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1.
J Surg Case Rep ; 2019(9): rjz236, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31807267

RESUMO

Peripheral nerve tumors are relatively uncommon with schwannomas being the most common type. Schwannomas are usually benign encapsulated tumors composed of neoplastic Schwann cells that generally do not transform to malignancy. Many are discovered incidentally as solitary tumors. The cause is unknown. Most occur spontaneously, while some develop in association with genetic disorders such as neurofibromatosis type 2 or schwannomatosis. Schwannomas can occur anywhere in the body. They affect all ages, with peaking incidence between ages 20 and 50 years, without predilection to sex or race. Many are asymptomatic; however, presenting signs and symptoms, such as paresthesia and pain, are due to mass effect and direct nerve invasion. Diagnosing includes combinations of thorough physical examination, imaging modalities such as magnetic resonance imaging and surgical biopsy. Treatment depends on factors such as location of the tumor and severity of symptoms. Asymptomatic patients are treated conservatively while symptomatic patients undergo surgical resection with favorable prognosis.

2.
Gastroenterol Rep (Oxf) ; 7(5): 367-370, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31687157

RESUMO

Strongyloidiasis is an intestinal infection caused by the parasitic nematodes of the Strongyloides species, most commonly Strongyloides stercoralis. We report a case of a 66-year-old immigrant male from Haiti who presented with complaints of diarrhea and an unintentional 80-lb weight loss over the past 5 years. Stool examination was positive for strongyloidiasis. Following albendazole therapy, esophagogastroduodenoscopy (EGD) showed a unique ampullary lesion. Histopathology of the ampullary lesion showed reactive epithelium with Strongyloides larva. In addition, endoscopic ultrasound (EUS) detected a large pancreatic cyst. Both these findings were absent on EGD 5 years previously, prior to the onset of his symptoms. This paper documents a rare case of an ampullary lesion and pancreatic cyst secondary to hepatobiliary strongyloidiasis in a non-Human Immunodeficiency Virus (HIV) patient. We review the epidemiology, life cycle, clinical presentation and treatment of strongyloidiasis.

3.
J Surg Case Rep ; 2019(11): rjz322, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31768244

RESUMO

Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy of neuroendocrine origin presenting as a painless, rapidly growing nodule. MCC often presents in elderly, fair-skinned individuals in sun-exposed areas. Diagnosis is often overlooked at time of presentation due to its rarity, but MCC is twice as deadly as malignant melanoma. There has been bigger interest in the disease due to increasing incidence and an association with the prevalent virus Merkel cell polyomavirus. This study describes an uncommon presentation of MCC as a right gluteal lesion in an Afro-Panamanian patient. The tumor was suspected to be fibrolipoma, but Immunohistochemistry revealed the diagnosis of MCC, as stains for CD56 and CK20 were positive. In addition to surgical excision, the patient was referred for adjuvant radiotherapy. This case report and literature review elucidates the clinical, histopathologic and management aspects of MCC, which will help in recognizing and treating these tumors.

4.
J Surg Case Rep ; 2019(6): rjz177, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31249659

RESUMO

Clear cell papillary renal cell carcinoma (CCPRCC), a type of low-grade renal cell neoplasm was recently included in the 2016 WHO classification of renal tumors (Tickoo SK, dePeralta-Venturina Mariza N, Harik LR, Worcester Heath D, Salama ME, Young AN et al. Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. Am J Surg Pathol 30:141-153, 2006). While being recognized as its own entity, there is little research on CCPRCC. The specific tumor comprises of 9.3% of all renal tumors in young adults with an age range of 18-88 years (Wang Y, Ding Y, Wang J, Gu M, Wang Z, Qin C et al. Clinical features and survival of clear cell papillary renal cell carcinoma: 10-year retrospective study from two institutions. Oncology letters 16:1010-22, 2018.). In this article we provide recent understanding of CCPRCC and how to identify its distinct pathological entity. It is strongly positive for cytokeratin 7 (CK7), vimentin and mostly negative for CD10 and AMACR (Zhanyong B and John TE Clear cell papillary renal cell carcinoma in bilateral native kidneys after 2 year of renal transplantation: report of a case and review of literature. Case Reports in Transplantation 2011:11-4, 2011). Histopathologically, all cases of CCPRCC exhibited a tubular and papillary architecture, cuboidal tumor cells with clear cytoplasm and low Fuhrman grade (Wang Y, Ding Y, Wang J, Gu M, Wang Z, Qin C et al. Clinical features and survival of clear cell papillary renal cell carcinoma: 10-year retrospective study from two institutions. Oncology letters 16:1010-22, 2018; Kuroda N, Ohe C, Kawakami F, Mikami S, Furuya M, Matsuura K et al. Clear cell papillary renal cell carcinoma: a review. Int J Clin Exp Pathol 7: 7312-18, 2004.; Srigley JR, Delahunt B, Eble JN, Egevad L, Epstein JI, Grignon D, et al. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J surg Pathol. 37:1469-89, 2013). This case report and literature review highlights the cryptomorphic, immunohistochemical and cytogenic features of CCPRCC which will assist in understanding and managing these tumors.

5.
J Surg Case Rep ; 2019(1): rjy355, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30697408

RESUMO

Adenoid cystic carcinoma of the breast (ACC) is a rare tumor, comprising <0.1% of all breast cancers. It has a unique dual-cell pattern and is indistinguishable from ACC arising from salivary tissue. It is a low-grade tumor with favorable prognosis, and rare metastasis, with unique features. It is more commonly seen in older women with a mean age at diagnosis of 63, with Caucasian women being at greatest risk. Most cases present as a painful, palpable mass in the outer quadrants of the breast, and must be diagnosed via core needle biopsy or surgical excisional biopsy. Although few other cancers resemble ACC it is commonly misdiagnosed. Given the rarity of this cancer, treatment guidelines have yet to be well established. Current treatment is focused around surgical resection, however, there are not specific recommendations for the extent of resection due to the lack of cases to draw from.

7.
Cureus ; 10(10): e3463, 2018 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-30564542

RESUMO

Certain cancers pave way for other primary cancers to emerge with genetic disturbances serving as a common denominator as demonstrated by our male patient who developed prostate cancer within three months of being diagnosed with breast cancer despite being negative for the major genetic mutations, BRCA1 and BRCA2 and having a negative family history for cancers. Here we examine overlapping major and minor contributing risk factors and the limitations of the most current screening guidelines.

8.
J Surg Case Rep ; 2018(9): rjy242, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30254732

RESUMO

Goblet cell carcinoid tumor is a rare form of carcinoid tumor of the appendix. It behaves more aggressively than classical carcinoid tumor of the appendix. Thus, special attention must be given to its disease course and treatment. Our case presentation is of a 68-year-old female who presented with abdominal pain. Computed tomography of her abdomen and pelvis showed a perforated appendicitis. She underwent an ileocectomy with pathological report showing a goblet cell carcinoid tumor of the appendix with negative lymph nodes. A subsequent colonoscopy done 5 months later showed no synchronous lesions and a healthy anastomosis. Given the limited amount of data available about goblet cell carcinoid tumors of the appendix, it is important to report all findings in an effort to improve our understanding and treatment approaches of this rare disease.

9.
J Surg Case Rep ; 2018(6): rjy136, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29977515

RESUMO

There is lack of information in the literature on long-term complications of suprapubic catheters. The most common complications include urinary tract infection, bladder calculi, urine leakage and neoplastic changes. We report a case of an unusual complication of bladder prolapse, with subsequent diagnosis of urothelial carcinoma, leading to a necrotizing soft tissue infection after a radical cystectomy in a patient with long-term catheterization and its management. Due to the rarity of this complication, its management has not been well studied. In this particular case, the logical indication was radical cystectomy due to the presence of bladder necrosis.

10.
Gastroenterology Res ; 11(2): 150-153, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29707083

RESUMO

Peutz-Jeghers syndrome is an autosomal dominant inherited medical condition characterized by hyperpigmented mucocutaneous macules, hamartomatous polyps in the digestive tract, and with a greater risk of gastrointestinal and non-gastrointestinal cancers. In fact, without appropriate medical surveillance, the lifetime risk for all cancers combined may be as high as 93%. The syndrome is rare, with estimates of incidence varying between 1 in 8,300 and 1 in 280,000 live births. Infrequently, individuals present for the first time with bowel obstruction secondary to intussusception. Here, we present an interesting case of a young Burmese man who, early on, showed traits of Peutz-Jeghers syndrome, including the characteristic hyperpigmented areas on the fingers and lips. Unfortunately, the diagnosis was not made until he later developed bowel obstruction caused by an intussusception, requiring exploratory laparoscopic bowel resection. A high index of suspicion is needed to diagnose accurately. However, early identification and close surveillance can lead to excellent prognosis in these individuals.

13.
Case Rep Gastroenterol ; 11(2): 434-439, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29033760

RESUMO

Ganglioneuromas are very rare clinical entities, and their occurrence in the large bowel lays further emphasis on their rarity. Ganglioneuromas are benign tumors of undifferentiated neural crest cells. Their clinical presentation is mostly asymptomatic, and if any symptoms are present at all, they are usually nonspecific, with excellent prognosis. We report an asymptomatic, 65-year-old male with a solitary ascending colonic polyp found on screening colonoscopy. Histology revealed benign polypoid spindle-cell proliferation as well as S100 reactivity, consistent with ganglioneuroma. We report on the clinical presentation and discuss the origin, epidemiology, treatment, and management of this lesion.

14.
J Surg Case Rep ; 2017(9): rjx174, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28928929

RESUMO

Inflammatory bowel disease (IBD) remains a topic of ongoing research given its prevalence, yet the pathogenesis and all clinical manifestations of the disease remain poorly understood. Giant inflammatory polyposis is one of the clinical manifestations of IBD that has rarely been described to the best of our knowledge. This is a recognized clinical entity, however, only a limited number of IBD associated cases have been described in literature to date. This phenomenon consists of numerous benign, inflammatory polyps that clump together giving the appearance of a larger mass, which may cause clinical colonic obstruction and radiographic findings mimicking colonic neoplasm. This clinical entity may present in 10-20% of patients with IBD.

15.
Breast J ; 23(5): 589-593, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28252252

RESUMO

The primary neuroendocrine carcinoma (NEC) of the breast is defined as immunohistochemical expression of neuroendocrine markers (chromogranin and synoptophysin) in more than 50% of the neoplastic cells according to World Health Organization (WHO) classification of tumors in 2003 (Tumours of the Breast and Female Genital Organs, 2003, Lyon: IARC Press). It accounts for less than 5% of all cancers arising from the breast (Tumours of the Breast and Female Genital Organs, 2003, Lyon, France: IARC Press). However, based on the study conducted by Wang et al., the primary NEC of breast comprises less than 0.1% of all mammary carcinomas (Frankf Z Pathol, 73, 1963, 24). Because of the rarity of the disease and absence of the prospective trials, there is no standard treatment for primary NEC of the breast. Herein, we report the case of a middle age woman with primary NEC with bone metastasis.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Neuroendócrino/tratamento farmacológico , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/secundário , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/secundário , Tomada de Decisões , Diagnóstico Diferencial , Feminino , Humanos , Vértebras Lombares , Pessoa de Meia-Idade , Metástase Neoplásica , Crânio , Vértebras Torácicas
16.
World J Surg Oncol ; 14: 101, 2016 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-27038637

RESUMO

BACKGROUND: Hodgkin's lymphoma (HL) is a rare malignancy which often presents with lymphadenopathy and classic "B symptoms" of weight loss, fever, and night sweats. Additional masses or nodes could easily be presumed to be a result of the initial diagnosis. On the other hand, adult rhabdomyosarcoma is a rare malignancy presenting with a new mass in a patient with previous diagnosis of Hodgkin's lymphoma. In both cases, a tissue diagnosis should be obtained to appropriately confirm the diagnosis. CASE PRESENTATION: We present a case of a 64-year-old male who presents with right axillary lymphadenopathy, diagnosed as Hodgkin's lymphoma. He subsequently developed left inguinal lymphadenopathy without the classic B symptoms of HL. Excisional biopsy revealed rhabdomyosarcoma. Stage III Hodgkin's lymphoma (lymph node involvement on both sides of the diaphragm) is not commonly seen without typical B symptoms. Once the diagnosis of two primary malignancies is made, the dilemma becomes determining the treatment course. In the case of Hodgkin's lymphoma and rhabdomyosarcoma, there is some overlap in the chemotherapeutic regimen and use of radiation. CONCLUSIONS: This case illustrates the importance of careful examination of Hodgkin's lymphoma patients and consideration of additional tissue diagnoses in atypical presentations of new masses or lymphadenopathy on the opposite side of the diaphragm.


Assuntos
Doença de Hodgkin/diagnóstico , Linfadenopatia/diagnóstico , Rabdomiossarcoma/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
17.
Arch Pathol Lab Med ; 139(6): 819-22, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26030252

RESUMO

Metaplastic carcinoma of the breast is a rare but aggressive type of breast cancer that has been recognized as a unique pathologic entity by the World Health Organization. Morphologically, it is characterized by the differentiation of neoplastic epithelium into squamous cells and/or mesenchymal-looking elements (squamous cells, spindle cells, cartilage or bone, etc). It shares many similarities with invasive ductal carcinoma and benign lesions on mammography, which further complicates the diagnosis. Treatment for metaplastic breast carcinoma is relatively unknown because of the rarity of the disease, but studies suggest that removal of the tumor and adjuvant radiation therapy has the greatest benefit.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/cirurgia , Neoplasias da Mama/terapia , Quimiorradioterapia , Etoposídeo/administração & dosagem , Feminino , Humanos , Ifosfamida/administração & dosagem , Metaplasia/cirurgia , Metaplasia/terapia , Prognóstico
18.
J Surg Case Rep ; 2014(7)2014 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-25015071

RESUMO

Invasive ductal carcinoma of the breast with clear cell changes is a very rare pathological entity. There are <150 cases of this breast cancer subtype reported in the literature. Clear cell carcinoma could be easily missed or under-diagnosed in a breast core biopsy specimen due to the fact that this subtype tends to show a papillary pattern with clear cell and pseudo-lactating changes, especially in young female patients. Normal breast tissue may possess clear cells as a consequence of the physiological changes of pregnancy, the clearing of the cytoplasm within myoepithelial cells, or the clearing of the cytoplasm in apocrine metaplasia. Owing to its aggressive clinical course, clear cell carcinoma must be differentiated from other subtypes of breast carcinoma. Special attention given to this rare subtype by pathologists and clinicians could avoid misdiagnosis and delay of treatment.

19.
J Gastric Cancer ; 14(4): 271-4, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25580360

RESUMO

Prostate cancer is the second most common cause of cancer death in men in the United States. The most common sites of metastasis include the bone, lymph nodes, lung, liver, pleura, and adrenal glands, whereas metastatic prostate cancer involving the gastrointestinal tract has been rarely reported. A 64-year-old African-American man with a history of prostate cancer presented with anemia. He reported the passing of dark colored stools but denied hematemesis or hematochezia. Colonoscopy revealed circumferential nodularity, and histology demonstrated metastatic carcinoma of the prostate. Esophagogastroduodenoscopy showed hypertrophic folds in the gastric fundus, and microscopic examination revealed tumor cells positive for prostate-specific antigen. Bone scanning and computed tomography of the abdomen and pelvis did not show metastasis. It is crucial to distinguish primary gastrointestinal cancer from metastatic lesions, especially in patients with a history of cancer at another site, for appropriate management.

20.
Arch Pathol Lab Med ; 137(8): 1152-4, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23899073

RESUMO

Primary effusion lymphoma is a large cell non-Hodgkin lymphoma localized predominantly in body cavities and occasionally in extracavitary regions. It presents with characteristic lymphomatous effusions in the absence of solid tumor masses, and pleural, peritoneal, and pericardial spaces are most often involved. It is typically associated with human herpesvirus 8 infection in immunocompromised individuals, in the setting of human immunodeficiency virus infection, organ transplantation, or in rare cases advanced age. Histologically, primary effusion lymphoma is characterized by atypical lymphoid cells of B-cell lineage with large nuclei and prominent nucleoli. Demonstration of human herpesvirus 8 latent antigens is required for diagnosis, and treatment modalities are limited at this time. In this review, we aim to summarize clinicopathologic features of this rare and unique entity.


Assuntos
Linfoma de Efusão Primária/patologia , Infecções Oportunistas Relacionadas com a AIDS/complicações , Diagnóstico Diferencial , Feminino , Infecções por Herpesviridae/complicações , Herpesvirus Humano 8/patogenicidade , Humanos , Linfoma não Hodgkin/diagnóstico , Linfoma de Efusão Primária/diagnóstico , Linfoma de Efusão Primária/etiologia , Masculino
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