ABSTRACT
We report an unusual presentation of recurrent atypical fibroxanthoma of the limbus. Clinical and histological appearances, as well as management are discussed and the current literature is reviewed.
Subject(s)
Eyelid Neoplasms , Histiocytoma, Malignant Fibrous , Neoplasm Recurrence, Local , Aged, 80 and over , Eyelid Neoplasms/pathology , Histiocytoma, Malignant Fibrous/pathology , Humans , Male , Neoplasm Recurrence, Local/pathologyABSTRACT
The clinical and pathological features of multiple different renal neoplasms arising in a setting of end-stage renal disease in a 72-year-old male are described. The kidney showed features of renal oncocytosis with multiple oncocytomas, hybrid tumours and chromophobe renal carcinoma. In addition, the kidney contained a type 2 papillary renal cell carcinoma, clear cell papillary and cystic renal cell carcinoma, and tubulocystic carcinoma. The occurrence of these three tumours in a setting of end-stage kidney disease is unique and suggests a common pathogenesis. Immunostaining of these tumours further suggests they are derived from similar stem cells which show immunophenotypic features of both the proximal and distal nephron.
Subject(s)
Adenoma, Oxyphilic/pathology , Carcinoma, Papillary/pathology , Carcinoma, Renal Cell/pathology , Kidney Neoplasms/pathology , Kidney Tubules/pathology , Neoplasms, Multiple Primary/pathology , Aged , Humans , MaleABSTRACT
BACKGROUND: Bimodal electric tissue ablation is a novel variation to standard radiofrequency ablation that produces significantly larger ablations by the addition of a direct electrical current. The negative electrode is attached to the radiofrequency current and the positive electrode is placed nearby. It has been identified that an electrolytic injury can occur at the positive electrode site. It is suggested that by increasing the surface area that is in contact with the positive electrode, the risk of tissue injury is reduced. This hypothesis was tested in a pig model. METHODS: Thirty-six ablations were carried out in the livers of six pigs (six ablations per pig). Two were standard radiofrequency ablation controls and two were carried out with positive electrode attached to a scalpel blade. Two were carried out with positive electrode attached to a grounding pad. After 48 h, liver was harvested and the ablation sizes were compared. Skin biopsies were taken from the scalpel site and one from the pad site and examined histopathologically. RESULTS: The scalpel blade ablations were significantly larger than controls and the grounding pad ablations (P < 0.001). The grounding pad ablation was significantly larger than controls. The scalpel blade skin site showed full-thickness tissue injury. The grounding pad site appeared microscopically normal. CONCLUSION: By increasing the surface area that connects to the positive electrode, significantly larger ablations can be carried out while minimizing the risk of associated tissue injury.
Subject(s)
Catheter Ablation/methods , Liver/surgery , Animals , Burns/etiology , Catheter Ablation/adverse effects , Catheter Ablation/instrumentation , Electrodes/adverse effects , Liver/anatomy & histology , Models, Animal , SwineABSTRACT
BACKGROUND: Radiofrequency ablation is a popular method of treating unresectable liver tumors but tumors greater than 3 cm in diameter have a much greater risk of local recurrence after treatment. Bimodal electric tissue ablation is a modified form of radiofrequency ablation that creates significantly larger ablations by the addition of extra direct current circuitry. This may help to reduce the risk of local recurrence in these larger tumors. Prior to use in a clinical setting, a long term study was performed to assess associated morbidity and the pathological changes in the ablations. METHODS: In eight pigs, six ablations were performed in each liver. Pigs were euthanized at 2 d, 2 wk, 2 mo, and 4 mo, and the ablations were assessed macroscopically and microscopically for pathological change. Regular blood tests were performed to assess changes in liver function. At death, any other abnormalities detected were reported. RESULTS: Histopathological examination of ablation zones revealed tissue death by coagulative necrosis and healing by fibrotic scarring. Transient rises in serum liver enzymes were seen in the postoperative period. Skin necrosis was noted at the site of the positive electrode of the direct electrical current but no other form of morbidity was seen associated with the procedure. CONCLUSIONS: Although the positive electrode placement requires further consideration, bimodal electric tissue ablation appears to be safe and behaves in a similar fashion to other thermal therapies such as standard radiofrequency ablation.
Subject(s)
Catheter Ablation/adverse effects , Catheter Ablation/methods , Liver/pathology , Liver/surgery , Alanine Transaminase/blood , Alkaline Phosphatase/blood , Animals , Aspartate Aminotransferases/blood , Bilirubin/blood , Female , L-Lactate Dehydrogenase/blood , Liver/metabolism , Liver Neoplasms/surgery , Necrosis , Swine , Time Factors , gamma-Glutamyltransferase/bloodABSTRACT
We present a patient with an enlarging calf mass 36 years after a tibia and fibula fracture. He developed a peroneal nerve palsy after the accident, which was probably due to a subclinical compartment syndrome. Imaging of the leg was consistent with calcific myonecrosis. The diagnosis was confirmed histologically. The radiopathological findings of calcific myonecrosis are discussed.