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2.
Hinyokika Kiyo ; 67(9): 427-431, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34610709

RESUMO

A 70-year-old man visited his doctor because of hip pain and gross hematuria. Digital rectal examination and computed tomography revealed a prostatic abscess. Although antibiotics were prescribed, his symptoms did not improve; he was transferred to our hospital, where transurethral fenestration of the prostatic abscess was performed. During prostatic fenestration, a papillary mucous membrane was confirmed inside the cavity of the prostatic abscess. Pathological examination revealed a mucinous adenocarcinoma of the prostate. Although hormonal therapy was administered, magnetic resonance imaging revealed tumor extension necessitating robot-assisted radical prostatectomy. Mucinous adenocarcinoma of the prostate is rare, and to our knowledge this is the first report of mucinous adenocarcinoma of the prostate diagnosed after transurethral treatment of a prostatic abscess.


Assuntos
Adenocarcinoma Mucinoso , Doenças Prostáticas , Neoplasias da Próstata , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Abscesso/cirurgia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Humanos , Masculino , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/cirurgia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia
3.
Hinyokika Kiyo ; 67(8): 395-398, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34472323

RESUMO

A 56-year-old man visited a clinic with the chief complaint of frequent micturition and residual sensation of urine. He was referred to our hospital for close examination. Cystoscopy showed a tumor protruding toward the bladder neck from the prostate with stones and debris on the surface. Magnetic resonance imaging showed an encapsulated tumor of iso-intensity in the prostate in T2-weighed images. Prostate specific antigen was 0.88 mg/dl. Transurethral resection of prostate was performed under the diagnosis of benign prostate hyperplasia. During the operation, a solid tumor with mucus deposit was observed. Intraoperative rapid pathological diagnosis was mucinous adenocarcinoma. A radical cystectomy was performed. Pathologically, mucinous adenocarcinoma was distributed in the bladder neck, the prostate and surrounding tissue, but the prostatic urethra was intact. The surgery was assessed to be curative. Neither neoadjuvant nor adjuvant chemotherapy was performed, since the effectiveness of chemotherapy for mucinous adenocarcinoma arising from urothelial epithelium has not been established.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias da Próstata , Ressecção Transuretral da Próstata , Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Bexiga Urinária
4.
Am J Case Rep ; 22: e932565, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473678

RESUMO

BACKGROUND Intraductal papillary mucinous neoplasm of the pancreas (IPMN) and pancreatic ductal adenocarcinoma (PDAC) often coexist in the same pancreas. Almost all IPMNs involving PDACs concomitant with IPMN have been shown to be branch duct type IPMNs (BD-IPMNs), and their histological subtypes are gastric type. Therefore, PDACs concomitant with main duct type IPMNs (MD-IPMNs) are considered to be rare. We herein report a rare case preoperatively diagnosed as being a PDAC concomitant with MD-IPMN on the basis of imaging findings and histological findings of pancreatic specimens endoscopically obtained from 2 lesions. CASE REPORT A 67-year-old man was referred to our hospital due to an enlarged pancreas. Using imaging studies, a solid mass was found in the pancreatic head and intraductal papillary masses in the dilated main pancreatic duct of the body and tail with a fistula in the duodenum. On the basis of histological results using specimens endoscopically obtained from each of the 2 lesions, total pancreatectomy was planned due to suspected PDAC concomitant with an MD-IPMN. Finally, resected specimens were used to confirm the presence of a rare case of PDAC concomitant with MD-IPMN. CONCLUSIONS We encountered a rare case of a PDAC concomitant with an MD-IPMN which could be preoperatively diagnosed by using imaging studies and histological specimens endoscopically obtained. In addition to invasive cancers derived from IPMNs, PDACs concomitant with IPMNs can rarely develop in the pancreas involving MD-IPMNs.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/diagnóstico , Adenocarcinoma Mucinoso/cirurgia , Idoso , Carcinoma Ductal Pancreático/complicações , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/cirurgia , Humanos , Masculino , Pâncreas , Ductos Pancreáticos , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico
5.
Br J Radiol ; 94(1126): 20210548, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34478331

RESUMO

OBJECTIVE: To explore the feasibility of CT and MRI in differentiating mucinous tubular and spindle cell carcinoma (MTSCC) and papillary renal cell carcinoma (PRCC). METHODS: 23 patients with MTSCC and 38 patients with PRCC were studied retrospectively. CT and MRI were undertaken to investigate differences in tumour characteristics. RESULTS: 23 patients with MTSCC and 38 patients with PRCC (included 15 cases Type 1,and 23 cases Type 2), tumours (mean diameter 3.7 ± 1.6 cm vs 4.6 ± 1.7 cm, p < 0.05), cystic components (5 vs 32, p < 0.01), calcifications (3 vs 11, p > 0.05), haemorrhage (1 vs 22, p < 0.01), tumour boundaries (1 vs 37, p < 0.01), and homogeneous enhancement (20 vs 11, p < 0.01). The density of MTSCC was lower than that of PRCC, normal renal cortex (p < 0.05), except for the medulla(p > 0.05). MTSCC and PRCC tumour enhancement were lower than that for normal cortex and medulla during all enhanced phases (p < 0.05). Enhancement was higher with PRCC than with MTSCC tumours during all phases (p < 0.05). On MRI, nine cases of MTSCC and 19 cases of PRCC, tumour showed homogeneous (9 vs 3, p < 0.01), heterogeneous (0 vs 16, p < 0.01), hyperintense on T1WI (0 vs 15, p < 0.01), slightly hyperintense on T2WI (9 vs 1, p < 0.01), hypointense on T2WI (0 vs 15, p < 0.05) , relatively high signal intensity was seen on DWI (9 vs 15, p > 0.05), respectively. CONCLUSION: CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries; however, PRCC showed mild hyperdensity, easily have cystic components. The degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI, whereas PRCC was hypointense. ADVANCES IN KNOWLEDGE: 1.CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries.2. CT imaging features of PRCC include mild hyperdensity on unenhanced CT, easily have cystic components.3. On enhanced CT, the degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI whereas PRCC was heterogeneously hypointense on T2WI.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Sarcoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Meios de Contraste , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Gan To Kagaku Ryoho ; 48(8): 1065-1068, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34404078

RESUMO

A 57-year-old Japanese woman underwent partial mastectomy of the right breast and sentinel lymph node biopsy in July 2005. The diagnosis was mucinous carcinoma with negative margins and no lymph node metastases(pT1cN0M0, pStage Ⅰ A). Postoperative adjuvant therapy included radiation therapy and oral administration of anastrozole for 5 years. In December 2015, we observed enlargement of left supraclavicular lymph nodes; a needle biopsy revealed lymph node metastases from breast cancer. We administered toremifene and the swelling disappeared. The patient was subsequently referred to the hospital for urinary frequency in November 2016. Imaging demonstrated a bladder tumor. Transurethral biopsy of bladder revealed adenocarcinoma with mucin production consistent with breast primary. After systemic chemotherapy(UFT, eribulin), endocrine therapy(fulvestrant), and molecular targeted therapy(palbociclib), her urologic symptoms were relieved. However, 2 years and 8 months after diagnosis of bladder metastasis, the patient showed disease progression and decided to discontinue all chemotherapy and pursue palliative care. We also present a review and discussion of the relevant literature.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias da Mama , Carcinoma Ductal de Mama , Adenocarcinoma Mucinoso/tratamento farmacológico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Bexiga Urinária
7.
BMJ Case Rep ; 14(8)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446520

RESUMO

We report a case of an enterocutaneous fistula resulting from drainage of a contained appendiceal perforation secondary to an obstructing appendiceal mucinous neoplasm. A 66-year-old otherwise healthy female patient proceeded to laparoscopic appendicectomy with resection of the fistula tract. Histopathology demonstrated a mid-appendiceal mucinous neoplasm, with a benign enterocutaneous fistula tract communicating with the distal, non-malignant portion of the appendix. We provide an overview of the literature and highlight the need to consider appendiceal mucinous neoplasm as a differential in the management of spontaneous right iliac fossa collections and fistulae.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias do Apêndice , Apêndice , Fístula Intestinal , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/cirurgia , Idoso , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/cirurgia , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Drenagem , Feminino , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/etiologia , Fístula Intestinal/cirurgia
8.
Medicine (Baltimore) ; 100(32): e26895, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397915

RESUMO

ABSTRACT: There is a similarity of histological features and survival between ovarian mucinous carcinoma (MC) with expansile invasion and ovarian mucinous borderline tumor (MBT). The aim of this study was to compare the clinical outcomes of MC with expansile invasion with those of MBT based on the 2020 World Health Organization (WHO) criteria.A pathological review was performed on patients with MC, ovarian MBT, and seromucinous borderline tumors that underwent surgery at our hospital between 1984 and 2019. Clinicopathological features were compared retrospectively between MC with expansile invasion and MBT.Among 83 cases of MC, 85 cases of MBT, and 12 cases of seromucinous borderline tumor, 25 MC cases with expansile invasion and 98 MBT cases were included through review. MC cases with expansile invasion were diagnosed with advanced International Federation of Gynecology and Obstetrics (FIGO) stages more frequently (P = .02) than that of MBT cases. In addition, patients with MC with expansile invasion received adjuvant chemotherapy more often (P < .01) than that of patients with MBT. There were no statistically significant differences in recurrence rate (P = .10) between MC with expansile invasion and MBT. Progression-free survival (PFS) was worse in MC cases with expansile invasion than that in MBT cases (P = .01). However, a multivariate analysis for PFS showed that histological subtype, FIGO stage, and adjuvant chemotherapy were not an independent prognostic factor.The prognostic outcome of MC with expansile invasion might mimic those of MBT. These results showed ovarian borderline tumor treatment could be applied to MC treatment.


Assuntos
Adenocarcinoma Mucinoso/patologia , Estadiamento de Neoplasias , Neoplasias Ovarianas/patologia , Biópsia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Intervalo Livre de Progressão , Estudos Retrospectivos
9.
Chirurgia (Bucur) ; 116(eCollection): 1-9, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34463245

RESUMO

Synchronous tumours of the pancreas are rare encounters, with few reported cases. Thus, new information can be brought about the diagnosis, proper management, and prognosis of cases. We believe that the presentation of this case can help to establish relevant conclusions. We report the case of a 54-year-old man, with the preoperative diagnosis of a cephalic intraductal papillary mucinous neoplasm (IPMN), who underwent a planned cephalic pancreatoduodenectomy with completion to total pancreatectomy based on the intraoperative extemporaneous histopathological examination of the resection margin. The final histopathological diagnosis was cephalic IPMN associated with invasive ductal adenocarcinoma (PDAC) and a small well-differentiated neuroendocrine tumour (NET) in the tail of the pancreas. No recurrence was detected in the 3 years of follow-up. We conducted a review of the literature to illustrate the particularities of the presented case; it identified 4 articles about the association of PDAC and NET and 8 articles regarding the association of IPMN with NET. Only 2 patients had a histopathological diagnosis of three synchronous tumours (IPMN, PDAC, and NET). We present a rare case of three synchronous pancreatic tumours, with a favourable evolution after a total pancreatectomy, only two other similar cases being reported in medical literature.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma Ductal Pancreático , Neoplasias Primárias Múltiplas , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/diagnóstico , Adenocarcinoma Mucinoso/cirurgia , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/cirurgia , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/cirurgia , Pâncreas/cirurgia , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgia , Resultado do Tratamento
10.
Pathologe ; 42(5): 472-483, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34402978

RESUMO

The latest WHO classification of tumors of the digestive system (2019) has introduced new concepts for the stratification of intraductal neoplasms of the pancreas, mostly based on molecular genetics and malignant potential. Among them, pancreatic intraepithelial neoplasias (PanINs) and intraductal papillary mucinous neoplasms (IPMN) are both precursors of pancreatic ductal adenocarcinoma, whereas intraductal oncocytic papillary neoplasms (IOPN) and intraductal tubulopapillary neoplasms (ITPN) are usually associated with less aggressive subtypes of pancreatic cancer and therefore have a much better prognosis. Hence, it is of utmost importance to correctly classify these lesions and to distinguish them from each other as well as from other nonductal types of neoplasms, which can rarely display an intraductal growth, such as neuroendocrine tumors and acinar cell carcinomas. PanIN are microscopic lesions with limited clinical significance. In contrast, all other intraductal neoplasms can be identified as cystic processes and/or solid tumors by means of imaging, thereby setting an indication for a potential surgical resection. This review presents diagnostically relevant aspects of intraductal neoplasms of the pancreas, which are instrumental for the discussion within interdisciplinary tumor boards (resection vs. watch-and-wait strategies) as well as to determine the extent of resection intraoperatively.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma in Situ , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Humanos , Pâncreas
11.
Zhonghua Bing Li Xue Za Zhi ; 50(7): 762-767, 2021 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-34405611

RESUMO

Objective: To explore the clinicopathological characteristics, immunophenotype, diagnosis and differential diagnosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), and to explore the all-exon mutations, microsatellite stability and tumor mutational burden (TMB) in MTSCC cases. Methods: The data of 5 patients with MTSCC that were submitted to the Department of Pathology, First Affiliated Hospital of Soochow University, China from January 2008 to May 2020, were reviewed and analyzed. The whole exome sequencing (WES) was conducted in all patients, while 3 of them were subject to the analyses of microsatellite stability and TMB. Results: Among the 5 patients, 3 were males and 2 were females. They were 37-76 years old. The maximum diameter of the tumor was 3.5-6.0 cm. The borders of the tumors were well defined. Microscopically, MTSCC was characterized by tubular structure, spindle cell and mucinous stroma, and the nuclear grade of tumor cells was overall low. The average follow-up was 15 months, and no recurrence or metastasis was found. Immunohistochemistry showed that all 5 cases were positive for broad-spectrum cytokeratin (CKpan), cytokeratin (CK)7, CK19, vimentin, PAX8, and P504s (varying expression levels), and the Ki-67 positive index was low. The WES of 5 cases showed that NF2 and PTPN14 exhibited higher mutation rates, which were 3/5 and 2/5, respectively. The microsatellite stability analysis indicated that the 3 cases were all microsatellite stable, and the TMB analysis showed that the TMB of the 3 cases were all <9 mut/Mb. Conclusions: MTSCC is a unique, low-grade pleomorphic kidney tumor. The WES analyses suggest that NF2 and PTPN14 have a higher mutation rate, indicating that the occurrence and development of MTSCC may be closely related to the Hippo pathway. The analysis of microsatellite stability indicates that there is no significant relationship between microsatellite stability and MTSCC, and the TMB analysis suggests that MTSCC patients may not benefit from immunotherapy.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma de Células Renais , Neoplasias Renais , Adenocarcinoma Mucinoso/genética , Adulto , Idoso , Feminino , Humanos , Neoplasias Renais/genética , Masculino , Pessoa de Meia-Idade , Vimentina , Sequenciamento Completo do Exoma
12.
BMJ Case Rep ; 14(8)2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362757

RESUMO

We present a 73-year-old woman who presented with a pathological fracture of her right humerus. Further imaging and biopsy indicated a mucinous adenocarcinoma of the lung as the primary neoplasm. This represents the first published case of a mucinous adenocarcinoma of the lung presenting as a metastatic lesion of the humerus. Operative management of pathological fractures of the humerus has typically included either intramedullary nailing or the use of single-plating or double-plating techniques. The authors describe a novel technique using both intramedullary fixation augmented with a locking plate, steel cables and bone cement, with good outcome.


Assuntos
Adenocarcinoma Mucinoso , Fixação Intramedular de Fraturas , Fraturas Espontâneas , Fraturas do Úmero , Adenocarcinoma Mucinoso/cirurgia , Idoso , Placas Ósseas , Feminino , Fixação Interna de Fraturas , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/cirurgia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/etiologia , Fraturas do Úmero/cirurgia , Pulmão , Resultado do Tratamento
14.
Hinyokika Kiyo ; 67(6): 233-238, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34265898

RESUMO

Renal mucinous tubular and spindle cell carcinoma (MTSCC) is a rare kidney cancer subtype with limited cases reported in the literature. Renal MTSCC has many similarities with papillary renal cell carcinoma (pRCC), and it is therefore often difficult to make a differential diagnosis between them. Herein, we report a case of renal MTSCC. The patient was a 76-year-old woman. Computed tomography revealed a left renal tumor. Magnetic resonance imaging (MRI) demonstrated an iso-intensity or high signal intensity mass on T2-weighted images, high signal intensity on diffusion-weighted images, and weak and gradual enhancement. We diagnosed the patient with left renal cell carcinoma (cT1bN0M0) and performed laparoscopic left nephrectomy in May 2019. The histopathological diagnosis was renal MTSCC. Six months after surgery, the patient remains free of recurrence and of metastasis. MRI is effective for the preoperative differentiation of renal MTSCC from pRCC since renal MTSCC presents an iso-intensity or high signal intensity on MRI T2-weighted images reflecting the mucin component in the intervening stroma within the tumor.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma de Células Renais , Neoplasias Renais , Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/cirurgia , Idoso , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Recidiva Local de Neoplasia , Nefrectomia
15.
Acta Cytol ; 65(5): 440-447, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34284376

RESUMO

BACKGROUND: Seromucinous borderline tumor (SMBT) is a rare neoplasm which was newly defined in the 2014 WHO classification. Although the clinical and histopathological characteristics of SMBT have been well described, its cytological characteristics have not. We recently experienced 2 cases of SMBT which were defined by cytological findings of ascites. CASE PRESENTATION: Case 1 was a 65-year-old Japanese woman. Preoperative imaging studies revealed abundant ascites and a cystic tumor, with a solid component measuring 13 cm on the left ovary. Radical surgery was performed during the intraoperative diagnosis of ovarian borderline tumor, made by histological examinations of frozen tumor sections. The cytological smears of preoperatively and intraoperatively collected ascites showed many atypical cells resembling reactive mesothelial cells. Alcian-blue staining of cell block sections revealed intracytoplasmic mucin, and the results of immunohistochemistry were consistent with SMBT. The final pathological diagnosis of tumor was SMBT. Case 2 was a 28-year-old Japanese woman. Preoperative imaging studies revealed a small amount of ascites and cystic tumors with solid components in the bilateral ovaries. She initially underwent fertility preservation surgery. SMBT was suspected by cytological examination of smears of intraoperatively collected ascites and the findings of cell block. She underwent additional radical surgery based on a final pathological diagnosis of SMBT. CONCLUSION: In our experience, the tumor cells of SMBT in ascites mimicked reactive mesothelial cells. The nuclear atypia of SMBTs was intermediate between that of reactive mesothelial cells and serous carcinoma. The immunohistochemistry and mucin staining using cell block were very helpful for facilitating the cytodiagnosis of SMBT.


Assuntos
Adenocarcinoma Mucinoso/cirurgia , Ascite/cirurgia , Neoplasias Ovarianas/patologia , Ovário/patologia , Adenocarcinoma Mucinoso/diagnóstico , Idoso , Ascite/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica/métodos , Neoplasias Ovarianas/diagnóstico , Ovário/metabolismo
16.
J Obstet Gynaecol Res ; 47(10): 3732-3736, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34278661

RESUMO

A 45-year-old multiparous woman with a STK11 mutation and a history of Peutz-Jeghers syndrome underwent radical hysterectomy and bilateral salpingo-oophorectomy for a gastric-type cervical mucinous carcinoma. Four and a half years later, blood tests revealed elevations in CEA and CA125 tumor marker levels, and computed tomography showed multiple calcifications in the peritoneum. Peritoneal dissemination was suspected, and a laparoscopic biopsy was performed. Histopathology showed a high-grade serous carcinoma, and the patient was diagnosed with a metachronous stage IIIC primary peritoneal carcinoma. She had no BRCA1/2 mutation. After chemotherapy with docetaxel, carboplatin, and bevacizumab, she achieved complete remission.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias Peritoneais , Síndrome de Peutz-Jeghers , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/diagnóstico , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Salpingo-Ooforectomia
17.
West Afr J Med ; 38(6): 604-606, 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34180217

RESUMO

Adenocarcinoma constitutes around 0.5 to 2% of all neoplastic lesions of the urinary bladder, out of which, the mucinous variant is seen on rare occasions. Intestinal metaplasia resulting from nephrolithiasis, chronic inflammation and hydronephrosis could be the precursor lesion. Bladder exstrophy and remnants of the urachus are considered as other possible risk factors. The tumour prefers patients who are over 50 years. Hematuria, difficult voiding and suprapubic pain are the most common presenting symptoms. The tumour has a very bad prognosis and is poorly responsive to chemo and radiotherapy and hence surgery is the treatment of choice. Hence early diagnosis is of paramount importance. While managing adenocarcinoma of the bladder, it is important to rule out any possibility of a metastatic lesion that could have come from other organs where mucinous adenocarcinoma is more common.


Assuntos
Adenocarcinoma Mucinoso , Adenocarcinoma , Úraco , Neoplasias da Bexiga Urinária , Humanos
18.
Abdom Radiol (NY) ; 46(10): 4779-4786, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34086091

RESUMO

PURPOSE: Assess the relationship between MRI-derived pancreatic fat fraction and risk of malignancy in intraductal papillary mucinous neoplasm (IPMN). METHODS: MRIs of patients with IPMN who underwent pancreaticoduodenectomy were analyzed. IPMN with low-grade dysplasia (n = 29) were categorized as low-risk while IPMN at high risk of malignancy consisted of those with high-grade dysplasia/invasive carcinoma (n = 33). Pancreatic fat-fraction (FFmean) was measured using the 2-point Dixon-method. Images were evaluated for the high-risk stigmata and worrisome features according to the revised 2017 Fukuoka consensus criteria. Data on serum CA19-9, Diabetes Mellitus (DM) status, body mass index (BMI), and histological chronic pancreatitis were obtained. RESULTS: A significant difference in FFmean was found between the high-risk IPMN (11.45%) and low-risk IPMN (9.95%) groups (p = 0.027). Serum CA19-9 level (p = 0.021), presence of cyst wall enhancement (p = 0.029), and solid mass (p = 0.008) were significantly associated with high-risk IPMN. There was a significant correlation between FFmean and mural nodule size (r = 0.36, p Ë‚ 0.01), type 2 DM (r = 0.34, p Ë‚ 0.01), age (r = 0.31, p Ë‚ 0.05), serum CA 19-9 (r = 0.30, p Ë‚ 0.05), cyst diameter (r = 0.30, p Ë‚ 0.05), and main pancreatic duct diameter (r = 0.26, p Ë‚ 0.05). Regression analysis revealed FFmean (OR 1.103, p = 0.035) as an independent predictive variable of high-risk IPMN. CONCLUSION: FFmean is significantly associated with high-risk IPMN and an independent predictor of IPMN malignant risk. FFmean may have clinical utility as a biomarker to complement the current IPMN treatment algorithm and improve clinical decision making regarding the need for surgical resection or surveillance.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/diagnóstico por imagem , Carcinoma Ductal Pancreático/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Neoplasias Pancreáticas/diagnóstico por imagem , Estudos Retrospectivos
19.
Clin J Gastroenterol ; 14(5): 1536-1543, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34106396

RESUMO

A 73-year-old man with mixed-type intraductal papillary mucinous neoplasm of the pancreas body was followed up for 14 years. Based on imaging findings, the intraductal papillary mucinous neoplasm of the pancreas met the high-risk stigmata, and new hepatic masses were suspected to be intraductal papillary neoplasms of the bile duct. With a diagnosis of intraductal papillary mucinous neoplasm of the pancreas and intraductal papillary neoplasm of the bile duct, the patient had undergone left lateral hepatectomy and distal pancreatectomy. Based on pathology, the pancreatic specimen was diagnosed as a high-grade intraductal papillary mucinous neoplasm of the pancreas, and the hepatic specimen was diagnosed as an intraductal papillary neoplasm of the bile duct and hepatocellular carcinoma. The intraductal papillary neoplasms of the bile duct and hepatocellular carcinoma were adjacent to each other. Fifteen months after surgery, recurrence in the remnant pancreas was detected. The patient had undergone residual total pancreatectomy, with no recurrence thirty months after the second resection. This case demonstrates that second surgery for metachronous high-risk lesions in the remnant pancreas of patients with intraductal papillary mucinous neoplasm of the pancreas and intraductal papillary neoplasm of the bile duct may also be considered to improve survival.


Assuntos
Adenocarcinoma Mucinoso , Carcinoma Hepatocelular , Carcinoma Ductal Pancreático , Neoplasias Hepáticas , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/cirurgia , Idoso , Ductos Biliares , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Carcinoma Ductal Pancreático/diagnóstico por imagem , Carcinoma Ductal Pancreático/cirurgia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia , Pâncreas , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia
20.
J Cancer Res Clin Oncol ; 147(9): 2555-2567, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34089362

RESUMO

PURPOSE: This study further approaches the role of estrogen-related receptors (ERRs) in ovarian cancer. Protein expression of ERRα, ERRß and ERRγ in ovarian cancer was assessed and was correlated with ovarian cancer markers, steroid hormone receptors and cancer-associated genes. Additionally, we examined to what extent expression of ERRs affects survival of ovarian cancer patients. METHODS: For this purpose, we established a tissue microarray from 208 ovarian cancer patients and performed immunohistochemical analyses of the mentioned proteins. RESULTS: ERRα and ERRγ protein could be detected at different levels in more than 90% of all ovarian cancer tissues, whereas expression of ERRß was observed in 82.2% of the cases. ERRα was found to positively correlate with ovarian cancer marker CEA (p < 0.005) and ERRγ correlated with ERα (p < 0.001). Univariate survival analyses revealed that ERRα expression did not affect overall (OS) or progression-free survival (PFS) of ovarian cancer patients. In contrast, higher expression of ERRß in serous ovarian cancers was found to lead to a significantly decreased OS (p < 0.05). The strongest impact on survival was exhibited by ERRγ. Lower expression of this receptor in women with serous ovarian cancers indicated significantly increased OS compared to those with higher levels of ERRγ (p < 0.05). Multivariate survival analyses revealed ERRγ as an independent prognostic marker regarding OS of patients with serous ovarian cancer. CONCLUSION: Our data demonstrating that ERR proteins are frequently expressed in ovarian cancer and high levels of ERRß and ERRγ significantly decreased OS of serous ovarian cancer patients suggest that these proteins might be interesting therapy targets in this cancer entity.


Assuntos
Biomarcadores Tumorais/metabolismo , Cistadenocarcinoma Seroso/mortalidade , Neoplasias Ovarianas/mortalidade , Receptores de Estrogênio/metabolismo , Adenocarcinoma de Células Claras/metabolismo , Adenocarcinoma de Células Claras/mortalidade , Adenocarcinoma de Células Claras/patologia , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/mortalidade , Adenocarcinoma Mucinoso/patologia , Cistadenocarcinoma Seroso/metabolismo , Cistadenocarcinoma Seroso/patologia , Neoplasias do Endométrio/metabolismo , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/patologia , Feminino , Seguimentos , Humanos , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
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