RESUMO
Chordoma is a rare malignant tumor of the spine. We report the case of a 26-year-old man who presented with facial paralysis and upper limbs paresthesia. Cerebral CT-scan and cerebro-spinal MRI revealed a 58mm locally advanced middle clival mass with deviation of median cerebral structures. Endoscopic biopsy concluded to a chondroid chordoma. Skeletal survey and thoraco-abdomino-pelvic CT-scan were normal. Treatment consisted in complete surgical removal of the tumor followed by adjuvant radiotherapy. The patient is alive free of disease with a follow up of 12 months.
Assuntos
Cordoma/diagnóstico por imagem , Fossa Craniana Posterior/diagnóstico por imagem , Neoplasias da Base do Crânio/diagnóstico por imagem , Adulto , Cordoma/patologia , Cordoma/terapia , Fossa Craniana Posterior/patologia , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Radioterapia Adjuvante , Neoplasias da Base do Crânio/patologia , Neoplasias da Base do Crânio/terapia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The classification of digestive neuroendocrine tumors is difficult due to their heterogeneity and rareness. AIMS: Reclassify the digestive neuroendocrine tumors according to the WHO-2010 classification . Methods: A retrospective study included 26 patients having digestive neuroendocrine tumors , is achieved in our Pathology Laboratory of the Military Hospital of Tunis between 2000 and 2013. RESULTS: The mean age of patients was 49.64 years. The Sex ratio was 1.36. It was 6 gastric tumors, 5 small intestine tumors , 5 pancreatic tumors, 5 appendix tumors , one hypatic tumor, one gall bladder tumor , one rectal tumor and one colon tumor. According to the WHO -2000 classification, tumors are categorised into 11 well differentiated endocrine tumors, 13 well differentiated endocrine carcinoma and 2 poorly differentiated carcinoma . According to the WHO -2010 classification, tumors were re-evaluated as 16 neuroendocrine tumors grade 1, 6 neuroendocrine tumors grade 2 and 4 neuroendocrine carcinoma . CONCLUSION: There was a concordance between the two classifications in 93% of cases. The WHO -2010 classification may allow a better classification for the digestive neuroendocrine tumors, however there are some histological categories that remained difficult to classify.
Assuntos
Neoplasias do Sistema Digestório/classificação , Tumores Neuroendócrinos/classificação , Neoplasias do Apêndice/classificação , Carcinoma Neuroendócrino/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/classificação , Estudos Retrospectivos , Neoplasias Gástricas/classificação , Organização Mundial da SaúdeRESUMO
BACKGROUND: The classification of digestive neuroendocrine tumors is difficult due to their heterogeneity and rareness. AIMS: Reclassify the digestive neuroendocrine tumors according to the WHO-2010 classification . Methods: A retrospective study included 26 patients having digestive neuroendocrine tumors , is achieved in our Pathology Laboratory of the Military Hospital of Tunis between 2000 and 2013. RESULTS: The mean age of patients was 49.64 years. The Sex ratio was 1.36. It was 6 gastric tumors, 5 small intestine tumors , 5 pancreatic tumors, 5 appendix tumors , one hypatic tumor, one gall bladder tumor , one rectal tumor and one colon tumor. According to the WHO -2000 classification, tumors are categorised into 11 well differentiated endocrine tumors, 13 well differentiated endocrine carcinoma and 2 poorly differentiated carcinoma . According to the WHO -2010 classification, tumors were re-evaluated as 16 neuroendocrine tumors grade 1, 6 neuroendocrine tumors grade 2 and 4 neuroendocrine carcinoma . CONCLUSION: There was a concordance between the two classifications in 93% of cases. The WHO -2010 classification may allow a better classification for the digestive neuroendocrine tumors, however there are some histological categories that remained difficult to classify.
Assuntos
Neoplasias do Sistema Digestório/classificação , Tumores Neuroendócrinos/classificação , Neoplasias do Apêndice/classificação , Neoplasias do Apêndice/patologia , Neoplasias do Sistema Digestório/patologia , Feminino , Humanos , Neoplasias Intestinais/classificação , Neoplasias Intestinais/patologia , Intestino Delgado , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/patologia , Estudos Retrospectivos , Neoplasias Gástricas/classificação , Neoplasias Gástricas/patologia , Tunísia , Organização Mundial da SaúdeRESUMO
BACKGROUND: Gastrointestinal stromal tumors - commonly called GISTs - are rare; yet, they represent an important type of mensenchymal tumors arising within the gastrointestinal tract. The acronym GIST was introduced in 1998 to define a well established pathological entity which bears a highly specific marker called KIT (CD117). Scientific interest for these tumors in recent years is mainly due to the progress in identification by immunohistochemistry and the advent of targeted molecular therapy. AIM: To reclassify mesenchymal tumors of the digestive tract using advanced immunophenotyping. METHODS: We examined the digestive tissue tumors operated at the Principal Military Hospital of Instruction of Tunis over a 19-year period from 1992 to 2011. RESULTS: We collected 22 cases of benign mesenchymal tumors of the digestive tract. Tumors were initially diagnosed as leiomyomas (4 cases), schwannomas (2 cases), gastrointestinal stromal tumors (14 cases), a leiomyoblastoma and a mesenchymal tumor with fusiform cells. The immunohistochemical study has allowed to correct some diagnoses and, in one case, the block has been exhausted. In total, we selected 18 cases of gastrointestinal stromal tumor, a tumors. The final diagnosis of GIST was confirmed by the positivity of C-kit or DOG1. CONCLUSIONS: The combined use of C-kit and DOG1 ensures accurate diagnosis of GIST. The DOG1 has allowed us to detect the 3 stromal tumors negative for C-kit. This antibody has achieved a diagnostic gain of 15 %. The rate of GIST tumors labeled increased from 71 % to 86 % among mesenchymal tumors.