RESUMEN
BACKGROUND: Primary cardiac tumors, while rare, present significant clinical challenges due to their diverse pathology and presentation. Lung cancer frequently metastasizes to the heart; however, cases involving primary cardiac tumors of different origins alongside primary lung cancer are exceedingly rare in the literature. CASE PRESENTATION: We report the case of a 53-year-old female who presented with hemoptysis and was subsequently diagnosed with a left atrial myxoma, pulmonary squamous cell carcinoma, and a thymic cyst. This coexistence of multiple non-homologous tumors in a single patient is exceedingly rare. CONCLUSION: This case underscores the complexity of diagnosing and managing patients with multiple distinct tumors. The simultaneous occurrence of a primary cardiac myxoma, pulmonary squamous cell carcinoma, and thymic cyst is unprecedented, providing valuable insights for future clinical practice.
Asunto(s)
Carcinoma de Células Escamosas , Atrios Cardíacos , Neoplasias Cardíacas , Neoplasias Pulmonares , Quiste Mediastínico , Mixoma , Humanos , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/patología , Femenino , Persona de Mediana Edad , Carcinoma de Células Escamosas/cirugía , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/patología , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/patología , Quiste Mediastínico/cirugía , Quiste Mediastínico/complicaciones , Quiste Mediastínico/patología , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/patología , Atrios Cardíacos/patología , Atrios Cardíacos/cirugía , Neoplasias Primarias Múltiples/cirugía , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/complicacionesRESUMEN
Ectopic ACTH syndrome (EAS) remains one of the most demanding diagnostic and therapeutic challenges for endocrinologists. Thymic neuroendocrine tumors account for 5%-10% of all EAS cases. We report a unique case of a 31-year-old woman with severe EAS caused by primary metastatic combined large-cell neuroendocrine carcinoma and atypical carcinoid of the thymus. The patient presented with severe hypercortisolemia, which was successfully controlled with continuous etomidate infusion. Complex imaging initially failed to detect thymic lesion; however, it revealed a large, inhomogeneous, metabolically active left adrenal mass infiltrating the diaphragm, suspected of primary disease origin. The patient underwent unilateral adrenalectomy, which resulted in hypercortisolemia resolve. The pathology report showed an adenoma with adrenal infarction and necrosis. The thymic tumor was eventually revealed a few weeks later on follow-up imaging studies. Due to local invasion and rapid progression, only partial resection of the thymic tumor was possible, and the patient was started on radio- and chemotherapy.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Carcinoma Neuroendocrino , Síndrome de Cushing , Neoplasias del Timo , Humanos , Femenino , Adulto , Neoplasias del Timo/complicaciones , Neoplasias del Timo/patología , Neoplasias del Timo/cirugía , Síndrome de Cushing/etiología , Síndrome de Cushing/patología , Carcinoma Neuroendocrino/patología , Carcinoma Neuroendocrino/secundario , Carcinoma Neuroendocrino/complicaciones , Carcinoma Neuroendocrino/cirugía , Neoplasias de las Glándulas Suprarrenales/complicaciones , Neoplasias de las Glándulas Suprarrenales/secundario , Neoplasias de las Glándulas Suprarrenales/patología , Síndrome de ACTH Ectópico/diagnóstico , Síndrome de ACTH Ectópico/patología , Síndrome de ACTH Ectópico/etiología , Adrenalectomía , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/complicacionesRESUMEN
Synchronous multiple primary lung tumors are a relatively rare entity with an increasing incidence in recent years due to the development of thoracic imaging and immunohistochemical techniques. The second lesion is considered in most cases as a secondary location, which partly explains the decrease in the incidence of this entity. We report the observation of a 74-year-old patient with two synchronous primary lung tumors, an adenocarcinoma and an epidermoid carcinoma. Through this clinical observation, we highlight the difficulty of diagnosing synchronous tumors and the major interest of new imaging modalities and immunohistochemical techniques for the optimal management of these tumors.
Asunto(s)
Adenocarcinoma , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Neoplasias Primarias Múltiples , Humanos , Anciano , Neoplasias Pulmonares/patología , Pulmón/patología , Adenocarcinoma/patología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/patologíaAsunto(s)
Neoplasias de las Glándulas Suprarrenales , Neoplasias Meníngeas , Meningioma , Neoplasias Primarias Múltiples , Feocromocitoma , Humanos , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/complicaciones , Meningioma/diagnóstico por imagen , Meningioma/cirugía , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/cirugía , Feocromocitoma/diagnóstico , Feocromocitoma/diagnóstico por imagen , Femenino , Persona de Mediana EdadRESUMEN
Background: Long-term survivors of cutaneous malignant melanoma (CMM) risk subsequent malignancies due to both host-related and environmental risk factors. This retrospective population-based study differentially assesses the risk of synchronous and metachronous cancers in a cohort of CMM survivors stratified by sex. Methods: The cohort study (1999-2018) included 9,726 CMM survivors (M = 4,873, F = 4,853) recorded by the cancer registry of all 5,000,000 residents in the Italian Veneto Region. By excluding subsequent CMM and non-CMM skin cancers, the incidence of synchronous and metachronous malignancies was calculated according to sex and tumor site, standardizing for age and calendar year. The Standardized Incidence Ratio (SIR) was calculated as the ratio between the number of subsequent cancers among CMM survivors and the expected number of malignancies among the regional population. Results: Irrespective of the site, the SIR for synchronous cancers increased in both sexes (SIR = 1.90 in males and 1.73 in females). Both sexes also demonstrated an excess risk for synchronous kidney/urinary tract malignancies (SIR = 6.99 in males and 12.11 in females), and women had an increased risk of synchronous breast cancer (SIR = 1.69). CMM male survivors featured a higher risk of metachronous thyroid (SIR = 3.51, 95% CI [1.87, 6.01]), and prostate (SIR = 1.35, 95% CI [1.12, 1.61]) malignancies. Among females, metachronous cancers featured higher SIR values than expected: kidney/urinary tract (SIR = 2.27, 95% CI [1.29, 3.68]), non-Hodgkin's lymphoma (SIR = 2.06, 95% CI [1.24, 3.21]), and breast (SIR = 1.46, 95% CI [1.22, 1.74]). Females had an overall increased risk of metachronous cancers in the first 5 years after CMM diagnosis (SIR = 1.54 at 6-11 months and 1.37 at 1-5 years). Conclusion: Among CMM survivors, the risk of metachronous non-skin cancers is higher than in the general population and differs significantly by sex. These results encourage sex-tailored interventions for metachronous secondary cancer prevention.
Asunto(s)
Supervivientes de Cáncer , Melanoma , Neoplasias Primarias Múltiples , Neoplasias Primarias Secundarias , Humanos , Masculino , Femenino , Estudios de Cohortes , Estudios Retrospectivos , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Primarias Secundarias/etiología , Melanoma/epidemiología , Sobrevivientes , Neoplasias Primarias Múltiples/epidemiología , Neoplasias Primarias Múltiples/complicaciones , Melanoma Cutáneo MalignoRESUMEN
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a frequent fatal complication of chronic liver diseases in the stage of liver cirrhosis. HCC develops at a higher rate in patients with type 2 diabetes mellitus (DM2). DM2 is associated with an increased risk of developing malignant tumors. The term multiple primary neoplasia (MPN) is used to describe the occurrence of multiple primary tumors of different organs in the same individual. To the best of the authors knowledge, the topic of the association between HCC and MPN and DM2 has not been addressed in the Czech literature. Here we present the outcomes of retrospective statistical analysis of a cohort of patients with HCC who were dispensed at the Internal Medicine Clinic of the 1st Faculty of Medicine of the Charles University in the period 2011-2021 and the impact of DM2 and MPN on overall survival (OS). MPNs are relatively common in patients with HCC. The occurrence of MPNs in our cohort was associated with DM2 in half of the cases. Median OS in HCC patients was not significantly affected by the coincidence of DM2 and/or MPNs.
Asunto(s)
Carcinoma Hepatocelular , Diabetes Mellitus Tipo 2 , Neoplasias Hepáticas , Neoplasias Primarias Múltiples , Humanos , Carcinoma Hepatocelular/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Neoplasias Hepáticas/complicaciones , Estudios Retrospectivos , Cirrosis Hepática/complicaciones , Neoplasias Primarias Múltiples/complicacionesRESUMEN
Oral microbiome studies have mainly focussed on bacteria, with the relationship between viruses and oral cancers remaining poorly understood. Oral cancers can develop even in the absence of any history of daily smoking or drinking. Oral cancer patients frequently have multiple primary cancers in the oral cavity and other organs, such as the upper gastrointestinal tract. Merkel cell polyomavirus (MCPyV) is a novel oncovirus identified from a subtype of skin cancer in 2008. In this study, we investigated the potential involvement of MCPyV in the pathogenesis of oral squamous cell carcinoma (OSCC). Participants comprised 115 Japanese patients with OSCC (single primary: 109 tumours in 109 patients; multiple primaries: 16 tumours in 6 patients) treated in our department between 2014 and 2017. DNA was extracted from formalin-fixed paraffin-embedded specimens of primary lesions. MCPyV DNA copy counts were analysed by quantitative real-time polymerase chain reaction. Twenty-four of the 115 patients (20.9%) were positive for MCPyV DNA. No association was found between presence or absence of MCPyV DNA and clinical characteristics other than number of primary lesions. The MCPyV DNA-positive rate was significantly higher for multiple primary OSCCs (62.5%, 10/16 tumours) than for single primary OSCCs (16.5%, 18/109 tumours; P < 0.001). Furthermore, MCPyV DNA load was significantly higher for patients with multiple primaries (P < 0.05). MCPyV was observed more frequently and DNA load was significantly higher with multiple primary OSCCs than with single primary OSCC. MCPyV may play some role as an oncovirus for multiple primary OSCCs.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Poliomavirus de Células de Merkel , Neoplasias de la Boca , Neoplasias Primarias Múltiples , Infecciones por Polyomavirus , Humanos , Poliomavirus de Células de Merkel/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/complicaciones , Infecciones por Polyomavirus/complicaciones , Infecciones por Polyomavirus/diagnóstico , ADN Viral/análisis , ADN Viral/genética , Neoplasias Primarias Múltiples/complicacionesAsunto(s)
Poliposis Adenomatosa del Colon , Obstrucción Intestinal , Neoplasias Primarias Múltiples , Femenino , Humanos , Embarazo , Poliposis Adenomatosa del Colon/complicaciones , Poliposis Adenomatosa del Colon/cirugía , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/cirugíaRESUMEN
BACKGROUND: The number of cancer survivors continues to increase, thanks to advances in cancer diagnosis and treatment. Unfortunately, the incidence of a second primary cancer (SPC) is also increasing, but limited studies reporting incidence data are available regarding multiple cancers. This study presents our observations on multiple primary malignant cancers, the associations between sites, and the inherent sex differences. PATIENTS AND METHODS: We report the data, disaggregated by sex, concerning the SPCs that were recorded in the "Registro Tumori Integrato" (RTI) a population-based cancer registry in Sicily, Italy, as observed in the period from 2003 to 2017, in a total population of approximately 2,300,000. SPCs were divided into synchronous and metachronous cancers. The International Classification of Diseases for Oncology, third edition (ICD-O-3), was used for topographical and morphological classifications. Multiple primary cancers with multi-organ primitiveness were selected from the database of the RTI by extracting patients with more than one diagnosis. SPCs had different histology or morphology from the particular cancer that was considered to be the index cancer case. Multicenter or multifocal cancers, or metastases, were excluded. The percentages of cancer by sex and topography, the average age of incidence, and a breakdown by age were computed. RESULTS: Differences were observed between sexes in terms of incidence and site for SPCs. The most frequent SPC was skin cancer (20% of the SPCs observed). The associations among sites of multiple cancers are reported. CONCLUSION: There are many gaps in our knowledge of sex differences in cancer. The study of multiple primary cancers could bring more likely opportunities for evaluation of the cancer burden and trends that can be used to identify new research areas by population health programs, as well as for clinical researchers.
Asunto(s)
Neoplasias Primarias Múltiples , Neoplasias Primarias Secundarias , Femenino , Humanos , Incidencia , Masculino , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/epidemiología , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Primarias Secundarias/prevención & control , Sistema de Registros , Factores de Riesgo , Caracteres Sexuales , Sicilia , SobrevivientesRESUMEN
OBJECTIVE: To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification. METHODS: A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage â ¢ or higher malignancy, which was defined as high risk. RESULTS: Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage â ¢ or above had a relatively poor prognosis. CONCLUSION: MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.
Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Neoplasias Primarias Múltiples , Anciano , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/terapia , Femenino , Humanos , Neoplasias Renales/complicaciones , Neoplasias Renales/terapia , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/epidemiología , Neoplasias Primarias Múltiples/terapia , Pronóstico , Estudios RetrospectivosRESUMEN
PURPOSE: To report a case of neurofibroma involving the lymph nodes and to perform a literature review on this topic. OBSERVATIONS: A 72-year-old woman with a history of neurofibromatosis and biopsy-proven malignant melanoma of the left forearm underwent wide local excision of the malignant lesion along with sentinel axillary lymph node biopsy. Histological examination of axillary nodes revealed diffuse neurofibromatosis within 2 lymph node capsules. A thorough review of the English literature pertaining to intranodal neurofibroma was performed by querying Google Scholar and PubMed. Only 5 cases of intranodal neurofibroma have been described until now. CONCLUSIONS AND IMPORTANCE: Neurofibroma involving the lymph nodes is rare and this is the first reported case that is shown to diffusely involve the intracapsular space. Furthermore, intranodal neurofibroma can represent a diagnostic pitfall in the evaluation of sentinel lymph nodes for metastatic melanoma.
Asunto(s)
Melanoma/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neurofibroma/diagnóstico , Neurofibromatosis , Ganglio Linfático Centinela/patología , Neoplasias Cutáneas/diagnóstico , Anciano , Axila , Diagnóstico Diferencial , Resultado Fatal , Femenino , Antebrazo , Humanos , Melanoma/complicaciones , Melanoma/secundario , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/patología , Neurofibroma/complicaciones , Neurofibroma/patología , Biopsia del Ganglio Linfático Centinela , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patologíaRESUMEN
Collision synchronous tumors that are found at the same anatomical site are very rare. Their diagnostics, staging and treatment is very complicated. Here we present a clinical case of collision tumor in a single lymph node which consists of breast cancer and chronic lymphocytic leukemia/small lymphocytic lymphoma. The management of such cases is discussed.
Asunto(s)
Neoplasias de la Mama/patología , Leucemia Linfocítica Crónica de Células B/patología , Ganglios Linfáticos/patología , Neoplasias Primarias Múltiples/patología , Anciano , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/terapia , Femenino , Humanos , Leucemia Linfocítica Crónica de Células B/complicaciones , Leucemia Linfocítica Crónica de Células B/terapia , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/terapia , PronósticoRESUMEN
ABSTRACT: Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated intramural/submucosal mass in the gastric antrum and prepyloric area. It was considered as a benign tumor that exhibited no recurrence, metastasis, or tumor-related mortality. In this study, we reported 2 cases of gastric PF. The first case was a PF patient coexisting with gastric adenocarcinoma. The second case occurred in the gastric upper body close to gastric fundus. They underwent distal gastrectomy and laparoscopic partial gastric resection, respectively. Both of them exhibited a plexiform growth pattern in the submucosa, muscularis propria, and subserosal adipose tissues. The nodules were composed of abundant myxoid or fibromyxoid matrix riching in small thin-walled blood vessels and bland-looking spindle cells. The first case partially showed staggered growth pattern of PF and adenocarcinoma. Immunohistochemically, the spindle cells were diffusely immunoreactive for SMA and vimentin, and focally immunoreactive for CD10. It was important to distinguish the PF from other spindle cell tumors involving the stomach.
Asunto(s)
Adenocarcinoma/diagnóstico , Fibroma/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adulto , Diagnóstico Diferencial , Femenino , Fibroma/complicaciones , Fibroma/patología , Fibroma/cirugía , Gastrectomía , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/complicaciones , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
BACKGROUND: Pure Leydig cell tumors (LCTs) represent 0.1% of ovarian masses. Postmenopausal patients typically present with virilization. Although LCTs can be challenging to locate on conventional imaging, positron emission tomography (PET) has been demonstrated to be effective. CASE: A 64-year-old postmenopausal woman presented with alopecia, facial hirsutism, and clitoromegaly. Laboratory findings included elevated testosterone and androstenedione. Ultrasound, computed tomography, and magnetic resonance imaging showed no adnexal masses. PET did not demonstrate ovarian fludeoxyglucose-avidity. Histopathology after bilateral salpingo-oophorectomy revealed bilateral Leydig cell tumors. Her testosterone normalized 2 weeks postoperatively. CONCLUSION: We describe the occult, symptomatic, bilateral ovarian Leydig cell tumors, an occurrence that has not been described in the literature. Virilizing tumors must be considered in patients with evidence of hyperandrogenism, even without pelvic masses on imaging.
Asunto(s)
Tumor de Células de Leydig/patología , Neoplasias Primarias Múltiples/patología , Neoplasias Ováricas/patología , Virilismo/diagnóstico , Androstenodiona/metabolismo , Femenino , Humanos , Tumor de Células de Leydig/complicaciones , Tumor de Células de Leydig/diagnóstico , Tumor de Células de Leydig/cirugía , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/cirugía , Tomografía de Emisión de Positrones , Posmenopausia , Salpingooforectomía , Testosterona/metabolismo , Virilismo/etiología , Virilismo/metabolismoAsunto(s)
Neoplasias de las Glándulas Suprarrenales/complicaciones , Cardiomiopatía Hipertrófica/etiología , Hipertensión/etiología , Feocromocitoma/complicaciones , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Complicaciones Neoplásicas del Embarazo/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/cirugía , Adulto , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Cardiomiopatía Hipertrófica/fisiopatología , Cesárea , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Feocromocitoma/diagnóstico , Feocromocitoma/cirugía , Embarazo , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Complicaciones Neoplásicas del Embarazo/cirugíaRESUMEN
The three most common pediatric solid tumors of the abdomen are neuroblastoma, Wilms tumor, and hepatoblastoma. These embryonal tumors most commonly present in the first decade of life. Each tumor has unique imaging findings, including locoregional presentation and patterns of distant spread. Neuroblastoma, Wilms tumor, and hepatoblastoma have unique staging systems that rely heavily on imaging and influence surgical and oncologic management. The staging systems include image-defined risk factors for neuroblastoma, the Children's Oncology Group staging system for Wilms tumor, and the pretreatment extent of tumor system (PRETEXT) for hepatoblastoma. It is important for radiologists to be aware of these staging systems to optimize image acquisition and interpretation. This article provides a practical and clinically oriented approach to the role of imaging in the staging of these common embryonal tumors of childhood. The selection among imaging modalities, key findings for determining tumor stage, and the role of imaging in posttreatment response evaluation and surveillance are discussed. Recent updates to the relevant staging systems are highlighted with attention to imaging findings of particular prognostic importance. The information presented will help radiologists tailor the imaging approach to the individual patient and guide optimal oncologic management.
Asunto(s)
Neoplasias Abdominales/diagnóstico por imagen , Neoplasias Abdominales/patología , Estadificación de Neoplasias/métodos , Neoplasias Abdominales/complicaciones , Neoplasias Abdominales/terapia , Niño , Hepatoblastoma/complicaciones , Hepatoblastoma/diagnóstico por imagen , Hepatoblastoma/patología , Hepatoblastoma/terapia , Humanos , Invasividad Neoplásica , Metástasis de la Neoplasia , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico por imagen , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/terapia , Neuroblastoma/complicaciones , Neuroblastoma/diagnóstico por imagen , Neuroblastoma/patología , Neuroblastoma/terapia , Pronóstico , Factores de Riesgo , Tumor de Wilms/complicaciones , Tumor de Wilms/diagnóstico por imagen , Tumor de Wilms/patología , Tumor de Wilms/terapiaRESUMEN
Multiple primary malignancies are defined as two or more primary malignant tumors diagnosed in one individual; they are further classified to synchronous or metachronous based on the period between each cancer diagnosis and the other. The diagnosis of four synchronous cancers is exceedingly rare. We report a case of a 72-year-old man, diagnosed with synchronous quadruple cancers, Hurthle cell carcinoma and papillary carcinoma of the thyroid, as well as squamous cell carcinoma and carcinoid tumor of the lung.
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Adenoma Oxifílico/patología , Tumor Carcinoide/patología , Carcinoma Papilar/patología , Carcinoma de Células Escamosas/patología , Neoplasias Pulmonares/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de la Tiroides/patología , Adenoma Oxifílico/complicaciones , Anciano , Tumor Carcinoide/complicaciones , Carcinoma Papilar/complicaciones , Carcinoma de Células Escamosas/complicaciones , Humanos , Neoplasias Pulmonares/complicaciones , Masculino , Neoplasias Primarias Múltiples/complicaciones , Neoplasias de la Tiroides/complicacionesAsunto(s)
Antineoplásicos/uso terapéutico , Artritis/tratamiento farmacológico , Carcinoma Hepatocelular/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Primarias Múltiples/tratamiento farmacológico , Síndromes Paraneoplásicos/tratamiento farmacológico , Compuestos de Fenilurea/uso terapéutico , Quinolinas/uso terapéutico , Anciano , Artritis/etiología , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/diagnóstico por imagen , Reducción Gradual de Medicamentos , Síndrome Mano-Pie/etiología , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico por imagen , Síndromes Paraneoplásicos/etiologíaRESUMEN
BACKGROUND: Primary hyperparathyroidism (PHPT) caused by double adenoma may carry a higher risk of failure to cure. We compared outcomes in single adenoma (SA), double adenoma (DA) and four-gland hyperplasia (HP). METHODS: Patients undergoing initial parathyroidectomy for PHPT were categorized by diagnosis. The primary outcome was persistent/recurrent disease postoperatively. RESULTS: Of 3408 patients, 81.3% had SA, 9.5% had DA, and 9.3% had HP. Rates of persistence/recurrence were 2.9%, 5.3%, and 4.5% in SA, DA, and HP, respectively (p = 0.281). Patients with persistence/recurrence had higher preoperative calcium (11.0 vs 10.7 mg/dl, p = 0.028) and PTH (96 vs 77 pg/ml, p = 0.015), and lower rates of IOPTH normalization (77% vs 96%, p < 0.001). On multivariable analysis, DA was associated with increased risk of persistent/recurrent disease (OR 3.0, p = 0.017). CONCLUSIONS: Most patients with DA are cured with removal of two glands, but approximately 5% experience disease persistence/recurrence. Low-normal final IOPTH was associated with lower risk of persistent/recurrent disease.
Asunto(s)
Adenoma/complicaciones , Hiperparatiroidismo Primario/etiología , Neoplasias Primarias Múltiples/complicaciones , Glándulas Paratiroides/patología , Neoplasias de las Paratiroides/complicaciones , Adenoma/sangre , Adenoma/patología , Adenoma/cirugía , Anciano , Calcio/sangre , Femenino , Humanos , Hipercalcemia/etiología , Hiperparatiroidismo Primario/sangre , Hiperparatiroidismo Primario/epidemiología , Hiperparatiroidismo Primario/cirugía , Hiperplasia/sangre , Hiperplasia/epidemiología , Hiperplasia/patología , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/epidemiología , Neoplasias Primarias Múltiples/sangre , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Glándulas Paratiroides/cirugía , Hormona Paratiroidea/sangre , Neoplasias de las Paratiroides/sangre , Neoplasias de las Paratiroides/patología , Neoplasias de las Paratiroides/cirugía , Paratiroidectomía , Periodo Preoperatorio , Recurrencia , Estudios Retrospectivos , Riesgo , Resultado del TratamientoRESUMEN
A 38-year-old male patient presented to the ear, nose and throat department with shortness of breath over last 2 months. The CT scan of the neck and chest revealed a 3.3×3 cm tumour behind the right thyroid lobe extending into the tracheo-oesophageal (TO) groove with tracheal compression. The ultrasound scan of the neck and targeted fine needle aspiration followed by core biopsy raised a suspicion of Hodgkin's lymphoma. The patient underwent a right hemithyroidectomy and incisional biopsy of the right TO groove tumour. The histology confirmed a Hasenclever's three nodular sclerosing Hodgkin's lymphoma for which he received adjuvant chemotherapy. An incidental pT1a pN0 thyroid papillary microcarcinoma in the adjacent thyroid parenchyma was completely excised. This represents a case of TO Hodgkin's lymphoma, of which there are no current published case reports. We aim to raise awareness about this rare condition by sharing the diagnostic work up and successful management in a multidisciplinary team setting.