RESUMO
RATIONALE: To investigate T lymphoma invasion and metastasis inducing factor 2 (Tiam2) protein for expression in esophageal carcinoma and relationship with clinical features among cases with tumors. PATIENT CONCERNS: In primary esophageal cancer patients, surgical resection of tumor tissue was performed in 65 cases and adjacent normal esophageal tissue in 20 cases. DIAGNOSES: Primary esophageal carcinoma (57 cases squamous cell carcinoma, 8 cases adenosquamous carcinoma). INTERVENTIONS: The expression level of Tiam2 protein in esophageal carcinoma tissues and normal esophageal tissues by SP immunohistochemical method. The expression intensity was quantitatively analyzed by using Image-pro plus software for image analysis, while SPSS26.0 software was used for a statistical analysis on the data. OUTCOMES: Tiam2 was highly expressed in esophageal squamous cell carcinoma and adenosquamous cell carcinoma, but low expressed in normal esophageal tissue. The expression level of Tiam2 protein was not correlated with gender and age of patients (Pâ >â .05), but was correlated with lymph node metastasis of esophageal carcinoma, TNM stage and differentiation degree of esophageal squamous cell carcinoma (Pâ <â .05). Tiam2 was positively correlated with Tiam1 for protein expression in esophageal carcinoma (râ =â .704, Pâ <â .001). LESSONS: The increased expression of Tiam2 protein in esophageal cancer may be an early molecular event of esophageal cancer. Tiam2 protein has a high expression level in esophageal carcinoma related to lymph node metastasis, TNM stage and differentiation degree, which suggests that Tiam2 protein plays an important role in the invasion and metastasis of esophageal carcinoma. There is a positive correlation between Tiam2 and Tiam1 protein expressions in esophageal carcinoma, suggesting that the 2 proteins may have a definite internal relationship.
Assuntos
Neoplasias Esofágicas , Humanos , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Fatores de Troca do Nucleotídeo Guanina/metabolismo , Metástase Linfática , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/metabolismo , Proteína 1 Indutora de Invasão e Metástase de Linfoma de Células T/metabolismo , Carcinoma de Células Escamosas do Esôfago/metabolismo , Carcinoma de Células Escamosas do Esôfago/patologia , Biomarcadores Tumorais/metabolismo , Adulto , Estadiamento de Neoplasias , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/metabolismo , Imuno-HistoquímicaRESUMO
RATIONALE: Breast low-grade adenosquamous carcinoma is an uncommon cancer that has been neglected in genetic and pathophysiological research. Consequently, medical practitioners face challenges in the effective diagnosis and treatment of this condition. PATIENT CONCERNS: We present the case of a 57-year-old Asian female patient who presented with bilateral breast masses on physical examination. Ultrasound and an MRI revealed a highly suspicious malignant mass in her right breast that was completely removed surgically. DIAGNOSES: After pathological analysis, the diagnosis was low-grade adenosquamous carcinoma with local high-grade transformation, and some of the tumor components were estrogen receptor positive. INTERVENTIONS: The patient underwent appropriate postoperative chemotherapy and achieved a favorable outcome. OUTCOMES: During the follow-up period after surgical resection, the patient did not experience any local recurrence or distant metastasis. LESSONS: Owing to the rare combination of estrogen receptor positivity and high-grade progression, this patient also required adjuvant chemotherapy. This enhances the essential foundation for diagnosing and treating this rare disease, and facilitates the implementation of treatment plans.
Assuntos
Neoplasias da Mama , Carcinoma Adenoescamoso , Receptores de Estrogênio , Humanos , Feminino , Pessoa de Meia-Idade , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/genética , Neoplasias da Mama/patologia , Receptores de Estrogênio/metabolismo , Progressão da Doença , Gradação de TumoresRESUMO
Importance: There is limited evidence with regard to the benefit of adjuvant chemotherapy chemoradiotherapy in resected gallbladder cancers (GBCs). Objective: To establish a baseline survival rate for operated GBCs in patients receiving either gemcitabine plus cisplatin (GC) or capecitabine and capecitabine concurrent with chemoradiation (CCRT). Design, Setting, and Participants: The GECCOR-GB study was a multicenter, open-label, randomized phase 2 noncomparator "pick the winner" design trial of adjuvant GC and CCRT in patients with resected histologically confirmed adenocarcinoma or adenosquamous carcinoma of the gallbladder, (stage II/III) with no local residual tumor (R0) or microscopic residual tumor (R1). The study was carried out in 3 tertiary cancer institutions in India. Patients 18 years or older with adequate end-organ functions, and Eastern Cooperative Oncology Group Performance Status of 1 or lower between May 2019 and February 2022 were enrolled. The cutoff date for data analysis was February 28, 2023. Interventions: Patients were randomized 1:1 to receive either GC every 3 weeks (maximum of 6 cycles) or CCRT comprising capecitabine with concurrent chemoradiation (capecitabine concurrent with radiotherapy) sandwiched between capecitabine chemotherapy. Main Outcomes and Measures: The primary outcome was disease-free survival (DFS) at 1 year in randomized patients. This study was conducted as 2 parallel, single-stage phase 2 clinical trials. Within each treatment arm, a 1-year DFS rate of less than 59% was considered as insufficient activity, whereas a 1-year DFS rate of 77% or higher would be considered as sufficient activity. Results: With a median follow-up of 23 months, 90 patients were randomized, 45 in each arm. Overall, there were 31 women (69%) and 14 men (31%) in the GC arm with a mean (range) age of 56 (33-72) years and 34 women (76%) and 11 men (24%) in the CCRT group with a mean (range) age of 55 (26-69) years. In the GC and CCRT arms, 1-year DFS and estimated 2-year DFS was 88.9% (95% CI, 79.5-98.3) and 74.8% (95% CI, 60.4-89.2), and 77.8% (95% CI, 65.4-90.2) and 74.8% (95% CI, 59.9-86.3), respectively. Completion rates for planned treatment was 82% in the GC arm and 62% in the CCRT arm. Conclusions and Relevance: In this randomized clinical trial, GC and CCRT crossed the prespecified trial end points of 1-year DFS in patients with resected stage II/III GBCs. The results set a baseline for a larger phase 3 trial evaluating both regimens in operated GBCs. Trial Registration: ClinicalTrials.gov Identifier: CTRI/2019/05/019323I.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Quimiorradioterapia , Cisplatino , Desoxicitidina , Neoplasias da Vesícula Biliar , Gencitabina , Humanos , Neoplasias da Vesícula Biliar/terapia , Neoplasias da Vesícula Biliar/mortalidade , Neoplasias da Vesícula Biliar/patologia , Neoplasias da Vesícula Biliar/tratamento farmacológico , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Desoxicitidina/administração & dosagem , Masculino , Feminino , Pessoa de Meia-Idade , Cisplatino/uso terapêutico , Cisplatino/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Idoso , Quimioterapia Adjuvante , Adulto , Capecitabina/uso terapêutico , Capecitabina/administração & dosagem , Intervalo Livre de Doença , Carcinoma Adenoescamoso/terapia , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/patologiaRESUMO
Primary gastric adenosquamous carcinoma (PGASC) is a rare type of gastric cancer with limited research and poorly understood clinicopathological features. This study investigated the clinicopathological features and outcomes of PGASC. Patients with PGASC from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and from the published literature were enrolled in this study. Survival curves were generated using the Kaplan-Meier method, and prognostic factors were identified through Cox proportional hazards regression models. This study identified 76 eligible cases of PGASC, with 45 cases from published literature and 31 from our center. The most prevalent symptoms were abdominal pain and dysphagia, with a median age of 62 years (range: 29-84 years). The primary lesions were predominantly in the proximal stomach, with a median tumor size of 6.5 cm (range: 1.5-16.0 cm). Tumor stages II, III, and IV were detected in 12 (16.7%), 43 (59.7%), and 17 (23.6%) patients, respectively. Most tumors were poorly differentiated in both the squamous cell carcinoma (SCC) component and adenocarcinoma (AC) component. The median survival time was 17 months (range: 2-122 months). The 1, 3, and 5-year overall survival (OS) was 60.7%, 31.1%, and 24.1%, respectively. Multivariate analysis revealed that OS was independently predicted by the proportion of SCC component, differentiation of AC component, and tumor stage. PGASC is a rare disease with a poor prognosis. A high proportion of SCC components, low differentiated AC components, and advanced tumor were associated with worse survival in patients with PGASC. Adjuvant therapy did not improve survival time.
Assuntos
Carcinoma Adenoescamoso , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/mortalidade , Pessoa de Meia-Idade , Masculino , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/mortalidade , Feminino , Idoso , Adulto , Idoso de 80 Anos ou mais , Prognóstico , Estadiamento de Neoplasias , Estimativa de Kaplan-MeierRESUMO
OBJECTIVE: To compare and explore the characteristics of squamous cell carcinoma (SCC), adenocarcinoma (AC) and adenosquamous carcinoma (ASC), usual-type endocervical adenocarcinoma (UEA) and gastric adenocarcinoma (GAC) of cervix. MATERIALS AND METHODS: A total of 728 cervical cancers (254 cases of AC, 252 cases of ASC, and 222 cases of SCC) confirmed by histopathology were retrospectively reviewed. Among AC, 119 UEA and 47 GAC were included. Clinical baseline data and tumor morphological features on MRI (including tumor location, shape, diameter and volume, margin, growth pattern, presence of fluid component or cyst, heterogenous and peritumoral enhancement) of all cases were collected and analyzed. The signal intensity (SI) of tumor and gluteus maximus muscle were measured and their ratios (SIR) were calculated based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and contrast-enhanced T1WI at arterial and delay phases (A/DCE-T1WI). These clinical and MRI features were compared between SCC, AC and ASC, UEA and GAC, and the specific ones of each subtype were identified. RESULTS: There was a significant difference in SCC-Ag, CA-199, CEA, ADC value, SIR-DWI, presence of intratumor cyst and peritumoral enhancement between AC and ASC; in patient age, menopausal status, International Federation of Gynecology and Obstetrics (FIGO) stage, SCC-Ag, CA-125, CA-199, CEA, tumor shape, growth pattern, margin, presence of intratumor fluid component and cyst, tumor diameter and volume, ADC value, SIR-T1WI, SIR-T2WI, and SIR-DWI between SCC and AC, as well as SCC and ASC. Also, there was a significant difference in deep stromal invasion (DSI), peritumoral and heterogenous enhancement between SCC and AC, and in SIR-ACE-T1WI between SCC and ASC. There was a significant difference in reproductive history, menopausal status, FIGO stage, CA-199, DSI, lymph node metastasis (LNM), parametrial invasion (PMI), tumor location, shape, margin, growth pattern, presence of fluid component and cyst, tumor diameter and volume, SIR-T1WI, SIR-DWI, and heterogenous enhancement between GAC and UEA. CONCLUSION: The clinical and MRI features with significant differences among SCC, AC and ASC, and between UEA and GAC, can help to identify each subtype of cervical cancer.
Assuntos
Adenocarcinoma , Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , Imageamento por Ressonância Magnética , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia , Carcinoma Adenoescamoso/diagnóstico por imagem , Carcinoma Adenoescamoso/patologia , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Adulto , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Estudos Retrospectivos , Idoso , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Meios de ContrasteRESUMO
This report aims to shed light on the intricate challenges encountered during the diagnosis and treatment of an uncommon variant of prostate cancer-mixed adenosquamous cell carcinoma of the prostate. Prostate cancers of this nature pose distinctive diagnostic and therapeutic dilemmas due to their rarity and complex histological composition. We present a case of a 63-year-old man with metastatic prostate cancer, featuring adenocarcinoma with squamous cell differentiation, who underwent a multimodal treatment approach. The patient responded to first-line carboplatin, docetaxel, and androgen deprivation therapy, followed by androgen receptor pathway inhibitor (ARPI) maintenance. However, disease progression led to radiation therapy and a subsequent switch to Lutetium (177Lu) vipivotide tetraxetan after chemotherapy challenges. Comprehensive genetic profiling revealed shared mutations in the prostate and liver lesions, emphasizing the role of targeted therapies. Prostate-specific membrane antigen (PSMA)-targeted therapy resulted in a notable PSA decline. This case highlights the evolving treatment landscape for rare prostate cancers, integrating genetic insights for tailored interventions. In conclusion, squamous cell carcinoma (SCC) of the prostate is rare, emphasizing the imperative for enhanced comprehension in diagnosis and management. Our case suggests the potential efficacy of ARPI and PSMA-targeted therapies. Our findings advocate for a more nuanced approach to the management of this rare prostate cancer variant, leveraging genomic insights for personalized treatment strategies. This exploration serves as a foundation for further research and clinical considerations in addressing the challenges posed by mixed adenosquamous cell carcinoma of the prostate.
Assuntos
Carcinoma Adenoescamoso , Neoplasias Hepáticas , Neoplasias da Próstata , Humanos , Masculino , Neoplasias Hepáticas/secundário , Pessoa de Meia-Idade , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/tratamento farmacológico , Carcinoma Adenoescamoso/secundárioAssuntos
Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , Neoplasias do Colo do Útero , Feminino , Humanos , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/patologia , Histerectomia , Procedimentos Cirúrgicos Minimamente Invasivos , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/patologia , Ensaios Clínicos como AssuntoRESUMO
The analysis of gene expression quantification data is a powerful and widely used approach in cancer research. This work provides new insights into the transcriptomic changes that occur in healthy uterine tissue compared to those in cancerous tissues and explores the differences associated with uterine cancer localizations and histological subtypes. To achieve this, RNA-Seq data from the TCGA database were preprocessed and analyzed using the KnowSeq package. Firstly, a kNN model was applied to classify uterine cervix cancer, uterine corpus cancer, and healthy uterine samples. Through variable selection, a three-gene signature was identified (VWCE, CLDN15, ADCYAP1R1), achieving consistent 100% test accuracy across 20 repetitions of a 5-fold cross-validation. A supplementary similar analysis using miRNA-Seq data from the same samples identified an optimal two-gene miRNA-coding signature potentially regulating the three-gene signature previously mentioned, which attained optimal classification performance with an 82% F1-macro score. Subsequently, a kNN model was implemented for the classification of cervical cancer samples into their two main histological subtypes (adenocarcinoma and squamous cell carcinoma). A uni-gene signature (ICA1L) was identified, achieving 100% test accuracy through 20 repetitions of a 5-fold cross-validation and externally validated through the CGCI program. Finally, an examination of six cervical adenosquamous carcinoma (mixed) samples revealed a pattern where the gene expression value in the mixed class aligned closer to the histological subtype with lower expression, prompting a reconsideration of the diagnosis for these mixed samples. In summary, this study provides valuable insights into the molecular mechanisms of uterine cervix and corpus cancers. The newly identified gene signatures demonstrate robust predictive capabilities, guiding future research in cancer diagnosis and treatment methodologies.
Assuntos
Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , MicroRNAs , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/metabolismo , Carcinoma de Células Escamosas/patologia , Perfilação da Expressão Gênica , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/patologia , MicroRNAs/genéticaAssuntos
Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Humanos , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Pulmão/patologia , Colo/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologiaRESUMO
A 52-year-old female presented with labial ulcer of 4-month duration. Examination showed 1 cm × 1 cm single superficial ulcer in the right labium majus. Excision was done, and histopathologic examination revealed surface ulceration and dermal invasion by epithelial neoplasm formed of biphasic proliferation of squamoid and gland-forming cells. Immunohistochemical staining with p63 showed nuclear staining of the squamoid nests and was negative in areas with glandular differentiation, while epithelial membrane antigen and carcinoembryonic antigen highlighted the glandular elements. The case was diagnosed as primary cutaneous adenosquamous carcinoma (ASC). ASC is an uncommon malignant cutaneous neoplasm that is more aggressive than conventional squamous cell carcinoma. There are a few reports of ASC that presented as an erythematous papule or plaque with a preference for the head, neck, or upper extremities. We report a novel case of vulval ASC presented as a superficial ulcer, which is considered a unique site, and its clinical presentation.
Assuntos
Carcinoma Adenoescamoso , Carcinoma de Células Escamosas , Neoplasias Cutâneas , Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma Adenoescamoso/patologia , Úlcera , Neoplasias Cutâneas/patologia , Carcinoma de Células Escamosas/patologia , Vulva/patologiaRESUMO
BACKGROUND: Adenosquamous carcinoma is a rare sub-type of colorectal cancer with a poor prognosis. Little is known about its clinicopathological and molecular characteristics in Asian populations. This study aimed to investigate these features in a cohort of patients with adenosquamous carcinoma in the colorectum. METHODS: Tumor cases pathologically diagnosed with colorectal adenosquamous carcinoma were retrieved from the Sixth Affiliated Hospital, Sun Yat-sen University tissue archive between December 2012 and June 2020. Clinicopathological features, molecular characteristics, and oncology outcomes were analyzed. RESULTS: Among 18,139 cases of colorectal cancer, 11 were diagnosed with adenosquamous carcinoma, providing an incidence rate of 0.061%. The median overall survival (OS) was 14 months, and the expected 3-year OS rate was 29.6%. As of October 14, 2022, four cases had local recurrence and five had distant metastasis. KRAS gene mutations were found in four of seven patients (57.1%), and three out of eleven (27.3%) patients had mismatch repair-deficient (dMMR) tumors. CONCLUSIONS: Adenosquamous carcinoma is associated with a poor prognosis. Compared to other sub-types of colorectal cancer, a higher proportion of patients with dMMR and KRAS mutations were observed. These findings suggested that more patients with adenosquamous carcinoma could benefit from targeted therapies, such as immunotherapy.
Assuntos
Neoplasias Encefálicas , Carcinoma Adenoescamoso , Neoplasias Colorretais , Síndromes Neoplásicas Hereditárias , Humanos , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/patologia , Prognóstico , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Colorretais/patologia , Estudos RetrospectivosRESUMO
RESUMO Objetivo: analisar a expressão do Fator de Crescimento do Endotélio Vascular (VEGF), seu receptor (VEGFR-2), idade e tipo histológico de carcinomas avançados de colo uterino com relação à resposta clínica à quimioterapia neoadjuvante. Métodos: foram incluídas 40 pacientes com diagnóstico de carcinoma de colo uterino (IB2 e IVA), com biópsias prévias ao tratamento. Todas as pacientes foram submetidas à quimioterapia neoadjuvante e avaliadas quanto à resposta clínica e à expressão do VEGF. Considerou-se boa resposta clínica uma regressão tumoral total ou maior do que 50%. Resultados: em relação à resposta à quimioterapia, 18 pacientes (45%) apresentaram boa resposta e 22 (55%), má resposta. Quanto à expressão do VEGF, em 16 pacientes foi considerada positiva e em 24, negativa. Quando os casos foram analisados separadamente em relação à resposta à quimioterapia, somente a expressão positiva de VEGF foi associada à boa resposta clínica (p=0,0157). Conclusão: a expressão de VEGF mostrou ser isoladamente, um importante marcador de boa resposta ao tratamento quimioterápico neoadjuvante das pacientes com carcinoma avançado de colo uterino.
ABSTRACT Objective: to analyze the expression of Vascular Endothelial Growth Factor (VEGF), its receptor (VEGFR-2), age and histological type of advanced cervical carcinomas with respect to the clinical response to neoadjuvant chemotherapy. Methods: we studied 40 patients with cervical carcinoma (IB2 and IVA) diagnosed by biopsies prior to treatment. All patients underwent neoadjuvant chemotherapy and evaluation for clinical response and expression of VEGF. We considered a tumor regression greater than 50% as a good clinical response. Results: eighteen patients (45%) had good response to chemotherapy, and 22 (55%), poor response. VEGF expression was positive in 16 patients and negative in 24. When analyzed separately for response to chemotherapy, only the positive expression of VEGF was associated with good clinical response (p=0.0157). Conclusion: VEGF expression alone was an important marker of good response to neoadjuvant chemotherapy in patients with advanced carcinoma of the cervix.
Assuntos
Humanos , Feminino , Adulto , Idoso , Carcinoma de Células Escamosas/tratamento farmacológico , Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Colo do Útero/tratamento farmacológico , Carcinoma Adenoescamoso/tratamento farmacológico , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Biópsia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Adenocarcinoma/cirurgia , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/patologia , Colo do Útero , Estudos Prospectivos , Cisplatino , Carcinoma Adenoescamoso/cirurgia , Carcinoma Adenoescamoso/patologia , Terapia Neoadjuvante , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions. We describe the case of an 82-years-old African American female, presenting to our institution with quantifiable weight loss (12 kg in 3 months), jaundice and abdominal pain. On admission, laboratory tests were obtained: total bilirubin: 11.07 mg/dl with a direct fraction of 10.32 mg/dl. Cross-sectional abdominal CT scan with contrast, showed a lesion localized in the pancreatic head (hypodense on T1, measuring 3.5 x 3.5 x 2.5 cm), with vascular invasion of the portal vein. EUS showed a solid, hypoechoic, not well-defined lesion (measuring 3.98 x 3.80 cm), localized between the head and neck of the pancreas. EUS-FNA was performed with a 22G needle using the fanning technique. The cytological specimens demonstrated components of both squamous carcinoma and adenocarcinoma. The patient underwent ERCP procedure, and biliary drainage was performed with an entirely covered metallic stent placement. After a month from the procedures, the patient died due to the severity of the disease. Endoscopic ultrasound has proven to be the best method to diagnose solid pancreatic lesions, including rare and aggressive type of tumors like primary adenosquamous cell carcinoma that we described in this very interesting case report
El cáncer de páncreas es la segunda neoplasia maligna más común del tracto gastrointestinal en los EE.UU. y el adenocarcinoma ha sido identificado como el tipo más común de cáncer de páncreas. Se han clasificado diferentes tipos de cáncer de páncreas: adenocarcinoma, carcinoma adenoescamoso ductal, tumores pseudopapilares sólidos, neoplasias endocrinas, carcinoma de células acinares, carcinoma de células escamosas, tumores quísticos, linfoma primario del páncreas y lesiones metastásicas del páncreas. El carcinoma adenoescamoso es extremadamente raro y se comporta de manera muy agresiva, es responsable del 1 al 4% de las lesiones pancreáticas exocrinas neoplásicas. Presentamos el caso de una mujer afroamericana de 82 años de edad, que fue admitida a nuestra institución con pérdida de peso cuantificable (12 kg en 3 meses), ictericia y dolor abdominal. Al momento de la admisión, se obtuvieron pruebas de laboratorio: bilirrubina total: 11,07 mg/dl con una fracción directa de 10,32 mg/dl. La tomografía computarizada abdominal transversal con contraste mostró una lesión localizada en la cabeza pancreática (hipodensa en T1, 5 x 3,5 x 2,5 cm) con invasión vascular de la vena porta. El ultrasonido endoscópico mostró una lesión sólida, hipoecoica, no bien definida de 3,98 x 3,80 cm, localizada entre la cabeza y el cuello del páncreas. La biopsia por aspiración con aguja fina guiada por ultrasonido endoscópico se realizó con una aguja 22G utilizando la técnica de ventilación (Fanning). Los especímenes citológicos demostraron componentes de carcinoma escamoso y adenocarcinoma. El paciente se sometió a CPRE y el drenaje biliar se realizó con una prótesis metálica completamente cubierta. Después de un mes de los procedimientos, el paciente falleció debido a la gravedad de la enfermedad. El ultrasonido endoscópico ha demostrado ser el mejor método para diagnosticar lesiones pancreáticas sólidas, incluyendo tumores raros y agresivos como el carcinoma primario de células adenoescamosas que describimos en este interesante relato de caso
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pancreáticas/patologia , Ultrassonografia de Intervenção/métodos , Carcinoma Adenoescamoso/patologia , Endossonografia/métodos , Biópsia por Agulha Fina/métodos , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/diagnóstico por imagem , Drenagem , Evolução Fatal , Carcinoma Adenoescamoso/cirurgia , Carcinoma Adenoescamoso/diagnóstico por imagem , CitodiagnósticoRESUMO
El tumor de colisión es una variante poco frecuente de tumores del cérvix uterino, originados de las células de reserva de la unión escamocelular y que debe ser diferenciado de los carcinomas adenoescamosos. El objetivo del presente artículo es determinar las características morfológicas de 17 casos de tumor de colisión de cérvix uterino. La edad promedio de presentación fue 48,7 años (rango: 34-87 años). Los 4 casos con metástasis ganglionares correspondieron al componente de adenocarcinoma.
Collision tumor is an uncommon variant of cervical tumors originating from the reserve cells of squamous cell union and must be differentiated from adenosquamous carcinomas. The aim of this paper is to determine the morphological characteristics of 17 cases of collision tumor of uterine cervix, in which it was found that the average age at diagnosis was 48.7 years (range: 34-87 years). In 5 cases lymph node metastases were of the adenocarcinoma component.
Assuntos
Humanos , Adulto , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adenocarcinoma/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias do Colo do Útero/patologia , Carcinoma Adenoescamoso/patologia , Diagnóstico Diferencial , Metástase Linfática , Tumor Misto MalignoRESUMO
Es infrecuente que tumores malignos del aparato genital femenino afecten al Sistema Nervioso Central (SNC). El carcinoma del cuello uterino raramente metastiza al SNC, siendo escasa la literatura científica relacionada con esta patología. El objetivo es presentar un nuevo caso de adenocarcinoma de cuello uterino el cual fue diagnosticado en el 2005, que metastizó al SNC a los 2 años del diagnóstico inicial. Se presenta femenina de 43 años de edad quien acude al Hospital Central de San cristóbal donde se le realizó histerectomía ampliada en el 2006. En el 2007 se diagnóstica Lesión Ocupante de Espacio Cerebral que es operado resultando ser metastasis cerebral de Adenocarcinoma Escamoso. Actualmente se encuentra en condiciones clínicas estables.
Assuntos
Humanos , Adulto , Feminino , Histerectomia/métodos , Metástase Neoplásica/fisiopatologia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Tratamento Farmacológico/métodos , Sistema Nervoso Central/patologia , Adenocarcinoma/cirurgia , Biópsia/métodos , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , OncologiaRESUMO
O carcinoma adenoescamoso primário do estômago é um tumor raro, cuja incidência nao excede 1 por cento dos tumores gástricos. Esse tumor mostra dois tipos celulares distintos: um escamoso e outro adenocarcinomatoso. Material e Método. Os autores reportam um caso de carcinoma adenoescamoso primário do estômago em um paciente branco de 55 anos, cuja patologia e imuno-histoquímica mostram a presença dos dois tipos celulares: adenocarcinomatoso e escamoso. Conclusao. É discutido um caso de um tumor raro e interessante do estômago, com relaçao à sua patogênese, diagnóstico e aspectos clínico-patológicos.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Carcinoma Adenoescamoso/patologia , Carcinoma de Células Escamosas/patologia , SeguimentosRESUMO
Se describen las características clínicas y morfológicas de 45 casos de carcinoma adenoescamosos diagnosticados en el Intituto Anatomopatológico, y se comparan con las otras variantes histológicas de carcinoma cervical invasor. Se evidenció un incremento relativo en el porcentaje de carcinomas adenoescamosos durante el período de las pacientes fué una década menor a la observada en los casos de carcinoma epidermoide y la asociación con el embarazo fué del 16,67 por ciento. La frecuencia de permeación linfovascular fué del 51,11 por ciento. La persistencia del carcinoma adenoescamoso fué mayor, en estados clínicos avanzados, que el carcinoma epidermoide. Toda clasificación de carcinomas cérvico-uterinos requiere la aplicación previa de tinciones para mucinas epiteliales para detectar este grupo de tumores de comportamiento agresivo
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Carcinoma Adenoescamoso/patologia , Neoplasias Uterinas/patologia , Anatomia , PatologiaRESUMO
Se presenta un caso clínico de carcinoma de células en vidrio esmerilado de cuello uterino, en una mujer joven, embarazada, de curso agresivo, con rápida progresión a estadio clínico fuera del alcance terapéutico