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1.
J Int Med Res ; 49(9): 3000605211038137, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34486433

RESUMO

Primary pulmonary high-grade mucoepidermoid carcinoma (MEC) with a cystic airspace is uncommon, and early metastasis is extremely rare. In such cases, however, it is clinically important for clinicians to consider whether the tumor has spread to the lymph nodes through the cystic airspace. A 77-year-old man presented to our hospital with cough and hemoptysis. Chest computed tomography showed a 25-mm-diameter mass with a cystic airspace located in the upper lobe of the left lung. The possibility of malignancy was considered. Without a definitive preoperative diagnosis, left upper lobectomy and mediastinal lymphadenectomy were performed. Histopathological examination revealed the typical histological characteristics of high-grade MEC (stage IA) and no lymph node metastasis. However, lymph node metastasis was found 6 months after surgical resection, and radiochemotherapy was performed. The patient developed widespread metastatic disease 4 months following completion of radiochemotherapy and died 2 months later. Primary pulmonary MEC with a cystic airspace is a rare malignant disease with uncommon imaging findings. Complete surgical resection is the main treatment method for high-grade MEC. In this case, we hypothesize that early metastasis was caused by seeding of tumor cells through the cystic airspace.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias Pulmonares , Idoso , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo , Metástase Linfática , Masculino
2.
Stomatologija ; 23(1): 22-25, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34528904

RESUMO

Salivary mucoepidermoid carcinoma is the most common malignant salivary gland tumor. Low or intermediate grade tumors are slow-growing and can be mistaken for benign lesions on both physical exam and imaging studies. We present a case of hypervascular mucoepidermoid carcinoma of the hard palate that was initially thought to represent a benign vascular lesion. To our knowledge, only two prior cases of hypervascular mucoepidermoid carcinoma have been previously reported. This is the first case showing the MRI features of this tumor and its temporal evolution on CT over several years. Our patient ultimately underwent angiographic tumor embolization so that her lesion could be safely biopsied without significant bleeding risk. We present this as a potential diagnostic pitfall and explain how the treatment for hypervascular mucoepidermoid carcinoma varies compared to conventional tumors.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Carcinoma Mucoepidermoide/diagnóstico por imagem , Feminino , Humanos , Palato , Neoplasias das Glândulas Salivares/diagnóstico por imagem
3.
Zhonghua Bing Li Xue Za Zhi ; 50(8): 891-898, 2021 Aug 08.
Artigo em Chinês | MEDLINE | ID: mdl-34344072

RESUMO

Objective: To investigate MAML2 gene rearrangement, gene fusion patterns, and the clinicopathological characteristics of primary pulmonary mucoepidermoid carcinoma (PMEC). Methods: Forty-six cases of primary PMEC from Fudan University Zhongshan Hospital and Fudan University Shanghai Cancer Center between 2017 and 2020 were collected. MAML2 gene rearrangement in all cases was detected by fluorescence in situ hybridization (FISH). In 20 cases, MAML2 fusion patterns were detected by targeted RNA sequencing (RNAseq). The relationship between MAML2 gene rearrangement, fusion patterns, clinicopathological characteristics, and prognosis was analyzed. Results: The average age of PMEC patients was 41 years (range 15-71 years); the ratio of male to female was about 1.1 ∶ 1.0. Most PMECs were low grade in histopathology with an early clinical stage (stageⅠ-Ⅱ).The overall positive rate of MAML2 gene rearrangement detected by FISH was about 80.4% (37/46), and the rate was higher in low-grade PMEC (91.7%, 33/36). Of the 20 cases detected by RNAseq, all the 19 FISH positive cases showed gene fusion, mainly CRTC1-MAML2 fusion (16/19), the other three cases showed CRTC3-MAML2 fusion (3/19), the break point of all the fusion patterns was CRTC1/3 (exon 1)-MAML2 (exon 2); No gene fusion was detected in the single FISH negative case; Compared with the MAML2 FISH negative patients, the PMECs carrying CRTC1-MAML2 fusion were more commonly found in patients age ≤ 40 years, maximum tumor diameter ≤ 2 cm, low histopathological grade and early clinical stage (all P<0.05); The three PMECs carrying CRTC3-MAML2 fusion gene were all female with early clinical stage; Univariate analysis showed that MAML2 gene rearrangement/fusion, onset age ≤ 40 years old, smaller tumor size, low histopathological grade, early clinical stage, no metastasis at diagnosis and surgical treatment were significantly correlated with overall survival (P<0.05), but Cox regression analysis suggested that none of the above indicators were the independent prognostic factors for the survival of PMEC. Conclusions: The high incidence of MAML2 gene rearrangement in PMEC suggests that it is an important molecular diagnostic marker of PMEC. RNAseq confirms that CRTC1/3-MAML2 is the main fusion pattern in PMEC, suggesting that MAML2 fusion transcription may be an important driving factor of PMEC. MAML2 rearrangement/fusion and related clinicopathological characteristics are associated with good prognosis.


Assuntos
Carcinoma Mucoepidermoide , Adolescente , Adulto , Idoso , Carcinoma Mucoepidermoide/genética , China , Proteínas de Ligação a DNA/genética , Feminino , Fusão Gênica , Rearranjo Gênico , Humanos , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Proteínas Nucleares/genética , Proteínas de Fusão Oncogênica/genética , Transativadores , Fatores de Transcrição/genética , Adulto Jovem
4.
Int J Mol Sci ; 22(15)2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34360635

RESUMO

Salivary gland cancers are rare but aggressive tumors that have poor prognosis and lack effective cure. Of those, parotid tumors constitute the majority. Functioning as metabolic machinery contributing to cellular redox balance, peroxisomes have emerged as crucial players in tumorigenesis. Studies on murine and human cells have examined the role of peroxisomes in carcinogenesis with conflicting results. These studies either examined the consequences of altered peroxisomal proliferators or compared their expression in healthy and neoplastic tissues. None, however, examined such differences exclusively in human parotid tissue or extended comparison to peroxisomal proteins and their associated gene expressions. Therefore, we examined differences in peroxisomal dynamics in parotid tumors of different morphologies. Using immunofluorescence and quantitative PCR, we compared the expression levels of key peroxisomal enzymes and proliferators in healthy and neoplastic parotid tissue samples. Three parotid tumor subtypes were examined: pleomorphic adenoma, mucoepidermoid carcinoma and acinic cell carcinoma. We observed higher expression of peroxisomal matrix proteins in neoplastic samples with exceptional down regulation of certain enzymes; however, the degree of expression varied between tumor subtypes. Our findings confirm previous experimental results on other organ tissues and suggest peroxisomes as possible therapeutic targets or markers in all or certain subtypes of parotid neoplasms.


Assuntos
Adenoma Pleomorfo/enzimologia , Carcinoma de Células Acinares/enzimologia , Carcinoma Mucoepidermoide/enzimologia , Neoplasias Parotídeas/enzimologia , Peroxissomos/enzimologia , Adenoma Pleomorfo/patologia , Carcinoma de Células Acinares/patologia , Carcinoma Mucoepidermoide/patologia , Estudos de Casos e Controles , Humanos , Proteínas de Neoplasias/metabolismo , Glândula Parótida/patologia , Neoplasias Parotídeas/patologia , Receptores Ativados por Proliferador de Peroxissomo/metabolismo
5.
Int J Mol Sci ; 22(13)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209768

RESUMO

Cytosolic 5'-nucleotidase II (cN-II) is an allosteric catabolic enzyme that hydrolyzes IMP, GMP, and AMP. The enzyme can assume at least two different structures, being the more active conformation stabilized by ATP and the less active by inorganic phosphate. Therefore, the variation in ATP concentration can control both structure and activity of cN-II. In this paper, using a capillary electrophoresis technique, we demonstrated that a partial silencing of cN-II in a pulmonary carcinoma cell line (NCI-H292) is accompanied by a decrease in adenylate pool, without affecting the energy charge. We also found that cN-II silencing decreased proliferation and increased oxidative metabolism, as indicated by the decreased production of lactate. These effects, as demonstrated by Western blotting, appear to be mediated by both p53 and AMP-activated protein kinase, as most of them are prevented by pifithrin-α, a known p53 inhibitor. These results are in line with our previous observations of a shift towards a more oxidative and less proliferative phenotype of tumoral cells with a low expression of cN-II, thus supporting the search for specific inhibitors of this enzyme as a therapeutic tool for the treatment of tumors.


Assuntos
5'-Nucleotidase/genética , Carcinoma Mucoepidermoide/genética , Metabolismo Energético/genética , Neoplasias Pulmonares/genética , 5'-Nucleotidase/metabolismo , Proteínas Quinases Ativadas por AMP/metabolismo , Carcinoma Mucoepidermoide/metabolismo , Carcinoma Mucoepidermoide/patologia , Linhagem Celular Tumoral , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Inativação Gênica , Humanos , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Transdução de Sinais/genética , Proteína Supressora de Tumor p53/metabolismo
7.
Braz Oral Res ; 35: e073, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34161412

RESUMO

The aim of this study was to identify tumor parenchyma cells exhibiting immunohistochemical profile of stem cells by evaluating the immunoreactivity of OCT4 and CD44 in a number of cases of salivary gland neoplasms. The sample consisted of 20 pleomorphic adenomas, 20 mucoepidermoid carcinomas, and 20 adenoid cystic carcinomas located in major and minor salivary glands. The expression of OCT4 and CD44 was evaluated by the percentage of positive cells and the intensity of expression. All studied cases showed positive expression of OCT4 and CD44 and higher values than the control groups. For OCT4, luminal and non-luminal cells were immunostained in the case of pleomorphic adenomas and adenoid cystic carcinomas. Moreover, the immunoreactivity of CD44 was particularly evident in the non-luminal cells of these lesions. In mucoepidermoid carcinomas, there was immunoreactivity for both markers in squamous and intermediate cells and absence of staining in mucous cells. For both markers, a significantly higher immunostaining was verified in neoplasms located in the major salivary glands compared with lesions in minor salivary glands (p<0.001). In the total sample and in minor salivary glands, malignant neoplasms exhibited higher immunoreactivity for OCT4 than pleomorphic adenoma. A significant moderate positive correlation (r = 0.444 and p ≤ 0.001) was found between OCT4 and CD44 immunoexpression in the total sample. The high expression of OCT4 and CD44 may indicate that these proteins play an important role in identifying tumor stem cells.


Assuntos
Adenoma Pleomorfo , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Receptores de Hialuronatos/genética , Fator 3 de Transcrição de Octâmero/genética , Neoplasias das Glândulas Salivares , Humanos , Imuno-Histoquímica
8.
Am J Surg Pathol ; 45(8): 1028-1037, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34091485

RESUMO

Mucoepidermoid carcinoma (MEC) is generally characterized by an admixture of mucous, epidermoid and intermediate type cells. Numerous variants morphologies are described and defined by stromal and/or cytoplasmic tinctorial characteristics. We now report 11 cases of MEC with serous acinar differentiation, reflecting a distal intercalated duct/acinar phenotype, which we designate as mucoacinar carcinomas. Seven patients were female while 4 were male with a mean age of 55 years (range: 21 to 72 y). Ten cases were from the parotid while 1 was from the submandibular gland. Mean size of the tumors was 1.8 cm (range: 0.7 to 4.5 cm). Three cases were low grade, 7 were intermediate grade, and 1 was high grade. Low to intermediate grade cases demonstrated prominent clear to vacuolated cells with focal serous acinar differentiation. The high-grade case showed a distinctive scattering of acinar cells interspersed between epidermoid cells. Periodic acid Schiff after diastase (9/9), SOX-10 (9/9), and DOG-1 (9/10) highlighted the acinar component. Six of 7 cases showed a focal acinar predominant NR4A3 expression. MAML2 fluorescence in situ hybridization was positive in all cases, in both acinar and mucoepidermoid components. Two cases tested by next generation sequencing showed standard CRTC1-MAML2 fusions. MSANTD3 and NR4A3 fluorescence in situ hybridization on the other hand were negative. Evidence thus suggests that mucoacinar carcinoma represents an acinar variant morphology in MEC, rather than a true MEC-acinic cell carcinoma hybrid, or collision tumor. The acinar differentiation, SOX-10, DOG-1, and even focal NR4A3 reactivity may thus be diagnostic pitfalls.


Assuntos
Células Acinares/patologia , Carcinoma Mucoepidermoide/patologia , Neoplasias das Glândulas Salivares/patologia , Adulto , Idoso , Biomarcadores Tumorais/análise , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/genética , Neoplasias das Glândulas Salivares/metabolismo
9.
Head Neck ; 43(9): 2663-2671, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33931913

RESUMO

BACKGROUND: Parotid gland mucoepidermoid carcinoma (MEC) has published five-year cancer-specific survival (CSS) rates of 77%-97%, with variance related to grade. METHODS: Patients receiving primary surgery for parotid gland MEC from 1995 to 2014 at a tertiary medical center underwent clinical review, histopathologic review, and cytogenetic analysis. Survival outcomes were evaluated. RESULTS: Among 58 patients, T/N/M classification was as follows: T1 in 35 patients, T2 in 14, T4a in 9, N0 in 53, N1 in 2, N2b in 3. Histologic grade was low in 27, intermediate in 17, and high in 12 patients with 98% MAML2 positivity. All patients underwent parotidectomy, and seven patients received adjuvant radiation therapy. CSS was 100% at 5 years and 94.1% at 10 and 15 years. Two patients experienced locoregional recurrence. CONCLUSIONS: Treatment with adequate surgical resection and adjuvant radiation therapy for high-grade or advanced-stage tumors yields excellent survival, independent of clinical stage or pathologic grade.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias Parotídeas , Neoplasias das Glândulas Salivares , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/cirurgia , Humanos , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/patologia , Resultado do Tratamento
11.
Head Neck ; 43(8): 2497-2509, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33893750

RESUMO

AIMS: In the era of precision medicine, accurate pathologic diagnoses are crucial for appropriate management. METHODS: We herein described the histologic features and clinical impacts of 66 salivary gland epithelial neoplasms in which the diagnosis was altered after expert review. RESULTS: The most common revised diagnosis was that of salivary duct carcinoma (SDC, n = 12), adenoid cystic carcinoma (n = 12), and myoepithelial carcinoma (n = 10). The most common initial diagnosis was mucoepidermoid carcinoma (n = 19) with SDC being the most common revised diagnosis (7/19). Thirteen salivary gland carcinomas were initially diagnosed as benign entities, whereas five benign tumors were initially interpreted as carcinoma. The change in diagnosis was considered to be clinically significant in 65 (97%) cases. CONCLUSIONS: Given their rarity, salivary gland neoplasms are prone to diagnostic inaccuracy and discrepancy. A constellation of histologic features and ancillary studies are useful in reaching the correct diagnosis, which can have significant clinical impacts.


Assuntos
Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Neoplasias Epiteliais e Glandulares , Neoplasias das Glândulas Salivares , Carcinoma Adenoide Cístico/diagnóstico , Humanos , Encaminhamento e Consulta , Neoplasias das Glândulas Salivares/diagnóstico , Glândulas Salivares , Centros de Atenção Terciária
12.
Schweiz Arch Tierheilkd ; 163(4): 295-300, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33821802

RESUMO

INTRODUCTION: The present case describes the treatment of a mucoepidermoid carcinoma in a 13-year-old female sterilized European domestic cat, using lung lobectomy and -accompanying mitoxantrone chemotherapy. Six, 14, 19 and 27 months after the initial treatment tomodensitometric and radiographic examinations showed no abnormalities. However, the cat had to be euthanized 27 months after the lung lobectomy due to a soft tissue sarcoma in the interscapular area.


Assuntos
Carcinoma Mucoepidermoide/veterinária , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Terapia Combinada/veterinária , Neoplasias Pulmonares/veterinária , Mitoxantrona/uso terapêutico , Animais , Antineoplásicos/uso terapêutico , Carcinoma Mucoepidermoide/tratamento farmacológico , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/cirurgia , Doenças do Gato/patologia , Gatos , Feminino , Seguimentos , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Resultado do Tratamento
13.
BMJ Case Rep ; 14(3)2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33766966

RESUMO

Salivary gland tumours can arise in any location in the oral cavity but are rather rare in the retromolar region. The majority of the salivary neoplasms arising here are malignant in nature. Mucoepidermoid carcinoma is more commonly seen in the palate. Tumours arising in the retromolar region tend to show symptoms late in onset and may be greater in extent than evident clinically. Imaging studies will help in understanding the full extent of these lesions. We report a case of mucoepidermoid carcinoma arising in a young female patient who reported for orthodontic correction. In the course of examination, a palpable swelling was identified in the right retromolar area, which was eventually diagnosed as intermediate-grade mucoepidermoid carcinoma. Wide resection with adjuvant radiotherapy was the treatment given for the patient.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Feminino , Humanos , Achados Incidentais , Radioterapia Adjuvante , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Neoplasias das Glândulas Salivares/cirurgia , Língua
15.
Intern Med ; 60(14): 2235-2240, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-33612673

RESUMO

A 75-year-old man visited our hospital for the examination of a tumor in the pancreas. Computed tomography showed an 85×85-mm low-density tumor in the pancreas. The tumor was pathologically diagnosed as poorly differentiated carcinoma by endoscopic ultrasound-guided fine-needle aspiration. Although we started chemotherapy, the patient died 84 days after the diagnosis. An autopsy demonstrated a ruptured anaplastic carcinoma with mucoepidermoid carcinoma of the pancreas. Anaplastic carcinoma with mucoepidermoid carcinoma is a very rare histologic subtype of pancreatic carcinoma, so pathological findings are important for predicting the patient's prognosis. Physicians should be aware of this rare but fatal disease.


Assuntos
Carcinoma Mucoepidermoide , Carcinoma , Neoplasias Pancreáticas , Idoso , Autopsia , Carcinoma/diagnóstico , Carcinoma Mucoepidermoide/diagnóstico por imagem , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Humanos , Masculino , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico
16.
Int J Oral Maxillofac Surg ; 50(10): 1280-1288, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33602646

RESUMO

Malignant tumours arising from the sublingual glands are very rare, and the extent and frequency of local invasion or regional spread in malignant sublingual gland tumour (MSLT) has not been fully studied due to the disease rarity. To provide comprehensive features of local and regional spread of MSLT, we reviewed 20 surgical cases for detailed pathological analyses among 26 cases diagnosed as having primary MSLT. Adenoid cystic carcinoma (ACC) was the most common pathological subtype, followed by mucoepidermoid carcinoma. Disease-free and overall survivals at 5 years were 76.1 % and 77.7 %, respectively. High-grade malignant tumours and grade 2-3 ACC accounted for 41.7 % and 85.7 %. Clinical and pathological extraparenchymal extensions were found in 34.6 % and 80.0 %, respectively. Tumour invasion to the lingual nerve and submandibular gland/ductal system were also detected in 40.0 % and 28.6 %. The incidences of lingual nerve invasion in ACC and ACC ≥4 cm were 30.8 % and 42.9 %. Regional nodal involvement occurred in seven of 26 cases, and all metastatic lymph nodes were found in neck levels Ib and IIa. In summary, a significant portion of MSLT cases consisted of high-grade tumours and grade 2-3 ACC; therefore local invasion into adjacent structures should be cautiously evaluated in cases of MSLT.


Assuntos
Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Neoplasias da Glândula Sublingual , Carcinoma Adenoide Cístico/epidemiologia , Carcinoma Adenoide Cístico/cirurgia , Carcinoma Mucoepidermoide/cirurgia , Humanos , Esvaziamento Cervical , Neoplasias das Glândulas Salivares/cirurgia , Neoplasias da Glândula Sublingual/epidemiologia , Neoplasias da Glândula Sublingual/cirurgia
17.
J Coll Physicians Surg Pak ; 31(1): 101-103, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33546545

RESUMO

Bronchial mucoepidermoid carcinoma is a rare disease in the field of thoracic surgery, and it is even more rarer in children. A 10-year Chinese child whose chief complaint was intermittent fever and cough for one year was referred to our hospital. Based on the imaging, pathology and immunohistochemistry findings, the patient was diagnosed with right inferior lobar bronchial mucoepidermoid carcinoma; and was treated with video-assisted thoracoscopic (VATS) right inferior lobe resection and had a good prognosis. Key Words: Mucoepidermoid carcinoma, Child, Lobe resection, VATS.


Assuntos
Carcinoma Mucoepidermoide , Cirurgia Torácica Vídeoassistida , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Criança , Humanos , Pneumonectomia
18.
BMC Cancer ; 21(1): 178, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602169

RESUMO

BACKGROUND: Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong indicator of prognosis in PGC. Nevertheless, some patients still present with large parotid mass, maybe due to the unawareness or ignorance of their disease. In this study, we aimed to present the clinical outcomes of bulky PGC (defined by a 4 cm cutoff point for T3-4 versus T1-2 tumors), to emphasize the necessity of a self-examination tool for parotid gland tumor. METHODS: We retrospectively reviewed 60 consecutive cases with bulky (equal to and greater than 4 cm in the longest diameter, determined radiologically) malignant tumors arising from the parotid gland from 1995 to 2016. The clinical and pathological factors were analyzed to identify risk factors for poor outcomes using Cox proportional hazard models. In addition, we designed a self-examination tool for parotid gland tumors, similar to breast self-examination for breast cancer detection. RESULTS: Patients with bulky parotid cancer showed 48.9% 5-year and 24.5% 10-year overall survival rates and a 47.9% risk of high-grade malignancy. The common pathological diagnoses were carcinoma ex pleomorphic adenoma (18.3%), adenocarcinoma (16.7%), mucoepidermoid carcinoma (16.7%), salivary duct carcinoma (16.7%), and adenoid cystic carcinoma (11.7%). Survival analyses revealed that tumor size (hazard ratio, HR = 1.262 upon increase of 1 cm, 95% confidence interval, 95%CI 1.059-1.502), lymph node metastasis (HR = 2.999, 95%CI 1.048-8.583), and high tumor grade (HR = 4.148, 95%CI 1.215-14.154) were independent prognostic factors in multivariable analysis. Functional preservation of the facial nerve was possible only in less than half of patients. CONCLUSION: In bulky PGC, lymph node metastasis at diagnosis and high tumor grade indicated poor survival outcomes, and functional outcomes of the facial nerve were suboptimal. Thus, a public effort seems to be necessary to decrease these patients with bulky PGC, and to increase patients' self-awareness of their disease. As a way of early detection, we proposed a parotid self-examination tool to detect parotid gland tumors at an early stage, which is similar to breast self-examination.


Assuntos
Neoplasias Parotídeas/diagnóstico , Autoexame/métodos , Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/mortalidade , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/terapia , Idoso , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/mortalidade , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/mortalidade , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/terapia , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Parotídeas/mortalidade , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Carga Tumoral
19.
J Cancer Res Clin Oncol ; 147(5): 1335-1340, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33598797

RESUMO

BACKGROUND: Treatment regimens for patients with metastatic or recurrent post-radiation, locoregional, unresectable salivary cancer are limited. An inverse correlation between somatostatin receptor 2 (SSTR2) and the proliferating marker Ki-67 in neuroendocrine tumors has enabled a treatment plan for metastatic disease, utilizing peptide receptor radionuclide therapy. Interestingly, healthy salivary glands express high levels of SSTR2. In this study, the presence of SSTR2, its correlation with Ki-67 in glandular salivary carcinomas and the clinical applicability thereof was determined. METHODS: In the retrospective part of this study, 76 adequate tumor tissue specimens obtained from patients diagnosed with primary or metastatic salivary carcinomas between 1988 and 2016, were collected for tissue array and histologically classified. Immunohistochemistry was performed to determine the presence, relative expression and potential correlation of SSTR2 and Ki-67. The clinical significance of SSTR2 expression was determined by prospectively assessing 68Ga-DOTATATE uptake using PET-CT imaging, in patients diagnosed with metastatic salivary gland malignant tumors between 2015 and 2016. RESULTS: Sixty-three primary cancer tumors and 14 metastatic tumors were tested. All tumor subtypes were found to express SSTR2 to some extent. The highest expression was seen in Mucoepidermoid carcinoma (MEC) tissues where the majority of specimens (86.4%) expressed SSTR2. A relatively strong immunohistochemical staining score for SSTR2 was observed in MEC, adenoid cystic carcinoma and polymorphous adenocarcinoma. Interestingly, an inverse correlation between SSTR2 and Ki-67 expressions was observed (44%) in MEC tissue. Uptake of 68Ga-DOTATATE was visualized using PET-CT imaging in 40% of patients, across metastatic MEC and ACC. All observations were found to be statistically significant. CONCLUSION: This study confirms the expression of SSTR2 in glandular salivary carcinomas and an inverse correlation in expression levels between SSTR2 and Ki-67. This lays a foundation for novel treatment options in salivary metastatic cancers where SSTR2 may be a potential novel therapeutic target.


Assuntos
Receptores de Somatostatina/metabolismo , Neoplasias das Glândulas Salivares/metabolismo , Glândulas Salivares/metabolismo , Adenocarcinoma/metabolismo , Carcinoma Adenoide Cístico/metabolismo , Carcinoma Mucoepidermoide/metabolismo , Feminino , Humanos , Imuno-Histoquímica/métodos , Antígeno Ki-67/metabolismo , Masculino , Recidiva Local de Neoplasia/metabolismo , Octreotida/análogos & derivados , Octreotida/metabolismo , Compostos Organometálicos/metabolismo , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos/metabolismo , Estudos Retrospectivos
20.
Ann Diagn Pathol ; 51: 151698, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33450549

RESUMO

Preoperative fine needle aspiration diagnosis and cyto-histologic correlation of primary pulmonary mucoepidermoid carcinoma have rarely been described in detail in the literature. A 26-year old male presented at our institution with cough, bloody sputum, and a 4.3 cm left lower lobe lung mass. He was accurately diagnosed with pulmonary mucoepidermoid carcinoma on preoperative aspiration cytology. The patient subsequently proceeded to left lower lobectomy, confirming the diagnosis. In this article, we present a detailed report of primary pulmonary mucoepidermoid carcinoma describing the cytologic and histologic morphologic features, its differential diagnosis with review of the literature.


Assuntos
Carcinoma Mucoepidermoide/diagnóstico , Citodiagnóstico/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Neoplasias Pulmonares/patologia , Adulto , Conscientização , Broncoscopia/métodos , Carcinoma Mucoepidermoide/cirurgia , Tosse/diagnóstico , Tosse/etiologia , Diagnóstico Diferencial , Hemoptise/diagnóstico , Hemoptise/etiologia , Humanos , Masculino , Cuidados Pré-Operatórios/métodos
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