, heterogeneously cystic mass (ovarian carcinoma. Depending on these indicators and with the diagnosis of ovarian carcinoma, laparotomy was planned. During the observation, a mass that compressed on the right ureter and dilatation in the right ureter were determined. The mass was approximately 6 cm long and smoothly contoured, including widespread adhesions, and also obliteration of the pouch of Douglas. The mass was excised and total abdominal hysterectomy and bilateral salpingo-oopherectomy performed. After a pathological examination, hydatid cyst was diagnosed. Although pointing at the issue of the distinctive diagnosis of pelvic and peritoneal mass, it should be realized that the existence of primary peritoneal and pelvic involvement of the hydatic cyst is generally a result of the second inoculation, and is also more common in regions in which Echinococcus granulosa is endemic and livestock production is prevalent.

A fatal case of primary basaloid squamous cell carcinoma in the intrahepatic bile ducts

DEFF Research Database (Denmark)

Kirkegaard, Johan; Grunnet, Mie; Hasselby, Jane Preuss

2014-01-01

of diagnosis but expired 20 months after surgery with epidural, lung, and spine metastasis. In addition to the unusual clinical presentation, the diagnosis of the liver tumor was that of a primary basaloid squamous cell carcinoma of the intrahepatic bile ducts, an entity with only one previous report......Primary squamous cholangiocellular carcinomas are very rare. We describe a case of a 67-year-old man, who underwent chemotherapy and surgery for a right-sided liver tumor with an unusual presentation of metastasis to a lymph node in the left armpit. The patient was asymptomatic at the time...

Primary Small Cell Carcinoma of the Stomach Successfully Treated With Cisplatin and Etoposide

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Shu-Chen Kuo

2009-11-01

Full Text Available We report a 44-year-old man with primary gastric small cell carcinoma who showed a remarkable response to chemotherapy specific for pulmonary small cell carcinoma. The patient had been admitted to another local hospital because of intermittent epigastralgia. An upper gastrointestinal examination there revealed an ulcerative tumor, 5 cm in diameter, on the lesser curvature side of the cardia, and endoscopic biopsy reported adenocarcinoma. Computed tomography revealed a mass over the lesser curvature of the stomach and some enlarged regional lymph nodes. Radical total gastrectomy, lymph node dissection, Roux-en-Y esophagojejunostomy and splenectomy were performed at our hospital. Pathology revealed gastric mucosa infiltrated by small-sized tumor cells with scanty cytoplasm and hyperchromatic nuclei. Immunohisto- chemically, the tumor cells were positive for synaptophysin, chromogranin A, and CD56. Primary gastric small cell carcinoma was diagnosed. The postoperative course, complicated by shock due to bleeding, wound infection and intra-abdominal abscess, took more than 2 months to resolve. Follow-up computed tomography showed tumor recurrence with multiple enlarged lymph nodes in the aortocaval region and hepatic hilum. The patient received palliative chemotherapy consisting of cisplatin 80 mg/m2 on day 1 and etoposide 80 mg/m2 on days 1–3 every 28 days, and had partial response to the chemotherapy, with a progression-free survival of 10 months. Chemotherapy with cisplatin and etoposide used for small cell carcinoma of the lung is a good treatment for gastric small cell carcinoma.

Thyroid metastasis in a patient with hepatocellular carcinoma: case report and review of literature

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Chai Chiah-Yang

2007-12-01

Full Text Available Abstract Background Despite the apparent low incidence of cancer metastatic to the thyroid, autopsy and clinical series suggest it is more common than generally. Although lung, renal, and breast cancer are probably the most common primary sites, a number of cancers have been reported to metastasize to the thyroid synchronously with diagnosis of primary tumor or years after apparently curative treatment. Case presentation We report a rare case of a hepatocellular carcinoma metasatic to the thyroid. The patient presented seven months after original diagnosis and treatment with hepatic lobectomy with multiple neck lesions producing a mass effect on the trachea and bilateral lymphadenopathy. Fine-needle aspiration revealed highly anaplastic carcinoma, and immunohistochemistry confirmed hepatocellular carcinoma. The patient received total thyroidectomy as palliative therapy because of the presence of multiple recurrent lesions in the liver. Conclusion Clinicians should consider the possibility of metastatic cancer in each patient who presents with a new thyroid mass, especially those with a history of cancer, however remote. In cases where cytology or histology is not diagnostic, immunohistochemistry may be definitive in making the diagnosis.

Synchronous lobular carcinoma in situ and invasive lobular cancer: marker or precursor for invasive lobular carcinoma.

Science.gov (United States)

Wallace, A S; Xiang, D; Hockman, L; Arya, M; Jeffress, J; Wang, Z; Dale, P S

2014-10-01

Lobular carcinoma in situ (LCIS) is a known risk factor for invasive breast carcinoma, but there is increasing data indicating a possible precursor relationship. This study investigates the incidence of lobular carcinoma in situ that occurs with invasive lobular carcinoma (ILC). Women diagnosed with ILC or LCIS from 2000 to 2010 were retrospectively identified and reviewed after institutional review board approval. This group was divided into two cohorts: ILC alone, and LCIS and ILC (ILC/LCIS). Patient demographics, disease characteristics, and treatment modalities were captured. p invasive ductal carcinoma at ∼40%. The association of pre-invasive and invasive lobular lesions should be further studied in a large scale prospective study to assess for a precursor relationship. Copyright © 2014 Elsevier Ltd. All rights reserved.

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

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Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary.

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

International Nuclear Information System (INIS)

Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary

CDC73 intragenic deletion in familial primary hyperparathyroidism associated with parathyroid carcinoma.

Science.gov (United States)

Korpi-Hyövälti, Eeva; Cranston, Treena; Ryhänen, Eeva; Arola, Johanna; Aittomäki, Kristiina; Sane, Timo; Thakker, Rajesh V; Schalin-Jäntti, Camilla

2014-09-01

CDC73 mutations frequently underlie the hyperparathyroidism-jaw tumor syndrome, familial isolated hyperparathyroidism (FIHP), and parathyroid carcinoma. It has also been suggested that CDC73 deletion analysis should be performed in those patients without CDC73 mutations. To investigate for CDC73 deletion in a family with FIHP previously reported not to have CDC73 mutations. Eleven members (six affected with primary hyperparathyroidism and five unaffected) were ascertained from the family, and multiplex ligation-dependent probe amplification was performed to detect CDC73 deletion using leukocyte DNA. A previously unreported deletion of CDC73 involving exons 1-10 was detected in five affected members and two unaffected members who were 26 and 39 years of age. Two affected members had parathyroid carcinomas at the ages of 18 and 32 years, and they had Ki-67 proliferation indices of 5 and 14.5% and did not express parafibromin, encoded by CDC73. Primary hyperparathyroidism in the other affected members was due to adenomas and atypical adenomas, and none had jaw tumors. Two affected members had thoracic aortic aneurysms, which in one member occurred with parathyroid carcinoma and renal cysts. A previously unreported intragenic deletion of exons 1 to 10 of CDC73 was detected in a three-generation family with FIHP, due to adenomas, atypical adenomas, and parathyroid carcinomas. In addition, two affected males had thoracic aortic aneurysms, which may represent another associated clinical feature of this disorder.

Approach and management of primary ectopic breast carcinoma in the axilla : Where are we? A comprehensive historical literature review

NARCIS (Netherlands)

Visconti, Giuseppe; Eltahir, Yassir; Van Ginkel, Robert J; Bart, Joost; Werker, Paul M N

Primary ectopic breast carcinoma is a rare disease and, at present, no specific guidelines on its diagnosis and treatment are available. The purpose of this article is to review the world literature in English on primary ectopic breast carcinoma located in the armpit and to offer guidelines for

Primary clear cell carcinoma of parotid gland: Case report and review of literature.

Science.gov (United States)

Rodríguez, Marta Saldaña; Reija, Maria Fe García; Rodilla, Irene González

2013-01-01

Clear cell carcinoma (CCC) is a rare low-grade carcinoma that represents only 1% to 2% of all salivary glands tumors. The finding of a clear cell tumor in a parotid gland involves the necessity of differential diagnosis between primary clear cell parotid tumors and metastases, mainly from kidney. The biological behavior is not very aggressive and development, which is very slow, is usually asymptomatic and indeed, the tumor often reaches considerable dimensions before being diagnosed. The treatment of choice is the surgical excision. There are rare cases of local recurrence and distant metastases. The aim of this article is to report a primary CCC in the parotid gland that microscopically closely resembled a metastatic CCC of renal origin, making microscopic differentiation difficult.

Variation of stemness markers expression in tumor nodules from synchronous multi-focal hepatocellular carcinoma - an immunohistochemical study.

Science.gov (United States)

Lo, Regina Cheuk-Lam; Leung, Carmen Oi-Ning; Chok, Kenneth Siu-Ho; Ng, Irene Oi-Lin

2017-08-01

Advancing knowledge in molecular pathogenesis of hepatocellular carcinoma (HCC) opens up new horizons in the diagnostic, prognostic and therapeutic perspectives. Assessing the expression of molecular targets prior to definitive treatment is gaining importance in clinical practice. In this study, we investigated the variation in expression pattern of stemness markers in synchronous multi-focal HCC. In the first cohort, 21 liver explants with multi-focal HCC were examined for expression of stemness markers EpCAM, Sox9 and CK19 by immunohistochemistry (IHC). Expression data of 50 tumor nodules were analyzed to determine the concordance of expression among nodules in the same livers. In the second cohort, 14 tumor nodules from 6 multi-focal HCC cases proven as intra-hepatic metastasis were examined for Soc9 immunoexpression. In the first cohort, thirty nodules from 16 cases expressed one or more markers, with Sox9 being most frequently expressed. Complete concordance of expression pattern for all 3 markers was observed in 6 cases. Discrepancy of staining degree was noted in 4 cases for EpCAM, 14 cases for Sox9, and 6 cases for CK19. A two-tier or three-tier difference in staining scores was noted in 5 cases for Sox9 and one case for CK19. With Sox9, identical tumor morphology in terms of Edmondson grading and growth pattern did not infer the same degree of immunoexpression; and the largest tumor nodule was not representative of highest IHC score. In the second cohort of intra-hepatic metastasis, complete concordance of Sox9 expression level was observed in 5 out of 6 cases; while the remaining case showed a 1-tier difference of positive staining. Our findings suggested that clonality of tumor nodules is apparently an important factor to infer immunoexpression pattern. When there is limited information to discern multiple primaries versus intra-hepatic metastasis in multi-focal HCC, discordant degree of stemness markers expression among tumor nodules was commonly

Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

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Prince Cheriyan Modayil

2009-01-01

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

Genetic dissimilarity between primary colorectal carcinomas and their lymph node metastases: ploidy, p53, bcl-2, and c-myc expression--a pilot study.

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Zalata, Khaled Refaat; Elshal, Mohamed Farouk; Foda, Abd AlRahman Mohammad; Shoma, Ashraf

2015-08-01

The current paradigm of metastasis proposes that rare cells within primary tumors acquire metastatic capability via sequential mutations, suggesting that metastases are genetically dissimilar from their primary tumors. This study investigated the changes in the level of expression of a well-defined panel of cell proliferation, differentiation, and apoptosis markers between the primary colorectal cancer (CRC) and the corresponding synchronous lymph node (LN) metastasis from the same patients. DNA flow cytometry and immunostaining of p53, bcl-2, and c-myc were carried out on 36 cases of CRC radical resection specimens with their corresponding LN metastases. There was very low probability that the histological patterns of primary tumors and LN metastases are independent (p < 0.001). Metastatic tumors were significantly more diffusely positive for p53 than the primary tumors (p < 0.001). Conversely, primary tumors were significantly more diffusely positive for c-myc than metastatic tumors (p = 0.011). No significant difference was found between the LNs and the primary tumors in bcl-2 positivity (p = 0.538) and DNA aneuploidy (p = 0.35), with a tendency towards negative bcl-2 and less aneuploidy in LN metastases than primary tumors. In conclusion, LN metastatic colorectal carcinomas have a tendency of being less differentiated, with a higher incidence of diffuse p53 staining, lower incidence of bcl-2 staining, and less aneuploidy in comparison to their primary counterparts suggesting a more aggressive biological behavior, which could indicate the necessity for more aggressive adjuvant therapy.

Breast abscess as the initial manifestation of primary pure squamous cell carcinoma: a rare presentation and literature review.

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Salemis, Nikolaos S

2011-01-01

Primary squamous cell carcinoma of the breast is a very rare tumor accounting for less than 0.4% of all breast cancers. Fewer than 100 cases have been reported in the literature so far. The diagnosis requires strict pathologic criteria to be fulfilled. Due to the rarity of this tumor the optimal treatment and prognosis are both unclear. Breast abscess as the initial presentation of a primary squamous cell breast carcinoma is an extremely rare clinical entity. In this study, we describe a case of a 61-year-old postmenopausal woman who presented with typical manifestations of a breast abscess and was diagnosed with a pure primary squamous cell breast carcinoma. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. Despite its rarity, the possibility of a primary pure squamous cell breast carcinoma should always be considered in the differential diagnosis in postmenopausal patients presenting with manifestations of a breast abscess, especially in those who respond poorly to the initial treatment. Physicians should be aware of this rare malignancy in order to avoid delays in diagnosis and treatment.

Synchronous Parathyroid Adenoma and Papillary Thyroid Carcinoma

African Journals Online (AJOL)

endocrine neoplasia (MEN) type 1 or IIa.[2] Coexistence ... are affected more frequently than men, especially after ... associated wıth thyroid cancer (i.e., family history, prior ... thyroid carcinoma in recent years in Greece: The majority are.

Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

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Ellsworth, Rachel E; Toro, Allyson L; Blackburn, Heather L; Decewicz, Alisha; Deyarmin, Brenda; Mamula, Kimberly A; Costantino, Nicholas S; Hooke, Jeffrey A; Shriver, Craig D; Ellsworth, Darrell L

2015-01-01

Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN) metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome (P = 0.009). In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance. PMID:26279627

Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

Directory of Open Access Journals (Sweden)

Rachel E. Ellsworth

2015-01-01

Full Text Available Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome ( P = 0.009. In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance.

Synchronous bilateral male breast cancer: a case report.

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Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young; Song, Young-Jin

2012-06-01

Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.

Melanoma Patients with Unknown Primary Site or Nodal Recurrence after Initial Diagnosis Have a Favourable Survival Compared to Those with Synchronous Lymph Node Metastasis and Primary Tumour

OpenAIRE

Weide, Benjamin; Faller, Christine; Els?sser, Margrit; B?ttner, Petra; Pflugfelder, Annette; Leiter, Ulrike; Eigentler, Thomas Kurt; Bauer, J?rgen; Meier, Friedegund; Garbe, Claus

2013-01-01

BACKGROUND: A direct comparison of prognosis between patients with regional lymph node metastases (LNM) detected synchronously with the primary melanoma (primary LNM), patients who developed their first LNM subsequently (secondary LNM) and those with initial LNM in melanoma with unknown primary site (MUP) is missing thus far. PATIENTS AND METHODS: Survival of 498 patients was calculated from the time point of the first macroscopic LNM using Kaplan Meier and multivariate Cox hazard regression ...

Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: retrospective review

International Nuclear Information System (INIS)

Baxi, S. H.; Burmeister, B.; Harvey, J. A.; Smithers, M.; Thomas, J.

2008-01-01

Full text: To determine the overall survival and gastrointestinal toxicity for patients treated with salvage definitive chemo-radiotherapy after primary surgery for locoregional relapse of oesophageal carcinoma. A retrospective review of 525 patients who had a resection for oesophageal or oesophagogastric carcinoma at Princess Alexandra Hospital identified 14 patients treated with salvage definitive radiotherapy or chemo-radiotherapy, following localized recurrence of their disease. We analysed the patient and treatment characteristics to determine the median overall survival as the primary end point. Gastrointestinal toxicity was examined to determine if increased toxicity occurred when the stomach was irradiated within the intrathoracic radiotherapy field. The median overall survival for patients treated with curative intent using salvage definitive chemo-radiotherapy was 16 months and the 2-year overall survival is 21%. One patient is in clinical remission more than 5 years after therapy. Age <60 years old and nodal recurrence were favourable prognostic factors. Treatment compliance was 93% with only one patient unable to complete the intended schedule. Fourteen per cent of patients experienced grade 3 or 4 gastrointestinal toxicity. Salvage definitive chemo-radiotherapy should be considered for good performance status patients with oesophageal carcinoma who have a locoregional relapse after primary surgery. The schedule is tolerable with low toxicity and an acceptable median survival

Metastatic primary neuroendocrine carcinoma of the breast (NECB

Directory of Open Access Journals (Sweden)

Tsung-Hsien Tsai

2018-03-01

Full Text Available Neuroendocrine carcinoma of the breast (NECB is a subtype of breast cancer. The diagnostic criteria of primary NECB were established in 2003 and updated in 2012. It is a rare entity, and few studies have reported the histogenesis, immunohistochemistry for a pathological diagnosis, clinical behavior, therapeutic strategies, and the prognostic factors. Because of the rarity of this disease, consistent diagnostic criteria will remind physicians of this disease when making a differential diagnosis to enable a timely diagnosis and prompt treatment. Herein, we report a case of primary NECB who presented with a history of right hip pain arising from an osteolytic lesion in the right acetabulum and ischium. The course of investigation started with metastasis in the right hip and concluded with a diagnosis of NECB. In addition to the case report, we also conducted a literature review.

Diagnostic value of combined determination of serum AFP, CEA, CA199, SF levels in patients with primary hepatic carcinoma

International Nuclear Information System (INIS)

Wu Jiaming; Rui Zhilian

2005-01-01

Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P 0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

The role of 18F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours

International Nuclear Information System (INIS)

Dijkman, Bernadette G.; Schuurbiers, Olga C.J.; Heijden, Henricus F.M. van der; Vriens, Dennis; Oyen, Wim J.G.; Geus-Oei, Lioe-Fee de; Looijen-Salamon, Monika; Bussink, Johan; Timmer-Bonte, Johanna N.H.; Snoeren, Miranda M.

2010-01-01

In lung cancer patients with multiple lesions, the differentiation between metastases and second primary tumours has significant therapeutic and prognostic implications. The aim of this retrospective study was to investigate the potential of 18 F-FDG PET to discriminate metastatic disease from second primary lung tumours. Of 1,396 patients evaluated by the thoracic oncology group between January 2004 and April 2009 at the Radboud University Nijmegen Medical Centre, patients with a synchronous second primary lung cancer were selected. Patients with metastatic disease involving the lungs served as the control group. Maximum standardized uptake values (SUVs) measured with 18 F-FDG PET were determined for two tumours in each patient. The relative difference between the SUVs of these tumours (∇SUV) was determined and compared between the second primary group and metastatic disease group. Receiver-operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the ∇SUV for an optimal cut-off value. A total of 37 patients (21 metastatic disease, 16 second primary cancer) were included for analysis. The ∇SUV was significantly higher in patients with second primary cancer than in those with metastatic disease (58 vs 28%, respectively, p 18 F-FDG PET images can be helpful in differentiating metastatic disease from second primary tumours in patients with synchronous pulmonary lesions. Further studies are warranted to confirm the consistency of these results. (orig.)

Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy

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Muto, Manabu; Ohtsu, Atsushi; Boku, Narikazu; Yoshida, Shigeaki [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East; Miyata, Yoshinori; Shioyama, Yasukazu

2001-06-01

Recent advances in chemoradiotherapy for esophageal carcinoma have resulted in improved survival rates. However, there are few options for recurrent dysphagia due to refractory carcinoma after failure of primary chemoradiotherapy. The aim of this study was to evaluate the safety and efficacy of self-expandable metallic stent placement for patients with recurrent esophageal carcinoma where definitive chemoradiotherapy has failed. Thirteen consecutive patients with recurrent squamous cell carcinoma of the esophagus, in whom self-expandable metallic stents were placed after failure of primary chemoradiotherapy, were studied retrospectively. All patients had esophageal obstruction or malignant fistula. The oral alimentation status of nine of 13 patients (69%) improved after successful placement of the stent. Following placement of the stent, fever (>38 deg C) and severe chest pain occurred in 85% (11/13) of the patients. In all patients examined, C-reactive protein was elevated within 1 week of the operation. Esophageal perforation occurred in three patients. Stent-related mediastinitis and pneumonia developed in six (46%) and three (23%) patients, respectively. Seven of the 13 patients (54%) died of stent-related pulmonary complications. Although the placement of a self-expandable metallic stent for patients with recurrent esophageal carcinoma after failure of chemoradiotherapy improved their oral alimentation status, we found that this treatment increases the risk of life-threatening pulmonary complications. (author)

Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy

International Nuclear Information System (INIS)

Muto, Manabu; Ohtsu, Atsushi; Boku, Narikazu; Yoshida, Shigeaki; Miyata, Yoshinori; Shioyama, Yasukazu

2001-01-01

Recent advances in chemoradiotherapy for esophageal carcinoma have resulted in improved survival rates. However, there are few options for recurrent dysphagia due to refractory carcinoma after failure of primary chemoradiotherapy. The aim of this study was to evaluate the safety and efficacy of self-expandable metallic stent placement for patients with recurrent esophageal carcinoma where definitive chemoradiotherapy has failed. Thirteen consecutive patients with recurrent squamous cell carcinoma of the esophagus, in whom self-expandable metallic stents were placed after failure of primary chemoradiotherapy, were studied retrospectively. All patients had esophageal obstruction or malignant fistula. The oral alimentation status of nine of 13 patients (69%) improved after successful placement of the stent. Following placement of the stent, fever (>38 deg C) and severe chest pain occurred in 85% (11/13) of the patients. In all patients examined, C-reactive protein was elevated within 1 week of the operation. Esophageal perforation occurred in three patients. Stent-related mediastinitis and pneumonia developed in six (46%) and three (23%) patients, respectively. Seven of the 13 patients (54%) died of stent-related pulmonary complications. Although the placement of a self-expandable metallic stent for patients with recurrent esophageal carcinoma after failure of chemoradiotherapy improved their oral alimentation status, we found that this treatment increases the risk of life-threatening pulmonary complications. (author)

Primary Endometrial Squamous Cell Carcinoma In Situ; Report of a rare disease

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Sujata Jetley

2015-11-01

Full Text Available Squamous cell carcinoma (SCC of the endometrium, whether primary or secondary to cervical cancer, is a rare entity. Primary endometrial squamous cell carcinoma in situ is even more uncommon; it usually occurs in postmenopausal women and has a strong association with pyometra. We report a 60-year-old multiparous postmenopausal woman who presented to the Hakeem Abdul Hameed Centenary Hospital, New Delhi, India, in May 2014 with a lower abdominal swelling corresponding in size to a pregnancy of 26 gestational weeks and vaginal discharge of one year’s duration. A total abdominal hysterectomy with a bilateral salpingooophorectomy was performed, which revealed an enlarged uterus with pyometra. Histopathology showed that the entire endometrial lining had been replaced with malignant squamous cells without invasion of the myometrium. Immunohistochemistry revealed that the tumour cells were positive for p63 with a high Ki-67 labelling index. No adjuvant therapy was required and the patient was disease-free at a seven-month follow-up.

Primary Endometrial Squamous Cell Carcinoma In Situ: Report of a rare disease.

Science.gov (United States)

Jetley, Sujata; Jairajpuri, Zeeba S; Hassan, Mohammad J; Madaan, Garima; Jain, Reena

2015-11-01

Squamous cell carcinoma (SCC) of the endometrium, whether primary or secondary to cervical cancer, is a rare entity. Primary endometrial squamous cell carcinoma in situ is even more uncommon; it usually occurs in postmenopausal women and has a strong association with pyometra. We report a 60-year-old multiparous postmenopausal woman who presented to the Hakeem Abdul Hameed Centenary Hospital, New Delhi, India, in May 2014 with a lower abdominal swelling corresponding in size to a pregnancy of 26 gestational weeks and vaginal discharge of one year's duration. A total abdominal hysterectomy with a bilateral salpingooophorectomy was performed, which revealed an enlarged uterus with pyometra. Histopathology showed that the entire endometrial lining had been replaced with malignant squamous cells without invasion of the myometrium. Immunohistochemistry revealed that the tumour cells were positive for p63 with a high Ki-67 labelling index. No adjuvant therapy was required and the patient was disease-free at a seven-month follow-up.

77 FR 24959 - Scientific Information Request on Local Therapies for Unresectable Primary Hepatocellular Carcinoma

Science.gov (United States)

2012-04-26

...The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of local, minimally invasive, medical devices for unresectable primary hepatocellular carcinoma (e.g., ablation, radiotherapy, or embolization devices). Scientific information is being solicited to inform our Comparative Effectiveness Review of Local Therapies for Unresectable Primary Hepatocellular Carcinoma, which is currently being conducted by the Evidence-based Practice Centers for the AHRQ Effective Health Care Program. Access to published and unpublished pertinent scientific information on this device will improve the quality of this comparative effectiveness review. AHRQ is requesting this scientific information and conducting this comparative effectiveness review pursuant to Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173.

Primary adrenal sarcomatoid carcinoma

Directory of Open Access Journals (Sweden)

Aftab S. Shaikh

2014-03-01

Full Text Available Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case of a 62-year old female with non-functional sarcomatoid carcinoma of the right adrenal gland. There was no radiological evidence of locoregional metastases. Patient underwent right adrenalectomy. Follow up after 3 months showed para-aortic lymphadenopathy and similar left adrenal mass on computed tomography. Patient refused further treatment and succumbed to the disease. A brief case report with review of literature is presented.

Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

Science.gov (United States)

Blumenthal, Laura; VandenBoom, Timothy; Melian, Edward; Peterson, Anthony; Hutchens, Kelli A.

2015-01-01

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our patient is an 80-year-old male with a 3-month history of multiple raised, rapidly enlarging tumors on the right ankle. Two separate biopsies were performed and demonstrated sheets and clusters of small blue cells filling the dermis with scant cytoplasm, dusty chromatin, and nuclear molding. Subsequent immunohistochemical stains confirmed the diagnosis of multiple primary MCC. Despite the characteristic immunohistochemical profile of primary MCC, the possibility of a metastatic neuroendocrine carcinoma from an alternate primary site was entertained, given his unusual clinical presentation. A complete clinical workup including CT scans of the chest, abdomen, and pelvis showed no evidence of disease elsewhere. Instead of amputation, the patient opted for nonsurgical treatment with radiation therapy alone, resulting in a rapid and complete response. This case represents an unusual presentation of primary MCC and demonstrates further evidence that radiation as monotherapy is an effective local treatment option for inoperable MCC. PMID:26594171

Approach and management of primary ectopic breast carcinoma in the axilla: where are we? A comprehensive historical literature review.

Science.gov (United States)

Visconti, Giuseppe; Eltahir, Yassir; Van Ginkel, Robert J; Bart, Joost; Werker, Paul M N

2011-01-01

Primary ectopic breast carcinoma is a rare disease and, at present, no specific guidelines on its diagnosis and treatment are available. The purpose of this article is to review the world literature in English on primary ectopic breast carcinoma located in the armpit and to offer guidelines for diagnosis and treatment. Data for this review were identified by searches of MEDLINE, PubMed, The Cochrane Library, ACNP (Italian catalogue of journals) and references from relevant articles using relevant search terms and data published in the previous reviews. Primary ectopic breast carcinoma of the axilla mostly affects women of over 40 (range 28-90 yrs) years of age. The most frequent histological diagnosis is invasive ductal carcinoma not otherwise specified (NOS) (72%). Because of its rareness, in most cases, the diagnosis is delayed for on average 40.5 months. This disease is rare, but a high level of suspicion for carcinoma is mandatory when confronted with a tumour in this area. Once diagnosed, patients should undergo staging, and prognostic and adjuvant treatment procedures identical to orthotopic breast carcinoma guidelines. There are some limitations for the staging. Loco-regional treatment, on indication, combined with endocrine therapy and/or chemotherapy seems the treatment of choice. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Synchronous Premaxillary Osteotomy with Primary Cheiloplasty for BCLP Patients with Protrusion of the Premaxillae

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Shinji Kobayashi, MD

2017-11-01

Conclusions:. As advantages, the patients’ facial structures improved, and the alveolar bones were formed by GPP. As a disadvantage, premaxillary necrosis might occur because of poor blood circulation. It is important to secure the following 2 blood supplies: from the periosteum and soft-tissue of the anterior premaxillae and from the periosteum and mucosa of the nasal septum. Synchronous premaxillary osteotomy and GPP with primary cheiloplasty are appropriate when the premaxillae cannot be properly repositioned by PSO or PSO cannot be done.

Carcinoma escamoso metastásico primario de origen desconocido. Presentación de un caso Primary Metastatic Squamous Cell Carcinoma of Unknown Origin. A Case Report

Directory of Open Access Journals (Sweden)

Miguel Ángel Serra Valdés

2012-12-01

Full Text Available El cáncer primario oculto representa según varias series del 0,5 al 7 % de todos los cánceres que se diagnostican y la edad media de presentación es 60 años. Se presenta un caso de metástasis ganglionar de carcinoma primario de células escamosas no identificado, de una paciente de 58 años de edad, de color de piel blanca, con antecedentes de salud, ama de casa, que fumaba desde joven e ingería alcohol frecuentemente. Ingresó con aumento de volumen de los ganglios del cuello. Se diagnosticó por biopsia metástasis de carcinoma escamoso. No pudo identificarse el primario en vida ni en la necropsia. El cáncer metastásico primario de origen desconocido sigue siendo un reto para la práctica clínica.Occult primary cancer represents, according to several series, from 0,5 % to 7 % of all diagnosed cancers, the average onset age being 60 years old. We report the case of nodal metastasis of unidentified primary squamous cell carcinoma in a 58 years old patient with white skin and a history of good health. The patient was a housekeeper who smoked from early age and frequently consumed alcohol. She was admitted with an enlargement of the neck glands. Metastases of squamous cell carcinoma were diagnosed through biopsy. Primary cancer was not identified neither while still alive or at necropsy. Primary metastatic cancers of unknown origin remain a challenge for clinical practice.

Primary temporal region squamous cell carcinoma diagnosed by a superficial temporal artery biopsy

DEFF Research Database (Denmark)

Andersen, S A W; Kiss, K

2015-01-01

artery biopsy was performed. The histopathology revealed perineural invasion of squamous cell carcinoma (SCC). A thorough investigation revealed no other primary site for the SCC and the patient was treated with surgical excision. CONCLUSION: Malignancy is rarely found in superficial temporal artery...

Inflammatory Cell Distribution in Primary Merkel Cell Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Wheat, Rachel [School of Cancer Sciences and CR UK Centre for Cancer Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT (United Kingdom); Roberts, Claudia [School of Cancer Sciences and CR UK Centre for Cancer Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT (United Kingdom); University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); Waterboer, Tim [Infection and Cancer Program, DKFZ (German Cancer Research Centre), 69120 Heidelberg (Germany); Steele, Jane [Human Biomaterials Resource Centre, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT (United Kingdom); Marsden, Jerry [University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); Steven, Neil M., E-mail: n.m.steven@bham.ac.uk [School of Cancer Sciences and CR UK Centre for Cancer Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT (United Kingdom); University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); Blackbourn, David J., E-mail: n.m.steven@bham.ac.uk [Department of Microbial and Cellular Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH (United Kingdom)

2014-05-06

Merkel cell carcinoma (MCC) is an aggressive poorly differentiated neuroendocrine cutaneous carcinoma associated with older age, immunodeficiency and Merkel cell polyomavirus (MCPyV) integrated within malignant cells. The presence of intra-tumoural CD8+ lymphocytes reportedly predicts better MCC-specific survival. In this study, the distribution of inflammatory cells and properties of CD8+ T lymphocytes within 20 primary MCC specimens were characterised using immunohistochemistry and multicolour immunofluorescent staining coupled to confocal microscopy. CD8+ cells and CD68+ macrophages were identified in 19/20 primary MCC. CD20+ B cells were present in 5/10, CD4+ cells in 10/10 and FoxP3+ cells in 7/10 specimens. Only two specimens had almost no inflammatory cells. Within specimens, inflammatory cells followed the same patchy distribution, focused at the edge of sheets and nodules and, in some cases, more intense in trabecular areas. CD8+ cells were outside vessels on the edge of tumour. Those few within malignant sheets typically lined up in fine septa not contacting MCC cells expressing MCPyV large T antigen. The homeostatic chemokine CXCL12 was expressed outside malignant nodules whereas its receptor CXCR4 was identified within tumour but not on CD8+ cells. CD8+ cells lacked CXCR3 and granzyme B expression irrespective of location within stroma versus malignant nodules or of the intensity of the intra-tumoural infiltrate. In summary, diverse inflammatory cells were organised around the margin of malignant deposits suggesting response to aberrant signaling, but were unable to penetrate the tumour microenvironment itself to enable an immune response against malignant cells or their polyomavirus.

Inflammatory Cell Distribution in Primary Merkel Cell Carcinoma

International Nuclear Information System (INIS)

Wheat, Rachel; Roberts, Claudia; Waterboer, Tim; Steele, Jane; Marsden, Jerry; Steven, Neil M.; Blackbourn, David J.

2014-01-01

Merkel cell carcinoma (MCC) is an aggressive poorly differentiated neuroendocrine cutaneous carcinoma associated with older age, immunodeficiency and Merkel cell polyomavirus (MCPyV) integrated within malignant cells. The presence of intra-tumoural CD8+ lymphocytes reportedly predicts better MCC-specific survival. In this study, the distribution of inflammatory cells and properties of CD8+ T lymphocytes within 20 primary MCC specimens were characterised using immunohistochemistry and multicolour immunofluorescent staining coupled to confocal microscopy. CD8+ cells and CD68+ macrophages were identified in 19/20 primary MCC. CD20+ B cells were present in 5/10, CD4+ cells in 10/10 and FoxP3+ cells in 7/10 specimens. Only two specimens had almost no inflammatory cells. Within specimens, inflammatory cells followed the same patchy distribution, focused at the edge of sheets and nodules and, in some cases, more intense in trabecular areas. CD8+ cells were outside vessels on the edge of tumour. Those few within malignant sheets typically lined up in fine septa not contacting MCC cells expressing MCPyV large T antigen. The homeostatic chemokine CXCL12 was expressed outside malignant nodules whereas its receptor CXCR4 was identified within tumour but not on CD8+ cells. CD8+ cells lacked CXCR3 and granzyme B expression irrespective of location within stroma versus malignant nodules or of the intensity of the intra-tumoural infiltrate. In summary, diverse inflammatory cells were organised around the margin of malignant deposits suggesting response to aberrant signaling, but were unable to penetrate the tumour microenvironment itself to enable an immune response against malignant cells or their polyomavirus

Neuroendocrine Merkel cell nodal carcinoma of unknown primary site: management and outcomes of a rare entity.

Science.gov (United States)

Kotteas, E A; Pavlidis, N

2015-04-01

Merkel cell nodal carcinoma of unknown primary (MCCUP) is a rare neuroendocrine tumour with distinct clinical and biological behaviour. We conducted a review of retrospective data extracted from 90 patients focusing on the management and outcome of this disease. We also compared life expectancy of these patients with the outcome of patients with known Merkel primaries and with neuroendocrine cancers of unidentifiable primary. There is a limited body of data for this type of malignancy, however, patients with Merkel cell nodal carcinoma of unknown primary site, seem to have better survival when treated aggressively than patients with cutaneous Merkel tumours of the same stage and equal survival with patients with low-grade neuroendocrine tumour of unknown origin. The lack of prospective trials, and the inadequate data, hamper the management of these tumours. Establishment of treatment guidelines is urgently needed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Synchronous Pulmonary Neoplasms: A Chance Occurrence or is There More Than Meets the Eye?

Science.gov (United States)

Ibrahim, Uroosa; Saqib, Amina; Pant, Manisha; Garcia, Gwenalyn; Odaimi, Marcel

2018-02-06

Primary bronchus-associated lymphoid tissue (BALT) lymphoma comprises 5% of non-Hodgkin's lymphoma (NHL) and usually has an indolent course. Synchronous primary lung cancers with BALT lymphoma are seldom seen in patients with adenocarcinoma of the lung. Synchronous squamous cell carcinoma (SCC) and BALT lymphoma is an extremely rare occurrence. We report an unusual case of stage 4 BALT lymphoma requiring treatment that revealed an underlying ipsilateral mass causing a diagnostic dilemma. An 84-year-old female with a history of systemic lupus erythematosus, deep vein thrombosis, and thrombotic microangiopathy presented to the hospital with cough and dyspnea on exertion. A chest X-ray revealed right hemi-thorax opacification and computed tomography (CT) of the chest showed a large right effusion and a soft tissue density extending into the proximal right bronchus. She required repeated thoracentesis until the pleural fluid analysis showed the presence of small lymphocytes and bronchial washings revealed an abnormal B cell population consistent with extranodal marginal zone lymphoma. The patient received four cycles of bendamustine and rituximab resulting in near-complete resolution of the effusion. Four months from diagnosis, imaging showed an increase in the size of the soft tissue density with pathologic fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET). A CT-guided biopsy was consistent with squamous cell lung cancer (SCLC) and radiotherapy was started for clinical stage 2 disease since the patient was not a surgical candidate. BALT lymphoma is a low-grade malignancy classified as extranodal marginal zone lymphoma with a five-year survival rate of over 80%. Several cases of synchronous lung adenocarcinoma and BALT lymphoma have been described. However, our case is among the rare few cases of synchronous occurrence of SCLC with BALT lymphoma. This report highlights the challenges associated with establishing an accurate and timely diagnosis.

Metastatic Gastric Linitis Plastica from Bladder Cancer Mimicking a Primary Gastric Carcinoma: a Case Report

International Nuclear Information System (INIS)

Hong, Won Sun; Chung, Dong Jin; Lee, Jae Mun; Byun, Jae Ho; Hahn, Seong Tae

2009-01-01

Primary gastric carcinoma is the most common cause of linitis plastica. Less frequently, metastatic gastric cancer from the breast, omental metastases and non-Hodgkin lymphoma involving the stomach have been reported to show similar radiographic findings as for linitis plastica. A metastatic gastric cancer from bladder cancer is extremely rare. We present an unusual case, the first to our knowledge, of gastric linitis plastica that resulted from a metastatic urothelial carcinoma of the bladder

Bilateral primary fallopian tube papillary serous carcinoma in postmenopausal woman: Report of two cases

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Dipanwita Nag

2016-01-01

Full Text Available Primary carcinoma of the fallopian tube is rare and accounts for about 0.14-1.8% of all gynecological malignancies. Correct diagnosis is rarely made preoperatively as clinically tubal carcinoma closely resembles ovarian carcinoma. Here, we report two cases of bilateral primary fallopian tube carcinomas. Case 1: A 54-year-old female presented with postmenopausal bleeding, abdominal pain, and pervaginal watery discharge for 10 days. Ultrasonography (USG of pelvis showed endometrial thickening and multiple tiny echogenic foci in omentum suggestive of omental cake. With a provisional diagnosis of endometrial carcinoma, total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy was done. On gross examination, small and rudimentary right ovary was adherent to the fimbrial end of the tube. Left-sided tubo-ovarian mass was present, cut section of which showed yellowish solid area in tubal wall and encroaching on ovarian surface. On histological examination, sections from the fimbrial end of both fallopian tubes showed features of papillary serous adenocarcinoma. Case 2: 70-year-old lady, 15 years postmenopausal presented with gradual onset pain and swelling of abdomen, urinary incontinence since 4 days. USG showed bulky uterus, 5 cm × 2 cm fibroid, bilateral tubes, and ovaries were not visualized. Serum cancer antigen-125 was raised (159.7 U/ml. Total hysterectomy and bilateral salpingo-oophorectomy with infracolic omentectomy was done. On gross examination, ovaries were firmly attached to tubes and no apparent solid area was noted. On microscopy, papillary serous adenocarcinoma arising from tubal wall was seen infiltrating focally into ovarian stroma; tubal epithelium showed dysplastic change. Sections from omentum showed numerous psammoma bodies.

Radiation therapy for primary carcinoma of the female urethra: a survey over 25 years

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Weghaupt, K.; Gerstner, G.J.; Kucera, H.

1984-01-01

Sixty-two patients with primary carcinoma of the female urethra were treated with a combined radiation therapy (high-dose intracavitary vaginal radium and external beam). Treatment was strictly individualized, but an administered tumor dose of 5500-7000 rad (55-70 Gy) was always attempted. Forty-two patients (67.7%) had tumors of the anterior urethra, and in 20 women (32.3%) the posterior urethra was involved. In 19 patients (30.6%) the clinical diagnosis of lymph node involvement was made. The overall 5-year-survival rate was 64.5%. Patients with anterior urethral carcinoma had a higher 5-year-survival rate (71.4%) than patients with posterior carcinoma (50.0%). The favorable results underline the substantial role of radiation therapy for this malignancy.

Radiation therapy for primary carcinoma of the female urethra: a survey over 25 years

International Nuclear Information System (INIS)

Weghaupt, K.; Gerstner, G.J.; Kucera, H.

1984-01-01

Sixty-two patients with primary carcinoma of the female urethra were treated with a combined radiation therapy (high-dose intracavitary vaginal radium and external beam). Treatment was strictly individualized, but an administered tumor dose of 5500-7000 rad (55-70 Gy) was always attempted. Forty-two patients (67.7%) had tumors of the anterior urethra, and in 20 women (32.3%) the posterior urethra was involved. In 19 patients (30.6%) the clinical diagnosis of lymph node involvement was made. The overall 5-year-survival rate was 64.5%. Patients with anterior urethral carcinoma had a higher 5-year-survival rate (71.4%) than patients with posterior carcinoma (50.0%). The favorable results underline the substantial role of radiation therapy for this malignancy

Unusual manifestations of secondary urothelial carcinoma

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Chaohui Lisa Zhao

2016-03-01

Full Text Available High-grade papillary urothelial carcinoma regularly invades the bladder wall, adjacent prostate, seminal vesicles, ureters, vagina, rectum, retroperitoneum, and regional lymph nodes. In advanced stages, it may disseminate to the liver, lungs, and bone marrow. On rare occasions, unusual metastatic foci like skin have been reported. The incidence of urothelial carcinoma has increased with associated rise in variants of urothelial carcinoma and unusual metastatic foci. It is imperative that urologists and pathologists are aware of the unusual variants and unusual metastatic locations to expedite the diagnostic process. Hereby we report an unusual case of secondary involvement of spinal nerve by conventional urothelial carcinoma. Also a second case of rhabdoid variant of urothelial carcinoma showing synchronous involvement of bladder and subcutaneous tissue of upper extremity is presented.

Primary intraosseous squamous cell carcinoma mimicking periapical disease: a case report

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Choi, Yoon Joo; Oh, Song Hee; Kang, Ju Han; Choi, Hwa Young; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of); Yu, Jae June [Dept. of Oral and Maxillofacial Radiology, Kangdong Sacred Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

2012-09-15

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.

Primary Squamous Cell Carcinoma of the Breast during Pregnancy: A Case Report

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John Adi Ashindoitiang

2011-01-01

Full Text Available Primary squamous cell carcinoma of the breast (SCCB is a very rare malignancy of the breast and is generally aggressive. It is even rarer during the gestational period. Only few cases have been reported during pregnancy and lactation (Rokutanda et al., 2000. SCCB seen within the gestational period tends to be very aggressive and has a larger size than other breast carcinomas. Pure SCCB is derived from the epidermis of the breast, nipple, or metaplasia on chronic inflammatory background (Bige et al., 2007, such as complicated breast cyst, dermoid cyst, or abscess. We report a case of SCCB in a 30-year-old primigravida that had an aggressive propensity and fatal outcome.

Synchronous resection of colorectal liver metastasis- a case report ...

African Journals Online (AJOL)

We present a case report of a young patient of. Carcinoma sigmoid colon with multiple liver metastases who was managed with synchronous resection of colorectal liver metastasis. The patient had an ulceroproliferative growth in the sigmoid colon 18 cm from the anal verge with multiple bilobar liver metastases. The CEA

Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

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Laura Blumenthal

2015-10-01

Full Text Available Merkel cell carcinoma (MCC is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our patient is an 80-year-old male with a 3-month history of multiple raised, rapidly enlarging tumors on the right ankle. Two separate biopsies were performed and demonstrated sheets and clusters of small blue cells filling the dermis with scant cytoplasm, dusty chromatin, and nuclear molding. Subsequent immunohistochemical stains confirmed the diagnosis of multiple primary MCC. Despite the characteristic immunohistochemical profile of primary MCC, the possibility of a metastatic neuroendocrine carcinoma from an alternate primary site was entertained, given his unusual clinical presentation. A complete clinical workup including CT scans of the chest, abdomen, and pelvis showed no evidence of disease elsewhere. Instead of amputation, the patient opted for nonsurgical treatment with radiation therapy alone, resulting in a rapid and complete response. This case represents an unusual presentation of primary MCC and demonstrates further evidence that radiation as monotherapy is an effective local treatment option for inoperable MCC.

Primary male neuroendocrine adenocarcinoma involving the nipple simulating Merkel cell carcinoma - a diagnostic pitfall.

Science.gov (United States)

Mecca, Patricia; Busam, Klaus

2008-02-01

Male breast cancer is a rare entity accounting for Nipple skin/subcutaneous tumors in men are even rarer. Likewise, true neuroendocrine carcinoma of the breast, defined as > 50% of tumor cells staining for either chromogranin or synaptophysin, is not a common entity, usually occurring in older women. We present the case of a 70-year-old man with a slowly growing nipple mass that had enlarged over the previous 1.5 years. The histology consisted of nests, trabeculae and sheets of basaloid cells with rare abortive gland formation and a pushing edge. The case was originally misdiagnosed as a Merkel cell carcinoma, based largely on histologic morphology. Strong staining for synaptophysin (in greater than 50% of cells), CD56, keratins AE1 : AE3 and Cam 5.2, as well as estrogen receptor and progesterone receptor was noted. Myoepithelial cells within in situ areas were identified using stains for calponin and 4A4, supporting a primary mammary duct origin. Additionally, a substantial portion of cells stained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), confirming some overlap with sweat duct differentiation. To the best of our knowledge, although reported in the male breast, no case of primary nipple neuroendocrine carcinoma in a male patient has been reported in the literature. The gender of the patient and association with the skin of the chest wall probably contributed to the original misdiagnosis of Merkel cell carcinoma in this patient.

Primary invasive squamous carcinoma of the vagina

International Nuclear Information System (INIS)

Pride, G.L.; Schultz, A.E.; Chuprevich, T.W.; Buchler, D.A.

1979-01-01

Forty-three cases of primary vaginal squamous cell cancer were treated at the University of Wisconsin Hospital between 1956 and 1971. These cases comprised of 1.2% of patients admitted to the University Hospital with female genital tract cancer. Evidence is presented to support a modification of the currently accepted FIGO staging system for vaginal carcinoma (Stage II disease). Radiation therapy using both external beam and brachyradium equivalents or interstitial implantation of suitable isotopes was an effective method for the treatment of patients having early and locally advanced invasive vaginal cancer. The 5-year absolute survival rate for the entire series was 37.2%. Absolute survival rate by modified FIGO clinical staging was 66% for Stages I and IIA, 31% for Stage IIB, 25% for Stage III, and 0% for Stage IV

Synchronous clear cell renal cell carcinoma and tubulocystic carcinoma: genetic evidence of independent ontogenesis and implications of chromosomal imbalances in tumor progression

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Quiroga-Garza Gabriela

2012-02-01

Full Text Available Abstract Seven percent of renal cell carcinoma (RCC cases are diagnosed as "unclassified" RCC by morphology. Genetic profiling of RCCs helps define renal tumor subtypes, especially in cases where morphologic diagnosis is inconclusive. This report describes a patient with synchronous clear cell RCC (ccRCC and a tubulocystic renal carcinoma (TCRC in the same kidney, and discusses the pathologic features and genetic profile of both tumors. A 67 year-old male underwent CT scans for an unrelated medical event. Two incidental renal lesions were found and ultimately removed by radical nephrectomy. The smaller lesion had multiple small cystic spaces lined by hobnail cells with high nuclear grade separated by fibrous stroma. This morphology and the expression of proximal (CD10, AMACR and distal tubule cell (CK19 markers by immunohistochemistry supported the diagnosis of TCRC. The larger lesion was a typical ccRCC, with Fuhrman's nuclear grade 3 and confined to the kidney. Molecular characterization of both neoplasms using virtual karyotyping was performed to assess relatedness of these tumors. Low grade areas (Fuhrman grade 2 of the ccRCC showed loss of 3p and gains in chromosomes 5 and 7, whereas oncocytic areas displayed additional gain of 2p and loss of 10q; the high grade areas (Fuhrman grade 3 showed several additional imbalances. In contrast, the TCRC demonstrated a distinct profile with gains of chromosomes 8 and 17 and loss of 9. In conclusion, ccRCC and TCRC show distinct genomic copy number profiles and chromosomal imbalances in TCRC might be implicated in the pathogenesis of this tumor. Second, the presence of a ccRCC with varying degrees of differentiation exemplifies the sequence of chromosomal imbalances acquired during tumor progression. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1790525735655283

Efficacy of sorafenib in BRAF-mutated non-small-cell lung cancer (NSCLC) and no response in synchronous BRAF wild type-hepatocellular carcinoma: a case report

International Nuclear Information System (INIS)

Casadei Gardini, Andrea; Chiadini, Elisa; Faloppi, Luca; Marisi, Giorgia; Delmonte, Angelo; Scartozzi, Mario; Loretelli, Cristian; Lucchesi, Alessandro; Oboldi, Devil; Dubini, Alessandra; Frassineti, Giovanni Luca; Ulivi, Paola

2016-01-01

Sorafenib is a multi-targeted kinase inhibitor with a demonstrated activity in renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC), and it is currently used for the treatment of these pathologies. Ongoing clinical trials are studying its activity in other malignancies, such as non-small-cell lung cancer (NSCLC). However, no biological marker is known to define either the sensitivity or resistance to the drug. Here we report a case of a patient with two synchronous tumors, HCC and NSCLC, with metastases in the contralateral lung and bone. The patient was treated with gemcitabine as first line, with a resulting progressive disease after two months, and then with sorafenib at standard dosage in the second line setting. After 6 months of treatment CT scan showed a partial response in the primary lesion of the lung, complete response of the metastasis in the contralateral lung, and stability of HCC. The patient had progression in the lung, liver and bone after 13 months of therapy. A molecular characterization of NSCLC and HCC lesions was performed, revealing a BRAF exon 11 mutation (G469V) only in NSCLC. We hypothesize that the response observed in NSCLC lesions could be due to the presence of BRAF mutation, and that this alteration could be responsible in determining sorafenib sensitivity. Results observed in this case encourage further research on the activity of sorafenib in both HCC and NSCLC, based on the presence of BRAF mutation. This could lead to a selection of HCC patients to be treated with this drug, and could help identify a novel treatment strategy for BRAF-mutated NSCLC patients

Concurrent Papillary Carcinoma Arising in Thyroglossal Duct Cyst and Thyroid Gland: A Case Report

International Nuclear Information System (INIS)

Kim, Kyoung Tae; Kim, Yeo Ju; Jeon, Yong Sun; Kim, Youn Jeong; Kim, Sei Joong; Cho, Young Up

2011-01-01

The occurrence and diagnosis of thyroglossal duct carcinoma is very rare. The synchronous occurrence of papillary carcinomas arising in a thyroglossal duct cyst (TGDC) and thyroid gland is extremely rare. Sistrunk's surgical technique must always be the initial treatment for a TGDC. However, if there is an intra-thyroidal carcinoma or local invasion, thyroidectomy has to be considered. Accurate pre-operative radiological evaluation should be performed in order to plan a surgical strategy. The aim of this report was to review our experience in the management of papillary thyroid carcinoma associated with TGDC. Our patient was a 67-year-old man who had a mural, micro- calcified nodule within a palpable, thick-walled cyst at the level of the hyoid and synchronously, a small macro-calcified mass in the isthmus of the thyroid gland.

Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: Normal tissue complication probability modeling with latent time correction

DEFF Research Database (Denmark)

Rønjom, Marianne Feen; Brink, Carsten; Bentzen, Søren

2013-01-01

To develop a normal tissue complication probability (NTCP) model of radiation-induced biochemical hypothyroidism (HT) after primary radiotherapy for head and neck squamous cell carcinoma (HNSCC) with adjustment for latency and clinical risk factors.......To develop a normal tissue complication probability (NTCP) model of radiation-induced biochemical hypothyroidism (HT) after primary radiotherapy for head and neck squamous cell carcinoma (HNSCC) with adjustment for latency and clinical risk factors....

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

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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.

Utility of CK7 and CK20 immunohistochemistry in the detection of synchronous breast and colon carcinoma in a pleural effusion: a case report and supporting survey of archival material

DEFF Research Database (Denmark)

Stopyra, G A; Warhol, M J; Multhaupt, H A

2001-01-01

, respectively. An immunohistochemical survey of archival breast and colon primary and metastatic carcinomas confirmed the established CK7+/CK20- phenotype of breast and CK7-/CK20+ phenotype of colon primary carcinomas, and the maintenance of this phenotype in metastases thereof. A survey of benign and malignant...

Liver cirrhosis and primary carcinoma of the liver among atomic bomb survivors. Study of autopsy cases

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Hamada, T [Hiroshima Atomic Bomb Hospital (Japan)

1980-11-01

Liver cirrhosis and primary carcinoma of the liver were investigated in 1699 autopsies of atomic bomb survivors carried out in Hiroshima from 1956 to 1980. Liver cirrhosis, hepatocellular carcinoma and intrahepatic biliary carcinoma were observed in 116, 111, and 17 cases respectively, the ratios of man to woman and were 2.3, 3.9, and 1.8 with a mean age of 56, 60, and 67 years respectively. There was no evidence that exposure to a-bomb increased the risk of these diseases significantly. About 90% of the hepatocellular carcinomas was combined with liver cirrhosis. Weight of liver and spleen, amount of ascites, hemorrhage from the digestive canals, esophageal varix, combination with other diseases, and histologic correlation with the activities of HBs antigen and ..cap alpha..-fetoprotein were discussed with the relation to the exposure.

Carcinoma epidermoide primario do estomago Primary epidermoid carcinoma of the stomach

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A. Penna de Azevedo

1936-01-01

Full Text Available Os AA. chamam a attenção para a raridade deste typo histologico de tumor do estomago e descrevem um caso verificado pela autopsia, em individuo branco, brasileiro, de 67 annos de edade. O tumor localiza-se na pequena curvatura do estomago, sob o aspecto de uma formação crateriforme de 3,5 cms. de diametro e com adherencias ao pancreas. O esophago e o cardia não são de modo algum comprometidos pelo processo. Foram encontradas metastases no coração, no figado, na capsula do pancrea, no pulmão e glandulas suprarenaes. O exame histologico mostra tratar-se de um carcinoma epidermoide, não só no tumor primitivo, como tambem nos fócos metastaticos. As AA. são inclinados a acreditar que o tumor tenha se originado por intermedio de um processo d metaplasia epidermoide da mucosa gastrica.Attention is called by the AA. to the rarity of this histological feature of gastric tumor verified and described, on post mortem examination, in a white Brazilian male, 57 years old. The tumor is located on the lesser curvature of the stomach under the appearance of a crateriform formation, 3.5 cms. in diameter, fast adhering to the pancreas. The esophagus and cardia are not affected by this process. Metastases were found in the heart, liver, capsule of the pancreas, lungs and adrenal glands. The histological examination reveals in te primary tumor and in the metastatic foci a carcinoma of epidermoid type. The AA. are inclined to believe that the tumor might have arisen through an epidermoid-metaplastic process of the gastric mucosa.

Evolution and pathology of colorectal carcinoma

International Nuclear Information System (INIS)

Hermanek, P.

1986-01-01

Numerous clinical, epidemiological, histological and experimental observations favour the adenoma-carcinoma sequence. Metastases occur only after invasion of the submucosa. The elevated rate of synchronous lesions (carcinomas and adenomas) is emphasized. In the rule, lymphatic spread precedes distant metastasis. Typing and grading should be performed according to the rules of WHO. The present UICC staging system will be replaced by a new 4th edition 1987. Early carcinoma (limited to the submucosa) has an excellent prognosis and may be treated by limited procedures (polypectomy, local excision) in the most cases. The modern concept of histology- and stage-adapted cancer therapy requires the pre-, intra- and postoperative cooperation with the pathologist. (Author)

Diagnostic Value of Early-Phase-Enhanced Computed Tomography for the Differentiation of Pulmonary Metastases from Hepatocellular Carcinoma and Primary Lung Cancer

International Nuclear Information System (INIS)

Choi, Joon-Il; Jung, Dae Chul; Kim, Min-Ju; Hong, Eun Kyung; Park, Joong-Won; Kim, Chang-Min; Choi, Hyuck Jae; Jang, Yun-Jin

2009-01-01

Background: The lung is the most common site of distant metastases from hepatocellular carcinoma. Correct differentiation between metastatic hepatocellular carcinoma of the lung and primary lung cancer is sometimes difficult without biopsy. Purpose: To evaluate the usefulness of measuring the attenuations of pulmonary nodules on early-phase contrast-enhanced computed tomography (CT) for the differentiation of pulmonary metastases from hepatocellular carcinoma and primary lung cancer. Material and Methods: Thirteen patients with pulmonary metastases from hepatocellular carcinoma (nine men, four women; age 53.9±14.2 years, range 16-70 years) and 25 patients with primary lung cancer (14 men, 11 women; age 62.2±9.4 years, range 43-72 years) were retrospectively evaluated. Contrast-enhanced scans were obtained 35 s after commencing intravenous injection of contrast medium. Attenuation values and the size of the pulmonary nodules were measured on contrast-enhanced CT scans. CT and clinical features were analyzed with regard to age, sex, body surface area of the patients, the attenuation values and size of the nodules, and CT machines using univariate analysis (Fisher's exact test for binary data sets and the Mann-Whitney U test for continuous data sets). Multiple linear regression analysis was used to eliminate confounding factors. Results: The mean attenuation value of metastatic pulmonary nodules from hepatocellular carcinoma (75.7±24.9 HU) was higher than that of primary lung cancer nodules (45.8±14.4 HU) (P<0.01). Other variables such as age, sex, body surface area of the patients, CT device, and nodule size were not significant variables on multiple regression analysis. When a cut-off value of 75 HU was applied, the positive predictive value for diagnosing metastatic nodules from hepatocellular carcinoma was 100%. Conclusion: Pending confirmation in a large study, our findings suggest that there is a difference in contrast enhancement between pulmonary

CT findings at the primary site of oropharyngeal squamous cell carcinoma within 6-8 weeks after definitive radiotherapy as predictors of primary site control

International Nuclear Information System (INIS)

Ojiri, Hiroya; Mendenhall, William M.; Mancuso, Anthony A.

2002-01-01

Purpose: To determine whether findings on CT studies, done 6 weeks after radiotherapy (RT), can predict the likelihood of ultimate control at the primary site in oropharyngeal carcinoma. Methods and Materials: Forty-six patients with oropharyngeal squamous cell carcinoma underwent RT with curative intent. A minimal 2-year clinical follow-up after RT was required. The primary site CT findings were graded for risk of recurrence on a modified 3-point scale as follows: Grade 0, no detectable focal abnormalities; Grade 1, anatomic asymmetry or focal mass 10 mm (2a) or 10 mm at the primary site, the likelihood of local control is high (93%). The study results indicate that CT findings, based on this relatively small series, may not add incremental information beyond that of clinical examination for predicting local control but may be useful as a baseline if imaging surveillance is contemplated

Synchronous triple urogenital cancer (renal cancer, bladder cancer, prostatic cancer). A case report

Energy Technology Data Exchange (ETDEWEB)

Takada, Tsuyoshi; Honda, Masahito; Momohara, Chikahiro; Komori, Kazuhiko; Fujioka, Hideki [Osaka Police Hospital (Japan)

2002-04-01

A case of synchronous triple urogenital cancer, which was comprised of renal cell carcinoma of the left kidney, transitional cell carcinoma of the urinary bladder, and adenocarcinoma of the prostate, is reported. A 72-year-old Japanese male patient was referred to our outpatient clinic with the complaint of asymptomatic hematuria. At that time, his serum of level of PSA was elevated to 20 ng/ml. Cystourethroscopy showed a papillary bladder tumor and coagula through the left urinary orifice. Ultrasonography, computed tomography and magnetic resonance imaging showed a mass lesion measuring about 6 cm by 5 cm in the left kidney. Angiography showed a hypervascular lesion measuring about 6 cm by 5 cm at the same site. Double cancer, consisting of renal cell carcinoma and transitional cell carcinoma of the urinary bladder, was suspected and we performed left total nephroureterectomy, hilar lymphadenectomy, and transurethral rection of the bladder tumor, one month later. At the same time, we performed a biopsy of the prostate. Histological diagnosis was renal cell carcinoma, clear cell carcinoma and transitional cell carcinoma of urinary bladder. Histological diagnosis of the prostate biopsy was moderately differentiated adenocarcinoma. Since this case fulfilled the criteria of Warren and Gates, it was classified as synchronous triple urogenital cancer. A review of the literature revealed 17 authentic cases of triple urogenital cancer, of which 14 and 10 cases were reported as a combination of renal cancer, bladder cancer and prostatic cancer, in the world and in Japan, respectively. Furthermore, he had been exposed to the atomic bomb explosion in Hiroshima in 1945. This carcinogenic precursor may be related to the development of the triple cancer. (author)

Synchronous triple urogenital cancer (renal cancer, bladder cancer, prostatic cancer). A case report

International Nuclear Information System (INIS)

Takada, Tsuyoshi; Honda, Masahito; Momohara, Chikahiro; Komori, Kazuhiko; Fujioka, Hideki

2002-01-01

A case of synchronous triple urogenital cancer, which was comprised of renal cell carcinoma of the left kidney, transitional cell carcinoma of the urinary bladder, and adenocarcinoma of the prostate, is reported. A 72-year-old Japanese male patient was referred to our outpatient clinic with the complaint of asymptomatic hematuria. At that time, his serum of level of PSA was elevated to 20 ng/ml. Cystourethroscopy showed a papillary bladder tumor and coagula through the left urinary orifice. Ultrasonography, computed tomography and magnetic resonance imaging showed a mass lesion measuring about 6 cm by 5 cm in the left kidney. Angiography showed a hypervascular lesion measuring about 6 cm by 5 cm at the same site. Double cancer, consisting of renal cell carcinoma and transitional cell carcinoma of the urinary bladder, was suspected and we performed left total nephroureterectomy, hilar lymphadenectomy, and transurethral rection of the bladder tumor, one month later. At the same time, we performed a biopsy of the prostate. Histological diagnosis was renal cell carcinoma, clear cell carcinoma and transitional cell carcinoma of urinary bladder. Histological diagnosis of the prostate biopsy was moderately differentiated adenocarcinoma. Since this case fulfilled the criteria of Warren and Gates, it was classified as synchronous triple urogenital cancer. A review of the literature revealed 17 authentic cases of triple urogenital cancer, of which 14 and 10 cases were reported as a combination of renal cancer, bladder cancer and prostatic cancer, in the world and in Japan, respectively. Furthermore, he had been exposed to the atomic bomb explosion in Hiroshima in 1945. This carcinogenic precursor may be related to the development of the triple cancer. (author)

PRIMARY SQUAMOUS CELL CARCINOMA OF RENAL PELVIS ASSOCIATED WITH RENAL CALCULUS AND RECURRENT PYONEPHROSIS

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Hoti Lal

2015-11-01

Full Text Available Primary Squamous Cell Carcinoma in the kidney is a rare malignant neoplasm associated with nephrolithiasis, typically monobacterial pyonephrosis and rarely Xanthogranulomatous pyelonephritis. It is an aggressive disease with a poor prognosis mostly due to lack of presenting clinical features like a palpable mass, gross haematuria and pain. We report a case presenting with renal calculus and pyonephrosis managed initially with percutaneous nephrostomy followed by nephrectomy due to complete loss of renal function. Histopathological evaluation revealed poorly differentiated squamous cell carcinoma which is managed by chemotherapy, although initially beneficial, patients later develop disseminated metastatic disease which holds a poor prognosis.

Concurrent Papillary Carcinoma Arising in Thyroglossal Duct Cyst and Thyroid Gland: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Kyoung Tae; Kim, Yeo Ju; Jeon, Yong Sun; Kim, Youn Jeong [Dept. of Radiology, Inha University School of Medicine, Seoul (Korea, Republic of); Kim, Sei Joong; Cho, Young Up [Dept. of General Surgery, Inha University School of Medicine, Seoul (Korea, Republic of)

2011-05-15

The occurrence and diagnosis of thyroglossal duct carcinoma is very rare. The synchronous occurrence of papillary carcinomas arising in a thyroglossal duct cyst (TGDC) and thyroid gland is extremely rare. Sistrunk's surgical technique must always be the initial treatment for a TGDC. However, if there is an intra-thyroidal carcinoma or local invasion, thyroidectomy has to be considered. Accurate pre-operative radiological evaluation should be performed in order to plan a surgical strategy. The aim of this report was to review our experience in the management of papillary thyroid carcinoma associated with TGDC. Our patient was a 67-year-old man who had a mural, micro- calcified nodule within a palpable, thick-walled cyst at the level of the hyoid and synchronously, a small macro-calcified mass in the isthmus of the thyroid gland.

Recurrent Merkel cell carcinoma of the testis with unknown primary site: a case report.

Science.gov (United States)

Mweempwa, Angela; Tan, Alvin; Dray, Michael

2016-11-05

Merkel cell carcinoma is a rare and aggressive neuroendocrine tumor that commonly arises in the skin. It is rare for it to occur in the testes. There are only seven cases of testicular Merkel cell carcinoma reported in the literature. A 66-year-old Maori man presented to our hospital with left testicular swelling. His alpha-fetoprotein and beta-human chorionic gonadotrophin levels were within normal limits. His lactate dehydrogenase concentration was elevated to 267 U/L. Ultrasound imaging confirmed a large testicular mass, and he underwent left orchiectomy. His histological examination revealed a neuroendocrine tumor with an immunostaining pattern suggesting Merkel cell carcinoma. He presented to our hospital again 3 months later with right testicular swelling that was confirmed on ultrasound sonography to be a tumor. He underwent a right orchiectomy, and his histological examination revealed metastatic Merkel cell carcinoma. A primary lesion was not identified, and computed tomographic imaging did not reveal spread to other organs. He received six cycles of adjuvant carboplatin and etoposide chemotherapy and remained disease-free 18 months after completion of chemotherapy. Given the paucity of studies, standard adjuvant treatment for testicular Merkel cell carcinoma remains uncertain, although platinum-based chemotherapy seems to be an appropriate option.

Four synchronous cancers in a patient with tongue pain as the only symptom

DEFF Research Database (Denmark)

Nyhøj Heidemann, Lene; Johansen, Jørgen; Larsen, Stine Rosenkilde

2016-01-01

with three synchronous squamous cell carcinomas, two in the tongue and one in the aryepiglottic fold. Positron emission tomography CT (PET-CT) was required for the detection of the carcinomas as the initial MRI and CT scans were inconclusive due to artefacts. Furthermore, PET-CT also revealed increased...... metabolic activity in the lymph nodes of the neck, which subsequently led to detection of a low-grade follicular lymphoma in addition to the squamous cell carcinomas. These findings support a generous use of PET-CT in patients with HNSCC, at least in those with obvious risk factors....

Primary merkel cell carcinoma clinically presenting as deep oedematous mass of the groin

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Gambichler T

2010-06-01

Full Text Available Abstract Merkel cell carcinoma (MCC is a relatively rare, polyomavirus associated, primary neuroendocrine carcinoma of the skin which is usually arising from dermal skin layers. However, the origin of MCC in the subcutaneous tissue is debatable. We report a 58-yearold female patient with an oedematous mass on her left groin that was firm in consistency and had no discoloration or other visible abnormality of the overlying skin. On histology and immunohistology the tumour was consistent with the diagnosis of MCC showing a predominant subcutanous growth pattern. Pelvic magnetic resonance tomography revealed a tumour conglomerate reaching from the subcutis of the left groin to the left paraaortal and parailiacal region indicating widespread lymphogenic metastisation. Despite complete medical work-up no other MCC primary could be detected. In conclusion, predominant subcutaneous growth pattern as well as tumour localization in the groin are uncommon features of MCC. MCC showing the aforementioned features may be associated with significant delay of diagnosis and therefore represents an unfavourable prognostic factor.

Application of primary cell cultures of laryngeal carcinoma and laser scanning cytometry in the evaluation of tumor reactivity to cisplatinum.

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Krzysztof Kupisz

2008-06-01

Full Text Available Unsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognostic factors. The aim of the present study was the evaluation of the use of primary cell cultures of the laryngeal carcinoma and laser scanning cytometry (LSC in the assessment of tumor reactivity to cisplatinum. Nineteen primary cultures of laryngeal carcinoma cells established from fragments of laryngeal carcinoma infiltrations were cultured with or without cisplatin, stained with monoclonal antibodies against P53 and BCL-2 proteins and analyzed by LSC. Cisplatin added to the culture medium leads to the significant increase of P53 expression and decrease of BCL-2 expression. Moreover, changes of P53 and BCL-2 expressions were significantly correlated. Our findings of apoptosis regulatory mechanisms could be useful in patient qualification for the chemotherapeutic follow-up treatment.

Application of primary cell cultures of laryngeal carcinoma and laser scanning cytometry in the evaluation of tumor reactivity to cisplatinum

International Nuclear Information System (INIS)

Klatka, J.; Trojanowski, P.; Paduch, R.; Pozarowski, P.; Rolinski, J.; Pietruszewska, W.; Kupisz, K.

2008-01-01

Unsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognostic factors. The aim of the present study was the evaluation of the use of primary cell cultures of the laryngeal carcinoma and laser scanning cytometry (LSC) in the assessment of tumor reactivity to cis platinum. Nineteen primary cultures of laryngeal carcinoma cells established from fragments of laryngeal carcinoma infiltrations were cultured with or without cisplatin, stained with monoclonal antibodies against P53 and BCL-2 proteins and analyzed by LSC. Cisplatin added to the culture medium leads to the significant increase of P53 expression and decrease of BCL-2 expression. Moreover, changes of P53 and BCL-2 expressions were significantly correlated. Our findings of apoptosis regulatory mechanisms could be useful in patient qualification for the chemotherapeutic follow-up treatment. (author)

Synchronous colon and renal cancer - case report

International Nuclear Information System (INIS)

Luczynska, E.; Pawlik, T.; Aniol, J.; Chwalibog, A.

2008-01-01

Primary cancer may occur synchronously in two different organs. We present an example of pathologically proven, coexistent renal and colony double malignant tumors. A 59 year old man, was admitted to the Institute of Oncology due to left renal lesion, discovered during a routine abdominal ultrasound examination. The CT exam was performed before surgery. The CT scans reveled a second abnormality, presenting irregular shaped and thickened to 20 mm intestinal wall within a patient's large bowel. As a next diagnostic step a CT-colonoscopy was undertaken, which confirmed the presence of an exophytic sigmoid lesion, eccentrically affecting the colonic wall and protruding into the lumen moderately narrowing it, placed about 50 cm from the external rectal sphincter. Patient underwent simultaneous radical left nephrectomy and sigmoidectomy. Both tumors were confirmed in pathologic evaluation, reveling renal clear cell carcinoma (Fuhrman G II) and colonic adenocarcinoma (Astler-Coller B2). Preoperative careful imaging studies reveled neoplastic tumors in two different organs, allowing for radical resection at the same surgical procedure. (author)

Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

Science.gov (United States)

Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

2018-03-01

Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer

International Nuclear Information System (INIS)

Li, Xiang Sheng; Fan, Hong Xia; Zhu, Hong Xian; Song, Yun Long; Zhou, Chun Wu

2012-01-01

To determine the value of the perfusion parameters in predicting short-term tumour response to synchronous radiochemotherapy for cervical squamous carcinoma. Ninety-three patients with cervical squamous carcinoma later than stage IIB were included in this study. Perfusion CT was performed for all these patients who subsequently received the same synchronous radiochemotherapy. The patients were divided into responders and non-responders according to short-term response to treatment. Baseline perfusion parameters of the two groups were compared. The perfusion parameters that might affect treatment effect were analysed by using a multivariate multi-regression analysis. The responders group had higher baseline permeability-surface area product (PS) and blood volume (BV) values than the non-responders group (P 0.05). At multivariate multi-regression analysis, BV, PS and tumour size were significant factors in the prediction of treatment effect. Small tumours usually had high PS and BV values, and thus had a good treatment response. Perfusion CT can provide some helpful information for the prediction of the short-term effect. Synchronous radiochemotherapy may be more effective in cervical squamous carcinoma with higher baseline PS and BV. (orig.)

18F-FDG PET for detecting metastases and synchronous primary malignancies in patients with oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Wallowy, P.; Kovacs, A.F.; Diener, J.; Gruenwald, F.

2009-01-01

Assessment of the efficiency of 18 F-FDG-PET (PET) for the detection of distant metastases and synchronous primary malignancies in patients with oral and oropharyngeal squamous cell cancer (OOSCC). Patients, methods: Retrospective evaluation of PET studies of 422 patients with histologically confirmed OOSCC. 99 patients (23.5%) demonstrated a suspect distant finding of whom 84 could be interdisciplinary evaluated and consecutively confirmed or refuted by other diagnostic modalities or biopsy. Results: In 74 of 80 evaluable cases, PET showed the primary tumour (92.5%). 26/84 suspect distant lesions (31%) showed by means of PET were confirmed to be malignancies (mean SUV 3.96; range 1.4-9.37). Main sites were the lung, the upper aerodigestive tract, and the gastrointestinal system. In the other 58 cases (69%), where the suspect lesions were confirmed as benign, mean SUV was 2.65 (range 0.7-6.5) (difference statistically significant). The SUV above which every suspect finding was proven to be of malignant condition was 6.5 (specificity 100%, sensitivity 38%, accuracy 81%). Conclusion: PET may have an important role in initial staging and the detection of distant metastases and synchronous primary malignancies. Setting a SUV threshold for determining malignancies can support interpretation. In borderline cases, however, interdisciplinary evaluation by means of other diagnostic modalities remains crucial. (orig.)

Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature

International Nuclear Information System (INIS)

Moon, Kyung-Sub; Jung, Shin; Lee, Kyung-Hwa; Hwang, Eu Chang; Kim, In-Young

2011-01-01

Transitional cell carcinoma (TCC) of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC. A 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis. To the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities

Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma

International Nuclear Information System (INIS)

Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Maeng, Lee So; Sohn, Kyung Myung; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo

2009-01-01

The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors (5.8±3.1 vs. 3.7±2.1, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) (5.7±3.2 vs. 3.7±2.0, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types (5.4±2.8 vs. 3.7±1.3, p=0.003). SUVmax between p53 positive group and negative group was significantly different (6.0±2.8 vs. 4.4±3.0, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor

Primary peritoneal anaplastic giant cell carcinoma: case report of an unusual and highly malignant müllerian neoplasm.

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Lu, Xian; Zhang, Cunxian; Liu, Fang; Sung, C James; Steinhoff, Margaret M; Lawrence, W Dwayne

2008-01-01

Virtually all primary peritoneal carcinomas (PPCs) are of serous papillary type. We report an unusual histologic type of PPC composed of anaplastic giant cells, which exhibited an aggressive clinical course. A 72-year-old woman presented with lower abdominal pain. Computed tomography showed a diffuse omental thickening. The patient underwent an exploratory laparotomy with omentectomy, total hysterectomy, bilateral salpingo-oophorectomy, and appendectomy. Pathologic examination revealed extensive omental replacement by tumor but only superficial surface cortical involvement of both ovaries, a disease distribution consistent with a typical müllerian-derived PPC. However, this neoplasm was composed of diffuse anaplastic tumor giant cells, rather than serous carcinoma, which is the usual histologic type encountered in PPC. The patient died within 1 month after surgery. We report this unusual histologic variant of PPC to raise awareness that anaplastic giant cell carcinoma may arise in the pelvic peritoneum as a primary tumor.

Primary Small-Cell Carcinoma of the Palate with Cushing’s Syndrome: A Case Report

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Yingqiu Song

2012-01-01

Full Text Available We report a 24-year-old woman presenting with a relapsed soy-bean-size tender mass at the junction of the soft and hard palate and a history of palatine tumor of small cell carcinoma. Reexcision surgery was performed and histopathological features were consistent. The patient was treated with six cycles of chemotherapy consisting of etoposide and cisplatin. After one year, the patient developed bone metastases and Cushing's syndrome, and successfully recovered with subsequent chemotherapy with irinotecan and cisplatin plus radiotherapy. There was no evidence of recurrence or metastasis for more than three years. Small cell carcinoma originating in the head and neck region has been reported to be highly aggressive and has a poor prognosis. This is the first case report of a patient with relapsed primary small cell carcinoma of the palate and successfully treated with second-line chemotherapy and local radiotherapy.

Metachronous Multiple Primary Malignant Neoplasms of the Stomach and the Breast: Report of Two Cases With Review of Literature

Science.gov (United States)

Karthikeyan, Vilvapathy Senguttuvan; Sistla, Sarath Chandra; Srinivasan, Ramachandran; Basu, Debdatta; Panicker, Lakshmi C.; Ali, Sheik Manwar; Rajkumar, Nagarajan

2014-01-01

Multiple primary malignant neoplasm is the occurrence of a second primary malignancy in the same patient within 6 months of the detection of first primary (synchronous), or 6 months or more after primary detection (metachronous). Multiple primary malignant neoplasms are not very frequently encountered in clinical practice. The relative risk for a second primary malignancy increases by 1.111-fold every month from the detection of the first primary malignancy in any individual. We present 2 patients treated for carcinoma of the breast who developed a metachronous primary malignancy in the stomach to highlight the rare occurrence of multiple primary malignant neoplasms. These tumors were histologically dissimilar, with distinct immunohistochemical parameters. The importance lies in carefully identifying the second primary malignancies, not dismissing them as metastases, and treating them accordingly. PMID:24444270

Synchronous uterine adenocarcinoma and leiomyosarcoma – a case study

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Kamila Dudzik

2017-04-01

Full Text Available Synchronous gynecological cancers are rarely described. Those cases account for approximately up to 6% of female genital tract malignancies. The presence of synchronous endometrial adenocarcinoma and gynecological tract neoplasia is rare – the most commonly described is synchronous adenocarcinoma and endometrial ovarian cancer (accounting for 15-20% of ovarian neoplasia and 5% of endometrial cancers. Concomitant uterine carcinosarcoma and ovarian cancer, or endometrial adenocarcinoma are extremely rare. Up till now, only 3 cases of synchronous adenocarcinoma and leiomyosarcoma were described. In the present study a case of 60-year-old woman diagnosed with synchronous endometrial adenocarcinoma and leiomyosarcoma uteri is described. As the preoperative evaluation revealed endometrial adenocarcinoma G2 with intermediate-risk of lymph node metastasis and synchronous leiomyosarcoma G3, total hysterectomy with bilateral salpingo-oophorectomy and systemic lymphadenectomy was performed showing no lymphatic involvement. In the postoperative evaluation the patient was qualified to adenocarcinoma low recurrence-risk group (adenocarcinoma G1 with no LVSI, FIGO IA – no further radiotherapy was required. However, as synchronous leiomyosarcoma G3 was diagnosed, we decided to refer the patient for adjuvant chemotherapy. Contemporary recommendation on the diagnosis and treatment of uterine carcinomas, especially uterine leiomyosarcomas, is also described in this paper. The presented case showed that diagnosis and treatment of women with uterine tumors should be individualized as in the same case an extremely rare cancer type can be present which, consequently, changes the treatment regimen and prognosis.

Accessory Breast Cancer Occurring Concurrently with Bilateral Primary Invasive Breast Carcinomas: A Report of Two Cases and Literature Review

International Nuclear Information System (INIS)

Hao, Jin-yan; Yang, Cui-cui; Liu, Fang-fang; Yang, Yi-ling; Li, Shuai; Li, Wei-dong; Li, Ya-qing; Lang, Rong-gang; Fan, Yu; Paulos, Estifanos; Zhang, Xin-min; Fu, Li

2012-01-01

The development of accessory breast tissue, which is found anywhere along the milk line, is attributed to the failure of milk line remnants to regress during embryogenesis. Primary tumors may arise from any ectopic breast tissue. Accessory breast cancer occurring concurrently with primary invasive breast cancer is extremely rare. Two such cases were reported in this article. One was a 43-year-old Chinese female who exhibited bilateral breast cancer (invasive ductal carcinoma, not otherwise specified, IDC-NOS) and an accessory breast carcinoma (IDC-NOS) incidentally identified in her left axilla. The ectopic breast tissue in her right axilla presented with adenosis. The patient was surgically treated, followed by postoperative docetaxel epirubicin (TE) chemotherapy. The second case was a 53-year-old Chinese female with bilateral breast cancer (apocrine carcinoma) accompanied by an accessory breast carcinoma (IDC-NOS) in her right axilla that was also incidentally identified. The patient was surgically treated after three doses of cyclophosphamide epirubicin docetaxel (CET) neoadjuvant chemotherapy, followed by adjuvant chemotherapy of the same regimen

Molecular analysis of primary gastric cancer, corresponding xenografts, and 2 novel gastric carcinoma cell lines reveals novel alterations in gastric carcinogenesis

NARCIS (Netherlands)

Milne, Anya N. A.; Sitarz, Robert; Carvalho, Ralph; Polak, Mirjam M.; Ligtenberg, Madolijn; Pauwels, Patrick; Offerhaus, G. Johan A.; Weterman, Marian A. J.

2007-01-01

We report the molecular characterization of 8 primary gastric carcinomas, corresponding xenografts, and 2 novel gastric carcinoma cell lines. We compared the tumors and cell lines, with respect to histology, immunohistochemistry, copy number, and hypermethylation of up to 38 genes using

Infratemporal fossa extension of primary parotid squamous cell carcinoma: a rare entity with diagnosis dilemma

International Nuclear Information System (INIS)

Karaf, J.H.; Gendeh, B.S.; Yunus, M.R.M.

2015-01-01

Primary squamous cell carcinoma of parotid gland is rare but it is an aggressive neoplasm that can have extension into the infratemporal fossa. We report a 60-year-old female presenting with toothache over left lower molar causing a diagnostic dilemma. (author)

Distinguishing synchronous from metachronous manifestation of distant metastases: a prognostic feature in differentiated thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Sabet, Amir [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Saarland University Hospital, Department of Nuclear Medicine, Homburg (Germany); Binse, Ina; Koch, Andrea; Rosenbaum-Krumme, Sandra J. [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Dogan, Semih; Biersack, Hans-Juergen [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Biermann, Kim [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Confessional Hospital ' ' Barmherzige Brueder' ' , Department of Radiology and Nuclear Medicine, Trier (Germany); Ezziddin, Samer [Saarland University Hospital, Department of Nuclear Medicine, Homburg (Germany); University Hospital, Department of Nuclear Medicine, Bonn (Germany)

2017-02-15

Distant metastasis has a negative impact on survival in differentiated thyroid carcinoma (DTC). The timing of this manifestation, however, is of unknown prognostic relevance. The aim of this retrospective study was to investigate the potential significance of discriminating synchronous versus metachronous distant metastases (SDM vs. MDM) for the outcome of patients with DTC. We retrospectively analyzed a consecutive cohort of n = 89 patients with distant metastases of DTC (43 with follicular, 46 with papillary DTC histology; mean age 52.6 ± 17.7 years) undergoing radioiodine treatment at our institution. All patients were treated with the same protocol consisting of ablative radioiodine therapy (RIT, 3.7 GBq) and one post-ablation treatment after 3 months (3.7-11.1 GBq). Further cycles of RIT were administered for recurrent, progressive or newly developed metastatic disease. We distinguished 2 types of distant metastases according to the time of manifestation: SDM (within ≤12 months after DTC diagnosis) and MDM (occurring >12 months after diagnosis). Tumor-related survival was analyzed using the Kaplan-Meier method. Uni- and multivariate analyses including the Cox proportional hazards model were performed with a significance level of p < 0.05. The mean follow-up period was 13.8 ± 1.2 years. SDM were present in 49 (55.1 %), MDM in 40 (44.9 %) patients. MDM were associated with shorter tumor-related survival (p = 0.002). 5-year and 10-year survival rates were 68.5 % and 34.8 % for MDM, and 84.3 % and 66.9 % for SDM, respectively. Within both age subgroups of <45 and ≥45 years, SDM were also linked with longer survival. No effect on tumor-related survival was found for the co-variables sex, lymph node metastases and histologic type. Distinguishing synchronous from metachronous manifestation of distant metastases may add an important prognostic feature to risk stratification in DTC, as proven metachronous appearance is associated with impaired survival. (orig.)

Primary enteric-type adenocarcinomas of the urinary bladder are histogenetically analogous to colorectal carcinomas: Immunohistochemical evaluation of 109 cases

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Saad S. Eissa

2010-04-01

In conclusion, primary non-urachal enteric-type adenocarcinoma of the urinary bladder is morphologically and immunophenotypically similar – if not identical – to colonic adenocarcinoma. The frequent association of enteric carcinomas of the urinary bladder with intestinal metaplasia and/or colonic-type adenomas with dysplasia suggests possible carcinogenetic pathways similar to that observed in colorectal carcinomas.

A CASE REPORT OF THE PATIENT WITH EXTRAOVARIAN PRIMARY PERITONEAL CARCINOMA AFTER BILATERAL SALPINGO-OOPHORECTOMY THIRTEEN YEARS AGO

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Drago Sredanović

2018-02-01

Full Text Available Abstract: We present a rare case of extraovarian primary peritoneal carcinoma in 65-year-old female with a history of total abdominal hysterectomy and bilateral salpingo-oophorectomy for larger symptomatic leiomyoma 13 years ago. In October 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adenocarcinoma and significantly elevated serum Ca-125 was 500 U/ml. Clinical examinations were performed, but could not identify a unique origin of disease. Background: Aproximatly 3.2 % to 21 % of extraovarian primary peritoneal carcinoma patients have a history bilateral oophorectomy for benign disease or prophylaxis – family history of ovar- ian carcinoma.1 Patients and methods: A 65-year old woman with a history of total abdominal hysterectomy and bileteral salpin- go-oophorectomy was operated for larger symptomatic leiomyoma 13 years ago. In Octobre 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adeno- carcinoma and significantly elevated serum Ca-125 was 500 U/ml. Radiologic imaging, gastroscopy, colonoscopy, mammography were performed, but couldn`t identify a unique origin of disease. Patient was treated for two years at the Oncology Institute Ljubljana. Significantly elevated serum Ca-125 and citology with immunohistochemical analysis pre- sented correct diagnosis of extraovarian primary peritoneal carcinoma. The patient was treated with combination systemic chemotherapy (Paclitaxel and Carboplatin with initial good response. In year 2006 and 2007 because of the progression of disease, the treatment was repeated with adjuvant chemotherapy. Conclusions: Look like in other similar cases we have confirmed our disease with three cytologic punction procedures, with significant elevated valves of Ca-125 and with several other directed proce- dures.1–3 Our patient has survived the characteristic critical period for this form of cancer of 7 to 27.8 months because of well orientated

Clinical study of ultrasound-guided percutaneous radiofrequency ablation for primary hepatic carcinoma adjacent to the diaphragm

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LI Meng

2015-04-01

Full Text Available ObjectiveTo investigate the safety and efficacy of ultrasound (US-guided percutaneous radiofrequency ablation (RFA for primary hepatic carcinoma adjacent to the diaphragm. MethodsThis study included 277 patients with 362 lesions of primary hepatic carcinoma managed with US-guided percutaneous RFA in 302 Hospital of PLA from January 2011 to October 2014. Sixty-six patients with 71 hepatocellular carcinomas (HCCs located less than 5 mm from the diaphragm were in study group, and 95 patients with 114 HCCs located more than 10 mm from the hepatic surface were in control group. The patients′ symptoms and complications were observed after the therapy. The complete ablation rate, local tumor progression rate, and complication rate were compared between the two groups. Comparison of continuous data between the two groups was made by independent-samples t test, while comparison of categorical data was made by chi-square test. ResultsAt one month after operation, 65 (91.5% of 71 tumors in the study group and 107 (93.9% of 114 tumors in the control group achieved complete ablation, according to contrast-enhanced CT and MRI, and there was no significant difference between the two groups (χ2=0.36, P=0.55. The postoperative follow-up showed that the local tumor progression rates in the study group and control group were 16.9% and 13.2%, respectively, without significant difference between the two groups (χ2=0.49, P=0.48. In the study group, 22 patients developed adverse reactions, versus 37 patients in the control group (χ2=2.60, P=0.11. ConclusionUS-guided percutaneous RFA is a safe and effective means for the treatment of primary hepatic carcinoma adjacent to the diaphragm.

A possible connective tissue primary lymphoepithelioma-like carcinoma (LELC)

OpenAIRE

Aurilio, G; Ricci, V; De Vita, F; Fasano, M; Fazio, N; Orditura, M; Funicelli, L; De Luca, G; Iasevoli, D; Iovino, F; Ciardiello, F; Conzo, G; Nol?, F; Lamendola, MG

2010-01-01

Lymphoepithelial carcinoma is an undifferentiated nasopharyngeal carcinoma with lymphoid stroma and non-keratinizing squamous cells with distinctive clinical, epidemiological and etiological features. Conversely, lymphoepithelioma-like carcinomas (LELCs) are carcinomas that arise outside the nasopharynx but resemble a lymphoepithelioma histologically. In this case study, LELC presentation in connective tissue (left sternocleidomastoid muscle) is peculiar and unusual, but its diagnosis is supp...

Synchronous occult metastasising duodenal carcinoid and ovarian mucinous cystadenocarcinoma- Multiple primary malignancies in the same patient

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Devadass Clement W, Sridhar Honnappa, Aarathi R Rau, Sharat Chandra

2014-01-01

Full Text Available Gastrointestinal carcinoid tumors are uncommon neuroendocrine tumours that may be associated with synchronous or metachronous primary tumours of other histological type, most frequently colorectal adenocarcinomas. Primary ovarian mucinous adenocarcinomas have been reported to coincide with few other ovarian tumours and minority of these tumours may occur in association with Lynch syndrome. However association of duodenal carcinoid with ovarian mucinous adenocarcinoma is distinctly unusual and, to our knowledge, has not been previously described. We report a case of occult metastasising duodenal atypical carcinoid that was incidentally detected during surgical intervention performed for left ovarian mucinous cystadenocarcinoma in a middle aged female. The carcinoid tumour was Stage IIIB with regional nodal metastasis and the ovarian tumour was Stage IA with low grade histology.

Synchronicity from Synchronized Chaos

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Gregory S. Duane

2015-03-01

Full Text Available The synchronization of loosely-coupled chaotic oscillators, a phenomenon investigated intensively for the last two decades, may realize the philosophical concept of “synchronicity”—the commonplace notion that related eventsmysteriously occur at the same time. When extended to continuous media and/or large discrete arrays, and when general (non-identical correspondences are considered between states, intermittent synchronous relationships indeed become ubiquitous. Meaningful synchronicity follows naturally if meaningful events are identified with coherent structures, defined by internal synchronization between remote degrees of freedom; a condition that has been posited as necessary for synchronizability with an external system. The important case of synchronization between mind and matter is realized if mind is analogized to a computer model, synchronizing with a sporadically observed system, as in meteorological data assimilation. Evidence for the ubiquity of synchronization is reviewed along with recent proposals that: (1 synchronization of different models of the same objective process may be an expeditious route to improved computational modeling and may also describe the functioning of conscious brains; and (2 the nonlocality in quantum phenomena implied by Bell’s theorem may be explained in a variety of deterministic (hidden variable interpretations if the quantum world resides on a generalized synchronization “manifold”.

Palliative radiation in primary squamous cell carcinoma of thyroid: A rare case report

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Sushmita Ghoshal

2013-01-01

Full Text Available Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm with aggressive behavior. Until date, only around 60 cases have been reported in the literature. Primary treatment of the patient is radical surgery. With optimum treatment survival is not more than 6 months in this aggressive malignancy. However in our patient surgery it was not possible because of unresectability of the mass due to encroachment of major vessels. Hence, we have delivered radiotherapy alone, with which effective palliation could be achieved and patient is leading a good quality-of-life for last 1 year.

Metastasis in urothelial carcinoma mimicking prostate cancer metastasis in Ga-68 prostate-specific membrane antigen positron emission tomography-computed tomography in a case of synchronous malignancy

International Nuclear Information System (INIS)

Gupta, Manoj; Choudhury, Partha Sarathi; Gupta, Gurudutt; Gandhi, Jatin

2016-01-01

Prostate cancer is the second most common cancer in man. It commonly presents with urinary symptoms, bone pain, or diagnosed with elevated prostate-specific antigen.(PSA) levels. Correct staging and early diagnosis of recurrence by a precise imaging tool are the keys for optimum management. Molecular imaging of prostate cancer with Ga-68 prostate-specific membrane antigen.(PSMA), positron emission tomography-computed tomography.(PET-CT) has recently received significant attention and frequently used with a signature to prostate cancer-specific remark. However, this case will highlight the more cautious use of it. A-72-year-old male treated earlier for synchronous double malignancy.(invasive papillary urothelial carcinoma right ureter and carcinoma prostate) presented with rising PSA.(0.51.ng/ml) and referred for Ga-68 PSMA PET-CT, which showed a positive enlarged left supraclavicular lymph node. Lymph node biopsy microscopic and immunohistochemistry examination revealed metastatic carcinoma favoring urothelial origin. Specificity of PSMA scan to prostate cancer has been seen to be compromised in a certain situation mostly due to neoangiogenesis, and false positives emerged in renal cell cancer, differentiated thyroid cancer, glioblastoma, breast cancer brain metastasis, and paravertebral schwannomas. Understanding the causes of false positive will further enhance the confidence of interpretating PSMA scans

Primary mucinous carcinoma of the skin: a population-based study

DEFF Research Database (Denmark)

Breiting, L.; Dahlstrom, K.; Breiting, V.

2008-01-01

Background Primary mucinous carcinoma of the skin (PMCS) is a rare malignant tumor deriving from the sweat glands. It is typically located on the head and is often mistaken for a metastasis from a more common primary tumor of the breast or gastrointestinal tract. We present the first population......-based study of PMCS. Materials and methods Data on PMCS was obtained from the Danish Cancer Registry, which has recorded incident cases of cancer on a nationwide basis since 1943. We extracted all patients diagnosed 1978-2003 with PMCS. Results Fifteen cases of PMCS have been registered during the study...... or PMCS related deaths were reported. Conclusion PMCS is a rare, slow-growing tumor which rarely metastasizes and is associated with low mortality. The age-standardized incidence rate, based on data from a population-based cancer registry of high quality and validity, is less than 0.1 per million. However...

Australian contemporary management of synchronous metastatic colorectal cancer.

Science.gov (United States)

Malouf, Phillip; Gibbs, Peter; Shapiro, Jeremy; Sockler, Jim; Bell, Stephen

2018-01-01

This article outlines the current Australian multidisciplinary treatment of synchronous metastatic colorectal adenocarcinoma and assesses the factors that influence patient outcome. This is a retrospective analysis of the prospective 'Treatment of Recurrent and Advanced Colorectal Cancer' registry, describing the patient treatment pathway and documenting the extent of disease, resection of the colorectal primary and metastases, chemotherapy and biological therapy use. Cox regression models for progression-free and overall survival were constructed with a comprehensive set of clinical variables. Analysis was intentionn-ton-treat, quantifying the effect of treatment intent decided at the multidisciplinary team meeting (MDT). One thousand one hundred and nine patients presented with synchronous metastatic disease between July 2009 and November 2015. Median follow-up was 15.8 months; 4.4% (group 1) had already curative resections of primary and metastases prior to MDT, 22.2% (group 2) were considered curative but were referred to MDT for opinion and/or medical oncology treatment prior to resection and 70.2% were considered palliative at MDT (group 3). Overall, 83% received chemotherapy, 55% had their primary resected and 23% had their metastases resected; 13% of resections were synchronous, 20% were staged with primary resected first and 62% had only the colorectal primary managed surgically. Performance status, metastasis resection (R0 versus R1 versus R2 versus no resection), resection of the colorectal primary and treatment intent determined at MDT were the most significant factors for progression-free and overall survival. This is the largest Australian series of synchronous metastatic colorectal adenocarcinoma and offers insight into the nature and utility of contemporary practice. © 2016 Royal Australasian College of Surgeons.

Primary signet-ring cell carcinoma of vermiform appendix clinically and pathologically presenting as acute appendicitis

Directory of Open Access Journals (Sweden)

Tadashi Terada, MD, PhD

2014-03-01

Full Text Available Primary signet-ring cell carcinoma (SRCC of vermiform appendix is extremely rare; only three cases have been reported in the English literature. An 89-year-old man suddenly presented right lower abdominal pain, and transferred to a hospital, where he was diagnosed with acute appendicitis by physical data, blood data, and CT. He was further transferred to our hospital for emergency operation. Physical examination showed positive abdominal pain, Blunberg sign, and Rosenstein sign. Blood test showed leukocytosis and increased C-reactive protein. An appendectomy was performed. Gross examination during operation showed inflamed appendix, appendiceal adhesion, and acute peritonitis. Gross pathological examination showed no apparent tumor, but the proximal appendix showed wall thickening and luminal occlusion. The appendix was cut into three sections, and was observed under microscopically. Nests of carcinoma cells were seen in the proximal appendix. The carcinoma was composed of SRCC (70% and mucinous carcinoma (30%. The size of carcinoma was 6 × 7 mm. The carcinoma cells invaded into muscular layer. No lymphovascular permeation was seen. The cut margins were negative for carcinoma cells. Immunohistochemically, SRCC cells were positive for cytokeratin (CK AE1/3, CK CAM5.2, CK8, CK18, CK19, CK20, EMA, CEA, CA19-9, p53, Ki-67 (labeling = 30%, CDX2, MUC2, and MUC5AC. They were negative for CK34PE1, CK5/6, CK7, CK14, p63, vimentin, TTF-1, MUC1, MUC 5AC, NSE, synaptophysin, chromogranin, and CD56. No further treatments were performed, because the appendiceal carcinoma was small, the surgical margins were negative and the patient was very old. He was followed up by various imaging modalities. No recurrence or metastasis is found 17 months after the operation.

Prognostic value of lymph node-to-primary tumor standardized uptake value ratio in endometrioid endometrial carcinoma

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Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

2018-01-15

To determine whether the relative metabolic activity of pelvic or para-aortic LN compared with that of primary tumor measured by preoperative [{sup 18}F]FDG PET/CT scan has prognostic value in patients with endometrioid endometrial carcinoma. We retrospectively reviewed patients with endometrioid endometrial carcinoma who underwent preoperative [{sup 18}F]FDG PET/CT scans. Prognostic values of PET/CT-derived metabolic variables such as maximum standardized uptake value (SUV) of the primary endometrial carcinoma (SUV{sub Tumor}) and LN (SUV{sub LN}), and the LN-to-endometrial carcinoma SUV ratio (SUV{sub LN} / SUV{sub Tumor}) were assessed. Clinico-pathological data, imaging data, and treatment results were reviewed for 107 eligible patients. Median post-surgical follow-up was 23 months (range, 6-60), and 7 (6.5%) patients experienced recurrence. Regression analysis showed that SUV{sub LN} / SUV{sub Tumor} (P < 0.001), SUV{sub LN} (P = 0.003), International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.006), and tumor grade (P = 0.011) were risk factors of recurrence. Multivariate regression analysis revealed that FIGO stage (P = 0.034) was the independent risk factor of recurrence. SUV{sub LN} / SUV{sub Tumor} showed significant correlation with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), recurrence (P = 0.001), tumor grade (P < 0.001), and deep myometrial invasion of tumor (P = 0.022). Patient groups categorized by SUV{sub LN} / SUV{sub Tumor} showed significant difference in progression-free survival (Log-rank test, P = 0.001). Preoperative SUV{sub LN} / SUV{sub Tumor} measured by [{sup 18}F]FDG PET/CT was significantly associated with recurrence, and may become a novel prognostic factor in patients with endometrioid endometrial carcinoma. (orig.)

Blending Online Asynchronous and Synchronous Learning

Directory of Open Access Journals (Sweden)

Lisa C. Yamagata-Lynch

2014-04-01

Full Text Available In this article I will share a qualitative self-study about a 15-week blended 100% online graduate level course facilitated through synchronous meetings on Blackboard Collaborate and asynchronous discussions on Blackboard. I taught the course at the University of Tennessee (UT during the spring 2012 semester and the course topic was online learning environments. The primary research question of this study was: How can the designer/instructor optimize learning experiences for students who are studying about online learning environments in a blended online course relying on both synchronous and asynchronous technologies? I relied on student reflections of course activities during the beginning, middle, and the end of the semester as the primary data source to obtain their insights regarding course experiences. Through the experiences involved in designing and teaching the course and engaging in this study I found that there is room in the instructional technology research community to address strategies for facilitating online synchronous learning that complement asynchronous learning. Synchronous online whole class meetings and well-structured small group meetings can help students feel a stronger sense of connection to their peers and instructor and stay engaged with course activities. In order to provide meaningful learning spaces in synchronous learning environments, the instructor/designer needs to balance the tension between embracing the flexibility that the online space affords to users and designing deliberate structures that will help them take advantage of the flexible space.

Simultaneous Primary Hodgkin's Lymphoma of the Sigmoid Colon and Papillary Thyroid Carcinoma in an HIV-Positive Patient.

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Liszewski, Walter; Sittig, Mark; Kandil, Emad; Van Sickels, Nicholas; Safah, Hana

2015-01-01

Primary Hodgkin's lymphoma of the colon is a rare phenomenon previously only reported in patients with chronic diverticulitis or inflammatory bowel disease. Herein we report a case of primary Hodgkin's lymphoma of the sigmoid colon in an HIV-positive patient without a history of inflammatory bowel disease or chronic diverticulitis that was later complicated by the discovery of concurrent papillary thyroid carcinoma.

Multifocal hyperfunctioning thyroid carcinoma without metastases.

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Nishida, Akiko T; Hirano, Shigeru; Asato, Ryo; Tanaka, Shinzo; Kitani, Yoshiharu; Honda, Nobumitsu; Fujiki, Nobuya; Miyata, Kouji; Fukushima, Hideyuki; Ito, Juichi

2008-09-01

Hyperthyroidism due to thyroid carcinoma is rare, and most cases are caused by hyperfunctioning metastatic thyroid carcinoma rather than primary carcinoma. Among primary hyperfunctioning thyroid carcinoma, multifocal thyroid carcinoma is exceedingly rare, with the only one case being reported in the literature. Here, we describe the case of a 62-year-old woman with multifocal functioning thyroid carcinoma. Technetium-99m (99m Tc) scintigraphic imaging showed four hot areas in the thyroid gland. Histopathological examination of all four nodules revealed papillary carcinoma, corresponding to hot areas in the 99m Tc scintigram. DNA sequencing of the thyrotropin receptor (TSH-R) gene from all nodules revealed no mutation, indicating that activation of TSH-R was unlikely in the pathophysiogenesis of hyperfunctioning thyroid carcinoma in the present case.

Synchronous gastric and duodenal metastases from head and neck squamous cell carcinoma: a unique presentation of upper gastrointestinal bleeding.

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Tarangelo, Nicholas P; Kistler, C Andrew; Daitch, Zachary; Jiang, Wei; Quirk, Daniel M

2018-01-01

Metastatic disease to the stomach or duodenum is an infrequent diagnosis, and head and neck squamous cell carcinoma (HNSCC) is one of the least common primary malignancies that lead to gastric or duodenal metastases. We report the case of a 65-year-old man with human immunodeficiency virus infection and previously diagnosed HNSCC who presented with melena. The patient had a percutaneous endoscopic gastrostomy tube placed 3 months prior to his presentation. Laboratory testing was significant for normocytic anemia and a digital rectal examination was positive for melena. Esophagogastroduodenoscopy revealed numerous cratered nodules with contact bleeding in the stomach as well as the duodenum that appeared malignant. Biopsies of the gastric and duodenal nodules were positive for p40 and CK 5/6, consistent with metastatic squamous cell carcinoma.

Clinical application of PET/CT imaging in search of the primary carcinoma

International Nuclear Information System (INIS)

Dang Yaping; Liu Gang; Li Miao

2004-01-01

Full text: To explore the clinical value of PET/CT scanning in search of the primary carcinoma, we selected 4 patients who were subjected to PET/CT examination during Oct. 2002 to Dec. 2002. The primary lesion in all these patients was not detected. One of them had metastasis to liver, one had metastases in both lungs and the other two were having metastases to the bones. 18F-FDG in doses of 5.55MBq / kg body weight was injected to a fasting patient (at least 6 hours). PET/CT whole body examination was done using Discovery LS-PET/CT (GE Medical System, U.S.A.) 40-60 minutes later. In the first patient with metastasis to liver, primary lesion was localized in the transverse colon near the liver. The PET/CT showed multiple high radioactive uptake lesions of different sizes in the liver. No obvious change in position of the colon uptake was seen on the delayed images. After PET/CT, barium examination showed thinned cavity of the colon near the liver with coarse ankylosis of colon wall just like saw tooth. The mucous membrane was destroyed. Of the two patients with metastases in the bone, first - a 31 years old, was diagnosed to have primary lung cancer with multiple metastases to the liver and the bones. PET/CT showed high radioactive uptake in the inferior left lobe near the hilum with irregular shaped uneven distribution. A round high radioactive uptake area of 1.82 x 1.84 x 1.46cm size was also seen in the right lobe of the liver having clear edge and uneven distribution. The destroyed bones (L-10, L-11, L-12, T-1 and ala ossis i lii) showed high radioactive uptake. Second patient, 57-year male was diagnosed to have malignant lymphoma. PET/CT fusion showed high radioactive uptake in the marrow of whole body. Few destroyed parts of bones were also seen on CT images. Several cervical and the thoracic vertebrae as well as the ninth rib showed irregular radioactive accumulation with clear edges and well-distributed tracer raising the possibility of multiple myeloma or

Excluding Lynch syndrome in a female patient with metachronous DNA mismatch repair deficient colon- and ovarian cancer

NARCIS (Netherlands)

S. Crobach (Stijn); Jansen, A.M.L. (Anne M. L.); Ligtenberg, M.J.L. (Marjolein J. L.); Koopmans, M. (Marije); M. Nielsen (Maartje); F.J. Hes (Frederik); J.T. Wijnen (Juul); W.N.M. Dinjens (Winand); T. van Wezel (Tom); H. Morreau (Hans)

2017-01-01

textabstractPatients synchronously or metachronously presenting with ovarian and colon cancer can pose diagnostic challenges. A primary colon carcinoma can metastasize to one or both ovaries, two independent primary tumors can arise or an ovarian carcinoma can metastasize to the colon. Clinical and

Clinical study of 18F-FDG PET/CT whole-body imaging in disseminated carcinoma of unknown primary site

International Nuclear Information System (INIS)

Wang Guohui; Liang Peiyan; Cai Yanjun; Zhang Weiguang; Xie Chuanmiao; Wu Peihong

2008-01-01

Objective: Carcinoma of unknown primary (CUP) is not uncommon in usual clinical settings. They are, by definition, those cases with clinically suspected primary malignancy but not revealed by conventional investigation. The aim of this study was to investigate the efficacy of whole-body 18 F-fluoro- deoxyglucose (FDG) PET/CT in detecting a primary neoplasm for these patients. Methods: A totle of 150 patients with retrievable records from 169 CUP patients were selected within a group of consecutive 2589 patients from Jan. 2006 to Jun. 2007. All cases underwent whole-body FDG PET/CT scan. The final diagnoses were confirmed by pathologic results, other imaging modalities or clinical follow-up. Results: Among 150 patients, primary tumor sites were successfully detected by whole-body 18 F-FDG PET/CT scan in 70 cases (46.7%), of which 52 were pathologically confirmed and 18 by clinical follow-up. And 38 cases (54.3%) were lung cancer, 8 (11.4%) were nasopharyngeal carcinoma, 13 (18.6%) in digestive sys- tem, and 11 (15.7%) in other systems. Three clinically suspected CUP cases with negative 18 F-FDG PET/ CT were subsequently confirmed of benign processes by clinical follow-up. Six patients were wrongly diagnosed by 18 F-FDG PET/CT, and 15 patients did not have a confirmed diagnosis by the end of research. The primary cause of malignancy after 18 F-FDG PET/CT remained obscure in 56 patients, only 3 of whom be- came known during the course of clinical follow-up (nasopharyngeal bladder and esophageal carcinoma). Conclusion: 18 F-FDG PET/CT whole-body imaging plays an important role in patients with metastatic CUP. (authors)

"Primary Squamous Cell Carcinoma of the Vagina: HPV Detection, p16INK4A Overexpression and Clinicopathological Correlations"

OpenAIRE

Fuste , Victoria; Del Pino , Marta; Perez , Assumpta; Garcia , Angel; Torne , Aureli; Pahisa , Jaume; Ordi , Jaume

2010-01-01

Abstract Aim: To determine the role of HPV in the pathogenesis of primary squamous cell carcinoma of the vagina (SCCVa), and to evaluate its clinico-pathological significance. Methods: All cases of SCCVa diagnosed over a 15 year period from two hospitals in Barcelona, Spain (n=32) were retrieved. Patients with a history of carcinoma of the cervix diagnosed less than 5 years before were excluded. HPV was detected and typed by PCR using the SPF10 primers. Immunohistochemistry for...

Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

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Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail: claudiomaurizio.pacella@fastwebnet.it; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)

2008-04-15

Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

International Nuclear Information System (INIS)

Pacella, Claudio M.; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico

2008-01-01

Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival

Laparoscopic versus open 1-stage resection of synchronous liver metastases and primary colorectal cancer.

Science.gov (United States)

Gorgun, Emre; Yazici, Pinar; Onder, Akin; Benlice, Cigdem; Yigitbas, Hakan; Kahramangil, Bora; Tasci, Yunus; Aksoy, Erol; Aucejo, Federico; Quintini, Cristiano; Miller, Charles; Berber, Eren

2017-08-01

The aim of this study is to compare the perioperative and oncologic outcomes of open and laparoscopic approaches for concomitant resection of synchronous colorectal cancer and liver metastases. Between 2006 and 2015, all patients undergoing combined resection of primary colorectal cancer and liver metastases were included in the study (n=43). Laparoscopic and open groups were compared regarding clinical, perioperative and oncologic outcomes. There were 29 patients in the open group and 14 patients in the laparoscopic group. The groups were similar regarding demographics, comorbidities, histopathological characteristics of the primary tumor and liver metastases. Postoperative complication rate (44.8% vs . 7.1%, P=0.016) was higher, and hospital stay (10 vs . 6.4 days, P=0.001) longer in the open compared to the laparoscopic group. Overall survival (OS) was comparable between the groups (P=0.10); whereas, disease-free survival (DFS) was longer in laparoscopic group (P=0.02). According to the results, in patients, whose primary colorectal cancer and metastatic liver disease was amenable to a minimally invasive resection, a concomitant laparoscopic approach resulted in less morbidity without compromising oncologic outcomes. This suggests that a laparoscopic approach may be considered in appropriate patients by surgeons with experience in both advanced laparoscopic liver and colorectal techniques.

Concordance Between FISH Analysis of Her-2/Neu Gene in Breast Duct Carcinoma and Corresponding Axillary Nodal Metastases: Egyptian National Cancer Institute Experience.

Science.gov (United States)

Badawy, Omnia M; Hassan, Hannan; ELBakey, Heba A; Mosaad, Maha

2018-05-10

Breast cancer is a major health problem in Egypt. Her-2/Neu gene is routinely assessed for all breast cancer patients primarily by immunohistochemistry. At National Cancer Institute (NCI), Cairo University, Flourescence In Situ hybridization (FISH) analysis of Her-2/Neu gene is carried out for Her-2/Neu score 2 and for some cases of score 3 (particularly those assessed outside NCI). The test is performed essentially on the primary tumor. However, some situations require testing on corresponding lymph node metastases. There is a debate about the concordance between Her-2/Neu status in the primary tumor and synchronous lymph node metastases in various studies. The aim of this study was to test for the concordance between Her-2/Neu status in the primary breast tumor and corresponding axillary nodal metastases. This is a retrospective study in which FISH analysis of Her-2/Neu was carried out simultaneously on archived material of 50 cases previously diagnosed as invasive duct carcinoma and the corresponding nodal metastases from the Pathology Department, NCI. There was complete concordance between Her-2 status in the primary tumor and the corresponding axillary lymph node metastatic deposits in which Her-2 was amplified in 44% of the studied cohort of Egyptian patients. Her-2/Neu gene assessed by FISH analysis on synchronous lymph node metastases is strongly correlated with the primary tumor. Hence, it is justified to carry out the Her-2/Neu test on synchronous lymph nodes to decide on whether to carry out anti-Her-2/Neu target therapy. Further studies on other metastatic sites is recommended.

Research advances in cellular immunotherapy for primary hepatocellular carcinoma

Directory of Open Access Journals (Sweden)

ZHANG Ye

2014-09-01

Full Text Available The present therapy for primary hepatocellular carcinoma (HCC consists of surgery as well as local radiotherapy and chemotherapy. However, the majority of patients are susceptible to recurrence after comprehensive treatment, and the overall treatment outcome is not ideal due to the lack of effective drugs and strategies. Increasing evidence has demonstrated that the immune system is closely related to the development, progression, metastasis, and recurrence of HCC. Thus, immune therapy, especially cellular immunotherapy, could regulate immune function and induce specific antitumor immunity to achieve the goal of controlling HCC and reducing its recurrence and metastasis, which has become an essential part in the comprehensive treatment of HCC. The findings in preclinical and clinical studies on cellular immunotherapy for HCC data are reviewed, and the current problems are discussed.

Adrenalectomy for metastases from hepatocellular carcinoma - a single center experience.

Science.gov (United States)

Popescu, Irinel; Alexandrescu, Sorin; Ciurea, Silviu; Brasoveanu, Vlad; Hrehoret, Doina; Gangone, Eliza; Boros, Mirela; Herlea, Vlad; Croitoru, Adina

2007-05-01

Adrenal metastases (AM) from hepatocellular carcinoma (HCC) are rarely seen in clinical practice. The treatment is not standardized, the indications and efficacy of different therapeutic approaches being still controversial. Between January 1995 and December 2005, 174 patients underwent liver resection for HCC in our center. AM were detected in four patients (2.3%): three of them had HCC and synchronous AM, and the remaining one developed AM 10 months after liver resection. All the patients with AM were treated by adrenalectomy (simultaneously with liver resection in synchronous metastases), followed by systemic chemotherapy. Non-resectable multifocal liver recurrences occurred in two patients, one of them having also a contralateral adrenal metastasis; these two patients are presently alive 26 and 43 months after adrenalectomy, respectively. Another patient died by liver recurrence 27 months postoperatively. The fourth patient is disease-free at 17 months after the initial operation. Adrenalectomy for AM from HCC should be performed whenever the primary tumor is well therapeutically controlled and the patient has a good performance status. Adrenalectomy offers the chance of more than 2 years survival in many patients. However, once AM are detected, the prognosis remains poor.

FGFR3 expression in primary and metastatic urothelial carcinoma of the bladder

International Nuclear Information System (INIS)

Guancial, Elizabeth A; Werner, Lillian; Bellmunt, Joaquim; Bamias, Aristotle; Choueiri, Toni K; Ross, Robert; Schutz, Fabio A; Park, Rachel S; O'Brien, Robert J; Hirsch, Michelle S; Barletta, Justine A; Berman, David M; Lis, Rosina; Loda, Massimo; Stack, Edward C; Garraway, Levi A; Riester, Markus; Michor, Franziska; Kantoff, Philip W; Rosenberg, Jonathan E

2014-01-01

While fibroblast growth factor receptor 3 (FGFR3) is frequently mutated or overexpressed in nonmuscle-invasive urothelial carcinoma (UC), the prevalence of FGFR3 protein expression and mutation remains unknown in muscle-invasive disease. FGFR3 protein and mRNA expression, mutational status, and copy number variation were retrospectively analyzed in 231 patients with formalin-fixed paraffin-embedded primary UCs, 33 metastases, and 14 paired primary and metastatic tumors using the following methods: immunohistochemistry, NanoString nCounterTM, OncoMap or Affymetrix OncoScanTM array, and Gain and Loss of Analysis of DNA and Genomic Identification of Significant Targets in Cancer software. FGFR3 immunohistochemistry staining was present in 29% of primary UCs and 49% of metastases and did not impact overall survival (P = 0.89, primary tumors; P = 0.78, metastases). FGFR3 mutations were observed in 2% of primary tumors and 9% of metastases. Mutant tumors expressed higher levels of FGFR3 mRNA than wild-type tumors (P < 0.001). FGFR3 copy number gain and loss were rare events in primary and metastatic tumors (0.8% each; 3.0% and 12.3%, respectively). FGFR3 immunohistochemistry staining is present in one third of primary muscle-invasive UCs and half of metastases, while FGFR3 mutations and copy number changes are relatively uncommon

Primary carcinoma of fallopian tubes in the material of the Institute of Oncology in Gliwice

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Franek, K; Zielonka, I; Kwasniewska-Rokicinska, C [Instytut Onkologii, Gliwice (Poland)

1976-01-01

The survival of 17 patients treated with postoperative radiotherapy at the Institute of Oncology in Gliwice for primary fallopian tube carcinoma is analysed. The causes of therapeutic failures and short survival (within 2 years) were - too far advanced disease at the time of main treatment which was due to diagnostic difficulties and too late reference of patients for surgery.

[Multiple primary colorectal cancer: Clinical aspects].

Science.gov (United States)

Soldatkina, N V; Kit, O I; Gevorkyan, Yu A; Milakin, A G

to define some clinical characteristics of synchronous and metachronous colorectal cancer (CRC). The investigation was concerned with the data of 150 patients with T1-4N0-2M0-1 multiple primary CRC. The clinical, biological, and morphological characteristics of synchronous and metachronous tumors were analyzed. Multiple primary tumors were 6.01% of all the cases of CRC. There was a preponderance of synchronous CRC (63.75%) with the tumor localized in the sigmoid colon and rectum. In women, synchronous colorectal tumors were more often concurrent with breast tumors; metachronous ones were detected after treatment for genital tumors. In men, synchronous colorectal tumors were more frequently concurrent with kidney cancer; metachronous ones were identified after treatment for gastric cancer. The found characteristics of multiple primary colorectal tumors may be taken in account in programs for both primary diagnosis and follow-up after treatment for malignant tumors, which will be able to improve the early detection of cancer patients and their treatment results.

Primary intraosseous squamous cell carcinoma arising in an odontogenic keratocyst previously treated with marsupialization: case report and immunohistochemical study.

Science.gov (United States)

Martínez-Martínez, Marisol; Mosqueda-Taylor, Adalberto; Delgado-Azañero, Wilson; Rumayor-Piña, Alicia; de Almeida, Oslei Paes

2016-04-01

A rare case of primary intraosseous squamous cell carcinoma arising in an odontogenic keratocyst (OKC) is presented here, with the clinical and histologic features of the first biopsy showing characteristics of OKC and the second biopsy disclosing a squamous cell carcinoma. Immunoprofile of this case was compared with five cases of classical OKC by using cytokeratins CK5, CK14, and CK19, CD138, p63, Ki-67, p53, and bcl-2. Classic OKCs showed expected positivity, mainly in the basal and/or suprabasal layers with most antibodies, except for p53, which was negative, whereas the present case showed irregular positivity in all layers, indicating that this can be useful for differential diagnosis and suggesting a possible role in malignant transformation into primary intraosseous squamous cell carcinoma. In conclusion, immunohistochemical differences between the first biopsy of the present case and classic OKC suggest that immunohistochemistry can be helpful in cases with areas of subtle initial malignant transformation. Copyright © 2016 Elsevier Inc. All rights reserved.

Multiple gastrointestinal metastases of Merkel cell carcinoma.

Science.gov (United States)

Poškus, Eligijus; Platkevičius, Gediminas; Simanskaitė, Vilma; Rimkevičiūtė, Ernesta; Petrulionis, Marius; Strupas, Kestutis

2016-01-01

Merkel cell carcinoma is an aggressive skin malignancy. Primary Merkel cell carcinomas are treated by wide radical excision with or without adjuvant radiotherapy, while benefits of adjuvant chemotherapy remain doubtful. There are only several cases of gastrointestinal metastases of Merkel cell carcinoma reported so far. We report a case of recurrent Merkel cell carcinoma with metastases to the stomach and the small intestines after wide excision of primary Merkel cell carcinoma. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

A Case of Squamous Cell Carcinoma of Unknown Primary that Responded to the Multi-Tyrosine Kinase Inhibitor Lenvatinib

Directory of Open Access Journals (Sweden)

Reiko Kimura-Tsuchiya

2018-02-01

Full Text Available Lenvatinib is an oral tyrosine kinase inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, fibroblast growth factor receptors 1 through 4, as well as platelet-derived growth factor receptor α, RET, and KIT. At present, lenvatinib is used in the treatment of thyroid cancer and renal cell carcinoma. We herein report a case of a 67-year-old patient with squamous cell carcinoma of unknown primary who was effectively treated with lenvatinib. The patient was initially diagnosed as having undifferentiated thyroid cancer, and after total thyroidectomy and bilateral lymph node dissection, lenvatinib was administered for the treatment of residual lymph node metastasis. A computed tomography scan after 1 month of lenvatinib administration showed marked regression of the lymph nodes, but interstitial pneumonia was also detected. Because the drug lymphocyte stimulation test for lenvatinib was strongly positive, we concluded that the interstitial pneumonia was induced by lenvatinib. The interstitial pneumonia only improved by the withdrawal of lenvatinib. Finally, his thyroid tumor was diagnosed as a metastasis of squamous cell carcinoma; however, we were unable to identify the primary lesion. This is the first reported case of interstitial pneumonia induced by lenvatinib.

Lymph node enhancement at MRI with MnDPDP in primary hepatic carcinoma. Technical report

International Nuclear Information System (INIS)

Burkill, Guy J.C.; Mannion, Ethna M.; Healy, Jeremiah C.

2001-01-01

AIMS: To report two cases of lymph node enhancement in primary hepatic carcinoma following the administration of Mangafodipir trisodium (MnDPDP, Teslascan[reg ], Nycomed Amersham U.K.), an hepatocyte specific magnetic resonance imaging (MRI) contrast agent. To review our experience with this contrast agent and the literature to establish if such enhancement occurs in normal lymph nodes or has been previously described in hepatocellular carcinoma (HCC) or other lesions. MATERIALS AND METHODS: The radiological reports of all MnDPDP enhanced abdominal MRI examinations were reviewed for lymph node enlargement. The MR images from examinations with reported nodal enlargement were re-evaluated for evidence of nodal enhancement and the hospital notes and histological reports were reviewed. Nodal enhancement was considered present if lymph node signal intensity was greater than that of the spleen following MnDPDP. Literature searches were performed on Medline and PubMed for previous descriptions of lymph node enhancement following MnDPDP. RESULTS: The reports of 90 MnDPDP abdominal MRI examinations were reviewed. Of 18 cases of lymph node enlargement, two had evidence of lymph node enhancement following MnDPDP. These two cases had hepatocellular carcinoma and fibrolamellar hepatocellular carcinoma, respectively, confirmed on liver biopsy. No reports of lymph node enhancement following MnDPDP were identified in the literature. CONCLUSION: Two cases of lymph node enhancement following MnDPDP have been presented. Although histological confirmation of the lymph nodes was not obtained, the authors propose that the lymph node enhancement was due to functioning hepatocytes in lymph node metastases from the patients' histologically confirmed hepatocellular carcinomas. Burkill, G.J.C., Mannion, E.M. and Healy, J.C. (2001)

Radiation therapy in recurrence of carcinoma of the uterine cervix after primary surgery

International Nuclear Information System (INIS)

Kim, Jin Hee; Kim, Ok Bae

2003-01-01

The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, following primary surgery. Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous ceH carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was performed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9%, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7% in vaginal cuff recurrence alone, 53.3% in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7% local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Radiation therapy was safe and effective treatment for a

Primary pure squamous cell carcinoma of breast in a young female - a rare occurrence

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P Raje

2014-04-01

Full Text Available Primary squamous cell carcinoma of breast is a rare disease. Incidence for primary SCC breast is 0.04-0.1 % of all malignancies of breast. A pure form of primary SCC breast is also described and its incidence is still less. Biologically it behaves differently and usually doesn’t metastasize to lymph nodes, though distant metastasis is more common. They occur usually in elderly women. Mean age of presentation is 54 years. We report the youngest patient so far - a 27 years old woman diagnosed initially as having fibrocystic disease and later as primary pure SCC breast. She did not have any other focus of malignancy in the body and is doing well 3-1/2 years post surgery and radiotherapy. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10322 Journal of Pathology of Nepal (2014 Vol. 4, 600-602

The effect of chemo-embolization on E-cadherin expression of primary hepatocellular carcinoma

International Nuclear Information System (INIS)

Xiao Enhua; Hu Guodong; Liu Pengcheng; Hu Daoyu; Liu Shaochun; Hao Chunrong

2001-01-01

Objective: To study the significance of E-cadherin (E-cad) expression of primary hepatocellular carcinoma (PHC), and the effect of the different chemo-embolization treatment on E-cad. Methods:Ninety-eight histopathological verified PHC specimens were obtained. The patients were treated with surgical resection alone (57 cases), and second stage surgical resection after four kinds of chemo-embolization (41 cases). Strept avidin-biotin complex (SABC) immunohistochemical staining with monoclonal antibody against human E-cad was used to observe the E-cad in all specimens. The experimental results were compared with the surgical and clinical findings. Results: The metastatic rates in E-cad (+) and (-) were 43.3%, 70.4% respectively (x 2 = 4.22, P 0.05). The E-cad expression of trabecular and clear cell PHC was higher than that of solid and poorly differentiated PHC. After chemo-embolization, the E-cad expression of the former decreased, the latter increased. The E-cad expression decreased as pathologic grades increasing. After chemo-embolization, the E-cad expression increased as pathological grades increasing. The metastatic rates in interventional group and surgical resection alone were 48.8%, 56.1% respectively (P > 0.05). Conclusions: The increased expression of E-cad would restrain PHC from metastasis. It could act as a prognosis-predictive marker. The effect of chemo-embolization on E-cadherin expression of primary hepatocellular carcinoma had histopathologic difference

Treatment and prognosis of primary parotid squamous cell carcinoma: study of 16 patients

International Nuclear Information System (INIS)

Ouyang Jinling; Gao Li; Yi Junlin; Huang Xiaodong; Luo Jingwei; Xu Guozhen

2007-01-01

Objective: To investigate the clinical characteristics and treatment of primary parotid squamous cell carcinoma through 16 patients. Methods: Sixteen such patients treated in our hospital from 1984 to 2005 were analyzed retrospectively. There were T1 2 patients, T2 and T3 5 patients each and T4 4. Ten patients had NO, and 6 N + lesions. Six patients were treated by monotherapy, ie-mono group (surgery alone or radiotherapy alone), the other 10 patients by surgery combined with postoperative radiotherapy. Results: The overall neck metastastic lymph nodes was observed in 12 patients (75%). The 3- and 5-year local control, overall survival and disease-free survival for the whole group was 45% and 30%, 58% and 58%; 36% and 27%, respectively. The 5-year survival for T1-T2 and T3-T4 patients was 100% and 29% (χ 2 =4.50, P=0.034), respectively. The 3-year overall survival of NO and N + patients was 80%, and 20% (χ 2 =8.70, P=0.003), with a disease-free survival of 54% and 0 (χ 2 =9.83, P=0.002), respectively. Conclusions: The choice of suitable treatment for locally advanced primary parotid squamous cell carcinoma is surgery plus postoperative radiotherapy. Prophylactic ipsilateral neck irradiation is necessary e- ven for N0 patients for the sake of high risk of neck node metastasis. (authors)

Synchronous multicentric osteosarcoma: the case for metastases

International Nuclear Information System (INIS)

Daffner, R.H.; Kennedy, S.L.; Fox, K.R.; Crowley, J.J.; Sauser, D.D.; Cooperstein, L.A.

1997-01-01

Objective. There is a current debate whether multicentric osteosarcoma represents synchronous multiple primary osteosarcomas or metastatic disease. The purpose of this report is to evaluate the etiology, presentation, and classification of this entity. Design and patients. Six patients ranging in age from 7 to 29 years were studied. The clinical, radiographic, and pathologic findings are reported. In addition, a review of the literature was undertaken. Results. The clinical courses of our six patients as well as a review of the literature suggest that multicentric osteosarcoma represent one extreme of a continuous scale of metastatic osteosarcoma rather than multiple synchronous primary tumors. The presentation is unusual and the clinical behavior distinctive, but the mechanism of spread remains the same: blood-borne and lymphatic-borne. Conclusions. Our experience with these six patients supports the concept in the recent literature that synchronous osteosarcoma is one extreme of the spectrum of metastatic osteosarcoma. Its unique features are: (1) multiple radiodense lesions that present simultaneously with or without pulmonary metastases; (2) a single ''dominant'' lesion with multiple smaller lesions; and (3) a uniformly rapid, fatal prognosis. Osteosarcoma should be regarded as a metastatic disease, even when only a single primary lesion is found at the initial presentation. (orig.)

ER, HER2, and TOP2A expression in primary tumor, synchronous axillary nodes, and asynchronous metastases in breast cancer

DEFF Research Database (Denmark)

Jensen, Jeanette Dupont; Knoop, Ann; Ewertz, Marianne

2011-01-01

with the primary tumors with respect to ER, HER2, and TOP2A. In the prospective tissue-collection study, 81 patients had biopsy from a suspected relapse. Additional archived paired material was included, leaving a total of 119 patients with paired primary tumor, synchronous axillary nodes (available in 52 patients......At recurrence of breast cancer, the therapeutic target is the metastases. However, it is current practice to base the choice of systemic treatment on the biomarker profile of the primary tumor. In the present study, confirmatory biopsies were obtained from suspected metastatic lesions and compared......) and asyncronous metastases available for analysis. ER, HER2, and TOP2A expression of primary tumors, axillary nodes and metastases were re-analysed and determined centrally by immunohistochemistry, chromogenic in situ hybridization, and fluorescence in situ hybridization. Of the 81 patients with a biopsy from...

Cytologic diagnosis of primary peritoneal high grade serous carcinoma in a man.

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Umphress, Brandon; Philip, John; Zhang, Yaxia; Lin, Xiaoqi

2018-04-16

Primary peritoneal serous carcinoma (PPSC) is a rare neoplasm histologically indistinguishable from ovarian serous carcinoma primarily occurring in the female population. To date, extremely rare cases of PPSC have been reported in men; however, diagnosis by cytology has yet to be described. Here we present the clinical, radiographic, cytomorphologic, histologic and immunohistochemical (IHC) findings of a high-grade (HG) PPSC in a 70-year-old man with a history of prostatic adenocarcinoma. Core needle biopsy (CNB) touch preparation smears showed pleomorphic, round, columnar and polygonal epithelioid cells present singly or arranged in loosely cohesive three-dimensional clusters. The tumor cells are characterized by enlarged nuclei containing prominent nucleoli, and variable scant to moderate, slightly dense cytoplasm. Scattered cells contained cytoplasmic vacuoles. Examination of CNB revealed an infiltrating tumor in sheets with focal papillary configuration. Tumor cells were morphologically consistent with HG carcinoma. IHC studies demonstrated diffuse positivity for CK7, PAX-8, ER, WT1, p53, p16 and BerEP4 with focal/weak staining for calretinin and CK5/6, which supporting the diagnosis of HG PPSC. The patient was treated with 6 cycles of carboplatin and paclitaxel with near resolution of the mass at 10 month follow-up. To the best of our knowledge, this is the first reported case in the literature of PPSC in a man diagnosed by cytology. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Collision tumor of the thyroid: follicular variant of papillary carcinoma and squamous carcinoma

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Kane Subhadra V

2006-09-01

Full Text Available Abstract Background Collision tumors of the thyroid gland are a rare entity. We present a case of a follicular variant of papillary carcinoma and squamous carcinoma in the thyroid. To the best of our knowledge, this is the first documentation of a collision tumor with a papillary carcinoma and a squamous carcinoma within the thyroid gland. The clinicopathological features and immunohistochemical profile are reported. The theories of origin, epidemiology and management are discussed with a literature review. Case presentation A 65 year old woman presented with a large thyroid swelling of 10 years duration and with swellings on the back and scalp which were diagnosed to be a follicular variant of papillary thyroid carcinoma with metastasis. Clinical examination, radiology and endoscopy ruled out any other abnormality of the upper aerodigestive tract. The patient was treated surgically with a total thyroidectomy with central compartment clearance and bilateral selective neck dissections. The histopathology revealed a collision tumor with components of both a follicular variant of papillary carcinoma and a squamous carcinoma. Immunohistochemical analysis confirmed the independent origin of these two primary tumors. Adjuvant radio iodine therapy directed toward the follicular derived component of the thyroid tumor and external beam radiotherapy for the squamous component was planned. Conclusion Collision tumors of the thyroid gland pose a diagnostic as well as therapeutic challenge. Metastasis from distant organs and contiguous primary tumors should be excluded. The origins of squamous cancer in the thyroid gland must be established to support the true evolution of a collision tumor and to plan treatment. Treatment for collision tumors depends upon the combination of primary tumors involved and each component of the combination should be treated like an independent primary. The reporting of similar cases with longer follow-up will help define the

Imaging of primary and metastatic colorectal carcinoma with monoclonal antibody 791T/36 and the therapeutic potential of antibody-drug conjugates

International Nuclear Information System (INIS)

Pimm, M.V.; Armitage, N.C.; Ballantyne, K.; Baldwin, R.W.; Perkins, A.C.; Durrant, L.G.; Garnett, M.C.; Hardcastle, J.D.

1987-01-01

Monoclonal antibody 791T/36, prepared against a tumor-associated 72,000 dalton glycoprotein, reacted with cells from primary and metastatic colorectal carcinomas. I-131 or In-111-labelled antibody localized in xenografts of colorectal carcinomas established from in vitro clonogenic populations. Clinically, with I-131-labelled antibody, 8/11 colonic tumors imaged positively. Imaging was negative in four patients with benign colon disease. 5/11 rectal tumors were positively imaged, but excreted I-131 in the bladder obscured tumors in several studies. In-111-labelled antibody gave superior images and positively imaged primary and metastatic sites in 13/14 patients. Prospectively in the detection of recurrent disease, I-131 or In-111-antibody detected 29/33 separate sites in 24 patients. Seven negative patients remain disease free. There were 3 false positives; overall sensitivity was 88%, with 70% specificity. Specific localization of radiolabel was confirmed immunochemically and by counting radioactivity in resected specimens. Antibody conjugates with methotrexate, vindesine and daunomycin retained drug activity and antibody function, including xenograft localization and conjugates were therapeutically effective against xenografts. 791T/36 antibody has potential for immunodetection of primary and recurrent colorectal carcinoma and for targeting of therapeutic agents

Esophageal Large-Cell Neuroendocrine Carcinoma with Inconsistent Response to Treatment in the Primary and Metastatic Lesions

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Takashi Tomiyama

2018-05-01

Full Text Available Esophageal large-cell neuroendocrine carcinoma (NEC is a rare malignant tumor that is characterized by high-grade malignancy and a poor prognosis. However, the rarity of esophageal NEC has prevented the development of an established treatment, and no reports have described a discrepancy in the effectiveness of cisplatin plus irinotecan between primary and metastatic lesions. A 43-year-old Japanese man was referred to our hospital with refractory epigastralgia. A previous gastrointestinal endoscopy had revealed a 50-mm type 2 tumor in the abdominal esophagus. The pathological findings indicated poorly differentiated squamous cell carcinoma. Contrast-enhanced computed tomography revealed a metastatic liver tumor. One cycle of fluorouracil and cisplatin was not effective, and endoscopy was repeatedly performed. The pathological findings indicated a large-cell malignant tumor with tumor cells that were positive for CD56, synaptophysin, and Ki-67 (> 80%. Based on a diagnosis of esophageal large-cell NEC with a metastatic liver tumor, the patient received cisplatin plus irinotecan biweekly. After 4 months, computed tomography revealed marked shrinkage of the metastatic tumor, but the patient complained of dysphagia. Endoscopy revealed enlargement of the primary tumor, which was then treated using radiotherapy plus fluorouracil and cisplatin. The primary tumor subsequently shrank, and the patient’s symptoms were relieved, but the metastatic tumor grew. Thus, chemoradiotherapy could be an option for managing a primary esophageal large-cell NEC that does not respond to chemotherapy alone. However, the possibility of an inconsistent response to therapy in primary and metastatic lesions should be considered.

Synchronous machines. General principles and structures; Machines synchrones. Principes generaux et structures

Energy Technology Data Exchange (ETDEWEB)

Ben Ahmed, H.; Feld, G.; Multon, B. [Ecole Normale Superieure de Cachan, Lab. SATIE, Systemes et Applications des Technologies de l' Information et de l' Energie, UMR CNRS 8029, 94 (France); Bernard, N. [Institut Universitaire de Saint-Nazaire, Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique (IREENA), 44 - Nantes (France)

2005-10-01

Power generation is mainly performed by synchronous rotating machines which consume about a third of the world primary energy. Electric motors used in industrial applications convert about two thirds of this electricity. Therefore, synchronous machines are present everywhere at different scales, from micro-actuators of few micro-watts to thermo-mechanical production units of more than 1 GW, and represent a large variety of structures which have in common the synchronism between the frequency of the power supply currents and the relative movement of the fixed part with respect to the mobile part. Since several decades, these machines are more and more used as variable speed motors with permanent magnets. The advances in power electronics have contributed to the widening of their use in various applications with a huge range of powers. This article presents the general principle of operation of electromechanical converters of synchronous type: 1 - electromechanical conversion in electromagnetic systems: basic laws and elementary structures (elementary structure, energy conversion cycle, case of a system working in linear magnetic regime), rotating fields structure (magneto-motive force and Ferraris theorem, superficial air gap permeance, air gap magnetic induction, case of a permanent magnet inductor, magnetic energy and electromagnetic torque, conditions for reaching a non-null average torque, application to common cases); 2 - constitution, operation modes and efficiency: constitution and main types of synchronous machines, efficiency - analysis by similarity laws (other expression of the electromagnetic torque, thermal limitation in permanent regime, scale effects, effect of pole pairs number, examples of efficiencies and domains of use), operation modes. (J.S.)

Medullary breast carcinoma: The role of radiotherapy as primary treatment

International Nuclear Information System (INIS)

Fourquet, A.; Vilcoq, J.R.; Zafrani, B.; Schlienger, P.; Campana, F.; Jullien, D.

1987-01-01

The results are reported of a selected series of 41 patients with medullary carcinoma of the breast, treated with primary radiotherapy with (24 patients) or without (17 patients) adjuvant chemotherapy. Complete responses to radiotherapy occurred with moderate doses (67% of the patients had a complete response after a dose of 55-60 Gy) and were increased by the addition of an irradiation boost. The 6-year actuarial free of local recurrence survival, metastase-free survival and survival rates were 86, 83, and 83%, respectively. The 6-year actuarial probability of living with breast preserved was 72%. Recurrences and survivals were not influenced by the tumor size or clinical axillary node status. Adjuvant chemotherapy had no effect on the rate of recurrence or survival. 14 refs.; 3 tabs

Prognostic value of primary tumour resection in synchronous metastatic colorectal cancer: Individual patient data analysis of first-line randomised trials from the ARCAD database

NARCIS (Netherlands)

van Rooijen, K. L.; Shi, Q.; Goey, K. K. H.; Meyers, J.; Heinemann, V.; Diaz-Rubio, E.; Aranda, E.; Falcone, A.; Green, E.; de Gramont, A.; Sargent, D. J.; Punt, C. J. A.; Koopman, M.

2018-01-01

Indication for primary tumour resection (PTR) in asymptomatic metastatic colorectal cancer (mCRC) patients is unclear. Previous retrospective analyses suggest a survival benefit for patients who underwent PTR. The aim was to evaluate the prognostic value of PTR in patients with synchronous mCRC by

Metastatic carcinoma of the urinary bladder in a 67-year-old female with underlying triple primary cancers

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Chia-Yen Hung

2016-06-01

A 67-year-old Taiwanese female presented to our institution in November 1997 with gastric signet ring cell carcinoma, pT2N0M0, status post subtotal gastrectomy. In February 2003 she was diagnosed with left breast invasive lobular carcinoma status post modified radical mastectomy, pT2N2M0. Further examination in January 2005 revealed proximal transverse colon cancer, Dukes' C2, with status post right hemicolectomy. She achieved disease-free status from all three malignancies after surgical resection and adjuvant chemotherapy for breast and colon cancers sequentially. In November 2011, she complained about sudden onset of gross hematuria for several days. Diagnostic cystoscopy showed a mass lesion over her urinary bladder. Cystoscope-assisted biopsy showed metastatic poorly differentiated adenocarcinoma with signet ring appearance. Herein we have discussed the pathologic role in the diagnosis of metastatic tumor involving a patient with multiple primary cancers. We also explored the epidemiologic risk and potential causal mechanism of patients with multiple primary cancers.

Carbon-ion radiotherapy for locally advanced primary or postoperative recurrent epithelial carcinoma of the lacrimal gland

International Nuclear Information System (INIS)

Mizoguchi, Nobutaka; Tsuji, Hiroshi; Toyama, Shingo; Kamada, Tadashi; Tsujii, Hirohiko; Nakayama, Yuko; Mizota, Atsushi; Ohnishi, Yoshitaka

2015-01-01

Purpose: To evaluate the applicability of carbon ion beams for the treatment of carcinoma of the lacrimal gland with regard to normal tissue morbidity and local tumor control. Methods and materials: Between April 2002 and January 2011, 21 patients with locally advanced primary epithelial carcinoma of the lacrimal gland were enrolled in a Phase I/II clinical trial of carbon-ion radiotherapy (CIRT) at the National Institute of Radiological Sciences. Acute radiation toxicity was the primary endpoint of this dose-escalation study and the late toxicity, local control, and overall survival were additionally evaluated as secondary endpoints. Of the 21 subjects enrolled, all patients were followed for more than 6 months and analyzed. Results: The radiation dose was increased from the initial dose of 48.0 Gy equivalents (GyE)/12 fractions at 10% increments up to 52.8 GyE. Of the 21 patients, five received a total dose of 48.0 GyE, and 16 received a total dose of 52.8 GyE. No patient developed grade 3 or higher skin toxicity. As late ocular/visual toxicity, three patients had grade 3 retinopathy and seven patients lost their vision. Among the 10 patients treated until May 2005, five patients had local recurrence, three of whom had marginal recurrence. Therefore, the margin for the CTV (clinical target volume) was set to a range according to the orbital exenteration since June 2005. After the application of the extended margin, no local recurrence has been observed. The three-year overall survival and local control rates were 82.2% and 79.0%, respectively. Conclusion: CIRT can be applied for primary epithelial carcinoma of the lacrimal gland, with a borderline acceptable morbidity and sufficient antitumor effect when an extended margin is adopted

Multiple primary cancers: Simultaneously occurring prostate cancer ...

African Journals Online (AJOL)

We also reviewed the existing literatures for possible biologic links between prostatic carcinoma and other primary tumors. ... The primary tumors co-existing with prostate cancer were colonic adenocarcinoma, rectal adenocarcinoma, urinary bladder transitional cell carcinoma, primary liver cell carcinoma, and thyroid ...

Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis

International Nuclear Information System (INIS)

Cho, Jae Keun; Woo, Seung-Hoon; Park, Junoh; Kim, Min-Ji; Jeong, Han-Sin

2014-01-01

Primary squamous cell carcinomas arising from the thyroid gland (SCCTh) is extremely rare diseases, which have never been fully studied. Thus, we performed a systematic review and individual participant data meta-analysis of published SCCTh cases, to understand the clinical characteristics and to identify the prognostic factors of primary SCCTh. A literature search was conducted within Medline, EMBASE, Cochrane library databases and KoreaMed using the following Medical Subject Headings (MeSH) keywords: “primary,” “squamous,” “carcinoma,” “cancer,” and “thyroid.” Eighty-four patients' individual data from 39 articles and five patients' data in our institute were selected for analysis (N = 89). The mean age at diagnosis was 63.0 years (range, 24–90) and female preponderance (M:F = 1:2) was noted. The commonest complaint was the anterior neck mass, followed by dyspnea or dysphagia, and extension to the adjacent structure was found in 72%. The median survival was 9.0 months (95% CI, 6.0–23.0) and 3-year survival rate (3YSR) was 37.6% by Kaplan–Meier method, but only 20.1% by a shared frailty model for adjusting heterogeneity. Complete resection (R0) of tumors was the only significant prognostic factor in multivariable analysis, and the benefit of adjuvant treatment was not proved. The prognosis of patients with SCCTh is very poor (20% in 3YSR), but complete resection of disease is correlated with improved survival. To achieve complete surgical eradication of tumors, early detection and accurate diagnosis should be emphasized

Radiotherapy for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site

International Nuclear Information System (INIS)

Colletier, Philip J.; Garden, Adam S.; Morrison, William H.; Geara, Fady B.; Kian Ang, K.

1996-01-01

PURPOSE/OBJECTIVE: To evaluate the outcome of patients treated with radiotherapy for carcinoma metastatic to cervical lymph nodes from an unknown primary site. This large retrospective series updates the results of our treatment policy in which patients receive radiation both to the involved neck(s) at risk as well as putative mucosal primary sites along the pharyngeal axis. MATERIALS/METHODS: Between July 1968 and December 1992, 196 patients with carcinoma metastatic to cervical lymph nodes from an unknown primary site were treated with curative intent using megavoltage external beam radiotherapy. One hundred thirty-nine patients received adjuvant radiation following either an excisional biopsy or neck dissection (S+XRT), and 57 received radiation to gross disease following either a diagnostic biopsy or incomplete resection (XRT). A neck dissection was performed following radiation in patients in the XRT group who were medically and technically operable if there were residual masses following radiation. Nodal stage distribution was as follows: N1 - 32 patients, N2a - 65, N2b - 35, N2c - 15, N3 - 36, and NX - 13. Thirty percent of patients in the XRT group had N3 disease vs. 14% in the S+XRT group (p = .008). Similarly, 33% of patients in the XRT group presented with low jugular or supraclavicular adenopathy compared with 16% in the S+XRT group (p = .006). Radiation was delivered to putative mucosal sites in 173 patients. Of these, 172 were treated to the oropharynx, 167 to the nasopharynx, 124 to the larynx and hypopharynx, and 5 to the oral cavity. All but one patient received bilateral treatment when covering putative mucosal primary sites. Treatment was limited to the ipsilateral neck only in 23 patients. Doses ranged from 24 to 90 Gy. The median doses to the sites of nodal involvement were 63 Gy and 68.1 Gy for the S+XRT and XRT groups, respectively. RESULTS: The range of follow-up was 1-267 months with a median follow-up in surviving patients of 87 months

Synchronous Occurance of Acute Myeloid Leukemia and Rhabdomyosarcoma.

Science.gov (United States)

Jayasudha, A V; Nair, Rekha A; Renu, S; Binitha, R; Reghu, K S; Kusumakumary, P

2015-09-01

Metachronous primary distinct tumors are frequently and increasingly encountered in oncology clinical practice of recent times, but synchronous tumours are still a rarity. We report an unusual case of a 2 year old male child who had synchronous occurrence of rhabdomyosarcoma of pelvis and acute myeloid leukemia.Our search of literature suggests that this may be the first reported case of simultaneous occurrence of these two malignancies.

Synchronous and Metachronous Malignant Tumours expect the un-expected

International Nuclear Information System (INIS)

Mehdi, I.; Shah, A.H.; Moona, M.S.; Verma, K.; Abussa, A.; Elramih, R.; El-Hashmi, H.

2010-01-01

Objective: To evaluate occurrence of synchronous and metachronous malignant tumours, to find tumour types, age group, and relationship to treatment received. Methods: Previously diagnosed first primary tumour cases experiencing a synchronous or metachronous tumour, seen at AOI from February 2003 to August 2009 (78 months) were included. The cases were analyzed for morphology/histology of first primary tumour, age and gender of patient, treatment received for first tumour, time interval between the first and second primary tumour, morphology/histology of second tumour, and the treatment conferred for second tumour. Results: The second synchronous and metachronous tumours were 46/4025 (1.14%), in 18 males and 28 females (M:F 1:1.6). The age range was 16-75 years (median 43 years). The follow up time was 24-150 months. The time to second primary tumour was 2-132 months. The first primary tumours were breast, ovary, GIT and urinary bladder. The patients received surgery, radiotherapy, chemotherapy, and hormonal therapy alone or as multi-modality treatment for the first tumours. The frequent second tumours were breast, ovary and Gastro Intestinal tumours. Conclusion: It is imperative that patients with a primary malignant tumour should be thoroughly, closely, and regularly followed. Genetic counseling, risk estimation, cancer screening and hemo prevention must be emphasized. Every subsequent occurring tumour should be biopsied. The effect of first tumour on the second or vice versa are still not fully understood and need exploration. The second primary tumour is usually more aggressive, treatment resistant, and metastasizes early requiring a more aggressive treatment strategy. (author)

Synchronized multiple regression of diagnostic radiation-induced rather than spontaneous: disseminated primary intracranial germinoma in a woman: a case report

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Natsumeda Manabu

2011-01-01

Full Text Available Abstract Introduction Examples of the spontaneous regression of primary intracranial germinomas can be found in the literature. We present the case of a patient with disseminated lesions of primary intracranial germinoma which synchronously shrunk following diagnostic irradiation. We will discuss whether this regression was spontaneous or radiation-induced. Case presentation A 43-year-old Japanese woman presented to our hospital complaining of memory problems over a period of one year and blurred vision over a period of three months. Following magnetic resonance imaging, she was found to have a massive lesion in the third ventricle and small lesions in the pineal region, fourth ventricle, and in the anterior horn of the left lateral ventricle. Prior to an open biopsy to confirm the pathology of the lesions, she underwent a single cranial computed tomography scan and a single cranial digital subtraction angiography for a transcranial biopsy. Fourteen days after the first magnetic resonance image - 12 and eight days after the computed tomography scan and digital subtraction angiography, respectively - a pre-operative magnetic resonance image was taken, which showed a notable synchronous shrinkage of the third ventricle tumor, as well as shrinkage of the lesions in the pineal region and in the fourth ventricle. She did not undergo steroid administration until after a biopsy that confirmed the pathological diagnosis of pure germinoma. She then underwent whole craniospinal irradiation and went into a complete remission. Conclusions In our case report, we state that diagnostic radiation can induce the regression of germinomas; this is the most reasonable explanation for the synchronous multiple regression observed in this case of germinoma. Clinicians should keep this non-spontaneous regression in mind and monitor germinoma lesions with minimal exposure to diagnostic radiation before diagnostic confirmation, and also before radiation treatment with or

CT diagnosis of thyroid carcinoma

International Nuclear Information System (INIS)

Luo Dehong; Shi Mulan; Luo Douqiang

1998-01-01

Purpose: To study the CT appearances of thyroid carcinoma and its cervical metastatic lymphadenopathy, as well as to evaluate the diagnostic criteria of tumor invasion of adjacent structures. Methods: CT findings of surgery and pathology proved thyroid carcinoma in 52 patients were analyzed. Results: All of the primary tumor were heterogeneous in density, 32 tumors (82.5%) were ill-defined. Fine granular calcifications were revealed in 11 primary tumors and metastatic lymph nodes in 5 cases. Cystic formation with intracystic high density papillary-like nodules were found in 4 primary tumors and metastatic lymphadenopathy in 5 cases. Trachea, esophagus and carotic artery invasion were proved by surgery in 22, 21 and 10 cases respectively. Serrated inner wall and tumor nodule protrusion into tracheal lumen were the definite signs of trachea invasion. Use tumor encasement over 1/2 of the circumference of esophagus and 1/3 of the circumference of carotid artery as the diagnostic criterion of invasion, sensitivity was 71.4%, 100.0% specificity was 96.3%, 95.2% respectively. Conclusion: Fine granular calcification and cystic formation with high attenuation intracystic papillary-like nodules were characteristic manifestations of primary thyroid carcinoma (especially papillary carcinoma) and its metastatic lymphadenopathy as well. Contrast enhanced CT scan is helpful in the diagnosis of thyroid carcinoma and the delineation of tumor extent, which is very important in surgical planning

Primary lymphoma of the breast involving both axillae with bilateral breast carcinoma

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Rubin Gary

2008-05-01

Full Text Available Abstract Background Primary Non-Hodgkin's Lymphoma (PHNL of the breast is a rare entity, while secondary involvement of the breast with diffuse disease of Non-Hodgkin's lymphoma (NHL is more common. However, PNHL is the most frequent haematopoietic tumour of the breast. Diagnostic criteria for PNHL of the breast are presence of technically adequate pathologic specimens, close association of mammary tissue and lymphomatous infiltrate, no prior diagnosis of an extarammamary lymphoma, and no evidence of concurrent widespread disease, except for ipsilateral axillary lymph nodes if concomitant with the primary lesion. Case presentation A 57-year-old woman was recalled because her screening mammograms revealed three separate lesions in her right breast and one in the left. Histology of the lesions confirmed lymphoma in one breast with ductal carcinoma in the other. Conclusion Most of reported cases in literature have been involving the right breast, and almost all the patients were females. NHLs of the breast typically present as unilateral mass; the frequency of bilateral disease at first presentation ranges from 5–25%. Our objective is to report a case of primary lymphoma of the breast involving both axillae with concomitant bilateral primary breast cancer which has not been reported yet to our best of knowledge in literature.

Primary Gastric Small Cell Carcinoma in Elderly Patients: A Case Report and Review of the Literature

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Jian-Han Lai

2017-03-01

Full Text Available We report the case of an 86-year-old man with primary gastric small cell carcinoma (SmCC. He was admitted to our hospital owing to gastrointestinal bleeding complicated by anemia. An upper gastrointestinal endoscopic examination revealed a large, irregularly ulcerated tumor on the upper to middle body of the stomach. Small cell carcinoma was diagnosed based on the results of histologic and immunohistochemical studies of an endoscopic biopsy specimen. According to previous reports of gastric SmCC, only one-sixth of cases have been correctly diagnosed preoperatively. In our case, it was an aggressive malignancy that had an extremely poor prognosis. We believe that careful endoscopic examination including immunohistochemical investigation is necessary to accurately diagnose gastric SmCC in clinical practice.

Somatostatin receptor scintigraphy on thyroid carcinoma

International Nuclear Information System (INIS)

Pan Weimin; Tan Tianzhi

2004-01-01

Purpose: To study the diagnostic value and clinical method of somatostatin receptor scintigraphy on thyroid carcinoma using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent; Methods: Somatostatin receptor scintigraphy (SRS) were performed on 25 patients with thyroid carcinoma, using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent, controlling with 131 I- whole- body- imaging(1312 -WBI). Results: Of 4 patients with MTC (medullary thyroid carcinoma), positive metastasis and primary tumour were detected on 3 patients by SRS, negative results were obtained by 131 I-WBI, the positive detective rate by SRS is 3/4; of 12 patients with PTC (papillary thyroid carcinoma), positive metastasis and primary tumour were detected on 2 patients by SRS or 131 I-WBI,1 of which only by SRS, while negative results were obtained by 131 I- WBI, the positive detective rate by SRS is 3/12; of 8 patients with FTC(follicular thyroid carcinoma), positive metastasis and primary tumour were detected on 1 patients by SRS or 131 I-WBI, and 2 positive results were obtained only by SRS, while negative by 131 I-WBI, the positive detective rate by SRS is 3/8; of 1 patients with HCC (hurthle cell carcinoma ), positive metastasis and primary tumour were detected by SRS, while negative by 131 I-WBI; Conclusions: SRS using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent has high diagnostic value on thyroid carcinoma, especially on MTC and HCC. (authors)

Long-term results of synchronized radiotherapy in squamous cell carcinomas

International Nuclear Information System (INIS)

Esser, E.; Wannenmacher, M.

1979-01-01

Two clinical pilot investigations concerning the so-called synchronised radiotherapy of inoperable oral cavity-oropharynx carcinomas are compared. There are no considerable therapeutical differences. Synchronisation-caused partial effects cannot be manifested clinically. Generally, chemoradiotherapy seems to bring an improvement of the short-term results, with an increased rate of side effects. (orig.) 891 MG/orig. 892 RDG [de

Primary Carcinoma of the Gallbladder

OpenAIRE

Paraskevopoulos, John A.; Dennison, Ashley R.; Johnson, Alan G.

1991-01-01

Carcinoma of the gallbladder is a relatively rare malignancy which is difficult to diagnose. The advent of improved imaging methods and the expansion of interventional radiology however, combined with advances in surgical technique, has produced a change in attitude towards this tumour. The available world literature since 1960 has been reviewed and is presented in this article. However, whilst the outlook for diagnosis and treatment is improving, clearly the association with cholelithiasis (...

A consecutive series of patients with laryngeal carcinoma treated by primary irradiation

International Nuclear Information System (INIS)

Greisen, O.; Carl, J.; Pedersen, M.

1997-01-01

In Denmark there is an increasing frequency of laryngeal carcinoma, in particular in women and among these especially in supraglottic tumours. The incidence during the past 20 years has risen from about 40 to 60 cases per million per year. A series of 335 consecutive patients treated with primary radiation is presented. In one-third of all patients the tumour was localized in the supraglottic area; in women in more than half and in men in about one-fourth of the cases. The frequency of primary lymph node metastases in the supraglottic and the glottic tumours was 24% and 2% respectively. A multivariate analysis identified sex and tumour size as independent prognostic parameters of local control. Five-year survival corrected for intercurrent deaths was obtained in 59% of all cases, in 56% of supraglottic and in 92% of glottic tumours. A multivariate analysis defined localization, tumour grade and stage as independent prognostic parameters of survival. Salvage surgery was performed in about 32% of the cases, total laryngectomy in 26%, and partial laryngectomy in 6%. The survival rate among all total laryngectomies was 55%. A tracheostomy during or before radiation treatment prior to total laryngectomy had no influence on complication rate, admission time or recurrence rate. The frequency of pharyngo-cutaneous fistulae in the entire series was 11.5%; after routine use of metronidazol, however, only 5.7%. Radical neck dissection was carried out in 7.8% of the cases, by far most in the supraglottic group, only a few in the glottic carcinomas, in three-fourth in connection with a laryngectomy and in one-fourth without local recurrence in the larynx. (orig.)

A consecutive series of patients with laryngeal carcinoma treated by primary irradiation

Energy Technology Data Exchange (ETDEWEB)

Greisen, O. [ENT Dept. and the Oncological Dept., Aalborg Sygehus (Denmark); Carl, J. [ENT Dept. and the Oncological Dept., Aalborg Sygehus (Denmark); Pedersen, M. [ENT Dept. and the Oncological Dept., Aalborg Sygehus (Denmark)

1997-09-01

In Denmark there is an increasing frequency of laryngeal carcinoma, in particular in women and among these especially in supraglottic tumours. The incidence during the past 20 years has risen from about 40 to 60 cases per million per year. A series of 335 consecutive patients treated with primary radiation is presented. In one-third of all patients the tumour was localized in the supraglottic area; in women in more than half and in men in about one-fourth of the cases. The frequency of primary lymph node metastases in the supraglottic and the glottic tumours was 24% and 2% respectively. A multivariate analysis identified sex and tumour size as independent prognostic parameters of local control. Five-year survival corrected for intercurrent deaths was obtained in 59% of all cases, in 56% of supraglottic and in 92% of glottic tumours. A multivariate analysis defined localization, tumour grade and stage as independent prognostic parameters of survival. Salvage surgery was performed in about 32% of the cases, total laryngectomy in 26%, and partial laryngectomy in 6%. The survival rate among all total laryngectomies was 55%. A tracheostomy during or before radiation treatment prior to total laryngectomy had no influence on complication rate, admission time or recurrence rate. The frequency of pharyngo-cutaneous fistulae in the entire series was 11.5%; after routine use of metronidazol, however, only 5.7%. Radical neck dissection was carried out in 7.8% of the cases, by far most in the supraglottic group, only a few in the glottic carcinomas, in three-fourth in connection with a laryngectomy and in one-fourth without local recurrence in the larynx. (orig.).

Synchronization and anti-synchronization coexist in Chen-Lee chaotic systems

International Nuclear Information System (INIS)

Chen, J.-H.; Chen, H.-K.; Lin, Y.-K.

2009-01-01

This study demonstrates that synchronization and anti-synchronization can coexist in Chen-Lee chaotic systems by direct linear coupling. Based on Lyapunov's direct method, a linear controller was designed to assure that two different types of synchronization can simultaneously be achieved. Further, the hybrid projective synchronization of Chen-Lee chaotic systems was studied using a nonlinear control scheme. The nonlinear controller was designed according to the Lyapunov stability theory to guarantee the hybrid projective synchronization, including synchronization, anti-synchronization, and projective synchronization. Finally, numerical examples are presented in order to illustrate the proposed synchronization approach.

Differential metabonomic profiles of primary hepatocellular carcinoma tumors from alcoholic liver disease, HBV-infected, and HCV-infected cirrhotic patients

OpenAIRE

Cao, Ding; Cai, Can; Ye, Mingxin; Gong, Junhua; Wang, Menghao; Li, Jinzheng; Gong, Jianping

2017-01-01

Our objective was to comparatively profile the metabolite composition of primary hepatocellular carcinoma (HCC) tumors from alcoholic liver disease (ALD), hepatitis B virus (HBV)-infected, and hepatitis C virus (HCV)-infected cirrhotic patients. Primary HCC tumors were collected from ALD, HBV-infected, and HCV-infected cirrhotic patients (n=20 each). High-resolution magic-angle spinning proton nuclear magnetic resonance spectroscopy and metabonomic data analysis were performed to compare HCC ...

Presumed choroidal metastasis of Merkel cell carcinoma

International Nuclear Information System (INIS)

Small, K.W.; Rosenwasser, G.O.; Alexander, E. III; Rossitch, G.; Dutton, J.J.

1990-01-01

Merkel cell carcinoma is a rare skin tumor of neural crest origin and is part of the amine precursor uptake and decarboxylase system. It typically occurs on the face of elderly people. Distant metastasis is almost uniformly fatal. Choroidal metastasis, to our knowledge, has not been described. We report a patient with Merkel cell carcinoma who had a synchronous solid choroidal tumor and a biopsy-proven brain metastasis. Our 56-year-old patient presented with a rapidly growing, violaceous preauricular skin tumor. Computed tomography of the head disclosed incidental brain and choroidal tumors. Light and electron microscopy of biopsy specimens of both the skin and the brain lesions showed Merkel cell carcinoma. Ophthalmoscopy, fluorescein angiography, and A and B echography revealed a solid choroidal mass. The brain and skin tumors responded well to irradiation. A radioactive episcleral plaque was applied subsequently to the choroidal tumor. All tumors regressed, and the patient was doing well 28 months later. To our knowledge this is the first case of presumed choroidal metastasis of Merkel cell carcinoma

Extracranial stereotactic radiotherapy for primary and metastatic renal cell carcinoma

International Nuclear Information System (INIS)

Wersaell, Peter J.; Blomgren, Henric; Lax, Ingmar; Kaelkner, Karl-Mikael; Linder, Christina; Lundell, Goeran; Nilsson, Bo; Nilsson, Sten; Naeslund, Ingemar; Pisa, Pavel; Svedman, Christer

2005-01-01

Background and purpose: We investigated the results of using stereotactic radiotherapy (SRT) for 58 patients with renal cell carcinomas (RCC) who were evaluated restrospectively for response rates, local control rates and side effects. Patients and methods: From October 1997 to January 2003, 50 patients suffering from metastatic RCC and eight patients with inoperable primary RCC received high-dose fraction SRT while placed in a stereotactic body-frame. The most common dose/fractionation schedules used were 8 Gyx4, 10 Gyx4 and 15 Gyx3 during approximately 1 week. Results: SRT-treated tumor lesions regressed totally in 30% of the patients at 3-36 months, whereas 60% of the patients had a partial volume reduction or no change after a median follow-up of 37 months (SD 17.4) for censored and 13 months (SD 12.9) for uncensored patients. Side effects were generally mild. Of 162 treated tumors, only three recurred, yielding a local control rate of 90-98%, considering the 8% non-evaluable sites as defined here. For patients with one to three metastases, the time to new spread was 9 months. Conclusions: Our use of SRT for patients with primary and metastatic RCC yielded a high local control rate with low toxicity. Patients with one to three metastases, local recurrences after nephrectomy or inoperable primary tumors benefited the most, i.e. had fewer distant recurrences (13/23) and longer survival times compared to patients with >3 metastases (24/27 recurrences)

Head and neck: treatment of primary and relapsed nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wang, C.C.

1995-01-01

Purpose/Objective: Nasopharyngeal carcinoma (NPC) is not a common malignancy of the head and neck in the United States and presents a great challenge to the radiation oncologists in this country. Its management is radiotherapeutic and technically demanding and calls for careful treatment techniques to include the primary and the lymphatic drainage areas to high doses while sparing the neighboring organs such as the spinal cord, eyes, temporal lobes and midrain. This refresher course will review the clinical course, pattern of spread with manifestations of various neurologic syndromes of the disease. The radiotherapeutic management of primary lesion will be discussed in detail including the treatment techniques, placement of the irradiation portals, dose levels, etc. Treatment results as reported in the literature as well as those achieved at the MGH will be presented. Special emphasis will be placed on the routine use of intracavitary implant to boost the primary site and its technical aspects. Relapsed NPC after previous radiation therapy presents a difficult problem in management, but can be re-irradiated with occasional success by observing careful technique and fractionated intracavitary brachytherapy and the local control rates will be briefly covered. Recurrent disease in the neck will be managed by neck dissection. Xerostomia is undesirable and common sequelae following radical radiation therapy for NPC. Efforts are being made to decrease its magnitude by using higher energies of photons, i.e. 10 MV to spare a portion of the parotid glands with some promising results. Because of the unique location of the primary lesion, currently a modified BID program (MBID) is used and its techniques and treatment concept are discussed

Short-term incubation in vitro with precursors of nucleic acids on human primary tumors and metastases of carcinoma of the breast

Energy Technology Data Exchange (ETDEWEB)

Kaufmann, M; Kubli, F; Volm, M; Fournier, D V; Reus, W [Heidelberg Univ. (Germany, F.R.). Frauenklinik; Deutsches Krebsforschungszentrum, Heidelberg (Germany, F.R.). Inst. fuer Experimentelle Pathologie)

1978-04-01

A technique of short-term tests in vitro by means of the incubation of tumor cell suspensions is utilized as a radioactive-biochemical method for pretherapeutic determination of the resistance in human cancers of the breast. Cell suspensions from primary tumors and metastases reveal individually different responses to cytostatics in vitro. It is possible, therewith, to differentiate two tumor collectives related to in vivo resistant or in vivo sensitive tumors. The responses of the primary lesion and the axillary lymphatic metastasis of the same carcinoma may in single cases also differ in vitro, according to clinical experience with the therapy of breast cancer. A distinct relation can be shown between the histological type of a carcinoma and its in vitro capacity of resistance.

Does synchronization reflect a true interaction in the cardiorespiratory system?

Science.gov (United States)

Toledo, E; Akselrod, S; Pinhas, I; Aravot, D

2002-01-01

Cardiorespiratory synchronization, studied within the framework of phase synchronization, has recently raised interest as one of the interactions in the cardiorespiratory system. In this work, we present a quantitative approach to the analysis of this nonlinear phenomenon. Our primary aim is to determine whether synchronization between HR and respiration rate is a real phenomenon or a random one. First, we developed an algorithm, which detects epochs of synchronization automatically and objectively. The algorithm was applied to recordings of respiration and HR obtained from 13 normal subjects and 13 heart transplant patients. Surrogate data sets were constructed from the original recordings, specifically lacking the coupling between HR and respiration. The statistical properties of synchronization in the two data sets and in their surrogates were compared. Synchronization was observed in all groups: in normal subjects, in the heart transplant patients and in the surrogates. Interestingly, synchronization was less abundant in normal subjects than in the transplant patients, indicating that the unique physiological condition of the latter promote cardiorespiratory synchronization. The duration of synchronization epochs was significantly shorter in the surrogate data of both data sets, suggesting that at least some of the synchronization epochs are real. In view of those results, cardiorespiratory synchronization, although not a major feature of cardiorespiratory interaction, seems to be a real phenomenon rather than an artifact.

Late Lung Metastasis of a Primary Eccrine Sweat Gland Carcinoma 10 Years after Initial Surgical Treatment: The First Clinical Documentation

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R. F. Falkenstern-Ge

2013-01-01

Full Text Available Background. Sweat gland carcinoma is a rare malignancy with a high metastatic potential seen more commonly in elderly patients. The scalp is the most common site of occurrence and it usually spreads to regional lymph nodes. Liver, lungs, and bones are the most common sites of distant metastasis. Late lung metastasis of sweat gland adenocarcinoma after a time span of 5 years is extremely rare. Aim. We report a patient with late lung metastasis of a primary sweat gland carcinoma 10 years after initial surgical resection. Conclusion. Sweat gland carcinomas are rare cancers with a poor prognosis. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Late pulmonary metastases with a latency of 10 years have never been reported in the literature. This is the first clinical documentation of late lung metastasis from sweat gland carcinoma with a latency period of 10 years.

Designing Learning Resources in Synchronous Learning Environments

DEFF Research Database (Denmark)

Christiansen, Rene B

2015-01-01

Computer-mediated Communication (CMC) and synchronous learning environments offer new solutions for teachers and students that transcend the singular one-way transmission of content knowledge from teacher to student. CMC makes it possible not only to teach computer mediated but also to design...... and create new learning resources targeted to a specific group of learners. This paper addresses the possibilities of designing learning resources within synchronous learning environments. The empirical basis is a cross-country study involving students and teachers in primary schools in three Nordic...... Countries (Denmark, Sweden and Norway). On the basis of these empirical studies a set of design examples is drawn with the purpose of showing how the design fulfills the dual purpose of functioning as a remote, synchronous learning environment and - using the learning materials used and recordings...

Synchronous advanced gastric adenocarcinoma and advanced esophageal squamous cell carcinoma

Directory of Open Access Journals (Sweden)

Fernando Augusto Mardiros Herbella

2002-01-01

Full Text Available CONTEXT: Synchronous associations of esophageal and gastric cancers are not a common finding, especially with differing histological types and both tumors in advanced forms. A case with such an association is presented, in which an unusual therapy was proposed: palliative gastrectomy and esophageal intubation. CASE REPORT: A 75-year-old white man was referred to our service complaining of malaise and weight loss for one year and dysphagia and vomiting for 2 months. The patient had sought out medical consultation as a result of the latter two complaints.

Primary control of upper gingiva and hard palate squamous cell carcinoma. A clinical evaluation

International Nuclear Information System (INIS)

Beppu, Takeshi; Mitani, Hiroki; Kawabata, Kazuyoshi

2005-01-01

The primary control of upper gingiva and hard palate squamous cell carcinoma was evaluated clinically. From 1985 to 1999, there were 51 cases that received definitive treatment in our hospital with a primary control rate of 70.6%. The primary control rates according to treatment modality were: 73.3% for surgery alone (69.2% for partial maxillectomy, 80% for total maxillectomy); 71.4% for definitive radiation therapy; and 68% for combined surgery and radiation therapy. The primary control rates according to the T stage were: 85.7% for T1; 60% for T2; 77.8% for T3; and 80% for T4. In general, primary control was better when the tumor was located anteriorly rather than posterolaterally in the oral cavity. Frequent recurrent sites following the operation were the infratemporal fossa and/or the pterygopalatine fossa, especially when the tumor had been located posterolaterally. In such cases, a salvage operation was often impossible, and the uncontrollable primary lesion progressed and caused death. Therefore, when the tumor is located posterolaterally, and especially if it has invaded deeply into the infratemporal fossa and the pterygopalatine fossa, it is vitally important to properly plan the surgical approach and to ensure a good visual operative field. (author)

Malignant Solitary Fibrous Tumor Metastatic to Widely Invasive Hurthle Cell Thyroid Carcinoma: A Distinct Tumor-to-Tumor Metastasis.

Science.gov (United States)

Kolson Kokohaare, Eva; Riva, Francesco M G; Bernstein, Jonathan M; Miah, Aisha B; Thway, Khin

2018-04-01

We illustrate a case of synchronous malignant solitary fibrous tumor of the thoracic cavity, and widely invasive thyroid Hurthle cell carcinoma. The Hurthle cell carcinoma was found to harbor distinct areas of malignant solitary fibrous tumor. This is a unique case of tumor-to-tumor metastasis that, to the best of our knowledge, has not been previously reported.

Primary epithelial myoepithelial carcinoma of lung, reporting of a rare entity, its molecular histogenesis and review of the literature.

Science.gov (United States)

Arif, Farzana; Wu, Susan; Andaz, Shahriyour; Fox, Stewart

2012-01-01

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

Scrotal metastases from colorectal carcinoma: a case report.

LENUS (Irish Health Repository)

McWeeney, Doireann M

2012-01-31

ABSTRACT: A 72-year-old man presented with a two month history of rectal bleeding. Colonoscopy demonstrated synchronous lesions at 3 cm and 40 cm with histological analysis confirming synchronous adenocarcinomata. He developed bilobar hepatic metastases while undergoing neoadjuvant chemoradiotherapy. Treatment was complicated by Fournier\\'s gangrene of the right hemiscrotum which required surgical debridement. Eight months later he re-presented with an ulcerating lesion on the right hemiscrotum. An en-bloc resection of the ulcerating scrotal lesion and underlying testis was performed. Immunohistological analysis revealed metastatic adenocarcinoma of large bowel origin. Colorectal metastasis to the urogenital tract is rare and here we report a case of rectal carcinoma metastasizing to scrotal skin.

Primary invasive carcinoma of the vagina after Le Fort partial colpocleisis for stage IV pelvic organ prolapse: a case report.

Science.gov (United States)

Cho, Moon Kyoung; Kim, Chul Hong; Kim, Yoon Ha

2011-11-01

We present here the case report of a postmenopausal woman who complained of recurrent pus-like vaginal discharge and perianal pain 1 year after Le Fort colpocleisis, which was subsequently identified as a primary invasive carcinoma of the vagina. Biopsy confirmed a squamous cell carcinoma in the vagina, and the disease was classified as stage III according to FIGO staging. The patient received pelvic radiotherapy. This case emphasizes that differential diagnosis of recurrent vaginal discharge that presents remote from obliterative procedure for pelvic organ prolapse should consider not only pyometra, but also other causes.

Primary Sjogren%u2019s Syndrome Associated with Basal Cell Carcinoma: Case Report

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Tugba Kosker

2013-04-01

Full Text Available Sjogren%u2019s syndrome is a chronic autoimmune disease characterized by xerostomia and xerophthalmia, known as the %u2018sicca symptoms%u2019. Patients with Sjogren%u2019s syndrome, characteristically have positive nuclear and cytoplasmic antigens, typically Anti-Ro/SSA and Anti-La/SSB because of lymphocytic infiltration of the exocrine glands. Patients with primary Sjogren%u2019s syndrome, develop systemic complications, non-Hodgkin lymphoma being the most feared of these. We describe here a case of Sjogren%u2019s syndrome with basal cell carcinoma, which presented with an ulcerated lesion on nasal dorsum.

Lobular breast carcinoma with colonic metastases: A synchronous diagnosis in a 4-day period

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Raquel Albero-González

2017-03-01

Full Text Available Lobular breast carcinoma involving the colon is a rare condition. In most cases reported in the literature, metastases are detected after a 20-year latency period after the initial diagnosis. Here we describe a case in which metastatic lobular breast carcinoma and colonic metastasis were simultaneously diagnosed—with only 4 days between the two diagnoses. A 55-year-old woman underwent mammography and colonoscopy in the setting of the National Cancer Screening Program. A malignant nodule in the left breast was detected, and core-biopsy revealed an invasive lobular carcinoma. Simultaneously, numerous intestinal micropolyps were sampled. Histological examination of the latter showed tumor cells growing in cords and presenting signet-ring appearance, thereby confirming metastatic breast carcinoma. In cases such as the one described here, pathological diagnosis can be extremely difficult and deep biopsies are required. Metastatic breast cancer involving the colon can be considerably underestimated because of the unspecificity of the clinical manifestations, the long latency period, and diverse radiological findings that can lead to misdiagnosis. We conclude that clinicians should rule out intestinal metastasis in patients diagnosed with breast cancer, especially the lobular type, and presenting non-specific abdominal symptoms.

Facial nerve palsy as a primary presentation of advanced carcinoma ...

African Journals Online (AJOL)

A. Abdulkadir

2016-07-02

Jul 2, 2016 ... advanced carcinoma of the prostate: An unusual occurrence. A. Abdulkadira,∗ ... PSA was 116 ng/ml and the six cores of the digital guided prostate biopsy taken all .... Benign prostatic hyperplasia and prostate carcinoma in ...

Small cell type neuroendocrine carcinoma colliding with squamous cell carcinoma at esophagus

Science.gov (United States)

Yang, Luoluo; Sun, Xun; Zou, Yabin; Meng, Xiangwei

2014-01-01

Collision tumor is an extremely rare tumor which defined as the concrescence of two distinct primaries neoplasms. We report here a case of collision tumor at lower third esophagus composed of small cell type neuroendocrine carcinoma (NEC), which is an very rare, highly aggressive and poorly prognostic carcinoma and squamous cell carcinoma (SqCC). In our case, pathologically, the small cell carcinoma display the characteristic of small, round, ovoid or spindle-shaped tumor cells with scant cytoplasm, which colliding with a moderately differentiated squamous cell carcinoma. Immunohistochemical staining demonstrated positive activities for CD56, synaptophysin, 34βE12, CK 5/6, ki-67 (70%-80%), but negative for CD99, chromogranin A, and TTF-1. Accurate diagnosis was made base on these findings. PMID:24817981

Lymph node metastasis in the biliary tract carcinoma: CT evaluation

International Nuclear Information System (INIS)

Lee, Byung Hee; Lee, Ah Ra; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil

1994-01-01

The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinoma. We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocacinima, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. The overall incidence of nodal metastases was 59.8% (55/92); 66.7% in peripheral cholangiocarcinoma, 54.5% in hilar cholangiocarcinoma, 55.6% in gallbladder carcinoma, and 42.9% in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarcinoma. The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma

Lymph node metastasis in the biliary tract carcinoma: CT evaluation

Energy Technology Data Exchange (ETDEWEB)

Lee, Byung Hee; Lee, Ah Ra; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1994-07-15

The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinoma. We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocacinima, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. The overall incidence of nodal metastases was 59.8% (55/92); 66.7% in peripheral cholangiocarcinoma, 54.5% in hilar cholangiocarcinoma, 55.6% in gallbladder carcinoma, and 42.9% in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarcinoma. The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.

Stereological estimates of nuclear volume in the prognostic evaluation of primary flat carcinoma in situ of the urinary bladder

DEFF Research Database (Denmark)

Sørensen, Flemming Brandt; Jacobsen, F

1991-01-01

Primary, flat carcinoma in situ of the urinary bladder is rare and its behaviour is unpredictable. The aim of this retrospective study was to obtain base-line data and investigate the prognostic value of unbiased, stereological estimates of the volume-weighted mean nuclear volume, nuclear vv, in ...

Endogenous synchronous fluorescence spectroscopy (SFS) of basal cell carcinoma-initial study

Science.gov (United States)

Borisova, E.; Zhelyazkova, Al.; Keremedchiev, M.; Penkov, N.; Semyachkina-Glushkovskaya, O.; Avramov, L.

2016-01-01

The human skin is a complex, multilayered and inhomogeneous organ with spatially varying optical properties. Analysis of cutaneous fluorescence spectra could be a very complicated task; therefore researchers apply complex mathematical tools for data evaluation, or try to find some specific approaches, that would simplify the spectral analysis. Synchronous fluorescence spectroscopy (SFS) allows improving the spectral resolution, which could be useful for the biological tissue fluorescence characterization and could increase the tumour detection diagnostic accuracy.

KRAS/BRAF Analysis in Ovarian Low-Grade Serous Carcinoma Having Synchronous All Pathological Precursor Regions

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Kohei Nakamura

2016-04-01

Full Text Available Ovarian low-grade serous carcinoma is thought to begin as a serous cystadenoma or adenofibroma that progresses in a slow stepwise fashion. Among the low-grade serous carcinomas, there is a high frequency of activating mutations in the KRAS or BRAF genes; however, it remains unclear as to how these mutations contribute to tumor progression. This is the first report to track the histopathological progression of serous adenofibroma to low-grade serous carcinoma. Each stage was individually analyzed by pathological and molecular genetic methods to determine what differences occur between the distinct stages of progression.

Serous tubal intraepithelial carcinoma: its potential role in primary peritoneal serous carcinoma and serous cancer prevention.

Science.gov (United States)

Carlson, Joseph W; Miron, Alexander; Jarboe, Elke A; Parast, Mana M; Hirsch, Michelle S; Lee, Yonghee; Muto, Michael G; Kindelberger, David; Crum, Christopher P

2008-09-01

A diagnosis of primary peritoneal serous carcinoma (PPSC) requires exclusion of a source in other reproductive organs. Serous tubal intraepithelial carcinoma (STIC; stage 0) has been described in asymptomatic women with BRCA mutations and linked to a serous cancer precursor in the fimbria. This study examined the frequency of STIC in PPSC and its clinical outcome in BRCA-positive women. Presence or absence of STIC was recorded in consecutive cases meeting the 2001 WHO criteria for PPSC, including 26 patients with nonuniform sampling of the fallopian tubes (group 1) and 19 patients with complete tubal examination (group 2; sectioning and extensively examining the fimbriated end, or SEE-FIM protocol). In selected cases, STIC or its putative precursor and the peritoneal tumor were analyzed for p53 mutations (exons 1 to 11). Outcome of STIC was ascertained by literature review. Thirteen (50%) of 26 PPSCs in group 1 involved the endosalpinx, with nine STICs (35%). Fifteen (79%) of 19 cases in group 2 contained endosalpingeal involvement, with nine STICs (47%). STIC was typically fimbrial and unifocal, with variable invasion of the tubal wall. In five of five cases, the peritoneal and tubal lesion shared an identical p53 mutation. Of 10 reported STICs in BRCA-positive women, all patients were without disease on follow-up. The fimbria is the source of nearly one half of PPSCs, suggesting serous malignancy originates in the tubal mucosa but grows preferentially at a remote peritoneal site. The generally low risk of recurrence in stage 0 (STIC) disease further underscores STIC as a possible target for early serous cancer detection and prevention.

Molecular Events in Primary and Metastatic Colorectal Carcinoma: A Review

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Rani Kanthan

2012-01-01

Full Text Available Colorectal cancer (CRC is a heterogeneous disease, developing through a multipathway sequence of events guided by clonal selections. Pathways included in the development of CRC may be broadly categorized into (a genomic instability, including chromosomal instability (CIN, microsatellite instability (MSI, and CpG island methylator phenotype (CIMP, (b genomic mutations including suppression of tumour suppressor genes and activation of tumour oncogenes, (c microRNA, and (d epigenetic changes. As cancer becomes more advanced, invasion and metastases are facilitated through the epithelial-mesenchymal transition (EMT, with additional genetic alterations. Despite ongoing identification of genetic and epigenetic markers and the understanding of alternative pathways involved in the development and progression of this disease, CRC remains the second highest cause of malignancy-related mortality in Canada. The molecular events that underlie the tumorigenesis of primary and metastatic colorectal carcinoma are detailed in this manuscript.

Melanoma patients with unknown primary site or nodal recurrence after initial diagnosis have a favourable survival compared to those with synchronous lymph node metastasis and primary tumour.

Directory of Open Access Journals (Sweden)

Benjamin Weide

Full Text Available BACKGROUND: A direct comparison of prognosis between patients with regional lymph node metastases (LNM detected synchronously with the primary melanoma (primary LNM, patients who developed their first LNM subsequently (secondary LNM and those with initial LNM in melanoma with unknown primary site (MUP is missing thus far. PATIENTS AND METHODS: Survival of 498 patients was calculated from the time point of the first macroscopic LNM using Kaplan Meier and multivariate Cox hazard regression analysis. RESULTS: Patients with secondary LNM (HR = 0.67; p = 0.009 and those with initial LNM in MUP (HR = 0.45; p = 0.008 had a better prognosis compared to patients with primary LNM (median survival time 52 and 65 vs. 24 months, respectively. A high number of involved nodes, the presence of in-transit/satellite metastases and male gender had an additional independent unfavourable effect. CONCLUSIONS: Survival of patients with LNM in MUP and with secondary LNM is similar and considerably more favourable compared to those with primary LNM. This difference needs to be considered during patient counselling and for stratification purposes in clinical trials. The assumption of an immune privilege of patients with MUP which is responsible for rejection of the primary melanoma, and results in a favourable prognosis is not supported by our data.

Evaluation of the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization ( TACE treatment

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Yong Zeng

2018-01-01

Full Text Available Objective: To analyze the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization (TACE treatment. Methods: A total of 68 cases of patients with primary hepatocellular carcinoma treated in our hospital from September 2011 to December 2014 were enrolled for study and divided into observation group 34 cases and control group 34 cases according to different treatment methods. Control group received transcatheter arterial chemoembolization (TACE treatment, observation group received endostar combined with TACE treatment, and then differences in serum amino acid levels, micro RNA levels, levels of GP73, GPC3, GS, etc as well as levels of ChE, TBA and AFP were compared between two groups after treatment. Results: Serum aspartic acid, leucine and arginine levels of observation group after treatment were higher than those of control group, and αα-aminoadipic acid, methionine, β-alanine and 3-methylhistidine levels were lower than those of control group; relative values of serum miR-106b, miR-222 and miR-21 expression of observation group after treatment were lower than those of control group, and relative values of miR-199a and miR-122 expression were higher than those of control group; GP73, IL-17, IL-6, GPC3, GS and HSP70 levels of observation group after treatment were lower than those of control group, and endostatin level was higher than that of control group; ChE level of observation group after treatment was higher than that of control group, and TBA and AFP levels were lower than those of control group. Conclusion: Endostar combined with TACE treatment for patients with primary hepatocellular carcinoma can effectively inhibit tumor proliferation, invasion and other malignant processes and improve liver function, and it has positive clinical significance.

Synchronous Computer-Mediated Communication and Interaction

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Ziegler, Nicole

2016-01-01

The current study reports on a meta-analysis of the relative effectiveness of interaction in synchronous computer-mediated communication (SCMC) and face-to-face (FTF) contexts. The primary studies included in the analysis were journal articles and dissertations completed between 1990 and 2012 (k = 14). Results demonstrate that interaction in SCMC…

A diagnostic dilemma following risk-reducing surgery for BRCA1 mutation – a case report of primary papillary serous carcinoma presenting as sigmoid cancer

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Nash Guy F

2007-09-01

Full Text Available Abstract Background Women that carry germ-line mutations for BRCA1 or BRCA2 genes are at an increased risk of developing breast, ovarian and peritoneal cancer. Primary peritoneal carcinoma is a rare tumour histologically identical to papillary serous ovarian carcinoma. Risk-reducing surgery in the form of mastectomy and oophorectomy in premenopausal women has been recommended to prevent breast and ovarian cancer occurrence and decrease the risk of developing primary peritoneal cancer. Case presentation We present a case report of a woman with a strong family history of breast cancer who underwent risk-reducing surgery in the form of bilateral salpingo-oophorectomy following a mastectomy for a right-sided breast tumour. Following the finding of a BRCA1 mutation, a prophylactic left-sided mastectomy was performed. After remaining well for twenty-seven years, she presented with rectal bleeding and altered bowel habit, and was found to have a secondary cancer of the sigmoid colon. She was finally diagnosed with primary papillary serous carcinoma of the peritoneum (PSCP. Conclusion PSCP can present many years after risk-reducing surgery and be difficult to detect. Surveillance remains the best course of management for patients with known BRCA mutations.

Intestinal lymphangiectasia mimicking primary peritoneal carcinoma.

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Steines, Jennifer C; Larson, Joshua H; Wilkinson, Neal; Kirby, Patricia; Goodheart, Michael J

2010-10-01

Intestinal lymphangiectasia is an obstruction of the lymphatic system. We report on a patient with mesenteric adenopathy and an elevated CA125 level, which were suspicious for peritoneal carcinoma. Further evaluation and bowel resection identified intestinal lymphangiectasia. This disease should be considered in patients with mesenteric adenopathy and a small bowel mass. Copyright © 2010 Mosby, Inc. All rights reserved.

Prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy for locally advanced breast carcinoma.

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Machiavelli, M R; Romero, A O; Pérez, J E; Lacava, J A; Domínguez, M E; Rodríguez, R; Barbieri, M R; Romero Acuña, L A; Romero Acuña, J M; Langhi, M J; Amato, S; Ortiz, E H; Vallejo, C T; Leone, B A

1998-01-01

The prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy was assessed in patients with noninflammatory locally advanced breast carcinoma. Between January 1989 and April 1995, 148 consecutive patients with locally advanced breast carcinoma participated in the study. Of these, 140 fully evaluable patients (67, stage IIIA; 73, stage IIIB) were treated with three courses of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC), followed by modified radical mastectomy when technically feasible or definitive radiation therapy. The median age was 53 years (range, 26 to 75 years); 55% of patients were postmenopausal. Objective response was recorded in 99 of 140 patients (71%; 95% confidence interval, 63% to 79%). Complete response occurred in 11 patients (8%), and partial response occurred in 88 patients (63%). No change was recorded in 37 patients (26%), and progressive disease occurred in 4 patients (3%). One hundred and thirty-six patients underwent the planned surgery. Maximal pathological response of the primary tumor (in situ carcinoma or minimal microscopic residual tumor) was observed in 24 (18%); 112 patients (82%) presented minimal pathological response of the primary tumor (gross residual tumor). The number of metastatic axillary nodes after neoadjuvant chemotherapy was as follows: N0, 39 patients (29%); N1-N3, 35 patients (26%); > N3, 62 patients (45%). Considering the initial TNM status, 75% of the patients had decreases in tumor compartment after neoadjuvant chemotherapy. Also, 31% and 23% of patients with clinical N1 and N2, respectively, showed uninvolved axillary lymph nodes. A significant correlation was noted between pathological response of primary tumor and the number of metastatic axillary lymph nodes. Median disease-free survival was 34 months, whereas median overall survival was 66 months. Pathological responses of both primary tumor and metastatic axillary lymph nodes

Initial-Stage Primary Intraosseous Squamous Cell Carcinoma Derived from Odontogenic Keratocyst with Unusual Keratoameloblastomatous Change of the Maxilla: A Case Report and Literature Discussion

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Kentaro Kikuchi

2018-01-01

Full Text Available Primary intraosseous squamous cell carcinoma (PIOSCC is a rare malignant neoplasm derived from odontogenic epithelial remnants in the central jaw bone. Most PIOSCCs originate from odontogenic cysts with a nonkeratinized epithelial lining, especially from radicular/residual and dentigerous cysts. There have been few reports of PIOSCCs derived from the odontogenic keratocyst (OKC, particularly those describing pathological features at the initial stage. The diagnosis of PIOSCC is difficult and based on exclusion of other carcinomas, including metastatic tumors from other primary sites. Here, we report an extremely rare case of initial-stage PIOSCC derived from the OKC with unusual keratoameloblastomatous change of the maxilla.

Clinicopathological comparison of colorectal and endometrial carcinomas in patients with Lynch-like syndrome versus patients with Lynch syndrome.

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Mas-Moya, Jenny; Dudley, Beth; Brand, Randall E; Thull, Darcy; Bahary, Nathan; Nikiforova, Marina N; Pai, Reetesh K

2015-11-01

Screening for DNA mismatch repair (MMR) deficiency in colorectal and endometrial carcinomas identifies patients at risk for Lynch syndrome. Some patients with MMR-deficient tumors have no evidence of a germline mutation and have been described as having Lynch-like syndrome. We compared the clinicopathological features of colorectal and endometrial carcinomas in patients with Lynch-like syndrome and Lynch syndrome. Universal screening identified 356 (10.6%) of 3352 patients with colorectal carcinoma and 72 (33%) of 215 patients with endometrial carcinoma with deficient DNA MMR. Sixty-six patients underwent germline mutation analysis with 45 patients (68%) having evidence of a germline MMR gene mutation confirming Lynch syndrome and 21 patients (32%) having Lynch-like syndrome with no evidence of a germline mutation. Most patients with Lynch-like syndrome had carcinoma involving the right colon compared to patients with Lynch syndrome (93% versus 45%; P Lynch syndrome confirmed by germline mutation analysis. Synchronous or metachronous Lynch syndrome-associated carcinoma was more frequently identified in patients with Lynch syndrome compared to Lynch-like syndrome (38% versus 7%; P = .04). There were no significant differences in clinicopathological variables between patients with Lynch-like syndrome and Lynch syndrome with endometrial carcinoma. In summary, 32% of patients with MMR deficiency concerning Lynch syndrome will have Lynch-like syndrome. Our results demonstrate that patients with Lynch-like syndrome are more likely to have right-sided colorectal carcinoma, less likely to have synchronous or metachronous Lynch syndrome-associated carcinoma, and less likely to demonstrate isolated loss of MSH6 expression within their tumor. Copyright © 2015 Elsevier Inc. All rights reserved.

Appendectomy in the surgical staging of ovarian carcinoma.

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Beşe, T; Kösebay, D; Kaleli, S; Oz, A U; Demirkiran, F; Gezer, A

1996-06-01

Extensive debulking is accepted as the primary method of operative management for carcinoma of the ovary. However, there is no consensus regarding the role of appendectomy in primary surgical treatment. The aim of this study was to assess the role of appendectomy in the surgical staging and cytoreduction of ovarian carcinoma. The study was a retrospective review of 90 primary malignant ovarian carcinoma patients who had an appendectomy in addition to primary cytoreductive surgery. Out of 90 patients, 10 (11.1%) had metastasis to the appendix. The rate of metastasis to the appendix was 11.5% (9/78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non-epithelial ovarian tumors. Of the patients with metastasis in the appendix, malignant epithelial ovarian tumors were identified in 90% (serous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metastases to the appendix in the other histological types. Although metastasis to the appendix was not observed in early stage ovarian carcinomas, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all patients with metastasis to the appendix. Appendectomy for stage I and II patients was not beneficial and did not affect final staging. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytoreductive surgery in early stage (stage I and II) malignant epithelial ovarian tumors. Appendectomy would contribute to the cytoreduction of advanced stage disease if it is macroscopically involved.

Primary pulmonary lymphoepithelioma-like carcinoma on FDG PET/CT

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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.

Squamous cell carcinoma of the breast: a case report

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Hofstee Mans

2008-12-01

Full Text Available Abstract Background Squamous cells are normally not found inside the breast, so a primary squamous cell carcinoma of the breast is an exceptional phenomenon. There is a possible explanation for these findings. Case presentation A 72-year-old woman presented with a breast abnormality suspected for breast carcinoma. After the operation the pathological examination revealed a primary squamous cell carcinoma of the breast. Conclusion The presentation of squamous cell carcinoma could be similar to that of an adenocarcinoma. However, a squamous cell carcinoma of the breast could also develop from a complicated breast cyst or abscess. Therefore, pathological examination of these apparent benign abnormalities is mandatory.

Surgical outcomes for liposarcoma of the lower limbs with synchronous pulmonary metastases.

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Illuminati, Giulio; Ceccanei, Gianluca; Pacilè, Maria Antonietta; Calio, Francesco G; Migliano, Francesco; Mercurio, Valentina; Pizzardi, Giulia; Nigri, Giuseppe

2010-12-01

Surgical resection of pulmonary metastases from soft tissues sarcomas has typically yielded disparate results, owing to the histologic heterogeneity of various series and the presentation times relative to primary tumor discovery. It was our hypothesis that with expeditious, curative surgical resection of both, primary and metastatic disease, patients with liposarcoma of the lower limb and synchronous, resectable, pulmonary metastases might achieve satisfactory outcomes. A consecutive sample clinical study, with a mean follow-up duration of 30 months. Twenty-two patients (mean age, 50 years), each presenting with a liposarcoma of the lower limb and synchronous, resectable, pulmonary metastases, underwent curative resection of both the primary mass and all pulmonary metastases within a mean of 18 days from presentation (range 9-32 days). Mean overall survival was 28 months, disease-related survival (SE) was 9% at 5 years (±9.7%), and disease-free survival was 9% at 5 years (±7.6%). Expeditious, curative resection of both--primary and metastatic lesions--yields acceptable near-term results, with potential for long-term survival, in patients with liposarcoma of the lower limb and synchronous pulmonary metastases. 2010 Wiley-Liss, Inc.

Critical features of coupling parameter in synchronization of small world neural networks

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Li Yanlong; Ma Jun; Xu Wenke; Li Hongbo; Wu Min

2008-01-01

The critical features of a coupling parameter in the synchronization of small world neural networks are investigated. A power law decay form is observed in this spatially extended system, the larger linked degree becomes, the larger critical coupling intensity. There exists maximal and minimal critical coupling intensity for synchronization in the extended system. An approximate synchronization diagram has been constructed. In the case of partial coupling, a primary result is presented about the critical coupling fraction for various linked degree of networks

[Synchronous bilateral breast cancer in a male].

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García-Mejido, José Antonio; Delgado-Jiménez, Carmen; Gutiérrez-Palomino, Laura; Sánchez-Sevilla, Miguel; Iglesias-Bravo, Eva; Caballero-Fernández, Virginia

2013-01-01

male breast cancer is a disease with low incidence, which is further reduced when it comes to bilateral synchronous presentation. There are few published cases in recent years. The aim is to establish guidelines for the management of this disorder that is so rare. a 75-year-old with tumors in both breasts, which were completely resected with removal of palpable nodes. The histopathological study reported ductal carcinoma. The indicated treatment was adjuvant tamoxifen and radiotherapy. The patient is currently in a disease-free period. this is a rare disease, whose main treatment is surgery, hence the importance of early diagnosis. Most cases require adjuvant chemotherapy and radiotherapy because they are usually diagnosed at an advanced stage.

[One-stage Operation through the Same Skin Incision for Synchronous Double Primary Breast and Lung Cancer;Report of a Case].

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Takahashi, Noriyuki; Kuga, Yoko; Uno, Satoko; Saito, Keita

2018-02-01

A 75-year-old woman noticed a small mass in the right side breast and consulted our hospital. The results of the detailed examination indicated the synchronous double primary right breast cancer and the same side lung cancer (rS5). One-stage operation from the same skin incision was scheduled. Volume rendering (VR) of computed tomography (CT)-scan was very useful in deciding the position and the length of the skin incision. The breast tumor resection and the right middle lobe resection were successfully performed through 6.5 cm skin incision.

Effect of presurgical radiotherapy on the steroid receptor concentrations in primary breast carcinoma

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Janssens, J. Ph.; Bonte, J.; Drochmans, A.; Mulier, J.; Rutten, J.; Wittevrongel, C.; Loecker, W. de

1981-01-01

With age, oestradiol receptor concentrations increased in primary breast carcinoma while age did not seem to affect the progesterone receptor levels. Above the age of 70, all tumours examined proved to be hormone-dependent. Analysis by light microscope did not allow correlation of the receptor-positive tumours to any specific or predominant cellular structure. Presurgical radiotherapy of 20 gray significantly reduced the oestradiol and to an even greater extent the progesterone receptor concentrations in the tumours. Prebioptic irradiation with 8 gray accentuated the inhibition of steroid receptor proteins. This reduction in receptor concentration after radiotherapy should be taken into account when interpreting steroid receptor values. (author)

Metastatic squamous cell carcinoma of the gingiva appearing as a solitary branchial cyst carcinoma: diagnostic role of PET/CT.

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Zhang, Xiong-Xin; Zhao, Kui; Zhou, Shui-Hong; Wang, Qin-Ying; Liu, Jian-Hua; Lu, Zhong-Jie

2014-01-01

We herein present a case of a left cervical cystic mass, for which the initial pathological diagnosis was branchial cleft cyst carcinoma (following complete mass excision). Thorough postoperative examinations, including with FDG positron emission tomography/computed tomography (PET/CT), revealed a primary tumor in the retromolar region of the left mandible. A 52-year-old female presented with a 2-month history of a painless, progressively enlarged left-sided neck mass. Fine-needle aspiration biopsy suggested a branchial cleft cyst. Physical examination revealed a 3 × 3-cm smooth, tender mass in the upper-left neck and anterior border of the sternocleidomastoid muscle. Examination using nasendoscopy and a strobolaryngoscope revealed no abnormalities of the nasal cavity, nasopharynx, oropharynx, hypopharynx or larynx. MRI of the neck revealed a solitary, round, cystic mass under the left parotid gland. The mass was excised completely. Pathologic results indicated a branchial cleft cyst carcinoma. According to the diagnostic criteria for a branchial cleft cystic carcinoma, PET/CT was performed to detect the occult primary site. PET/CT revealed high FDG uptake in the tooth root of the left mandible. Frozen sections of the mass were indicative of moderate, differentiated squamous cell carcinoma. The carcinoma in the retromolar region of the left mandible was locally excised under general anesthesia. A partial left maxillectomy, partial mandibulectomy, and left radical neck dissection were performed. The patient received postoperative concurrent chemoradiotherapy, and was disease-free at the 8-month follow-up. True branchial cleft cyst carcinoma is rare: once diagnosed, it should be distinguished from metastatic cystic cervical lymph and occult primary carcinoma. FDG PET/CT is useful in the identification of occult primary tumor.

Gastric metastasis from invasive lobular breast cancer, mimicking primary gastric cancer: A case report.

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Kim, Dae Hoon; Son, Seung-Myoung; Choi, Young Jin

2018-03-01

Gastric metastasis from invasive lobular breast cancer is relatively rare, commonly presented among multiple metastases, several years after primary diagnosis of breast cancer. Importantly, gastric cancer that is synchronously presented with lobular breast cancer can be misdiagnosed as primary gastric cancer; therefore, accurate differential diagnosis is required. A 39-year-old woman was visited to our hospital because of right breast mass and progressive dyspepsia. Invasive lobular carcinoma of breast was diagnosed on core needle biopsy. Gastroscopy revealed a diffuse scirrhous mass at the prepyloric antrum and diagnosed as poorly differentiated adenocarcinoma on biopsy. Synchronous double primary breast and gastric cancers were considered. Detailed pathological analysis focused on immunohistochemical studies of selected antibodies, including those of estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, were studied. As a result, gastric lesion was diagnosed as metastatic gastric cancer originating from breast. Right breast conserving surgery was performed, and duodenal stent was inserted under endoscopic guidance to relieve the patient's symptoms. Systemic chemotherapy with combined administration of paclitaxel and trastuzumab was initiated. Forty-one months after the diagnosis, the patient is still undergoing the same therapy. No recurrent lesion has been identified in the breast and evidence of a partial remission of gastric wall thickening has been observed on follow-up studies without new metastatic lesions. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis, including immunohistochemistry, are necessary for diagnosis of metastatic gastric cancer from the breast.

Decreased expression of cell adhesion genes in cancer stem-like cells isolated from primary oral squamous cell carcinomas.

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Mishra, Amrendra; Sriram, Harshini; Chandarana, Pinal; Tanavde, Vivek; Kumar, Rekha V; Gopinath, Ashok; Govindarajan, Raman; Ramaswamy, S; Sadasivam, Subhashini

2018-05-01

The goal of this study was to isolate cancer stem-like cells marked by high expression of CD44, a putative cancer stem cell marker, from primary oral squamous cell carcinomas and identify distinctive gene expression patterns in these cells. From 1 October 2013 to 4 September 2015, 76 stage III-IV primary oral squamous cell carcinoma of the gingivobuccal sulcus were resected. In all, 13 tumours were analysed by immunohistochemistry to visualise CD44-expressing cells. Expression of CD44 within The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma RNA-sequencing data was also assessed. Seventy resected tumours were dissociated into single cells and stained with antibodies to CD44 as well as CD45 and CD31 (together referred as Lineage/Lin). From 45 of these, CD44 + Lin - and CD44 - Lin - subpopulations were successfully isolated using fluorescence-activated cell sorting, and good-quality RNA was obtained from 14 such sorted pairs. Libraries from five pairs were sequenced and the results analysed using bioinformatics tools. Reverse transcription quantitative polymerase chain reaction was performed to experimentally validate the differential expression of selected candidate genes identified from the transcriptome sequencing in the same 5 and an additional 9 tumours. CD44 was expressed on the surface of poorly differentiated tumour cells, and within the The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma samples, its messenger RNA levels were higher in tumours compared to normal. Transcriptomics revealed that 102 genes were upregulated and 85 genes were downregulated in CD44 + Lin - compared to CD44 - Lin - cells in at least 3 of the 5 tumours sequenced. The upregulated genes included those involved in immune regulation, while the downregulated genes were enriched for genes involved in cell adhesion. Decreased expression of PCDH18, MGP, SPARCL1 and KRTDAP was confirmed by reverse transcription quantitative polymerase chain reaction. Lower expression of

Clinicopathological characteristics of head and neck Merkel cell carcinomas.

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Knopf, Andreas; Bas, Murat; Hofauer, Benedikt; Mansour, Naglaa; Stark, Thomas

2017-01-01

There are still controversies about the therapeutic strategies and subsequent outcome in head and neck Merkel cell carcinoma. Clinicopathological data of 23 Merkel cell carcinomas, 93 cutaneous head and neck squamous cell carcinomas (HNSCCs), 126 malignant melanomas, and 91 primary parotid gland carcinomas were comprehensively analyzed. Merkel cell carcinomas were cytokeratin 20 (CK20)/neuron-specific enolase (NSE)/chromogranin A (CgA)/synaptophysin (Syn)/thyroid transcription factor-1 (TTF-1)/MIB1 immunostained. All Merkel cell carcinomas underwent wide local excision. Parotidectomy/neck dissection was performed in 40%/33% cutaneous Merkel cell carcinoma and 100%/100% in parotid gland Merkel cell carcinoma. Five-year recurrence-free interval (RFI)/overall survival (OS) was significantly higher in malignant melanoma (81/80%) than in cutaneous Merkel cell carcinoma/HNSCC. Interestingly, 5-year RFI/OS was significantly higher in Merkel cell carcinoma (61%/79%) than in HNSCC (33%/65%; p Merkel cell carcinoma and parotid gland carcinomas, nor in the immunohistochemical profile. Five-year RFI/OS was significantly better in cutaneous Merkel cell carcinoma when compared with TNM classification matched HNSCC. Five-year RFI/OS was comparable in parotid gland Merkel cell carcinoma and other primary parotid gland malignancies. © 2016 Wiley Periodicals, Inc. Head Neck 39: 92-97, 2017. © 2016 Wiley Periodicals, Inc.

The role of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in the management of patients with carcinoma of unknown primary.

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Deonarine, P; Han, S; Poon, F W; de Wet, C

2013-08-01

Carcinoma of unknown primary is one of the ten most frequent cancers worldwide. Its median survival time is less than 10 months. Detecting primary tumour locations and/or occult metastatic lesions may inform definitive treatment and improve patients' prognosis. We aimed to determine: (1) the sensitivity, specificity and accuracy of (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography; (2) its detection rate of primary tumour locations and occult metastases and (3) factors associated with improved survival times. We retrospectively reviewed all cases in the West of Scotland for the period 1 December 2007 to 31 May 2011 that met all our selection criteria: (1) diagnosis of carcinoma of unknown primary; (2) a thorough but negative 'work-up' and (3) (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography report. Statistical methods included frequencies, Kaplan-Meier graphs and log-rank tests to compare survival times. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected primary tumour sites in 19/51 (37.3%) and occult metastases in 28/51 (54.9%) of eligible patients. Its sensitivity, specificity and accuracy were 79.2%, 70.4% and 74.5%, respectively; 20/51 (39.2%) patients died during the study period with a median survival of 8.4 months (range 21.4, SD ± 6.2). The number of metastatic locations was strongly associated with survival (p = 0.002), but detection of a primary tumour site (p = 0.174) or histopathology (p = 0.301) was not. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected occult metastatic sites in the majority and a primary cancer location in a substantial minority of patients. Our results were comparable with international literature and may indicate that (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography have an early role to improve the accuracy of cancer staging and to optimise carcinoma of unknown

Radiotherapy of bronchogenic carcinoma

International Nuclear Information System (INIS)

Heilmann, H.P.

1982-01-01

Radiotherapy of branchogenic carcinoma comprises; palliative treatment, postoperative or pre-operative radiotherapy, radiotherapy as part of a combination of chemotherapy and radiotherapy of small cell carcinoma and curative radiotherapy of non-operable non-small cell carcinoma. Atelectasis and obstruction are indications for palliative radiotherapy. Postoperative radiotherapy is given only in cases of incomplete resection or mediastinal metastases. In the treatment of small cell carcinoma by combined irradiation and chemotherapy the mediastinum and primary tumour are irradiated, generally after chemotherapy, and the C.N.S. receives prophylactic radiotherapy. Curative radiotherapy is indicated in cases of non-operable small cell carcinoma. Irradiation with doses of 60-70 Gy produced 5-years-survival rates of 10-14% in cases classified as T 1 -T 2 N 0 M 0 . (orig.) [de

Synchronization of metronomes

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Pantaleone, James

2002-10-01

Synchronization is a common phenomenon in physical and biological systems. We examine the synchronization of two (and more) metronomes placed on a freely moving base. The small motion of the base couples the pendulums causing synchronization. The synchronization is generally in-phase, with antiphase synchronization occurring only under special conditions. The metronome system provides a mechanical realization of the popular Kuramoto model for synchronization of biological oscillators, and is excellent for classroom demonstrations and an undergraduate physics lab.

Five Simultaneous Primary Tumors in a Single Patient: A Case Report and Review of the Literature

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Casey W. Williamson

2015-10-01

Full Text Available Multiple primary malignancies (MPMs are present when a patient is diagnosed with more than one primary malignancy and when each tumor is histologically unrelated to the others. MPMs are considered synchronous when they present within 6 months of one another. Here, we report the case of a 57-year-old woman with a past medical history significant for melanoma in 1988, who presented in 2014 with 5 distinct tumors within 4 months: malignant melanoma of the right popliteal fossa, invasive lobular breast carcinoma, diffuse large B cell lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, and a giant cell tumor of tendon sheath/pigmented villonodular synovitis. We discuss her treatment and also present a brief review of the literature. The incidence of MPMs appears to be on the rise, which demands an interdisciplinary, multimodal, and personalized approach to care.

Dosimetric verification for primary focal hypermetabolism of nasopharyngeal carcinoma patients treated with dynamic intensity-modulated radiation therapy.

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Xin, Yong; Wang, Jia-Yang; Li, Liang; Tang, Tian-You; Liu, Gui-Hong; Wang, Jian-She; Xu, Yu-Mei; Chen, Yong; Zhang, Long-Zhen

2012-01-01

To make sure the feasibility with (18F)FDG PET/CT to guided dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma patients, by dosimetric verification before treatment. Chose 11 patients in III~IVA nasopharyngeal carcinoma treated with functional image-guided IMRT and absolute and relative dosimetric verification by Varian 23EX LA, ionization chamber, 2DICA of I'mRT Matrixx and IBA detachable phantom. Drawing outline and making treatment plan were by different imaging techniques (CT and (18F)FDG PET/CT). The dose distributions of the various regional were realized by SMART. The absolute mean errors of interest area were 2.39%±0.66 using 0.6 cc ice chamber. Results using DTA method, the average relative dose measurements within our protocol (3%, 3 mm) were 87.64% at 300 MU/min in all filed. Dosimetric verification before IMRT is obligatory and necessary. Ionization chamber and 2DICA of I'mRT Matrixx was the effective dosimetric verification tool for primary focal hyper metabolism in functional image-guided dynamic IMRT for nasopharyngeal carcinoma. Our preliminary evidence indicates that functional image-guided dynamic IMRT is feasible.

Cytogenetic comparisons of synchronous carcinomas and polyps in patients with colorectal cancer

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Bardi, G; Parada, L A; Bomme, L

1997-01-01

Thirty tumorous lesions from seven patients with colorectal cancer were short-term cultured and cytogenetically analysed: 16 non-adenomatous polyps, six adenomas, seven carcinomas, including one in polyp, and one lymph node metastasis. Clonal chromosome aberrations were found in 20 samples in 100...

Capecitabine and oxaliplatin as second-line treatment in patients with carcinoma of unknown primary site

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Møller, Anne Kirstine Hundahl; Pedersen, Karen Damgaard; Abildgaard, Julie Rafn

2010-01-01

tumours may be overrepresented. These patients could be candidates for GI tract-directed therapy. We here report the results obtained with oxaliplatin and capecitabine as second-line therapy in 25 recurrent/refractory CUP patients following first-line treatment with paclitaxel, cisplatin and gemcitabine.......Treatment of patients with carcinoma of unknown primary site (CUP) remains a challenge, and no effective second-line treatment has been identified. In CUP patients who are non-responsive or relapse early after first-line platinum/taxane-based regimens, it is likely that gastrointestinal (GI) tract...

Primary signet-ring cell carcinoma of the urinary bladder successfully managed with cisplatin and gemcitabine: a case report

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El Ammari Jalal Eddine

2013-02-01

Full Text Available Abstract Introduction Primary signet-ring cell carcinoma of the urinary bladder is a rare variant of mucus-producing adenocarcinoma constituting approximately 0.5% to 2.0% of all primary carcinomas of the bladder. This tumor initially presents as a high-grade, high-stage lesion and diffusely invades the bladder wall without forming intraluminal growth. The patients have no specific symptoms, which leads to delayed diagnosis and poor prognosis. Case presentation We report the case of a 51-year-old Moroccan Berber man consulting for gross hematuria. Ultrasonography and a computed tomography scan found a bladder tumor diffusely invading the bladder wall. A histopathological examination of the tumor chips from a transurethral resection of the bladder revealed signet-ring cell adenocarcinoma. The gastrointestinal tract exploration did not reveal any other tumor localization. A radical cystectomy and adjuvant cisplatin and gemcitabine chemotherapy were therefore performed resulting in 18 months of survival without metastasis and a good quality of life within that time. Conclusion The rarity and the successful management with carboplatin and gemcitabine as adjuvant chemotherapy of this entity, which is rarely reported in the literature, are two remarkable characteristics described in this case report.

Primary squamous cell carcinoma with mucormycosis in a diabetic foot ulcer.

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Mandal, Palash Kumar; Bhattacharyya, Nirmal Kumar; Mookerjee, Sekhar Kumar; Chaudhuri, Bhaskarnarayan

2013-02-01

The diabetic foot ulcer is one of the major complications of diabetes mellitus leading to prolonged hospital stay. Non-healing foot ulcers in diabetes may be due to peripheral neuropathy and/or vasculopathy. Non-healing occurs following a trivial trauma due to loss of local immunity and increased infection by bacteria and fungus. Candida and mucormycosis are common fungal infection in diabetic foot ulcer. Squamous cell carcinoma in any non-healing ulcer is a common occurrence. But squamous cell carcinoma in non-healing diabetic foot ulcer is rarely reported. Here, mucormycosis in a diabetic foot ulcer which turned into squamous cell carcinoma is reported in a 62-year-old male with poor glycaemic control for last 21 years who presented with a non-healing ulcer of 8 months' duration over dorsum of left forefoot. Microbiological examination revealed presence of mucormycosis infection and histopathology of ulcer showed infiltrating well-differentiated squamous cell carcinoma. The clinicians and pathologists should be aware of these combinations because only eradication of mucormycosis may not cure the ulcer, rather presence of squamous cell carcinoma may be ignored that may be an immediate threat to the patient's life.

Exclusive radiotherapy for primary squamous cell carcinoma of the vagina

International Nuclear Information System (INIS)

Crevoisier, Renaud de; Sanfilippo, Nicholas; Gerbaulet, Alain; Morice, Philippe; Pomel, Christophe; Castaigne, Damiene; Pautier, Patricia; Lhomme, Catherine; Duvillard, Pierre; Haie-meder, Christine

2007-01-01

Purpose: To retrospectively analyze results of external beam therapy (EBT) with brachytherapy (BT) for primary vaginal squamous cell carcinoma (PVSCC). Materials and methods: From 1970 to 2001, 91 patients were included. FIGO stages were: I (29%), II (38%), III (29%) and IVa (4%). EBT delivered a median total dose of 50 Gy to the pelvis. BT was performed with a customized intra-vaginal applicator and in 36% of applications combined endocavitary and interstitial BT. ICRU Report 38 parameters were reported. Results: The 5-year cause specific survival (CSS) rates were: 83% for stage I, 76% for stage II, 52% for stage III, and 2 of the 4 stage IVa patients died 9 and 36 months after treatment. The 5-year pelvis control rates were: 79% for stage I and II and 62% for stage III. Recurrences as a first event were local only in 68% of cases, nodal only in 10%, metastatic only in 13% and combined in 9%. In multivariate analysis: stage (I and II versus II and IV), response to EBT (evaluated at BT), and the number of BT applications were statistically significant for CSS. Grade 2-3 toxicities were as follows (Franco-Italian Glossary): rectum (n = 3), sigmoid colon and small bowel (n = 8), bladder (n = 5), ureter (n = 4) and vagina (n = 13). Anterior location of the tumor increased bladder toxicity (p = 0.01) and total reference air kerma was higher in patients who experienced grade 2-3 urinary or digestive toxicity (p = 0.03). Conclusion: EBT with BT is an effective treatment for patients with stage I-II PVSCC. The incidence and severity of late toxicity were relatively low. Recent advances in the treatment of cervix carcinoma emphasize the need for concomitant radio-chemotherapy in stages III-IV and the use of MRI for treatment planning

Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

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Galleberg, R B; Knigge, U; Tiensuu Janson, E

2017-01-01

Background: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce......., particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.......Background: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce....... The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. Methods: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended...

Effects of fractionated stereotactic radiotherapy for primary hepatocellular carcinoma

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Choi, Byeong Ock; Jang, Hong Seok; Kang, Young Nam; Choi, Ihl Bhong; Kang, Ki Mun; Chai, Gyu Young; Lee, Sang Wook

2005-01-01

Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. In this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC. A retrospective analysis was performed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was 2 ∼ 6.5 cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was 5 or 10 Gy; each dose was prescribed based on the planning target volume and normalized to 85 ∼ 99% isocenter dose. Patients were treated 3 ∼ 5 times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was 3 ∼ 55 months (the median follow up period: 23 months). The response rate was 60% (12 patients), with 4 patients showing complete response (20%), 8 patients showing partial response (40%), and 8 patients showing stable disease (40%). The 1-year and 2-year survival rates were 70.0% and 43.1%, respectively,and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were 65% and 32.5%, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients (60%), nausea/emesis in 8 patients (40%), and transient liver function impairment in 6 patients (30%). However, there was no treatment related death. The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC

Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

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Vergeer, Marije R.; Doornaert, Patricia; Jonkman, Anja; Kaanders, Johannes H.A.M.; Ende, Piet L.A. van den; Jong, Martin A. de; Leemans, C. Rene; Slotman, Ben J.; Langendijk, Johannes A.

2010-01-01

Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

Metastatic nonpalpable invasive lobular breast carcinoma presenting as rectal stenosis: a case report.

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Osaku, Tadatoshi; Ogata, Hideaki; Magoshi, Shunsuke; Kubota, Yorichika; Saito, Fumi; Kanazawa, Shinsaku; Kaneko, Hironori

2015-04-24

Invasive lobular carcinomas have an increased propensity for distant metastases, particularly to the peritoneum, ovaries, and uterus. In contrast, distant metastases of nonpalpable lobular carcinomas are extremely rare, and the causes of underlying symptoms of primary carcinomas remain unclear. We report a case of an asymptomatic invasive lobular carcinoma with a primary mammary lesion in a patient with rectal stenosis. A 69-year-old Japanese woman presented to our hospital for treatment of constipation. Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause. Thus, an exploratory laparotomy and tissue biopsy was performed, and the presence of an invasive lobular carcinoma was confirmed. Subsequent breast examinations showed that the invasive lobular carcinoma that led to the rectal stenosis was a metastatic lesion from a primary lesion of the breast duct. As the present breast lobular carcinoma was asymptomatic and nonpalpable, we did not initially consider metastatic breast cancer as a cause of her symptoms, and the final diagnosis was delayed. Peritoneal metastasis from nonpalpable invasive lobular carcinomas is very rare. However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.

Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

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S. K. Seelig

2010-01-01

Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years identified. The primary tumor was located in the pancreatic head (n=9, 45%, in pancreatic tail (n=9, 45%, and in the papilla Vateri (n=2, 10%. Metastases were located in the liver (n=14, 70%, peritoneum (n=5, 25%, and omentum majus (n=2, 10%. Lymphnode metastases were present in 16 patients (80%. All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; P=.1. Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.

Excluding Lynch syndrome in a female patient with metachronous DNA mismatch repair deficient colon- and ovarian cancer

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Crobach, Stijn; Jansen, A.M.L. (Anne M. L.); Ligtenberg, M.J.L. (Marjolein J. L.); Koopmans, M. (Marije); Nielsen, Maartje; Hes, Frederik; Wijnen, Juul; Dinjens, Winand; Wezel, Tom; Morreau, Hans

2017-01-01

textabstractPatients synchronously or metachronously presenting with ovarian and colon cancer can pose diagnostic challenges. A primary colon carcinoma can metastasize to one or both ovaries, two independent primary tumors can arise or an ovarian carcinoma can metastasize to the colon. Clinical and immunohistochemical characterization can aid the diagnosis. Recently, we reported that in difficult cases finding pathogenic APC variants supports a colonic origin. In this case report we describe ...

Quantification of tumor infiltrating Foxp3+ regulatory T cells enables the identification of high-risk patients for developing synchronous cancers over upper aerodigestive tract.

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Wang, Wen-Lun; Chang, Wei-Lun; Yang, Hsiao-Bai; Chang, I-Wei; Lee, Ching-Tai; Chang, Chi-Yang; Lin, Jaw-Town; Sheu, Bor-Shyang

2015-07-01

Patients with squamous cell carcinomas (SCC) of upper aerodigestive tract, either over head and neck (HNSCC) or esophagus (ESCC), frequently developed synchronous multiple cancers, leading to worse prognosis. This study validated whether suppression of host cancer immunosurveillance mediated by regulatory T cells (Treg) may predispose to the development of synchronous cancers. Tumor tissues of 200 patients (100 ESCC only, 50 HNSCC only, and 50 synchronous SCCs) were quantitatively accessed for the tumor infiltrating Treg by immunohistochemistry. The density of Treg was also correlated to the level of Treg-associated inhibitory cytokines (IL-10, IL-35 and TGF-β1), and chemokine (CCL22). The density of tumor infiltrating Treg in the index tumor (i.e. the first malignancy diagnosed) of synchronous SCC group was higher than those of HNSCC or ESCC only (prisk of synchronous cancer development to initiate a proper surveillance program. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary mucinous carcinoma of thyroid gland with prominent signet-ring-cell differentiation: a case report and review of the literature

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Wang J

2018-03-01

Full Text Available Jian Wang,1,2 Qie-Re Guli,3 Xiao-Cui Ming,3 Hai-Tao Zhou,3 Yong-Jie Cui,3 Yue-Feng Jiang,1,2 Di Zhang,1,2 Yang Liu1,2 1Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China; 2Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; 3Department of Pathology, The People’s Hospital of Tacheng Region, Tacheng, China Purpose: This study reports a case of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation, and reviews the literature to evaluate its real incidence and the prognosis of these patients.Patients and methods: A 74-year-old Chinese woman, presenting with a mass in the right lobe of thyroid gland, came to the hospital. Computed tomography revealed a mass in the right lobe of the thyroid gland, accompanied with right neck lymphadenectasis and airway deviation caused by tumor compression. Thyroid imaging suggested a thyroid malignant tumor and suspicious lymph node metastasis. Histologically, the tumor was characterized by the tumor cells arranged in small nests or trabeculae with an abundant extracellular mucoid matrix. The tumor cells formed diffuse invasion among thyroid follicles. In the peripheral regions, prominent signet-ring-cells formed a sheet-like structure and extended into the extrathyroidal fat tissue. The tumor cells were diffusely positive for thyroid transcription factor-1 (TTF-1 and PAX8, while they were focally positive for pan-cytokeratin (AE1/AE3 and weakly expressed thyroglobulin. Results: Based on the histological features and immunohistochemical profile, a diagnosis of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation was rendered.Conclusion: Using a panel of immunohistochemical markers may be helpful for differential diagnosis and for determining whether the tumor is primary or not. Keywords: mucinous carcinoma, primary thyroid cancer

Cholangiographic evaluation of bile duct carcinoma

International Nuclear Information System (INIS)

Nichols, D.A.; MacCarty, R.L.; Gaffey, T.A.

1983-01-01

Cholangiograms and clinical histories of 82 patients with biopsy-proved bile duct carcinoma were reviewed. The carcinomas were classified according to morphologic findings and clinical outcome. Ulcerative colitis and antecedent inflammatory disease of the biliary tree, particularly primary sclerosing cholangitis, seem to predispose to the development of bile duct carcinoma. Focal stenotic lesions were the most common morphologic type (62/82). Polypoid carcinomas and diffuse sclerosing carcinomas were less common and of about equal frequency. Prognosis was best for patients with polypoid carcinomas and worst for those with diffuse sclerosing carcinomas. In 69 cases (84%), the tumors involved the intrahepatic or proximal extrahepatic ducts, makin curative resection difficult or impossible. Patients with carcinomas limited to the more distal extrahepatic bile ducts had a longer average survival and a higher probability of surgical cure. Proper management of patients with bile duct carcinoma requires a complete and accurate cholangiographic evaluation of the morphology, location, and extent of the disease

Multiple squamous cell carcinomas within the head and neck region

International Nuclear Information System (INIS)

Sato, Katsuro; Hanazawa, Hideyuki; Sato, Yuichiro; Takahashi, Sugata

2004-01-01

Clinical features of multiple squamous cell carcinoma (SCC) cases within the head and neck that were treated in our department during the recent 10 years are discussed. Multiple SCCs arose in 6.6% of the cases with primary SCC; 67% of the cases had two carcinomas, and 33% had more than three carcinomas. The most common site of the multiple SCCs was the oral cavity (54%). The most frequent interval between treatment of previous carcinoma and diagnosis of subsequent carcinoma was simultaneous, but more than 5 years' interval was observed in 36% of the patients. The most common initial treatment of the carcinoma was irradiation, but the ratio of surgery increased for subsequent carcinomas. Prognosis of the patients with more than three carcinomas was not worse than that of patients with two carcinomas. Therefore, early diagnosis of the subsequent carcinomas based on careful long-term observation in the head and neck is necessary for follow-up of the patients with SCC of the head and neck. Treatment strategies considering the treatment of subsequent carcinomas are needed for the patients with primary head and neck SCC. (author)

Neuroendocrine Cell Carcinoma of Unknown Primary Arising in Long Standing History of Multiple Sclerosis

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Stergios Boussios

2015-01-01

Full Text Available Multiple sclerosis (MS is a chronic autoimmune disease that targets myelinated axons in the central nervous system (CNS. Cancer of unknown primary site (CUP is a well-recognised clinical disorder, accounting for 3–5% of all malignant epithelial tumors. CUP is clinically characterised as an aggressive disease with early dissemination. Studies of cancer risk in MS patients have shown inconsistent findings. An increased risk of malignancy in patients with MS has been suggested, but recently serious questions have been raised regarding this association. Use of disease-modifying therapies might contribute to an increased cancer risk in selected MS patients. The concurrence of MS and CUP is exceptionally rare. Here we describe the case of a neuroendocrine carcinoma of unknown primary diagnosed in a male patient with a nine-year history of MS. The discussion includes data from all available population-based register studies with estimates of certain malignancies in patients with MS.

Primary small cell carcinoma of the lesser omentum

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Ji-Feng Feng

2012-02-01

Full Text Available Although pulmonary small cell carcinoma (SCC is seen frequently, SCC that originates from the extrapulmonary organs is extremely rare. We herein report a case of a SCC located in the lesser omentum. A 61-year-old male was admitted to our department due to intermittent epigastralgia for 2 months. Ultrasonography (US revealed an irregular hypoechoic mass measuring about 58 mm × 50 mm × 45 mm under the left lobe of the liver. Magnetic resonance imaging (MRI was performed to verify the irregular mass with T1- and T2- weighted images between the left lobe of liver and the stomach. At laparotomy, the well-circumscribed neoplasm was found in the lesser omentum, and the fundus of the neoplasm was located in the root of left gastric artery. Intraoperative microscopic evaluation of frozen sections revealed malignancy of the lesser omentum. Resection of the neoplasm was performed, and the combined resection of the vagal nerve was also performed for the partial adhesion. Pyloroplasty was performed for avoiding delayed gastric emptying caused by combined resection of vagal nerve. The lymph nodes dissection at lesser curvature and right cardia was also performed with a negative result. Based on the histological findings, the final diagnosis of primary lesser omental SCC was confirmed. The pathologic staging showed locoregional disease.

Thallium-201 chloride per-rectal scintigraphy in primary hepatocellular carcinoma

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Tonami, Norihisa; Nakajima, Kenichi; Hisada, Kinichi; Matsui, Osamu; Kadoya, Masumi; Takashima, Tsutomu

1985-10-01

The results of Thallium-201(Tl-201) per-rectal scintigraphy in 10 patients with primary hepatocellular carcinoma(HCC) were presented with other clinical findings of contrast hepatic angiography, computed tomography and ultrasonography. Tl-201 accumulation within the tumor was seen in 7 of 10 patients. This accumulation was thought to be due to Tl-201 supply not from the portal vein but from the hepatic artery since significant high heart to liver uptake ratio(H/L) from 0.71 to 1.21(mean 0.95) was observed. Clear visualization of the heart and kidneys indicated the presence of abundant portal-to-systemic shunting. Other 3 patients showed negative Tl-201 accumulation within the tumor and near-normal H/L from 0.32 to 0.47(mean 0.37)which indicates a little portal-to-systemic shunting. This finding reveals the evidence of the lack of Tl-201 supply to the tumor from the portal vein. The results support the idea that HCC does not receive any significant amount of blood flow from the portal system.

SLAC synchronous condenser

International Nuclear Information System (INIS)

Corvin, C.

1995-06-01

A synchronous condenser is a synchronous machine that generates reactive power that leads real power by 90 degrees in phase. The leading reactive power generated by the condenser offsets or cancels the normal lagging reactive power consumed by inductive and nonlinear loads at the accelerator complex. The quality of SLAC's utility power is improved with the addition of the condenser. The inertia of the condenser's 35,000 pound rotor damps and smoothes voltage excursions on two 12 kilovolt master substation buses, improving voltage regulation site wide. The condenser absorbs high frequency transients and noise in effect ''scrubbing'' the electric system power at its primary distribution source. In addition, the condenser produces a substantial savings in power costs. Federal and investor owned utilities that supply electric power to SLAC levy a monthly penalty for lagging reactive power delivered to the site. For the 1993 fiscal year this totaled over $285,000 in added costs for the year. By generating leading reactive power on site, thereby reducing total lagging reactive power requirements, a substantial savings in electric utility bills is achieved. Actual savings of $150,000 or more a year are possible depending on experimental operations

Coexistence of borderline ovarian epithelial tumor, primary pelvic hydatid cyst, and lymphoepithelioma-like gastric carcinoma.

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Gungor, Tayfun; Altinkaya, Sunduz Ozlem; Sirvan, Levent; Lafuente, Roberto Alvarez; Ceylaner, Serdar

2011-06-01

Borderline ovarian tumors (BOTs) represent a heterogeneous group of ovarian epithelial neoplasms. Despite a favorable prognosis, 10-20% of BOTs exhibit progressively worsening clinic. Primary involvement of pelvic organs with echinococcus is very rare. Lymphoepithelioma-like gastric carcinoma is a rare neoplasm of the stomach. A 58-year-old woman referred with abdominal swelling and gastric complaints. Imaging studies revealed a huge cystic mass with multiple septations and solid component, another cystic mass with an appearance of cyst hydatid in the pelvis, and thickening of the small curvature of stomach. Gastroscopy revealed an ulcer with a suspicious malignant appearance, and histology of the endoscopic specimen showed severe chronic inflammation and lymphocytic infiltration. No other involvement of hydatid cyst was detected. In the exploration, there was a 25cm cystic lesion with solid components arising from right ovary, another 6cm cyst over the former, 7cm cystic lesion arising from left ovary, and 10cm mass near the small curvature of the stomach. Excision of the masses; total gastrectomy with esophagojejunal anastomosis; total abdominal hysterectomy; bilateral salpingo-oophorectomy; omentectomy; appendectomy; splenectomy; and pelvic, paraaortic, and coeliac lympadenectomy were performed. Final pathology revealed lymphoepithelioma-like gastric carcinoma, bilateral serous BOT, and hydatid cyst. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions of the world. Preoperative diagnosis of primary pelvic hydatid disease is difficult and awareness of its possibility is very important especially in patients residing in or coming from endemic areas. Copyright © 2011. Published by Elsevier B.V.

FDG-PET in the initial staging of squamous cell oesophageal carcinoma

International Nuclear Information System (INIS)

Buchmann, I.; Schreckenberger, M.; Bartenstein, P.; Hansen, T.; Brochhausen, C.; Kneist, W.; Junginger, T.; Oberholzer, K.

2006-01-01

Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in N- and M-staging of squamous cell oesophogeal carcinoma. Patients, methods: in 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus, FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: in 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) ± 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDG-PET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma. (orig.)

Stereotactic body radiotherapy for primary renal cell carcinoma and adrenal metastases.

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Kothari, Gargi; Louie, Alexander V; Pryor, David; Vela, Ian; Lo, Simon S; Teh, Bin S; Siva, Shankar

2017-09-01

The incidence of renal cell carcinoma (RCC) and metastatic adrenal lesions continues to rise and present evolving complexities in terms of management. Technical challenges in treatment delivery are compounded by the setting of an ageing patient population with multiple medical co-morbidities. While the standard of care treatment for both primary RCC and oligometastatic adrenal lesions has typically been surgery, a number of patients may be medically or surgically inoperable, and for whom alternative options require consideration. Additionally, in metastatic disease, surgery presents an invasive option, sometimes with unacceptable risks of perioperative morbidity and therefore is considered a less desirable option to some. Stereotactic body radiotherapy (SBRT) is an established radiotherapy technique that is rapidly being incorporated into many radiotherapy departments, particu-larly with the increasing availability and capabilities of modern linear accelerators to deliver precise image guided treatment. There are considerable advantages of SBRT including its ability to provide a non-invasive ablative treatment with very few treatment sessions, with emerging evidence showing promising rates of local control (LC) and low associated mor-bidity. This review details the use of SBRT for primary RCC as well as adrenal metastases, focusing on issues including patient selection, technical considerations, and patient out-comes. Furthermore, this review explores some recent insights into the radiobiology of RCC, the immunomodulatory effects of SBRT, and the use of systemic agents with SBRT.

Primary neuroendocrine carcinoma of breast with liver and bone metastasis detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

International Nuclear Information System (INIS)

Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshak; Shibu, Deepu; Radhakrishnan, Edathuruthy Kalarikal; Shinto, Ajit Sugunan

2014-01-01

Cases of primary neuroendocrine carcinoma (NEC) of the breast have been reported, though rare. We report the case of a 45-year-old woman presented with jaundice and evaluated to have liver metastasis from neuroendocrine origin. She underwent whole body positron emission tomography/computed tomography, which showed left breast lesion and bone metastasis. Fine-needle aspiration (FNA) of breast revealed a NEC. A diagnosis of a primary NEC of the breast was rendered with hepatic and bone metastasis. She was treated with peptide receptor radionuclide therapy and is on follow-up

Overview of Cell Synchronization.

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Banfalvi, Gaspar

2017-01-01

The widespread interest in cell synchronization is maintained by the studies of control mechanism involved in cell cycle regulation. During the synchronization distinct subpopulations of cells are obtained representing different stages of the cell cycle. These subpopulations are then used to study regulatory mechanisms of the cycle at the level of macromolecular biosynthesis (DNA synthesis, gene expression, protein synthesis), protein phosphorylation, development of new drugs, etc. Although several synchronization methods have been described, it is of general interest that scientists get a compilation and an updated view of these synchronization techniques. This introductory chapter summarizes: (1) the basic concepts and principal criteria of cell cycle synchronizations, (2) the most frequently used synchronization methods, such as physical fractionation (flow cytometry, dielectrophoresis, cytofluorometric purification), chemical blockade, (3) synchronization of embryonic cells, (4) synchronization at low temperature, (5) comparison of cell synchrony techniques, (6) synchronization of unicellular organisms, and (7) the effect of synchronization on transfection.

Metastatic Squamous Cell Carcinoma of the Stomach.

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Hamzaoui, Lamine; Bouassida, Mahdi; Kilani, Houda; Medhioub, Mouna; Chelbi, Emna

2015-11-01

Primary squamous cell carcinoma of the stomach is very rare. Its pathogenesis is unclear and the treatment strategy is controversial. We report an agressive primary squamous cell carcinoma of the stomach with liver and lung metastases in a 55-year-old man. The patient presented with a 1-month history of abdominal pain, vomiting and weight loss. Abdominal ultrasound revealed multiple liver metastases. Endoscopic examination showed two tumour masses on the fundus of the stomach. Biopsy of the lesions revealed squamous cell carcinoma of the stomach. Chest x-ray showed multiple large pulmonary nodules highly suggestive of pulmonary metastases. The patient died ten days after he was admitted because of progression of the tumour and before any therapeutic decision.

Cryotherapy for hepatocellular carcinoma

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Awad, Tahany; Thorlund, Kristian; Gluud, Christian

2009-01-01

BACKGROUND: Hepatocellular carcinoma is the most common primary malignant cancer of the liver. Evidence for the role of cryotherapy in the treatment of hepatocellular carcinoma is controversial. OBJECTIVES: The aim of this review is to evaluate the potential benefits and harms of cryotherapy...... for the treatment of hepatocellular carcinoma. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and LILACS until June 2009. We identified further studies by searching...... of benefit but included for the assessment of harm. Both severe and non-severe adverse events were reported, but the true nature and extent of harm was difficult to asses. AUTHORS' CONCLUSIONS: At present, there is no evidence to recommend or refute cryotherapy for patients with hepatocellular carcinoma...

Coexistence of tuberculosis and mammary carcinoma in a goat.

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Quintas, H; Alegria, N; Mendonça, A; Botelho, A; Alves, A; Pires, I

2014-08-01

Synchronic occurrence of tuberculosis mastitis and mammary cancer is rare in humans and, to the best of our knowledge, not reported in domestic animals. Here, we present a case of a female adult goat of Serrana breed with simultaneous occurrence of a granulomatous mastitis, due to Mycobacterium caprae, and a mammary carcinoma. Both pathological conditions are rare in goats and should be included in differential diagnosis of mammary lesions. © 2014 Blackwell Verlag GmbH.

Coexistence of tuberculosis and mammary carcinoma in a goat

OpenAIRE

Quintas, Hélder; Alegria, Nuno; Mendonça, Álvaro; Botelho, A.; Alves, A.; Pires, Isabel

2014-01-01

Synchronic occurrence of tuberculosis mastitis and mammary cancer is rare in humans and, to the best of our knowledge, not reported in domestic animals. Here, we present a case of a female adult goat of Serrana breed with simultaneous occurrence of a granulomatous mastitis, due to Mycobacterium caprae, and a mammary carcinoma. Both pathological conditions are rare in goats and should be included in differential diagnosis of mammary lesions. info:eu-repo/semantics/publishedVersion

Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma

International Nuclear Information System (INIS)

Inaba, Koji; Morota, Madoka; Mayahara, Hiroshi; Ito, Yoshinori; Sumi, Minako; Uno, Takashi; Itami, Jun; Kushima, Ryoji; Murakami, Naoya; Kuroda, Yuuki; Harada, Ken; Kitaguchi, Mayuka; Yoshio, Kotaro; Sekii, Shuhei; Takahashi, Kana

2013-01-01

There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma. The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population. There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma. There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma

Myoepithelial carcinoma on the right shoulder: Case report with published work review.

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Yokose, Chiharu; Asai, Jun; Kan, Saori; Nomiyama, Tomoko; Takenaka, Hideya; Konishi, Eiichi; Goto, Keisuke; Ansai, Shin-Ichi; Katoh, Norito

2016-09-01

Myoepithelial carcinoma is a malignant tumor that can differentiate towards myoepithelial cells and commonly occur in the salivary glands. There have been only a few reports of primary cutaneous myoepithelial carcinoma; however, most cases showed subcutaneous involvement and could also be diagnosed as soft tissue myoepithelial carcinoma arising from the subcutis with dermal involvement. It may thus be impossible to distinguish a primary cutaneous from a soft tissue myoepithelial carcinoma. Herein, we describe a case of myoepithelial carcinoma on the shoulder in an 85-year-old Japanese woman. The tumor was located in the whole dermis and subcutis; therefore, it could be diagnosed as either a cutaneous or soft tissue myoepithelial carcinoma. We reviewed previous cases of primary cutaneous and soft tissue myoepithelial carcinomas and compared their clinical and immunohistological features. We found no obvious differences in anatomical distribution or immunohistochemical findings. However, the recurrence rate of cutaneous myoepithelial carcinomas seems to be lower than that of soft tissue carcinomas. Such a difference may be attributable to the adequate surgical margin in cutaneous carcinomas compared with the deep-seated soft tissue carcinomas. The metastatic frequency did not significantly differ between the two types. Although we could summarize from only a small number of cases, these results indicate the difficulty in distinguishing between cutaneous and soft tissue myoepithelial carcinomas; furthermore, it may not be suitable to distinguish them on the basis of aggressive behavior. © 2016 Japanese Dermatological Association.

New type of chaos synchronization in discrete-time systems: the F-M synchronization

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Ouannas Adel

2018-04-01

Full Text Available In this paper, a new type of synchronization for chaotic (hyperchaotic maps with different dimensions is proposed. The novel scheme is called F – M synchronization, since it combines the inverse generalized synchronization (based on a functional relationship F with the matrix projective synchronization (based on a matrix M. In particular, the proposed approach enables F – M synchronization with index d to be achieved between n-dimensional drive system map and m-dimensional response system map, where the synchronization index d corresponds to the dimension of the synchronization error. The technique, which exploits nonlinear controllers and Lyapunov stability theory, proves to be effective in achieving the F – M synchronization not only when the synchronization index d equals n or m, but even if the synchronization index d is larger than the map dimensions n and m. Finally, simulation results are reported, with the aim to illustrate the capabilities of the novel scheme proposed herein.

New type of chaos synchronization in discrete-time systems: the F-M synchronization

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Ouannas, Adel; Grassi, Giuseppe; Karouma, Abdulrahman; Ziar, Toufik; Wang, Xiong; Pham, Viet-Thanh

2018-04-01

In this paper, a new type of synchronization for chaotic (hyperchaotic) maps with different dimensions is proposed. The novel scheme is called F - M synchronization, since it combines the inverse generalized synchronization (based on a functional relationship F) with the matrix projective synchronization (based on a matrix M). In particular, the proposed approach enables F - M synchronization with index d to be achieved between n-dimensional drive system map and m-dimensional response system map, where the synchronization index d corresponds to the dimension of the synchronization error. The technique, which exploits nonlinear controllers and Lyapunov stability theory, proves to be effective in achieving the F - M synchronization not only when the synchronization index d equals n or m, but even if the synchronization index d is larger than the map dimensions n and m. Finally, simulation results are reported, with the aim to illustrate the capabilities of the novel scheme proposed herein.

Circumscribed breast carcinoma: Mammographic and sonographic findings

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Chung, Soo Young; Lee, Yul; Park, Ki Soon; Lee, Ke Sook [College of Medicine, Hallym University, Seoul (Korea, Republic of)

1992-03-15

Circumscribe breast cancer is a well demarcated mass with or without a lobulated border simulating a benign tumor like fibroadenoma on mammography or breast US and is reported as approximate 10% of the incidence among primary breast carcinoma(1.2). Pathologically medullary, colloid, papillary, intraductal and rarely invasive ductal carcinomas are included in this group which show the less intense desmoplastic reaction than the scirrhous type cancer, resulting in the most favorable prognosis of all carcinoma of the breast. Among 214 primary breast carcinoma during the past 8 years, we experienced 6 case of pathologically proven circumscribed breast cancer(2 cases of medullary carcinoma, 1 of colloid carcinoma, 1 of intracystic papillary carcinoma, 2 of comedo type intraductal carcinoma). Clinically 2 cases showed bloody nipple discharge from one hole of a unilateral nipple orifice. Mammography showed a well circumscribed nodule with or without partial lobular contour and no pathologic calcification. Breast sonographic findings were a well defined heterogeneous hypoechoic nodule with weak posterior acoustic enhancement. Characteristically a thin dilated lactiferous duct between the mass and the nipple on US could be detected in 2 cases which clinically was accompanied by bloody nipple discharge. Although the mammographic criteria is promising as benign tumor, the possibility of circumscribed as benign tumor, the possibility of circumscribed breast carcinoma must be considered in heterogeneous hypoechoic nodule with weak posterior acoustic enhancement in US, especially in the presence of a dilated lactiferous duct between the mass and the nipple with bloody nipple discharge.

On Synchronization Primitive Systems.

Science.gov (United States)

The report studies the question: what synchronization primitive should be used to handle inter-process communication. A formal model is presented...between these synchronization primitives. Although only four synchronization primitives are compared, the general methods can be used to compare other... synchronization primitives. Moreover, in the definitions of these synchronization primitives, conditional branches are explicitly allowed. In addition

Carcinoma multiplex

International Nuclear Information System (INIS)

Shah, S. A.; Riaz, U.; Zahoor, I.; Jalil, A.; Zubair, M.

2013-01-01

Multiple primaries in a single patient are uncommon, though not very rare. The existence of such cancers in two un-related, non-paired organs is even more un-common. Here, we present a case of 55 years old male who presented to us with a mucoepidermoid carcinoma of the parotid gland and was operated. Later on, he presented with a large cystic swelling in the pelvis which turned out to be pseudomyxoma peritonei. A review of slides and immunohistochemistry indicated it to be adenocarcinoma colon. He presented again with recurrent mucoepidermoid carcinoma of the parotid which was operated successfully with the use of myocutaneous flap for wound closure. He is currently undergoing chemotherapy. In order to establish a separate mono-clonal etiology of both tumours, immunohistochemistry was performed. To the best of our knowledge, carcinoma multiplex in the colon and the parotid has never been reported before. (author)

Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

Institute of Scientific and Technical Information of China (English)

HU Man; YU Jin-ming; ZHAO Wei; ZHANG Pin-liang; JU Gui-fang; FU Zheng; ZHANG Guo-li; KONG Li; YANG Yan-qin; MA Yi-dong

2011-01-01

Background Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP,including detecting the occult primary tumor and effecting on disease therapy.Methods One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients,the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350-425 MBq of 18F-FDG.Results In 24.8% of patients,FDG PET/CT detected primary tumors that were not apparent after conventional workup.In this group of patients,the overall sensitivity,specificity,and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%,87.7%,and 87.2%,respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%,47 of 149) patients underwent a change in therapeutic management.Conclusions FDG PET/CT is a valuable tool in patients with CUP,because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases,and optimized the mangement of these patients.

Primary adenocarcinoma of the fallopian tube: a case series

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Kemal Güngördük

2007-09-01

Full Text Available Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resembles primary ovarian carcinoma. In this article, seven patients with primary fallopian tube carcinoma who were managed at our clinic between 2002 and 2007 were evaluated. All cases were treated by total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy,appendectomy and lymph node dissection followed by chemotherapy. Fallopian tube carcinoma is rarely suspected preoperatively. The symptom complex of ‘hydrops tubae profluence’, said to be pathognomonic for this tumor, is rarely encountered. Appropriate therapy for each stage of the disease should be defined, and further studies are required to better depict the clinical course and; prognostic factors.

Primary Cutaneous Carcinosarcoma of the Basal Cell Subtype Should Be Treated as a High-Risk Basal Cell Carcinoma.

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Bourgeault, Emilie; Alain, Jimmy; Gagné, Eric

2015-01-01

Cutaneous carcinosarcoma is a rare primary tumor of the skin, characterized by biphasic epithelial and mesenchymal differentiation. Due to the limited number of cases reported, there is no consensus regarding treatment and prognosis. Some authors suggest that cutaneous carcinosarcomas should be viewed as aggressive tumors, with ancillary imaging used to evaluate potential metastatic disease. Other reports demonstrate an indolent disease course, especially with epidermal-type cutaneous carcinosarcomas. We report a case of cutaneous carcinosarcoma, which we treated with electrodessication and curettage following a shave biopsy. The tumor had an epithelial component resembling a basal cell carcinoma and a fibrosarcomatous stroma. At 1-year follow-up, our patient did not show evidence of recurrence or metastasis. Our case suggests that a cutaneous carcinosarcoma with an epithelial component composed of basal cell carcinoma can be regarded as a high-risk nonmelanoma skin cancer. © The Author(s) 2015.

CLINICAL RELEVANCE OF COEXISTENCE OF DUCTAL CA IN SITU AND INVASIVE DUCTAL CARCINOMA OF BREAST

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Kirithiga Ramalingam

2017-06-01

Full Text Available BACKGROUND There are many studies reported in the literature with respect to the Ductal Carcinoma in Situ (DCIS progressing into Invasive Ductal Carcinoma (IDC of the breast. However, there is hardly any study on the coexistence of both and its clinical significance. The aim of the study is to analyse the clinical and pathological parameters of synchronous DCIS and IDC to predict the prognostic factors. MATERIALS AND METHODS 42 patients with a final pathological diagnosis of synchronous DCIS and IDC diagnosed in 2009-11 were included in the study. Statistical analysis was done using SPSS software utilising the appropriate analytical methods. RESULTS Majority of the patients in this study group presented with early breast cancer (64.3%. Forty eight percent were Her2 subtype (ER, PR negative and HER2/neu-positive and 31% were triple negative. Eighty one percent of the IDC associated histology was Not Otherwise Specified (NOS type. Grade 3 lesions were more common (57%. Recurrence of the disease occurred in 66% of patients during a mean duration of follow up of 3.6 years with predominance of visceral metastasis (51.5%. Recurrence was more common in node positive disease (59.5%, those with lymphovascular emboli (59.5% and perinodal spread (76% on histopathological examination. CONCLUSION Synchronous DCIS and IDC disease entity appears to have an aggressive nature compared to the course of IDC alone entity. Prognostic factors relating to IDC appears to correlate well with recurrence than that of the prognostic factors of DCIS component in such synchronous setting.

Stages of chaotic synchronization.

Science.gov (United States)

Tang, D. Y.; Dykstra, R.; Hamilton, M. W.; Heckenberg, N. R.

1998-09-01

In an experimental investigation of the response of a chaotic system to a chaotic driving force, we have observed synchronization of chaos of the response system in the forms of generalized synchronization, phase synchronization, and lag synchronization to the driving signal. In this paper we compare the features of these forms of synchronized chaos and study their relations and physical origins. We found that different forms of chaotic synchronization could be interpreted as different stages of nonlinear interaction between the coupled chaotic systems. (c) 1998 American Institute of Physics.

FGFR-1 amplification in metastatic lymph-nodal and haematogenous lobular breast carcinoma

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Brunello Eleonora

2012-12-01

Full Text Available Abstract Background Lobular breast carcinoma usually shows poor responsiveness to chemotherapies and often lacks targeted therapies. Since FGFR1 expression has been shown to play pivotal roles in primary breast cancer tumorigenesis, we sought to analyze the status of FGFR1 gene in a metastatic setting of lobular breast carcinoma, since promising FGFR1 inhibitors has been recently developed. Methods Fifteen tissue metastases from lobular breast carcinomas with matched primary infiltrative lobular breast carcinoma were recruited. Eleven cases showed loco-regional lymph-nodal and four haematogenous metastases. FGFR-1 gene (8p12 amplification was evaluated by chromogenic in situ hybridization (CISH analysis. Her-2/neu and topoisomerase-IIα gene status was assessed. E-cadherin and Hercept Test were also performed. We distinguished amplification (>6 or cluster of signals versus gains (3–6 signals of the locus specific FGFR-1 gene. Results Three (20% primary lobular breast carcinomas showed >6 or cluster of FGFR1 signals (amplification, six cases (40% had a mean of three (range 3–6 chromogenic signals (gains whereas in 6 (40% was not observed any abnormality. Three of 15 metastasis (20% were amplified, 2/15 (13,4% did not. The ten remaining cases (66,6% showed three chromogenic signals. The three cases with FGFR-1 amplification matched with those primary breast carcinomas showing FGFR-1 amplification. The six cases showing FGFR-1 gains in the primary tumour again showed FGFR-1 gains in the metastases. Four cases showed gains of FGFR-1 gene signals in the metastases and not in the primary tumours. Her-2/neu gene amplification was not observed in all cases but one (6% case. Topoisomerase-IIα was not amplified in all cases. Conclusions 1 a subset of metastatic lobular breast carcinoma harbors FGFR-1 gene amplification or gains of chromogenic signals; 2 a minor heterogeneity has been observed after matching primary and metastatic carcinomas; 3 in the

Synchronous ethernet and IEEE 1588 in telecoms next generation synchronization networks

CERN Document Server

2013-01-01

This book addresses the multiple technical aspects of the distribution of synchronization in new generation telecommunication networks, focusing in particular on synchronous Ethernet and IEEE1588 technologies. Many packet network engineers struggle with understanding the challenges that precise synchronization distribution can impose on networks. The usual “why”, “when” and particularly “how” can cause problems for many engineers. In parallel to this, some other markets have identical synchronization requirements, but with their own design requirements, generating further questions. This book attempts to respond to the different questions by providing background technical information. Invaluable information on state of-the-art packet network synchronization and timing architectures is provided, as well as an unbiased view on the synchronization technologies that have been internationally standardized over recent years, with the aim of providing the average reader (who is not skilled in the art) wi...

Short primary linear drive designed for synchronous and induction operation mode with on-board energy storage

Energy Technology Data Exchange (ETDEWEB)

Fernandes Neto, Tobias Rafael

2012-06-28

guide way (induction rail or stationary magnets), and the energy and information should be transmitted contactless to the active vehicle. Regarding the features of the material handling application, the short or long primary topology can be used. Short primary linear drives on passive track are advantageous in material handling applications, where high precision, moderate dynamic, very long track and closed paths are required. Nevertheless, depending on the requirements of the section, the costs can be reduced considerably by using a simple induction rail at the long transporting sections, instead of permanent magnets on the track. Therefore, in this thesis a combined operation of permanent magnet linear synchronous motor (PMLSM) and linear induction motor (LIM) is applied to operate the short primary as vehicle, avoiding adjustment or releasing of the material during the drive cycle. In summary, the passive track will consist of two section types: a high thrust force section (processing station) with PMLSM and a low thrust force section with LIM (transporting section). To the author's knowledge, using two operation modes (PMLSM / LIM) in the same drive is a new approach. A theoretical and experimental study was conducted to assess the feasibility of employing the short primary linear motor for a flexible manufacturing system, in which a contactless energy transmission provides the basic power and an ultracapacitor (UC) storage system provides the peak power. The system uses a bidirectional DC-DC converter between the ultracapacitor bank and the DC-link, to make sure that the ultracapacitor can store the braking energy and supply the peak power demanded by the active vehicle. A control strategy has been developed for controlling the ultracapacitor to deliver the peak of power, to charge, to protect against overvoltage and to recover the energy generated when the vehicle is braking. A control strategy for the transition between the two operation modes (PMLSM / LIM

The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period

International Nuclear Information System (INIS)

Lee, Kuan-Der; Lu, Chang-Hsien; Chen, Ping-Tsung; Chan, Chunghuang Hubert; Lin, Jen-Tsun; Huang, Cih-En; Chen, Chih-Cheng; Chen, Min-Chi

2009-01-01

The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case

Radiotherapy of carcinoma of the esophagus

International Nuclear Information System (INIS)

Nishikawa, Kiyoshi; Suzumiya, Junji; Koga, Kenji; Sumiyoshi, Akinobu; Kusuhara, Toshiyuki; Watanabe, Katsushi

1984-01-01

The specimens obtained from 32 patients with carcinoma of the esophagus were histologically studied to evaluate the radiation effect on the primary lesions and regional lymph node metastases. The patients consist of 21 preoperatively irradiated cases and 11 autopsy cases. Radiation effect was divided into three grades according to Ohboshi-Shimosato's classification. A total dose of 20 to 55 Gy was given to preoperatively irradiated cases and that of 38 to 80 Gy to autopsy cases. The microscopic examination of the primary lesions revealed marked effect in 11 cases, moderate effect in 12 cases and mild or none effect in 9 cases. Radiation effect on carcinoma of the esophagus seemed to be related to the length of the primary lesion (p<0.001); the tumor of 6 cm or less showed marked effect in 9 out of 12 cases (75%), and that of more than 6 cm in only 1 of 19 cases (5%). As for the radiological type of the primaty lesions, superficial or tumorous type seemed to be more effective than serrated or spiral type. As for the histological subtypes, poorly defferentiated squamous cell carcinoma seemed to be more radiosensitive than moderately or well differentiated squamous cell carcinoma. Radiation effect on lymph node metastases within radiation field was correlated to that of the primary lesions. Our results suggest that for radical treatment of esophageal cancer a patient with the tumor length of 6 cm or less should be chosen, although radiological type and/or tumor grade can't also be ignored as a predictor. (author)

Primary hepatic peripheral T-cell lymphoma mimicking hepatocellular carcinoma: a case report.

Science.gov (United States)

Lee, Jisun; Park, Kil Sun; Kang, Min Ho; Kim, Yook; Son, Seung-Myoung; Choi, Hanlim; Choi, Jae-Woon; Ryu, Dong Hee

2017-08-01

Peripheral T-cell lymphomas (PTCLs) are aggressive neoplasms which may involve the liver. The imaging manifestations of hepatic lymphoma are highly variable and show overlapping appearances of numerous other hepatic diseases. As the management and prognosis of lymphoma differ markedly from those of other malignant diseases, prompt diagnosis and early effective treatment are very important. Here, we report an atypical case of primary PTCL not otherwise specified involving the liver that exhibited a solitary hepatic mass mimicking hepatocellular carcinoma (HCC) on CT. Liver biopsy is not commonly recommended in highly suspicious cases of HCC. However, in a patient without risk factors for HCC, consideration of other diagnostic possibilities is required and needle biopsy may be a more rational choice. An imaging approach, based on a careful review of clinical and laboratory findings is essential to prevent false-positive diagnosis of HCC and subsequent invasive treatment.

Impulsive Synchronization and Adaptive-Impulsive Synchronization of a Novel Financial Hyperchaotic System

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Xiuli Chai

2013-01-01

Full Text Available The impulsive synchronization and adaptive-impulsive synchronization of a novel financial hyperchaotic system are investigated. Based on comparing principle for impulsive functional differential equations, several sufficient conditions for impulsive synchronization are derived, and the upper bounds of impulsive interval for stable synchronization are estimated. Furthermore, a nonlinear adaptive-impulsive control scheme is designed to synchronize the financial system using invariant principle of impulsive dynamical systems. Moreover, corresponding numerical simulations are presented to illustrate the effectiveness and feasibility of the proposed methods.

Significance of serum tumor markers monitoring in carcinomas of unknown primary site

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Pejčić Ivica

2010-01-01

Full Text Available Background/Aim. Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis. Cancer of unknown primary site (CUP is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies. The aim of this report was to present the prognostic and predictive value of 8 serum tumor markers in this group of patients. Methods. The study involved 63 patients. On histological examination, all the patients were presented with metastatic tumors whose primary site (origin could not be detected with noninvasive diagnostic techniques. Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma - 8 patients; adenocarcinoma - 33 patients; unclassifiable (undifferentiated carcinoma - 22 patients. In all the cases we evaluated 8 serum tumor markers: alpha-fetoproteins (AFP, chronic gonadotrophin beta submit, human (beta-HCG, neuron specific enolase (NSE, marker of malignant ovarian tumors (CA 125, prostate-specific antigene (PSA, marker of malignant brest tumor (CA 15-3, marker of malignant pancreas tumor and gastrointestinal tumor (Ca 19-9, carcinoembryonic antigen (CEA at the time of diagnosis. The patients on chemotherapy had the markers determined after the third and sixth chemocycle, i.e. at the time of illness progression observation, if present. The patients responding to chemotherapy with complete response (CR, partial response (PR or stable disease (SD had the markers determined after three-month periods until the time of relapse or progression. Chemotherapy was applied in 32 patients (20 females and 12 males, aged 29-70 years, who met the inclusion criteria. The following chemotherapy regimen was used: doxorubicin 50mg/m2 (day 1, cisplatin 60mg/m2 (day 1, and etoposide 120 mg/m2 (days 1-3. The period between two chemotherapy

In vivo 1H MR spectroscopy of thyroid carcinoma

International Nuclear Information System (INIS)

King, Ann D.; Yeung, David K.W.; Ahuja, Anil T.; Tse, Gary M.K.; Chan, Amy B.W.; Lam, Sherlock S.L.; Hasselt, Andrew C. van

2005-01-01

To determine if proton magnetic resonance spectroscopy ( 1 H MRS) of thyroid carcinoma is feasible and to determine if 1 H MRS spectra of malignant tumors differ from that of normal thyroid tissue. We performed 1 H MRS at 1.5 T at echo-times (TE) 136 and 272 ms to examine eight patients with thyroid cancer (primary tumour or nodal metastasis) larger than 1 cm 3 in size and five volunteers with normal thyroids. Spectra acquired from six primary tumors (three anaplastic carcinomas, two papillary carcinomas and one follicular carcinoma) and two nodes (two papillary carcinoma metastases) were analyzed in the time-domain using a non-linear least squares fitting algorithm with incorporation of prior knowledge. Choline (3.2 ppm) was identified in all solid carcinomas with a mean choline/creatine of 4.3 at TE 136 ms and 5.4 at TE 272 ms. Ratios for malignant tumors at TE 136 ms ranged from 1.6 in well differentiated follicular carcinoma to 9.4 in anaplastic carcinoma. No choline was detected in normal thyroid tissues. Our results showed that 1 H MRS is a feasible technique for the evaluation of malignant thyroid tumors larger than 1 cm 3 and that proton spectra of malignant tumors differ from that of normal thyroid tissue

Synchronous atypical fibroxanthoma and Bowen’s disease of the head and neck in an otherwise normal patient – a case report and review of literature [Simultanes Auftreten eines atypischen Fibroxanthoms und Plattenepithelkarzinoms im Kopf-Hals-Bereich – Fallbericht und Literaturübersicht

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Eweida, Ahmad

2012-03-01

Full Text Available [english] Although both atypical fibroxanthoma and squamous cell carcinoma arise on top of sun-damaged skin of the elderly, there is no evidence in literature reporting a synchronous presentation of primary lesions of both malignancies in the head and neck regions. We report a case of synchronous atypical fibroxanthoma and squamous cell carcinoma in situ (Bowen’s disease of the head and neck in an otherwise normal old Caucasian male patient. We reviewed the literature for cases of head and neck atypical fibroxanthoma in association with other skin malignancies with an overview over the risk factors and modalities of treatment. We would like to raise the awareness for the concept of multiple synchronous primary malignant lesions and the importance to anticipate and differentiate between different pathologies in order to provide adequate investigations and treatment for the patient. [german] Obwohl sowohl das atypische Fibroxanthom der Haut als auch das Plattenepithelkarzinom bei sonnengeschädigter Haut älterer Menschen gehäuft vorkommen, gibt es in der Literatur keine Beschreibung eines simultanen Auftretens beider Malignome als Primärläsionen im Kopf-Hals-Bereich. Aus diesem Grund möchten wir über einen Fall berichten, bei dem sowohl ein atypisches Fibroxanthom als auch ein Morbus Bowen (als in situ Variante des Plattenepithelkarzinoms im Kopf-Hals-Bereich eines sonst gesunden 74-jährigen männlichen Patienten aufgetreten ist. Auf Grundlage der bestehenden Publikationen von Fällen mit atypischen Fibroxanthomen in Assoziation mit anderen Hautmalignomen, verglichen wir diese mit dem vorliegenden Fall, insbesondere in Hinblick auf die Risikofaktoren und das empfohlene Behandlungsregime. Ein simultanes Auftreten von mehreren primären Hauttumoren verschiedener Entität ist in einigen Fällen möglich und sollte daher insbesondere bei älteren Menschen deutlich häufiger in die Beurteilung und Diagnosestellung mit eingeschlossen werden

Appendectomy with cytoreductive surgery for ovarian and type 2 endometrial carcinoma.

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Wong, L F A; Wahab, N A; Gleeson, N

2014-01-01

There is considerable variation within and between cancer centers in the practice of appendectomy as part of cytoreductive surgery for ovarian carcinoma and in the surgical staging of endometrial carcinoma. The purpose of this study was to determine the prevalence and the type of appendiceal pathology, the morbidity associated with appendectomy in gynaecologic cancer surgery. This is a retrospective review of all cytoreductive surgery for ovarian carcinoma and surgical staging for endometrial carcinoma with appendectomy over a four year period. Two hundred and fifty-one patients (38 patients for endometrial carcinoma surgery and 213 patients for ovarian cytoreduction) had an appendectomy performed. Metastases to the appendix was present in 46 (23.2%) of primary ovarian carcinoma and one (2.6%) primary endometrial carcinosarcoma. The appendix was more likely to be involved in advanced stage ovarian cancer with positive peritoneal washings, omental deposits, grade 3 differentiation, and papillary serous histology. Sixteen (6.4%) co-incidental primary appendiceal tumours were detected. No postoperative morbidity specific to appendectomy was identified. One case of ovarian carcinoma was upstaged from IC to IIIA by the appendiceal metastases. There was no upstaging of disease in the endometrial carcinoma group. Appendectomy is an integral part of ovarian cytoreductive surgery but the authors found it did not upstage the disease in a clinically significant manner. The incidence of co-incidental appendiceal primary tumours was high in this series and may add value to the procedure in preventing further surgeries. The absence of procedure related morbidity is reassuring. The authors recommend appendectomy for all ovarian staging surgery and its consideration in type 2 endometrial cancer.

Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma

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Giang Tran H

2012-01-01

Full Text Available Abstract Background Carcinoma of the gallbladder (GBC clinically mimics benign gallbladder diseases and often escapes detection until advanced stage. Despite the frequency of cholecystectomy, diagnosis of GBC remains problematic in many situations. We sought to identify pathologic features that contribute to the difficulty in recognition of GBC. Methods We identified 23 patients (ranged from 45 to 86 years, male to female ratio 1:4.5 with carcinoma involving the gallbladder referred to an academic medical center over a period of 10 years for study. This includes 10 cases of primary GBC, 6 cases of metastatic tumor to gallbladder, 6 cases of directly invasive adenocarcinoma arising elsewhere in the biliary tree, and one case of unidentified origin adenocarcinoma. Primary tumors include adenocarcinoma not otherwise specified (NOS in 6 cases, papillary adenocarcinoma in 2 cases, and single cases of undifferentiated carcinoma and combined adenocarcinoma and neuroendocrine carcinoma (NEC. Metastatic tumors to gallbladder were from a wide range of primary sites, predominantly the gastrointestinal tract. Results These cases illustrate seven potential pitfalls which can be encountered. These include: 1 mistakenly making a diagnosis of adenocarcinoma of gallbladder when only benign lesions such as deeply penetrating Rokitansky-Aschoff sinuses are present (overdiagnosis, 2 misdiagnosing well-differentiated invasive carcinoma with minimal disease as benign disease (underdiagnosis, 3 differentiating between primary NEC of gallbladder and metastasis, 4 confusing primary mucinous adenocarcinoma of gallbladder with pseudomyxoma peritonei from a low grade appendiceal neoplasm disseminated to gallbladder, 5 confusing gangrenous necrosis related to cholecystitis with geographic tumoral necrosis, 6 undersampling early, grossly occult disease, and 7 misinterpreting extracellular mucin pools. Conclusions Clinical history and a high index of suspicion are

Combined human papillomavirus typing and TP53 mutation analysis in distinguishing second primary tumors from lung metastases in patients with head and neck squamous cell carcinoma.

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Daher, Tamas; Tur, Mehmet Kemal; Brobeil, Alexander; Etschmann, Benjamin; Witte, Biruta; Engenhart-Cabillic, Rita; Krombach, Gabriele; Blau, Wolfgang; Grimminger, Friedrich; Seeger, Werner; Klussmann, Jens Peter; Bräuninger, Andreas; Gattenlöhner, Stefan

2018-06-01

In head and neck squamous cell carcinoma (HNSCC), the occurrence of concurrent lung malignancies poses a significant diagnostic challenge because metastatic HNSCC is difficult to discern from second primary lung squamous cell carcinoma (SCC). However, this differentiation is crucial because the recommended treatments for metastatic HNSCC and second primary lung SCC differ profoundly. We analyzed the origin of lung tumors in 32 patients with HNSCC using human papillomavirus (HPV) typing and targeted next generation sequencing of all coding exons of tumor protein 53 (TP53). Lung tumors were clearly identified as HNSCC metastases or second primary tumors in 29 patients, thus revealing that 16 patients had received incorrect diagnoses based on clinical and morphological data alone. The HPV typing and mutation analysis of all TP53 coding exons is a valuable diagnostic tool in patients with HNSCC and concurrent lung SCC, which can help to ensure that patients receive the most suitable treatment. © 2018 Wiley Periodicals, Inc.

Gastric metastasis of triple negative invasive lobular carcinoma

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Caglayan Geredeli; Osman Dogru; Ethem Omeroglu; Farise Yilmaz; Faruk Cicekci

2015-01-01

Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis o...

Prognosis and histology in Stage I nasopharyngeal carcinoma (NPC)

International Nuclear Information System (INIS)

Saw, D.; Ho, J.H.C.; Fong, M.; Chan, C.L.; Tse, C.H.; Lau, W.H.

1985-01-01

During 1969-1975, 212 new patients with Stage I nasopharyngeal carcinoma (NPC) with a tumor apparently confined to the nasopharynx were treated at Queen Elizabeth Hospital, Kowloon, Hong Kong. The initial histologies of 137 patients were available for review and further studies. The primary tumors were histologically classified into two major types - squamous cell carcinoma (35 patients) and undifferentiated carcinoma (102 patients). The latter was further divided into 4 sub-types: lymphoepithelioma of the Schmincke type, lymphoepithelioma of the Regaud type, spindle cell carcinoma, and undifferentiated carcinoma of the nasopharyngeal type. Such histological typing of the initial tumor was not of value in predicting the clinical outcome, whether in terms of 5-year crude or disease-free survival rate, or the tendency of the tumor to develop recurrence at the primary site, or distance metastases after a standardized course of radiation therapy. There is not significant correlation between the extent of mononuclear infiltration nor fibrosis in the tumor stroma and the survival or tumor control rates

Pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions

International Nuclear Information System (INIS)

Yan-Li, Zou; Guan-Rong, Chen

2009-01-01

This paper studies pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions. To study a state-feedback pinning-controlled network with N nodes, it first converts the controlled network to an extended network of N+1 nodes without controls. It is shown that the controlled synchronizability of the given network is determined by the real part of the smallest nonzero eigenvalue of the coupling matrix of its extended network when the synchronized region is unbounded; but it is determined by the ratio of the real parts of the largest and the smallest nonzero eigenvalues of the coupling matrix when the synchronized region is bounded. Both theoretical analysis and numerical simulation show that the portion of controlled nodes has no critical values when the synchronized region is unbounded, but it has a critical value when the synchronized region is bounded. In the former case, therefore, it is possible to control the network to achieve synchronization by pinning only one node. In the latter case, the network can achieve controlled synchronization only when the portion of controlled nodes is larger than the critical value. (general)

Less aggressive disease in patients with primary squamous cell carcinomas of the thyroid gland and coexisting lymphocytic thyroiditis.

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Asik, Mehmet; Binnetoglu, Emine; Sen, Hacer; Gunes, Fahri; Muratli, Asli; Kankaya, Duygu; Uysal, Fatma; Sahin, Mustafa; Ukinc, Kubilay

2015-01-01

Primary squamous cell carcinoma (SCC) of the thyroid gland is extremely rare. Infrequently, primary SCC of the thyroid gland is accompanied by other thyroid diseases such as Hashimoto's thyroiditis (HT). Recently, studies have demonstrated that differentiated thyroid cancer with coexisting HT has a better prognosis. However, the prognosis of patients with primary SCC of the thyroid gland and coexistent HT has not been clearly identified. We compared the clinical characteristics and disease stages of patients with primary SCC with and without lymphocytic thyroiditis (LT). We reviewed reports of primary SCC of the thyroid gland published in the English literature. We identified 46 papers that included 17 cases of primary SCC of the thyroid gland with LT and 77 cases of primary SCC of the thyroid gland without LT. Lymph node metastasis and local invasion rates did not differ between these two groups. Distant metastases were absent in patients with LT, and were observed in 13 (16.9%) patients without LT. A greater proportion of patients without LT had advanced stage disease (stage IV A-B-C) than patients with LT (p thyroid gland and coexisting LT had lower tumour-node-metastasis stage and frequency of distant metastasis than those without LT. Lymphocytic infiltration in patients with SCC appears to limit tumour growth and distant metastases.

Fibroblast Growth Factor Receptor 3 (FGFR3–Analyses of the S249C Mutation and Protein Expression in Primary Cervical Carcinomas

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Haiyan Dai

2001-01-01

Full Text Available Fibroblast growth factor receptor 3 (FGFR3 seems to play an inhibitory role in bone development, as activating mutations in the gene underlie disorders such as achondroplasia and thanatophoric dysplasia. Findings from multiple myeloma (MM indicate that FGFR3 also can act as an oncogene, and mutation of codon 249 in the fibroblast growth factor receptor 3 (FGFR3 gene was recently detected in 3/12 primary cervical carcinomas. We have analysed 91 cervical carcinomas for this specific S249C mutation using amplification created restriction site methodology (ACRS, and detected no mutations. Immunohistochemistry was performed on 73 of the tumours. Reduced protein staining was seen in 43 (58.8% samples. Six of the tumours (8.2% revealed increased protein staining compared with normal cervical tissue. These patients had a better prognosis than those with reduced or normal levels, although not statistically significant. This report weakens the hypothesis of FGFR3 as an oncogene of importance in cervical carcinomas.

CARCINOMA OF UNKNOWN PRIMARY WITH SECONDARY METASTASIS TO NECKANALYSIS OF PATIENT AND DISEASE RELATED FACTORS PREDICTING SUPERIOR PATIENT OUTCOMES IN CUPS NECK

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Preeti Singh

2017-11-01

Full Text Available BACKGROUND Carcinoma of unknown primary with secondary metastasis to neck (CUPS Neck is involvement of cervical nodes with squamous cell carcinoma without identifiable primary lesion in oral cavity, oropharynx and upper aerodigestive tract. Most commonly affects older male with history of tobacco and alcohol abuse. Commonly involved neck nodes are level II and III. Metastasis to these nodes usually comes from head and neck tumours. The aims of this study are to evaluate the factors (relating to patient and disease associated with improved outcomes following treatment in patients with metastatic squamous cell carcinoma of neck with unknown primary site. MATERIALS AND METHODS Study was done in ENT and Head Neck Centre, Base Hospital, Delhi Cantt. The investigation and treatment of such cases aim to detect a primary lesion, if possible in the upper aerodigestive tract (UADT and in any case to institute the optimal management protocol. Many factors impact the outcomes of treatment in terms of survival and quality of life. RESULTS After followup of 0.5 to 2 years data were compared among various groups, various disease related factors like volume of disease, staging of neck node, extracapsular spread in final HPE report and various patient related factors like age and sex of patient, performance status of patient, and presence of comorbidities were compared with final outcome in terms of recurrence or disease free survival with less complications. CONCLUSION 1. Most prominent tumour related prognostic factors were low volume nodal disease in the neck and absence of extracapsular spread. Patients with TNM stage I (T0N1M0 were associated with lower recurrence and less complication postoperatively as compared to advanced stage disease (T0N2M0 and T0N3M0. 2. In our study, patient related variables associated with superior patient outcomes in terms of locoregional recurrence or disease free survival were good performance status, females, young age

Primary squamous cell carcinoma of the thyroid. Initial assessment and follow-up using 18F-FDG PET/CT.

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Caballero Gullón, L; Carmona González, E; Martínez Estévez, A; Gómez Camarero, M P; Corral, J J; Borrego Dorado, I

Squamous cell carcinoma of thyroid is an uncommon, very aggressive neoplasm, having a poor prognosis and poor response to chemotherapy and radiotherapy. Surgery is the initial treatment of choice, although it often presents as a widespread disease at the time of diagnosis, usually with cervical swelling that causes most of the symptoms due to local infiltration or metastasis. Local infiltration from adjacent tumour and metastatic disease needs to be excluded from other primary epidermoid carcinomas, in order to make a correct diagnosis. This also requires the typical cytokeratin pattern seen in histological studies. The case is presented of a 53 year-old man with a medical history of hepatocarcinoma, with a cervical hypermetabolic lesion detected in an 18 F-FDG PET/CT performed to exclude widespread disease. The follow-up of this lesion with this technique and its usefulness is also described. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Multiple primary cancer

International Nuclear Information System (INIS)

Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

1989-01-01

It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

Synchronization on effective networks

International Nuclear Information System (INIS)

Zhou Tao; Zhao Ming; Zhou Changsong

2010-01-01

The study of network synchronization has attracted increasing attentionrecently. In this paper, we strictly define a class of networks, namely effective networks, which are synchronizable and orientable networks. We can prove that all the effective networks with the same size have the same spectra, and are of the best synchronizability according to the master stability analysis. However, it is found that the synchronization time for different effective networks can be quite different. Further analysis shows that the key ingredient affecting the synchronization time is the maximal depth of an effective network: the larger depth results in a longer synchronization time. The secondary factor is the number of links. The increasing number of links connecting nodes in the same layer (horizontal links) will lead to longer synchronization time, whereas the increasing number of links connecting nodes in neighboring layers (vertical links) will accelerate the synchronization. Our analysis of the relationship between the structure and synchronization properties of the original and effective networks shows that the purely directed effective network can provide an approximation of the original weighted network with normalized input strength. Our findings provide insights into the roles of depth, horizontal and vertical links in the synchronizing process, and suggest that the spectral analysis is helpful yet insufficient for the comprehensive understanding of network synchronization.

Synchronization on effective networks

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Zhou Tao [Web Sciences Center, University of Electronic Science and Technology of China, Chengdu 610054 (China); Zhao Ming [Department of Modern Physics, University of Science and Technology of China, Hefei 230026 (China); Zhou Changsong, E-mail: cszhou@hkbu.edu.h [Department of Physics, Hong Kong Baptist University, Kowloon Tong (Hong Kong)

2010-04-15

The study of network synchronization has attracted increasing attentionrecently. In this paper, we strictly define a class of networks, namely effective networks, which are synchronizable and orientable networks. We can prove that all the effective networks with the same size have the same spectra, and are of the best synchronizability according to the master stability analysis. However, it is found that the synchronization time for different effective networks can be quite different. Further analysis shows that the key ingredient affecting the synchronization time is the maximal depth of an effective network: the larger depth results in a longer synchronization time. The secondary factor is the number of links. The increasing number of links connecting nodes in the same layer (horizontal links) will lead to longer synchronization time, whereas the increasing number of links connecting nodes in neighboring layers (vertical links) will accelerate the synchronization. Our analysis of the relationship between the structure and synchronization properties of the original and effective networks shows that the purely directed effective network can provide an approximation of the original weighted network with normalized input strength. Our findings provide insights into the roles of depth, horizontal and vertical links in the synchronizing process, and suggest that the spectral analysis is helpful yet insufficient for the comprehensive understanding of network synchronization.

Breast metastases from rectal carcinoma

Institute of Scientific and Technical Information of China (English)

LI Jia; FANG Yu; LI Ang; LI Fei

2011-01-01

Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

Continuous theta-burst stimulation modulates tactile synchronization.

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Lee, Kevin Gh; Jacobs, Mark F; Asmussen, Michael J; Zapallow, Christopher M; Tommerdahl, Mark; Nelson, Aimee J

2013-08-23

Temporal order judgement (TOJ) is the ability to detect the order of occurrence of two sequentially delivered stimuli. Previous research has shown that TOJ in the presence of synchronized periodic conditioning stimuli impairs TOJ performance, and this phenomenon is suggested to be mediated by GABAergic interneurons that cause perceptual binding across the two skin sites. Application of continuous theta-burst repetitive TMS (cTBS) over primary somatosensory cortex (SI) alters temporal and spatial tactile perception. The purpose of this study was to examine TOJ perception in the presence and absence of synchronized periodic conditioning stimuli before and after cTBS applied over left-hemisphere SI. A TOJ task was administered on the right index and middle finger (D2 and D3) in two separate sessions in the presence and absence of conditioning stimuli (a background low amplitude sinusoidal vibration). CTBS reduced the impact of the conditioning stimuli on TOJ performance for up to 18 minutes following stimulation while sham cTBS did not affect TOJ performance. In contrast, the TOJ task performed in the absence of synchronized conditioning stimulation was unaltered following cTBS. We conclude that cTBS suppresses inhibitory networks in SI that mediate perceptual binding during TOJ synchronization. CTBS offers one method to suppress cortical excitability in the cortex and potentially benefit clinical populations with altered inhibitory cortical circuits. Additionally, TOJ measures with conditioning stimuli may provide an avenue to assess sensory processing in neurologically impaired patient populations.

Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of 18F-FDG PET and extended-field multi-detector row CT

International Nuclear Information System (INIS)

Ng, Shu-Hang; Ko, Sheung-Fat; Chin, Shu-Chyn; Chan, Sheng-Chieh; Yen, Tzu-Chen; Liao, Chun-Ta; Huang, Shiang-Fu; Chang, Joseph Tung-Chieh; Lin, Chin-Yu.; Wang, Hung-Ming

2008-01-01

Patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) have a high risk of having distant metastases or second primary tumors. We prospectively evaluate the clinical usefulness of 18 F-fluoro-2-deoxyglucose positron emission tomography ( 18 F-FDG PET), extended-field multi-detector computed tomography (MDCT), and their side-by-side visual correlation for the detection of distant malignancies in these two tumors at presentation. A total of 160 patients with SCC of the oropharynx (n = 74) or hypopharynx (n=86) underwent 18 F-FDG PET and extended-field MDCT to detect distant metastases or second primary tumors. Suspected lesions were investigated by means of biopsy, clinical, or imaging follow-up. Twenty-six (16.3%) of our 160 patients were found to have distant malignancy. Diagnostic yields of 18 F-FDG PET and MDCT were 12.5% and 8.1%, respectively. The sensitivity of 18 F-FDG PET for detection of distant malignancies was 1.5-fold higher than that of MDCT (76.9% vs. 50.0%, P=0.039), while its specificity was slightly lower (94.0% vs. 97.8%, P=0.125). Side-by-side visual correlation of MDCT and 18 F-FDG PET improved the sensitivity and specificity up to 80.8% and 98.5%, respectively, leading to alteration of treatment in 13.1% of patients. A significant difference in survival rates between its positive and negative results was observed. 18 F-FDG PET and extended-field MDCT had acceptable diagnostic yields for detection of distant malignancies in untreated oropharyngeal and hypopharyngeal SCC. 18 F-FDG PET was 1.5-fold more sensitive than MDCT, but had more false-positive findings. Their visual correlation improved the diagnostic accuracy, treatment planning, and prognosis prediction. (orig.)

Hepatocellular carcinoma localized in the bile duct lumen: two case report

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Bae, Kyeung Kug; Chang, Jay Chun [Yeungnam Univ. School of Medicine, Seoul (Korea, Republic of)

1998-10-01

Intrabile duct tumor growth of hepatocellular carcinoma is an uncommon manifestation, but intraluminal bile duct hepatocellular carcinoma without primary hepatic parenchymal lesions is extremely rare. To our knowledge, only a few case reports have been published. We encountered two cases of primary hepatocellular carcinoma arising in the bile duct;serum alpha-fetoprotein levels were within the normal limits. Both showed the following characteristic radiologic features: (1) Cholangiography revealed filling defects within the dilated bile duct; (2) two-phase abdominal CT showed enhancement during the arterial-dominant phase and washout during the tissue equilibrium phase, as in typical HCC; and (3) hepateic arteriography revealed hypervascular tumor staining. Surgery was performed and the resected specimen showed no detectable primary hepatic parenchymal mass;on the basis of the pathologic finding, intraluminal bile duct hepatocellular carcinoma was confirmed. We cautiously assume that this peculiar type of HCC may arise primarily from bile duct mucosa.=20.

Carcinoma of the stomach in atomic bomb survivors

International Nuclear Information System (INIS)

Suehiro, Shinichi; Ogawa, Yuichiro; Nagasue, Naofumi; Abe, Shunichi; Sasaki, Yukiharu.

1985-01-01

A retrospective study of 135 atomic bomb survivors (A-bomb group) and 377 non-atomic bomb survivors (control group) who had carcinoma of the stomach was made with respect to surgical and pathological findings of carcinoma. An average age was significantly older in the A-bomb group (65 years) than in the control group (57 years). The number of female patients was significantly larger in the A-bomb group than in the control group. Although there was no difference of incidence in liver and peritoneal metastases, lymph node metastases along the left gastric artery, common hepatic artery and splenic artery, around the celiac artery, and at the splenic hilus occurred less frequently in the A-bomb group than in the control group. When carcinoma of the stomach was histologically classified as differentiated and undifferentiated, the incidence of differentiated type was higher than that of undifferentiated type in the A-bomb group. Regarding postoperative complications and follow-up results, there was no significant difference between the groups, synchronous or heterochronous multiple cancer occurred more frequently in the A-bomb group than in the control group. (Namekawa, K.)

Synchronous activity in cat visual cortex encodes collinear and cocircular contours.

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Samonds, Jason M; Zhou, Zhiyi; Bernard, Melanie R; Bonds, A B

2006-04-01

We explored how contour information in primary visual cortex might be embedded in the simultaneous activity of multiple cells recorded with a 100-electrode array. Synchronous activity in cat visual cortex was more selective and predictable in discriminating between drifting grating and concentric ring stimuli than changes in firing rate. Synchrony was found even between cells with wholly different orientation preferences when their receptive fields were circularly aligned, and membership in synchronous groups was orientation and curvature dependent. The existence of synchrony between cocircular cells reinforces its role as a general mechanism for contour integration and shape detection as predicted by association field concepts. Our data suggest that cortical synchrony results from common and synchronous input from earlier visual areas and that it could serve to shape extrastriate response selectivity.

Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study.

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Thompson, Bridie S; Olsen, Catherine M; Subramaniam, Padmini; Neale, Rachel E; Whiteman, David C

2016-04-01

To investigate the accuracy of Medical Benefit Schedule (MBS) item numbers to identify treatments for basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). We linked records from QSkin Study participants (n=37,103) to Medicare. We measured the proportion of Medicare claims for primary excision of BCC/SCC that had corresponding claims for histopathology services. In subsets of participants, we estimated the sensitivity and external concordance of MBS item numbers for identifying BCC/SCC diagnoses by comparing against 'gold-standard' histopathology reports. A total of 2,821 (7.6%) participants had 4,830 separate Medicare claims for BCC/SCC excision; almost all (97%) had contemporaneous Medicare claims for histopathology services. Among participants with BCC/SCC confirmed by histology reports, 76% had a corresponding Medicare claim for primary surgical excision of BCC/SCC. External concordance for Medicare claims for primary BCC/SCC excision was 68%, increasing to 97% when diagnoses for intra-epidermal carcinomas and keratoacanthomas were included. MBS item numbers for primary excision of BCC/SCC are reasonably reliable for determining incident cases of keratinocyte skin cancers, but may underestimate incidence by up to 24%. Medicare claims data may have utility in monitoring trends in conditions for which there is no mandatory reporting. © 2015 Public Health Association of Australia.

Primary Papillary Serous Carcinoma of the Fallopian Tube Presenting as a Vaginal Mass: A Case Report and Review of the Literature.

Science.gov (United States)

Kadour-Peero, Einav; Sagi-Dain, Lena; Cohen, Gil; Korobochka, Roman; Agbarya, Abed; Bejar, Jacob; Sagi, Shlomi

2018-05-07

BACKGROUND There is now evidence to support that some cases of high-grade serous papillary carcinoma arise from the fallopian tubes rather than the ovaries. Common symptoms at presentation include abdominal pain and swelling, vomiting, altered bowel habit and urinary symptoms. To our knowledge, this is the first case of serous papillary carcinoma presenting as a vaginal mass lesion. CASE REPORT A 41-year-old woman was referred to the Bnai-Zion Medical Center with the main complaint of irregular vaginal bleeding, vaginal mucous discharge, and suspected pelvic mass. Physical examination showed a soft, painless mass, measuring about 10 cm in diameter located mainly in the recto-vaginal septum, but not involving the uterus. Ultrasound examination showed no abnormal ovarian or uterine findings. Transvaginal biopsies of the mass showed a poorly differentiated serous papillary carcinoma of ovarian, tubal, or peritoneal origin. The physical examination and imaging findings strongly indicated an inoperable tumor, and the patient was treated with neoadjuvant (pre-surgical) chemotherapy. Pre-operative computed tomography (CT) imaging showed the partial involvement of the colon, and so surgical treatment included total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, partial vaginectomy, anterior rectal resection, and lymph node dissection. Histopathology of the surgical specimens showed a poorly differentiated serous carcinoma originating from the fimbria of the right fallopian tube. CONCLUSIONS To the best of our knowledge, this is the first report to describe primary fallopian tube papillary serous carcinoma presenting as a vaginal mass. Therefore, physicians should be aware of this possible diagnosis.

Synchronization of chaotic systems

International Nuclear Information System (INIS)

Pecora, Louis M.; Carroll, Thomas L.

2015-01-01

We review some of the history and early work in the area of synchronization in chaotic systems. We start with our own discovery of the phenomenon, but go on to establish the historical timeline of this topic back to the earliest known paper. The topic of synchronization of chaotic systems has always been intriguing, since chaotic systems are known to resist synchronization because of their positive Lyapunov exponents. The convergence of the two systems to identical trajectories is a surprise. We show how people originally thought about this process and how the concept of synchronization changed over the years to a more geometric view using synchronization manifolds. We also show that building synchronizing systems leads naturally to engineering more complex systems whose constituents are chaotic, but which can be tuned to output various chaotic signals. We finally end up at a topic that is still in very active exploration today and that is synchronization of dynamical systems in networks of oscillators

Assessment of intracranial metastases from neuroendocrine tumors/carcinoma

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Ahmed M Ragab Shalaby

2016-01-01

Full Text Available Background: The most common sites of origin for neuroendocrine carcinoma are gastrointestinal tract and its accessory glands, and lungs. Materials and Methods: One-hundred fifty cases diagnosed with metastatic brain lesions were retrieved from hospital records within 5 years. For these cases, the primary neoplasm, histopathological classification, metastasis, treatment, and fate all were studied. Results: Intracranial deposits were detected in 10%. The primary lesion was in the lungs in 87% of patients, and 1 patient in the breast and 1 in esophagus. Pathological classification of the primary lesion was Grade 2 (MIB-1: 3–20% in 1 patient and neuroendocrine carcinoma (MIB-1: ≥21% in 14 patients. The median period from onset of the primary lesion up to diagnosis of brain metastasis was 12.8 months. About 33% of patients had a single metastasis whereas 67% patients had multiple metastases. Brain metastasis was extirpated in 33% of patients. Stereotactic radiotherapy alone was administered in 20% of patients, and brain metastasis was favorably controlled in most of the patients with coadministration of cranial irradiation as appropriate. The median survival period from diagnosis of brain metastasis was 8.1 months. Conclusion: Most of patients with brain metastasis from neuroendocrine carcinoma showed the primary lesion in the lungs, and they had multiple metastases to the liver, lymph nodes, bones, and so forth at the time of diagnosis of brain metastasis. The guidelines for accurate diagnosis and treatment of neuroendocrine carcinoma should be immediately established based on further analyses of those patients with brain metastasis.

Multiple neoplasms, single primaries, and patient survival

International Nuclear Information System (INIS)

Amer, Magid H

2014-01-01

Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first) primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284), and three or more primaries (n=38). Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%), with a tendency to develop thrombosis (20.2%), had a strong family history of similar cancer (22.3%), and usually presented with earlier stage 0 through stage II disease (78.9%). When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001). Five-year survival rates were higher for metachronous cancers (95%) than for synchronous primaries (59%) and single primaries (59%). The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years) and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991). Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition

Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography

International Nuclear Information System (INIS)

Teo, P.; Yu, P.; Lee, W.Y.; Leung, S.F.; Kwan, W.H.; Yu, K.H.; Choi, P.; Johnson, P.J.

1996-01-01

Purpose: To evaluate the significant prognosticators in nasopharyngeal carcinoma (NPC). Methods and Materials: From 1984 to 1989, 903 treatment-naive nondisseminated (MO) NPC were given primary radical radiotherapy to 60-62.5 Gy in 6 weeks. All patients had computed tomographic (CT) and endoscopic evaluation of the primary tumor. Potentially significant parameters (the patient's age and sex, the anatomical structures infiltrated by the primary lesion, the cervical nodal characteristics, the tumor histological subtypes, and various treatment variables were analyzed by both monovariate and multivariate methods for each of the five clinical endpoints: actuarial survival, disease-free survival, free from distant metastasis, free from local failure, and free from regional failure. Results: The significant prognosticators predicting for an increased risk of distant metastases and poorer survival included male sex, skull base and cranial nerve(s) involvement, advanced Ho's N level, and presence of fixed or partially fixed nodes or nodes contralateral to the side of the bulk of the nasopharyngeal primary. Advanced patient age led to significantly worse survival and poorer local tumor control. Local and regional failures were both increased by tumor infiltrating the skull base and/or the cranial nerves. In addition, regional failure was increased significantly by advancing Ho's N level. Parapharyngeal tumor involvement was the strongest independent prognosticator that determined distant metastasis and survival rates in the absence of the overriding prognosticators of skull base infiltration, cranial nerve(s) palsy, and cervical nodal metastasis. Conclusions: The significant prognosticators are delineated after the advent of CT and these should form the foundation of the modern stage classification for NPC

MAML2 rearrangement in primary pulmonary mucoepidermoid carcinoma and the correlation with FLT1 expression.

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Fen Zhu

Full Text Available INTRODUCTION: Primary pulmonary mucoepidermoid carcinoma (PMEC is an uncommon neoplasm with remarkable resemblance to mucoepidermoid carcinoma of the salivary glands. The latter has been shown to harbor t(11,19 resulting in MECT1-MAML2 fusion, which may be of diagnostic and prognostic values. However, the importance of such feature in PMEC has not been well studied. METHODS: We detected MAML2 rearrangement using fluorescence in situ hybridization (FISH in tissue samples from 42 cases of PMEC and 40 of adenosquamous carcinoma (ASC, and the expression of potential downstream targets of MECT1-MAML2, including HES1, FLT1 and NR4A2 with immunohistochemistry (IHC. The findings were then examined regarding the clinicopathological parameters and patient outcomes. RESULTS: FISH analysis revealed MAML2 rearrangement in 50% of the PMEC cases, and such property was prominent in considerable younger patients (33 versus 60 years; p = 0.001 and restricted to cases of low and intermediate grades. IHC analysis showed that FLT1 and HES1 were expressed at lower level in MAML2 rearranged group than MAML2 non-rearranged group (p<0.001 and p = 0.023, respectively. Survival analysis showed significant correlation between MAML2 rearrangement and overall survival (p = 0.023 or disease-free survival (p = 0.027 as well as correlation between FLT1 and overall survival (p = 0.009. CONCLUSIONS: MAML2 rearrangement appears frequent in PMEC and specific with this tumor. Both the presence of MAML2 rearrangement and absence of FLT1 tend to confer a favorable clinical outcome. These findings suggest that molecular detection of MAML2 rearrangement combined with FLT1 may be of important clinical value for PMEC.

Metastatic urachal carcinoma in bronchial brush cytology

Directory of Open Access Journals (Sweden)

Fatima Zahra Aly

2013-01-01

Full Text Available Urachal carcinoma is rare comprising less than 1% of all bladder carcinomas. Metastases of urachal carcinoma have been reported to meninges, brain, ovary, lung, and maxilla. Cytologic features of metastatic urachal carcinoma have not been previously reported. We present a case of metastatic urachal adenocarcinoma in bronchial brushings and review the use of immunohistochemistry in its diagnosis. A 47-year-old female was seen initially in 2007 with adenocarcinoma of the bladder dome for which she underwent partial cystectomy. She presented in 2011 with a left lung mass and mediastinal adenopathy. Bronchoscopy showed an endobronchial lesion from which brushings were obtained. These showed numerous groups of columnar cells with medium sized nuclei and abundant cytoplasm. The cells were positive for CK20 and CDX2 and negative for CK7. The cytomorphological findings were similar to those in the previous resection specimen and concurrent biopsy. This is the first case report of bronchial brushings containing metastatic urachal carcinoma. No specific immunohistochemical profile is available for its diagnosis. The consideration of a second primary was a distinct possibility in this case due to the lapse of time from primary resection, absence of local disease, and lack of regional metastases.

Assessment of occult cervical lymph node metastasis in primary squamous cell carcinoma of the head and neck by computed tomography

International Nuclear Information System (INIS)

Shakil, U.

2015-01-01

To determine the frequency of occult (node negative) cervical lymph node metastasis in primary head and neck squamous cell carcinoma, using contrast enhanced computed tomography (CT). Study Design: Cross sectional descriptive study. Place and Duration of Study: Study was conducted in Department of Radiology, Combined Military Hospital Rawalpindi. Duration of the study was 06 months i.e. from 19th February 2011 to 19th August 2011. Patients and Methods: A total of 141 cases, fulfilling the inclusion criteria, reporting to the radiology department, were included in the study after seeking written informed consent. All patients underwent contrast enhanced CT scan of the neck from base of skull to root of neck using Asteion Whole Body X-ray CT Scanner (Model TSX-021A). Images were evaluated for the presence or absence of cervical lymph node metastasis according to the cervical lymph node metastatic criteria at each level of the neck. Results: Of the 141 patients with clinically no head and neck squamous cell carcinoma, 45.4% were found to have lymph node metastases. Frequency of occult metastases in squamous cell carcinoma of oral cavity was 47.6%, oropharynx 23.5%, larynx 33.3% and hypopharynx 78.6%. Conclusion: In clinically node negative neck, the risk of lymph node metastases is significantly high in patients of head and neck squamous cell carcinoma in our population. All patients presenting with node negative neck should undergo CT scans for early detection of occult metastasis. (author)

Content-based intermedia synchronization

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Oh, Dong-Young; Sampath-Kumar, Srihari; Rangan, P. Venkat

1995-03-01

Inter-media synchronization methods developed until now have been based on syntactic timestamping of video frames and audio samples. These methods are not fully appropriate for the synchronization of multimedia objects which may have to be accessed individually by their contents, e.g. content-base data retrieval. We propose a content-based multimedia synchronization scheme in which a media stream is viewed as hierarchial composition of smaller objects which are logically structured based on the contents, and the synchronization is achieved by deriving temporal relations among logical units of media object. content-based synchronization offers several advantages such as, elimination of the need for time stamping, freedom from limitations of jitter, synchronization of independently captured media objects in video editing, and compensation for inherent asynchronies in capture times of video and audio.

Primary squamous cell carcinoma of the rectum: An update and implications for treatment

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Guerra, Glen R; Kong, Cherng H; Warrier, Satish K; Lynch, Andrew C; Heriot, Alexander G; Ngan, Samuel Y

2016-01-01

AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma (SCC). METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert. RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC’s are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-node-metastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external site of primary SCC with metastasis to the rectum. While the

Fast Self-Synchronization between LowVoltage Microgrid and Inverter using Virtual Synchronous Converter

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Md Ruhul Amin

2017-12-01

Full Text Available In this paper, a fast self-synchronization known as virtual synchronous converter (VSCon between single-phase microgrid and inverter in low-voltage microgrid, has been developed in Matlab/Simulink. The idea is to any phase locked loop (PLL circuit for inverter-microgrid synchronization in order to improve the synchronization time. As known, it is difficult and lengthy process to tune the PLL gain parameters to reach suitable performance for synchronizing among the voltage, phase-angle and frequency between them. Due to this problem, a fast self synchronization technique is needed in order to minimize the time losses at the microgrid connection. Therefore, the VSCon has been developed which is based on the synchronous generator mathematical model but in virtual environment representation. It has been applied in the inverter control for generating switching pattern to the inverter switches in order to respond to the grid voltage for improve the synchronization. For a prove of concept, several simulation tests in MATLAB models have been conducted, in order to see the effectiveness of this VSCon. First test has been conducted, when a 240V, 50Hz frequency grid source is used for observing the self-synchronization the system with the power flows output. Furthermore, the next test is conducted when the grid frequency is changed from the rated frequency at 50Hz to 51Hz and the result shows the VSCon in inverter control takes nearly 40ms to synchronize to this new frequency value. The test on grid phase-angle delay also been tested when ac grid voltage has 150 phase delay. As from all the results, the improved inverter control with VSCon structure is able to have fast and self-synchronized between the invertergrid connection before the power from the inverter can be transferred.

Uterus effusion after irradiation for carcinoma of the cervix

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Ma Shaokang; Gao Juzhen; Wu Lingying

2007-01-01

Objective: To analyse the clinical characteristics of patients with uterus effusion after irradiation for carcinoma of the cervix. Methods: 151 patients with uterus effusion after irradiation for carcinoma of the cervix were retrospectively analyzed. Results: All these 151 patients who had been treated by radiotherapy had FIGO stage IIB or IIIB lesions including 32 adenocarcinomas. The most common symptom was irregular vaginal discharge or drainage (65 patients), followed by irregular vaginal bleeding (32 patients), and abdominal or pelvic mass (27 patients). Twenty-seven patients were entirely asymptomatic. The positive rate of uterus effusion found by B-ultrasound scan was 100%. When uterus effusion was found, 87 patients (57.6%) had malignant tumor, including 62 with residual or recurrent cervical carcinoma and 25 with secondary primary malignant uterus tumor. Sixty-four patients had uterus effusion alone including 8 with pyometra. Of these 64 patients, 17 underwent abdominal hysterectomy with bilateral salpingo-oophorectomy (BSOH), the others were treated with drainage till the fluid disappeared. Of the 62 patients with residual or recurrent cervical carcinoma, 19 underwent BSOH and 43 were treated by palliative irradiation or chemotherapy. Twenty-five patients who had secondary primary malignant uterus tumor were treated by BSOH. The 5-year survival rate of patients with uterus effusion alone, with residual tumor (with recurrent tumor), or with secondary primary malignancy were 54.8%, 0%, 28.7% and 47.5%, respectively. The prognosis of the patients with uterus effusion alone was better than those with secondary primary malignant uterus tumor. Patients with residual or recurrent cervical cancer had the worst prognosis. Conclusions: Patients with uterus effusion after irradiation for carcinoma of the cervix often have tumor including secondary primary, malignant uterus tumor. The prognosis is different, which depends on if the patient has tumor or not. (authors)