Pelvic retroperitoneal pleomorphic hyalinizing angiectatic tumor (PHAT) of soft tissue: a case report.

BACKGROUND: Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare soft tissue tumor of low malignant potential, which most often arises in the lower extremities. Lesions occurred in other anatomic locations have been rarely reported. Moreover, their imaging features have not been well discussed. Here we report a case of PHAT arising primarily in the pelvic retroperitoneum. To our knowledge, this is the first radiological description for retroperitoneum PHAT. CASE PRESENTATION: A 26-year-old female was referred to our hospital for evaluation of a pelvic mass incidentally noted in routine pre-pregnancy ultrasonography examination. Magnetic resonance imaging (MRI) and computed tomography (CT) scan revealed an irregular mass with clear boundary in the pelvic retroperitoneum. Its signal intensity or density was inhomogeneous. On MRI images, it mainly showed isointense and slight hypointense on T1 weighted image and isointense and hyperintense on T2 weighted image. On contrast-enhanced images, it showed marked but heterogenous enhancement. With the delay time increasing, the enhanced area in the lesion increased but the CT value decreased. Dilated vessels and hemorrhage were detected in the tumor. With patience and careful separation, it was completely excised with great amount of bleeding during operation. Pathological and immunohistochemistry analysis confirmed the diagnosis of PHAT of the soft parts. We found no evidence of recurrence 18 months after operation. CONCLUSION: We present an extremely rare case of PHAT arising primarily in the pelvic retroperitoneum. To our knowledge, this is the first radiological description for retroperitoneum PHAT. The provided information is useful for summarizing the characteristics of this kind of tumor. It should be included in the differential diagnosis of a well-defined, inhomogenously enhanced hypervascular soft-tissue mass in pelvic cavity.

Cardiac fibromas in the adult.

BACKGROUND: Cardiac fibromas are primarily detected in infants and children but are extremely rare in adults. METHODS: We report a case of a cardiac fibroma in a 37 year old male and review the literature on this subject. RESULT: The patient was referred for evaluation of a cardiac mass. Echocardiography and computed tomography examinations revealed it as an inhomogeneous mass with calcifications. Subsequently, the lesion was completely excised and confirmed to be a cardiac fibroma. Cardiac fibromas account for only a very small percentage of all cardiac tumors. The occurrence and severity of symptoms caused by cardiac fibromas are primarily determined by the sites and size of lesions. Imaging techniques are very sensitive in diagnosing cardiac fibromas, defining the extent and planning surgical approach. Surgical treatment of cardiac fibromas gives excellent early and late survival. CONCLUSION: Although cardiac fibromas are benign, their behavior is unpredictable. Surgery appears to be the optimal treatment for patients with resectable tumors.

Extrahepatic primary adrenal alveolar echinococcosis: a review.

BACKGROUND: Primary echinococcosis, and especially primary alveolar echinococcosis (AE) is rare among adrenal lesions. METHODS: We report a case of primary AE in a 28-year-old male with low backache and occasional upper limb pain lasting for six months, and review the pertinent but sparse literature on this disorder. RESULTS: Evaluation of the patient revealed an abdominal mass as right adrenal AE. The adrenal gland is a rare extrahepatic site of occurrence of echinococcosis, and particularly of AE. Patients with adrenal echinococcosis usually have nonspecific clinical symptoms. Imaging examinations revealed clearly the features of AE and its surrounding pathology. Alveolar echinococcosis was seen as an inhomogeneous pseudotumor with irregular boundaries, an irregular central pseudocystic appearance, and infiltration into surrounding structures. On contrast-enhanced computed tomography, the periphery of the mass in AE may be enhanced and multicentric vesicles may be seen. Magnetic resonance imaging may show the multivesicular morphology of lesions. The definitive diagnosis of AE should be confirmed by pathologic or serologic examination. Radical surgical resection of the removable parasitic lesion, followed by anti-infective therapy with benzimidazoles, is the primary method for treating AE. CONCLUSION: Although primary adrenal AE is rare, it should be included in the differential diagnosis of adrenal masses, especially in regions where AE is endemic.

Ghost cell odontogenic carcinoma arising from calcifying cystic odontogenic tumor: a case report.

Ghost cell odontogenic carcinoma (GCOC) is an exceptionally rare and malignant odontogenic tumor with aggressive growth characteristics. We describe a case of GCOC which was considerably derived from a previously resected calcifying cystic odontogenic tumor (CCOT). Cellular atypia, mitotic activity, Ki-67 labeling index and matrix metalloprotease-9 positive expression rate were all increased in the currently resected specimen compared to the initial one. This is a rare case of malignant transformation of CCOT to GCOC with respect to its histopathological and immunohistochemical findings.

Solid variant of keratocystic odontogenic tumor with ameloblastomatous transformation: a case report and review of the literature.

The solid variant of keratocystic odontogenic tumor is an extremely rare tumor. Its clinical and pathologic features remain poorly defined, even in the 2005 World Health Organization odontogenic tumor classification. We report an unusual lesion in a 38-year-old female Chinese patient. The lesion demonstrated the solid or multiple cystic architecture of a keratocystic odontogenic tumor, but also exhibited ameloblastomalike lining epithelium in some areas. The complex histopathology made a pathologic diagnosis difficult. Finally, the lesion was diagnosed as solid variant of keratocystic odontogenic tumor with ameloblastomatous transformation. We present the clinical and pathologic details of the case, and review the relevant literature.

Small peripheral lung adenocarcinoma: CT and histopathologic characteristics and prognostic implications.

Since the introduction of computed tomography (CT), detection of small lung cancer, especially small peripheral adenocarcinoma, is common. Recently, the morphological characteristics, including thin-section CT and pathologic findings, and prognosis of small peripheral lung adenocarcinomas have been studied extensively. The radiologic and microscopic findings correlate well with each other and are closely associated with tumour prognosis. Most importantly, some subtypes of small lung adenocarcinomas with specific CT or pathologic features are curable. Therefore, all defining characteristics (CT, pathologic and prognostic) of this kind of tumour should be integrated to improve our understanding, provide guidelines for management and accurately assess its prognosis.

[Anti-proliferative and anti-metastatic effects of curcumin on oral cancer cells].

OBJECTIVE: The purpose of this article is to examine the effect of curcumin on the proliferation and metastasis of human tongue squamous cell carcinoma and analyze its mechanism. METHODS: SCC-4 were treated with curcumin of 0, 5, 10, 20, 30, 60, 100 micromol x L(-1) in 24 h. MTT assay, Matrigel invasion assay, flow cytometry and fluorescence microscopy were used to examine the effect of curcumin on the growth and metastasis of SCC-4. cDNA microarray and RT-PCR were employed to analyze the expression of genes treated by curcumin. RESULTS: The results showed that curcumin could concentration-dependently inhibit SCC-4 cell proliferation at the concentration range from 20 to 100 micromol x L(-1). Furthermore, Matrigel invasion assay indicated that curcumin can reduce SCC-4 cell invasion under the dosage of 20, 30, 60 micromol x L(-1). Flow cytometry also showed that curcumin can influence the distribution of cell cycle of SCC-4 cell with the dosage of 20, 30, 60 micromol x L(-1). And the dosage of 30 micromol x L(-1) curcumin could lead to the recruitment of alpha-tubulin. cDNA microarray showed that 87 genes were activated and 198 genes were inhibited with the effect of curcumin. These results were validated by the real time quantitative RT-PCR. CONCLUSION: According to the results, it suggests that curcumin has the potential as the leading compound for anti-cancer proliferation and invasion in oral cancer treatment, and cdc27, EGFR substrate 15, PPAR-alpha and H2A histone may play an important role among this multiple anticancer-targeting ability.

Features of cranio-maxillofacial trauma in the massive Sichuan earthquake: analysis of 221 cases with multi-detector row CT.

OBJECTIVE: In a massive earthquake, cranio-maxillofacial trauma was common. The present study was to determine the features of cranio-maxillofacial trauma sustained in the massive Sichuan earthquake by multi-detector row computed tomography (MDCT). METHODS: The study included 221 consecutive patients (123 males and 98 females; age range, 1-83 years; median age, 35 years) with cranio-maxillofacial trauma in the Sichuan earthquake, who underwent cranio-maxillofacial MDCT scans. The image data were retrospectively reviewed focusing on the injuries of the cranio-maxillofacial soft tissue, facial bones and cranium. RESULTS: All patients had soft tissue injuries frequently with foreign bodies. Ninety-seven (43.9%) patients had fractures (1.5 involved sites per patient, range from 1 to 8) including single cranial fractures in 36 (37.1%) cases, single maxillofacial fractures were seen in 48 (49.5%) and cranio-maxillofacial fractures in 13 (13.4%). Single bone fracture was more common than multiple bone fractures (p<0.05). Nasal, ethmoid bones and the orbits were the most commonly involved sites of the craniofacial region. Thirty-eight (17.2%) patients had intracranial injuries, the commonest being subarachnoid haemorrhage and the commonest sites were the temporal and frontal regions. Coexisting intracranial injuries were more common in patients with cranial fractures than in patients with maxillofacial fractures (p<0.05). CONCLUSION: Our results indicate that the cranio-maxillofacial trauma arising from the massive Sichuan earthquake had some characteristic features, and a significant number of individuals had the potential for combined cranial and maxillofacial injuries, successful management of which required a multidisciplinary approach.

Comparative study of earthquake-related and non-earthquake-related head traumas using multidetector computed tomography

OBJECTIVE: The features of earthquake-related head injuries may be different from those of injuries obtained in daily life because of differences in circumstances. We aim to compare the features of head traumas caused by the Sichuan earthquake with those of other common head traumas using multidetector computed tomography. METHODS: In total, 221 patients with earthquake-related head traumas (the earthquake group) and 221 patients with other common head traumas (the non-earthquake group) were enrolled in our study, and their computed tomographic findings were compared. We focused the differences between fractures and intracranial injuries and the relationships between extracranial and intracranial injuries. RESULTS: More earthquake-related cases had only extracranial soft tissue injuries (50.7 percent vs. 26.2 percent, RR=1.9), and fewer cases had intracranial injuries (17.2 percent vs. 50.7 percent, RR = 0.3) compared with the non-earthquake group. For patients with fractures and intracranial injuries, there were fewer cases with craniocerebral injuries in the earthquake group (60.6 percent vs. 77.9 percent, RR = 0.8), and the earthquake-injured patients had fewer fractures and intracranial injuries overall (1.5 + 0.9 vs. 2.5 +1.8; 1.3 + 0.5 vs. 2.1 + 1.1). Compared with the non-earthquake group, the incidences of soft tissue injuries and cranial fractures combined with intracranial injuries in the earthquake group were significantly lower (9.8 percent vs. 43.7 percent, RR = 0.2; 35.1 percent vs. 82.2 percent, RR = 0.4). CONCLUSION: As depicted with computed tomography, the severity of earthquake-related head traumas in survivors was milder, and isolated extracranial injuries were more common in earthquake-related head traumas than in non-earthquake-related injuries, which may have been the result of different injury causes, mechanisms and settings.

Characteristics of coronary artery disease in symptomatic type 2 diabetic patients: evaluation with CT angiography.

BACKGROUND: Coronary artery disease (CAD) is a common and severe complication of type 2 diabetes mellitus (DM). The aim of this study is to identify the features of CAD in diabetic patients using coronary CT angiography (CTA). METHODS: From 1 July 2009 to 20 March 2010, 113 consecutive patients (70 men, 43 women; mean age, 68 ± 10 years) with type 2 DM were found to have coronary plaques on coronary CTA. Their CTA data were reviewed, and extent, distribution and types of plaques and luminal narrowing were evaluated and compared between different sexes. RESULTS: In total, 287 coronary vessels (2.5 ± 1.1 per patient) and 470 segments (4.2 ± 2.8 per patient) were found to have plaques, respectively. Multi-vessel disease was more common than single vessel disease (p < 0.001), and the left anterior descending (LAD) artery (35.8%) and its proximal segment (19.1%) were most frequently involved (all p < 0.001). Calcified plaques (48.8%) were the most common type (p < 0.001) followed by mixed plaques (38.1%). Regarding the different degrees of stenosis, mild narrowing (36.9%) was most common (p < 0.001); however, a significant difference was not observed between non-obstructive and obstructive stenosis (50.4% vs. 49.6%, p = 0.855). Extent of CAD, types of plaques and luminal narrowing were not significantly different between male and female diabetic patients. CONCLUSIONS: Coronary CTA depicted a high plaque burden in patients with type 2 DM. Plaques, which were mainly calcified, were more frequently detected in the proximal segment of the LAD artery, and increased attention should be paid to the significant prevalence of obstructive stenosis. In addition, DM reduced the sex differential in CT findings of CAD.

[Changes of IL-8 and TNF-α in gingival crevicular fluid before and after treatment from chronic periodontitis].

AIM: To investigate the changes of IL-8 and TNF-α in gingival crevicular fluid (GCF) before and after treatment from chronic periodontitis. METHODS: 96 patients with chronic periodontitis were selected as study group and experienced initial periodontal therapy. 50 healthy people were selected as control group. Gingival crevicular fluid was collected before and after treatment. At the same time, the clinical parameters, including PLI, PD, SBI and AL were recorded, and the levels of IL-8 and TNF-α in GCF were measured by ELISA in two groups. RESULTS: The levels of IL-8 and TNF-α in GCF after treatment were significantly lowered in study group as compared with those before treatment (P < 0.05), while PLI, PD, SBI and AL showed significant reduction (P < 0.05). The levels of IL-8 and TNF-α in GCF before and after treatment were significantly highered in study group as compared with those in control group (P < 0.05). There was significant correlation between PD and IL-8 in GCF (r = 0.486, P < 0.05) and between SBI, PD and TNF-α in GCF (r = 0.495, 0.648, P < 0.05). CONCLUSION: IL-8 and TNF-α may be associated with the development and the severity of periodontitis.

Myopericytoma involving the parotid gland as depicted on multidetector CT.

Myopericytoma is a newly proposed subgroup of perivascular tumors in the World Health Organization classification of soft tissue tumors. In this study, we report a case of a benign myopericytoma with detailed multidetector CT (MDCT) findings in the parotid gland, a location that has not been described for this type of tumor previously. The clinical presentation, imaging features, histopathological and immunohistochemical findings, and the differential diagnosis with other tumors in the parotid gland are described and reviewed.

[Central mucoepidermoid carcinoma of the jaws: a clinical and pathological analysis of eight cases].

OBJECTIVE: To report eight cases of central mucoepidermoid carcinoma of the jaws (CMCJ) and to analyze its clinical and pathological features. METHODS: Eight cases of central mucoepidermoid carcinoma were diagnosed between 1989 and 2008. The clinical manifestation, radiological and histopathological changes were analyzed. RESULTS: The mean age of this group of patients was 43.3 years, with 5 male and 3 female. Seven cases occurred in mandible, mainly in the molar, angle and ramus areas, and one in maxilla. The first complain usually was local swelling, pain or paraesthesia of the jaw and loosening and pain of the tooth. X-ray displayed unilocular or multilocular radiolucent lesion with distinct or ill-distinct border, and the light microscopic findings were similar to the mucoepidermoid carcinoma originated in the salivary gland. CONCLUSIONS: To diagnose a CMCJ, it's necessary to synthetically analyze the case history, clinical examination, radiological and histopathological features. The treatment is wide local resection. Selective neck dissection and radiochemotherapy may improve curative effect and prognosis.