Serie de preguntas que los pacientes con cáncer pueden hacerle al médico sobre las opciones de tratamiento si el cáncer es avanzado, las formas de controlar los síntomas y cómo prepararse para la etapa final de la vida.
\\u000a Anaplastic thyroid carcinoma is often rapidly growing and therefore large when diagnosed. The frequently elderly patient,\\u000a therefore, has different symptoms [6,7]. At the time of presentation anaplastic carcinoma is often infiltrating and inoperable.\\u000a The tumors are often derived from papillary or follicular carcinomas, and may contain both papillary and anaplastic carcinoma\\u000a cells . Therefore, it may be impossible to distinguish
Arne Heilo; Eva Sigstad; Krystyna Grřholt
Summary Among 54 mediastinal tumours we examined in the past 20 years, there were 5 cases of primary thymic carcinomas, each with widespread metastases. Histological features in three cases were consistent with lymphoepithelioma-like carcinoma. One case showed an epidermoid pattern with keratotic pearls resembling Hassall bodies. One undifferentiated carcinoma developed from a cortical thymoma. Epstein-Barr virus could not be detected
C.-A. Hartmann; Chr Roth; C. Minck; G. Niedobitek
... Diseases and treatments Q - T Squamous cell carcinoma Squamous cell carcinoma Squamous cell carcinoma : This man's skin has been ... treatment, SCC is highly curable. Learn more about squamous cell carcinoma Squamous cell carcinoma: Signs and symptoms Squamous cell ...
With the remarkable recent diagnostic and therapeutic advances and the discovery of a possible pathogenetic role of hepatitis B virus, the study and treatment of hepatocellular carcinoma are entering a new era. Parallel developments in the pathological study of this malignancy are also to be expected. To coincide with this new era, this book presents the authors' accumulated pathomorphological knowledge of hepatocellular carcinoma. The detailed coverage is based on the examination findings of 439 cases of hepatocellular carcinoma autopsied at the authors' department in the last twenty years.
Nakashima, T.; Kojiro, M.
\\u000a Parathyroid carcinoma is a rare cause of primary hyperparathyroidism (PHPT) (<1%) and is usually associated with more severe\\u000a clinical manifestations than its much more common benign counterpart, the parathyroid adenoma [1–3].
Claudio Marcocci; Filomena Cetani; John P. Bilezikian
... this tumor. Adrenocortical carcinoma can produce the hormones cortisol, aldosterone, estrogen, or testosterone, as well as other ... Symptoms that suggest increased cortisol or other adrenal gland ... high on the back just below the neck ( buffalo hump ) Flushed ...
Primary hepatocellular carcinoma is one of the 10 most common tumours, and the most common primary liver malignancy, in the world. In the majority of cases, it occurs against a background of hepatitis B or C viral infection and/or liver cirrhosis, and is associated with a dismal prognosis of a few months. Current treatments in routine clinical practice are surgical resection and liver transplantation, but these therapies are applicable to only a small proportion of patients and prolongation of survival is restricted. Other treatment options include intra-arterial chemotherapy, transcatheter arterial chemoembolisation, percutaneous ethanol injection, cryotherapy, thermotherapy, proton therapy, or a wide range of their possible combinations. The current lack of definitive data, however, limits the use of these therapies. Another option is gene therapy, which although in its infancy at the present time, may have a significant role to play in the future management of hepatocellular carcinoma.???Keywords: hepatocellular carcinoma; hepatic resection; liver transplantation; transcatheter arterial chemoembolisation
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. PMID:23552543
Shah, Syed Aslam; Riaz, Umbreen; Zahoor, Imran; Jalil, Ana; Zubair, Muhammad
Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC ... The cause of medullary carcinoma of the thyroid (MTC) is unknown. Unlike other types of thyroid cancer, MTC is less likely to be caused by radiation therapy to the neck given ...
Cloacogenic carcinoma is a rare tumor of the anorectal region originating from a persistant remnant of the cloacal membrane of the embryo. The tumor accounts for 2-3% of anorectal carcinomas and occurs more than twice as often in women. Most tumors present as fungating or ulcerating lesions, but the tumor may arise in anal ducts and present as a submucosal mass. Wide abdominoperineal resection is the treatment of choice with a five year survival of 50%. Metastases occurs to the inguinal lymph nodes in more than 50% of the patients at sometime during the course of the disease with distant metastases occuring most commonly to liver and lungs. Images Fig. 1. Fig. 2. Fig. 3.
Sink, J D; Kramer, S A; Copeland, D D; Seigler, H F
Parathyroid carcinoma is a rare cause of hypercalcaemia due to primary hyperparathyroidism. Ninety five percent of parathyroid carcinomas are functional tumours. Surgery is the only potential curative treatment. This is a case of a 53 years lady, who presented with pathological fracture of femur, hypercalcaemia, deranged renal functions, change in voice, difficulty in swallowing and markedly raised parathormone levels. Doppler ultrasound localized an irregular mass at right lower gland. SESTAMIBI scan showed probability of adenoma in the region of right lower thyroid pole. Intra-operatively, tumour was found stuck to esophagus and right recurrent laryngeal nerve passing through it. Enlarged parathyroid gland was removed in toto along with the recurrent laryngeal nerve, right thyroid lobe and its isthmus. PMID:23217487
Gauhar, Tooba Mahmud; Shahzad, Noman; Mahmud, Tayyaba; Khwaja, Muhammad Azim
Forty-eight female patients who developed bronchogenic carcinoma synchronously with or after the occurrence of breast carcinoma are reported. The object of the study was to review the radiographic findings for possible clues to the diagnosis of bronchogenic carcinoma and to ascertain the histologic diagnoses observed. In 40 patients on whom films were available, the original radiographs before surgery for bronchogenic carcinoma were examined. The clinical records of the 48 patients were also reviewed. Histologic diagnosis of primary bronchogenic carcinoma was required. A solitary pulmonary lesion in a patient with breast carcinoma, a cavitated lesion, or a lesion that failed to respond to appropriate therapy for metastatic breast carcinoma suggested the diagnosis of bronchogenic carcinoma. An increase in the frequency of small cell carcinoma and a decrease in the frequency of adenocarcinoma was seen in bronchogenic carcinomas developing 5 years or more after radiation therapy for breast carcinoma. It was concluded that the benefits of radiation therapy in selected patients far outweighed the risk of bronchogenic carcinoma.
Hill, C.A.; North, L.B.; Osborne, B.M.
Fibrolamellar hepatocellular carcinoma is an uncommon malignancy seen in young adults without underlying liver disease. Physical signs are minimal and laboratory values are noncontributory. Diagnosis is suggested by clinical history, supported by radiographic studies, and confirmed by histologic examination. Individuals with fibrolamellar carcinoma generally have a greater survival than those with hepatocellular carcinoma. Although most patients with fibrolamellar carcinoma undergo
Sammy Saab; Francis Yao
Parathyroid carcinoma is a rare endocrine malignancy. The reported incidence is from 0.5 to 5% of primary hyperparathyroidism cases in various series. The cause is unknown, but clinical correlations with different genetic syndromes exist. Mutations in the HPRT2 gene seem to play a significant role in the pathogenesis of this disease. Men and women are equally affected, usually in the fourth or fifth decade of life. Most patients will present with signs and symptoms of hypercalcaemia. Cases of non-functioning carcinoma are exceedingly rare. Surgical resection is the most effective method of treatment and palliation. A significant proportion of patients will experience recurrence, and will need further surgical and, eventually, medical management of hypercalcaemia. The disease is progressive but slow growing. Most patients will require multiple operations to resect recurrent disease. The main cause of morbidity and mortality is the sequela of uncontrolled chronic hypercalcaemia rather than tumour burden. The current paper will review the epidemiology, pathogenesis, clinical presentation and diagnostic work-up of this disease. Surgical management in different scenarios is reviewed in detail, followed by other types of treatment and management of incurable disease.
Givi, B.; Shah, J.P.
Forty-eight female patients who developed bronchogenic carcinoma synchronously with or after the occurrence of breast carcinoma are reported. The object of the study was to review the radiographic findings for possible clues to the diagnosis of bronchogenic carcinoma and to acertain the histologic diagnoses observed. In 40 patients on whom films were available, the original radiographs before surgery for bronchogenic carcinoma were examined. The clinical records of the 48 patients were also reviewed. Histolgic diagnosis of primary bronchogenic carinoma was required. A solitary pulmonary lesion in a patient with breast carcinoma, a cavitated lesion, or a lesion that failed to respond to appropriate therapy for metastatic breast carcinoma suggested the diagnosis of bronchogenic carcinoma. An increase in the frequency of small cell carcinoma and a decrease in the frequency of adenocarcinoma was seen in bronchogenic carcinomas developing 5 years or more after radiation therapy for breast carcinoma. It was concluded that the benefits of radiation therapy in selected patients far outweighted the risk of bronchogenic carcinoma.
Hill, C.A.; North, L.B.; Osborne, B.M.
What is squamous cell skin carcinoma? The second most common skin cancer, squamous cell skin carcinoma affects 250,000 Americans each year. This type ... to spread. Who is most likely to have squamous cell skin carcinoma? This slow-growing disease affects individuals who have ...
Endometrioid carcinoma is the third most frequent cancer among women in France. They are divided in two groups: type I and type II. This article describes anatomopathological and molecular features of this disease. Type I carcinoma, the most frequent, develops in a context of hyperoestrogenia. Endometrial glandular hyperplasia is the precursor lesion. The histological type is an endometrioid carcinoma. Its prognosis is good. Type II carcinoma is less frequent. It occurs on an atrophic mucosa. It is usually a more aggressive tumor like serous adenocarcinoma, clear cells carcinoma or carcinosarcoma with a poor prognosis. Type I and type II carcinoma also present different molecular pathways. PTEN inactivation, an early event in carcinogenesis, is the most frequent abnormality in type I carcinoma. An average of 28% of type I carcinoma also acquire PI3K mutations. On the contrary, P53 mutation is involved in 90% of type II carcinoma. Identifying and understanding these two types of endometrial carcinoma led to various therapeutic management. PMID:22231875
Albertini, Anne-Flore; Devouassoux-Shisheboran, Mojgan; Genestie, Catherine
Summary Adenoid cystic carcinomas are malignant tumours and occur in the major and the minor salivary glands. Laryngeal adenoid cystic carcinomas are rare and account for less than 1% of all malignant tumours in the larynx. Adenoid cystic carcinoma is characterised by slow progression, multiple recurrences and late distant metastasis. The aetiology of adenoid cystic carcinoma remains unknown. They usually originate in the supraglottic or subglottic area. Wide-margin surgery alone or in combination with post-operative radiotherapy is the best tumour management. In this article, the case of laryngeal adenoid cystic carcinoma is described in a 55-year-old male patient who presented with a 3-month history of prelaryngeal pain. The patient underwent total laryngectomy and post-operative radiotherapy. For patients with laryngeal adenoid cystic carcinomas, regular and long-term follow-up is mandatory, in order to detect relapses and metastases.
Zvrko, E; Golubovic, M
Pulmonary sarcomatoid carcinomas are a rare group of tumors accounting for about 1 % of non-small cell lung carcinoma (NSCLC). In 2004, World Health Organization classification united under this name all the carcinomas with sarcomatous or sarcomatous-like component with spindle cell or giant cell appearance. There are five subtypes: spindle cell carcinoma, giant cell carcinoma, pleomorphic carcinoma, carcino-sarcoma and pulmonary blastoma. Clinical characteristics are not specific from the others subtypes of NSCLC. Epithelial to mesenchymal transition pathway may play a key role. Patients are frequently symptomatic. Tumors are voluminous more often peripherical than central, with strong fixation on FDG TEP CT. Distant metastasis are frequent with atypical locations such as peritoneal or retroperitoneal sites. These tumors have poorer prognosis than the other NSCLC subtypes because of great aggressivity, and frequent chemoresistance. Here, we present a review of litterature in order to better describe these tumors. PMID:22889810
Vieira, Thibault; Duruisseaux, Michaël; Ruppert, Anne-Marie; Cadranel, Jacques; Antoine, Martine; Wislez, Marie
Ductal carcinoma in situ (DCIS) is now found far more frequently because of mammograms, appearing with microcalcifications. Actually, it is probably very common. Premalignant lesions such as ductal carcinoma in situ are demonstrating the truth of a major concept: that there are lesions within the breast that may be locally removed and controlled before the development of metastatic disease. This article, presents the current management of ductal carcinoma in situ. PMID:15065365
Roisman, Isaac; Lifshitz, Isaac; Bitterman, A; Cohen, O
Sebaceous carcinoma of the Zeis gland of the cilia is a rare malignant tumor. A 90-year-old Japanese man with a Zeis gland carcinoma on the left upper eyelid is reported. The tumor was a 12 x 3-mm, reddish, partially yellow, papillomatous nodule accompanied by loss of several lashes. Histologically, two types of tumor cells, a dark basaloid cell and a larger pale cell, showed lobular and comedo-acinar growth patterns. The carcinoma did not recur during the 8 months following surgery; however, the patient died of gastric carcinoma. PMID:9350107
Kato, N; Sotodate, A; Tomita, Y
Primary peritoneal serous carcinoma (PPSC), also commonly called primary peritoneal cancer, often presents with clinical features identical to advanced epithelial ovarian carcinoma (EOC). The diagnosis is made only after a laparotomy. The main differentiating feature is advanced peritoneal involvement with tumour without gross involvement of the ovaries. In the absence of any randomised trials, the management of PPSC is very
A. Ilancheran; Joesph Ng Soon Yau
A case of thymic carcinoma arising within a lymphocyte rich thymoma is reported. The undifferentiated carcinoma contained cellular elements resembling choriocarcinoma but could be differentiated there-from by positive staining for prekeratin antigen and an absence of staining for B-HCG antigen utilizing immunohistochemical techniques.
E. Herczeg; Leonard B. Kahn
The authors are presenting here, a case of sebaceous carcinoma in a 50-year-old male who presented with 6-month history of a fungating mass in the right eye near medial canthus. Exenteration of eye was done, and a diagnosis of sebaceous carcinoma was made on histopathological examination.
Varshney, Manoranjan; Alam, Kiran; Aziz, Mehar; Maheshwari, Veena; Gaur, Kavita; Rizvi, SyedAli Raza
Fibrolamellar hepatocellular carcinoma (FHLCC) generally occurs in young individuals lacking a background of chronic liver disease and other risk factors for hepatocellular carcinoma. The clinical presentations of FLHCC are generally nonspecific, and the ?-fetoprotein level is typically within the normal range in most cases. Imaging studies have a major role in clinical diagnosis, but pathology is the gold standard in
Shu Liu; Kwok Wah Chan; Bingyuan Wang; Liang Qiao
A case of pulmonary clear cell carcinoma is demonstrated. A large left lower lobe mass, without lymphadenopathy was detected on a screening chest X-ray, and a left lower lobectomy was performed. The tumor was composed predominantly of clear cells with some areas showing cells typical for small cell carcinoma. Ultrastructurally, the larger clear cell had cytoplasm containing many rough endoplasmic reticuli and free ribosomes, while the smaller dark cell showed a serrated nucleus and scanty cytoplasm having many free ribosomes without neurosecretory granules. This is the first report on pulmonary clear cell carcinoma with small cell carcinoma patterns, and this case will throw doubt on the conclusion of previous studies that clear cell carcinoma is not a separate entity. PMID:1921401
Inase, N; Takayama, S; Nakayama, M; Miura, H; Kimula, Y
Renal cell carcinomas are rare in children, and they show significant differences in their histology and pathogenesis when compared to those common in adults. The most common subtypes seen preferentially in children are the translocation-associated tumors, papillary renal cell carcinoma, renal medullary carcinoma, and oncocytic renal cell carcinoma following neuroblastoma. The histological diagnosis of renal cell carcinoma is made difficult by the considerable heterogeneity within and overlap between each of the above subtypes and by similarities to other pediatric renal neoplasms. While no effective therapies have yet been identified, there is considerable promise that the new Children’s Oncology Group protocol will provide knowledge that will guide the future therapy of these lesions.
Perlman, Elizabeth J.
Vulval carcinoma is an uncommon disease of old women and may manifest as verrucous carcinoma. Intraepithelial cancer of the vulna of women in their twenties and thirties is increasing. Invasive carcinoma of vulva usually appears long time after intraepithelial neoplasia or chronic irritation. We are presenting one young lady of 21 years who noticed whitening of vulva since her childhood and irregular vulval itching in that area. After nine to ten years she further noticed swelling in that area which used to discharge off an on along with itching. As she got married and had disturbed sexual life, on consulting with a specialist doctor, the lesion was diagnosed as an ulcerated malignant growth. Further investigation revealed the lesion to be as verrucous carcinoma of vulva. This is the first report of such case in our country. Any persistent complaints of vulva like itching, discharge, even ulcer should be taken care of for detection of intraepithelial vulvar cancer. PMID:17917632
Kabir, N; Ara, I; Ahmed, A; Muhsin, A U
The authors present a case of parathyroid carcinoma in a patient with primary hyperparathyroidism. Following a literature review, the clinical and diagnostic profile, treatment and prognosis of this rare disease are discussed. PMID:23837957
Sturniolo, G; Gagliano, E; Tonante, A; Taranto, F; Papalia, E; Cascio, R; Damiano, C; Vermiglio, F; Sturniolo, G
Squamous cell carcinoma is a common cancer to the head and neck region that is typically diagnosed when it is 2 cm in size. This case report illustrates a patient who had neglected an auricular carcinoma for over a year. At the time of presentation the entire ear was infected with pseudomonas and yeast and chronic friability and bleeding caused an anemia which required blood transfusion. PMID:21824416
Kloss, Brian; Lapoint, Jeff; Dougher, Katherine
Squamous cell carcinoma is a common cancer to the head and neck region that is typically diagnosed when it is 2 cm in size. This case report illustrates a patient who had neglected an auricular carcinoma for over a year. At the time of presentation the entire ear was infected with pseudomonas and yeast and chronic friability and bleeding caused an anemia which required blood transfusion.
Adenoid cystic carcinoma is a rare tumor arising from the minor salivary glands;, the palate being the commonest site. Distant metastasis and perineural invasion areis common in adenoid cystic carcinoma. Diagnosis of adenoid cystic carcinoma is made usually with the help of clinical features, radiographic features and histologic features. We reported a case of adenoid cystic carcinoma of palate involving left maxillary sinus. The diagnosis of the case and brief review of literature of adenoid cystic carcinoma is discussed. The aim here is to highlight the importance of diagnosis, treatment and long-term follow-up of the patients with adenoid cystic carcinoma.
Mehta, Dhaval N.; Parikh, Shilpa J.
Background Ocular sebaceous carcinoma can masquerade as benign lesions resulting in delay of diagnosis. Early recognition is even more difficult in young patients where the disease rarely occurs. Here, we provide a clinicopathological correlation of ocular sebaceous carcinoma in a young individual lacking history of hereditary cancer or immunosuppression. Findings A detailed histopathological study including p53 DNA sequencing was performed on an aggressive sebaceous carcinoma presenting in a healthy 32 year-old Caucasian woman. She had no history of retinoblastoma, evidence for a hereditary cancer syndrome, or radiation therapy. However, she potentially was at risk for excessive UV light exposure. A detailed review of the literature is also provided. A moderately well differentiated sebaceous carcinoma was established histopathologically arising from the meibomian gland of the upper eyelid. In most areas, the cytoplasm contained small but distinct Oil-red-O positive vacuoles. Direct sequencing of p53 identified a G:C?A:T mutation at a dipyrimidine site. The mutation results in substitution of arginine for the highly conserved glycine at residue 199 located at the p53 dimer-dimer interface. Energy minimization structural modeling predicts that G199R will neutralize negative charges contributed by nearby inter- and intramonomeric glutamate residues. Discussion This study points to the importance of recognizing that sebaceous carcinoma can occur in young patients with no evidence for hereditary cancer risk or radiation therapy. The G199R substitution is anticipated to alter the stability of the p53 tetrameric complex. The role of UV light in the etiology of sebaceous carcinoma deserves further study. Our findings, taken together with those of others, suggest that different environmental factors could lead to the development of sebaceous carcinoma in different patients.
A study was made of the differential features of transglottic laryngeal carcinomas. We made a retrospective study of patients with laryngeal carcinoma diagnosed in our center from 1985 to 1996. In this period, 1212 laryngeal carcinomas were diagnosed, of which 99 (8%) were considered transglottic. In relation to factors such as sex, toxic habits, level of histological differentiation or affected nodes, patients with transglottic carcinomas had characteristics that were intermediate between patients with glottic and supraglottic carcinomas. An analysis was made of the treatments and the results obtained in patients treated with radical intention and a minimum follow-up of 3 years. The treatment most frequently used in patients with transglottic carcinoma was surgery (total laryngectomy) and complementary radiotherapy. The 5-year actuarial adjusted survival rate jor patients with transglottic carcinoma was 78%, which was intermediate between the survival rates of patients with glottic (90%) or supraglottic (69%) carcinoma. PMID:9866224
León, X; Quer, M; de Juan, M; Sańudo, J R; del Prado Venegas, M; López, M; Burgués, J
Thymic epithelial neoplasm is a quite rare malignancy arising from the thymic epithelium, and comprises thymoma, thymic carcinoma, and thymic neuroendocrine carcinoma. The incidence of thymic carcinoma and neuroendocrine carcinoma is much less than thymoma, accounting for 1-4%of anterior mediastinal tumors. These rare tumors are called"orphan tumors,"and standards of clinical management(including chemotherapeutic regimens)have not yet been determined for them yet because of their rarity. In the advanced setting, palliative-intent chemotherapy has been applied using cisplatin-based triplet or quartet chemotherapy with second-generation antitumor drugs, with reference to chemotherapeutic regimens for invasive thymoma such as ADOC, CAP, and VIP chemotherapy. However, biological plausibility is lacking for this approach, given that these tumors differ from thymoma in their expression of cellular surface proteins such as c-Kit and epidermal growth factor receptors. While limited to thymic carcinoma, platinum doublet chemotherapy with a third-generation antitumor drug as first-line chemotherapy is anticipated to offer the same clinical efficacy as multiple-agent combination chemotherapy, but with less toxicities. In second-line or later-lines of chemotherapy, single-agent chemotherapy may be optimal. Molecular biological approaches have been under investigation, but molecular targeted agents remain unavailable. PMID:22584319
Merkel cell carcinoma is a rare, highly aggressive neuroendocrine cutaneous neoplasm with a variable clinical presentation. Histologically, it is a predominantly dermal-based lesion composed of monotonous small round cells with scanty cytoplasm, often difficult to differentiate from small round cell tumors, metastatic small cell carcinoma, blastic hematologic malignancies, and melanoma. The malignant cells express both epithelial and neuroendocrine immunohistochemical markers, a unique feature that helps differentiate this neoplasm from other entities. The pathogenesis of Merkel cell carcinoma has remained a mystery despite its association with various chromosomal abnormalities and with growth signaling and apoptotic pathways. The discovery of the Merkel cell polyomavirus suggests another clue to its pathogenesis. This virus integrates into band 3p14 and promotes carcinogenesis by altering the activity of tumor suppressor and cell cycle regulatory proteins. This discovery of the Merkel cell polyomavirus may greatly enhance our understanding of this rare aggressive neoplasm and allow further advancements in treatment. PMID:21043828
Wong, Hannah H; Wang, Jun
Background Anaplastic thyroid carcinoma (ATC), a rare and highly malignant tumor, has long been thought to arise from well-differentiated\\u000a carcinoma (WDC) such as follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC). The purpose of this study\\u000a was to test this notion by examining whether and, if so, how often ATC harbors the oncogenes that are commonly associated\\u000a with WDC, such
Hwei-Ming Wang; Yu-Wen Huang; Jen-Seng Huang; Cheng-Hsu Wang; Victor C. Kok; Chao-Ming Hung; Han-Ming Chen; Chin-Yuan Tzen
The tongue enables taste and plays a critical role in formation of food bolus and deglutition. The tongue is also crucial for speech and the earliest sign of tongue paresis is a change in the quality of speech. Given the importance of the tongue, tongue carcinoma should be accurately staged in order to optimise treatment options and preserve organ function. The intent of this review is to familiarise radiologists with the pertinent anatomy of the tongue and the behaviour of tongue carcinoma so as to map malignant infiltration accurately.
Ong, Cheng K; Chong, Vincent F H
The tongue enables taste and plays a critical role in formation of food bolus and deglutition. The tongue is also crucial for speech and the earliest sign of tongue paresis is a change in the quality of speech. Given the importance of the tongue, tongue carcinoma should be accurately staged in order to optimise treatment options and preserve organ function. The intent of this review is to familiarize radiologists with the pertinent anatomy of the tongue and the behaviour of tongue carcinoma so as to map malignant infiltration accurately. PMID:17208674
Ong, Cheng K; Chong, Vincent F H
Urachal carcinoma is a rare neoplasm, which accounts for only 0.5–2% of bladder malignancies, and arises from a remnant of the fetal genitourinary tract. A 46-year-old woman presented with a history of pelvic pain and frequent daytime urination. Ultrasound (US), computed tomography (CT), and magnetic resonance (MR) demonstrated a supravesical heterogeneous mass with calcifications. The patient underwent a partial cystectomy with en-bloc resection of the mass and histopathological examination revealed the diagnosis of urachal adenocarcinoma. Urachal carcinomas are usually associated with poor prognosis and early diagnosis is fundamental. CT and MR are useful to correctly diagnose and preoperatively staging.
Monteiro, Vanessa; Cunha, Teresa Margarida
Hepatocellular carcinoma and cholangiocarcinoma are relatively rare tumors of the gastrointestinal tract in western Europe but their incidence has been increased in recent years. Newly diagnosed intrahepatic lesions or intrahepatic cholestasis require extensive laboratory tests and imaging studies in order to confirm the diagnosis of hepatocellular carcinoma, intrahepatic or extrahepatic cholangiocarcinoma. The treatment options range from liver resection or liver transplantation to conservative measures (in cases of non-resectable lesions). This review article aims to provide an overview on the diagnostic options and the subsequent treatment. PMID:20827454
Rauchfuss, F; Scheuerlein, H; Götz, M; Dittmar, Y; Voigt, R; Heise, M; Settmacher, U
Hepatocellular Carcinoma (HCC) is the most frequent primary liver malignancy, mostly occurring in the context of chronic liver diseases leading to cirrhosis. Epidemiological data demonstrate the increasing incidence of HCC worldwide, mainly related to viral hepatitis and metabolic syndrome. Pathological analysis recognizes several types of HCC according to macroscopic and microscopic features. A subset of HCC can develop on normal liver and usually corresponds to specific variants, including fibrolamellar carcinoma mostly encountered in young population. Prognosis of HCC remains poor, depending on delayed tumor diagnosis, the clinical status of the patient but also tumor behavior with a great propensity for angioinvasion. PMID:22941011
Primary site control, anatomical site of failure, survival, and complications of treatment were determined in a retrospective review of primary maxillary sinus carcinoma. Sixty-one patients were treated by radiation followed by surgery and 35 by radiation alone. Primary tumor control was achieved in 69% of patients receiving combined treatment, 14% of patients treated with radiation alone, and 49% of all patients. Local control did not differ with histological type. Virtually all epidermoid and undifferentiated carcinoma recurrences occurred within 2 years, but 27% of adenocarcinomas recurred after 2 years.
Lee, F.; Ogura, J.H.
\\u000a Merkel cell carcinoma is a rare and aggressive neuroendocrine malignancy. In this chapter, we summarize the current knowledge\\u000a regarding its epidemiology, pathogenesis, clinical features, histopathologic features, clinical staging, and prognosis. Furthermore,\\u000a we review the evidence for various therapeutic approaches, including surgery, radiation therapy, and chemotherapy.
Leonid Izikson; Nathalie C. Zeitouni
Background. Thymic carcinoma is a malignancy of the anterior mediastinum, always with poor prognosis. Up to the present, very few articles have discussed and evaluated either the clinical or pathologic features or treatments of this tumor. Therefore, we are in a position to analyze our research data to support our belief as follows.Methods. From January 1977 until December 1997, we
Hung-Chang Liu; Wen-Hu Hsu; Yu-Jen Chen; Yu-Jan Chan; Yu-Chung Wu; Biing-Shium Huang; Min-Hsiung Huang
Carcinoma of the prostate is a common cancer, and its incidence is rising. A digital rectal examination should be routine to allow early diagnosis. Several screening and investigative techniques are available. Choice of treatment depends on the age and health of the patient and whether the cancer has spread. Treatments include observation, prostatectomy, radiation, and surgical or medical castration.
Donnelly, Bryan J.
Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC. PMID:19294759
Gomaa, Asmaa I; Khan, Shahid A; Leen, Edward L S; Waked, Imam; Taylor-Robinson, Simon D
Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world, with an incidence well under 1 per 100000 person-years. Exceptions are the Chinese, especially the Cantonese living in the central region of Guangdong Province in Southern China. Other populations with elevated rates include the natives of Southeast Asia, the natives of the Artic region, and the Arabs
Mimi C. Yu; Jian-Min Yuan
Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.
Gomaa, Asmaa I; Khan, Shahid A; Leen, Edward LS; Waked, Imam; Taylor-Robinson, Simon D
Mitochondrial mutations are well documented in hepatocellular carcinoma, but their role in carcinogenesis remains unclear. To clarify their significance, a comprehensive analysis was performed of hepatocellular carcinomas (N=24), including quantifying the total mitochondrial DNA levels, quantifying the levels of mitochondrial DNA with the common deletion, and complete sequencing of the mitochondrial control region. In addition, these studies were expanded and reinforced by analysis of fibrolamellar carcinomas (N=15), a unique type of liver carcinoma that has increased numbers of mitochondria on electron microscopy. Overall, approximately 50% of hepatocellular carcinomas had lower levels of total mitochondrial DNA than paired non-neoplastic tissues. Interestingly, despite their increased numbers of mitochondria, primary fibrolamellar carcinomas had lower levels of total mitochondrial DNA. In contrast, metastatic fibrolamellar carcinomas had greatly increased mitochondrial DNA levels. Overall, deletions in the control region were associated with lower total DNA levels in typical hepatocellular carcinoma, but somatic single base pair mutations were not. In fact, almost all single base pair mutations were either reversions to the wild type sequence or known population polymorphisms, strongly suggesting they are not directly oncogenic. Complete sequencing of the entire mitochondrial genome in fibrolamellar carcinomas identified several somatic mutations but no consistent pattern of mutations was found. Overall, the levels of the common deletion were highest in tissues with lower total mitochondrial DNA. In conclusion, control region deletions but not somatic mutations, may influence total DNA copy numbers. Somatic control region mutations in hepatocellular carcinoma are not directly oncogenic but instead may be adaptive.
Vivekanandan, Perumal; Daniel, Hubert; Yeh, Matthew M.; Torbenson, Michael
Mitochondrial mutations are well documented in hepatocellular carcinoma, but their role in carcinogenesis remains unclear. To clarify their significance, a comprehensive analysis was performed of hepatocellular carcinomas (N=24), including quantifying the total mitochondrial DNA levels, quantifying the levels of mitochondrial DNA with the common deletion, and complete sequencing of the mitochondrial control region. In addition, these studies were expanded and reinforced by analysis of fibrolamellar carcinomas (N=15), a unique type of liver carcinoma that has increased numbers of mitochondria on electron microscopy. Overall, approximately 50% of hepatocellular carcinomas had lower levels of total mitochondrial DNA than paired non-neoplastic tissues. Interestingly, despite their increased numbers of mitochondria, primary fibrolamellar carcinomas had lower levels of total mitochondrial DNA. In contrast, metastatic fibrolamellar carcinomas had greatly increased mitochondrial DNA levels. Overall, deletions in the control region were associated with lower total DNA levels in typical hepatocellular carcinoma, but somatic single base pair mutations were not. In fact, almost all single base pair mutations were either reversions to the wild-type sequence or known population polymorphisms, strongly suggesting they are not directly oncogenic. Complete sequencing of the entire mitochondrial genome in fibrolamellar carcinomas identified several somatic mutations, but no consistent pattern of mutations was found. Overall, the levels of the common deletion were highest in tissues with lower total mitochondrial DNA. In conclusion, control region deletions, but not somatic mutations, may influence total DNA copy numbers. Somatic control region mutations in hepatocellular carcinoma are not directly oncogenic but instead may be adaptive. PMID:20228784
Vivekanandan, Perumal; Daniel, Hubert; Yeh, Matthew M; Torbenson, Michael
\\u000a Undifferentiated (anaplastic) thyroid carcinoma (UTC), also called “giant and spindle cell carcinoma,” is an extremely aggressive\\u000a thyroid malignancy. Accounting for less than 5% of malignant thyroid tumors, it carries the poorest prognosis as compared\\u000a to well differentiated and poorly differentiated thyroid carcinomas. Most patients succumb to their disease within six months\\u000a to one year of their initial diagnosis, typically as
Gregg A. Staerkel; Britt-Marie E. Ljung; Vinod Shidham; William J. Frable; Juan Rosai
Recurrent Neuroendocrine Carcinoma of the Skin; Stage I Neuroendocrine Carcinoma of the Skin; Stage II Neuroendocrine Carcinoma of the Skin; Stage III Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin
Squamous Cell Carcinoma: What it Looks Like Squamous cell carcinoma accounts for approximately 16% of all new skin cancer ... and human immunodeficiency virus (HIV). Diagnosed Cases of Squamous Cell Carcinoma This tumor developed rapidly over a six-month ...
Thymic carcinomas are rare neplasm. The standard treatment for advanced thymic carcinoma has not yet been established, and the prognosis is poor. We report 3 cases of thymic carcinoma involving major vessely. Case 1:The aortic arch and the innominate vein were involved. Case 2:The left brachiocephalic vein was involved. Case 3:Tumor invaded to superior vena cava. Complete resection of the tumor was possible with vascular reconstruction. PMID:22647333
Yamaki, Minoru; Noriyuki, Toshio; Hamamoto, Masaki; Yonehara, Syuji
Advanced esophageal carcinoma has poor prognosis with 5-year survival of less than 20%. This poor prognosis is the same for squamous cell carcinoma and adenocarcinoma. Surgical therapy, external radiation and chemotherapy with curative intent are usually impossible because of the advanced disease. Dysphagia is the most frequent symptom affecting quality of life. Bougies or balloon dilation improves dysphagia only short-term (few days). Nd-YAG laser, ACP and photodynamic therapy all have mid-range effect and require repetition after few weeks. Brachytherapy and esophageal self-expanding stent insertion have longer benefit. Stent insertion provides fastest improvement of dysphagia; however, complications in later setting occur in30% and require further endoscopic treatment. Brachytherapy has slower onset of benefit but has fewer complications and longer benefit. Brachytherapy is suitable for patients wit expected lifespan more than 3 months. Most important contraindication of brachytherapy is tracheo-esophageal fistula. PMID:19202963
Fibrolamellar hepatocellular carcinoma (FHLCC) generally occurs in young individuals lacking a background of chronic liver disease and other risk factors for hepatocellular carcinoma. The clinical presentations of FLHCC are generally nonspecific, and the alpha-fetoprotein level is typically within the normal range in most cases. Imaging studies have a major role in clinical diagnosis, but pathology is the gold standard in confirming diagnosis. Pathological characteristics of FLHCC include the presence of tumor cells with a deeply eosinophilic cytoplasm and macronucleoli surrounded by abundant fibrous bands. The most effective treatment for FLHCC is aggressive surgical resection. This comprehensive literature review gives a full account of the clinical, pathological, and molecular features of FLHCC. PMID:19638962
Liu, Shu; Chan, Kwok Wah; Wang, Bingyuan; Qiao, Liang
The hepatocellular carcinoma (HCC) is one of the most common malignant tumors and carries a poor survival rate. The management of patients at risk for developing HCC remains challenging. Increased understanding of cancer biology and technological advances have enabled identification of a multitude of pathological, genetic, and molecular events that drive hepatocarcinogenesis leading to discovery of numerous potential biomarkers in this disease. They are currently being aggressively evaluated to establish their value in early diagnosis, optimization of therapy, reducing the emergence of new tumors, and preventing the recurrence after surgical resection or liver transplantation. These markers not only help in prediction of prognosis or recurrence but may also assist in deciding appropriate modality of therapy and may represent novel potential targets for therapeutic interventions. In this paper, a summary of most relevant available data from published papers reporting various tissue and serum biomarkers involved in hepatocellular carcinoma was presented.
Behne, Tara; Copur, M. Sitki
A 53-year-old woman presented with labile and difficult to control hypertension on 3 different anti-hypertensive medications. Abdominal computed tomography and ultrasonography of the thyroid gland showed a 1.8 cm thyroid nodule. Fine needle aspiration biopsy of the thyroid nodule revealed papillary thyroid carcinoma. Serum thyroid stimulating hormone and free thyroxine, calcitonin, carcinoembryonic antigen, intact parathyroid hormone, and calcium levels were within normal limits. A 24-hour urine metanephrine showed significant elevation in urine metanephrine of approximately 3 times the upper limit of normal, and the result of 131I-metaiodobenzyleguanjdjne (131I-MIBG) scintigraphy confirmed that the adrenal mass was pheochromocytoma. Right adrenalectomy and total thyroidectomy were performed. The final pathology was pheochromocytoma and papillary thyroid carcinoma. An analysis of c-ret porto-oncogene mutation yielded a negative result. This unusual association of 2 tumors represents a new entity. PMID:19668893
Nasser, Tariq; Qari, Faiza
Transitional cell carcinoma is a common urological malignancy and in up to 5% of cases occurs in the kidney. The multicentric\\u000a nature of TCC makes assessment of the entire urothelium essential prior to treatment. Vigilant urological and radiological\\u000a follow-up is also warranted post-treatment to assess for metachronous lesions and recurrence. Conventional imaging modalities,\\u000a such as IVU, RP, and US, still
Ronan F. Browne; William C. Torreggiani
Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney cancer are highest in European\\u000a and Scandinavian countries and North America (1). It is estimated that 36,160 new cases of kidney and renal pelvis cancer were diagnosed in 2005, with an estimated 12,660\\u000a resulting deaths in the United States (2). There has been a
Ziya Kirkali; Cag Cal
Introduction Hepatocellular carcinoma (HCC) is a tumor of increasing incidence and high mortality worldwide. Diagnosis of HCC is often\\u000a difficult, especially at early stages of disease. Additionally, current treatment options are limited. HCC usually develops\\u000a in an environment of chronic liver disease. The immune system has an important role in shaping this environment, especially\\u000a in chronic viral hepatitis, the leading cause
Tobias Flecken; Hans Christian Spangenberg; Robert Thimme
\\u000a Fibrolamellar hepatocellular carcinoma (FLM) is a rare tumor that occurs in young adults. It occurs in the absence of chronic\\u000a liver disease or cirrhosis. Serum alpha-fetoprotein is typically normal. FLM is characterized by a triad of morphological\\u000a features: polygonal tumour cells with eosinophilic cytoplasm, prominent nucleoli and lamellar pattern of fibrosis. A central\\u000a scar is seen in some cases. FLM
\\u000a Nasopharyngeal carcinoma (NPC) is a distinctly radiosensitive and chemosensitive tumor. Best quality radiotherapy is demanded\\u000a to build up the complex concave high-dose zone for this critical location. Intensity-modulated (IMRT) technique is advocated,\\u000a image guidance to ensure setup precision and adaptive re-planning if major deviations from intended dose distribution occur\\u000a during the treatment course are useful improvements if resources allow. Stringent
Anne W. M. Lee; Wai-Tong Ng; Tsz-Kok Yau; Stephen C. K. Law; William I. Wei
A case report and two additional cases of pedunculated, primary hepatocellular carcinoma (PHCC) are added to those previously reviewed, and are compared with the more typical presentations of PHCC. Distinct differences include lesser associations with hepatitis B and alpha fetal protein among the pedunculated lesions. More importantly, this unique form of PHCC carries a much higher resectability rate that hopefully can be translated into longer survival in this subgroup. PMID:6094924
Cunningham, P L; Nava, H; Lopez, C; Douglass, H O
Multiple prognostic factors for outcome in papillary thyroid carcinoma are identified. For a cohort of 1500 consecutive patients followed an average of 16 years, survival rates for tumor recurrence and cause-specific mortality are described. Risk groups derived from novel prognostic scoring or staging systems and the role of DNA ploidy testing are discussed specifically. Lastly, controversies are reviewed regarding the extent of primary surgical resection and the efficacy of postoperative radioiodine remnant ablation in papillary thyroid cancer.
Hay, I.D. (Mayo Medical School, Rochester, MN (USA))
\\u000a Surgery is the mainstay of therapy for adrenocortical carcinoma (ACC). It is thought that the first technically successful\\u000a resection of an ACC was performed in 1889 by Thornton  (see Thompson history). Although reported as a sarcoma, it is likely\\u000a this was an ACC based on the description of size (>20 pounds), accompanying hirsutism, and recurrence of disease with death
James T. Broome; Barbra S. Miller; Paul G. Gauger; Gerard M. Doherty
A 65-year-old female patient was admitted to our hospital presenting with a superior mediastinal big mass that was elastic, hard, and painless. Laboratory data including serum calcium level and thyroid and parathyroid hormonal functions revealed no abnormalities. Further examination consisting of computed tomography, magnetic resonance imaging, and ultrasonography demonstrated that it was a solid tumor extending into the superior mediastinum. Technetium (Tc-99) sestamibi scan revealed a hypofunctioning focus in that area. The preoperative diagnosis was a thyroid tumor or a metastatic lymph node. Parathyroid carcinoma was suspected on intraoperative frozen pathological examination. The tumor was successfully removed with left thyroid lobectomy, and neck node dissection was performed. Macroscopically, it appeared as a dark reddish solid tumor, and the cut surface presented opalescence. Immunohistology confirmed that there was proliferation of tumor cells with positive chromogranin A staining. Thus, the tumor was diagnosed as parathyroid carcinoma histopathologically despite a lack of clinical evidence for hyperparathyroidism. This patient has been followed with no evidence of recurrence, a normal serum calcium 4 years after surgery, and postoperative radiotherapy. This report describes a case of nonfunctional parathyroid carcinoma with a massive mass that technetium (Tc-99) sestamibi scan failed to detect, and we showed negative immunostaining for parathyroid hormone (PTH) (N). PMID:20224881
Nakamura, Yosuke; Kataoka, Hideyuki; Sakoda, Takema; Horie, Yasushi; Kitano, Hiroya
We present a case of primary ureteral carcinoma composed of both transitional cell carcinoma and mucinous carcinoma. A 79-year-old woman visited her home doctor with the chief complaint of right lower abdominal pain. Abdominal computed tomographic scan (CT) disclosed a tumor measuring about 5 cm in diameter at the right lower quadrant of the abdomen. Percutaneous nephrostomy was performed for hydronephrosis and pyonephrosis. The urinary cytology revealed class V, transitional cell carcinoma. Re-abdominal CT showed further enlargement of tumor diameter, but the primary site of the tumor was not identified. Her general condition worsened, and she died 42 days after her initial complaint. Pathologic examinations upon autopsy revealed both mucinous carcinoma and transitional cell carcinoma in the right ureter. Pathogenesis and management of this rare condition are discussed. PMID:18203527
Suzuki, Takahisa; Kurita, Yutaka; Nagata, Masao; Otsuka, Atsushi; Shinbo, Hitoshi; Furuse, Hiroshi; Terada, Hiroshi; Mugiya, Soichi; Ushiyama, Tomomi; Ozono, Seiichiro; Kawasaki, Hideya
The diagnosis of parathyroid carcinoma can be challenging, and adjuvant therapies such as radiotherapy and chemotherapy are not particularly beneficial in the management of this disease, creating a challenge when dealing with unresectable recurrent and metastatic malignancy. We investigated the expression profile of biomarkers that represent potential markers of malignancy or targets for novel therapies in this disease. We constructed a tissue microarray of parathyroid carcinomas from 10 patients as well as parathyroid adenomas from 25 patients and stained the slides for 34 proteins involved in angiogenesis (platelet-derived growth factor receptor (PDGFR)-?, PDGFR-?, vascular endothelial growth factor receptor-2 (VEGFR-2), and epidermal growth factor receptor (EGFR)), inflammation (cyclooxygenase (COX)-1 and COX-2), cell adhesion (matrix metalloproteinase (MMP)-1, CD9, and keratin 7), cell cycle (Cdc2p34, cyclin D1, retinoblastoma (Rb), p27, p21, parafibromin, Bmi-1, 14-3-3?, and p53), and apoptosis (Bcl-2a, Mcl-1, Bcl-xL, and glutathione-S-transferase-isoenzyme ? (Gst-?)) along with some markers of the sonic hedgehog (Smo, SHH, Gli-1, Gli-2, Gli-3, and patched), mTOR (AKT, mammalian target of rapamycin (mTOR), and Forkhead box O (FoxO)-1), and WNT (Wisp-1, Wisp-2, and ?-catenin) signal transduction pathways. Protein expression was determined using computerized image analysis software (Spectrum Plus©, Aperio). Bcl-2a, parafibromin, Rb, and p27 were significantly decreased to variable degrees in all parathyroid carcinomas. COX-1/2, CD9, MMP-1, FoxO-1, VEGFR-2, PDGFR-?/?, Gst-?, Gli-1, Gli-2, Gli-3, and patched were expressed in the majority of benign and malignant tumor cells. These results indicate that the use of a panel that includes Bcl-2a, parafibromin, Rb, and p27 may be helpful in the assessment of atypical parathyroid neoplasms. Although the majority of other markers studied are also expressed in both benign and malignant parathyroid neoplasms, we have identified several potentially important target proteins related to angiogenesis and cell proliferation along with COX-1/2, Gst-? and members of sonic hedgehog pathway that may be therapeutic targets in parathyroid carcinoma. While these results are preliminary, a successful outcome of a clinical trial directed against these novel targets would provide much needed systemic adjuvant treatment for patients with metastatic parathyroid carcinoma. PMID:23001705
Erovic, Boban M; Harris, Luke; Jamali, Mina; Goldstein, David P; Irish, Jonathan C; Asa, Sylvia L; Mete, Ozgur
Radiation may cause radiation-induced cancers after a long latency period. In a group of 111 patients surgically treated for hypopharyngeal carcinoma, patients previously treated with radiotherapy for tuberculosis in the neck were compared to patients without previous radiotherapy. Seven patients (7.4%) underwent radiotherapy (median age 15 years) and developed a hypopharyngeal carcinoma (median age 70 years, median latency period 54.4 year). Considering this long latency period and the localisation in the previous radiation field these tumours can be classified as potentially radiation-induced carcinomas. Patients with potentially radiation-induced carcinomas were significantly older when the hypopharyngeal carcinoma was diagnosed (p=0.048), were more frequently females (p=0.05) and had a worse 5-year regional control rate (p=0.048). When radiotherapy is considered in young patients the risk of induction of tumours has to be kept in mind. PMID:20656544
van der Putten, Lisa; de Bree, Remco; Kuik, Dirk J; Rietveld, Derek H F; Langendijk, Johannes A; Leemans, C René
Fibrolamellar hepatocellular carcinoma is a subtype of hepatocellular carcinoma occurring in non-cirrhotic liver at a younger age. The tumor expresses both hepatocellular and cholangiocellular markers. Previously, our group described overexpression of tight junction protein claudin 4 in cholangiocellular carcinoma in contrast to hepatocellular carcinoma. In the present study, tight junction protein expressions were studied to possibly clarify bipotential lineage of fibrolamellar hepatocellular carcinoma. Eleven fibrolamellar hepatocellular carcinomas were compared with seven "conventional" hepatocellular carcinomas, seven cholangiocellular carcinomas, and five normal liver samples. By immunohistochemistry, all fibrolamellar hepatocellular carcinomas were positive for HepPar1 and cytokeratins 7, 8, and 18, but negative for cytokeratin 19. Glypican-3 gave weak staining in two cases. Expression of claudin 1 was lower, while that of claudin 2 was higher in fibrolamellar hepatocellular carcinomas than in other tumors. Claudins 3, 4, and 7 were not detectable in fibrolamellar hepatocellular carcinomas as in the majority of "conventional" hepatocellular carcinomas, contrary to high expression observed in cholangiocellular carcinomas. Focal or diffuse claudin 5 expression was detected in nine of 11 fibrolamellar hepatocellular carcinomas contrary to other tumors. Tricellulin was significantly downregulated in all tumors compared with normal liver. Our findings showed claudins to exhibit specific expression patterns in fibrolamellar hepatocellular carcinomas not observed in other primary liver tumors, with unique claudin 5 expression and pattern features similar to common hepatocellular carcinoma, but different from cholangiocellular carcinoma. This is the first report describing the loss of tricellulin expression in human hepatic tumors. PMID:21503766
Patonai, Attila; Erdélyi-Belle, Boglárka; Korompay, Anna; Somorácz, Aron; Straub, Beate K; Schirmacher, Peter; Kovalszky, Ilona; Lotz, Gábor; Kiss, András; Schaff, Zsuzsa
Background: Pancreatic carcinoma arising from the uncinate process (pancreatic uncinate carcinoma) is relatively rare. We wished to define its clinical manifestations and sonographic findings. Methods: Clinical and sonographic data of eight cases were reviewed. Results: The common bile duct and the pancreatic duct were not dilated until a very late stage. The lesion mimicked a mesenteric tumor in two cases.
M. Sato; H. Ishida; K. Konno; Y. Hamashima; H. Naganuma; T. Komatsuda; M. Funaoka; J. Ishida; S. Watanabe
The occurence of squamous cell carcinoma on long-lasting ulcers is classic. Malignant transformation may occur on burn scars and chronic ulcers of varying etiology, including infectious agents. Transformation of old lobomycosis lesion scars into squamous cell carcinoma has been rarely reported. Careful and long-term follow-up of such patients is important to avoid carcinomatous transformation.
Nogueira, Lisiane; Rodrigues, Luciana; Rodrigues, Carlos Alberto Chirano; Santos, Monica; Talhari, Sinesio; Talhari, Carolina
A study of 336 patients with bronchogenic carcinoma was carried out in Chandigarh, Northern India. The findings suggest that its epidemiology differs in several respects from that in Western countries. Almost a third of all patients and 94.4% of the 54 women had never smoked. The peak frequency of bronchogenic carcinoma occurred between the ages of 51 and 60 years,
S K Jindal; S K Malik; R Dhand; J S Gujral; A K Malik; B N Datta
Mediastinal metastasis of ovarian tumors are not rare as autopsy findings. Ovarian carcinomas usually spread by transcaelomic, lymphatic or haematogenous dissemination to peritoneum, pelvic and para-aortic lymph nodes, lung and pleura. A case of mediastinal metastasis of ovarian carcinoma is reported. A retrosternal mass was identified by CT scan and resected by VTC surgery.
Carlos A Montero; Josep M Gimferrer; Xavier Baldo; Josep Ramirez
Thymic carcinomas are tumors of the anterior mediastinum derived from the epithelial cells of the thymic gland. Due to their low incidence they are often investigated in combination with thymomas under the rubric of "thymic epithelial neoplasms" and studies exclusively addressing thymic carcinomas are sparse. Thymic carcinomas are characterized by their histologic variability, often resembling tumors seen in other organ systems. This morphologic variation coupled with their rarity has prevented large scale research of these tumors and little is known about the etiology, biologic behavior or best treatment for thymic carcinoma. In recent years, attempts have been made to investigate the molecular characteristics of these tumors in the hope that molecular profiling can be used to predict the prognosis or lead to the development of new treatment strategies. Herein we provide an overview of the recent advances of the molecular analysis of thymic carcinoma with particular emphasis on the potential use for molecularly targeted therapies. PMID:22921473
Weissferdt, Annikka; Wistuba, Ignacio I; Moran, Cesar A
The term "carcinoma erysipeloides" (CE) designates an uncommon form of cutaneous metastasis. CE is most often associated with carcinoma of the breast. However, there have been reports of CE from carcinoma of the uterus, prostate, lung, ovary, stomach, tonsils, thyroid, pancreas, rectum, parotid glands and melanoma. To our knowledge, CE of laryngeal origin has not been previously reported. We describe a patient diagnosed with human immunodeficiency virus and hepatitis C virus coinfection who developed a supraglottic laryngeal squamous cell carcinoma and erythematous cutaneous lesions. A skin biopsy demonstrated invasion of dilated dermal lymphatics by clusters of atypical squamous cells with polymorphic nuclei and extensive infiltration of the dermis by tumor cells. The histology of the metastatic cells was similar to that of the laryngeal carcinoma. PMID:22668578
Álvarez, María Á; Casas, Enrique; Ruano, Juan; Vélez, Antonio; Salvatierra, Juan; Moreno, Jose C
Pancreatic cancer patients present late in their course and surgical resection as a modality of treatment is of limited value. Majority develop loco-regional failure and distant metastasis, therefore, adjuvant therapy comprising of radiotherapy and chemotherapy are useful treatment options to achieve higher loco-regional control. Specialized irradiation techniques like intra-operative radiotherapy that help to increase the total tumor dose have been used, however, controvertible survival benefit was observed. Various studies have shown improved median and overall survival with chemoradiotherapy for advanced unresectable pancreatic carcinoma. The role of new agents such as topoisomerase I inhibitors also needs further clinical investigations.
Pathy, Sushmita; Chander, Subhash
Histiocytoid breast carcinoma is an uncommon entity that is mostly regarded as a variant of lobular carcinoma. Its occurrence with apocrine lobular carcinoma in situ and consistent expression of gross cystic disease fluid protein 15 suggest apocrine differentiation. Its recognition is often challenging, particularly when histiocytoid tumour cells occur in a metastatic site before the primary diagnosis of breast carcinoma,
Puay Hoon Tan; Oi Harada; Aye Aye Thike; Gary Man-Kit Tse
Frequency of a BRAFV600E mutation in anaplastic thyroid carcinoma, which is thought to be derived mainly from papillary carcinoma by multi-step carcinogenesis, is much lower than that in papillary carcinomas. To clarify this phenomenon, we analysed BRAFV600E mutation in 20 cases of anaplastic carcinoma and 13 accompanying differentiated carcinomas. Among twenty cases of anaplastic carcinomas, nine and four accompanied papillary
T Takano; Y Ito; M Hirokawa; H Yoshida; A Miyauchi
The fibrolamellar variant of hepatocellular carcinoma (FLC) differs from conventional hepatocellular carcinoma (HCC) in some clinical and pathological features. The authors investigated possible differences in reactivity between FLCs and HCCs using glypican-3 (GPC3), an oncofetal protein, and survivin, an antiapoptotic protein. They also compared staining of FLC and HCC with antibodies to cytokeratins 7 (CK7) and 19 (CK19) and CD34.
Hala M. Abdul-Al; Guanghua Wang; Hala R. Makhlouf; Zachary D. Goodman
Current therapies for advanced hepatocellular carcinoma (HCC) are marginally effective and exacerbate underlying liver disease. The ability of immunotherapy to elicit nontoxic, systemic, long-lived anti-tumor activity makes it particularly well-suited for use in the setting of HCC. While therapeutic benefit has been achieved in early clinical trials, the efficacy of immune-based therapies is limited by several unique properties of HCC, most notably the inherently tolerogenic character of the liver in both healthy and diseased (chronically-infected or tumor-bearing) states. Therapeutic regimens that both counteract these immunosuppressive mechanisms and amplify tumor-specific immunity are expected to profoundly improve clinical outcomes for HCC patients.
Pardee, Angela D.; Butterfield, Lisa H.
Hepatocellular carcinoma (HCC) is considered to be one of the most common malignancies worldwide, and the most common one in Africa and Asia. Over the last decade, a rising incidence of up to 10-15/100,000 per population has been seen in the Western world, with an estimate of 250,000 deaths and more than a million worldwide per year. By the year 2010, the World Health Organization expects that HCC will be the leading cause of cancer mortality surpassing lung cancer. This increasing incidence is most likely related to an increasing prevalence of chronic hepatitis C (HC) and B (HB) virus infections and other diseases inducing chronic inflammation (Befeler and Di Bisceglie 2002; Llovet et al. 2003).
Helmberger, Thomas K.
Most endometrial cancers are diagnosed at stage I (disease limited to the uterine corpus). The definitive treatment for endometrial carcinoma consists in total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy. The decision of adjuvant treatment depends on risk factors. Postoperative radiotherapy plays a major role in the management of stage I endometrial cancer but the respective place of external radiotherapy and vaginal brachytherapy remains controversial. Adjuvant external beam radiotherapy reduces locoregional recurrences, but carries a risk of toxicity without overall survival benefits. Recent data suggest that vaginal brachytherapy is effective in preventing vaginal recurrence with lower toxicity and should be the treatment of choice for intermediate risk endometrial cancer. PMID:18706845
Peignaux, K; Truc, G; Blanchard, N; Créhange, G; Maingon, P
The clinical, gross, and microscopical features of 22 cases of cystic squamous cell carcinoma of the neck that originally were considered to be of branchiogenic origin are reviewed. Detailed follow-up investigation demonstrated subsequent distal primary s...
A series of 26 white women aged under 50 who developed hepatocellular carcinoma in a non-cirrhotic liver were studied for the possible role of oral contraceptives. Eighteen of the women had used the \\
J Neuberger; D Forman; R Doll; R Williams
No clinical or laboratory data allow a preoperative diagnosis of parathyroid carcinoma and only occasionally does a definitive finding differentiate an adenoma from a carcinoma. We present a case of primary hyperparathyroidism presenting with severe elevation of parathyroid hormone and serum calcium as well as complications. We go on to discuss the case in the light of a literature review. The severity of the elevation of the parathyroid hormone, other biochemical alterations, the presence of skeletal and renal complications and of a neck mass should alert the clinician to a possible parathyroid carcinoma. Radical surgery is the only effective therapy for parathyroid carcinoma, and should always be performed if a preoperative suspicion is entertained.
Al-Fadhli, Mariam; Doi, Suhail A R; Muttikkal, Thomas; Al-Sumait, Basel
Nasopharyngeal biopsies were obtained from suspected cancer cases. The 83 patients with malignancies selected for study had lived at their present address at least 15 years. All of the cancers were differentiated or undifferentiated epidermoid carcinomas....
J. W. Fresh S. C. Sun J. W. Rampsch
By integrating genetic data into the traditional histology and immunohistochemistry-based classification system, the revised WHO classification of malignant tumors (2004) defined additional renal cell carcinoma subtypes, thereby enabling the application of additional diagnostic procedures. PMID:23801160
Stöhr, C G; Amann, K; Hartmann, A
Thyroid cancers represent about 1% of all human cancers. Differentiate thyroid carcinomas (DTCs), papillary and follicular cancers, are the most frequent forms, instead Anaplastic Thyroid Carcinoma (ATC) is estimated to comprise 1–2% of thyroid malignancies and it accounts for 14–39% of thyroid cancer deaths. The annual incidence of ATC is about one to two cases/million, with the overall incidence being higher in Europe (and area of endemic goiter) than in USA. ATC has a more complex genotype than DTCs, with chromosomal aberrations present in 85–100% of cases. A small number of gene mutations have been identified, and there appears to be a progression in mutations acquired during dedifferentiation. The mean survival time is around 6?months from diagnosis an outcome that is frequently not altered by treatment. ATC presents with a rapidly growing fixed and hard neck mass, often metastatic local lymph nodes appreciable on examination and/or vocal paralysis. Symptoms may reflect rapid growth of tumor with local invasion and/or compression. The majority of patients with ATC die from aggressive local regional disease, primarily from upper airway respiratory failure. For this reason, aggressive local therapy is indicated in all patients who can tolerate it. Although rarely possible, complete surgical resection gives the best chance of long-term control and improved survival. Therapy options include surgery, external beam radiation therapy, tracheostomy, chemotherapy, and investigational clinical trials. Multimodal or combination therapy should be useful. In fact, surgical debulking of local tumor, combined with external beam radiation therapy and chemotherapy as neoadjuvant (before surgery) or adjuvant (after surgery) therapy, may prevent death from local airway obstruction and as best may slight prolong survival. Investigational clinical trials in phase I or in phase II are actually in running and they include anti-angiogenetic drugs, multi-kinase inhibitor drugs.
Taccaliti, Augusto; Silvetti, Francesca; Palmonella, Gioia; Boscaro, Marco
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.
Nichols, D.A.; MacCarty, R.L.; Gaffey, T.A.
Background: Anaplastic thyroid carcinoma, albeit rare, is one of the most aggressive human tumors, with a dismal prognosis.Methods: Twenty-eight patients with anaplastic thyroid carcinoma were identified during the past 30 years to evaluate its clinicopathologic features and to document our experience in management. Potential risk factors for survival time were analyzed.Results: The usual presentation was that of a rapidly enlarging
Chung-yau Lo; King-yin Lam; Koon-yat Wan
We report a rare case of a patient with esophageal carcinoma diagnosed using transthoracic echocardiography. This examination proved to be useful in the identification of a paracardiac mediastinal mass. Images of the esophageal carcinoma, of the stent in the esophagus, and the bubbles inside the stent generated with the ingestion of a carbonated beverage, have not been previously published. Therefore, we believe our findings may be useful to other echocardiographers. PMID:23834459
Cianciulli, Tomás F; Saccheri, María C; Lax, Jorge A; Bianchi, Ricardo A; Beck, Martín A; Ferreiro, Daniel E
Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma.
Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.
\\u000a Gastric carcinoma represents a fascinating disease in terms of the history, development, philosophy, and future of the field\\u000a of surgical oncology. Many facets of gastric carcinoma intrigue us: the long-term decline in incidence in the United States\\u000a and other western countries , the rapid improvement in stage that has been seen in Japan as a result of widespread population\\u000a screening
\\u000a In this article, we review available evidence on the treatment of patients with nonurothelial cancer of the bladder. More\\u000a than 150 published works were reviewed in preparation for this summary. Squamous cell carcinoma and adenocarcinoma are ideally\\u000a treated with radical cystectomy. High-risk groups for these diseases are defined. Small cell carcinoma should be treated with\\u000a multimodality therapy, including chemotherapy. Other
Hassan Abol-Enein; Bruce R. Kava; Adrienne J. K. Carmack
Sarcomatoid carcinoma is a rare pathological entity of the cervix. A case of FIGO stage III sarcomatoid carcinoma of the cervix is reported. The patient was treated with concurrent radiotherapy and chemotherapy. Despite the initial excellent local response to therapy, she developed an early metastatic disease. In a review of the published studies, only 19 cases were reported on this type of cervical cancer. PMID:22871628
Nageeti, Tahani H; Jastania, Raid A
Sarcomatoid carcinoma is a rare pathological entity of the cervix. A case of FIGO stage III sarcomatoid carcinoma of the cervix is reported. The patient was treated with concurrent radiotherapy and chemotherapy. Despite the initial excellent local response to therapy, she developed an early metastatic disease. In a review of the published studies, only 19 cases were reported on this type of cervical cancer. PMID:22634482
Nageeti, T H; Jastania, R A
BACKGROUNDFibrolamellar carcinoma (FLC) is a variant of hepatocellular carcinoma (HCC) with distinctive clinical and histological features. To date there have been few studies on the genotypic aspects of FLC and no previous attempts have been made to use the arbitrarily primed-polymerase chain reaction (AP-PCR) technique to detect genetic alterations in this disease.AIMThe aim of this study was to assess the
Y Sirivatanauksorn; V Sirivatanauksorn; N R Lemoine; R C N Williamson; B R Davidson
Background: Tongue squamous cell carcinoma is a very rare disease in children with only a few cases reported in the literature. A case of 15 year old female tongue squamous cell carcinoma (SCC) with review of reported cases is presented. Pediatricians and family physicians should also be aware of the possibility of this disease entity occurring at an earlier age to decrease delay in diagnosis and initiation of treatment.
Harirchi, Iraj; Hakimian, Sayyedmohammadreza; Kiamoosavi, Sayyedmortaza; Mahmoodzadeh, Habibollah
Objectives To estimate the incidence of breast carcinoma and survival in patients less than 25 years old, and to describe presenting clinical signs and symptoms of breast cancer in this age group. Methods A population-based descriptive study and case review in Olmsted County, Minnesota, was conducted using the resources of the Rochester Epidemiology Project. Participants were Olmsted County females under 25 years old with histopathologically confirmed breast carcinoma diagnosed between 1935 to 2005. Non-residents who presented to a medical facility within Olmsted County during this time period were included in some portions of the analysis. Main outcome measures were age-adjusted incidence, 5-year survival and clinical presentation of breast carcinoma in females under 25 years of age. Results With four breast carcinomas observed in Olmsted County residents over 1,201,539 person-years, the annual age-adjusted incidence of breast cancer in this population was 3.2 per million (95% CI, 0.1–6.2). All four cancers occurred in the 20–24 year age-group (age-specific incidence, 16.2 per million). Eight additional cases of breast carcinoma were identified in nonresidents. Delay in diagnosis was common. All had at least one feature worrisome for an aggressive neoplasm identified in their clinical history, on physical examination or by imaging. Conclusions Breast carcinoma in young women is very rare, associated with delayed diagnosis, and usually associated with concerning features requiring biopsy.
Simmons, Patricia S.; Jayasinghe, Yasmin L.; Wold, Lester E.; Melton, L. Joseph
With advances in diagnostic techniques and treatment modalities, the number of patients identified with colorectal carcinoma who develop multiple primary malignancies during long-term followup has been increasing. We report a patient who developed three histologically distinct malignancies. Primary colon carcinoma treated radically followed by an 8-year disease-free period. The patient then presented with progressive dysphagia and was investigated and diagnosed to have a synchronous multicentric squamous cell carcinoma of the oesophagus and basal cell carcinoma of the skin. There was a simultaneous multicentric recurrence in the colon. This case is worth mentioning because the clustering of three primary malignancies (synchronous and metachronous) is of rare occurrence in a single patient, and, to our knowledge, this is the first report of this combination occurring in the same individual. In addition, the report emphasizes the importance of evaluating patients with known colonic primary neoplasms for synchronous colonic and extracolonic tumors.
Gupta, Nidhi; Kapoor, Rakesh; Sharma, Suresh C.
There are few specific pathologic findings that can be relied on to distinguish primary thymic carcinomas from lung carcinomas with mediastinal extension or showing metastasis to the anterior mediastinum. The immunohistochemical reactivity on frozen sections of thymic carcinomas and lung carcinomas, which are histologically similar to each other, was examined with the use of monoclonal antibodies to cytokeratins 7 and
Ichiro Fukai; Akira Masaoka; Takahiko Hashimoto; Yosuke Yamakawa; Hiroshi Niwa; Masanobu Kiriyama; Tadaaki Eimoto
Fibrolamellar carcinomas have a unique predilection for younger individuals and arise in livers without recognizable liver disease. In contrast to typical hepatocellular carcinomas, fibrolamellar carcinomas show few chromosomal changes and lack mutation in key genes such as TP53 and CTNNB1. Epigenetic instability, manifesting as methylation of important tumor suppressor gene promoters, has not been investigated in fibrolamellar carcinomas. Thus, the
Perumal Vivekanandan; Michael Torbenson
Fibrolamellar carcinoma arises in noncirrhotic livers of young individuals and has been considered to be less aggressive than conventional hepatocellular carcinoma. This study compares survival and clinicopathologic features of fibrolamellar carcinoma with hepatocellular carcinoma arising in noncirrhotic and cirrhotic livers. Clinical and pathologic features including age, gender, tumor size, stage and survival were recorded in 20 resected cases of fibrolamellar
Sanjay Kakar; Lawrence J Burgart; Kenneth P Batts; Joaquin Garcia; Dhanpat Jain; Linda D Ferrell
Development of carcinomas of the pancreas over an underlying chronic pancreatitis is a rare event. Diminution of pancreatic calcification, following the development of carcinoma, has been previously reported only once. We report another such case. PMID:2212748
Misra, S P; Thorat, V K; Vij, J C; Anand, B S
Thymic tumors comprise a heterogeneous group of neoplasms with a wide spectrum of clinical presentations. The evolution of the disease is often unpredictable, ranging from an indolent attitude to the possibility of intra- and extrathoracic spread. From the histological point of view, thymoma and thymic carcinoma are the most frequent subtypes and arise only from thymic epithelial cells. Other histological types are even more rare and are usually considered separately. A number of prognostic factors have been validated as predictors of outcome: staging, World Health Organization histological classification, diameter of the tumor, associated paraneoplastic syndromes, completeness of resection, and early onset of recurrence. Complete surgical resection is the key factor for cure and should be considered the gold standard at any stage. Especially for more aggressive lesions, surgery should be considered with a multimodality approach, involving induction and adjuvant therapy according to the stage. Multimodality therapy protocols have been designed based on the integration of clinical staging and histology. Neoadjuvant therapy is now administered before surgical resection in patients with tumors considered inoperable as it improves resectability and survival and reduces the risk of recurrence. Adjuvant treatment has been extensively reported after both complete or partial resection. New targeted therapies are in the developmental stage, and in the future they will be part of the standard protocols. Integrated treatment modalities require strict cooperation between medical and radiation oncologists, thoracic surgeons, and pathologists. PMID:22237733
Venuta, Federico; Rendina, Erino A; Anile, Marco; de Giacomo, Tiziano; Vitolo, Domenico; Coloni, Giorgio F
Truly mixed corticomedullary tumors (MCMTs) are extremely rare and present as a single tumor mass composed of an intimately admixed population of both adrenal cortical cells and pheochromocytes. The current study describes the first case of a mixed corticomedullary adrenal carcinoma. In addition, we also review the published data on MCMTs to determine their clinical features, biochemical characteristics, pathological findings, and management. In order to compose this review, a search of the international literature for MCMTs was conducted. Fifteen related articles were found. The clinical and pathological information was obtained for all reported cases. MCMTs were found almost exclusively in females. In the vast majority of patients, the symptoms were related to the tumor's hormone hypersecretion. Hypertension and diabetes were present in 80 and 40 % of cases, respectively. Cushing's syndrome was reported in eight cases (53.33 %). A final diagnosis was made in all cases after surgery based on the pathological results. As of the writing of this article, all published cases of MCMTs had benign clinical behavior, with no instances of metastasis or death due to the tumor. MCMTs are currently considered to be benign tumors. Ours is the first case of malignant MCMT reported in the literature. The potential for malignancy should therefore be considered for these tumors. PMID:23435808
Michalopoulos, Nick; Pazaitou-Panayiotou, Kalliopi; Boudina, Maria; Papavramidis, Theodossis; Karayannopoulou, Georgia; Papavramidis, Spiros
This is a new case of Merkel cell carcinoma of the vulva. It is a rare neuroendocrine carcinoma with an aggressive behavior. Because of its rarity in this location, it is not clear whether it behaves differently from the usual neuroendocrine carcinomas of the skin. A case of a 63-year-old patient with vulvar Merkel carcinoma is presented. The clinical presentation, microscopic and immunohistochemical features, and treatment are discussed.
Iavazzo, C.; Terzi, M.; Arapantoni-Dadioti, P.; Dertimas, V.; Vorgias, G.
\\u000a Unlike most thyroid carcinomas, undifferentiated carcinoma (anaplastic carcinoma) is an extremely aggressive malignancy with\\u000a a poor prognosis. It generally occurs in elderly patients where it presents as a large, firm mass that infiltrates extrathyroidal\\u000a tissues. For most undifferentiated carcinomas, surgical resection is not an effective treatment and only palliative therapies\\u000a are used. Consequently, the pathologist may be called upon to
Douglas P. Clark; William C. Faquin
The aim of this research is to establish the cell basis for the carcinoma tissue diagnosis by exploring a method to obtain the FTIR (Fourier transform infrared) spectra of the cultured carcinoma cells with FTIR spectroscopy and investigating the special spectral features of the carcinoma cells compared with the carcinoma tissues. In the present paper, the gastric carcinoma tissues confirmed by histology were measured using a Nicolet Magna750-II FTIR spectrometer and the corresponding FTIR spectra were obtained. The cultured gastric carcinoma cells (SGC7901) were centrifuged to provide a small pellet of cells for FTIR analysis. The cell pellet was then placed on a specially designed salt plate made of BaF2. Then the infrared spectra were recorded by the same equipment. Based on the previously established criteria, a comparative study was subsequently carried out between the spectra of the cultured carcinoma cells (SGC7901) and that of the corresponding gastric tissues. Several infrared spectral features of the carcinoma cells were obtained: the different bands between cells and tissues locate in the range of 3 000-3 600 cm(-1) and 1 640 cm(-1) which are the range of the hydroxy stretching and blending bands of H2O. There are more H2O out of carcinoma cells in carcinoma tissues, so the strong bands of H2O cover the distinctive bands of carcinoma cells in carcinoma tissues. Although the carcinoma tissue is more complicated, which might originate from the intrinsic complexity of the tissue, the results suggest that the spectral features of the carcinoma cells can be well reflected by that of the carcinoma tissue. This study shows that the diagnosis of carcinoma tissue by FTIR method exhibits sufficient cell basis. PMID:18422118
Du, Jun-Kai; Shi, Jing-Sen; Xu, Yi-Zhuang; Zhang, Yuan-Fu; Sun, Xue-Jun; Wang, Jian-Sheng; Weng, Shi-Fu; Wu, Jin-Guang
For a long time radiotherapy has been excluded from the therapeutic strategy for hepatocellular carcinoma, given its significant toxicity on the non-tumoral liver parenchyma. Conformal radiation is a recent advance in the field of radiotherapy, allowing dose escalation and combination with other therapeutic options for hepatocellular carcinoma, including trans-arterial chemo-embolization. Conformal radiotherapy is associated with interesting features, especially in cirrhotic patients: wide availability, non-invasiveness, possibility to target multiple localizations anywhere within the liver parenchyma, and favorable tolerance profile even in patients with cirrhosis and/or in a poor medical condition. Recently, radiation delivery has been optimized through several technical developments: respiratory gating and intensity-modulated radiotherapy, which allow a better focalization of the ballistics, stereotactic techniques and proton-beam radiotherapy, whose availability is currently limited in Europe. Given the high response rates of hepatocellular carcinoma to radiation, conformal radiotherapy may be regarded as a curative-intent treatment for hepatocellular carcinoma, similar to surgery and per-cutaneous techniques. Yet the impact of radiotherapy has to be evaluated in randomized trials to better integrate in the complex therapeutic algorithm of hepatocellular carcinoma. PMID:21237691
Girard, N; Mornex, F
A case of breast carcinoma, showing both lymphoepithelioma-like and lobular infiltrating carcinoma, is described, which must\\u000a be distinguished from the medullary carcinoma with which it shares some features, such as the strong lymphocytic infiltration,\\u000a but not sharp circumscription, syncytial growth pattern, nuclear pleomorphism, and high mitotic rate. Unlike the lymphoepithelial\\u000a carcinoma of the nasopharynx and some lymphoepithelioma-like carcinomas of the
Silvia Cristina; Renzo Boldorini; Francesco Brustia; Guido Monga
Background: Approximately 10% of gastric carcinomas are associated with Epstein–Barr virus (EBV). The Inuit in Greenland have a high incidence of EBV-associated nasopharyngeal carcinoma. Methods: We conducted a population-based case–control study comparing gastric carcinomas in Greenland and in Denmark. Results: The prevalence rate of EBV-associated gastric carcinomas was 8.5% in both populations. Conclusion: The findings of this study argue against a general susceptibility to EBV-associated carcinomas among the Inuit.
Boysen, T; Mohammadi, M; Melbye, M; Hamilton-Dutoit, S; Vainer, B; Hansen, A V; Wohlfahrt, J; Friborg, J
Objective: Thymic carcinoma is a rare thymic neoplasm. It is more invasive and has a poorer prognosis than thymoma. We report our experience in the treatment of 13 thymic carcinomas. Methods: Thirteen patients with histologically confirmed thymic carcinoma were treated from June 1989. Six patients underwent surgery, followed by adjuvant therapy. Seven patients underwent neoadjuvant chemotherapy, followed by surgery and
M Lucchi; A Mussi; M Ambrogi; A Gunfiotti; G Fontanini; F Basolo; C. A Angeletti
Penile tumors, although not frequent, represent a difficult diagnostic and therapeutic challenge. Of the malignant penile neoplasms, the most frequent is penile carcinoma, which includes squamous cell carcinoma and its well-differentiated variant, verrucous carcinoma. Current concepts about classification, epidemiology, pathogenesis, histopathology, diagno sis, staging, prognosis, and treatment are presented.
Giuseppe Micali; Daniele Innocenzi; Maria Rita Nasca; Maria Letizia Musumeci; Francesco Ferraú; Manfredi Greco
Four different genetic abnormalities may occur in endometrioid adenocarcinomas of the endometrium (mircosatellite instability and mutations in the PTEN, k-RAS and ?-catenin genes), whereas nonendometrioid carcinomas of the endometrium often have p53 mutations and loss of heterozygosity on several chromosomes. Occasionally, a nonendometrioid carcinoma may develop as a result of dedifferentiation of a preexisting endometrioid carcinoma; in such a case,
Xavier Matias-guiu; Lluis Catasus; Elena Bussaglia; Helena Lagarda; Arnald Garcia; Cristina Pons; Josefina Muńoz; Rosmary Argüelles; Pilar Machin; Jaime Prat
Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites. A case of a combined hepatoid and serous papillary carcinoma of the ovary in a 72-year-old woman is reported. The hepatoid component showed ?-fetoprotein production. Imperceptible merging of the hepatoid and serous papillary components was seen, supporting the theory of a surface epithelial
James P. Scurry; Robert W. Brown; Thomas Jobling
Background: Parathyroid carcinoma is a rare malignancy with a wide range of aggressiveness. There is no current staging system. Our primary aim was to review the presentation, diagnosis, surgical treatment, and outcomes of patients, with the goal of assessing the incidence of death related to parathyroid carcinoma. Methods: The authors present a retrospective chart review on patients with parathyroid carcinoma
Kenneth P. Kleinpeter; James F. Lovato; Paige B. Clark; Tom Wooldridge; Elizabeth S. Norman; Simon Bergman; Nancy D. Perrier
Patients with a rising serum carcinoembryonic antigen level and no clinical or roentgenographic evidence of recurrent or metastatic cancer present a treatment dilemma. Eleven such patients, 10 with a previously treated colorectal carcinoma and 1 with a previously treated breast carcinoma, received an injection of the anticarcinoembryonic antigen monoclonal antibody ZCE-025 labeled with the radioisotope indium 111. Nuclear scintigraphy was performed on days 3 and 5 through 7 to detect potential sites of tumor recurrence. The monoclonal antibody scan accurately predicted the presence or absence of occult malignancy in 7 (64%) patients. Second-look laparotomy confirmed the monoclonal antibody scan results in the patients with colorectal cancer, and magnetic resonance imaging confirmed metastatic breast cancer. This study demonstrates that In-ZCE-025 can localize occult carcinoma and may assist the surgeon in facilitating the operative exploration. In-ZCE-025 assisted in the initiation of adjuvant therapy for the patient with breast cancer.
Duda, R.B.; Zimmer, A.M.; Rosen, S.T.; Gilyon, K.A.; Webber, D.; Spies, S.; Spies, W.; Merchant, B. (Northwestern Univ. Medical School, Chicago, IL (USA))
The authors studied 80 hepatocellular carcinomas from three continents for p53 gene (TP53) mutations and hepatitis B virus (HBV) sequences. p53 mutations were frequent in tumors from Mozambique but not in tumors from South Africa, China, and Germany. Independent of geographic origin, most tumors were positive for HBV sequences. X gene coding sequences of HBV were detected in 78% of tumors, whereas viral sequences in the surface antigen- and core antigen-encoding regions were present in less than 35% of tumors. These observations indicate that hepatocellular carcinomas are genetically heterogeneous. Mozambican-types of hepatocellular carcinomas are characterized by a high incidence of p53 mutations related to aflatoxins. In other tumors, the rarity of p53 mutations combined with the frequent presence of viral X gene coding sequences suggests a possible interference of HBV with the wild-type p53 function.
Unsal, H.; Isselbacher, K.J. (Massachusetts General Hospital Cancer Center, Charlestown, MA (United States)); Yakicier, C.; Marcais, C.; Ozturk, M. (Institut National de la Sante et de la Recherche Medicale, Lyon (France)); Kew, M. (Univ. of Witwatersrand, Johannesburg (South Africa)); Volkmann, M. (Univ. of Heidelberg (Germany)); Zentgraf, H. (Deutsches Krebsforschungszentrum, Heidelberg (Germany))
Nasophryngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for diagnosis and follow-up study. The virus has not been conclusively shown to cause nasopharyngeal cancer, however. Histologically, nasopharyngeal carcinoma is anaplastic in 75% of cases and better differentiated in 25% of patients. All tumors are treated by high-dose radiation to the primary site and both sides of the neck. Surgical treatment, in the neck only, is reserved for irradiation failures. The prognosis is better in patients younger than 40 years, in patients without clinical cervical nodal involvement and, unexpectedly, in patients with anaplastic tumors. 18 references, 2 figures, 2 tables.
Moloy, P.J.; Chung, Y.T.; Krivitsky, P.B.; Kim, R.C.
OBJECTIVE: The author seeks to provide an update on the current management of pancreatic carcinoma, including diagnosis and staging, surgical resection and adjuvant therapy for curative intent, and palliation. SUMMARY BACKGROUND DATA: During the 1960s and 1970s, the operative mortality and long-term survival after pancreaticoduodenectomy for pancreatic carcinoma was so poor that some authors advocated abandoning the procedure. Several recent series have reported a marked improvement in perioperative results with 5-year survival in excess of 20%. Significant advances also have been made in areas of preoperative evaluation and palliation for advanced disease. CONCLUSION: Although carcinoma of the pancreas remains a disease with a poor prognosis, advances in the last decade have led to improvements in the overall management of this disease. Resection for curative intent currently should be accomplished with minimal perioperative mortality. Surgical palliation also may provide the optimal management of selected patients. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 7.
Lillemoe, K D
The fibrolamellar variant of hepatocellular carcinoma is a rare primary liver cancer occurring in adolescents and young adults without chronic liver disease or known risk factors. Histologically, it is defined by lamellar bands of fibrosis surrounding well-differentiated tumor cells. Radiologic imaging typically demonstrates a large, solitary mass with calcifications and a central scar. Lymph node metastases in the porta hepatis are frequently diagnosed upon presentation. More patients with fibrolamellar carcinoma are candidates for surgical resection than those with conventional hepatocellular carcinoma, owing to their young age and absence of cirrhosis. The most important prognostic factor is surgical resection, which results in 5-year overall survival rates ranging between 50 and 76 %. Despite complete surgical resection, relapse rates are high, and novel therapies are needed to prevent and treat recurrent disease. PMID:22941016
Chun, Yun Shin; Zimmitti, Giuseppe
Micropapillary carcinoma (MPC) of urinary tract is an uncommon variant of urothelial carcinoma with significant diagnostic and prognostic implications. Though MPC shows characteristic microscopic features, there exists interobserver variability and also it needs to be differentiated from the metastasis from other organs. The prognosis is generally poor, depending on the proportion of the micropapillary component in some reports. Early cystectomy in cases with only lamina propria invasion may be indicated according to recent studies. This review outlines the general features of this entity and briefly comments on the controversies and the recent development.
Kwon, Ghee Young; Ro, Jae Y.
We present a case of concurrent metastatic thymic carcinoma and postirradiation sarcoma in the same lobe of the lung in a woman who had received partial resection of thymic carcinoma with chemoradiotherapy 11 years ago. One tumor showed similar histology to the previous carcinoma. The other tumor was a pleomorphic sarcoma, suggestive of a postirradiation sarcoma. Irradiation-induced sarcomas are rare and have not been reported in patients with thymic carcinoma. This case may serve as a model in considering the possibility of postirradiation sarcoma for patients encountering recurrent masses with the history of radiotherapy for thymic carcinoma several years ago. PMID:22450080
Chen, Tzu-Ju; Lu, Hung-I; Huang, Cheng-Hua; Hsu, Hsuan-Chih; Chen, Sung-Ting; Chen, Wei-jen; Huang, Chao-Cheng
Intrahepatic cholangiocellular carcinoma (CCC) is known to be associated with severe symptoms and a particularly poor prognosis. Nonsurgical methods have failed to change this situation up to now. Surgical therapy, so far, is the only chance for effective treatment, but it has had limited success. The relative infrequency of this tumor does not allow extensive statistics and limits our present
Rudolf Pichlmayl; Peter Lamesch; Arved Weimann; Gfinter Tusch; Burkhardt Ringe
Hepatocellular carcinoma (HCC) is a leading cause of cancer death, particularly in Asia where the major eti- ology, chronic hepatitis B virus infection, is endemic. The tumor frequently develops in a background of cir- rhosis, and liver transplantation offers a chance to cure both the tumor and the underlying cirrhosis. The Milan criteria based on tumor size and number as
VANESSA DE VILLA; S.-T. Fan
Renal cell carcinoma (RCC) represents 3% of adult malignancies. About 30% of RCC patients develop metastatic disease. So far, drugs cannot significantly increase the survival of these patients. We present a recent review of proteomics and RCC. Proteomic technologies have been used in the research to discover new markers of RCC that might increase survival. Furthermore, newly discovered markers cannot
Vanessa Sandim; Denise A. Pereira; Antonio A. Ornellas; Gilda Alves
We retrospectively compared the outcome of 13 patients at our institution and that of 163 reported cases of pedunculated hepatocellular carcinoma (HCC) with that of conventional HCC subdivided by tumor diameter (group A: less than 2 cm; group B: 2–5 cm, group C: more than 5 cm). The survival of patients with pedunculated HCC in the 163 reported cases was
Yutaka Horie; Azusa Shigoku; Hisao Tanaka; Yasushi Tomie; Naoto Maeda; Ushio Hoshino; Masahiko Koda; Goshi Shiota; Tetsuo Yamamoto; Seiichi Kato; Yoshikazu Murawaki; Takeaki Suou; Hironaka Kawasaki
Transrectal ultrasonography (US) scanning facilitates the ultrastructural differentiation of the various histologic layers of the rectal wall. In particular, the muscularis propria is represented by the 4th sonographic layer. Rectal carcinoma appears on US as a low echogenic area that suddenly interrupts the regular sequence of parietal layers.
Giulio Di Candio; Franco Mosca; Alessandro Campatelli; Andrea Cei; Mauro Ferrari; Fulvio Basolo
Aim: The article focuses on the radioprotective effect of acute hypoxia on healthy tissues during preoperative accelerated hypoxyradiotherapy of colorectal carcinoma performed as locoregional irradiation including the common iliac lymph nodes. Analysis of early and late side effects and complications. Patients and Methods: In this prospective study, early and late complications were assessed in 50 patients as a function of
Ta?o Ta?ev; Tomáš Sk?i?ka; Jan Žaloudík; Zden?k Pa?ovský
Background To assess changing trends in histological types of thyroid cancer in an Irish hospital over the past 30 years. Methods Biographical data, tumour characteristics, treatment and outcome from 190 patients with thyroid carcinoma from 1970 to 2000 were reviewed retrospectively. Results Detailed records of 190 patients with thyroid cancer were identified with a mean age at presentation of 50
B. Dijkstra; R. S. Prichard; A. Lee; L. M. Kelly; P. P. A. Smyth; T. Crotty; E. W. McDermott; A. D. K. Hill; N. O’Higgins
Hepatocellular carcinoma (HCC) is one of the most common and lethal malignant tumors worldwide in the human population. Due to late diagnosis and\\/or advanced underlying liver cirrhosis, only limited treatment options with marginal clinical benefit are available in up to 70% of patients. During the last decades, no effective conventional cytotoxic systemic therapy was available contributing to the dismal prognosis
Marcus Alexander Wörns; Arndt Weinmann; Marcus Schuchmann; Peter Robert Galle
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. The resistance of HCC to existing treatments and the lack of biomarkers for early detection make it one of most hard-to-treat cancers. Surgical tumor resection, including liver transplantation, remains the only curative modality for HCC. Several clinical prognostic models have been developed for the staging of patients
Volker Meier; Giuliano Ramadori
Abstract Background No effective systemic therapy exists for patients with advanced hepatocellular carci- noma. A preliminary study suggested that sorafenib, an oral multikinase inhibitor of the vascular endothelial growth factor receptor, the platelet-derivedgrowth factor receptor, and Raf may be effective in hepatocellular carcinoma. Methods
Josep M. Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F. Greten; Peter R. Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The major etiologies and risk factors for development of HCC are well defined and some steps of hepatocellular carcinogenesis have been elucidated. Despite these scientific advances and the implementation of measures for early detection of HCC in patients who are at risk of this disease, survival of patients
Hans Christian Spangenberg; Robert Thimme; Hubert E. Blum
The spectral morphometric characteristics of standard haematoxylin and eosin breast carcinoma specimens were evaluated by light microscopy combined with a spectral imaging system. Light intensity at each wavelength in the range of 450–800 nm was recorded for 104 pixels from each field and represented as transmitted light spectra. A library of six characteristic spectra served to scan the cells and reconstruct new images depicting the nuclear area occupied by each spectrum. Fifteen cases of infiltrating ductal carcinoma and six cases of lobular carcinoma were examined; nine of the infiltrating ductal carcinoma and three of the lobular carcinoma showed an in situ component. The spectral morphometric analysis revealed a correlation between specific patterns of spectra and different groups of breast carcinoma cells. The most consistent result was that lobular carcinoma cells of in situ and infiltrating components from all patients showed a similar spectral pattern, whereas ductal carcinoma cells displayed spectral variety. Comparison of the in situ and the infiltrating ductal solid, cribriform and comedo carcinoma cells from the same patient revealed a strong similarity of the spectral elements and their relative distribution in the nucleus. The spectrum designated as number 5 in the library incorporated more than 40% of the nuclear area in 74.08% of the infiltrating lobular cells and in 13.64% of the infiltrating ductal carcinoma cells (P < 0.001). Spectrum number 2 appeared in all infiltrating ductal cells examined and in none of the lobular cells. These results indicate that spectrum number 5 is related to infiltrating lobular carcinoma, whereas spectrum number 2 is characteristic for infiltrating ductal carcinoma cells. Spectral similarity mapping of central necrotic regions of comedo type in situ carcinoma revealed nuclear fragmentation into defined segments composed of highly condensed chromatin. We conclude that the spectral morphometric features found for lobular and ductal cell populations may serve future automated histological diagnostics. © 1999 Cancer Research Campaign
Barshack, I; Kopolovic, J; Malik, Z; Rothmann, C
Background\\/Aims: Many randomized clinical trials have been performed to treat colon carcinoma with the exclusion of transverse colon carcinoma or descending colon carcinoma. The aim of the present study was to investigate the difference in surgical outcomes between laparoscopic surgery for transverse\\/descending colon carcinomas and that for other colon carcinomas. Methods: A total prospective registry of 455 patients with colon
Seiichiro Yamamoto; Shin Fujita; Takayuki Akasu; Tomohiro Yamaguchi; Yoshihiro Moriya
Pleomorphic lobular carcinoma is a recently described entity separated from classical lobular carcinoma by cytologic pleomorphism. It can have an aggressive clinical course with a higher frequency of recurrence. Histologic differentiation with ductal carcinoma may be difficult, but it is important for this differentiation to be made. E-cadherin is a transmembrane glycoprotein, and complete loss of E-cadherin expression has been observed in invasive lobular carcinoma and lobular carcinoma in situ. Ductal carcinoma retains at least some expression of E-cadherin. We examined the pattern of E-cadherin expression in a series of 14 cases of pleomorphic lobular carcinoma by immunohistochemistry. Twelve of the 14 cases showed no staining (86%); the remaining two cases exhibited 10% to 25% positive cells. In cases with histologic equivocal features, immunohistochemical detection of E-cadherin expression can be a useful diagnostic aid for the differentiation of pleomorphic lobular and ductal carcinoma. PMID:12478484
Wahed, Amer; Connelly, John; Reese, Tommy
Introduction Intracystic papillary carcinoma represents a small distinctive subgroup of noninvasive breast cancer, accounts for <0.5% of breast malignancies and is extremely rare in men, it was originally reported as a localized non-invasive carcinoma, but is usually associated with ductal carcinoma in situ around the main tumor or invasive carcinoma. Case presentation We report a case of 50-year-old man with intracystic papillary carcinoma in man with ductal carcinoma in situ who underwent a tumorectomy following by a radical Patey intervention (Halsted). Conclusion Nowadays, there is still no clear consensus regarding optimal treatment of intracystic papillary carcinoma. Most papers reinforce the importance of an adequate surgical margin in conservative treatment. Surgeons must pay much attention to the potential for ductal carcinoma in situ around the tumor when selecting the operative procedure.
El M'rabet, Fatema Zahra; Akesbi, Yusra; Benbrahim, Zineb; El Hind, fatemi; Znati, Kawtar; Benlemlih, Amal; Tbaili, Naima; Maaroufi, Mustapha; Tizniti, Siham; Amarti, Afaf; El Mesbahi, Omar
We report a 75-year-old male with anaplastic carcinoma in an extrathyroid area. Thyroid remained unchanged. The patient is alive without incident of tumor recurrence at 3.5 years after total resection and at 5 years after initial symptom.The tumor developed between the sternocleidomastoid muscle and common carotid artery, and was completely separated from the thyroid. The tumor location was consistent with
Shinji Togashi; Kuniyuki Oka; Ryoji Kanayama; Sumiko Koyamatsu; Tomomi Tobita; Yasushi Yatabe; Toshiharu Matsumoto; Hando Hakozaki
AIM--To study the expression of p53 tumour suppressor gene in anaplastic carcinomas arising from thyroid papillary carcinomas. METHODS--Formalin fixed, paraffin wax embedded tissues from four cases of anaplastic carcinomas associated with thyroid papillary carcinomas were studied by immunohistochemistry with two different p53 monoclonal antibodies. RESULTS--The anaplastic component showed nuclear immunostaining in two cases, but not in the other two. In
X Matias-Guiu; M Cuatrecasas; E Musulen; J Prat
Pulmonary infarction may be associated with bronchogenic carcinoma. Radiopathological correlation was performed in four patients. There were two cases of squamous cell carcinoma, one case of adenocarcinoma and one case of large cell carcinoma. Infarcts in patients with squamous cell carcinoma were obscured on plain radiographs by a large primary tumor or atelectasis of the affected lobe. Infarcts in adenocarcinoma and large cell carcinoma were clearly demonstrated on plain radiographs; 1 to 2 cm in size, round or polygonal in shape, blurred in margin, and located at the periphery of the same lobe as the primary tumor. Rapid appearance of infarcts was helpful in distinguishing from intrapulmonary metastasis. Invasion of the pulmonary artery, pulmonary vein and bronchial wall in hilar region was thought to be responsible for pulmonary infarction. Pulmonary infarct should be considered in patients with centrally invasive bronchogenic carcinoma, when a small ill-defined opacity appears at the periphery of the involved lobe over a short period. PMID:2587194
Tsunoda, H S; Saida, Y; Doy, M; Kimula, Y; Matsueda, K; Kurosaki, Y; Kuramoto, K; Akisada, M
We herein reported a primary pulmonary papillary carcinoma with colloid-like luminal content in the glandular cavity and classic nuclear features such as pseudo-inclusions, intranuclear grooves in the tumor cell nuclei and ground glass nuclei which closely mimics papillary thyroid carcinoma. Meanwhile, lymph node in the left pulmonary hilum was involved and showed similar features to the primary pulmonary papillary carcinoma. This specific histopathological presentation caused a diagnostic dilemma.The patient didn't show previous concomitant or subsequent evidence of a thyroid tumor. Immunohistochemistry further confirmed pulmonary origin and excluded a metastasis from the thyroid, as it was thyroglobulin negative, thyroid transcription factor 1 and surfactant apoprotein A positive, which was consistent with the imageology and history.Based on the above features, the diagnosis of primary pulmonary papillary carcinoma was confirmed. Understanding the existence of papillary thyroid carcinoma-like pulmonary papillary carcinoma will avoid misdiagnosis or unnecessary clinical and radiologic investigations in future. PMID:23684153
Zhu, Ya-Zhen; Li, Wei-Ping; Wang, Zhi-Yuan; Yang, Hai-Feng; He, Qing-Lian; Zhu, Hong-Guang; Zheng, Guang-Juan
Renal cell carcinoma is the most common type of renal malignancy and it originates from the renal tubular epithelium. Due to the diversity in the histopathological and molecular characteristics, it is typically subclassified into five different categories. Papillary renal cell carcinoma is one subclassification and it includes two variants: sporadic and hereditary. Although the hereditary form comprises a smaller number of cases of papillary renal cell carcinoma, an understanding of the molecular pathways and genetic changes continues to play a significant role in the development of new targeted therapies. Along with recommending appropriate lifestyle modification, further investigation into the molecular pathogenesis of hereditary papillary renal cell carcinoma will continue to be invaluable for the clinical management of renal cell carcinoma. In this article, we discuss a case of the hereditary papillary renal cell carcinoma along with an overview of the disease.
Mustafa, Sadaf; Jadidi, Nima; Faraj, Sheila F.; Rodriguez, Ronald
Accurate morphologic distinction between small cell carcinoma and poorly differentiated squamous cell carcinoma has critical therapeutic significance, but can be limited by crush artifact, tumor necrosis, limited tumor representation, and overlapping morphologic features. We evaluated a panel of antibodies for their efficacy in distinguishing between these neoplasms. Formalin-fixed paraffin-embedded tissue sections of small cell carcinomas and poorly differentiated squamous cell
Hong Zhang; Jing Liu; Philip T Cagle; Timothy C Allen; Alvaro C Laga; Dani S Zander
A histological study was made of prostate glands from 383 Hiroshima men and 105 Nagasaki men, aged 50 y up, with no bomb exposure. Latent prostatic carcinoma was found in 26.8% and active carcinoma in 1.8%. Latent carcinoma increased with age and was most...
R. Yatani M. A. Bean P. I. Liu K. Fukazawa S. Fujita
Mucinous carcinoma is considered a distinct pathological entity. However, mucinous tumours can be divided into a least two groups: mucinous A (or paucicellular) and mucinous B (or hypercellular). Mucinous B cancers display histological features that significantly overlap with those of neuroendocrine carcinomas. We investigate using genome-wide oligonucleotide microarrays whether mucinous A, mucinous B and neuroendocrine carcinomas are entities distinct from
Britta Weigelt; Felipe C Geyer; Hugo M Horlings; Bas Kreike; Hans Halfwerk; Jorge S Reis-Filho
AIMS--To determine (1) the detection rate of primary carcinoma of the lung by serological assay of CEA (carcinoembryonic antigen); and (2) whether addition of seroassay of squamous cell carcinoma related antigen before treatment improves detection sensitivity. METHODS--A prospective study spanning 27 months was conducted at the University Hospital, Kuala Lumpur. Serum CEA (Abbott IMx) and serum squamous cell carcinoma antigen
P L Cheah; C K Liam; S F Yap; L M Looi
A thymic basaloid carcinoma is rare, as is an unusual case with extra-thoracic metastasis. We report on a 41-year-old woman who had a thymic basaloid carcinoma with liver metastases. The patient underwent resection of the thymic basaloid carcinoma followed by curative partial hepatectomy. At 1 year later, another metastatic lesion developed in the residual liver, which was also curatively resected.
Toshihiro Matsuo; Ryozo Hayashida; Keita Kobayashi; Yoshihisa Tanaka; Shoji Ohtsuka
We are reporting a case of ovarian carcinoma, who presented with polymyositis. Polymyositis, without any evidence of dermatomyositis, as the presentation of ovarian carcinoma has never been reported. In fact, for patients with polymyositis, there does not appear to be a great increase in the risk of malignancy. The purpose of this report is to make the gynaecologists aware that polymyositis alone can also be the presenting symptom for ovarian carcinoma. PMID:16819613
Ghosh, Anshuman; Malak, T M; Pool, A J
Squamous cell carcinoma complicating ulcerative prurigo nodularis is described in 2 patients who were having prurigo nodularis on dorsum of the feet for duration of many years. Biopsy specimens from the ulcerating nodules showed features of squamous cell carcinoma. This finding has not been previously reported. Squamous cell carcinoma should be considered in the evaluation of long standing ulcerative lesion of prurigo nodularis especially when not responding to conventional therapy. PMID:11533804
Al-Waiz, M M; Maluki, A H
Basal cell carcinoma (BCC) is the most common malignant tumor of skin. The most common site (80%) is head and neck. BCC exhibits a varied morphology such as adenoid, keratotic, sebaceous, basosquamous, apocrine, eccrine or fibroepithelial. Tumors with a similar histopathological picture are cutaneous adenoid cystic carcinoma and primary cutaneous cribriform apocrine carcinoma. Immunohistochemistry, along with clinical findings, acts as an adjunct in reaching an accurate diagnosis. Here, we present an interesting case of adenoid BCC in a 55-year-old man.
Jetley, Sujata; Jairajpuri, Zeeba S; Rana, Safia; Talikoti, Majid A
Fibrolamellar carcinomas are a unique type of liver carcinoma that arise in non-cirrhotic livers of young individuals. Despite their distinctive appearance, recent studies have demonstrated a lack of consistency in how fibrolamellar carcinomas are diagnosed by pathologists. As a potential aide in diagnosis, we investigated the staining properties of CD68. The CD68 gene encodes for a transmembrane glycoprotein located within lysosomes and endosomes. Macrophages as well as other cell types rich in lysosomes/endosomes are CD68 positive. Cases of fibrolamellar carcinoma were collected from four academic centers. Control groups included hepatocellular carcinomas arising in both non-cirrhotic livers and cirrhotic livers. A group of cholangiocarcinomas were also stained. CD68 immunostaining was scored for both intensity and distribution on a scale of 0 to 3+. Twenty-three primary fibrolamellar carcinomas and 9 metastases (total of 24 individuals) were immunostained and showed a distinctive granular, dot-like or stippled pattern of cytoplasmic staining in nearly all cases (31/32), with a median distribution and intensity score of 3+. In control hepatocellular carcinomas that arose in non-cirrhotic livers, 10/39 showed CD68 staining with a median distribution and intensity score of 2+. In hepatocellular carcinomas arising in cirrhotic livers, 3/27 cases showed CD68 positivity, all with stippled dot-like cytoplasmic staining similar to that of fibrolamellar carcinomas. All five cholangiocarcinomas were negative. Overall, CD68 positivity was strongly associated with fibrolamellar carcinomas, P<0.001 and had a sensitivity of 96%, a specificity of 80%, and a negative predictive value of 98%. In sum, tumor positivity for CD68 staining was highly sensitive for fibrolamellar carcinoma and a lack of CD68 staining should suggest caution in making a diagnosis of fibrolamellar carcinoma. PMID:21113139
Ross, Hillary M; Daniel, Hubert D J; Vivekanandan, Perumal; Kannangai, Rajesh; Yeh, Matthew M; Wu, Tsung-Teh; Makhlouf, Hala R; Torbenson, Michael
The aim of this report is to describe the frequency, clinical, and morphologic characteristics of fibrolamellar hepatocellular\\u000a carcinoma in Mexican patients. Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare variant of hepatocellular carcinoma.\\u000a Although this tumor appears to be predominant among the Caucasian population of the U.S, FLHCC has been described in many\\u000a other countries. The frequency and characteristics of FLHCC
Julian Arista-Nasr; Lisa Gutierrez-Villalobos; Juan Nuncio; Hector Maldonaldo; Leticia Bornstein-Quevedo
We present the case of a young woman, 22 years old, with an aggressive form of fibrolamellar hepatocellular carcinoma. She began with the signs and symptoms of a hyperammonemic encephalopathy, an uncommon form of presentation. Fibrolamellar carcinoma is a rare liver tumor, which affects young patients without previous liver disease. Its etiology is unknown, and it has been considered as a tumor with a better prognosis than the classic hepatocellular carcinoma. PMID:23089120
Berger, Cintia; Dimant, Pablo; Hermida, Laura; Paulin, Francisco; Pereyra, Matías; Tejo, Mariana
Summary The human adrenal cortex secretes mineralocorticoids, glucocorticoids and adrenal androgens. These steroids are produced from unique cell types located within the three distinct zones of the adrenal cortex. Disruption of adrenal steroid production results in a variety of diseases that can lead to hypertension, metabolic syndrome, infertility and androgen excess. The adrenal cortex is also a common site for the development of adenomas, and rarely the site for the development of carcinomas. The adenomas can lead to diseases associated with adrenal steroid excess, while the carcinomas are particularly aggressive and have a poor prognosis. In vitro cell culture models provide an important tool to examine molecular and cellular mechanisms controlling both the normal and pathologic function of the adrenal cortex. Herein we discuss the human adrenocortical cell lines and their use as model systems for adrenal studies.
Wang, Tao; Rainey, William E.
Clinical and pathological associations with molecular genetic alterations were studied in colorectal carcinomas from 83 patients. Fractional allelic loss, a measure of allelic deletions throughout the genome, and allelic deletions of specific chromosomal arms (the short arm of 17 and long arm of 18) each provided independent prognostic information by multivariate analysis when considered individually with Dukes' classification. Distant metastasis was significantly associated with high fractional allelic loss and with deletions of 17p and 18q. Mutations of ras proto-oncogenes and deletions of 5q had no prognostic importance. Statistically significant associations were also found between allelic losses and a family history of cancer, left-sided tumor location, and absence of extracellular tumor mucin. Allelic deletion analysis thus identified subsets of colorectal carcinoma with increased predilection for distant metastasis and cancer-related death. Further studies may define a subset of genetic alterations that can be used clinically to help assess prognosis.
Kern, S.E.; Fearon, E.R.; Tersmette, K.W.F.; Enterline, J.P.; Vogelstein, B.; Hamilton, S.R. (Johns Hopkins Medical Institutions, Baltimore, MD (USA)); Leppert, M.; Nakamura, Yusuke; White, R. (Univ. of Utah School of Medicine, Salt Lake City (USA))
As for many other tumors, development of hepatocellular carcinoma (HCC) must be understood as a multistep process with accumulation of genetic and epigenetic alterations in regulatory genes, leading to activation of oncogenes and inactivation or loss of tumor suppressor genes (TSG). In the last decades, in addition to genetic alterations, epigenetic inactivation of (tumor suppressor) genes by promoter hypermethylation has been recognized as an important and alternative mechanism in tumorigenesis. In HCC, aberrant methylation of promoter sequences occurs not only in advanced tumors, it has been also observed in premalignant conditions just as chronic viral hepatitis B or C and cirrhotic liver. This review discusses the epigenetic alterations in hepatocellular carcinoma focusing DNA methylation. PMID:18350605
Tischoff, Iris; Tannapfe, Andrea
Bronchioloalveolar carcinoma (BAC) is a subtype of adenocarcinoma with unique epidemiology, pathology, clinical features,\\u000a radiographic presentation, and natural history compared with other non-small cell lung cancer (NSCLC) subtypes. According\\u000a to criteria of the revised 2004 World Health Organization classification it accounts for only 5% of all cases of NSCLC. BAC\\u000a cases are mostly represented by females and non-smokers and are
Giorgio Vittorio Scagliotti; Giovanni Selvaggi
Hepatocellular carcinoma (HCC) is an aggressive malignancy of the liver and occurs most often in the setting of chronic liver\\u000a disease. The most common acquired causes for this are chronic viral hepatitis infections (mostly HBV and HCV), and alcohol.\\u000a Other causes include nonalcoholic fatty liver disease–related nonalcoholic steatohepatitis, autoimmune liver disease, and\\u000a biliary diseases. In addition, certain heritable diseases like
Davendra P. S. Sohal; Weijing Sun
The study was done to determine the clinical, radiological and histopathological characteristics along with the management outcome of differentiated thyroid carcinoma. This Retrospective study included sixty patients with differentiated thyroid carcinoma presented to Department of Otolaryngology and Head-Neck Surgery at Dhaka Medical College Hospital and Apollo Hospitals Dhaka from June 2006 to December 2008. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operation notes, histopathological examination and state at follow up. This study included 28 males and 32 females. The mean age was 42.7 years. Maximum patients presented at 4th decade. The commonest presentation was thyroid swelling followed by lateral neck swelling. Detailed clinical assessment before operative treatment has been done for all patients. Fifty five patients (91.66%) presented with single nodule. Distant metastasis was found in 2 cases. All patients underwent fine needle aspiration cytology which was conclusive in 38 patients (63.33%). All the sixty patients underwent surgical excision; either total thyroidectomy or completion thyroidectomy. Neck dissection was performed in 8 patients. All patients received postoperative radio-iodine. Fifty one cases were papillary carcinoma and 9 cases were follicular carcinoma. Except for one case with local recurrence the remaining cases were disease free on follow up (up to 10-40 months). One patient died with bone metastasis 2 years after operation. Of all thyroid cancers, majority cases are papillary cancer (85%). In contrast to other cancers, thyroid cancer is almost always curable. Most thyroid cancers grow slowly and are associated with a very favorable prognosis. Early diagnosis and treatment of the same is strongly advisable. PMID:22081181
Fakir, A Y; Bhuyan, A H; Rahman, M M; Khan, F M
In this study, we retrospectively reviewed the MRI features of recurrent nasopharyngeal carcinoma (NPC) in 72 patients who\\u000a underwent MRI before and after gadolinium injection. Recurrent NPC exhibited a high degree of regional spread and a variety\\u000a of signal intensities and contours. MRI showed a nasopharyngeal mass in 50 patients (69.4 %); other sites of involvement included\\u000a the parapharyngeal space
S. H. Ng; J. T. C. Chang; S. F. Ko; Y. L. Wan; L. M. Tang; W. C. Chen
Squamous carcinoma of the esophagus must be accurately staged before treatment. Although multimodality therapy is the current\\u000a standard of care, the timing of surgery with respect to chemotherapy and radiation depends critically on the stage of disease.\\u000a Staging modalities include laparoscopy, thoracoscopy, computed tomography (CT), magnetic resonance imaging (MRI), positron\\u000a emission tomography (PET), and endoscopic ultrasound. In this chapter, several
Samuel M. Maurice; Beate Rau; Prasad S. Adusumilli; Amit N. Patel
The paper presents the data available in the literature and theauthors' own case of hepatic fibrolamellar carcinoma developing in a 49-year-old male patient. A complex morphological (histological and immunohistochemical) study has shown that the tumor is presented by trabecular, alveolar, and glandular structures separated by connective tissue interlayers. The tumor cells showed a positive reaction with cytokeratins 7, 8,18, 19, vimentin, synaptophysin, alpha-fetoprotein, carcinoembryonic antigen, and CA 19-9. PMID:19507574
Dubova, E A; Pavlov, K A; Shchegolev, A I
Background Although there are reports of squamous cell carcinoma arising within and adjacent to Merkel cell carcinoma, and one report\\u000a of an atypical fibroxanthoma-like tumor arising in an irradiated recurrent Merkel cell carcinoma, there have previously been\\u000a no reports of an immunohistochemically verified atypical fibroxanthoma occurring in conjunction with a Merkel cell carcinoma.\\u000a \\u000a \\u000a \\u000a Objective We report on a neoplasm with distinct features
Summer R. Youker; Elizabeth M. Billingsley
Upper tract urothelial cell carcinoma accounts for 5% of all urothelial tumors. Compared to lower urinary tract tumors, upper tract urothelial carcinoma is diagnosed more frequently at advanced stages. Open radical nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, with the advancement of minimally invasive techniques and the benefits of these procedures regarding perioperative morbidity, cosmesis, and earlier convalescence, these options have shown promise in managing the patients with upper tract urothelial carcinoma. Despite the perioperative advantages, concerns exist on the oncological safety after minimally invasive surgery. In this article, we provide a comprehensive overview of the surgical management of upper tract urothelial carcinoma.
Bird, Vincent G.; Kanagarajah, Prashanth
In a twenty-year period we have treated five patients with intranasal squamous cell carcinomas who initially were thought to have benign cutaneous disorders of the nasal skin. Advanced squamous cell carcinoma requiring total rhinectomy, often with extensive contiguous midface excision, was found in all patients. Three of these five patients died of their disease. In one patient, a red nose resembling acne rosacea was present. In the four others, chronic cellulitic or ulcerative cutaneous involvement was caused by squamous cell carcinoma. These cases emphasize the need for intranasal examination and appropriate radiologic studies to exclude intranasal carcinoma in patients with apparently unresponsive cutaneous nasal disease. PMID:3234028
Stanley, R J; Olsen, K D; Muller, S A; Roenigk, R K
Breast carcinoma is the commonest cancer among females in a majority of the Indian cities. The advances in the research and management have improved the breast cancer survival significantly in the past three decades globally. Adenocarcinoma is the commonest histological variant which arises from the ductal epithelia. The myoepithelial cells (ME) are the normal components of the breast parenchyma, which separate the ductal epithelia from the basement membrane and the stroma. The pure ME cell carcinoma is extremely rare and only 38 cases have been reported so far in the indexed literature. This may owe to the difficulties in the identification, and the non availability of established diagnostic criteria. We herein describe the clinical, radiological and the pathological characteristics of a case of myoepithelial carcinoma, to supplement the available literature. The possible impact of these cells in clinical practice was also reviewed. Identification and the further research on the genesis of these tumours, and the pathways by which the ME cells regulate the milieu interior of the breast epithelia, may unravel new molecular targets to prevent or treat both epithelial and myoepithelial cancers at early stages.
R, Santhosh; Padu, Kemba; Singh TH, Bipin; Sharma, M Birkumar; Singh, TH. Sudhir Chandra
A case of papillary endobronchial squamous cell carcinoma incidentally discovered on routine imaging studies is described. The patient, a 75-year-old woman, underwent imaging studies as part of a standard evaluation for a fracture on the right side of the hip. Chest radiographs were unremarkable other than for a nodular opacity overlying the left hemidiaphragm. Computed tomography of the chest, however, demonstrated an elongated, irregular mass in the right lower lobe that appeared to be associated with an adjacent segmental right lower lobe bronchus. Endoscopy followed by surgical resection was undertaken, revealing a tan, soft mass measuring 1.5 x 1.3 x 0.8 cm that was confined to the bronchus and did not appear to extend into the surrounding lung parenchyma. Microscopically, the mass showed a papillary, superficial squamous cell carcinoma confined to the bronchial mucosa without invasion of adjacent structures. The pathological and imaging features of this unusual variant of bronchogenic carcinoma are reviewed as well as the radiological differential diagnosis of endobronchial lesions. To our knowledge, this is the first report that describes the computed tomographic features of this rare lesion. PMID:16198957
Cooper, Lynn; Hagenschneider, Jennifer K; Banky, Sadra; Rosado-de-Christenson, Melissa L; Suster, Saul
Parathyroid carcinoma accounts for about 4% of all diseases of the parathyroid glands. It usually presents as a tumor mass in the neck region. Mediastinal parathyroid carcinoma has been reported very rarely. The present paper reports an ectopic parathyroid carcinoma in the anterior mediastinum in a 54-year male that failed to be recognized antemortem. The markedly elevated serum calcium levels were repeatedly put down to laboratory errors, and the clinical features of primary hyperparathyroidism were misjudged and managed only symptomatically. The terminal cardiogenic shock was associated with myocardial infarction. Coronary plastic surgery was carried out and a stent was placed. The postmortem examination found a solid elastic tumor mass (4 cm) firmly encapsulated in the upper half of the anterior mediastinum having trabecular structure, mild nuclear and cellular polymorphism, single irregular mitoses and an area of necrosis. The mass invaded the capsule and the surrounding adipose tissue, there were tumor emboli found in the lymph and blood vessels. Immunohistochemical study showed diffuse expression of low molecular weight cytokeratin, chromogranin A and synaptophysin, and more than 20% of the tumor cells were Ki-67 positive. Glycogen granules were found in their cytoplasm. There were clearly seen metastatic calcifications in the intramural coronary vessels, the cardiomyocytes, the kidneys and the lungs. The present case report contributes considerably to the differential diagnosis of hypercalcemia. PMID:23441474
Peshev, Zhivko V; Borisov, Borislav B; Genova, Sylvia N; Danev, Vladimir H
Salivary gland tumours represent 1-4% of all human neoplasms and less than 5% occur in children and adolescents. Malignant salivary gland tumours only represent 0.08% of all childhood tumours and mucoepidermoid carcinoma (MEC) is the most common histological type. The majority of MECs in the paediatric group are histologically classified as low or intermediate grade of malignancy, favouring a good prognosis. Complete excision of the lesion with free surgical margins is the treatment of choice and the one that offers the best local control of the disease. Experience with minor salivary gland carcinoma arising specifically within the nasopharynx is limited because nasopharyngeal MEC is an extremely rare malignancy and there is controversy regarding its optimal treatment. We hereby report a case of mucoepidermoid carcinoma arising from the nasopharynx in a 7-year-old girl, which was managed via an endonasal endoscopic procedure. To our knowledge the case we describe is the second case of nasopharyngeal MEC in paediatric age reported in literature and is the only one occurred in the first decade of life. PMID:23294931
Re, M; Pasquini, E
Cervical carcinoma is the fifth most common cancer world-wide and the second major cause of cancer related death in women. Recent studies have suggested that chromosome 10, particularly the short arm, may be significant in the pathogenesis of the disease. The relationship has not, however, been investigated directly in cervical tumor material. We analyzed 21 paired blood and tumor samples from patients with cervical carcinoma for allele loss on chromosome 10. Ten polymorphic loci spanning the length of chromosome 10 were used including 4 RFLPs and 4 microsatellite markers. Tumor samples were carefully dissected to remove the majority of contaminating normal tissue. Twenty of the 21 pairs were heterozygous for at least one locus. Loss of heterozygosity for one or more chromosome 10 loci was observed in 5 out of the 20 informative cases (25%). One sample showed the apparent loss of an entire copy of chromosome 10. In 3 cases allele loss was confined to loci on the short arm of chromosome 10. We are currently using further markers mapped to chromosome 10p to define the shortest consistent region of allele loss. We suggest that this region may contain one or more tumor suppressor genes involved in the development and/or progression of cervical carcinoma.
Sarkar, S.; Tai, C.C.; Mowatt, J. [Univ. of Cambridge (United Kingdom)] [and others
BackgroundThe purpose of this study was to evaluate the incidence rate of endometrial disease, particularly endometrial carcinoma, in patients with primary peritoneal serous papillary carcinoma (PSPC).
Abdi Bafghi; Yaelle Zafrani; Patricia Pautier; Catherine Lhommé; Pierre Duvillard; Damienne Castaigne; Chistine Haie-Meder; Philippe Morice
The differences between invasive lobular and ductal carcinomas affect the diagnostic and therapeutic management for patients with breast cancer. In most cases, this can be accomplished because of distinct histomorphologic features. However, occasionally, this task may become quite difficult, in particular when dealing with the variants of infiltrating lobular carcinoma. Lobular carcinoma has been considered a variant of mucin-secreting carcinoma with only intracytoplasmic mucin. The presence of extracellular mucin is a feature of ductal carcinoma. Herein is presented a case of lobular carcinoma with extracellular and intracellular mucin in a 43-year-old female patient, and confirmed by immunohistochemistry. Up to the present, infiltrating lobular carcinoma displaying extracellular mucin has not been described in the literature except two case. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1839906067716744
This study aimed to evaluate MR as an imaging modality for the assessment of myometrial and cervical invasion in endometrial carcinoma and for the assessment of parametrial and lymph node involvement in cervical carcinoma. Twenty-eight patients with a preoperative histological diagnosis of endometrial carcinoma/cervical carcinoma were included in the study. The findings were compared with the surgical staging and the histopathological report of the hysterectomy specimen. Accuracy in detecting myometrial and cervical involvement in patients with endometrial carcinoma was 78% for both. Accuracy in detecting parametrial and lymph node involvement in patients with cervical carcinoma was 71% and 86% respectively. MR is a reliable method for preoperative assessment of endometrial and cervical carcinoma. It helps decide operability, the type of operation and aids in the selection of patients who need to be considered for specialist referral to a gynaecologist oncologist.
Pakkal, M. V.; Rudralingam, V.; McCluggage, W. G.; Kelly, B. E.
Surgery for renal carcinoma metastases During the last few years, the increasing use of diagnostic imaging (especially ultrasound) has allowed a remarkable rise in the detection of asymptomatic, early-stage renal neoplasms, possibly treatable by radical surgery. Renal cell carcinoma, however, is still the renal neo- plastic condition with the highest mortality rate, due in most cases to the presence of
A. ANTONELLI; S. COSCIANI CUNICO
Objective. Papillary serous peritoneal carcinoma (PSPC) is histologically indistinguishable from papillary serous ovarian carcinoma (PSOC) with a similar clinical presentation, yet may differ in its carcinogenesis. The purpose of this study was to determine the incidence of allelic loss and the frequency of p53 mutation by p53 overexpression in PSPC compared to PSOC.Methods. An allelotype analysis of 26 patients with
Ilana Cass; Rae Lynn Baldwin; Ella Fasylova; Abbie L. Fields; Harold P. Klinger; Carolyn D. Runowicz; Beth Y. Karlan
carcinoma. Methods: Between 1973 and 1998, 14 patients with thymic carcinoma were treated at Gunma PrefecturalCancerCenter.Twopatientswhohadhematogenousmetastasiswereexcludedfrom this study, therefore 12 patients were analyzed. The Masaoka staging system was used; four patients were diagnosed with stage III disease and eight patients with stage IV disease. The pathological subtype according to the World Health Organization histological criteria for thymic tumors was squamous
Tetsuo Nonaka; Yoshio Tamaki; Keiko Higuchi; Hiroyuki Katoh; Masumi Nakahashi; Hiroyuki Horikoshi; Kenro Takahashi; Koichi Minato; Shiro Sugihara; Masaru Kojima
Objectives: Thymic carcinoma is a rare neoplasm more invasive and with a poorer prognosis than ordinary thymoma. Complete curative resection is sometimes not possible, but good response rates to chemotherapy are reported in literature. We report our experience with seven cases of thymic carcinoma, who took part to a multimodality treatment including neoadjuvant chemotherapy, surgery and post-operative radiotherapy in our
Marco Lucchi; Alfredo Mussi; Fulvio Basolo; Marcello Carlo Ambrogi; Gabriella Fontanini; Carlo Alberto Angeletti
NUT midline carcinoma (NMC) is a rare, highly lethal cancer that occurs in children and adults of all ages. NMCs uniformly present in the midline, most commonly in the head, neck or mediastinum, as poorly differentiated carcinomas with variable degrees of squamous differentiation. This tumour is defined by rearrangement of the nuclear protein in testis (NUT) gene on chromosome 15q14.
Christopher A French
Intracystic papillary carcinoma of the male breast is a very rare disease with only a few cases reported in the literature. A case is described and the additional value of MRI is discussed. To our knowledge, this is the first report regarding the MRI findings of an intracystic papillary carcinoma of the male breast. PMID:12195471
Blaumeiser, B; Tjalma, W A A; Verslegers, I; De Schepper, A M; Buytaert, P
The Epstein-Barr virus (EBV) is detected in the tissue of about 10% of gastric carcinoma cases throughout the world. In each case, 100% of carcinoma cells are infected with EBV. Analysis of EBV in carcinoma biopsies indicates that carcinoma is formed by the proliferation of a single EBV infected cell. These findings suggest that EBV plays an important role in the development of EBV positive gastric carcinomas. The EBV genes expressed are EBV determined nuclear antigen 1 (EBNA1), two small non-polyadenylated RNAs known as EBER1 and EBER2, and the transcripts from the BamHI-A region (BARF0); in addition, some cases also express a small amount of latent membrane protein 2A (LMP2A). Epithelial cells are refractory to EBV infection in vitro. This has hampered the study of the role of EBV in epithelial malignancies. The use of recombinant EBV carrying a selectable marker has enabled this difficulty to be overcome. EBV infected cell clones can be obtained from most carcinoma cell lines examined, and it was found that cell to cell contact was an efficient mode of EBV infection. Furthermore, it was possible to immortalise primary gastric epithelial cells by EBV infection. The cells expressed identical EBV genes to those typically seen in EBV positive gastric carcinoma, and showed accelerated malignant properties, including growth in soft agarose and tumorigenicity in severe combined immunodeficient (SCID) mice. These results suggest that EBV contributes to the maintenance of the malignant phenotype of EBV positive gastric carcinoma.
Preoperative diagnosis of tubal carcinoma is difficult and a diagnosis cannot usually be established until the time of operation. However, since prognosis is strictly related to the stage of the neoplasm, it is very important to be familiar with the clinical and imaging characteristics of primary fallopian tube carcinoma in order to make an early and accurate diagnosis. This report
E. Ekici; K. Vicdan; N. Danisman; M. Emin Soysal; Ö. Çobano?lu; O. Gökmen
Clinically apparent renal cell carcinoma that has metastasized to the prostate is a rare finding. When identified, it has been associated with widespread metastatic disease and short-term survival. We present a case of metachronous renal cell carcinoma found only in the prostate with the longest reported interval of 9 years between radical nephrectomy and clinically apparent disease.
Graham F. Greene; Neriman Gokden; Laura F. Hutchins; Robert C. Williams
Thirty-one dog thyroid tumours and 28 spontaneous rat thyroid tumours were studied histologically and the findings compared with those of a study of 67 cases of medullary carcinoma of the human thyroid.Five of the dog tumours and 24 of the rat tumours were considered to belong to the same group of tumours as medullary carcinoma, a group characterized by solid
E. D. Williams
With the emerging evidence that the five major ovarian carcinoma subtypes (high-grade serous, clear cell, endometrioid, mucinous, and low-grade serous) are distinct disease entities, management of ovarian carcinoma will become subtype specific in the future. In an effort to improve diagnostic accuracy, we set out to determine if an immunohistochemical panel of molecular markers could reproduce consensus subtype assignment. Immunohistochemical
Steve E Kalloger; Martin Köbel; Samuel Leung; Erika Mehl; Dongxia Gao; Krista M Marcon; Christine Chow; Blaise A Clarke; David G Huntsman; C Blake Gilks
Cancers of the perionychium are relatively rare occurrences and are often related to chronic inflammation associated with trauma, infection, exposure to ultraviolet radiation, or other carcinogens. Squamous cell carcinoma is the most common tumor reported of the nail bed. Synchronous squamous cell carcinomas of the perionychium have been rarely reported. We present a case of a 46-year-old woman with synchronous squamous cell carcinomas involving both hands and multiple digits. Treatment modalities include chemotherapeutics, Mohs surgery, and amputation. Early diagnosis of squamous cell carcinoma of the nail bed provides the greatest chance to preserve maximal function of the hand. Onychomycosis may be the presenting symptom of a patient with squamous cell carcinoma and may also be a predisposing factor in patients with occupational risk factors. Suspicion of this disease process can help the clinician establish the diagnosis via biopsy and provide optimal care for these patients. PMID:21369367
Abner, Sabra; Redstone, Jeremiah; Chowdhry, Saeed; Kasdan, Morton L; Wilhelmi, Bradon J
Cancers of the perionychium are relatively rare occurrences and are often related to chronic inflammation associated with trauma, infection, exposure to ultraviolet radiation, or other carcinogens. Squamous cell carcinoma is the most common tumor reported of the nail bed. Synchronous squamous cell carcinomas of the perionychium have been rarely reported. We present a case of a 46-year-old woman with synchronous squamous cell carcinomas involving both hands and multiple digits. Treatment modalities include chemotherapeutics, Mohs surgery, and amputation. Early diagnosis of squamous cell carcinoma of the nail bed provides the greatest chance to preserve maximal function of the hand. Onychomycosis may be the presenting symptom of a patient with squamous cell carcinoma and may also be a predisposing factor in patients with occupational risk factors. Suspicion of this disease process can help the clinician establish the diagnosis via biopsy and provide optimal care for these patients.
Abner, Sabra; Redstone, Jeremiah; Chowdhry, Saeed; Kasdan, Morton L.; Wilhelmi, Bradon J.
A rare case of primary squamous cell carcinoma of the endometrium, probably originating from adenomyosis, is presented. A 58-year-old Japanese woman was referred to Kitasato Institution Medical Center Hospital to explore the cause of her postmenopausal bleeding. The endometrial cytology specimen obtained with the Endocyte (an device for endometrial check up) showed cells suggesting well differentiated squamous cell carcinoma. The patient underwent modified radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy, followed by postoperative radiation therapy. The dissected uterus revealed keratinizing-type squamous cell carcinoma localized in the fundal portion of the uterine body and invading deeply into the myometrium, coexistent with a large area of adenomyosis with a transitional area to carcinoma. The residual endometrium was atrophic. There was no atypical finding in the cervix. Human papilloma virus DNA was not detected. The carcinoma recurred 26 months after the surgery, and the patient died of the disease. PMID:20563701
Sato, R; Jobo, T; Genda, T; Izumi, T; Yokono, H; Imai, T; Ohbu, M; Kuramoto, H
Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear. PMID:924104
Carl, P; Marx, F J
PURPOSE The purpose of this study was to investigate the significance of fascin expression in colorectal carcinoma. METHODS This is a retrospective study of 167 consecutive, well-documented cases of primary colorectal adenocarcinoma for which archival material of surgical specimens from primary tumor resections were available. We chose a representative tissue sample block and examined fascin expression by immunohistochemistry using a primary antibody against “fascin”. We calculated the “immunohistochemical score (IHS)” of fascin for each case, which was calculated from the multiplication of scores for the percentage of stained cells and the staining intensity. RESULTS Fascin immunoreactivity was observed in 59 (35.3%) of all cases with strong reactivity in 24 (14.4%), moderate reactivity in 25 (14.9%) and weak reactivity in 10 (6.0%) cases. Strong/moderate immunoreactivities were mostly observed in invasive fronts of the tumors or in both invasive and other areas. Fascin immunoreactivity scores were significantly higher in tumors with lymph node metastasis (p:0.002) and advanced stage presentation (p:0.007). There was no relation between fascin expression and age, gender, depth of invasion, distant metastasis or histological grade (p>0.05). There was a higher and statistically significant correlation between fascin immunoreactivity in the invasive borders of tumors and lymph node metastasis (r:0.747, p:0.005). In stage III/IV tumors, two-year survival was 92.2% in tumors without fascin immunoreactivity, and only 60.0% in tumors with a fascin IHS>10 (p:0.003). CONCLUSION These findings suggest that fascin is heterogeneously expressed in approximately one third of colorectal carcinomas with a significant association with lymph node metastasis, tumor stage and location. Moreover, these results indicate that fascin may have a role in the lymph node metastasis of colorectal carcinomas.
Ozerhan, Ismail Hakki; Ersoz, Nail; Onguru, Onder; Ozturk, Mustafa; Kurt, Bulent; Cetiner, Sadettin
The fibrolamellar variant of hepatocellular carcinoma (FLC) differs from conventional hepatocellular carcinoma (HCC) in some clinical and pathological features. The authors investigated possible differences in reactivity between FLCs and HCCs using glypican-3 (GPC3), an oncofetal protein, and survivin, an antiapoptotic protein. They also compared staining of FLC and HCC with antibodies to cytokeratins 7 (CK7) and 19 (CK19) and CD34. GPC3 was significantly more often and more strongly expressed in HCCs (72%) than in FLCs (17%). Survivin nuclear translocation in tumor cells did not differ between HCCs (10%) and FLCs (9%). There was more abundant expression of CK7 in FLCs (92%) than in HCCs (33%), whereas CK19 was more often found in HCCs (20%) than in FLCs (5%). All tumors had CD34-positive sinusoids. This study shows that FLCs and HCCs differ in the expression of GPC3, CK7, and CK19 and that there is a lack of difference as regards survivin and CD34. PMID:20444731
Abdul-Al, Hala M; Wang, Guanghua; Makhlouf, Hala R; Goodman, Zachary D
Radiofrequency ablation (RFA) is a well-established treatment modality in the treatment of early hepatocellular carcinoma (HCC) . Safe trajectory of the RFA probe is crucial in decreasing collateral tissue damage and unwarranted probe transgression. As a percutaneous technique, however, the trajectory of the needle is sometimes constrained by the available imaging plane. The presence of a hemangioma beside an HCC is uncommon but poses the question of safety related to probe transgression. We hereby describe a case of transhemangioma ablation of a dome HCC.
Pua, Uei, E-mail: email@example.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)
Renal cell carcinoma (RCC) represents 3% of adult malignancies. About 30% of RCC patients develop metastatic disease. So far, drugs cannot significantly increase the survival of these patients. We present a recent review of proteomics and RCC. Proteomic technologies have been used in the research to discover new markers of RCC that might increase survival. Furthermore, newly discovered markers cannot increase patient survival, rather their prognostic value supporting therapeutic decisions or new agents targeted at these new markers. More research is required to develop proteomic technologies and biomarkers for identification and validation. PMID:20224258
Sandim, Vanessa; Pereira, Denise A; Ornellas, Antonio A; Alves, Gilda
Acinic cell carcinomas of the parotid should be considered distinct malignancies despite descriptions of low-grade malignant potential and innocuous histologic patterns. Benign-appearing tumors frequently have a clinically malignant course. Blood-borne metastases may oocur early despite gross and microscopic innocence. Indolent growth may be a characteristic of local disease, which may then be approached with less than radical parotidectomy and sacrifice of the facial nerve. These tumors prove to be radiosensitive. More agressive postoperative irradiation and palliative irradiation is recommended. Two cases of successful palliation of spinal metastases are presented as examples of radiosensitivity of this tumor.
A retrospective review of patients treated for carcinoma of the common bile duct has demonstrated improvement in diagnostic capabilities, leading to earlier management by resectional therapy. The ability to resect these tumors is directly translatable to improved long-term survival. Efforts to obtain proof of malignancy prior to resection are often frustrated by the inability to obtain adequate representative tissue for frozen section. Choledochoscopic biopsies and incisional biopsies have given the highest yield of positive diagnoses. In experienced hands, a program of fewer preoperative tests with emphasis on early operation, diagnosis, and definitive treatment may be more cost-effective in the management of patients with common bile duct cancer. PMID:1990877
Tompkins, R K; Aizen, B M; Saunders, K D; Roslyn, J J; Longmire, W P
BackgroundPleomorphic carcinoma is a rare epithelial malignant tumor. Pulmonary pleomorphic carcinoma was introduced by the 1999 World Health Organization classification as a new peculiar type of lung carcinoma showing concurrent malignant epithelial and sarcomatoid spindle cell elements. Few reports describe its clinical behavior. My colleagues and I report a series of patients surgically treated for pulmonary pleomorphic carcinoma to describe
Federico Raveglia; Maurizio Mezzetti; Tiziana Panigalli; Simone Furia; Luigi Giuliani; Serena Conforti; Stefano Meda
Objective: We retrospectively evaluated 15 patients with thymic carcinoma treated with various modalities and investigated overall management of this disease. Methods: From 1983 to 2003, we treated 15 patients with thymic carcinoma (12 squamous cell carcinomas, 2 undifferentiated carcinomas and one adenocarcinoma). According to Masaoka's staging system, they consisted of 2 at stage II, 5 at stage III, 4 at
Shin-ichi Takeda; Noriyoshi Sawabata; Masayoshi Inoue; Masaru Koma; Hajime Maeda; Hiroshi Hirano
We evaluated genomic alterations and biomarker expression in 20 florid lobular carcinomas in situ using array-based comparative genomic hybridization and immunohistochemical analysis. The genetic characteristics of florid lobular carcinoma in situ were compared with 20 classic lobular carcinomas in situ and 21 pleomorphic lobular carcinomas in situ (which included 8 apocrine variants), from our previously published data performed on a similar array-based comparative genomic hybridization platform. All 20 florid lobular carcinoma in situ cases were E-cadherin negative, and 92% were positive for estrogen receptor. Cyclin D1 expression correlated significantly negatively with estrogen receptor expression and was higher in cases with cyclin D1 (CCND1) gene amplification. Compared with classic lobular carcinoma in situ, florid lobular carcinoma in situ displayed significantly more fraction genome alteration (mean, 0.109 versus 0.072; P=.007), fraction genome loss (mean, 0.06 versus 0.03; P=.007), numbers of breakpoints (mean, 11.55 versus 6.95; P=.002), numbers of chromosome with breakpoints (mean, 5.85 versus 3.8; P=.004), and higher numbers of amplifications (mean, 2.10 versus 0.25; P=.03). Interestingly, florid lobular carcinoma in situ had the same genetic complexity as apocrine pleomorphic lobular carcinoma in situ. Our study demonstrated that florid lobular carcinoma in situ shares the cytologic features, E-cadherin loss, and the lobular genetic signature of 1q gain and 16q loss found in classic lobular carcinoma in situ. However, this variant demonstrates more genomic alterations than classic lobular carcinoma in situ and shares the same genetic complexity as apocrine pleomorphic lobular carcinoma in situ. Our data support the conclusion that florid lobular carcinoma in situ is genetically more advanced compared with the indolent phenotype of classic lobular carcinoma in situ. This may explain the greater frequency of concurrent invasive carcinoma in florid lobular carcinoma in situ compared with classic lobular carcinoma in situ. PMID:23809857
Shin, Sandra J; Lal, Aseem; De Vries, Sandy; Suzuki, Junko; Roy, Ritu; Hwang, E Shelley; Schnitt, Stuart J; Waldman, Frederic M; Chen, Yunn-Yi
To investigate changes in the results of treatment of gastric carcinoma, two 10-year periods between 1963 and 1982 with 641 and 630 patients, respectively, were compared. In the two groups, 94 percent and 92 percent of patients were operated on. The operation was considered curative in 200 and 265 patients in Groups 1 and 2, respectively. There was a shift towards more radical operations, with 215 total or subtotal gastrectomies in Group 2 compared with 76 in Group 1, when distal gastric resection was considered radical enough. Despite the increasing number of curative operations and more radical surgery in Group 2, no progress in the 5-year survival rate was noted. Distal and subtotal gastrectomies gave slightly better results than total gastrectomies, but the most important single factor contributing to the long-term survival was cancerous invasion of the serosa. It is concluded that in the past 20 years, the results of surgical treatment of gastric carcinoma have not improved, despite the more advanced diagnostic methods and more radical surgery. PMID:2817231
Ovaska, J; Kruuna, O; Saario, I; Schröder, T; Lempinen, M
Radiation therapy is often used in an attempt to palliate or cure oesophageal neoplasms. However, the radiation tolerance of the normal structures around the oesophagus (heart, lung and spinal cord) restricts the radiation dose that can be delivered. We used a nasogastric catheter to deliver High Dose Intra-luminal Iridium-192 irradiation for carcinoma of the oesophagus using HDR-Varisource machine. This technique for treatment of carcinoma of the oesophagus can help overcome the dose restraints. The external beam radiation dose was about 46 Gy and the intra luminal dose was 5 Gy at 1 cm from central axis. These after loading procedures are simple, fast and accurate and can be used to boost external radiation therapy doses. Since the intra luminal boost delivers a high-localized dose with little side effects, this simple technique should be used to obtain palliation, delay tumour progression, reduce overall treatment time and attempt to improve survival in patients with oesophageal neoplasm. Intra luminal brachytherapy helps achieve good palliation in these neoplasms. PMID:17160092
Jha, A K; Prasiko, G; Mod, H; Chaurasia, P P; Srivastava, E
Sarcomatoid carcinoma of the prostate is among the rarest malignant neoplasm types and has been well known for its aggressive clinical course. Patient was admitted with the symptoms of lower urinary tract. Transurethral resection of prostate (TUR-P) was carried out. Revealing Gleason 5 + 3 = 8 prostate adenocarcinoma in TUR-P material. Thereby, a Radical Prostatectomy procedure was planned. In operation, frozen examination revealed adenocarcinoma metastasis to the obturator lymph node. The operation was terminated. In the postoperative 3rd month, the patient was re-admitted with acute urinary system symptoms. A cystoscopy performed and complete resection of the mass was performed. The pathological examination reported that the tumor was compatible with undifferentiated adenocarcinoma owing to presence of poorly differentiated tumoral cells and detection of adenocarcinoma in a relatively small (<1%) focus. 4 month after the operation, the patient underwent another cyctoscopic examination which revealed the prostatic lounge and most of the bladder lumen to be filled with tumoral tissue. The tumoral tissues was resected incompletely. This material was diagnosed to be "Sarcomatoid Malignant Tumor" upon the new evidences of progressive dedifferentiation and predominant sarcomatoid appearance, compared with the former TUR-P materials. Subsequent PET-CT scan depicted multiple metastasis. The patient was referred to oncology department. In conclusion, sarcomatoid carcinoma is a malignant variant that brings along diagnostic and treatment difficulties. PMID:23691427
Aç?kgöz, Onur; Gazel, Eymen; Zengin, Neslihan ?nci; Kasap, Yusuf; Camtosun, Ahmet; Yaz?c?o?lu, Ahmet Hamdi
The presentation, growth patterns, and response to therapy of 11 consecutive children with choroid plexus carcinomas were analyzed, and the results were compared with the outcome reported in other series. Patients were a median of 26 months of age at diagnosis. Two patients had thalamic tumors, one had a posterior fossa primary, and the rest had ventricular lesions. Five of 11 (45%) children remain in continuous progression-free remission a median of 48 months from diagnosis. Four of the five in continuous remission had a "gross total" surgical resection, and only one received radiation therapy. Five of six patients with subtotal resections relapsed despite postoperative treatment with radiation therapy (three) and chemotherapy (one). The response to treatment with radiation therapy or chemotherapy at relapse was disappointing, with only one child (treated with etoposide) responding. In combination with other series, 11 of 14 children had prolonged progression-free survival after gross total resection (only two of whom received adjuvant therapy) compared with two of 20 after less than total resections, independent of the type of adjuvant therapy given. Adjuvant therapy for children with choroid plexus carcinomas is of unproven benefit, and this must be considered when analyzing innovative treatment trials for such children, especially for those with totally resected tumors. Patients with partially resected lesions fare poorly with present forms of treatment. PMID:1728390
Packer, R J; Perilongo, G; Johnson, D; Sutton, L N; Vezina, G; Zimmerman, R A; Ryan, J; Reaman, G; Schut, L
We evaluated positon emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in 120 patients with intestinal malignancies, focusing on its diagnostic yield and influence on the surgical strategy. PET had a sensitivity of 67% and a specificity of 100% for metastases in 28 patients with cardio-esophageal carcinoma. PET detected 64% of 22 primary pancreatic carcinomas, and had a sensitivity of 70% and a specificity of 83% for metastases. In two cases, PET showed false-positive signs of peritoneal metastasis (not found at laparotomy). Among 70 patients with recurrent or metastatic colorectal carcinoma, eight had signs of local recurrence of rectal carcinoma treated by abdominoperineal resection; PET gave four true-positive, one false-negative, and three false-positive results. PET was better than computed tomography (CT) for the diagnosis of peritoneal metastasis, but its sensitivity was only 58%. The diagnostic value of PET for hepatic metastases (87%) was similar to that of CT (77%) and sonography (87%). The diagnostic sensitivity of PET for pulmonary metastases (82%) was similar to that of CT (84%). PET modified the surgical strategy in two (7%) of 28 patients with cardio-esophageal carcinoma, one (5%) of 22 patients with pancreatic carcinoma, and 22 (33%) of 70 patients with colorectal carcinoma (appropriately in 11 cases, inappropriately in 11 cases). These disappointing results suggest that PET must be thoroughly evaluated in this setting before being widely adopted. PMID:16878447
Huguier, Michel; Barrier, Alain; Zacharias, Thomas; Valinas, Roberto
Thymic carcinomas are very rare and heterogeneous groups of anterior mediastinum neoformations with an extremely aggressive behavior. Often, the diagnosis is made in the advanced stages. Paraneoplastic syndromes associated with thymic carcinoma are extremely rare. We report a case of a 64-year-old man presenting with early stage thymic carcinoma which was discovered because of associated paraneoplastic dermatomyositis. The dermatomyositis disappeared completely after radical resection of the tumor. After 20-month follow-up, the patient is in good clinical condition without recidivism of disease. PMID:22907201
Dell'Amore, Andrea; Asadi, Nizar; Caroli, Guido; Dolci, Giampiero; Bini, Alessandro; Stella, Franco
Alcohol is a risk factor for oral squamous cell carcinoma. It enhances the permeability of the oral epithelium, acts as a solvent for tobacco carcinogens, induces basal-cell proliferation, and generates free radicals and acetaldehyde, which have the capacity to cause DNA damage. Alcohol-associated malnutrition and immune suppression may further promote carcinogenesis. However, acetaldehyde, the first metabolite of ethanol, is the critical agent by which prolonged and excessive consumption of alcoholic beverages increases the risk of oral squamous cell carcinoma. Alcohol also acts synergistically with the products of tobacco combustion in the pathogenesis of oral squamous cell carcinoma. PMID:23971298
Feller, L; Chandran, R; Khammissa, R A G; Meyerov, R; Lemmer, J
Acinic cell carcinoma (ACC) is a low-grade salivary gland malignancy characterized by serous acinar differentiation. Most ACCs arise in the parotid gland, but ACCs have been reported to originate in nonparotid salivary glands where serous acini are less abundant. Given the recent discovery of mammary analog secretory carcinoma (MASC)-a salivary malignancy that histologically mimics ACC-a retrospective reevaluation of nonparotid ACCs is warranted. The surgical pathology archives of The Johns Hopkins Hospital were searched for all ACCs arising outside of the parotid gland. For each case, the histologic slides were reviewed; immunohistochemical analysis (mammaglobin, S100 protein) was performed; and confirmatory ETV6 breakapart fluorescence in situ hybridization assay was completed. Demographic and clinical data were obtained from the medical records. Fourteen extraparotid tumors diagnosed as ACC were identified. Eleven of 14 (79%) tumors harbored the ETV6 translocation (oral cavity=9 of 11; submandibular gland=2 of 2). The translocation-positive tumors occurred in 7 women and 4 men ranging in age from 20 to 86 years (mean, 56 y) and usually presented as painless masses. Immunohistochemistry for mammaglobin and S100 was positive in all 11 translocation-positive tumors but negative in the 3 translocation-negative tumors. Histologically, the translocation-positive tumors exhibited uniform cells with vacuolated cytoplasm, microcystic/cystic and papillary architecture, and intraluminal secretions; however, the presence of basophilic cytoplasmic granules was conspicuously absent. Basophilic cytoplasmic granules, indicative of true serous acinar differentiation, were present in the 3 translocation-negative tumors. Of the translocation-positive tumors, only 1 locally recurred, and none metastasized. Most alleged ACCs of nonparotid origin actually represent misclassified MASCs. The impact of diagnostic error is mitigated by the low-grade nature of MASC that, like ACCs, do not appear to be clinically aggressive. PMID:23681074
Bishop, Justin A; Yonescu, Raluca; Batista, Denise; Eisele, David W; Westra, William H
This article reviews and summarizes chromosomal changes responsible for the initiation and progression of uroepithelial carcinomas. Characterization of these alterations may lead to a better understanding of the genetic mechanisms and open the door for molecular markers that can be used for better diagnosis and prognosis of the disease. Such information might even help in designing new therapeutic strategies geared towards prevention of tumor recurrences and more aggressive approach in progression-prone cases. The revision of 205 cases of uroepithelial carcinomas reported with abnormal karyotypes showed karyotypic profile characterized by nonrandom chromosomal aberrations varying from one or few changes in low-grade and early stage tumors to massively rearranged karyotypes in muscle invasive ones. In general, the karyotypic profile was dominated by losses of chromosomal material seen as loss of entire chromosome and/or deletions of genetic materials. Rearrangements of chromosome 9 resulting in loss of material from 9p, 9q, or of the entire chromosome were the most frequent cytogenetic alterations, seen in 45% of the cases. Whereas loss of material from chromosome arms 1p, 8p, and 11p, and gains of chromosome 7, and chromosome arm 1q, and 8q seem to be an early, but secondary, changes appearing in superficial and well differentiated tumors, the formation of an isochromosome for 5p and loss of material from 17p are associated with more aggressive tumor phenotypes. Upper urinary tract TCCs have identical karyotypic profile to that of bladder TCCs, indicating the same pathogenetic mechanisms are at work in both locales. Intratumor cytogenetic heterogeneity was not seen except in a few post-radiation uroepithelial carcinomas in which distinct karyotypic and clonal pattern were characterized by massive intratumor heterogeneity (cytogenetic polyclonality) with near-diploid clones and simple balanced and/or unbalanced translocations. In the vast majority of cases strong correlation between the tumors grade/stage and karyotypic complexity was seen, indicating that progressive accumulation of acquired genetic alterations is the driving force behind multistep bladder TCC carcinogenesis. Although most of these cytogenetic alterations have been identified for many years, the molecular consequences and relevant cancer genes of these alterations have not yet been identified. However, loss of TSG(s) from chromosome 9 seems to be the primary and important event(s) in uroepithelial carcinogenesis. PMID:16083510
The etiologic relationship of hepatocellular carcinoma (HCC) and chronic hepatitis B viral infection was proved clinically, epidemiologically, virologically, serologically and by other methods. Together with viruses, carcinogenesis is promoted by faster recovery of hepatocytes (liver cirrhosis, chronic hepatitis, etc.). We have discovered 103 HCC in the period of 21 years. There were 81 men and 22 women; they were in the sixth and seventh decade of life in 90% of cases. Liver cirrhosis was also confirmed in 55% of cases and chronic hepatitis in 19%, namely, in 74% of patients HCC has developed on the changed liver. Fifty three patients were HBsAg positive (51.45%). The ultrasound and determination of alpha-feto proteins proved to be most valuable. It is a slow growing tumour and by its early detection surgical treatment is possible. PMID:1664995
Redzi?, B; Elakovi?, M; Petrovi?, M; Petrovi?, Z; Sosi?, M; Lukacevi?, S; Vi?entijevi?, R; Jovanovi?, D; Rabrenovi?, L
Renal calyx carcinoma (RCXC) may mimic collecting duct carcinoma (CDC) or urothelial carcinoma (UC) of the renal pelvis. RCXC is distinguished from CDC and UC of the renal pelvis as having the tumor epicenter in the renal calyx, with limited involvement of the surrounding renal pelvis surface urothelium. In this study, we summarize our experience with this entity. Ten cases of RCXC, including 9 cases with urothelial differentiation (RCXC-UC) and 1 case with salivary gland-type differentiation (RCXC-SC), were identified. Ten consecutive cases of UC were selected for comparison, with extensive renal pelvis involvement and with secondary renal parenchymal invasion. Two cases of collecting duct carcinoma (CDC) were also examined. Immunohistochemistry (IHC) was performed on representative tissue blocks for PAX8, PAX2, CK5, CK7, CK20, p63, GATA3, AMACR, RCC, CD10, vimentin, S100, and MSA. The 10 cases of RCXC (M:F=4:6, ages: 62-91 years, mean: 76) presented with renal masses of 3-6cm. Ureteroscopic studies and renal pelvic washings showed atypical/malignant cells in three cases. Seven patients were treated with nephrectomy followed by radiation±chemotherapy, and all cases developed metastases to lymph nodes or liver/lung/bone. In all 7 cases with nephrectomy, there was extensive renal parenchymal involvement with infiltrating borders and diffuse spread along collecting ducts. Six RCXC-UC contained focal squamous differentiation. The RCXC-SC displayed features of adenoid cystic and basaloid features. In situ UC, with or without papillary components, was identified in the calyces in all 7 nephrectomy cases with remaining renal pelvis harboring small tumor burden in 5 cases, and no tumor in another 2 cases. Of the three cases without nephrectomy, no tumor in the renal pelvis could be visualized with endoscopy, however one case was associated with UC of the urinary bladder. Of 10 control UC cases, tumor was limited to the tip of renal papilla in 7 cases, extensive in 3 cases, and with no extension into the collecting ducts. RCXC-UC were all positive for p63, CK5, CK7, and PAX2, with all negative for RCC. PAX8 (70% positive) and GATA3 (50% positive) reactivity was variable. The 10 UC cases shared IHC properties with RCXC-UC but frequent negativity for PAX8 and positivity for GATA3. RCXC is an aggressive neoplasm with high risk of metastases. Similar to CDC, it is located in the renal papilla and rarely with clinically visible renal pelvis tumor or ureteral urine positive for tumor cells. Unlike CDC and non-calyceal UC, RCXC shows predominantly urothelial and squamous differentiation and is associated with an in situ component of adjacent renal calyces. By IHC, RCXC exhibited features intermediate between UC and CDC with decreased or negative immunoreactivity for PAX8 and GATA. PMID:23999038
Williams, Phillip A; Mai, Kien T
AIM:To study the therapeutic effects of transcatheter arterial three-segment chemoembolization for hepatocellular carcinoma (HCC).METHODS: According to the anatomy of vessels, the tumor capillary networks, muscular arterioles and feeding arteries were successively occluded using lipiodol ultra-fluid (LUF), sinobufagin microsphere (SBMs) and particles of gelatin sponge (PGS). In this series of 80 cases, therapeutic effects were evaluated in 76 cases.RESULTS: There were 22 cases (28.9%) with partial response and 41 (53.9%) with minor response in the 76 evaluated patients. The 6-month, 1-year, 2-year and 3-year survival rates were 97.4%, 86.8%, 46.1% and 27.6% respectively.CONCLUSION: This regimen was a rational chemoembolization method for HCC patients. PMID:11819226
Fan, Jian; Ten, Gao-Jing; He, Shi-Cheng; Guo, Jin-He; Yang, Dong-Pei; Wang, Guo-Ying
Experience of surgical treatment of 171 patients, suffering hepatocellular carcinoma (HCC), was summarized. Extensive hepatic operations were performed in 99 (71.2%) patients, of them in 22.2%--on the concurrent hepatic cirrhosis background. Late results of treatment, depending on the main prognostic factors present, were analyzed. Cumulative survival in the terms of 5, 10 and 20 years have constituted 53.5, 37.3 and 28.8% accordingly. Accomplishment of a radical hepatic resection for HCC permits to achieve a durable remission of a tumoral process. While revealing a concurrent hepatic cirrhosis stage B (according to Child--Pugh classification) it is appropriate to use a hepatic transplantation and other methods of treatment, including chemoembolization, radiofrequency ablation, chemotherapy. PMID:22168020
Patiutko, Iu I; Chuchuev, E S; Gakhramanov, A D; Saga?dak, I V; Kotel'nikov, A G; Podluzhny?, D V; Abgarian, M G; Poliakov, A N; Konovalov, A M
The management of hepatocellular carcinoma (HCC) has substantially changed in the past few decades, the introduction of novel therapies (such as sorafenib) have improved patient survival. Nevertheless, HCC remains the third most common cause of cancer-related deaths worldwide. Decision-making largely relies on evidence-based criteria, as showed in the US and European clinical practice guidelines, which endorse five therapeutic recommendations: resection; transplantation; radiofrequency ablation; chemoembolization; and sorafenib. However, areas still exist in which uncertainty precludes a strong recommendation, such as the role of adjuvant therapies after resection, radioembolization with yttrium-90 or second-line therapies for advanced HCC. Many clinical trials that are currently ongoing aim to answer these questions. The first reported studies, however, failed to identify novel therapeutic alternatives (that is, sunitinib, erlotinib or brivanib). Efforts that focus on the implementation of personalized medicine approaches in HCC will probably dominate research in the next decade. PMID:24101112
Germano, D; Tinessa, V; Barletta, E; Cannella, L; Daniele, B
Cholangiocarcinoma is a primary liver tumor arising from the small bile ducts within the liver. According to its different location, clinical features, frequency of metastases, treatment modalities and prognosis, intrahepatic cholangiocarcinoma should well be differentiated from proximal bile duct carcinoma. To date, there is no therapeutic measure with curative potential apart from surgical treatment. Partial hepatectomy is the treatment of choice. It is of overriding importance to achieve microscopically tumor-free margins. However, only few patients treated in an early stage have a prolonged recurrence-free survival or a chance for cure. Liver transplantation is not an alternative therapeutic option for unresectable cholangiocarcinoma, due to early tumor recurrence in almost all recipients. Liver transplantation has a place in preventing cholangiocarcinoma in primary sclerosing cholangitis, although the timing of replacement is still a matter of debate. Results of surgery need further improvement by adjuvant or neoadjuvant treatment protocols. PMID:10414181
Hanack, U; Lorf, T; Binder, L; Braun, F; Oestmann, J W; Sattler, B; Ringe, B
Barrett's esophagus (BE) is the premalignant lesion from which esophageal adenocarcinoma near the esophagogastric junction arises. The management of BE and the treatment of Barrett's esophageal adenocarcinoma (BEA) are important clinical issues in Europe and the United States. As the Helicobacter pylori infection rate in Japan is decreasing in the younger population, the incidence of BE and adenocarcinoma arising from BE may start increasing. Thus, we review the current status of BEA and its management. Magnifying endoscopy with narrow-band imaging is important for diagnosing dysplasia arising from BE. In Japan, adenocarcinoma arising from BE is managed the same way as squamous cell carcinoma in the same location. Strategies to prevent BEA may include medication such as non-steroidal anti-inflammatory drugs and proton pump inhibitors, and anti-reflux surgery. Understanding the pathophysiology of BE will help to reduce the incidence of BEA. PMID:23283352
Miyazaki, Tatsuya; Inose, Takanori; Tanaka, Naritaka; Yokobori, Takehiko; Suzuki, Shigemasa; Ozawa, Daigo; Sohda, Makoto; Nakajima, Masanobu; Fukuchi, Minoru; Kato, Hiroyuki; Kuwano, Hiroyuki
Maspin, a member of the serine protease inhibitor (serpin) family, is a tumor suppressor in breast and prostate cancer. To address molecular mechanisms underlying maspin's activity, we restored its expression in invasive carcinoma cells and analyzed the resulting changes by shotgun proteomics. Using a mass spectrometry-based multidimensional proteomic method, we observed changes to the expression of approximately 27% of the detectable proteome. In particular, we noted changes to the expression of proteins that regulate cytoskeletal architecture, cell death, and protein turnover. In each case, changes in protein expression were accompanied by measurable changes in tumor cell phenotype. Thus, maspin-expressing cells exhibit a more prominent actin cytoskeleton, a reduced invasive capacity, an increased rate of spontaneous apoptosis, and an altered proteasome function. These observations reveal for the first time the far reaching effects of maspin on multiple protein networks and a new hypothesis of maspin function based on the regulation of proteasome function. PMID:15857880
Chen, Emily I; Florens, Laurence; Axelrod, Fumiko T; Monosov, Edward; Barbas, Carlos F; Yates, John R; Felding-Habermann, Brunhilde; Smith, Jeffrey W
A 68-year-old man presented with a rapidly growing, asymptomatic mass on his left mid-back for the past 3 months. The patient's medical history revealed an intentional 60-pound weight loss over the previous 2 years along with smoking approximately 1 pack of cigarettes per day. On physical examination, a fungating, 11-cm red tumor with palpable broader underlying extension (23 cm total) was present on the left mid-back with distinct red dermal nodules in a dermatomal distribution. In close proximity were two ulcerated nodules, proven histologically to be basal cell carcinomas. In the left groin was massive, fixed lymphadenopathy. A punch biopsy of the tumor was performed, which showed a dense infiltrate of small, round hyperchromatic blue cells that stained positive for CD 56 and pancytokeratin in a perinuclear dot pattern. Tumor cells were negative for CK20, TTF, CK7, and LCA. PMID:23930360
Bognet, Rachel; Thompson, Christina; Campanelli, Carmen
This is a molecular epidemiologic case-control study of breast carcinoma in situ in Los Angeles County designed to address issues related to the cause and progression of breast CIS by determining epidemiologic risk factors, characterizing selected molecul...
M. F. Press
This is a molecular epidemiologic case-control study of breast carcinoma in situ in Los Angeles County designed to address issues related to the cause and progression of breast CIS by determining epidemiologic risk factors, characterizing selected molecul...
Lobular carcinoma is a special type of breast cancer that shows distinct clinical presentation, morphologic and molecular features, and clinical behavior, and its incidence is rising in recent years. Infiltrating lobular carcinoma (ILC) and its precursor lesions may result in diagnostic difficulties, particularly in the screening settings and their management may be problematic. Variants of lobular carcinoma, such as the pleomorphic variant, although not common, exist and some show differences in behavior warranting their recognition in view of requirements for different management strategies. Here we present a review of lobular carcinomas with particular attention to lobular in situ lesions, epidemiology, subtypes, diagnosis, molecular pathology, and grading of ILC in addition to the clinical behavior, response to therapy, and outcome of patients with ILC. PMID:20306830
Rakha, Emad A; Ellis, Ian O
The pathology of renal cell carcinoma is briefly reviewed. Histologically, the tumors present a variegated appearance; although the clear and granular cells predominate, many other cell types, such as spindle cells, dark cells, and giant cells, may be obs...
F. K. Mostofi
The first part of the study is a literature survey. The second part deals with patients and results of radiotherapy of the Klinik and Poliklinik fuer Radiologie der Universitaet Muenchen. The patients with mammary carcinomas, who were treated between 1960...
The case is described of a woman who died with a functioning parathyroid carcinoma 19 years after removal of two parathyroid tumours, considered at the time to be benign. Following operation hyperparathyroidism subsided, with a short period of hypocalcaemia, and severe osteitis fibrosa cystica healed. Five years before death progressive renal failure developed with normal and later raised serum calcium levels. At necropsy a parathyroid carcinoma infiltrated the thyroid at the site of the previous operation and there was a solitary hepatic metastasis. A remaining parathyroid gland was nodularly hyperplastic and the bones showed evidence of active osteitis fibrosa. The relationship between parathyroid hyperplasia and neoplasia is discussed. Acceptable cases of parathyroid carcinoma are rare, but carcinoma is an important cause of recurrent hyperparathyroidism even months or years after removal of an `adenoma'. Images
Ellis, H. A.; Floyd, M.; Herbert, F. K.
Squamous cell carcinoma of the prostate is a rare tumor, making up 0.5% to 1% of all prostate carcinomas. It is typically described as an aggressive cancer, with a median postdiagnosis survival of 14 months. Presented here is a case of primary squamous cell carcinoma of the prostate, with a complicated presentation of metastatic disease. Due to the extent of the patient’s disease, he was treated with palliative radiation therapy using a four-field technique (AP/PA and left and right lateral fields) with 18 mV photons prescribed to the 100% isodose line. The prescription dose was 4000 cGy in 16 fractions of 250 cGy per fraction. No definitive treatment of squamous cell carcinoma of the prostate exists but varying approaches including surgical intervention, chemotherapy, and radiation therapy have been implemented without durable response. However, multimodal treatments appear to be the most promising with longer durations of survival.
Malik, Rena D; Dakwar, George; Hardee, Matthew E; Sanfilippo, Nicholas J; Rosenkrantz, Andrew B; Taneja, Samir S
This is a molecular epidemiologic case-control study of breast carcinoma in situ in Los Angeles County designed to address issues related to the cause and progression of breast CIS by determining epidemiologic risk factors, characterizing selected molecul...
M. F. Press
Sarcomatoid carcinoma or carcinosarcomas of the skin are rare. Basal cell carcinoma (BCC) with osteosarcomatous differentiation is the second most common sarcomatoid carcinoma of the skin, following squamous cell carcinoma with heterologous mesenchymal differentiation. There are only 11 cases of BCC with osteosarcomatous component reported in the literature, with limited documented molecular analyses. The authors report the clinical and histological features of 2 cases with molecular analyses for recurrent mutations in 17 cancer genes. In both cases, the epithelial or BCC component was positive for BerEP4 and high-molecular weight cytokeratin, whereas the sarcomatous component was negative for both markers. Mutational analyses revealed TP53 mutation in 1 case with p53 expression noted in both components. The other case was negative for both p53 expression and TP53 mutation. PMID:23221485
Tse, Julie Y; Pawlak, Amanda C; Boussahmain, Chakib; Routhier, Caitlin Ann; Dias-Santagata, Dora; Kalomiris, Dimitrios; Hoang, Mai P
The Authors take a hint from recent observation of two patients with hepatocellular carcinoma presenting with obstructive jaundice to analyse the litterature and their clinical cases. They conclude that in the evolution of hepatocellular carcinoma can be found "early" or "late" jaundice. The latest is hepatocellular and/or obstructive jaundice and it is harbinger of fatal prognosis because of a big hepatocelluar carcinoma that has invaded biliary tree and/or liver failure by concomitant cirrhosis. The "early" jaundice appears when the tumor is still small and it is always obstructive due to intrabile duct tumor growth. This kind of jaundice has a good prognostic meaning because, together with imaging techniques, permits an early diagnosis of the hepatocellular carcinoma necessary for satisfactory palliation or occasional cure. PMID:16821515
Nardello, Oreste; Farina, Gian Paolo; Cagetti, Marino
INTRODUCTION Carcinosarcoma is a rare malignant biphasic tumor which has sarcomatous and carcinomatous components. Stomach localization is very rare. We discuss the diagnosis, follow-up and treatment of patients diagnosed with gastric carcinosarcoma in company with the literature review. PRESENTATION OF CASE A 73-year-old white male patient applied to hospital with dyspeptic complaints lasting for 2 months. His endoscopic examination revealed an ulcero-vegetating mass in the cardiac region of his stomach. Total gastrectomy and D2 lymph node dissection were performed for the patient. In the pathologic evaluation, the tumor was found consistent with Stage IIA stomach adenocarcinoma in accordance with AJCC (7edt, 2010) classification. Pathologic specimen was reevaluated by an expert pathologist for the patient with progression and liver metastasis under adjuvant chemotherapy and concomitant radiotherapy. The new pathology was consistent with gastric carcinosarcoma, and 90% of the tumor was identified as osteosarcoma whereas 10% was identified as carcinoma. Cisplatin doxorubicine-based chemotherapy was given considering the fact that sarcomatous component was dominant.1 The patient was given 3 courses of chemotherapy. However, as the patient showed progression under therapy, he died after 14 months of the diagnosis. DISCUSSION Gastric carcinosarcoma is a very rare and clinically aggressive malignancy. Recurrence is likely to occur with a rate of more than 50% in patients who have undergone resection within the first year following surgery, and overall survival time is 10–15 months. CONCLUSION In refractory gastric carcinoma cases with rapid progression, we suggest that gastric carcinosarcoma with biphasic component should be taken into consideration and the pathological evaluation should be performed by an expert pathologist.
Selcukbiricik, Fatih; Tural, Deniz; Senel, Elif Tuba; Dervisoglu, Sergulen; Serdengecti, Suheyla
The etiological association between primary hepatocellular carcinoma (PHCC) and chronic viral hepatitis has been proved by now beyond doubt in the hepatitis B virus (HBV) and C virus (HCV). PHCC develops most frequently in cirrhotic livers, sometimes also in the absence of cirrhosis. Extensive epidemiological studies provided convincing evidence of this etiological relationship which is also supported by observations and animal experiments. An important factor in hepatocarcinogenesis due to the influence of HBV is integration of the viral genoma into the liver cell genoma. In the tumourous part of the liver integrated HBV sequences are more frequent than in the non-tumourous part. The integration can produce changes in the genome of the liver cell which may sometimes lead to malignant transformation. The mechanisms of this process are not quite clear so far. Their outcome--the development of carcinoma--can be summarized as the peak effect of factors leading to the disorganization of DNA with participation of chromosomal changes, the action of transactivation of HBs protein, transformation growth factors and the important influence of mutations of the suppressor gene p 53 on the 17th chromosome which is probably the target of HBV. HCV produces chronic live: disease developing into cirrhosis and PHCC, even more frequent than HBV; however its integration into the liver cell does not take place. The genetic variability of this gene is great. Its transformating action is probably implemented rather as a co-carcinogen on the background of cirrhosis of the liver which alone regardless of its cause is an increased risk for the development of PHCC. In clinical practice these findings imply the necessity of optimal prevention of chronic viral hepatic infection (vaccination, so far available for HBV, transfusions) and the necessity to assess the virological status in patients with chronic liver disease and early detection of small tumourous liver lesions where nowadays due to modern therapeutic approaches the prognosis has improved greatly. PMID:9490205
The ultimate goal of defining cancer specific precursors is to facilitate early detection and intervention before the development of invasive malignancy. Unlike other malignancies involving the female genital tract such as cervical or endometrial carcinomas, precursor lesions of ovarian carcinomas have not been well characterised, resulting in a failure to develop effective screening programs. Recent clinicopathological and molecular studies have provided new insight into the origin and pathogenesis of ovarian carcinomas. It has been shown that ovarian cancer is comprised of different tumour types differing not only in morphology, but also in pathogenesis, molecular alterations and clinical progression. A dualistic model of ovarian carcinogenesis has been proposed. Type I tumours which include low grade serous, low grade endometrioid, clear cell, mucinous carcinomas and Brenner tumours, are generally indolent and tend to be genetically stable, although clear cell carcinoma would probably belong to an intermediate category. They demonstrate a step-wise progression from a benign precursor such as a benign to borderline tumour or endometriosis and are characterised by genetic aberrations targeting specific cell signalling pathways. Type II tumours comprise high grade serous, high grade endometrioid, and undifferentiated carcinomas as well as malignant mixed mesodermal tumours. They are clinically aggressive and exhibit high genetic instability with frequent p53 mutations. Mounting evidence suggests that many high grade serous carcinomas originate from the epithelium of the distal fallopian tube, and that serous tubal intraepithelial carcinoma (STIC) represents the putative precursor of these neoplasms. Low grade serous carcinomas arise via transformation of benign and borderline serous tumours, thought to be derived from inclusion cysts originating from the ovarian surface or tubal epithelium. Recently it has been suggested that papillary tubal hyperplasia may be a putative precursor lesion for serous borderline tumours. Both endometrioid and clear cell carcinomas develop from endometriosis, via alterations affecting different genetic pathways. The origin of mucinous and transitional cell neoplasms is not well characterised, although new data suggest a possible origin from transitional cell nests present at the tubal-mesothelial junction. Likewise, the pathogenesis of carcinosarcomas is also not well established because of their rarity but there is accumulating evidence that the carcinomatous component determines the course of the disease and gives rise to the malignant mesenchymal component. This review discusses recent developments in the pathogenesis of ovarian carcinoma, with particular emphasis on the putative precursor lesions that give rise to the major histological subtypes. Recognition of these lesions is not only important in improving the understanding of ovarian carcinogenesis, but it will also influence our approach to prevent, detect and treat these tumours. PMID:23478230
Lim, D; Oliva, E
Fibrolamellar hepatocellular carcinoma (FLH) is a variant of hepatocellular carcinoma (HCC) with distinct clinical, histologic and prognostic features different from conventional HCC. Herein, we present a 14-year-old girl with a palpable mass over the right upper -quad- rant of the abdomen. A well-defined mass in the left liver with heterogeneous density and a central linear band was demonstrated by ultrasound
Ju-Bei Yen; Kuei-Wen Chang
The association between leukocytoclastic vasculitis and solid tumors like renal carcinoma has been infrequently described. We present the case of a 76-year-old woman who began with skin lesions on the legs that were clinically and histologically diagnosed as leukocytoclastic vasculitis. During analysis of the symptoms, she was diagnosed with renal carcinoma. After the tumor was excised, the vasculitis lesions disappeared, with no recurrence during the follow-up period. PMID:16801023
Hernández-Núńez, Almudena; Córdoba, Susana; Arias, Dolores; Romero, Alberto; García-Donoso, Carmen; Mińano, Román; Martínez, Diego; Borbujo, Jesús
There are two clinicopathological types of vulvar squamous cell carcinoma, human papillomavirus (HPV)-positive and HPV-negative, which can be distinguished to some degree on routine histology. Human papillomavirus-positive carcinomas account for one-quarter to one-third of cases, occur in women on average 20 years younger than in HPV-negative, and are associated with multiple lower genital tract neoplasia. Human papillomavirus negative carcinoma is linked to lichen sclerosus. Of all carcinomas, 7-96% show lichen sclerosus in skin adjacent to the carcinoma, the majority being the first presentation of lichen sclerosus, and up to 5% of patients with lichen sclerosus develop carcinoma after long-term follow up. Where lichen sclerosus is associated with malignancy, it is often hyperplastic, may show a subtle form of intraepithelial neoplasia termed 'differentiated vulvar intraepithelial neoplasia', and may lose its pathognomonic oedematous-hyaline layer. The local additional factors causing lichen sclerosus to develop malignancy on the vulva are not known. PMID:10994466
Scurry, J P; Vanin, K
Neuroendocrine carcinomas are ubiquitous neoplasms that may occur anywhere in the human body. A unifying concept regarding the classification of these tumors has been controversial. Although most neuroendocrine neoplasms occur in the gastrointestinal tract, current concepts regarding classification and nomenclature are being driven by studies of thoracic tumors. One issue that has been put forward to keep separate nomenclatures for these tumors in different organ systems is the different clinical behavior of these neoplasms in different systems. The most important aspect regarding this group of tumors is the fact that they should be considered neoplasms capable of local recurrence and distant metastasis. Close clinical correlation and appropriate treatment are important to improve the survival rate in this group of patients. PMID:17548031
Moran, Cesar A; Suster, Saul
It is unknown whether the type and grade of a primary endometrial carcinoma is reliably maintained in recurrence. All matched primary and recurrent endometrial carcinomas diagnosed from 2000 to 2010 at our institution were identified; 34 cases had available slides. Histologic classification was performed using modifications to the World Health Organization criteria. Immunohistochemical analysis for p53, p16, progesterone receptor (PR), and DNA mismatch-repair proteins (MMR) (MLH1, MSH2, MSH6, and PMS2) was performed. Endometrioid carcinoma recurrences were mostly local, whereas serous carcinoma recurrences were mostly peritoneal. Compared with endometrioid carcinoma patients, serous carcinoma patients were older, presented at high stage, and had shorter survival. Serous carcinomas were the most common recurrent endometrial carcinoma (18/34 cases). Overall, 21 cases (62%) displayed similar morphology when comparing primary and recurrent carcinomas, whereas 13 displayed discordant morphology. Seven of 13 endometrioid carcinomas (54%) had a morphologically discordant recurrence, compared with 3 of 14 serous carcinomas (21%), 1 of 4 morphologically ambiguous carcinomas (25%), and both mixed epithelial carcinomas. Serous and morphologically ambiguous carcinomas therefore demonstrated relative morphologic fidelity compared with endometrioid carcinomas. Four morphologically discordant cases demonstrated either pure clear cell carcinoma or clear cell features at recurrence. Seven of 23 matched pairs displayed discordant PR results, with 5 cases, including both endometrioid and serous carcinomas, showing diminished PR expression at recurrence. p53, p16, and DNA MMR staining results were generally concordant when evaluating matched pairs, with only occasional exceptions. Sixty-four percent of all pure endometrioid carcinomas and mixed epithelial carcinomas with an endometrioid component showed loss of expression of MLH1 and/or PMS2; no serous carcinoma demonstrated this abnormality. Clinical and immunohistochemical data supported the use of modifications to the World Health Organization diagnostic criteria. More importantly, the data suggest that when confronted with recurrent endometrial carcinoma, particularly a serous carcinoma, it is reasonable to base therapeutic decisions on the type of the primary tumor, especially if sampling or excising the recurrent tumor is problematic. However, in light of the PR results, sampling a recurrent endometrioid carcinoma may be worthwhile if hormonal therapy is planned. Recurrent endometrioid carcinoma may be enriched for tumors with DNA MMR abnormalities. PMID:23154767
Soslow, Robert A; Wethington, Stephanie L; Cesari, Matthew; Chiappetta, Daniel; Olvera, Narciso; Shia, Jinru; Levine, Douglas A
Clear cell carcinoma of the thymus is a rare tumor. Few cases of clear-cell carcinoma of thymus have been documented (Truong et al., 1990 and Wolfe III et al., 1983). All these cases were diagnosed by histopathological examination of the tissue. Diagnosis of thymic clear cell carcinoma on cytology is extremely challenging. Here we report the first case of thymic clear cell carcinoma diagnosed by cytological examination of the pericardial fluid with the help of immunocytochemistry. Differential diagnosis included adenocarcinoma, mesothelioma, and thymic clear cell carcinoma. Thymic carcinoma with clear cell features has an aggressive clinical behavior including our case, where it was already metastasized at the time of presentation.
Lale, Seema A.; Tiscornia-Wasserman, Patricia G.; Aziz, Mohamed
Sarcomatoid carcinomas exhibit features that are common to epithelial and mesenchymal tumors. These carcinomas are rare, particularly in the small intestine. In the current case report, we describe a case of an intestinal sarcomatoid carcinoma in a 70-year-old Chinese female. Sarcomatoid carcinoma was confirmed based on light microscopy and immunohistochemical observations. The patient presented with symptoms of acute abdomen, which was due to an intestinal perforation caused by sarcomatoid carcinoma of the small bowel. Patients with sarcomatoid carcinoma are usually associated with a poor prognosis. However, this patient experienced a relatively favorable prognosis, which may be attributed to low positivity for Ki67 in the tumor.
HAN, NING; HAN, QING-HUI; LIU, YANG-ZHOU; LI, ZENG-CHUN; LI, JIAO
Verrucous carcinoma (VC) is a rare variant of squamous cell carcinoma (SCC) with an extremely well-differentiated microscopic appearance. It is able to show extensive local invasion, but practically never metastasizes. VCs mostly occur in the oral cavity, larynx, nasal cavity, esophagus, vulva, vagina, anorectal region, penis and skin. VCs sometimes coexist with conventional SCCs, and in these instances they are
Cavit Can; Turgut Dönmez
Pleomorphic (spindle) cell carcinoma, also known as monophasic sarcomatoid carcinoma, is a rare primary pulmonary malignancy. This type of tumor shows concurrent presence of malignant epithelial and homologous sarcomatoid spindle cell components by coexpressing cytokeratin and vimentin in various degrees. Sixteen cases (four central endobronchial lesions and 12 peripheral parenchymal masses) were studied clinicopathologically. Men were affected far more frequently
Yih-Leong Chang; Yung-Chie Lee; Jin-Yuan Shih; Chen-Tu Wu
We report a case of local squamous cell carcinoma recurrence of thyroid papillary carcinoma, 4 years after subtotal thyroidectomy, in an 82-year-old woman. The papillary cancer of the right thyroid was histopathologically classified as T2a, N0, M0, Ex1; pT2a, pN1b, pEx1; Stage III. Fine-needle aspiration cytology of the recurrent tumor revealed atypical squamous epithelium-like cells with keratinization. The tumor was judged cytologically to be class III, defined as a suspicious malignancy and, after reoperation, it was diagnosed histopathologically as papillary carcinoma recurrence with extensive squamous metaplasia. The recurrent papillary carcinoma was thought to have changed to a squamous cell carcinoma because most of the tumor was occupied by atypical squamous cells, with a small amount of glandular tissue. The primary tumor was histologically diagnosed as a well-differentiated papillary carcinoma at the initial operation. It contained numerous tall neoplastic cells with eosinophilic granules and pseudostratified nuclei, indicating that it could potentially transform into squamous cell carcinoma. We report this case as an example of how squamous cell carcinoma of the thyroid can develop. PMID:16440166
Kitahara, Shinzo; Ito, Toshihide; Hamatani, Shigeharu; Shibuya, Kazutoshi; Shiba, Tadaaki
The clinical picture, treatment and course of invasive, aggressive basal cell terebrans carcinoma of the face, scalp and neck in eight patients is presented in detail. Based on the analysis of these patients, as well as our experience of a total of 93 patients with aggressive, invasive basal cell carcinoma, treated so far, the conclusion is reached that basal cell
R. Ron?evi?; V. Aleksi?; M. Stoj?i?; M. Jovanovi?; D. Ron?evi?
Quality of life is an important treatment outcome for conditions that are rarely fatal, such as cutaneous basal cell carcinoma and squamous cell carcinoma (typically called nonmelanoma skin cancer (NMSC)). The purpose of this study was to compare quality-of-life outcomes of treatments for NMSC. We performed a prospective cohort study of 633 consecutive patients with NMSC diagnosed in 1999 and
Mary-Margaret Chren; Anju P Sahay; Daniel S Bertenthal; Saunak Sen; C Seth Landefeld
Parafibromin is a protein encoded by the hyperparathyroidism 2 oncosuppressor gene and its down-regulated expression is involved in the pathogenesis of parathyroid, gastric and colorectal carcinomas. To clarify the roles of parafibromin expression in lung carcinomas, it was examined by immunohistochemistry and in situ hybridization on tissue microarray containing lung carcinomas (n=144) and normal lung tissue (n=20), with a comparison to clinicopathological parameters of carcinomas. Lung carcinoma cell lines and tissues were studied for parafibromin expression by Western blot and RT-PCR. Down-regulated expression of parafibromin mRNA was found in lung carcinoma in comparison with matched normal tissue (p<0.05). Parafibromin protein was found in the cilia and nuclei of pseudo-stratified columnar epithelium, and the nuclei of lung carcinoma. According to immunostaining and in situ hybridization, there was no difference in parafibromin expression between histological subtypes of lung carcinoma (p>0.05). The Kaplan-Meier method indicated that nuclear parafibromin expression was positively correlated with adenocarcinoma patients (p<0.05). Down-regulated parafibromin mRNA expression might play an important role in lung carcinogenesis, but not in its histogenesis. Strong parafibromin expression in cilia of the pseudo-stratified columnar epithelium indicated its possible involvement in cell mobility. Parafibromin expression could be employed to indicate the favorable prognosis of patients with adenocarcinoma. PMID:21692036
Xia, Pu; Wang, Wei; Xu, Xiao-yan; Wang, Jian-ping; Takano, Yasuo; Zheng, Hua-chuan
Metatypical Basal Cell Carcinoma, also known as Basosquamous Carcinoma is a subtype of Basal Cell Carcinoma. It is similar to Basal Cell Carcinoma for the gross aspect and regional recurrences, but it has the capacity to spread and develop metastasis. This terrible characteristic endangers the life of the patient if it is not readily recognized by the physicians. Herein we present a report of two patients affected by BSC originating in the nasal region and external ear that after a series of devastating local recurrences metastasized to the lung and bones in one case. The true incidence of Basoquamous Carcinoma may be higher, with underreporting arising because of rarity of diagnosis and lack of awareness on the part of clinicians. Our experience suggests that a deep biopsy is often necessary to discover a BSC that appears as BCC but with local aggressive features. PMID:23200564
De Stefano, Alessandro; Dispenza, Francesco; Petrucci, Anna Grazia; Citraro, Leonardo; Croce, Adelchi
Thymic carcinoma is a rare thymic epithelial tumor in which chemotherapy for advanced disease has not yet been established. Thymidylate synthase (TS) and orotate phosphoribosyltransferase (OPRT) protein expression levels in thymic carcinoma were evaluated as possible indicators of the anticancer activity of 5-fluorouracil (5-FU) drugs using immunohistochemistry (IHC). A total of 24 samples of thymic carcinoma were used in the present study. The tumor sections were immunohistochemically stained for TS and OPRT. As a comparison with thymic carcinoma, we also assessed the TS and OPRT protein expression levels in 55 lung cancer samples. The TS expression was positive in 12 of 24 thymic carcinoma samples (50%) and OPRT expression was positive in 10 (42%). The association between TS and OPRT expression and Masaoka stages of thymic carcinoma was analyzed. The TS and OPRT expressions in stage IV were significantly higher compared to that in stages I, II or III. We also compared the TS and OPRT expression levels between thymic carcinoma and lung cancer (33 adenocarcinomas and 22 squamous cell carcinomas). TS expression in thymic carcinoma was significantly lower compared with lung squamous cell carcinoma. OPRT expression in thymic carcinoma was significantly higher compared to lung adenocarcinoma. The combination of a relatively low expression of TS and high expression of OPRT suggests an improved antitumor effect of 5-FU drugs in thymic carcinoma compared to in lung carcinoma. PMID:23170110
Yokota, Keisuke; Sasaki, Hidefumi; Okuda, Katsuhiro; Shitara, Masayuki; Hikosaka, Yu; Moriyama, Satoru; Yano, Motoki; Fujii, Yoshitaka
Thymic carcinoma is a rare thymic epithelial tumor in which chemotherapy for advanced disease has not yet been established. Thymidylate synthase (TS) and orotate phosphoribosyltransferase (OPRT) protein expression levels in thymic carcinoma were evaluated as possible indicators of the anticancer activity of 5-fluorouracil (5-FU) drugs using immunohistochemistry (IHC). A total of 24 samples of thymic carcinoma were used in the present study. The tumor sections were immunohistochemically stained for TS and OPRT. As a comparison with thymic carcinoma, we also assessed the TS and OPRT protein expression levels in 55 lung cancer samples. The TS expression was positive in 12 of 24 thymic carcinoma samples (50%) and OPRT expression was positive in 10 (42%). The association between TS and OPRT expression and Masaoka stages of thymic carcinoma was analyzed. The TS and OPRT expressions in stage IV were significantly higher compared to that in stages I, II or III. We also compared the TS and OPRT expression levels between thymic carcinoma and lung cancer (33 adenocarcinomas and 22 squamous cell carcinomas). TS expression in thymic carcinoma was significantly lower compared with lung squamous cell carcinoma. OPRT expression in thymic carcinoma was significantly higher compared to lung adenocarcinoma. The combination of a relatively low expression of TS and high expression of OPRT suggests an improved antitumor effect of 5-FU drugs in thymic carcinoma compared to in lung carcinoma.
YOKOTA, KEISUKE; SASAKI, HIDEFUMI; OKUDA, KATSUHIRO; SHITARA, MASAYUKI; HIKOSAKA, YU; MORIYAMA, SATORU; YANO, MOTOKI; FUJII, YOSHITAKA
The vast majority of prostatic cancers are acinar adenocarcinomas. Histological variants of prostatic carcinoma have been variably defined. One approach is to consider two groups of variants. The first group comprises histological variants of acinar adenocarcinoma and the second group non-acinar carcinoma variants or types. Variants of usual acinar adenocarcinoma defined in 2004 by the World Health Organization (WHO) include atrophic, pseudohyperplastic, foamy, colloid, signet ring, oncocytic and lymphoepithelioma-like carcinomas. The second group of non-acinar carcinoma histological variants or types of prostatic carcinoma accounts for about 5-10% of carcinomas that originate in the prostate. These include sarcomatoid carcinoma, ductal adenocarcinoma, urothelial carcinoma, squamous and adenosquamous carcinoma, basal cell carcinoma, and neuroendocrine tumours, specifically small-cell carcinoma. Recently characterized variants not present in the 2004 WHO classification, including microcystic adenocarcinoma, prostatic intraepithelial neoplasia-like adenocarcinoma, large-cell neuroendocrine carcinoma, and pleomorphic giant cell carcinoma, are also described. The aims of this review are to present the essential histomorphological diagnostic attributes of these variants, and to emphasize the clinical signficance of the variants, when different from usual acinar adenocarcinoma, including clinical presentation and outcome. PMID:22212078
Humphrey, Peter A
Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with "Roman Bridges", "pseudocribriform" proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in non-invasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/high-grade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are non-invasive neoplasms; the terms "cribriform cystadenocarcinoma" and LG-SDC should be replaced by "low-grade intraductal carcinoma" (LG-IDC) of salivary gland or "low-grade intraductal carcinoma with areas of invasive carcinoma" in those cases with evidence of invasive carcinoma. PMID:23821212
Kuo, Ying-Ju; Weinreb, Ilan; Perez-Ordonez, Bayardo
The large number of cases in the Surveillance, Epidemiology and End Results (SEER) program of the US National Cancer Institute allowed a detailed analysis of the age distribution of the histologic types of invasive breast carcinoma. Between ages 50 and 85 years in females, the age-specific incidence rate shows little change for medullary, inflammatory and apocrine carcinomas; is about doubled for Paget's disease and for ductal, lobular, tubular and metaplastic carcinomas; and increases to 4 to 8 times the menopausal level for mucinous, papillary and signet-ring-cell carcinomas. The peri-menopausal break on the age-incidence curve is most marked for carcinomas of predominantly lobular origin and virtually absent for carcinomas of predominantly ductal origin. In males, the age distribution of papillary carcinoma is similar to that of all types combined, whereas that of mucinous carcinoma is skewed towards older ages, as in females. PMID:8478135
Stalsberg, H; Thomas, D B
Pregancy in a patient with hepatocellular carcinoma is rare. Fibrolamellar hepatocellular carcinoma is a distinct clinicopathologic\\u000a variant with a better prognosis. We report such a case in which pregnancy was apparently not deleterious.
O. Gemer; S. Segal; E. Zohav
A 13 year old patient with juvenile type IV glycogen storage disease died of the complications of hepatocellular carcinoma. To our knowledge this is the first reported case of hepatocellular carcinoma in association with type IV glycogen storage disease.??
de Moor, R A; Schweizer, J; van Hoek, B; Wasser, M; Vink, R; Maaswinkel-Mooy, P
Mucinous carcinomas are a rare entity accounting for up to 2% of all breast cancers, which have been shown to display a gene expression profile distinct from that of invasive ductal carcinomas of no special type (IDC-NSTs). Here, we have defined the genomic aberrations that are characteristic of this special type of breast cancer and have investigated whether mucinous carcinomas might constitute a genomic entity distinct from IDC-NSTs. Thirty-five pure and 11 mixed mucinous breast carcinomas were assessed by immunohistochemistry using antibodies against oestrogen receptor (ER), progesterone receptor, HER2, Ki67, cyclin D1, cortactin, Bcl-2, p53, E-cadherin, basal markers, neuroendocrine markers, and WT1. Fifteen pure mucinous carcinomas and 30 grade- and ER-matched IDC-NSTs were microdissected and subjected to high-resolution microarray-based comparative genomic hybridization (aCGH). In addition, the distinct components of seven mixed mucinous carcinomas were microdissected separately and subjected to aCGH. Pure mucinous carcinomas consistently expressed ER (100%), lacked HER2 expression (97.1%), and showed a relatively low level of genetic instability. Unsupervised hierarchical cluster analysis revealed that pure mucinous carcinomas were homogeneous and preferentially clustered together, separately from IDC-NSTs. They less frequently harboured gains of 1q and 16p and losses of 16q and 22q than grade- and ER-matched IDC-NSTs, and no pure mucinous carcinoma displayed concurrent 1q gain and 16q loss, a hallmark genetic feature of low-grade IDC-NSTs. Finally, both components of all but one mixed mucinous carcinoma displayed similar patterns of genetic aberrations and preferentially clustered together with pure mucinous carcinomas on unsupervised clustering analysis. Our results demonstrate that mucinous carcinomas are more homogeneous between themselves at the genetic level than IDC-NSTs. Both components of mixed mucinous tumours are remarkably similar at the molecular level to pure mucinous cancers, suggesting that mixed mucinous carcinomas may be best classified as variants of mucinous cancers rather than of IDC-NSTs. PMID:20815046
Lacroix-Triki, Magali; Suarez, Paula H; MacKay, Alan; Lambros, Maryou B; Natrajan, Rachael; Savage, Kay; Geyer, Felipe C; Weigelt, Britta; Ashworth, Alan; Reis-Filho, Jorge S
In 2001 UNAIDS initiated the development of a toolkit with techniques and practices for AIDS competence in consultation with the UNAIDS Secretariat, with the UN Theme Groups in different countries and members of the UNAIDS Technical Network on Local Responses to HIV\\/AIDS. The toolkit aims to further strengthen the capacity and competence of different actors to address HIV\\/AIDS at local
M. Wegelin-Schuringa; G. Tiendrebéogo
The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.
Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)], E-mail: firstname.lastname@example.org; Mancuso, Anthony A. [Department of Diagnostic Radiology, University of Florida College of Medicine, Gainesville, FL (United States); Hinerman, Russell W.; Malyapa, Robert S. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Werning, John W. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States); Amdur, Robert J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Villaret, Douglas B. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States)
Proton radiotherapy has seen an increasing role in the treatment of hepatocellular carcinoma (HCC). Historically, external beam radiotherapy has played a very limited role in HCC due to a high incidence of toxicity to surrounding normal structures. The ability to deliver a high dose of radiation to the tumor is a key factor in improving outcomes in HCC. Advances in photon radiotherapy have improved dose conformity and allowed dose escalation to the tumor. However, despite these advances there is still a large volume of normal liver that receives a considerable radiation dose during treatment. Proton beams do not have an exit dose along the beam path once they enter the body. The inherent physical attributes of proton radiotherapy offer a way to maximize tumor control via dose escalation while avoiding excessive radiation to the remaining liver, thus increasing biological effectiveness. In this review we discuss the physical attributes and rationale for proton radiotherapy in HCC. We also review recent literature regarding clinical outcomes of using proton radiotherapy for the treatment of HCC. PMID:23359779
Ling, Ted C; Kang, Joseph I; Bush, David A; Slater, Jerry D; Yang, Gary Y
Proton radiotherapy has seen an increasing role in the treatment of hepatocellular carcinoma (HCC). Historically, external beam radiotherapy has played a very limited role in HCC due to a high incidence of toxicity to surrounding normal structures. The ability to deliver a high dose of radiation to the tumor is a key factor in improving outcomes in HCC. Advances in photon radiotherapy have improved dose conformity and allowed dose escalation to the tumor. However, despite these advances there is still a large volume of normal liver that receives a considerable radiation dose during treatment. Proton beams do not have an exit dose along the beam path once they enter the body. The inherent physical attributes of proton radiotherapy offer a way to maximize tumor control via dose escalation while avoiding excessive radiation to the remaining liver, thus increasing biological effectiveness. In this review we discuss the physical attributes and rationale for proton radiotherapy in HCC. We also review recent literature regarding clinical outcomes of using proton radiotherapy for the treatment of HCC.
Ling, Ted C.; Kang, Joseph I.; Bush, David A.; Slater, Jerry D.
One hundred twenty-eight patients with T3 or T4 glottic cancers were treated by initial surgery; 59 had a total laryngectomy and 69 had total laryngectomy with regional node dissection. Fifty-eight percent of the total laryngectomy group and forty-nine percent of the total laryngectomy with neck dissection group remained free of disease for 5 or more years. Forty-seven percent (60 of 128 patients) treated surgically developed regional recurrences requiring further treatment. Nine patients had evidence of widespread metastases, leaving 51 suitable for salvage radiotherapy. Twenty-three percent (12 of 51 patients) were salvaged with radiotherapy given for postoperative recurrences. Twenty-five patients received an initial 6,600 rads to larynx and neck with curative intent, 28 percent of whom remained free of disease for 5 or more years. Seventeen percent of patients were salvaged with one laryngectomy for persistent or recurring tumors. Initial total laryngectomy gave better survival figures for advanced glottic carcinoma. PMID:2802034
Razack, M S; Maipang, T; Sako, K; Bakamjian, V; Shedd, D P
Penile carcinoma (PeCa) represents an important public health problem in poor and developing countries. Despite its unpredictable behavior and aggressive treatment, there have only been a few reports regarding its molecular data, especially epigenetic mechanisms. The functional diversity in different cell types is acquired by chromatin modifications, which are established by epigenetic regulatory mechanisms involving DNA methylation, histone acetylation, and miRNAs. Recent evidence indicates that the dysregulation in these processes can result in the development of several diseases, including cancer. Epigenetic alterations, such as the methylation of CpGs islands, may reveal candidates for the development of specific markers for cancer detection, diagnosis and prognosis. There are a few reports on the epigenetic alterations in PeCa, and most of these studies have only focused on alterations in specific genes in a limited number of cases. This review aims to provide an overview of the current knowledge of the epigenetic alterations in PeCa and the promising results in this field. The identification of epigenetically altered genes in PeCa is an important step in understanding the mechanisms involved in this unexplored disease.
Kuasne, Hellen; Marchi, Fabio Albuquerque; Rogatto, Silvia Regina; de Syllos Colus, Ilce Mara
A 75-year-old woman with full dentures had a progressive growth on the tongue for the past 15 years. She reported ulceration of the lesion 4 months prior that was accompanied by pain and odinophagia. She denied addiction to alcohol or tobacco. On examination, there was an ulcerated, vegetating, verrucous lesion, with yellow-whitish areas intermingled with erythematous areas, being infiltrated and having well-defined borders, on almost all areas of the back of the tongue (Figure 1). No adjacent lymphadenopathy was found. Biopsy of the tongue was compatible with verrucous carcinoma demonstrating squamous cell neoplasia with prevailing areas of rounded borders. There were "tunnels" filled with parakeratotic material surrounded by an extensive inflammatory response, plus isolated foci of neutrophils inside the tumor (Figure 2). There were relatively well-differentiated neoplastic cells with little cytological atypia. In addition, there were several foci of individual or grouped dyskeratotic cells (Figure 3), plus tunnelling of parakeratotic material and an intratumor inflammatory response (Figure 4). Following surgical removal, the woman underwent chemotherapy and radiation treatment. PMID:22779105
Vilela, Fernanda Aguiar Santos; Trope, Beatriz Moritz; Gurfinkel, Paula Cabral Menezes; Pińeiro-Maceira, Juan Manuel; Ramos-e-Silva, Marcia
Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of airways, great vessels, and other mediastinal structures. In this paper we presented a patient with fibrosing mediastinitis mimicking bronchogenic carcinoma. The patient was a 32-year-old diabetic male admitting with cough and hemoptysis. There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomography. Positron emission tomography with computed tomography (PET/CT) scan demonstrated increased fluorodeoxyglucose (FDG) uptake at the right hilar mass lesion and mediastinal lymph nodes. Fiberoptic bronchoscopy showed mucosal distortion of right upper lobe. Pathologic examination of the mucosal biopsy revealed inflammation. Endobronchial ultrasound guided transbronchial needle and cervical mediastinoscopic lymph node biopsies were undiagnostic. Diagnostic thoracotomy confirmed the diagnosis fibrosing mediastinitis. Administration of six months of systemic corticosteroid and antituberculous therapy was not beneficial. In conclusion, despite being a rare clinical entity, fibrosing mediastinitis should be kept in mind in the differential diagnosis of mediastinal mass lesions of unknown etiology. The diagnosis is exceptionally difficult in the presence of atypical radiological findings. The treatment is particularly challenging without any proven effective therapy. PMID:23372962
Koksal, Deniz; Bayiz, Hulya; Mutluay, Neslihan; Koyuncu, Adem; Demirag, Funda; Dagli, Gulfidan; Berktas, Bahadir; Berkoglu, Mine
Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of airways, great vessels, and other mediastinal structures. In this paper we presented a patient with fibrosing mediastinitis mimicking bronchogenic carcinoma. The patient was a 32-year-old diabetic male admitting with cough and hemoptysis. There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomography. Positron emission tomography with computed tomography (PET/CT) scan demonstrated increased fluorodeoxyglucose (FDG) uptake at the right hilar mass lesion and mediastinal lymph nodes. Fiberoptic bronchoscopy showed mucosal distortion of right upper lobe. Pathologic examination of the mucosal biopsy revealed inflammation. Endobronchial ultrasound guided transbronchial needle and cervical mediastinoscopic lymph node biopsies were undiagnostic. Diagnostic thoracotomy confirmed the diagnosis fibrosing mediastinitis. Administration of six months of systemic corticosteroid and antituberculous therapy was not beneficial. In conclusion, despite being a rare clinical entity, fibrosing mediastinitis should be kept in mind in the differential diagnosis of mediastinal mass lesions of unknown etiology. The diagnosis is exceptionally difficult in the presence of atypical radiological findings. The treatment is particularly challenging without any proven effective therapy.
Bayiz, Hulya; Mutluay, Neslihan; Koyuncu, Adem; Demirag, Funda; Dagli, Gulfidan; Berktas, Bahadir; Berkoglu, Mine
Urinary bladder urothelial carcinoma with expression of KIT and PDGFRA and showing diverse differentiations into plasmacytoid, clear cell, acantholytic, nested, and spindle variants, and into adenocarcinoma, signet-ring cell carcinoma, small cell carcinoma, large cell carcinoma, and pleomorphic carcinoma
Various tumors can arise in the urinary bladder (UB); most common is urothelial carcinoma (UC). UC of the UB have many variants. Other types of carcinomas such as adenocarcinoma (AC) and small cell carcinoma (SmCC) can occur in UB carcinomas. Expression of KIT and PDGFRA has not been reported. A 66-year-old man admitted to our hospital because of hematuria. Cystoscopy revealed papillary invasive tumor and a transurethral bladder tumorectomy (TUR-BT) was performed. The TUR-BT showed UC, AC, SmCC, large cell carcinoma (LCC), and pleomorphic carcinoma (PC). The UC component showed plasmacytoid, spindle, nested, clear cell, acantholytic variants. The AC element showed tubular adenocarcinoma and signet-ring cell carcinoma (Sig). Immunohistochemically, all of these subtypes were positive for cytokeratin (CK) AE1/3, CK CAM5.2, CK34BE12, CK5, CK6, CK7, CK8, CK18, CK19, CK20, EMA, CEA, p63, CA19-9, p53 (positive 45%), MUC1, NSE, NCAM, KIT, PDGFRA, and Ki-67 (87%). They were negative for vimentin, chromogranin, synaptophysin, S100 protein, CD34, CD14, ?-smooth muscle actin, CD31, caldesmon, CD138, CD45, ?-chain, ?-chain, MUC2, MUC5AC and MUC6. Mucin histochemistry revealed mucins in AC element including Sig. A molecular genetic analysis using PCR-direct sequencing method identified no mutations of KIT (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) genes. The carcinoma was highly aggressive and invaded into muscular layer. The nuclear grade was very high, and there were numerous lymphovascular permeations were seen. The surface showed carcinoma in situ involving von-Brunn’s nests. This case shows that carcinoma of UB can show diverse differentiations into numerous histological types and variants, and can express KIT and PDGFRA. The both genes showed no mutations in the present case.
Urinary bladder urothelial carcinoma with expression of KIT and PDGFRA and showing diverse differentiations into plasmacytoid, clear cell, acantholytic, nested, and spindle variants, and into adenocarcinoma, signet-ring cell carcinoma, small cell carcinoma, large cell carcinoma, and pleomorphic carcinoma.
Various tumors can arise in the urinary bladder (UB); most common is urothelial carcinoma (UC). UC of the UB have many variants. Other types of carcinomas such as adenocarcinoma (AC) and small cell carcinoma (SmCC) can occur in UB carcinomas. Expression of KIT and PDGFRA has not been reported. A 66-year-old man admitted to our hospital because of hematuria. Cystoscopy revealed papillary invasive tumor and a transurethral bladder tumorectomy (TUR-BT) was performed. The TUR-BT showed UC, AC, SmCC, large cell carcinoma (LCC), and pleomorphic carcinoma (PC). The UC component showed plasmacytoid, spindle, nested, clear cell, acantholytic variants. The AC element showed tubular adenocarcinoma and signet-ring cell carcinoma (Sig). Immunohistochemically, all of these subtypes were positive for cytokeratin (CK) AE1/3, CK CAM5.2, CK34BE12, CK5, CK6, CK7, CK8, CK18, CK19, CK20, EMA, CEA, p63, CA19-9, p53 (positive 45%), MUC1, NSE, NCAM, KIT, PDGFRA, and Ki-67 (87%). They were negative for vimentin, chromogranin, synaptophysin, S100 protein, CD34, CD14, ?-smooth muscle actin, CD31, caldesmon, CD138, CD45, ?-chain, ?-chain, MUC2, MUC5AC and MUC6. Mucin histochemistry revealed mucins in AC element including Sig. A molecular genetic analysis using PCR-direct sequencing method identified no mutations of KIT (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) genes. The carcinoma was highly aggressive and invaded into muscular layer. The nuclear grade was very high, and there were numerous lymphovascular permeations were seen. The surface showed carcinoma in situ involving von-Brunn's nests. This case shows that carcinoma of UB can show diverse differentiations into numerous histological types and variants, and can express KIT and PDGFRA. The both genes showed no mutations in the present case. PMID:23696935
Hepatocellular carcinoma is a common and aggressive malignancy the world over. Metastasis commonly occurs in lungs, bone, lymph node and adrenals. Skeletal muscle metastases from any primary is a rare occurrence, those occurring from hepatocellular carcinoma even more so. We present a case of a 61-year-old man presenting with hepatocellular carcinoma with synchronous symptomatic metastasis to the skeletal muscle. This article discusses approach to hepatocellular carcinoma with skeletal muscle metastases aetiopathogenesis, differential diagnosis and approach to treatment. PMID:24057331
Subramaniam, Narayana; Hiremath, Bharati; Pujar, Anupama
Malignant skin tumors, including squamous cell carcinoma and malignant melanoma, have occurred in tattoos. Seven documented cases of basal cell carcinoma associated with tattoos have also been reported in the medical literature. We encountered a patient with basal cell carcinoma in a tattooed eyebrow. We report on this case as the eighth reported case of a patient with basal cell carcinoma arising in a tattooed area.
Lee, Jong-Sun; Park, Jin; Kim, Seong-Min; Kim, Han-Uk
Two separate primary carcinomas occurring simultaneously in the esophagus and stomach are uncommon. The authors report three cases of this entity, squamous cell carcinoma of the osophagus and adenocarcinoma of the stomach, one of which is classified as a collision carcinoma of the stomach. Because of the rarity of collision tumors of this histologic variety, the world literature was reviewed. Diagnostic features and the relative prognosis of dual primary carcinomas are discussed. ImagesFigure 1Figure 2
Lim, Sook K.; Sampson, Calvin C.; Warner, Oswald G.
This investigation was designed to study the myoepithelium of the human mammary carcinoma. Tissues were obtained from 30 infiltrating ductal carcinomas. Under light microscope, there were no significant changes noted in the myoepithelium. Glutaraldehyde-fixed tissues were examined under electon microscope. In infiltrating carcinoma the myoepithelial cells contained increased endoplasmic reticulum, abundant microfilaments, secretory granules and intracytoplasmic duct formation. This observation suggests that myoepithelium takes an important and active role in the infiltrating stage of the human mammary carcinoma. PMID:6252391
Mucoepidermoid carcinoma in the external auditory canal is extremely rare. Strategies used for treatment of mucoepidermoid carcinoma remain controversial. We present a case of mucoepidermoid carcinoma of the external auditory canal. The patient underwent lateral temporal bone resection and the surgical defect was obliterated with temporal muscle. He is currently disease-free, four years after surgery. Proper diagnostic measures and strategy for treatment of mucoepidermoid carcinoma are discussed. PMID:23341793
Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Tae, Kyung
Mucoepidermoid carcinoma in the external auditory canal is extremely rare. Strategies used for treatment of mucoepidermoid carcinoma remain controversial. We present a case of mucoepidermoid carcinoma of the external auditory canal. The patient underwent lateral temporal bone resection and the surgical defect was obliterated with temporal muscle. He is currently disease-free, four years after surgery. Proper diagnostic measures and strategy for treatment of mucoepidermoid carcinoma are discussed.
Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won
Dedifferentiated adenoid cystic carcinomas are a recently defined, rare variant of adenoid cystic carcinomas characterized histologically by two components: conventional low-grade adenoid cystic carcinoma and high-grade “dedifferentiated” carcinoma. We examined six cases and analyzed their clinicopathologic profiles, including immunohistochemical features and p53 gene alterations. The 6 patients (3 men and 3 women) had a mean age of 46.8 years (range,
Toshitaka Nagao; Thomas A Gaffey; Hiromi Serizawa; Isamu Sugano; Yasuo Ishida; Kazuto Yamazaki; Ryoji Tokashiki; Tomoyuki Yoshida; Hiroshi Minato; Paul A Kay; Jean E Lewis
Lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia are rare lesions, found incidentally in breast biopsies. They have been regarded traditionally as high-risk lesions, but recent genetic evidence and follow-up data indicates that they also constitute nonobligate precursors of invasive carcinoma. In addition to 16q deletion, a genetic alteration common across the spectrum of low-grade mammary epithelial neoplasia, lobular lesions consistently demonstrate deletion or functional inactivation of the CDH1/E-cadherin gene, with consequent loss of membranous immunoreactivity for the same antigen. The use of E-cadherin in the evaluation of solid mammary carcinoma in situ with ambiguous morphology has identified variants of LCIS characterized by massive acinar expansion and necrosis with calcifications, and/or marked nuclear pleomorphism or signet ring cell formation. In contrast to classic LCIS, these rare lesions are detected mammographically and often occur in association with invasive carcinoma. Genetic analysis of these tumors has confirmed lobular lineage and demonstrated more extensive chromosomal alterations than in classic LCIS. A pleomorphic variant of invasive lobular carcinoma has also been described. Here, we summarize our evolving knowledge of in situ and invasive lobular neoplasia and highlight the implications for patient management. PMID:21050299
Brogi, Edi; Murray, Melissa P; Corben, Adriana D
Micropapillary carcinoma is regarded as an aggressive variant of adenocarcinoma in any location. It is histologically characterized by papillary cell clusters surrounded by clear spaces. The reported proportion of micropapillary carcinoma component in the entire tumor ranges from 5-80% and no pure cases have been reported. To date, there are approximately 130 cases reported in the colorectum. We recently examined a patient with a pure micropapillary carcinoma showing co-expression of CK7, CK20, and absence of CDX2, which had an aggressive tumor with extensive perineural, vascular, and lymphatic invasion as well as extensive nodal metastasis. The presence of a micropapillary carcinoma in the colorectum seemed to be closely related with nodal metastasis, as observed in micropapillary carcinomas from other organs. Thus, if a micropapillary component is identified in a tumor, particularly in a biopsy specimen, extensive surgical resection should be considered due to the high potential for nodal metastasis, even if the preoperative diagnosis is a pedunculated early colorectal cancer. PMID:22089678
Lino-Silva, Leonardo Saúl; Salcedo-Hernández, Rosa Angélica
Oncolytic herpes simplex viruses (HSV) have demonstrated potent antitumoral effects against a variety of human malignancies in preclinical studies and are in early clinical trials. We explored the activity of an attenuated, replication-competent, oncolytic HSV (NV1023) for the treatment of human salivary gland carcinomas. NV1023 was able to successfully enter into 4 mucoepidermoid carcinoma (H292, H3118, HTB-41, UT-MUC-1) and 2 adenocarcinoma (HSY, HSG) cell lines, as measured by lacZ assays after exposure to 5 viral particles per cell (MOI 5). Viral plaque assays showed variation of viral replication within these cell lines, ranging from a 268-fold increase (H292) to a 3-fold increase (HSG) in viral titer. At MOI 5, all cell lines showed >95% cytotoxicity from NV1023 by Day 7, except for HSY (73%). At MOI 0.1, H3118 and UT-MUC-1 remained highly sensitive to NV1023, both showing >95% cytotoxicity by Day 7. The mucoepidermoid carcinomas were more sensitive to NV1023 at low viral concentrations compared with the adenocarcinomas. Flank tumors of H3118, HTB-41 and HSY in nude mice showed significant tumor volume reductions after a single intratumoral injection of NV1023 (2 x 10(7) plaque-forming units). These data suggest that oncolytic herpes viruses have significant efficacy entering, replicating within, and lysing human salivary gland carcinomas. These promising biologic agents should be further investigated as novel therapy for patients with salivary carcinomas failing conventional treatment. PMID:17764117
Reid, Vincent; Yu, Zhenkun; Schuman, Theodore; Li, Sen; Singh, Paramjeet; Fong, Yuman; Wong, Richard J
Renal cell carcinoma is characterized by intense angiogenesis associated with the inactivation of the von Hippel-Lindau oncosuppressor gene with consequent hyperexpression of proangiogenic factors. Functional and molecular characterization of renal tumor endothelial cells has demonstrated an increase in angiogenesis and cell survival. The proangiogenic phenotype was due to hyperactivation of the PI3K/Akt/mTor pathway, which downregulates the synthesis of the antiangiogenic factor thrombospondin-1. Moreover, renal tumor endothelial cells presented an immature and embryonic phenotype with expression of the embryonic kidney-specific gene PAX-2. It is conceivable that the endothelium present in renal carcinoma is heterogeneous, with a possible origin from adjacent vessels, resident or circulating stem cells, or from the tumor cells themselves. The relevance of the angiogenic process in renal carcinoma is underlined by the therapeutic effect of antiangiogenic drugs. Different drugs against VEGF, such as the anti-VEGF monoclonal antibody bevacizumab, and small molecule tyrosine-kinase inhibitors, such as sunitinib and sorafenib, showed a clinical effect in patients with metastatic carcinoma. However, antiangiogenic therapy, although beneficial, is not sufficient per se. These studies suggest a role for the angiogenic program in the growth and dissemination of renal carcinoma and indicate the need for new therapeutic strategies. PMID:18473301
Bussolati, B; Satolli, M A; Camussi, G
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.
Aly, Fatima Zahra; Tabbarah, Abeer Z.; Voltaggio, Lysandra
The spectroscopic characteristics of autofluorescence for the nasopharyngeal carcinoma in vitro and nasopharyngeal carcinoma cells (CNE cells) were investigated, respectively. The characteristics of fluorescence agree with the results that deduced from the nasopharyngeal carcinoma in vivo, and the optimal excitation-emission wavelength was found at 350-500 nm. Secondly, the selectivity and optimal time for optical diagnosis of nasopharyngeal carcinoma by using the new photosensitizer of Hematoporphyrin Monomethyl Ether (HMME) has been demonstrated and determined by incubated CNE cells with HMME. The fluorescence emission peaks of 615 and 675 nm characterized the selective accumulation of HMME in CNE cells, and the optimal time for optical diagnostics with HMME was about 140 mins after clinic intravenous administration. Moreover, when the concentration of HMME in CNE cells below 32 ?g/mL, the fluorescence intensity versus HMME concentration reveals an obvious linearity. Finally, the fluorescence intensity of CNE cells increases linearly with concentration over the entire range up to 9.0E+05 cells/mL. These results can be used to helpfully improve the accuracy of optical diagnosis for nasopharyngeal carcinoma.
Li, Buhong; Zhang, Zhenxi; Xie, Shusen; Lin, Huiyun
Metaplastic carcinoma of the breast refers to a heterogenous group of mammary carcinomas that contain a mixture of various cell types, including squamous cells, spindle cells and/or a mesenchymal component, such as bone or cartilage. To the best of our knowledge, the clinical course of a tumour that has undergone a transformation from one type of metaplastic carcinoma to another subtype has not previously been reported. The present study reports the five-year clinical and pathological course of a metaplastic breast carcinoma in a 55-year-old female, who was diagnosed with a sclerosing fibroadenomatous nodule with osseous metaplasia and focal atypia. A recurrent tumour was documented four years later, showing a predominant component of osteosarcoma with adenosquamous carcinoma. Upon pathological review of the initial mass, the diagnosis was changed to low-grade adenosquamous carcinoma. The patient was treated with breast conserving therapy. However, one year later, a recurrent metaplastic carcinoma with spindle cell morphology was documented and surgically removed by mastectomy. Subsequently, pulmonary invasion of the chest wall occurred and the patient eventually succumbed due to the invasive nature of the disease.
CHUTHAPISITH, SUEBWONG; WARNNISSORN, MALEE; AMORNPINYOKIAT, NATTAWUT; PRADNIWAT, KANAPON; ANGSUSINHA, TAMNIT
Thymic carcinoma is an unusual neoplasm, and the undifferentiated type is rare. Thymic carcinoid is also rare. This report describes a patient with coexisting undifferentiated thymic carcinoma and a carcinoid tumor. Both lesions were completely excised. The carcinoid cells showed argyrophilic granules by Grimelius’ method and immunoreactivity against neuron-specific enolase, whereas the undifferentiated carcinoma cells were negative for argyrophilic stain
K. Sensaki; S. Aida; K. Takagi; H. Shibata; T. Ogata; S. Tanaka; S. Tamai
Adenoid cystic carcinoma (ACC), which is a subtype of the nonpapillary adenocarcinoma of the thymus, is extremely rare. We report a patient with thymic carcinoma with ACC-like features presented with multiple bone and pulmonary metastases that underwent surgery. The present case firstly demonstrated that thymic carcinoma with ACC-like features could have metastatic potential. PMID:22572229
Kanzaki, Ryu; Ikeda, Naoki; Okura, Eiji; Kitahara, Naoto; Okimura, Akira; Kawahara, Kunimitsu; Ohta, Mitsunori
Background. Thymic carcinoma is a rare, indolent, and invasive cancer. This study investigated the treatment results of thymic carcinoma and clinical prognostic factors. Methods. From June 1988 to January 2002, 38 patients were enrolled in this study with the diagnosis of thymic carcinoma in the Cheng-Kung University Hospital based on Rosai's and Muller-Hermelink's classification. Clini- cal and pathologic data were
Yau-Lin Tseng; Shan-Tair Wang; Ming-Ho Wu; Mu-Yen Lin; Wu-Wei Lai; Fen-Fen Cheng
Background: Thymic carcinomas are currently staged by Masaoka classification, a staging system for thymomas. We retrospectively evaluated surgical patients with thymic carcinoma to determine prognostic factors and to evaluate the usefulness of Masaoka staging in this disease.Methods: Our computerized tumor registry yielded 118 patients with thymoma. Review of pathologic material revealed 43 cases of thymic carcinoma. Collection of data was
David Blumberg; Michael E. Burt; Manjit S. Bains; Robert J. Downey; Nael Martini; Valerie Rusch; Robert J. Ginsberg
The diagnosis of DCIS is not always straightforward. Many studies have illustrated the central problem in diagnosing DCIS, which is that the heterogeneity of the disease allows it to be easily confused with a variety of other diseases, such as atypical ductal hyperplasia (ADH), microinvasive carcinoma, invasive carcinoma, lymphatic invasion, lobular carcinoma in situ (LCIS), and other intraductal lesions.
Two patients with anaplastic carcinoma of the thyroid following irradiation for Hodgkin's disease are presented, and the previously reported cases briefly reviewed. The risk of late development of thyroid carcinoma is life-long and high-dose irradiation in patients with prolonged life expectancy may result in anaplastic carcinoma as well as less malignant histological forms.
E. Paul Gétaz; Katsutaro Shimaoka; Umo Rao
"Dedifferentiation" and/or high-grade transformation (HGT) has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, adenoid cystic carcinoma, epithelial-myoepithelial carcinoma, polymorphous low-grade adenocarcinoma, myoepithelial carcinoma, low-grade mucoepidermoid carcinoma and hyalinizing clear cell carcinoma, although the phenomenon is a rare event. Recent authors tend to preferably use the term HGT instead of "dedifferentiation" in these cases. HGT-tumors are composed of conventional carcinomas juxtaposed with areas of HG morphology, usually either poorly differentiated adenocarcinoma or "undifferentiated" carcinoma, in which the original line of differentiation is no longer evident. The HG component is generally composed of solid nests, sometimes occurring in cribriform pattern of anaplastic cells with large vesicular pleomorphic nuclei, prominent nucleoli and abundant cytoplasm. Frequent mitoses and extensive necrosis is evident. The Ki-67 labeling index is consistently higher in the HG component. p53 abnormalities have been demonstrated in the transformed component in a few examples, but the frequency varies by the histologic type. HER-2/neu overexpression and/or gene amplification is considerably exceptional. The molecular-genetic mechanisms responsible for the pathway of HGT in salivary gland carcinomas largely still remain to be elucidated. Salivary gland carcinomas with HGT have been shown to be more aggressive than conventional carcinomas with a poorer prognosis, accompanied by higher local recurrence rate and propensity for cervical lymph node metastasis, suggesting the need for wider resection and neck dissection. PMID:23821210
Invasive micropapillary carcinoma is associated with frequent lymph node metastasis and adverse clinical outcome. Initially described as a variant of breast and ovarian carcinoma, it has subsequently been found in other organs, most recently the colon. Reports of colorectal micropapillary carcinoma to date are limited in number, and their molecular profile has not been established. The aims of the present
Montse Verdú; Ruth Román; Miquel Calvo; Natŕlia Rodón; Beatriz García; Marta González; August Vidal; Xavier Puig
OBJECTIVE. Breast carcinomas may contain varying quantities of extracellular mucin. The purpose of this study was to correlate the mammographic and sono- graphic appearance of mucin-containing carcinomas of the breast with the histologic features of these tumors. MATERIALS AND METHODS. The tumor registry and breast imaging files at our institution identified 34 women with 37 mucin-containing breast carcinomas for which
E. F. Conant; R. L. Dillon; J. Palazzo
Acinar cell carcinoma of the pancreas is a rare malignant tumour developing from acinar cells, accounting for approximately 1% of pancreatic exocrine tumours. We experienced a case of an acinar cell carcinoma with fatty change. To the best of our knowledge, this is the first case report of an acinar cell carcinoma with fatty change in the clinical literature.
Chung, W-S; Park, M-S; Kim, D W; Kim, K W
ObjectiveThree groups of “high-risk” ovaries have previously been studied for possible precursors of ovarian carcinoma: ovaries removed prophylactically from women at high risk, normal ovaries contralateral to a unilateral ovarian carcinoma, and normal ovarian tissue found adjacent to primary ovarian carcinomas. No data are available for a fourth high-risk group: normal-sized ovaries from women with primary peritoneal serous carcinoma.
Jeffrey D. Seidman; Brant G. Wang
This is the third part of a review of the clinicopathologic features of intraosseous carcinoma of the jaws (IOCJ). In parts 1 and 2, we discussed metastatic and salivary-type and odontogenic carcinomas, respectively. This part deals with primary intraosseous squamous cell carcinoma. Again, based on a critical approach, we emphasize histopathologic features, diagnostic difficulties, discuss histogenesis, and highlight areas of uncertainty. The 3-part review also offers speculations on how future studies may refine our understanding of the unusual and interesting IOCJ. PMID:22290827
Woolgar, Julia A; Triantafyllou, Asterios; Ferlito, Alfio; Devaney, Kenneth O; Lewis, James S; Rinaldo, Alessandra; Slootweg, Pieter J; Barnes, Leon
FA (Fanconi's Anemia) is an autosomal recessive disorder that is characterized by pancytopenia with bone marrow hypoplasia, diverse congenital abnormalities and an increased predisposition towards malignancy. The mainstay of the treatment for these cancers has been surgery, because of the hypersensitive reactions of FA patients to DNA cross- linking agents or radiation. Therefore, there has been no effective therapy for advanced squa mous cell carcinoma. We report here on a patient suffering from advanced multiple squamous cell carcinoma and hepatocellular carcinoma along with an FA, and this patient was treated with gefitinib.
Jung, Hae Sun; Byun, Gun-Woo; Lee, Kyoung-Eun; Mun, Yeung Chul; Nam, Seung Hyun; Kwon, Jung Mi; Lee, Shi Nae; Im, Seock-Ah; Seong, Chu-Myong
In medicinal chemistry, one of the most studied molecules in recent history is taxol. Taxol is a versatile natural product that is used in various cancer treatment regimens. It is administered to patients with breast, lung, and ovarian cancers, and is currently being studied for the treatment of squamous cell carcinoma of the oral cavity and tongue. Taxol has been tested in a number of research and clinical phase trials to determine feasibility, toxicity, and cytotoxicity against oral squamous cell carcinoma as a single drug regimen and as a contributing drug component in treatment plans. This paper reviews over forty articles that examine cell lines, murine models, and human results for the response of taxol against squamous cell carcinoma (SCC) of the oral cavity and the tongue. PMID:23373651
Ledwitch, Kaitlyn; Ogburn, Ryenne; Cox, Jodi; Graham, Rebekah; Fritzsche, Allison; Gosnell, Donna; Manning, Thomas
Unknown primary carcinoma presenting as cervical lymph node metastasis accounts for approximately 5% of all head and neck malignancies. The typical presentation involves a middle-aged man with a painless neck mass that has been present for several months. Over 90% of these malignancies represent squamous cell carcinoma originating within Waldeyer's ring (lymphoid tissue of the nasopharynx, tonsil, and base of tongue). The remainder are comprised of adenocarcinoma, melanoma, and other rare histologic variants. The ability to identify the occult primary tumor is imperative because identification allows site-specific therapy and avoidance of wide-field radiation side effects. Following confirmation of metastatic cervical disease with fine-needle aspiration, all patients presenting with an unknown primary carcinoma require a thorough head and neck history and physical examination, radiographic imaging, panendoscopy with directed biopsies of Waldeyer's ring, and bilateral tonsillectomy. Positron emission tomography has proved helpful in identifying occult primary tumors of the head and neck region. PMID:17288881
Schmalbach, Cecelia E; Miller, Frank R
Pituitary carcinomas, defined as distant metastases of a pituitary neoplasm, are rare; fewer than 140 reports exist in the English literature. The initial presenting pituitary tumor is usually a secreting, invasive macroadenoma, with adrenocorticotropic hormone (ACTH)--and prolactin (PRL)--secreting tumors being the most common. The latency period between the diagnosis of a pituitary tumor and the diagnosis of a pituitary carcinoma is 9.5 years for ACTH-producing lesions and 4.7 years for PRL-secreting tumors. Survival after documentation of metastatic disease is poor; 66% of patients die within 1 year. Treatment options include additional surgery, radiotherapy, and chemotherapy, all of which are associated with poor results. Future studies will focus on identifying those invasive pituitary tumors most likely to metastasize and treating them aggressively before they progress to pituitary carcinomas. PMID:15191336
Ragel, Brian T; Couldwell, William T
Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Jung, Jae Ho; Shin, Dong Hoon; Cho, Kyu Sup
The gene expression profiles of human thyroid carcinomas were analysed by serial analysis of gene expression (SAGE) which allows quantitative and simultaneous analysis of a large number of transcripts. More than 29 000 transcripts derived from a normal thyroid tissue and four thyroid tumours were analysed. While extensive similarity was noted between the expression profiles of the normal thyroid tissue and three differentiated thyroid tumours, many transcripts, such as osteonectin, a-tubulin, glyceraldehyde-3-phosphate dehydrogenase, glutathione peroxidase, and thyroglobulin, were expressed at extremely different levels in differentiated and undifferentiated carcinomas. These data provide new information that might be used to identify genes useful for the diagnosis and treatment of thyroid carcinomas. © 2000 Cancer Research Campaign http://www.bjcancer.com
Takano, T; Hasegawa, Y; Matsuzuka, F; Miyauchi, A; Yoshida, H; Higashiyama, T; Kuma, K; Amino, N
Primary gallbladder carcinoma is a malignant neoplasm with an incidence of 1.2 cases per 100 000 people each year. Its occurrence increases with age, particularly in women. It is the fifth most common cancer of the gastrointestinal tract, and the most common malignancy in the biliary tract. Adenocarcinoma is the most common type of gallbladder neoplasm whereas sarcomatoid carcinoma is rare with an incidence of less than one percent of all malignant gall bladder neoplasms. Sarcomatoid carcinomas are composed of malignant epithelial and sarcomatous components, sometimes with heterologous sarcomatous elements. In general, conservative treatments are thought to be unfavourable to the tumor. Prognosis is poor following curative resection for carcinosarcoma of the gall bladder because of recurrence as systemic metastasis of the liver and peritoneal dissemination.
Kataria, K; Yadav, R; Seenu, V
Gastric endocrine cell carcinoma is rare and associated with a poor prognosis. The first case was a man in his sixties with gastric endocrine cell carcinoma, of which a clinical finding was T2N1M0H1 (Stage IV). S-1 + CDDP therapy was selected and failed. CDDP+CPT-11 therapy was started and CT showed a partial response in ten months. But the tumor was re-grown and the patient died twenty months after diagnosis. The second case was a man in his seventies with gastric endocrine cell carcinoma, of which a clinical finding was T3N1M0H0P0, Stage IIIa, underwent total gastrectomy. Abdominal contrast-enhanced CT scan performed a month after the operation disclosed hepatic metastasis. After two months of S-1 regimen, CDDP + CPT-11 therapy was started. PMID:21224621
Nakano, Shiro; Shomura, Hiroki; Akabane, Hiromitsu; Inagaki, Mitsuhiro; Yanagida, Naoyuki
BACKGROUND: Sinonasal undifferentiated carcinoma (SNUC) is an uncommon neoplasm characterized by local extension and an aggressive course. Treatment often includes a combination of chemotherapy, radiation therapy, and surgery, although the optimal strategy remains unclear. Here, we present the first reported case of leptomeningeal carcinomatosis from SNUC. METHODS AND RESULTS: A 28-year-old man with rapidly progressive headaches, congestion, and exophthalmos was found to have a nasal mass. Biopsy revealed sinonasal undifferentiated carcinoma. He had a transient response to chemotherapy followed by a sustained response to concurrent chemoradiation. At the completion of radiation, he developed subtle neurologic findings and MRI revealed diffuse, bulky leptomeningeal spread. He was able to receive only a single fraction of external beam radiation to his spinal axis before his disease rapidly progressed, leading to respiratory failure and death. CONCLUSIONS: Sinonasal undifferentiated carcinoma can be associated with leptomeningeal carcinomatosis, which can lead to a fulminant clinical course. Head Neck, 2012. PMID:23471826
Liu, Stephen V; Wagle, Naveed; Zada, Gabriel; Sun, Bonnie; Go, John; Rashtian, Afshin
Sebaceous gland carcinoma, commonly arises in the periocular area, is an uncommon condition. It represents 1–5.5% of eyelid malignancies and is considered to be the third most common eyelid malignancy after basal cell and squamous cell carcinomas, although few reports placed this tumor as second most common after basal cell carcinoma. It usually affects elderly women and characterized by high rate of local recurrence, regional, and distant metastases. A delay in diagnosis, which can be attributed primarily to ability of this tumor to masquerade as more benign conditions, often leads to inappropriate management with increased morbidity and mortality rates. In this study, the authors discuss key elements of the primary disease and therapeutic options available to treat such devastating problem.
Wali, Upender K.; Al-Mujaini, Abdullah
\\u000a Abstract The most important factor to consider in decision making for treatment of patients with bone metastases from carcinoma is\\u000a the expected survival.\\u000a \\u000a For this reason it seems important to identify reliable prognostic factors in patients with bone metastases from carcinoma\\u000a in order to predict long survivors requiring a more aggressive and durable surgical treatment.\\u000a \\u000a \\u000a \\u000a The most significative prognostic factors resulted
D. A. Campanacci; G. Scoccianti; G. Beltrami; P. De Biase; R. Capanna
Objective To present an update on anti-angiogenic drugs in the treatment of metastatic renal cell carcinoma.\\u000a \\u000a \\u000a \\u000a Recent findings A better understanding of molecular pathways that are involved in clear cell carcinomas has led to the development of multiple\\u000a targeted therapies with significant clinical benefits. Two tyrosine kinase inhibitors targeting the vascular endothelial growth\\u000a factor (VEGF) receptor have been shown to improve the
Jean-Jacques Patard; Damien Pouessel; Karim Bensalah; Stéphane Culine
Background The goal of the present study was to make our medical practice evidence-based for patients with parathyroid carcinoma.\\u000a \\u000a \\u000a \\u000a Methods We posed six clinical questions relevant to the management of parathyroid cancer. A comprehensive search and critical appraisal\\u000a of the literature was then carried out.\\u000a \\u000a \\u000a \\u000a Results Most of the literature retrieved was retrospective in design and differed in the definition of carcinoma. The
Takahiro Okamoto; Masatoshi Iihara; Takao Obara; Toshihiko Tsukada
The authors have encountered four cases of oil aspiration pneumonia complicated by carcinoma. Each had a clear-cut history of chronic intake of an oily substance, radiographic changes, and histologically documented oil aspiration pneumonia. Lung cancer later appeared in the involved area. A small number of similar cases also have been reported. The implication is that oil aspiration pneumonitis may induce bronchogenic carcinoma, particularly either the alveolar cell or the squamous cell variety. The radiographic diagnosis of the malignant transformation is difficult, and consequently the prognosis is poor.
Felson, B.; Ralaisomay, G.
Metastatic tumours of the oral cavity are uncommon, they may occur in soft tissue as well as in bone in the oropharyngeal region. Owing to its rarity, metastatic tumours of the oral regions are a challenge to diagnose. We report a case of metastasis of the oral cavity, arising from uterine cervix mimicking as mucoepidermoid carcinoma. The metastatic lesions were noticed in the soft tissue of the lower buccal and gingival side of a oral cavity, in a 40-year-old woman with history of an adenosquamous carcinoma of uterine cervix treated by panhysterectomy. PMID:23771978
Ram, Hari; Kumar, Manoj; Bhatt, M L B; Shadab, Mohammad
Ameloblastic carcinomas are rare odontogenic tumors. Treatment usually consists of surgical resection and sometimes adjuvant radiation. We report the case of a 71 year-old male patient undergoing carbon ion therapy for extensive local relapse of ameloblastic carcinoma. Treatment outcome was favourable with a complete remission at 6 weeks post completion of radiotherapy while RT-treatment itself was tolerated well with only mild side effects. High dose radiation hence is a potential alternative for patients unfit or unwilling to undergo extensive surgery or in cases when only a subtotal resection is planned or the resection is mutilating.
Renal cell carcinoma (RCC) is well known for its propensity to metastasize to unusual sites. Metastasis to the gall bladder (GB) has been reported in the literature rarely. We herein report an interesting case of metastatic RCC, which presented with cholecystitis. Gall bladder is a rare site of metastasis of RCC. Polypoid lesions of the GB in patients who have a synchronous or a prior history of RCC should be considered as metastatic lesions. It needs to be differentiated from primary clear cell carcinoma of the GB with the help of immunohistochemistry. PMID:23354202
Jain, Deepali; Chopra, Prem
Fibrolamellar hepatocellular carcinoma (FLH) is a variant of hepatocellular carcinoma (HCC) with distinct clinical, histologic and prognostic features different from conventional HCC. Herein, we present a 14-year-old girl with a palpable mass over the right upper -quadrant of the abdomen. A well-defined mass in the left liver with heterogeneous density and a central linear band was demonstrated by ultrasound and computed tomogram. FLH was proved by the histopathology study of a liver specimen taken from an echo-guided liver core needle biopsy before surgery and from a left hepatectomy. No tumor recurrence was detected by ultrasound in the 2-year follow-up. PMID:19527614
Yen, Ju-Bei; Chang, Kuei-Wen
Fibrolamellar hepatocellular carcinoma (FLHC) is recognized as a distinct clinicopathologic variant of hepatocellular carcinoma.\\u000a Ten consecutive patients with FLHC undergoing operative management at our institution were reviewed. At the initial presentation\\u000a seven patients had stage II disease (pT2N0M0), whereas three patients were in stage III (pT2N0M0 or pT3N0M0). Initial procedures included formal right or left hepatectomy in four patients, right
Alan W. Hemming; Bernard Langer; Patricia Sheiner; Paul D. Greig; Bryce R. Taylor
Thymic carcinoma (TC) is a rare intrathoracic malignancy that it can be invasive and refractory to conventional treatment. Comprehensive genomic analysis evidenced a molecularly distinct subset of thymic carcinoma with high prevalence of c-kit mutation, which may behave as a gastrointestinal stromal tumor (GIST). Here, we present a case report of TC with c-Kit mutation, who has relapsed after exposure to multiple lines of combination chemotherapy, but he has shown an impressive and long lasting response to sunitinib after imatinib failure. PMID:23375402
Rossi, Valentina; Donini, Maddalena; Sergio, Pietro; Passalacqua, Rodolfo; Rossi, Giulio; Buti, Sebastiano
Eccrine carcinoma is an extremely rare malignancy of the skin with few well documented cases reported in the literature. It is frequently found on the lower extremities, and it equally affects both sexes in the sixth and seventh decade. In our case, we present a 46- year-old female with a recurring exophytic tumor on the right lower extremity, without local extension. The initial tumor was biopsied, excised and diagnosed as an eccrine carcinoma. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3568051328673318.
Apocrine carcinoma of the breast is a rare, special type of breast carcinoma showing distinct morphologic, immunohistochemical and molecular genetic features. Apocrine epithelium has a characteristic steroid receptor profile that is estrogen receptor and progesterone receptor negative and androgen receptor positive. This combination of morphologic and immunohistochemical characteristics is essential for the proper recognition of the apocrine carcinomas. Strictly defined, apocrine carcinomas express either Her-2/neu or EGFR, which along with androgen receptor positivity make patients with the apocrine carcinoma eligible for targeted therapies. PMID:23771415
Vranic, Semir; Schmitt, Fernando; Sapino, Anna; Costa, Jose Luis; Reddy, Sandeep; Castro, Michael; Gatalica, Zoran
Association between progressive systemic sclerosis (PSS) and lung malignancy is rare yet well recognised. In order of frequency bronchioloalveolar carcinoma (BAC) is most common followed by squamous cell carcinoma, oat cell carcinoma, anaplastic carcinoma of lung. We present a 55 year old non-smoker male patient with PSS, who presented to us with progressively increasing shortness of breath and dry cough. Initially clinico-radiologically he was provisionally diagnosed as a case of non-resolving pneumonia. Subsequent investigations revealed it is a case of squamous cell carcinoma of lung with PSS. PMID:23781672
Kundu, Susmita; Mitra, Ritabrata; Misra, Swapnendu; Chatterjee, Sumit
Papillary thyroid carcinoma is the most common form of differentiated thyroid carcinoma. It is generally confined to the neck with or without spread to regional lymph nodes. Metastatic thyroid carcinomas are uncommon and mainly include lung and bone. Metastases involving oral and maxillofacial region are extremely rare. We described a case of malar metastasis revealing a follicular variant of papillary thyroid carcinoma, presenting with pain and swelling of the left cheek in a 67-years-old female patient with an unspecified histological left lobo-isthmectomy medical history. To our knowledge, this is the first recorded instance of a malar metastasis from a follicular variant of papillary thyroid carcinoma.
Slim, Ihsen; Mhiri, Aida; Meddeb, Imene; Goucha, Aida; Gritli, Said; Ben Slimene, Mohamed Faouzi
Combined large cell neuroendocrine carcinoma of the lungs (combined LCNEC) with giant cell carcinoma is extremely rare. A 65-year-old man was found to have an abnormal shadow in his left lung field. Computed tomography revealed a solid, round mass measuring 2.8 × 2.2 cm that was located in the left S9. The patient underwent left lower lobectomy and mediastinal lymph node dissection. Histopathological examination revealed an LCNEC, combined with giant cell carcinoma. The patient received by S-1 (TS-1, an oral fluoropyrimidine) chemotherapy, and he has been disease-free for over 8 months. Combined LCNEC with giant cell carcinoma is an extremely rare tumor with high malignant potential, and thus, multidisciplinary therapy and close follow-up are advised. PMID:23957954
Hayashi, Satoshi; Kitada, Masahiro; Ishibashi, Kei; Matsuda, Yoshinari; Miyokawa, Naoyuki
The cDNA microarrays allows the classification of breast cancers into 6 groups: luminal A, luminal B, luminal C, normal breast-like, human epidermal growth factor receptor 2-positive, and basal-like. This latter is characterized by the expression of basal cytokeratins (CKs), and frequent negativity for hormone receptors and human epidermal growth factor receptor 2. There is a marked parallelism between triple negative breast carcinomas and basal-like carcinoma, but these are not equivalent terms. Estimated concordance is around 80%. CK5 seems to be the best marker for the identification of these tumors. Other good markers to identify these tumors are CK14, CK17, and epidermal growth factor receptor. A subset of triple negative breast carcinomas has myoepithelial differentiation, with positivities for smooth muscle actin, p63, S-100, and CD10 among others. Recent studies suggest that basal like carcinomas are originated from mammary stem cells. PMID:19620842
Lerma, Enrique; Barnadas, Agusti; Prat, Jaime
This article sums up the histochemical and immunohistochemical study of 55 cases of gastric carcinoma and 21 controls with benign gastric lesions. The results showed most of the adjacent mucosa of gastric carcinoma developed incomplete type intestinal metaplasia (IM). The percentage of Type IIb (ie, secreting sulphomucin) reached 72.5%. In most cases, high iron diamine (HID) rose in cancerous tissue and concomitantly in the IM epithelium of the adjacent gastric carcinoma. The phenomena of separation condition of HID+ in cancerous tissue, HID- in IM epithelium surrounding carcinoma, or HID- in cancerous cell but HID+ in IM of the surrounding epithelium of carcinoma, were much fewer. The two kinds of mucin antigen distribution were observed simultaneously. In the control and gastric carcinoma groups, neither large intestinal mucin antigen (LIMA) nor small intestinal mucin antigen (SIMA) could be detected in the normal epithelium of gastric mucosa. SIMA was mainly found in the goblet cells of IM and the mucous cells of columnar epithelium, while LIMA was mainly present in the columnar cells, in luminal border and/or in goblet cells. LIMA in the carcinoma group is apparently higher than that in the controls. The percentage of LIMA+ in the IM epithelium of adjacent gastric carcinoma and that in carcinoma cells were also raised in most cases. All these demonstrated a close relationship between IM and gastric carcinoma. Our results also showed that not only HID+, but also LIMA+ may represent a precancerous lesion in gastric carcinoma. PMID:2125255
Jiang, Y Q; Du, X X; Guo, S Y; Ma, Z
Morphologic distinction of high-grade adenoid cystic carcinoma from basaloid squamous cell carcinoma can be difficult. Equivocal diagnoses can mislead treatment. We have investigated the possibility that immunohistochemical staining for the presence of p63, a novel epithelial stem-cell regulatory protein, could be a useful means of distinguishing these two neoplasms. Archival, routinely processed slides were subjected to citrate-based antigen retrieval, exposure
Patrick Emanuel; Beverly Wang; Maoxin Wu; David E Burstein
We report a case of a morphologically unusual renal cell carcinoma with features of both chromophobe and papillary carcinoma.\\u000a Immunohistochemical analysis of high molecular weight cytokeratins (HMWCK), cytokeratin 7 (CK7), cytokeratin 19 (CK19), c-Kit,\\u000a and ?-methylacyl-CoA racemase (AMACR) demonstrated differential profiles for the two components of the tumor, consistent with\\u000a the respective patterns commonly observed for pure chromophobe and papillary
Michael H. A. Roehrl; Martin K. Selig; G. Petur Nielsen; Paola Dal Cin; Esther Oliva
The presence of pleomorphic tumor giant cells in thyroid carcinomas of follicular cell origin is always worrisome for the\\u000a pathologist as they first of all refer to anaplastic carcinoma, one of the most aggressive human malignancies. However, non-anaplastic\\u000a pleomorphic giant cells are well described in other thyroid diseases, most often benign. In this paper, we describe four cases\\u000a of papillary
Juliette Hommell-Fontaine; Angela Borda; Florence Ragage; Nicole Berger; Myriam Decaussin-Petrucci
Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor that has morphologic features similar to secretory carcinoma of the breast and that also harbors the same ETV6 translocation. Diffuse mammaglobin and S-100 immunoreactivity are used to differentiate MASC from its morphologic mimics, especially acinic cell carcinoma and adenocarcinoma, not otherwise specified. However, the combination of mammaglobin and S-100 immunoreactivity has not been well studied in other types of salivary gland carcinomas that may have focal areas reminiscent of MASC. Here we evaluated mammaglobin and S-100 immunoreactivity in 15 cases each of polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma and mucoepidermoid carcinoma, and also in 2 cases of adenocarcinoma, not otherwise specified, and 1 mucinous adenocarcinoma. Cases with significant co-expression of mammaglobin and S-100 (moderate or strong immunoreactivity in >25% of tumor cells) were further analyzed by fluorescence in situ hybridization using the ETV6 (12p13) break-apart probe. Nine cases (60%) of polymorphous low-grade adenocarcinoma and two (13.3%) of adenoid cystic carcinoma met the criteria for significant co-expression of mammaglobin and S-100. All were negative for the ETV6 translocation by fluorescence in situ hybridization. Although mammaglobin and S-100 positivity was seen in the majority of polymorphous low-grade adenocarcinomas and a minority of adenoid cystic carcinomas, none were positive for the ETV6 translocation characteristic of MASC. This indicates a need for caution in the use of immunohistochemistry for diagnosing MASC, especially in the absence of cytogenetic confirmation. PMID:24029710
Patel, Kalyani R; Solomon, Isaac H; El-Mofty, Samir K; Lewis, James S; Chernock, Rebecca D
Fibrolamellar carcinoma (FLC) of the liver is a rare variant of hepatocellular carcinoma (HCC), and only 13 cases have been reported in Japan up to 1997. We described a histologically unusual case of FLC. A 52-yr-old man was admitted to our hospital for work-up of hepatic mass. Laboratory examinations revealed no abnormalities except elevated serum alpha-fetoprotein (AFP) (2098 ng\\/ml). A
Akihiro Okano; Kiyoshi Hajiro; Hiroshi Takakuwa; Yoichiro Kobashi
The histopathologic type of lung cancer is known to be correlated with tumor behavior and prognosis. However, this classification is subjective and no specific molecular markers have been identified. The aim of this study was to identify protein markers in different types of nonsmall cell lung cancers. Two-dimensional polyacrylamide gel electrophoresis analysis was performed with paired samples of three squamous cell carcinomas, three adenocarcinomas, four large cell carcinomas, and four basaloid carcinomas. We found that 25 proteins in 14 cases of lung cancer were differentially expressed compared to matched nontumorous lung tissues. Among these 25 proteins, 11 proteins were down-regulated and 14 were up-regulated in these four types of lung cancer. Alloalbumin venezia, selenium-binding protein 1, carbonic dehydratase, heat shock 20KD-like protein, and SM22 alpha protein were down-regulated in all 14 cases of lung cancer examined, whereas alpha enolase was consistently up-regulated. Supervised hierarchical cluster analysis based on the 25 differentially expressed proteins showed that basaloid carcinoma formed one independent group, whereas the other three cancer types were not uniquely classifiable. Our findings suggest that basaloid carcinoma is a unique subtype of nonsmall cell lung carcinoma. PMID:15378762
Li, Long Shan; Kim, Hyunki; Rhee, Hwanseok; Kim, Se Hoon; Shin, Dong Hwan; Chung, Kyung Young; Park, Kang-Sik; Paik, Young-Ki; Chang, Joon; Kim, Hoguen
Received 15 July 2003 Abstract Objective. The present study investigates the influence of lymph node pathological features and HPV DNA status on the prognosis of vulvar invasive tumors. Methods. This study includes 184 consecutive cases of primary invasive squamous cell carcinoma of the vulva treated by radical surgery from 1975 to 1992, in Sao Paulo, Brazil. Clinical follow-up data was
Alvaro P. Pinto; Nicolas F. Schlecht; Javier Pintos; Jane Kaiano; Eduardo L. Franco; Christopher P. Crum; Luisa L. Villa
Maspin (mammary serine protease inhibitor) is a member of the serpin superfamily of protease inhibitors and it has a role as a tumor suppressor. Maspin has been reported to be important in processes relevant to tumor growth and metastasis such as cell invasion, angiogenesis, and apoptosis. A high expression of maspin was correlated with better rates of survival and absence of nodal metastases in head and neck squamous cell carcinoma. In contrast, some studies have shown that maspin overexpression is correlated with a poor prognosis in pancreatic and ovarian cancers and in lung adenocarcinoma. The aim of this study was an immunohistochemical evaluation of the maspin expression in oral squamous cell carcinoma and thus 89 patients were evaluated. Maspin expression in oral squamous cell carcinoma was significantly associated with the tumor differentiation grade (chi test: P = 0.0318) and the lymph node status (chi test: P < 0.005), but not with the tumor stage (chi test: P = 0.666). Metastatic involvement of lymph nodes was observed more frequently in maspin-negative cases than in tumors with more than 5% of positive cells (P = 0.0024). The present results confirm that maspin expression predicts a better prognosis in oral squamous cell carcinoma and that maspin probably plays a role in tumor progression. PMID:17912078
Iezzi, Giovanna; Piattelli, Adriano; Rubini, Corrado; Goteri, Gaia; Artese, Luciano; Perrotti, Vittoria; Carinci, Francesco
Background: The association between gall bladder removal (cholecystectomy) and hepatocellular carcinoma warrants investigation. An increased intrahepatic bile duct pressure following cholecystectomy might cause chronic inflammation in the surrounding liver tissue, which might induce cancer development. Methods: A nationwide Swedish population-based cohort study in 1965–2008 included 345?251 patients undergoing cholecystectomy because of gallstone. The number of observed hepatocellular carcinoma cases was divided by the expected number, calculated from the corresponding background Swedish population, thus providing standardised incidence ratios (SIRs) with 95% confidence intervals (CIs). Results: During follow-up of 4?854?969 person-years, 333 new cases of hepatocellular carcinoma were identified, rendering an overall increased risk (SIR 1.24, 95% CI: 1.11–1.38). The risk increased with longer follow-up (P for trend=0.003). Among patients who underwent cholecystectomy 30–43 years earlier, SIR was 2.00 (95% CI: 1.32–2.87). The results were similar after exclusion of 15?634 patients with any recorded risk factor, that is, diabetes, obesity, hepatitis, liver cirrhosis, alcoholism, or blood transfusion. Conclusion: Cholecystectomy might be associated with a long-term increased risk of hepatocellular carcinoma.
Lagergren, J; Mattsson, F; El-Serag, H; Nordenstedt, H
A pleomorphic liposarcoma arising in a site previously irradiated as a treatment for breast carcinoma is described. This case fulfills the criteria for a tumor to be radiation-induced. The tumor is localized with an irradiated area, there is a clear histologic distinction between the previous and current tumor, and there is a long latent interval.
Arbabi, L.; Warhol, M.J.
A pleomorphic liposarcoma arising in a site previously irradiated as a treatment for breast carcinoma is described. This case fulfills the criteria for a tumor to be radiation-induced. The tumor is localized with an irradiated area, there is a clear histologic distinction between the previous and current tumor, and there is a long latent interval.
Linda Arbabi; Michael J. Warhol
We describe an unusual case of peritoneal papillary serous carcinoma (PPSC) arising in a female patient with dermatomyositis (DM). Despite periodic extensive searches for an underlying malignancy, no malignancy had been detected in this patient during the first 2.5 years after the diagnosis of DM. It was only when the patient presented with pleural effusion and ascites that the underlying
Benjamin Piura; Mihai Meirovitz; Yoram Cohen; Jacob Horowitz
Thymic carcinoma is a rare malignancy, which differs from thymoma in that it displays histopathologically malignant features, extensive local invasion, and a substantial potential for metastasis, predominantly to the liver and kidney and rarely to the central nervous system. Most of cerebral metastases are the intraaxial tumor, whereas extraaxial masses mimicking meningioma are extremely rare. A 32-year-old woman who had
Jung Yong Ahn; Nam Keun Kim; Doyeun Oh; Hui Jung Ahn
Fibrolamellar hepatocellular carcinoma (FLH) is a rare primary tumor of the liver, which typically arises from noncirrhotic livers and affects patients below the age of 35. We report on a 29-year-old male patient who presented with a ruptured FLH and was treated with surgical resection. Options for treatment and review of the management are described.
Minutolo, Vincenzo; Licciardello, Alessio; Arena, Manuel; Minutolo, Orazio; Lanteri, Raffaele; Arena, Goffredo
Primary hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. However, the viral-chemical etiology as well as molecular mechanisms of HCC pathogenesis remains largely unknown. Recent studies in our laboratory have identified several potential factors that may contribute to the pathogenesis of HCC. Oxidative stress and chronic inflammation have been linked to an increased risk of liver cancer.
Xin W Wang; S. Perwez Hussain; Teh-Ia Huo; Chuan-Ging Wu; Marshonna Forgues; Lorne J Hofseth; Christian Brechot; Curtis C Harris
Unrestrained growth of various malignant tumours has been shown to depend upon a critical number of tumour cells which have switched to the angiogenic phenotype. Angiogenic phenotypes were noted in the early stage of prostatic carcinoma (PCa). We investigated 65 cases of latent PCa to define the correlation between tumour angiogenesis and tumour volume. Tumour angiogenesis was determined by the
M Furusato; S Wakui; H Sasaki; K Ito; S Ushigome
Four cases of epithelial-myoepithelial carcinoma of the salivary glands arose as painless masses in patients over 60 years old, three in the parotid and one in the submandibular gland. Histologically, all the tumours were composed of small ducts with a double cell lining surrounded by a basement membrane. The inner cells were epithelial and the outer cells myoepithelial, the latter
R H Simpson; T J Clarke; P T Sarsfield; P G Gluckman
Sebaceous gland carcinoma is considered a relatively rare tumor and represents approximately 1 and 5% of all eyelid tumors. These tumors usually arise in the Meibomian glands of tarsus, in the Zeis glands, and the sebaceous glands of caruncle or eyebrow. In some instances it had multicentric origin, while in other cases the initial location was unable to be determined. It occurs more frequently in women than in men and presentation age varies from 50 to 90 years. Clinical diagnosis is difficult because is can be confused with chalazion, blepharoconjunctivitis, conjunctivitis, and basocellular carcinoma. Sebaceous gland carcinoma could go unnoticed; thus, it is necessary to carry out excision of conjunctiva as well as to inform the pathologist of the possibility of malignancy, because pagetoide spread can be easily incorrectly interpreted or not observed even by expert pathologists (up to 50%). Five-years mortality has been estimated at 30% due delayed diagnosis and treatment. The present work intends to describe incidence, and clinical and histopathologic presentation of sebaceous gland carcinoma during the last 40 years at the Dr. Luis Sanchez Bulnes Hospital, Association to Prevent Blindness in Mexico, as well as to review treatment modalities forecast for this entity. PMID:15087053
Valenzuela-Flores, Gabriela; Mozas-Dávila, Dulce; Rodríguez-Reyes, Abelardo A; Gómez-Leal, Alfredo
Merkel cell carcinoma is the second most deadly form of skin cancer after melanoma, with a mortality rate of as high as 35 percent. It usually occurs as a deep red or purple dome-shaped tumor on sun-exposed skin of elderly people. Transplant recipients or AIDS patients have a higher incidence of this tumor than normal individuals. There is an association of a polyoma virus with this tumor that may explain the increased incidence in immunosuppression. Surgery, followed by radiation therapy is the standard of treatment. Sentinel node dissection is recommended because this tumor metastasizes often. Chemotherapy, such as is used for oat cell carcinoma of the lung, is advised for metastatic disease. However, systemic chemotherapy protocols have not been overly successful. We have treated four cases of stage-I Merkel cell carcinoma with surgery followed by intralesional bleomycin and have followed these cases for up to five years with no evidence of recurrence or metastasis. One case had radiation post operatively but the tumor recurred. Intralesional bleomycin caused complete regression of this tumor with minimal scarring and long term cure. Bleomycin, besides being a potent chemotherapy agent, has direct antiviral effects that may explain why this drug is so effective in treating Merkel cell carcinoma. PMID:19061585
Ely, Haines; Pascucci, Annabella
Three case reports of patients with bronchial carcinoma who presented with visual disturbances due to ocular metastases are described. The reasons for the rarity of this syndrome are discussed and its frequent association with cerebral metastases is explained. Cytotoxic drugs provide short-term effective therapy. Images
Evans, C. C.; Mearns, A. J.; Delaney, J.; Littler, W. A.
Summary We performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas using array- and sequencing-based technologies. Uterine serous tumors and ~25% of high-grade endometrioid tumors have extensive copy number alterations, few DNA methylation changes, low ER/PR levels, and frequent TP53 mutations. Most endometrioid tumors have few copy number alterations or TP53 mutations but frequent mutations in PTEN, CTNNB1, PIK3CA, ARID1A, KRAS and novel mutations in the SWI/SNF gene ARID5B. A subset of endometrioid tumors we identified had a dramatically increased transversion mutation frequency, and newly identified hotspot mutations in POLE. Our results classified endometrial cancers into four categories: POLE ultramutated, microsatellite instability hypermutated, copy number low, and copy number high. Uterine serous carcinomas share genomic features with ovarian serous and basal-like breast carcinomas. We demonstrated that the genomic features of endometrial carcinomas permit a reclassification that may impact post-surgical adjuvant treatment for women with aggressive tumors.
Esophageal carcinoma is an uncommon malignancy accounting for approximately 7% of gastrointestinal tract cancers and 1% of all cancers. Esophageal cancer still remains one of the most lethal of all cancers. Since a multimodality approach is presently used to treat esophageal cancer, early radiologic diagnosis and accurate tumor staging are essential to direct therapy toward cure or palliation. This article
A wide variety of non-surgical therapies can result in clinical responses in patients with hepatocellular carcinoma. Two recent studies have suggested that transarterial chemoembolisation can, in highly selected patients with good liver function, result in an improvement in survival. No other approaches have, to date, demonstrated convincing evidence of survival advantage.
Epithelial ovarian carcinomas are successfully treated but seldom cured with standard platinum-based chemotherapy regimens. Investigation continues on the role of high-dose chemotherapy as part of salvage, consol- idation and primary induction treatment strategies. Currently, the majority of available clinical studies suggest that modest increases in the dose of platinum in primary induction therapy does not translate into increased sur- vival
THOMAS MAKATSORIS; MICHAEL V. S EIDEN
Eight cases of acinar cell carcinoma of the exocrine pancreas were diagnosed in Japanese medaka (Oryzias latipes) from a pool of approximately 10,000 specimens used in a variety of carcinogenesis bioassays. hree cases occurred in specimens from control groups and one case in a sp...
p53 is one of the most frequently mutated genes in human tumors including head and neck tumors like oral squamous cell carcinoma. It might be responsible for more than 50% of all relapses in patients with surgically treated oral carcinoma and clean margins. The aim of the present study was to explore p53 protein expression in peritumoral tissue and correlate it with relapse of the disease. The study included 25 patients (17 males and 8 females) with oral squamous cell carcinoma in the period August 2006 till August 2008. For immunohistochemical assay, a monoclonal antibody against p53 protein was applied (clone DO-7, DAKO Glostrup, Denmark). Peritumoral expression of p53 was as follows: 10 out of 25 cases (40%) were negative, 2 cases (8%) showed weak, 5 cases (20%) moderate and 8 cases (32%) strong p53 positivity. No significant correlation between peritumoral expression of p53 protein and patient's relapse was found. In contrast, we found a trend toward association between intratumoral p53 expression and patient's relapse (p = 0.07). There was also trend toward higher peritumoral p53 expression in females comparing with p53 expression in males (52.9% of males did not have p53 expression while 87.5% females had mild, moderate or high p53 expression, p = 0.088). Peritumoral expression of p53 protein is frequently seen in oral squamous cell carcinoma and merits further research. PMID:23397771
Foco, Faris; Bilalovi?, Nurija; Vrani?, Semir; Serdarevi?, Fadila; Ramovi?, Irma; Imamovi?, Edin
External auditory canal (EAC) carcinomas are frequently misdiagnosed. The aim of this study was to conduct a review of misdiagnosed cases and analyze the factors involved. This study was a retrospective assessment. Eighteen of 44 EAC carcinoma cases seen at the Eye and ENT Hospital were misdiagnosed. All medical records were retrospectively analyzed for the age, sex, presenting symptoms, type of misdiagnosis, computed tomographic (CT) or magnetic resonance imaging (MRI) findings, stage of the cancer, surgical approach, histopathological examination, adjunctive therapy (postoperative radiotherapy) and outcomes of treatment. Six cases were misdiagnosed as otitis media, five cases were misdiagnosed as otitis externa, and two cases were misdiagnosed as external auditory canal cholesteatomas. Other misdiagnoses were stenosis of the EAC, ear neuralgia, furuncle of the EAC, benign neoplasm of the EAC and pre-auricular fistula. Our analyses suggest that a biopsy should be conducted to obtain a histopathological diagnosis if an EAC carcinoma is suspected, in case otitis media or otitis externa does not respond to routine anti-bacterials. Head and neck MRI should be used to explore the involvement of soft tissues. Patients with bloody ear discharge and otalgia, particularly with temporal bone erosion seen in a CT scan, are highly likely to have a malignant carcinoma of the temporal bone. PMID:22926989
Zhang, Ting; Dai, ChunFu; Wang, ZhengMin
Adrenocortical carcinoma (ACC) is a rare endocrine malignancy. Due to its rarity, heterogeneity, and a lack of a comprehensive understanding of the pathogenesis, little progress has been made in treatment and outcomes. The current review explores the past, present, and future of the understanding and treatment of this disease process. PMID:22473597
Lafemina, Jennifer; Brennan, Murray F
A case is described of tuberculosis of the cecum mimicking carcinoma so closely that a conventional cancer operation was carried\\u000a out. Ileocecal tuberculosis, reported in the literature, is briefly reviewed with special attention to its incidence, clinical\\u000a manifestations, clinical investigation, and treatment.
Halifax C. King; Edward C. Voss
Relevant studies on the etiology and pathogenesis of hepatocellular carcinoma (HCC) have been reviewed. Chronic hepatitis B virus infection and food aflatoxin B1 contamination have been identified as the major and possibly synergistic risk factors for HCC in endemic areas. Chronic hepatitis C virus is also an important risk factor. Cirrhosis of any etiology, particularly viral and alcoholic, is an
Sun-Lung Tsai; Yun-Fan Liaw
Hepatocellular carcinoma (HCC) is the fifth most common cancer, but the third leading cause of cancer death, in the world, with more than 500 000 fatalities annually. The major etiology of HCC\\/liver cancer in people is hepatitis B virus (HBV), followed by hepatitis C virus infection (HCV), although nonviral causes also play a role in a minority of cases. Recent
Timothy M Block; Anand S Mehta; Claus J Fimmel; Robert Jordan
In this clinical trial, 20 patients with recurrent, metastatic, or otherwise unresectable adrenocortical carcinoma who have not been previously treated with systemic therapies will receive IMC-A12 and mitotane to determine the safety of the combined therapy. If the combination is safe, an additional 102 patients will be randomly assigned to receive the combined treatment or mitotane alone.
Adenoid cystic carcinoma (ACC) is a rare malignant tumour arising from salivary glands. ACC of the head and neck shows a long natural course, high recurrence rates, late metastasis and a tendency for perineural invasion. The authors present a woman with ACC at base of tongue with good response to radiotherapy. PMID:22744242
Akhavan, Ali; Navabii, Hossein; Saeb, Mohsen
In this review, the current approach to the screening, diagnostic evaluation, staging, and treatment for hepatocellular carcinoma (HCC) is outlined. The serum ?-fetoprotein (AFP) level and abdominal ultrasonography (US) remain the cornerstones of screening protocols for HCC. Other serum marker proteins, such as abnormal serum prothrombin (PIVKA-II), when used in conjunction with AFP, can increase the yield for HCC. For
William H. Ramsey; George Y. Wu
\\u000a The morbidity caused by adrenocortical carcinoma (ACC) derives both from the spread of malignant cells into other organs and\\u000a from the consequences of hormone excess. Consequently, the goals of treatment in ACC include both control of tumor growth\\u000a and mitigation of the effects derived from hormone excess.
Richard J. Auchus
Hepatocellular carcinoma (HCC) ranks as the third most common cause of death from cancer worldwide. Although major risk factors for the development of HCC have been defined, many aspects of the evolution of hepatocellular carcinogenesis and metastasis are still unknown. Suitable animal models are, therefore, essential to promote our understanding of the molecular, cellular and pathophysiological mechanisms of HCC and
Yan Li; Jin-Xuan Hou; Zhao-You Tang
The incidence of early and advanced-stage renal cell carcinoma (RCC) is increasing. Methods of diagnosing, staging and evaluating tumor burden that are more accurate and reliable than the currently available options are needed in order to identify RCC at a stage at which it is curable and to accurately determine the response to treatment. Functional imaging, particularly with combined PET–CT,
Ian D. Davis; Damien M. Bolton; Andrew M. Scott; Nathan Lawrentschuk
The incidence of hepatocellular carcinoma (HCC) is increasing worldwide. A multi- disciplinary approach is required for its management. Screening high-risk patients allows for earlier diagnosis and the use of potentially curative therapies. Current recommendations for HCC screening for patients with cirrhosis are an abdominal ultrasound and serum alpha fetoprotein level every 6 to 12 months. Treatment choice depends on tumor
Kathleen E. Corey; Daniel S. Pratt
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.
Small, K.W.; Rosenwasser, G.O.; Alexander, E. III; Rossitch, G.; Dutton, J.J. (Duke Univ. Medical Center, Durham, NC (USA))
Merkel cell carcinoma (MCC) typically presents as an isolated cutaneous lesion with a measurable risk of regional lymph node involvement. Uncommonly, synchronous or metachronous lesions have been described to be attributed to a field effect. This case report describes a patient presenting with metachronous lesions, separated by several years, which cannot be attributed to a field effect given the tumor distribution.
Pollock, Jondavid; Caranosos, Thomas; Polack, E.P.
Laparoscopic radical nephrectomy has been developed and applied for patients with renal cell carcinoma since 1992. The number of patients undergoing laparoscopic radical nephrectomy has explosively increased worldwide in the recent years, and laparoscopy is extended to patients with advanced disease. It is very important to clarify the present status of laparoscopic radical nephrectomy among the treatment modalities for patients
Yoshinari Ono; Ryohei Hattori; Momokazu Gotoh; Tsuneo Kinukawa; Shin Yamada; Osamu Kamihira
Fibrolamellar hepatocellular carcinoma (FLH) is a rare primary tumor of the liver, which typically arises from noncirrhotic livers and affects patients below the age of 35. We report on a 29-year-old male patient who presented with a ruptured FLH and was treated with surgical resection. Options for treatment and review of the management are described. PMID:23956918
Minutolo, Vincenzo; Licciardello, Alessio; Arena, Manuel; Minutolo, Orazio; Lanteri, Raffaele; Arena, Goffredo
Gastric carcinoma was detected nine, 10, 18, and 21 years after the biopsy diagnosis of atrophic gastritis in four patients of a group of 40. The gastritis was presumed to be of the simple type. Tests of vitamin B12 absorption in three patients gave normal results, no gastric autoantibodies were detected in the two patients tested, in all patients histological
I. R. Walker; R. G. Strickland; B. Ungar; I. R. Mackay
A 36-year-old man was treated by radiotherapy for tinea capitis many years before discovery of microcystic adnexal carcinoma (MAC). Because of patient's refusal of any surgical intervention, we were able to follow the natural course of this tumor for 13 years. This case emphasizes the typical slow development of (MAC). The implication of the association of MAC and radiotherapy are
AMIRAM BORENSTEIN; DANIEL S. SEIDMAN; HENRI TRAU; HAGGAI TSUR
Background Metatypical cell carcinoma can be considered as a new entity of skin cancer, being an intermediate typology between basal cell carcinomas and squamous cell carcinomas. The behaviour of the metatypical cell carcinoma lies between these two varieties of skin cancer. It is difficult to perform a differential diagnosis based on morphological and clinical features – therefore it is only possible by accurate histology. Methods The authors have retrospectively analysed clinical records of 240 patients who were affected by metatypical skin cancer and who were treated by surgery, radiotherapy and chemotherapy. Results MTC affected more males than females (62.5% vs 37.5%) than males. The most affected site was the cervicofacial area, 71.7%; then the trunk, 10%; the limbs, 9.6%; the scalp 3.7%; and other regions 5%. A recurrence occurred in 24 cases (10%), mainly in head and neck area. Conclusion In this manuscript, the authors have emphasised the importance of conducting a differential diagnosis, and the importance of the specific treatment for metatypical skin cancer, even though more clinical studies and long-term follow-ups are required before establishing specific guidelines.
Tarallo, Mauro; Cigna, Emanuele; Frati, Riccardo; Delfino, Sergio; Innocenzi, Daniele; Fama, Umberto; Corbianco, Annamaria; Scuderi, Nicolo
Adenoid cystic carcinoma (ACC) is a relatively common malignant neoplasm which occurs in the head and neck region, particularly in the salivary glands. It is a slow growing, locally aggressive neoplasm with a unique feature of perineural spread. Intracranial extension can occur by direct extension, hematogenous metastases or by perineural spread. However, the occurrence of primary intracranial ACC with no
S. Jayalakshmi; S. Agarwal; P. L. Nachiappan; R. R. Prasad; S. Bhuthra; M. C. Sharma; P. K. Julka
Primary small cell carcinoma (SmCC) of the breast is very rare and may be difficult to distinguish from metastatic small cell carcinoma. Confident histopathological diagnosis of a primary breast SmCC requires the demonstration of an in situ component. We report a case of primary small cell carcinoma of the breast with coexisting carcinoma in situ in which the invasive carcinoma and in situ component both expressed neuroendocrine markers and Thyroid transcription factor-1 (TTF-1) by immunohistochemistry. Expression of neuroendocrine markers and TTF-1 in the in situ component allowed a highly confident diagnosis of primary small cell carcinoma of the breast. To our knowledge there is only one previous report of TTF-1 expressing in situ carcinoma associated with a primary SmCC of the breast. PMID:20661411
Christie, Michael; Chin-Lenn, Laura; Watts, Monique M; Tsui, Alpha E; Buchanan, Malcolm R
Breast carcinoma frequently metastasizes to endocrine organs, a behavior which may have prognostic or therapeutic relevance. Whether endocrine organ involvement represents a trophic influence on some carcinomas or is simply a "mass effect" of tumor dissemination is uncertain. To investigate this question, the authors reviewed the clinical and pathologic features of 187 subjects with metastatic breast carcinoma, all of whom had been subjected to complete autopsy at The Johns Hopkins Hospital. Metastases to primary endocrine organs, ie, the anterior pituitary, thyroid, parathyroid, or adrenal cortex, occurred in 57%, and metastases to secondary endocrine organs, ie, the pineal, posterior pituitary, thymus, adrenal medulla, or pancreas, occurred in 62% of patients. In general, patients with endocrine organ metastases were significantly younger and had significantly greater numbers of metastases and greater overall tumor burden than those without endocrine organ metastases (all P less than 0.001). There was no correlation between endocrine organ metastases and survival, therapy, histologic type of tumor, or grade of anaplasia or desmoplasia. Metastases to primary endocrine organs were correlated with one another and with metastases in secondary endocrine organs. Metastases in secondary endocrine organs were intercorrelated and also correlated with several nonendocrine organs, chiefly the heart, liver, and gut (all P less than 0.005). These findings indicate that metastases of breast carcinoma to endocrine organs occur in a setting of widely disseminated tumor. However, the observed correlations among metastatic sites suggest that the distributions are nonrandom; these distributions may reflect fundamental properties of some breast carcinomas with respect to hormone receptors, biologic behavior, or environmental growth requirements.
de la Monte, S. M.; Hutchins, G. M.; Moore, G. W.
Follicular cell-derived well-differentiated thyroid cancer, papillary (PTC) and follicular thyroid carcinomas comprise 95% of all thyroid malignancies. Familial follicular cell-derived well-differentiated thyroid cancers contribute 5% of cases. Such familial follicular cell-derived carcinomas or non-medullary thyroid carcinomas (NMTC) are divided into two clinical–pathological groups. The syndromic-associated group is composed of predominately non-thyroidal tumors and includes Pendred syndrome, Warner syndrome, Carney complex (CNC) type 1, PTEN-hamartoma tumor syndrome (PHTS; Cowden disease), and familial adenomatous polyposis (FAP)/Gardner syndrome. Other conditions with less established links to the development of follicular cell-derived tumors include ataxia–telangiectasia syndrome, McCune Albright syndrome, and Peutz–Jeghers syndrome. The final group encompasses syndromes typified by NMTC, as well as pure familial (f) PTC with or without oxyphilia, fPTC with multinodular goiter, and fPTC with papillary renal cell carcinoma. This heterogeneous group of diseases does not have the established genotype–phenotype correlations known as in the familial C-cell-derived tumors or medullary thyroid carcinomas (MTC). Clinicians should have the knowledge to identify the likelihood of a patient presenting with thyroid cancer having an additional underlying familial syndrome stemming from characteristics by examining morphological findings that would alert pathologists to recommend that patients undergo molecular genetic evaluation. This review discusses the clinical and pathological findings of patients with familial PTC, such as FAP, CNC, Werner syndrome, and Pendred syndrome, and the heterogeneous group of familial PTC.
Son, Eun Ju; Nose, Vania
Carcinoma of breast is the second most common cancer among women next to uterine cervical cancer in Bangladesh. It was well established that 5 years survival rates greatly vary among the different stages of carcinoma of breast disease. The study was carried out to see the stages of presentation of carcinoma of breast patient to a tertiary level hospital attended first time for medical help as well as to find out the factors responsible for the late (advanced) stage presentation. This descriptive type of cross sectional study was carried out in the department of surgery, Mymensingh Medical College and Hospital (MMCH) during the period of May 2010 to April 2011. A total of 110 cases admitted with carcinoma breast diagnosed by means of FNAC positive or suspicious findings were selected purposively during the study period. Patients were staged initially according to the TNM staging system by through clinical examination as well as final clinicopathological stages were done after histopathological examination of the resected specimen (breast with or without axillary lymphnode) in resectable cases. Among the advanced stage presentation, attempts were made to find out the factors responsible for advanced stage of the disease. The results showed that carcinoma of breast predominantly a disease of female and comparatively younger age group 40-49 years affected mostly in 40.9% cases with a mean age of 44.02 ± 10.32 years. Premenopausal lady mostly affected in 63.6% cases. Majority of patients presented in advanced stage of the disease in 62.8% cases. Multiple factors were observed responsible for the advanced stage of the disease - among them delay in hospital presentation, poor socioeconomic condition and illiteracy have found to be associated which were statistically significant (p<0.001). It was needed for mass awareness program against the breast cancer in our society. Necessary steps should be taken for the initiation of breast self examination (BSE) to patients and clinical breast examination (CBE) to health care providers. PMID:22561765
Mohiuddin, M; Gafur, M A; Karim, M R; Khan, S A; Hoque, M M; Islam, M S; Ali, M S
Although persistent hepatitis C virus infection is closely associated with the development of hepatocellular carcinoma, the nature of hepatitis C virus replication in the hepatocellular carcinoma tissue has not been fully characterized. To study this, carcinoma and non-carcinoma tissues were obtained from five patients with hepatocellular carcinoma. Total RNA was recovered from each tissue, and a portion of the envelope
Masayuki Kurosaki; Nobuyuki Enomoto; Naoya Sakamoto; Yujiro Tanaka; Liang Tang; Yuji Hoshino; Namiki Izumi; Fumiaki Marumo; Chifumi Sato
Trabecular carcinoma has been renamed as Merkel cell carcinoma because, ultrastructurally, tumour cells resemble Merkel cells of the skin. Recently, evidence of exocrine (sweat gland) differentiation in some trabecular carcinomas has been reported. These findings raise two possibilities: (1) trabecular carcinomas are a heterogeneous group of lesions; or (2) that trabecular carcinomas are glandular tumours, in which exocrine features are rarely detected.
Squamous cell carcinoma of the oral cavity evolves within a field of precancerized oral epithelium containing keratinocytes at different stages of transformation. Following acquisition of additional genetic alterations, these precancerous keratinocytes may become cancerous. Persons with apparently successfully treated oral squamous cell carcinoma are at high risk of developing a new carcinoma at, or close to the site of the treated tumour. This second carcinoma may have developed either from malignant keratinocytes left behind at surgery (recurrence), or from transformed keratinocytes within the field of precancerized epithelium from which the primary carcinoma had arisen (new carcinoma). The cells of the new carcinoma may have genetic changes in common with the cells of the original carcinoma because both are descended from a proliferating monoclone within the precancerized field; but if the new cancer originates from a different clone, it may have a dissimilar genetic profile even if the original and the new carcinoma are closely contiguous. The purpose of this article is to review the pathobiology of oral squamous cell carcinoma in relation to fields of precancerised oral epithelium.
BACKGROUND Ovarian clear-cell and endometrioid carcinomas may arise from endometriosis, but the molecular events involved in this transformation have not been described. METHODS We sequenced the whole transcriptomes of 18 ovarian clear-cell carcinomas and 1 ovarian clear-cell carcinoma cell line and found somatic mutations in ARID1A (the AT-rich interactive domain 1A [SWI-like] gene) in 6 of the samples. ARID1A encodes BAF250a, a key component of the SWI–SNF chromatin remodeling complex. We sequenced ARID1A in an additional 210 ovarian carcinomas and a second ovarian clear-cell carcinoma cell line and measured BAF250a expression by means of immunohistochemical analysis in an additional 455 ovarian carcinomas. RESULTS ARID1A mutations were seen in 55 of 119 ovarian clear-cell carcinomas (46%), 10 of 33 endometrioid carcinomas (30%), and none of the 76 high-grade serous ovarian carcinomas. Seventeen carcinomas had two somatic mutations each. Loss of the BAF250a protein correlated strongly with the ovarian clear-cell carcinoma and endometrioid carcinoma subtypes and the presence of ARID1A mutations. In two patients, ARID1A mutations and loss of BAF250a expression were evident in the tumor and contiguous atypical endometriosis but not in distant endometriotic lesions. CONCLUSIONS These data implicate ARID1A as a tumor-suppressor gene frequently disrupted in ovarian clear-cell and endometrioid carcinomas. Since ARID1A mutation and loss of BAF250a can be seen in the preneoplastic lesions, we speculate that this is an early event in the transformation of endometriosis into cancer. (Funded by the British Columbia Cancer Foundation and the Vancouver General Hospital–University of British Columbia Hospital Foundation.)
Wiegand, Kimberly C.; Shah, Sohrab P.; Al-Agha, Osama M.; Zhao, Yongjun; Tse, Kane; Zeng, Thomas; Senz, Janine; McConechy, Melissa K.; Anglesio, Michael S.; Kalloger, Steve E.; Yang, Winnie; Heravi-Moussavi, Alireza; Giuliany, Ryan; Chow, Christine; Fee, John; Zayed, Abdalnasser; Prentice, Leah; Melnyk, Nataliya; Turashvili, Gulisa; Delaney, Allen D.; Madore, Jason; Yip, Stephen; McPherson, Andrew W.; Ha, Gavin; Bell, Lynda; Fereday, Sian; Tam, Angela; Galletta, Laura; Tonin, Patricia N.; Provencher, Diane; Miller, Dianne; Jones, Steven J.M.; Moore, Richard A.; Morin, Gregg B.; Oloumi, Arusha; Boyd, Niki; Aparicio, Samuel A.; Shih, Ie-Ming; Mes-Masson, Anne-Marie; Bowtell, David D.; Hirst, Martin; Gilks, Blake; Marra, Marco A.; Huntsman, David G.
Endocrine Cancer; Metastatic Gastrointestinal Carcinoid Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin; Thyroid Gland Medullary Carcinoma
Epidemiological evidence of an association between anal carcinoma and symptomatic HIV-related disease suggests that the number of cases of this disease may increase significantly over the next few years. The role of oncogenic HPV types in the pathogenesis of anal carcinoma is substantiated by both epidemiological evidence that tumours are associated with a past history of anal warts and by experimental evidence showing that over 85% of tumours contain HPV 16/18 DNA on PCR. The physical state of the virus in the tumour cell genome is currently under investigation, and cellular interactions between HPV, HIV and other sexually transmitted viruses require further research. Clinical studies have shown that patients with anal warts and those who are HIV positive also show an increased tendency to develop dysplasia within the anal epithelium. However, the malignant potential of dysplasia remains unclear and, it presents problems in management, particularly when multifocal and high grade. Problems in classification of anal carcinomas involve both the site of the tumours and the histological appearance. Despite the difficulties which exist in estimating the origin of a tumour from canal or margin, this information does appear to have clinical significance and should therefore continue to be assessed. Recent morphological and keratin studies have emphasized the heterogeneity of these tumours and have revealed a similar heterogeneous profile of keratin expression in the normal anal epithelium. These results support the body of opinion which suggests that, with the exception of small cell carcinoma and adenocarcinoma, anal carcinomas should be considered as squamous cell tumours which are able to display a range of further morphological characteristics within which ductal differentiation and mucin production appear to carry the worst prognosis. Although there is no universally accepted staging system for anal carcinoma, depth of invasion and extent of spread at the time of diagnosis are the most important clinical factors determining survival and response to therapy. Randomized clinical trials are now under way to compare the outcome of various combinations of radiotherapy and chemotherapy, which have replaced radical surgery as a first line treatment and resulted in a significant decrease in patient morbidity from this disease. PMID:7698728
Williams, G R; Talbot, I C
Clear cell carcinoma of the thymus is a rare tumor. Few cases of clear-cell carcinoma of thymus have been documented (Truong et al., 1990 and Wolfe III et al., 1983). All these cases were diagnosed by histopathological examination of the tissue. Diagnosis of thymic clear cell carcinoma on cytology is extremely challenging. Here we report the first case of thymic clear cell carcinoma diagnosed by cytological examination of the pericardial fluid with the help of immunocytochemistry. Differential diagnosis included adenocarcinoma, mesothelioma, and thymic clear cell carcinoma. Thymic carcinoma with clear cell features has an aggressive clinical behavior including our case, where it was already metastasized at the time of presentation. PMID:24175107
Lale, Seema A; Tiscornia-Wasserman, Patricia G; Aziz, Mohamed
Poorly differentiated neuroendocrine carcinoma is a rare malignancy that remains a challenge to treat. Poorly differentiated neuroendocrine carcinoma occurs at an incidence of 2% annually in United States. The current standard of care is based largely upon retrospective data. There remains a need for large prospective cooperative group trials in the management of poorly differentiated neuroendocrine carcinoma. In this paper, we will review abstract #e15096 (Paclitaxel, carboplatin, and etoposide (TCE) in advanced poorly differentiated neuroendocrine carcinoma) by Loeffler et al. and #e15071 (Poorly differentiated neuroendocrine carcinoma (NEC G3): prognostic factors and potential novel targets) by Heetfeld et al. presented at the 2013 ASCO Annual Meeting highlighting treatment options in first and second lines for poorly differentiated neuroendocrine carcinoma. PMID:23846932
Gupta, Anumeha; Duque, Marvin; Saif, Muhammad Wasif
Carcinoma cuniculatum is a rare variant of squamous cell carcinoma originally described on the sole of the foot and for a long time believed to be restricted to the skin. However, since its first description in 1954, several cases have been reported at other sites. Carcinoma cuniculatum characteristically invades the underlying subcutaneous, submucosal, or bone tissues, forming so-called "rabbit burrows," with crypts filled with keratin that are of utmost importance for distinguishing this neoplasm from other variants of squamous cell carcinoma. Oral carcinoma cuniculatum is an even rarer entity that is frequently misdiagnosed initially, a phenomenon described in about one-third of previously reported cases. The aim of this report is: (1) to describe the clinicopathologic features of 2 new cases of oral carcinoma cuniculatum, initially misdiagnosed as infected orthokeratinized cyst and abscess, respectively; and (2) to review the related English language literature. PMID:24035112
Fonseca, Felipe Paiva; Pontes, Hélder Antônio Rebelo; Pontes, Flávia Sirotheau Corręa; de Carvalho, Pedro Luiz; Sena-Filho, Marcondes; Jorge, Jacks; Santos-Silva, Alan Roger; de Almeida, Oslei Paes
Metastases of esophageal carcinoma to the skeletal muscle are rare, but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT). A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases. Four patients had skeletal muscle metastases of esophageal carcinoma, including two patients with squamous cell carcinoma. In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases, muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma. In all cases, skeletal muscle metastases were the first manifestation of systemic disease. In three patients palliation was obtained with the combination of external beam radiation therapy, systemic chemotherapy or surgical resection. Skeletal muscle metastases are a rare complication of esophageal carcinoma. PMID:23002370
Cincibuch, Jan; Myslive?ek, Miroslav; Melichar, Bohuslav; Neoral, Cestmír; Metelková, Iva; Zezulová, Michaela; Procházková-Študentová, Hana; Flodr, Patrik; Zlevorová, Miloslava; Aujeský, René; Cwiertka, Karel
Background: Merkel cell carcinoma is a high-grade neuroendocrine carcinoma of skin that is characterized by immature cells which, because of its striking morphologic similarity, may be confused with other small round blue cell tumors such as pulmonary small cell carcinoma or lymphoblastic leukemia/lymphoma. Immunohistochemistry is therefore paramount to ensuring accurate diagnostic distinction between these tumors. The aim of our study was to evaluate and compare the expression of PAX5 and Terminal deoxynucleotidyl transferase (TdT), in Merkel cell carcinoma and pulmonary small cell carcinoma. Design: PAX5 and TdT immunohistochemical stains were performed on 27 Merkel cell carcinomas and 10 pulmonary small cell carcinomas. Results: PAX5 was expressed in 24/27 (89%) Merkel cell carcinomas and 0/10 (0%) pulmonary small cell carcinomas. TdT was expressed in 21/27 (78%) Merkel cell carcinomas and 9/10 (90%) pulmonary small cell carcinomas. Conclusions: Our study confirms that PAX5 and TdT expression can be expressed in a high percentage of Merkel cell carcinomas and so when positive are not diagnostic of lymphoblastic leukemia/lymphoma. When dealing with metastatic lesions, PAX5 negativity would favor a diagnosis of pulmonary small cell carcinoma over Merkel cell carcinoma. In addition, TTF-1 negative pulmonary small cell carcinoma is to be differentiated from Merkel cell carcinoma.
Kolhe, Ravindra; Reid, Michelle D; Lee, Jeffrey R; Cohen, Cynthia; Ramalingam, Preetha
Skin involvement is a late complication that rarely occurs in ovarian cancer patients. This event invariably carries a bad\\u000a prognosis in the course of an advanced stage ovarian carcinoma which is usually of the conventional serous type. Micropapillary\\u000a serous carcinoma (MPSC) was recently recognized as a distinct neoplasm that seems to be less aggressive than conventional\\u000a serous ovarian carcinoma. Indeed,
Adnčne Moussa; Walid Denguezli; Leďla Njim; Anis Haddad; Raja Faleh; Mohamed Sakouhi; Abdelfattah Zakhama
The rarity of rectal carcinoma in children has prompted us to report this patient who presented with bleeding per rectum and constipation. Histopathological examination of biopsy revealed the growth to be a colloid carcinoma of rectum and it was inoperable on exploratory laparotomy. There are three factors which contribute to an overall poor prognosis of rectal carcinoma in children viz. delay in diagnosis, advanced stage of disease and poorly differentiated histology. PMID:7527858
Redkar, R G; Kulkarni, B K; Naik, A; Borwankar, S S
Liver fibrosis is a growing concern among adults with congenital heart disease, particularly for those who have undergone a Fontan operation. Liver fibrosis leads to cirrhosis, a precursor of hepatocellular carcinoma. A few cases of hepatocellular carcinoma in patients with prior palliative surgery for congenital heart disease have been identified in the literature. The current case reports the first known case of hepatocellular carcinoma in a 45-year-old male with repaired tetralogy of Fallot. PMID:22897884
McCabe, Nancy; Farris, Alton Brad; Hon, Huiming; Ford, Ryan; Book, Wendy M
Malignant neoplasms known to develop following external beam radiation include squamous cell carcinoma, osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma, mixed mullerian tumors, malignant schwannoma, myelogenous leukemia and angiosarcoma. Latency periods of many years characterize the onset of these tumors following the exposure. Cutaneous angiosarcoma following radiotherapy for breast carcinoma has been rarely documented, occurring up to 13 years postirradiation. Two cases of this entity are reported occurring 37 months postradiotherapy at the site of mastectomy performed for mammary duct carcinoma.
Otis, C.N.; Peschel, R.; McKhann, C.; Merino, M.J.; Duray, P.H.
\\u000a Bladder cancer is estimated to be the seventh most prevalent malignancy worldwide. Greater than 90% of the tumors within the\\u000a bladder are urothelial carcinoma. Urothelial carcinoma of the bladder is distinct from other epithelial carcinomas in that\\u000a it is thought to have two divergent pathways of carcinogenesis. Studies have shown that superficial\\/low grade papillary tumors\\u000a develop along one molecular pathway
Shang-Tian Chuang; Robert A. Tracy; Ximing J. Yang
Verrucous carcinoma of the vagina is a rare neoplasm. This entity is a slow-growing, locally invasive but generally nonmetastasizing neoplasm, with a characteristic gross and microscopic appearance.We report a case of verrucous carcinoma of the vagina in a postmenopausal woman diagnosed 4 years after transvaginal hysterectomy for grade 4 uterine prolapse. We also discuss the differential diagnosis and treatment.Verrucous carcinoma
Concepción Lara Bohórquez; Virginia Porras Hidalgo; Pilar Jurado Escámez; M. Luz López Hidalgo
No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts\\u000a for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile\\u000a duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated\\u000a type of PBM is a
Shuichi Miyakawa; Shin Ishihara; Tadahiro Takada; Masaru Miyazaki; Kazuhiro Tsukada; Masato Nagino; Satoshi Kondo; Junji Furuse; Hiroya Saito; Toshio Tsuyuguchi; Fumio Kimura; Hideyuki Yoshitomi; Satoshi Nozawa; Masahiro Yoshida; Keita Wada; Hodaka Amano; Fumihiko Miura
Summary The case history of a 24-year-old woman with Gardner's syndrome [familial adenomatous polyposis (FAP)] and papillary thyroid carcinoma is presented, representing the 37th report of this association. Although FAP is transmitted as an autosomal dominant trait with similar penetrance in both sexes, thyroid carcinoma has been found almost exclusively in women (94.3%). The majority have been papillary carcinomas (88.5%),
Brenda Bell; Ernest L. Mazzaferri
A select group of patients with upper tract urothelial carcinoma may be appropriate candidates for minimally invasive management. Organ-preserving endoscopic procedures may be appropriate for patients with an inability to tolerate major surgery, solitary kidney, bilateral disease, poor renal function, small tumor burden, low-grade disease, or carcinoma in situ. We review the published literature on the use of topical treatment for upper tract urothelial carcinoma and provide our approach to treatment in the office setting.
Nepple, Kenneth G.; Joudi, Fadi N.; O'Donnell, Michael A.
Carcinoma cell mitochondria preferentially accumulate and retain certain cationic dyes to a much greater extent than most normal cells. Thus, they can potentially serve as targets for highly selective photochemotherapy. We evaluated 10 rhodamine and cyanine dyes as carcinoma-specific mitochondrial photosensitizers in vitro. The most effective, N,N'-bis(2-ethyl-1,3-dioxolane)kryptocyanine (EDKC), caused marked, light-dependent killing of human bladder, squamous, and colon carcinoma cell
A. R. Oseroff; D. Ohuoha; G. Ara; D. McAuliffe; J. Foley; L. Cincotta
Rhabdoid colorectal carcinomas are very rare and only 10 cases have been previously reported. We report two cases of rhabdoid colorectal carcinoma, one arising in the sigmoid colon of a 62-year-old man and another in the rectum of an 83-year-old woman. In both cases, the patients had advanced tumors with lymph node metastases. The tumors mostly showed a diffuse arrangement with rhabdoid features and small glandular regions were combined. Transitional areas from the adenocarcinomas to the rhabdoid tumors were also noted. Adenocarcinoma cells were positive for mixed cytokeratin (CK), CK20 and epithelial membranous antigen (EMA), but focal positive for vimentin. The rhabdoid tumor cells were positive for mixed CK, but focal positive or negative for CK20 and EMA. In addition, they were diffusely positive for vimentin, but negative for desmin. The histological and immunohistologial findings of these two cases suggest that the rhabodid tumor cells originated from dedifferentiated adenocarcinomas.
Lee, Sang Hwa; Seol, Hyesil; Kim, Wook Youn; Lim, So Dug; Kim, Wan Seop; Hwang, Tae Sook
The incidence of parathyroid carcinoma is no more than 0.5 to 3% of parathyroid neoplasms and can often be cured by an adequate initial surgical excision. If the carcinoma has already spread outside the capsule or is implanted at surgery, the chance of local recurrence is high, but is best managed by surgical resection of any recurrence. Distant metastases occur less frequently, but the associated hypercalcemia is poorly controlled by hormonal, chemotherapy, or radiation therapy. Though the chance for cure is small, a review of previously reported cases and our own experience leads us to encourage an aggressive search for metastases, and if possible, surgical resection. If not curative, this approach will often allow prolonged palliation of the effect of hypercalcemia. Images Fig. 1. Fig. 2. Fig. 3a. Fig. 3b. Fig. 4. Fig. 5.
Flye, M W; Brennan, M F
Hepatocellular carcinoma represents the fifth most frequent cancer in the world; it commonly occurs on cirrhotic liver. Prognosis and survival are still poor, mainly because of diagnosis at a late stage and/or recurrence of the disease. For this reason, surveillance strategies are widely used to screen for early occurrence of cancer in populations at risk. Alpha-foetoprotein is so far the only serological marker available, but its diagnostic accuracy is unsatisfactory because of low sensitivity despite reliable specificity. For this reason, new biomarkers for the diagnosis of hepatocellular carcinoma are in strong demand by clinicians. In this review, we will focus on new biomarkers currently under investigation, but also on still newer, very promising biomarkers that seem to significantly improve diagnosis. PMID:16782417
Giannelli, G; Antonaci, S
Inflammatory Breast Carcinoma (IBC) is a rare but aggressive form of breast carcinoma. Characteristic clinical and pathological features are well documented. Pathological response to chemotherapy is currently the only identified prognostic factor. This high-grade tumor exhibits phenotypical features of an aggressive tumor: absence of hormonal receptors in 56 to 83% of cases, high proliferating index, p53 expressed in 30 to 69%, Immunohistochemistry (IHC) detection of HER2 over expression in 38 to 60%. Current work on IBC points out specific molecular mechanisms: adhesion molecules such as E-Cadherin, apomucin MUC1 and angiogenesis processes contribute to the IBC phenotype. So does a gene named WISP3. This gene has been recently cloned and sequenced. It has been shown to be lost in IBC and could control tumor growth, invasion, and angiogenesis. This paper summarizes current knowledge on IBC and describes a new basis for a molecular definition of IBC. PMID:15094594
Charafe-Jauffret, Emmanuelle; Tarpin, Carole; Ginestier, Christophe; Bertucci, François; Penault-Llorca, Frédérique; Xerri, Luc; Birnbaum, Daniel; Viens, Patrice; Hassoun, Jacques; Jacquemier, Jocelyne
Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.
Hishikawa, Y.; Tanaka, S.; Miura, T.
Rhabdoid colorectal carcinomas are very rare and only 10 cases have been previously reported. We report two cases of rhabdoid colorectal carcinoma, one arising in the sigmoid colon of a 62-year-old man and another in the rectum of an 83-year-old woman. In both cases, the patients had advanced tumors with lymph node metastases. The tumors mostly showed a diffuse arrangement with rhabdoid features and small glandular regions were combined. Transitional areas from the adenocarcinomas to the rhabdoid tumors were also noted. Adenocarcinoma cells were positive for mixed cytokeratin (CK), CK20 and epithelial membranous antigen (EMA), but focal positive for vimentin. The rhabdoid tumor cells were positive for mixed CK, but focal positive or negative for CK20 and EMA. In addition, they were diffusely positive for vimentin, but negative for desmin. The histological and immunohistologial findings of these two cases suggest that the rhabodid tumor cells originated from dedifferentiated adenocarcinomas. PMID:24009633
Lee, Sang Hwa; Seol, Hyesil; Kim, Wook Youn; Lim, So Dug; Kim, Wan Seop; Hwang, Tae Sook; Han, Hye Seung
A 70-year-old female underwent follow-up colonoscopy after colonic polypectomy. The colonoscopy revealed the presence of a 7-mm submucosal tumor in the sigmoid colon. The tumor surface was smooth and covered with normal mucosa. It was diagnosed as a submucosal tumor, and polypectomy was performed. Histopathological examination of the resected specimen revealed moderately to poorly differentiated adenocarcinoma measuring 2 × 5 × 3 mm with marked peritumoral lymphocytic infiltration and lymphoid follicle formation. It was diagnosed as carcinoma with lymphoid stroma (lymphoepithelioma-like carcinoma), SM (1,800 ?m), ly2, v0, budding; grade 1. We confirmed the indication for noncurative additional surgical resection and performed laparoscopic sigmoid colectomy. No metastases were observed in the dissected lymph nodes. PMID:23626513
Mori, Yasuharu; Akagi, Kazunari; Yano, Masaaki; Sashiyama, Hiroshi; Tsutsumi, Osamu; Hamahata, Yukihiro; Tsujinaka, Yasunobu; Tsuchida, Akihiko; Matsubayashi, Jun
The cross talk between tumor cells and the surrounding peritumoral stroma has been extensively studied as a dynamic system involving the processes of hepatocarcinogenesis, tumor invasion, and metastasis in recent few decades. Besides hepatocytes, liver tumor microenvironments are generally classified into cellular and noncellular components, including hepatic stellate cells, fibroblasts, immune, endothelial, mesenchymal stem cells, together with growth factors, cytokines, extracellular matrix, hormone as well as viruses et al. The noncellular components manipulate hepatocellular carcinoma invasion and metastasis by facilitating epithelial-mesenchymal transition, increasing proteolytic activity of matrix metalloproteinases, and regulating antitumor immunity, etc. Because the main cause of death in hepatocellular carcinoma patients is tumor progression with metastasis, a better understanding of the interplay between hepatocytes and their environment during tumor metastasis may be helpful for the discovery of novel molecular targets. PMID:23855295
Wang, Hongyang; Chen, Lei
Among 910 survivors of childhood cancer, four developed infiltrating carcinoma of the breast and another had noninfiltrating breast tumor. Expected frequency was 0.3 cases of breast cancer in the series. The affected women developed breast carcinoma at ages 20, 25 and 38 years, and the men at ages 38 and 39 years, respectively. Each patient had received orthovoltage chest irradiation for treatment of Wilms' tumor or bone sarcoma between seven and 34 years previously, and estimated radiation dose to the breast exceeded 300 rad in each instance. Four patients also received diverse forms of chemotherapy. Survivors of childhood cancer have increased risk of developing breast cancer and should undergo periodic screening, particularly after breast tissue had been irradiated. Individualized radiotherapy planning can help exclude the breasts from treatment fields for some thoracic neoplasms.
Li, F.P.; Corkery, J.; Vawter, G.; Fine, W.; Sallan, S.E.
According to the cancer stem cell hypothesis tumors are maintained by a cancer stem cell population which is able to initiate and maintain tumors. Tumor-initiating stem cells display stem or progenitor cell properties such as self-renewal and capacity to re-establish tumors that recapitulate the tumor of origin. In this paper, we discuss data relative to the presence of cancer stem cells in human renal carcinoma and their possible origin from normal resident stem cells. The cancer stem cells identified in human renal carcinomas are not derived from the normal CD133+ progenitors of the kidney, but rather from a more undifferentiated population that retains a mesenchymal phenotype. This population is able to self-renewal, clonogenicity, and in vivo tumor initiation. Moreover, they retain pluripotent differentiation capability, as they can generate not only the epithelial component of the tumor, but also tumor endothelial cells. This suggests that renal cancer stem cells may contribute to the intratumor vasculogenesis.
Bussolati, Benedetta; Brossa, Alessia; Camussi, Giovanni
Only three examples of acinic cell carcinoma of the larynx or trachea are found in the recent literature. A case of acinic cell carcinoma of the subglottic larynx and trachea was diagnosed and treated at the University of Virginia Medical Center. To our knowledge this is the first such case with a prior history of radiation to the neck. The patient is a 56-year-old woman who was irradiated for hyperthyroidism 46 years ago. When seen she also had parathyroid hyperplasia and multiple thyroid adenomas, conditions that frequently follow irradiation of the thyroid in children. These findings in this case support the concept that radiation may be responsible for inducing this tumor, which otherwise rarely occurs in this location. The use of electron microscopy was extremely useful in the diagnosis of this tumor. She was treated with total laryngectomy and right neck dissection and is now free of disease one year after surgery.
Reibel, J.F.; McLean, W.C.; Cantrell, R.W.
Medullary carcinoma of the thyroid may occur in three patient groups: multiple endocrine neoplasia, type 2b (MEN2b), MEN2a, and sporadic. The prognosis is best in MEN2a and worst in MEN2b. Multicentric disease occurs in approximately 90% of patients in the MEN groups and in 20% of the patients in the sporadic group. The minimal surgical procedure advocated is total thyroidectomy with dissection of the central compartment nodes. When neck dissection is performed, there appears to be no advantage in resecting the internal jugular vein or the sternomastoid muscle. Primary relatives of all patients with medullary carcinoma should be screened by measurement of plasma immunoreactive calcitonin to identify C-cell disease in a generally unsuspecting group/reservoir and because it results in earlier diagnosis, which leads to a less extensive surgical procedure and a higher percentage of patients with a disease-free state.
Russell, C F; Van Heerden, J A; Sizemore, G W; Edis, A J; Taylor, W F; ReMine, W H; Carney, J A
Thirteen patients with resectable pancreatic carcinoma were examined by computed tomography (CT). Nine had a mass, 2 had dilatation of the main pancreatic duct, 1 appeared to have ductal dilatation, and 1 had no sign of abnormality. Resectable carcinoma was diagnosed retrospectively in 8 cases, based on the following criteria: a mass with a distinct contour, frequently containing a tiny or irregular low-density area and accompanied by dilatation of the caudal portion of the main pancreatic duct without involvement of the large vessels, liver, or lymph nodes. Including unresectable cancer, chronic pancreatitis, and obstructive jaundice from causes other than cancer, the false-positive rate was less than 6%. However, a small cancer without change in pancreatic contour is difficult to detect with CT.
Itai, Y. (Univ. of Tokyo, Japan); Araki, T.; Tasaka, A.; Maruyama, M.
Metastatic carcinoma from the female genitalia to the oral mucosa is exceptionally rare, with only 11 such cases having been previously reported in the English-language literature. We describe a new case in a 65-year-old woman with a history of endometrial carcinoma who presented with swelling of the retromolar pad. Radiographic examination showed slight opacities and irregular trabecular bone in the left posterior mandible. Following an incisional biopsy, histologic examination and immunohistochemical studies revealed glandular adenocarcinoma with positivity for progesterone receptor, estrogen receptor, and cytokeratin 7. The patient was referred to her primary care physician for comprehensive treatment. This case illustrates the value of considering cancer metastasis in the differential diagnosis of an oral swelling, particularly in a patient with a history of cancer. PMID:24057909
Hatoum, Hisham; Jham, Bruno C; Garber, Karen; Brahim, Jaime S; Scheper, Mark A
Hyalinizing clear cell carcinoma (HCCC) is a rare, recently described tumor of salivary gland origin. Differential diagnosis includes benign lesions as clear cell change in a pleomorphic adenoma or in oncocytoma and malignant tumors – i.e. epithelial-myoepithelial carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, clear cell acinic carcinoma, clear cell squamous carcinoma, clear cell malignant melanoma, clear cell odontogenic carcinoma, clear
Alessandra Rinaldo; Kathryn M. McLaren; Paolo Boccato; Arnold G. D. Maran
Pellagra is a nutritional disease caused by the deficiency of niacin. It presents with a photodistributed rash, gastrointestinal symptoms, and neuropsychiatric disturbances. In the Western world, this disease is mostly confined to alcoholics or the impoverished. However, this condition must be recognized in other clinical settings because it is easily treated and can be fatal if not identified. We describe a case of pellagra caused by esophageal carcinoma and alcoholism; we also review the literature. PMID:19624986
Nogueira, Ana; Duarte, Ana F; Magina, Sofia; Azevedo, Filomena
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide with about 600,000 patients dying from the disease annually. In 70–90%, HCC develops on the background of chronic liver cirrhosis or inflammation. Risk factors and etiologies vary among geographical regions. In regions with a high incidence the majority of cases are related to HBV and HCV hepatitis.
Kerstin Schütte; Jan Bornschein; Peter Malfertheiner
We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone mimicking a metastatic carcinoma. A 74-year-old\\u000a female with a 15-year history of rheumatoid arthritis (RA) on treatment with methotrexate presented with tenderness of the\\u000a right base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies were unsuccessful and the
Fernando Gomez-Rivera; Adel K El-Naggar; Nandita Guha-Thakurta; Michael E Kupferman
Background: Obesity, hypertension, smoking, and amphetamine diet pills increase the risk for renal cell carcinoma (RCC). Obesity\\u000a causes a four-fold increase. We report our 11-year experience with RCC after bariatric operations. Methods: 5 patients with\\u000a RCC were identified out of 2,287 bariatric surgical patients since 1993 on retrospective chart review. Results: 4 of the 5\\u000a patients were females. At time
Myur S. Srikanth; S. Ross Fox; Ki H. Oh; Kevin Ward; Howard Sun; Thomas Keskey; Earl R. Fox; Katherine M. Fox
Kidney cancer is most often diagnosed incidentally at the time of radiographic imaging for other complaints. Although numerous improvements and greater use of screening measures have occurred in the setting of renal cell carcinoma (RCC), screening for this disease is usually only carried out for patients who have been identified as having one of the known genetic lineages linked with specific RCC subtypes. This article reviews key concepts in the screening, diagnosis, and prognosis of patients with RCC. PMID:19948453
Wood, Laura S
Adenoid cystic carcinoma (ACC) of salivary glands is a slow-growing malignant tumor, characterized by wide local infiltration, perineural spread, a propensity to local recurrence and late distant metastasis. Although ACC is the second most common malignant salivary gland neoplasm and constitutes approximately one-third of all salivary gland malignancies, it is relatively rare in parotid gland. Here, we present a case report of a cribriform type of ACC involving parotid salivary gland in a 66-year-old female.
Godge, Pournima; Sharma, Shubhra; Yadav, Monica
Symptomatic metastases to the pituitary (MP) from renal cell carcinoma (RCC) are rare. In this largest case series reported,\\u000a we describe the clinical features, treatment and outcome of 5 patients. Over a 6-year period (2000–2006), we treated 5 patients\\u000a (3 males; mean age 61 years) with large sellar masses and RCC. Four patients had a history of RCC, while in one,
Thottathil Gopan; Steven A. Toms; Richard A. Prayson; John H. Suh; Amir H. Hamrahian; Robert J. Weil
\\u000a The advent of “targeted” therapy directed against the VEGF or mTOR pathways has markedly increased the survival of patients\\u000a with metastatic renal cell carcinoma (RCC) over the last 5 years. Since RCC ranks 3rd in incidence-proportion percentage of\\u000a brain metastases, it is not surprising, that management of this complication has become an increasingly important clinical\\u000a challenge. Some form of systematic
Aida Loudyi; Wolfram E. Samlowski
. The present study reports on the usefulness of microwave coagulonecrotic therapy (MCT) as a treatment option for\\u000a hepatocellular carcinoma (HCC) with poor hepatic reserve. From June 1992 to March 1995, MCT using a microwave electrode was\\u000a employed on 8 patients using laparoscopic control and 19 with the open method, and wedge resection (Hx) was applied to the\\u000a 23 patients.
Naoki Yamanaka; Tsuneo Tanaka; Takeshi Oriyama; Kazutaka Furukawa; Wataru Tanaka; Eizo Okamoto
Esophageal carcinoma is an uncommon malignancy accounting for approximately 7% of gastrointestinal tract cancers and 1% of all cancers. Esophageal cancer still remains one of the most lethal of all cancers. Since a multimodality approach is presently used to treat esophageal cancer, early radiologic diagnosis and accurate tumor staging are essential to direct therapy toward cure or palliation. This article presents a review of radiologic diagnosis and staging of esophageal cancer. PMID:12044696
A 64-year-old man had a prostatic nodule on routine physical examination; per-rectal needle biopsies revealed a single focus of well differentiated adenocarcinoma. The patient had no history of urinary obstruction or of bowel difficulties. Accordingly, this was clinical stage II carcinoma of the prostate. The patient chose to receive external radiation therapy and was given small-field rotational treatment to a
A. R. Kagan; R. J. Steckel
Cervical cancer is a disease in which cancer develops in the tissues of the cervix. The Cancer Genome Atlas is studying the two main types of cervical cancer. Squamous cell carcinoma develops in the thin, flat, squamous cells that line the vagina. Adenocarcinoma arises in the glandular cells in the vagina that secrete mucus. Risk factors for cervical cancer include smoking and human papillomavirus (HPV) infection. In the future, the HPV vaccine will lower the infection rate.
Hepatocellular carcinoma (HCC) continues to represent a major worldwide problem. Although treatments such as resection, transplantation, and ablation may provide a chance for a cure, these options are often precluded because of advanced disease presentation. Palliative treatments include transarterial embolization and systemic therapies. This review will summarize the state of the science for embolic therapies in HCC (conventional and drug-eluting chemoembolization, radioembolization) as well as discuss related topics including HCC staging, assessment of response, and ongoing clinical trials. PMID:23357493
Salem, Riad; Lewandowski, Robert J
SummaryCarcinoma of unknown primary (CUP) is an intriguing clinical finding that is defined as biopsy-proven metastasis from a malignancy in the absence of an identifiable primary site after a complete clinical work-up. CUP is a relatively common clinical entity, accounting for approximately 3–5% of all cancer diagnoses, and consists of a heterogeneous group of tumors that have acquired the capacity
Alwin Krämer; Gerdt Hübner; Andreas Schneeweiss; Gunnar Folprecht; Kai Neben
Worldwide, colorectal carcinoma (CRC) varies by race-ethnicity. The highest incidence occurs in whites of European descent. Rates in blacks of South Africa are much lower, but rise with migration to westernized countries, i.e. African Americans (blacks) in the US. In the US, CRC age-specific incidence rates increased dramatically with biologic aging for black and white men and women. For all
William F. Anderson; Asad Umar; Otis W. Brawley
Thermostability of epithelial cell matrix in composition of normal and breast ductal carcinoma tissues at various stages of the disease has been studied in the temperature range 40-90°C with help of differential scanning calorimeter (DSC). It has been shown that the denaturation process has three stages of transition in both cases. The temperatures corresponding to maxima of these structural transitions (Td) in case of normal and ductal carcinoma tissues equals to 55 , 66,78 C and 48, 55, 60, 85°C, respectively. Denaturation enthalpy (?Hd) reflects contribution of hydrogen bonds, electrostatic and hydrophobic interactions in stability of native structures of biomacromolecules; in case of normal tissues, it equals 68,5±6.0 J/g dry biomass and decreases up to 52.5±6.0 J/g dry biomass in stage III of the disease. On the basis of presented and published experimental data, it is affirmed that the dominant transitions with Td around 66 and 60°C in case of norm and carcinoma, accordingly, correspond to denaturation of collagen IV fibers--the main component of microenvironment of duct epithelial cells (ECM)--and weakly expressed transition stages at 55, 78, 85°C correspond to denaturation of cytoplasmatic proteins. It is supposed that the observed significant differences in thermostability, in particular, 6° decrease of the ECM main component collagen, 7° increase of cytoplasmic proteins, and a significant decrease of total ?Hd in case of ductal carcinoma compared to norm may be used as a new express test together with other existed tests for diagnosis of breast cancer at early stage of disease using some mg quantities of biopsy tissue. PMID:21778550
Monaselisdze, J; Lezhava, T; Nemsadze, G; Kikalishvili, L; Ramishvili, M
BACKGROUNDOverexpression of regulatory peptide receptors in selected human tumours is of diagnostic and therapeutic relevance.AIMSTo evaluate the expression of somatostatin, vasoactive intestinal peptide (VIP), substance P, cholecystokinin (CCK) A and B, and neurotensin receptors in hepatocellular carcinoma (HCC).METHODSIn vitro receptor autoradiography for the various peptide receptors using selective iodinated radioligands on tissue sections in 59 cases of HCC.RESULTS41% of HCC
J C Reubi; A Zimmermann; S Jonas; B Waser; P Neuhaus; U Läderach; B Wiedenmann
A clinical and pathological study was undertaken to define the prevalence, clinical presentation and outcome of thyroid carcinoma\\u000a in children and adolescents. Clinical records from 48 patients under 20 years of age at diagnosis, out of 372 patients with\\u000a thyroid cancer examined between 1980 and 1994, were retrospectively reviewed. Female\\/male ratio was 3.8\\/1. None had a previous\\u000a positive history of
D. Danese; A. Gardini; A. Farsetti; S. Sciacchitano; M. Andreoli; A. Pontecorvi
The management of advanced renal cell carcinoma (RCC) has evolved greatly in recent years. The role and benefit of debulking\\u000a nephrectomy has been more clearly defined. Long-considered an immunoresponsive tumor, cytokines such as interferon-? (IFN-?)\\u000a and interleukin-2 (IL-2) evolved into the standard initial treatment for advanced RCC through clinical trials in the 1980s\\u000a and 1990s. More recently, a growing understanding
Brian I. Rini; Ronald M. Bukowski
A trend in the incidence of hepatocellular carcinoma (HCC) in Japan was studied from the data of the Osaka Cancer Registry (population, 8,512,351 in 1981) for the period of 1963-1983, the Vital Statistics of Japan, Ministry of Health and Welfare, and the Japan Autopsy Registry which contained 594,132 individually filed cases in the 26-year period from 1958 to 1983. Both
Kunio Okuda; Isaburo Fujimoto; Aya Hanai; Yoshinori Urano
Basement membranes can be a barrier to tumour growth, but basement membrane molecules, including laminins, are also important autocrine factors produced by cancers to promote tumorigenesis. Many studies have shown the importance of laminin 332 (previously known as laminin 5) in this process, especially in squamous cell carcinoma. Through interactions with several cell-surface receptors (including ?6?4 and ?3?1 integrins, epidermal
M. Peter Marinkovich
Precise assessment of the extent of nasopharyngeal carcinoma (NPC) represents the basic step towards optimal treatment. We\\u000a compared the capacity of CT and MRI in assessing the extent of NPC in 67 patients. MRI was superior to CT in demonstrating\\u000a lesions in the retropharyngeal node, skull base, intracranial area, carotid space, longus colli muscle and levator palatini\\u000a muscle. Of 25
S. H. Ng; T. C. Chang; S. F. Ko; P. S. Yen; Y. L. Wan; L. M. Tang; M. H. Tsai
OBJECTIVE:Hepatocellular carcinoma (HCC) is common in Asia, and the majority are not suitable for curative surgical treatment. We studied the natural history of untreated nonsurgical HCC to examine whether the prognosis has changed with improved supportive treatment and to identify factors affecting survival.METHODS:One hundred and six ethnic Chinese patients with HCC not amenable to curative treatment were managed symptomatically as
Yuk Pang Yeung; Chung Mau Lo; Chi Leung Liu; Benjamin C. Wong; Sheung Tat Fan; John Wong
Hepatocellular carcinoma is a significant cause of mortality worldwide and a growing problem in the United States. Treatment\\u000a options are often limited, and median survival is less than 1 year. Thus, prevention may provide the best opportunity to alter\\u000a the natural history of this disease. Primary prevention is best exemplified by the successes of such public health measures\\u000a as universal
Will J. Fecht; Alex S. Befeler
An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery.
Gojska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech
An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery. PMID:23204580
Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech
Resistance to cytotoxic chemotherapy is the main cause of therapeutic failure and death in women suffering from ovarian carcinoma.\\u000a The standard first-line chemotherapy of ovarian cancer consists of a combination of a taxane and a platinum-containing drug.\\u000a Thus, the cellular and molecular mechanisms involved in resistance against these compounds are of vital importance in the\\u000a context of chemotherapy of ovarian
Hermann Lage; Carsten Denkert
A 36-year-old man was treated by radiotherapy for tinea capitis many years before discovery of microcystic adnexal carcinoma (MAC). Because of patient's refusal of any surgical intervention, we were able to follow the natural course of this tumor for 13 years. This case emphasizes the typical slow development of (MAC). The implication of the association of MAC and radiotherapy are discussed. PMID:2012112
Borenstein, A; Seidman, D S; Trau, H; Tsur, H
A case is described of a patient who developed radiation-induced optic neuropathy 18 months following cobalt-60 irradiation for carcinoma of the left maxillary antrum and ethmoid sinus. This case is unusual because of the early onset of the optic nerve damage following radiation therapy and the ultimate emergence of the eye involved by tumor compression as the better eye in terms of visual acuity.
Singh, J.; Vashist, S.
Primary submandibular gland oncocytic carcinoma is a rare pathology, with only 10 cases being reported to date. We encountered a case of primary submandibular gland oncocytic carcinoma and report it herein. The patient was a 69-year-old man who came to our hospital with right submandibular cancer as the main complaint. Based on the results of computed tomography and magnetic resonance imaging, submandibular gland tumor was diagnosed. Preoperative cytodiagnosis suggested class III oncocytic carcinoma. Resection of the right submandibular tumor was performed along with right neck dissection. Postoperative histopathological diagnosis was oncocytic carcinoma. As of 3 years following surgery, no recurrence has been identified.
Tokashiki, Kunihiko; Tsukahara, Kiyoaki; Motohashi, Ray; Nakamura, Kazuhiro; Suzuki, Mamoru
An editorial is presented which discusses the treatment of carcinoma of the anal canal. Following the initial report of the successful preoperative use of combined chemotherapy and radiation by Nigro in 1974, several centers have confirmed the effectiveness of such combinations either as preoperative or as definitive treatment of anal carcinomas, and many patients are now being referred for radiation therapy. The article by Cantril in this issue describe the successful treatment of anal carcinomas by radiation alone, and raises the important issue of whether radiation plus chemotherapy is more effective treatment than radiation alone for squamous or cloacogenic carcinomas arising in the anal canal or perianal area. Several studies are cited.
Anterior Gradient-2 expression is critical in normal embryonic development. Aberrant expression of Anterior Gradient-2 in adult tissues has been linked to breast, prostate, esophageal, and pancreatic carcinoma. To define the role of Anterior Gradient-2 in primary hepatocellular neoplasms, we used tissue microarrays and examined protein expression in typical hepatocellular carcinomas (N=44), fibrolamellar carcinomas (N=12), and hepatic adenomas (N=9). In non-neoplastic liver tissues, Anterior Gradient-2 was expressed in the septal-sized bile ducts and weakly in zone 3 hepatocytes in 11/61 (18%) of cases. In tumors, Anterior Gradient-2 was over expressed by only 1/44 (2%) of hepatocellular carcinomas. In contrast, 6/8 (75%) of fibrolamellar and 3/4 (75%) metastatic fibrolamellar carcinomas were positive. All 9 hepatic adenomas were negative. Further analysis of mRNA in fibrolamellar carcinomas identified 2 novel splice variants, but expression levels were very low. Sequencing of the Anterior Gradient-2 gene in fibrolamellar carcinomas identified several polymorphisms (refSNP Ids: rs6842, rs8071, rs1051905) but no mutations. In conclusion, Anterior Gradient-2 is over expressed in the majority of fibrolamellar carcinomas but only rarely is over-expressed in hepatocellular carcinomas.
Vivekanandan, Perumal; Micchelli, Shien T.L.; Torbenson, Michael
Mucoepidermoid carcinoma is the most common malignant salivary gland tumour. However, short series or individual case reports have identified this tumour in the maxilla, mandible, breast tissue and thymus. Mucoepidermoid carcinoma originates from minor salivary glands, and it is therefore surprising that it is not more commonly seen in the tonsil. To date, we believe there has been only one previously reported case in the world literature of mucoepidermoid carcinoma occurring in the tonsil 1. We present a very rare case of mucoepidermoid carcinoma arising from within the structure of the palatine tonsil, rather from the adjacent pharyngeal wall, together with a short review of the literature. PMID:24043918
Jarvis, S J; Giangrande, V; Brennan, P A
Anterior gradient-2 expression is critical in normal embryonic development. Aberrant expression of anterior gradient-2 in adult tissues has been linked to breast, prostate, esophageal, and pancreatic carcinoma. To define the role of anterior gradient-2 in primary hepatocellular neoplasms, we used tissue microarrays and examined protein expression in typical hepatocellular carcinomas (n = 44), fibrolamellar carcinomas (n = 12), and hepatic adenomas (n = 9). In nonneoplastic liver tissues, anterior gradient-2 was expressed in the septal-sized bile ducts and weakly in zone 3 hepatocytes in 11 (18%) of 61 cases. In tumors, anterior gradient-2 was overexpressed by only 1 (2%) of 44 hepatocellular carcinomas. In contrast, 6 (75%) of 8 fibrolamellar and 3 (75%) of 4 metastatic fibrolamellar carcinomas were positive. All 9 hepatic adenomas were negative. Further analysis of mRNA in fibrolamellar carcinomas identified 2 novel splice variants, but expression levels were very low. Sequencing of the anterior gradient-2 gene in fibrolamellar carcinomas identified several polymorphisms (refSNP Ids: rs6842, rs8071, rs1051905) but no mutations. In conclusion, anterior gradient-2 is overexpressed in the majority of fibrolamellar carcinomas but is only rarely overexpressed in hepatocellular carcinomas. PMID:18973922
Vivekanandan, Perumal; Micchelli, Shien T L; Torbenson, Michael
Insular carcinoma, once considered a poorly-differentiated thyroid cancer, has been reclassified as a distinct thyroid neoplasm. Since this neoplasm is composed of follicular epithelial cells, it may concentrate radioiodide (131I) making postoperative 131I imaging for detection of metastases and radiotherapy possible. A 20-yr review of 35 cases diagnosed as anaplastic or undifferentiated thyroid carcinoma at this medical center revealed five patients with insular carcinoma. Four patients showed postoperative 131I localization and received therapeutic doses of 131I. Three of the four showed extrathyroidal 131I localization in neoplastic lesions. In one patient, the resolution of metastatic lesions by magnetic resonance and 131I imaging suggests that 131I may have an important therapeutic role in this aggressive neoplasm.
Justin, E.P.; Seabold, J.E.; Robinson, R.A.; Walker, W.P.; Gurll, N.J.; Hawes, D.R. (Department of Radiology, University of Iowa College of Medicine, Iowa City (USA))
A 98-year-old woman with aspiration pneumonia caused by vomiting was admitted to our hospital. Abdominal computed tomography and ultrasonography showed common bile duct dilation and occlusion of the gastrointestinal tract due to a large tumor in the duodenum. Aspiration pneumonia and hepatic failure led to the patient's death. Pathological autopsy showed an 11 × 6 × 2.5-cm polypoid tumor originating from the descending part of the duodenum and involving the common bile duct. Histological examination of the tumor showed mainly spindle cells but also some adenocarcinoma cells. Tumor cells, including spindle cells, were strongly positive for cytokeratin 7; therefore, sarcomatoid carcinoma originating from the duodenum was diagnosed. To the best of our knowledge, only 5 cases of sarcomatoid carcinoma originating from the duodenum have been reported, and they often show polypoid growth. The possibility of sarcomatoid carcinoma should be considered if such findings are noted. PMID:22306544
Katsube, Tomoya; Watanabe, Yoshihisa; Hannoda, Rie; Umeda, Shugo; Wada, Rikimon; Takahashi, Makoto; Kobayashi, Yasutsugu; Arakawa, Tetsuo
Concomitant primary sarcomatoid hepatocellular carcinoma (SHC) with gallbladder carcinoma is a rare type of hepatobillary disease. To the best of our knowledge, this coexistence has rarely been reported. An 80-year-old male presented with right-sided epigastric pain and a low fever. Computed tomography (CT) imaging revealed a hypodense lesion in the right lobe of the liver and a regular intraluminal polypoid mass in the gallbladder. The patient underwent a partial hepatectomy of the right lobe of the liver and a cholecystectomy. Following pathological examination, the patient was diagnosed with SHC combined with gallbladder adenocarcinoma. The patient and his family refused post-operative adjuvant chemotherapy and radiation therapy. The patient succumbed to intrahepatic and lung metastases at six months post-surgery. In conclusion, concomitant gallbladder carcinoma and SHC may occur. Surgery-based multimodal treatment is the preferred strategy for compound tumors. Adjuvant chemotherapy or radiotherapy may be necessary for the high risk hepatobiliary malignancies.
XUE, DONG; ZUO, KAI; LI, XINJUN; CHEN, HONGQIANG; XU, YUNFEI; CHENG, YU; CHEN, YUXIN
Sclerosing Odontogenic Carcinoma (SOC) was first described by Koutlas et al. in 2008. SOC is a low-grade odontogenic carcinoma, which presents as an expansile radiolucency that causes tooth displacement and root resorption. It is locally aggressive but reports suggest a very low probability of regional or distant metastasis. SOC contains small nests and thin cords of small cuboidal or polygonal epithelial cells with cytoplasmic clearing. Pleomorphism and mitoses are not prominent. Skeletal muscle and perineural infiltration with stromal sclerosis is characteristic. Immunohistochemically, SOC stains for cytokeratins (CK) 5/6 and 19, and e-cadherin. Nuclear staining with p63 is also positive. CK20, carcinoembryonic antigen and CAM 5.2 are negative. We report a rare entity of primary intraosseous carcinoma of the maxilla which has the clinical and histological markers of SOC. Occurrence in the maxilla has been reported only once before in the literature. PMID:23567261
Hussain, Omar; Rendon, Alica Torres; Orr, Robert L; Speight, Paul M
New minimally invasive technologies are currently being applied to the management of renal cell carcinoma in an effort to decrease operative time, pain, morbidity and hospital stay. Foremost among these is the burgeoning role of laparoscopy in tumor destruction and complete in vivo resection. The primary modalities in clinical use today are laparoscopic radical nephrectomy, laparoscopic partial nephrectomy, laparoscopic renal cryoablation and laparoscopic radiofrequency ablation. Most initial reports include only highly selected patients with unifocal, small, exophytic, peripheral lesions away from the collecting system. As experience with these techniques increases, larger and more difficult lesions are being approached laparoscopically, with promising anecdotal results reported. Laparoscopic access to the kidney may be retroperitoneal or transperitoneal. Complete tumor destruction with maximal preservation of unaffected nephrons remains the goal. Herein, an update on laparoscopic surgery for renal cell carcinoma is presented. For each procedure, the current indications and contraindications, perioperative data, complications and oncological outcomes are described. In the future, it appears likely that laparoscopy will play a major role in the established treatment options for renal cell carcinoma, with open surgery being reserved for specific indications. PMID:14686705
Hasan, Waleed A; Abreu, Sidney C; Gill, Inderbir S
The aggressiveness of small (oat) cell carcinoma of the larynx presents a therapeutic challenge to the oncologist. Since the first description of this type of carcinoma in 1972, 52 patients have been reported in the literature and a variety of treatment regimens have been used. The purpose of this study was to report two new cases and review all previous reports to determine the disease's biological behavior, clinical manifestations, and optimum treatment. Thirty-five percent of the tumors were transglottic, and 27% were supraglottic. Fifty-four percent of patients had regional metastases at initial presentation and 17.6% had distant metastases. The median survival was 10 months for all patients. Patients who were treated with chemotherapy with or without other modalities had the best 2-year survival rates (52.2%). Forty-one percent of patients had regional recurrence only, 12.5% had regional recurrence and distant metastases, and 2% developed distant metastases only. We conclude that patients with oat cell carcinoma of the larynx should be treated with combination chemotherapy and radiation therapy. Surgery is best reserved for persistent and recurrent disease at the primary site and neck.
Aguilar, E.A. III; Robbins, K.T.; Stephens, J.; Dimery, I.W.; Batsakis, J.G.
Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor characterized by ETV6 translocation. It appears that prior studies have identified MASC by reviewing salivary gland carcinomas, such as acinic cell carcinoma and adenocarcinoma, not otherwise specified. To address the possibility of MASC mimicking benign salivary neoplasms we reviewed 12 salivary gland (cyst)adenomas diagnosed prior to the discovery of MASC. One encapsulated (cyst)adenoma of the parotid gland demonstrated features of MASC. The diagnosis was confirmed by fluorescence in situ hybridization with an ETV6 break-apart probe. An unusual complex pattern of ETV6 rearrangement with duplication of the telomeric/distal ETV6 probe was identified. This case illustrates that MASC may mimic salivary (cyst)adenomas. To more accurately assess true clinical and morphologic spectrum of MASC, future studies may have to include review of salivary (cyst)adenomas. The differential diagnosis of MASC may have to be expanded to include cases resembling salivary (cyst)adenomas. PMID:23620147
Williams, Lindsay; Chiosea, Simion I
The treatment of advanced renal cell carcinoma has been completely changed by the development of new therapeutic modalities during the past 3 years. In this time period six targeted agents have been approved for the treatment of advanced or metastatic disease. Phase 3 data support the use of sunitinib, bevacizumab plus interferon-? and pazopanib for patients with low and intermediate risk of clear-cell renal cell carcinoma. In the pivotal study of temsirolimus a significant longer overall survival compared with interferon-? in high-risk disease including non-clear-cell histology was observed. Patients pretreated with cytokines will benefit from sorafenib and pazopanib while everolimus has been shown to increase significantly progression-free survival after previous anti-angiogenesis therapy. In addition to these phase 3 data-based recommendations, several other factors have to be considered for treatment selection, for example, side effect profile and patients’ comorbidities. Currently, the sequential use of the available targeted drugs and adjuvant treatment are the subject of ongoing clinical trials. However, medical treatment of renal cell carcinoma remains palliative and surgery remains the only curative approach in patients with localized, locally advanced and limited metastatic disease.
Grimm, Marc-Oliver; Wolff, Ingmar; Zastrow, Stefan; Frohner, Michael; Wirth, Manfred
Despite significant advances in the diagnosis, staging and treatment of patients with renal cell carcinoma, recurrence rates following surgical resection of locally aggressive tumours remain high. In an effort to delay disease progression and improve survival, the concept of adjuvant therapy has been proposed. Optimal adjuvant therapy for surgically resected renal cell carcinoma remains to be defined and the evaluation of adjuvant therapies will require properly controlled and adequately powered randomised trials. Promising preliminary results have been seen with active immunotherapies and agents that target critical signalling pathways, and there are several Phase III trials of these novel treatment options that are underway. In addition, classification of patients into high- and low-risk subgroups on the basis of a prognosis profile will serve as a useful means to guide clinicians in improving the selection of patients who are likely to derive benefit from adjuvant therapy. This will lead to a future area of investigation, which will be the identification of patients within the target population that should respond to a given treatment. This review will discuss the role and current status of adjuvant therapies for renal cell carcinoma. PMID:16556087
Lam, John S; Belldegrun, Arie S; Figlin, Robert A
The purpose of this study was to assess the ability of intraoperative tissue staining with consecutive application of 0.4% indigo carmine and 0.5% Congo red to demonstrate the extent and border of oral carcinoma invasion. Seventeen patients were included in the study. Once the oral tumor was resected, a vertical section of surgical specimen was taken from the central part of the tumor. The extent and border of the invaded carcinoma were assessed on digital microscopic examination with tissue staining. The results of assessments were compared with corresponding results of conventional histopathological analysis with HE staining, which is considered the gold standard. Tissue staining produced a brown-black stain on normal muscle, connective, and salivary tissues but not tumor and epithelial tissues. It clearly demonstrated the extent and border of tumor invasion in 13 of 17 patients (76.5%); however, detection of remnant vital tumor cells in scar tissue after neoadjuvant chemotherapy, and distinction between the tumor and adipose tissue scattered in the muscle tissue was difficult. The results of this study showed that intraoperative tissue staining was a possible method in demonstrating the extent and border of carcinoma deeply invaded in the soft tissue and selecting the site for additional frozen section analysis, although the method needed some refinement. PMID:18575826
Kurita, Hiroshi; Kamata, Takahiro; Koike, Takeshi; Kobayashi, Hiroichi; Kurashina, Kenji
Pegylated liposomal doxorubicin for platinum-resistant or refractory Müllerian carcinoma (epithelial ovarian carcinoma, primary carcinoma of Fallopian tube and peritoneal carcinoma): A single-institutional experience.
The aim of the present study was to evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) in patients with Müllerian carcinoma treated at our hospital. Nineteen patients with platinum-resistant Müllerian carcinoma were treated with intravenous PLD 50 mg/m(2) every 4 weeks. Tumor response was assessed by MRI following every 2-3 cycles of treatment. The severity of adverse events was assessed according to the Common Terminology Criteria for Adverse Events (v3.0). The best overall responses in the 19 patients were identified as 5 partial responses (PR), 6 stable diseases (SD) and 8 progressive diseases (PD). Response rate was 26.3%. The proportion of patients with CR, PR or SD was 57.9%. The median time to progression was 188.0 days. The median survival time was 381.0 days. Toxicity grades were identified as one grade III hand-foot syndrome, two grade III neutropenia, one grade IV hand-foot syndrome, one grade IV stomatitis and one grade IV neutropenia. The present study confirmed that PLD is an effective drug when administered as a salvage therapy for the treatment of Müllerian carcinoma and is associated with a reduced toxicity profile compared with current therapeutic options. PMID:23255889
Fukuda, Takeshi; Sumi, Toshiyuki; Teramae, Masatomo; Nakano, Yusuke; Morishita, Masanari; Terada, Hiroyuki; Yoshida, Hiroyuki; Matsumoto, Yoshinari; Yasui, Tomoyo; Ishiko, Osamu
To determine the computed tomographic (CT) characteristics of nonfunctioning islet cell carcinoma of the pancreas, the CT scans of 27 patients with that disease were reviewed. The pancreatic tumor was identified as a mass in 26 patients (96%) Of the 25 tumors evaluated with contrast enhancement, 20 became partially diffusely hyperdense relative to nearby normal pancreatic tissue. Hepatic metastases were identified in 15 patients (56%), regional lymphadenopathy in 10 (37%), atrophy of the gland proximal to the tumor in six (22%), dilatation of the biliary ducts in five (19%), and dilatation of the pancreatic duct in four (15%). The CT appearances of the nonfunctioning islet cell tumors were compared with those of 100 ordinary (ductal) pancreatic adenocarcinomas. Although the two types of tumors were sometimes indistinguishable, features found to be more characteristic of islet cell carcinoma included a pancreatic mass of unusually large size, calcification within the tumor, and contrast enhancement of either the primary tumor or hepatic metastases. Involvement of the celiac axis or proximal superior mesenteric artery was limited to ductal carcinoma.
Eelkema, E.A.; Stephens, D.H.; Ward, E.M.; Sheedy, P.F. II
A pulmonary resection of metastatic colorectal carcinoma is an accepted method of treatment. The purpose of this study was to confirm the role of resections for pulmonary metastases from colorectal carcinoma, and to determine the clinical course, outcome, and prognostic factors after surgery. A retrospective analysis was conducted of the records of all patients with pulmonary metastases from colorectal carcinoma who underwent a surgical resection between 1995 and 2008, at a single surgical center. The overall 5-year survival rate was 74%. Multivariate Cox analysis demonstrated that the number of pulmonary metastases (HR: 9.40, 95% confidence interval (CI): 1.08-82.2, P=0.0428) and prethoracotomy carcinoembryonic antigen (CEA) level (HR: 9.79, 95% CI: 1.11-86.8, P=0.0404) were statistically significant predictors of survival after the first pulmonary metastasectomy. In addition, a second resection for recurrent metastases was performed in eight patients, and a third resection was done in one patient. There were no major postoperative complications among the patients who underwent second or third resections. Pulmonary resections are considered to be a safe and effective treatment in selective patients. PMID:19635733
Maeda, Ryo; Isowa, Noritaka; Onuma, Hideyuki; Miura, Hiroshi; Harada, Tomoya; Touge, Hirokazu; Tokuyasu, Hirokazu; Kawasaki, Yuji
This research uses the tools of modern medical science to examine the ancient descriptions of the symptoms suffered by King Jehoram who was affected by some disease. The Biblical texts were examined, and passages relating to the disease that afflicted King Jehoram, who ruled in Jerusalem 843-851 B.C., were closely studied. We have not included any commentaries, but referred only to the words of the Bible exactly as written. The Passages ''...the Lord smote him in his bowels with an incurable disease in the process of time, after the end of two years, his bowels fell out by reason of his sickness: so he died of sore diseases'' indicate that the King suffered from some kind of disease which affected his bowels. Among the various diseases which may be associated with prolapse of the bowel, colorectal carcinoma is the most acceptable. It seems that the colorectal carcinoma was poorly differentiated, invaded perirectal adipose tissue, blood vessels, and/or lymphatic vessels, and/or perineural areas, was lymph node positive and reached the 4th stage with the spread of metastases to the distal organs. Viewed by a modern physician, the story of King Jehoram unfolds as possibly the earliest description of a patient afflicted by colorectal carcinoma. PMID:15785440
Liubov Louba, Ben-Noun
The definition of Barrett esophagus is currently under discussion. It is now suggested that a distal esophagus coated with cylinder epithelium with cardia-fundus mucosa should also be classified as Barrett esophagus because the risk of cancer is significantly increased even without histological evidence of intestinal metaplasia with goblet cells. The results of recent epidemiological investigations imply that the cancer risk of cylinder cell metaplasia and low grade intraepithelial neoplasia in Barrett esophagus has previously been overestimated. The histological detection of dysplasia still remains the best biomarker for estimation of the risk of cancer of Barrett esophagus. Exact determination of invasion depth in the mucosa, respective submucosa is now established as prognostic marker for overall survival in Patients with early carcinomas and this classification is useful for therapy decisions (endoscopic versus surgical removal). In advanced Barrett carcinoma following neoadjuvant therapy the lymph node status (ypN) is a better prognostic factor than the ypT category. In metastasized tumors therapies targeting HER2/new, EGFR or c-Met have been investigated explicitly in Barrett carcinoma only in phase I/II studies, whereby the predictive value of appropriate molecular pathology investigations is not yet reliably established. PMID:23011020
Werner, M; Laßmann, S
Fibrolamellar hepatocellular carcinoma (FLC) occurs in non-cirrhotic liver and the etiopathogenesis is still obscure. Both hepatocellular and cholangiocellular markers are expressed in the tumor, however, molecular alterations and altered pathways playing role in the tumor pathogenesis are not clearly identified. The purpose of the present study was to compare the expression level of EGFR, syndecan-1 and ß-catenin in FLC, conventional hepatocellular carcinoma (cHCC) and cholangiocellular carcinoma (CCC) and to investigate the possibility of mutation both in EGFR and K-RAS. Eight FLCs were compared with 7 cHCCs, 7 CCCs and 5 normal liver samples. Cytokeratins 7, 8, 18, 19, HepPar1 (HSA), EGFR, syndecan-1 (CD138) and ß-catenin were detected by immunohistochemistry. In addition EGFR, ß-catenin and syndecan-1 were evaluated by digital morphometry and K-RAS, EGFR mutations in FLC cases using paraffin-embedded samples. All FLCs were positive for HepPar1 (HSA) and cytokeratins 7, 8, 18, but negative for cytokeratin 19 by immunohistochemistry. EGFR was significantly overexpressed in all three tumor types, being highest in FLCs (p?=?0,0001). EGFR, K-RAS mutation analyses revealed no mutations in exons studied in FLCs. Our findings proved that expression of EGFR is higher in FLC than in other types of primary malignant hepatic tumors and no K-RAS mutation can be detected, so FLC is a good candidate for anti-EGFR treatment. PMID:22872444
Patonai, Attila; Erdélyi-Belle, Boglárka; Korompay, Anna; Somorácz, Aron; Törzsök, Péter; Kovalszky, Ilona; Barbai, Tamás; Rásó, Erzsébet; Lotz, Gábor; Schaff, Zsuzsa; Kiss, András
A 68-year-old woman was referred to the Oculofacial Plastic and Reconstructive Surgery service for evaluation of a left upper eyelid lesion that was worrisome for carcinoma. The mass measured 8 × 8 mm; it was well-circumscribed, pink, and firm with distortion of the eyelid margin, central ulceration, and loss of the lashes. The patient denied previous surgery or trauma in this area, but she had a history of blepharopigmentation (tattoo eyeliner) of all 4 eyelids approximately 7 years prior. Incisional biopsy revealed inflammatory changes consistent with a localized reaction to the tattoo pigment granules. Local kenalog injection was attempted with improvement of the overall appearance but with persistent deformity including irregularity of the margin and loss of lashes. The persistent abnormal appearance was worrisome for an underlying carcinoma missed on the initial incisional biopsy and prompted a full-thickness wedge resection and reconstruction of the abnormal area. The results of biopsy of the excised tissue confirmed absence of malignant neoplasm and showed changes consistent with tattoo granuloma. Tattoo granuloma of the eyelid should be considered in the differential diagnosis of eyelid lesions worrisome for carcinoma in patients with a history of blepharopigmentation. PMID:23511999
Bee, Carson R; Steele, Eric A; White, Kevin P; Wilson, David J
Most intraductal papillary-mucinous carcinomas (IPMCs) of the pancreas are resectable and curable, but some develop into frankly invasive carcinomas. We studied the clinicopathologic features of eight cases of invasive carcinoma derived from IPMC (IC-IPMC) of the pancreas. The patients were aged 54-75 years (mean, 66.6 years); six were male and two were female. The mean tumor size was 7.7 cm
Noriyoshi Fukushima; Kiyoshi Mukai; Michiie Sakamoto; Takahiro Hasebe; Kazuaki Shimada; Tomoo Kosuge; Taira Kinoshita; Setsuo Hirohashi
We report herein a case of papillary carcinoma which appeared to transform into anaplastic carcinoma during postoperative\\u000a radioactive iodine-131 (131I) therapy. A 67-year-old man who was diagnosed as having papillary thyroid carcinoma with bilateral neck lymph node involvement\\u000a and multiple lung metastases underwent total thyroidectomy prior to131I therapy. Immediately after a second course of131I therapy, the patient complained of right
Kiyoshi Shingu; Shinya Kobayashi; Shiro Yokoyama; Minoru Fujimori; Kazuhiko Asanuma; Ken-ichi Ito; Yoshihisa Hama; Masayuki Maruyama; Ritsu Kusama; Jun Amano
The sequence of tumorigenesis in the thyroid is unclear. It has been proposed that anaplastic carcinomas of the thyroid develop\\u000a by dedifferentiation in pre-existing differentiated carcinomas. We reviewed all anaplastic and insular (poorly differentiated)\\u000a thyroid carcinomas in a consultation practice of thyroid pathology that included more than 400 thyroid cancers. Sixteen tumors\\u000a (4%) were classified as anaplastic or insular (poorly
Bernard F. A. M. Van der Laan; Jeremy L Freeman; Richard W. Tsanq; Sylvia L Asa
Recent studies have reported that pancreatic ductal carcinomas are frequently found during the follow-up of pancreatic cysts\\u000a distinct from carcinoma; however, the majority of them are detected in advanced stages. Therefore, the early detection of\\u000a metachronous ductal carcinomas is one of the issues in the management of pancreatic cysts. A 25-mm pancreatic cyst in the\\u000a pancreatic head was found during
Natsuko KawadaHiroyuki; Hiroyuki Uehara; Kazuhiro Katayama; Sachiko Tanaka; Rena Takakura; Yasuna Takano; Tatsuya Ioka; Miho Nakao; Kazuho Imanaka; Kazuyoshi Ohkawa; Akemi Takenaka; Yasuhiko Tomita; Osamu Ishikawa
This is the second of a 3-part review of the clinicopathologic features of intraosseous carcinoma of the jaws (IOCJ). This part deals with odontogenic carcinomas, rare entities that are difficult to evaluate because of changes in classification/nomenclature, lack of standardized diagnostic criteria, and variable consistency of the existing literature. Endorsing a critical approach, problems are addressed and areas of uncertainty are highlighted. As in part I, we emphasize histopathologic features from a diagnostic point of view and also question the existence of some "distinct" entities. PMID:22290834
Woolgar, Julia A; Triantafyllou, Asterios; Ferlito, Alfio; Devaney, Kenneth O; Lewis, James S; Rinaldo, Alessandra; Slootweg, Pieter J; Barnes, Leon
The occurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) synchronously in the same kidney is exceedingly rare. All reported cases have been managed with either nephroureterectomy or nephrectomy. We report on a patient who required renal-sparing management of his double malignancy, including open partial nephrectomy of his pT1a RCC and endoscopic laser ablation of his low-grade Ta renal pelvis UC. After 4 years, the patient is in good health and disease-free under strict surveillance. It, therefore, would appear justified to combine partial nephrectomy for RCC and endoscopic management of UC in the same kidney of an appropriately selected patient.
Bay, Benjamin N.; Black, Peter
This is the first part of a 3-part comprehensive review of intraosseous carcinoma of the jaws. We have outlined 4 groups of intraosseous carcinoma of the jaws (metastatic, salivary-type, odontogenic, and primary intraosseous carcinoma), emphasizing the need for accurate diagnosis and the problems associated with changing classification systems, standardization of diagnostic criteria and nomenclature, and the accuracy of existing literature. In this first part, the features of metastatic and the very rare salivary-type carcinomas of the jaws are examined with particular emphasis on histologic and immunohistochemical characteristics, diagnostic difficulties, and uncertainties. PMID:22290811
Woolgar, Julia A; Triantafyllou, Asterios; Ferlito, Alfio; Devaney, Kenneth O; Lewis, James S; Rinaldo, Alessandra; Slootweg, Pieter J; Barnes, Leon