Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.754
Filtrar
2.
Cancer Immunol Immunother ; 69(2): 189-197, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31853575

RESUMO

Peptide-based immunotherapy does not usually elicit strong immunological and clinical responses in patients with end-stage cancer, including sarcoma. Here we report a myxofibrosarcoma patient who showed a strong clinical response to peptide vaccinations and whose immune responses were reboosted by anti-PD1 therapy combined with peptide vaccinations. The 46-year-old man showed a strong response to the peptide vaccinations (papillomavirus binding factor peptide, survivin-2B peptide, incomplete Freund's adjuvant, and polyethylene glycol-conjugated interferon-alpha 2a) and subsequent wide necrosis and massive infiltration of CD8+ T cells in a recurrent tumor. The patient's immune responses weakened after surgical resection; however, they were reboosted following the administration of nivolumab combined with peptide vaccinations. Thus, anti-PD1 therapy combined with peptide vaccinations might be beneficial, as suggested by the observations in this sarcoma patient.


Assuntos
Vacinas Anticâncer/imunologia , Fibroma/imunologia , Fibroma/terapia , Fibrossarcoma/imunologia , Fibrossarcoma/terapia , Imunização Secundária , Peptídeos/imunologia , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Biomarcadores Tumorais , Vacinas Anticâncer/administração & dosagem , Terapia Combinada , Fibroma/diagnóstico , Fibrossarcoma/diagnóstico , Humanos , Imuno-Histoquímica , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
4.
J Card Surg ; 34(10): 1120-1122, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31376223

RESUMO

Surgical treatment of cardiac fibroma is rare in patients with left ventricular noncompaction (LVNC). Although several case reports regarding cardiac fibroma have been published, resection in a patient with LVNC has not been described. Here, we describe the surgical treatment of left ventricular fibroma in a child with LVNC. We resected a cardiac fibroma in a 10-year-old boy with LVNC to control ventricular arrhythmia. Partial resection with careful tumor dissection was performed to avoid endocardial damage and entering the ventricular cavity. The postoperative course was uneventful, and the patient remains asymptomatic without heart failure or arrhythmia. Surgical excision of cardiac fibroma can be performed safely with excellent results, even in a child with LVNC.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Fibroma/cirurgia , Cardiopatias Congênitas/complicações , Neoplasias Cardíacas/cirurgia , Criança , Ecocardiografia Transesofagiana , Fibroma/complicações , Fibroma/diagnóstico , Cardiopatias Congênitas/diagnóstico , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Ventrículos do Coração , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
6.
Can J Gastroenterol Hepatol ; 2019: 3960920, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360694

RESUMO

Plexiform fibromyxoma is a rare and newly described gastric mesenchymal tumor with only 121 reported cases in the literature. Our understanding of plexiform fibromyxoma requires updating since the first case has been reported by Takahashi et al. 12 years ago. The present review summarized reported cases in the literature, and both clinical and pathological aspects of plexiform fibromyxoma were comprehensively discussed. Plexiform fibromyxoma usually causes nonspecific or bleeding signs or symptoms, and therefore clinical recognition of the disease is challenging. Plexiform fibromyxoma is of benign nature without any metastasis or recurrence reported, and more conservative surgical treatment should be considered.


Assuntos
Fibroma/patologia , Neoplasias Gástricas/diagnóstico , Fibroma/diagnóstico , Fibroma/cirurgia , Humanos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
7.
Dermatol Online J ; 25(5)2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31220904

RESUMO

Cowden syndrome (CS) is an infrequent genodermatosis caused by mutations in the phosphatase and tensin homolog (PTEN) gene in the majority of cases. As such, it belongs to the PTEN hamartoma tumor syndrome spectrum. This disease has a variable clinical expression characterized by the development of multiple hamartomatous tumors in different organs, usually during the second and third decades of life, and a high cumulative risk of several malignancies. We present a case of Cowden syndrome with late diagnosis presenting with a florid dermatological expression and multiple benign tumors, but no malignancies. A novel PTEN mutation was identified.


Assuntos
Fibroma/genética , Síndrome do Hamartoma Múltiplo/genética , Neoplasias Bucais/genética , PTEN Fosfo-Hidrolase/genética , Neoplasias Cutâneas/genética , Feminino , Fibroma/diagnóstico , Fibroma/etiologia , Fibroma/patologia , Folículo Piloso , Síndrome do Hamartoma Múltiplo/complicações , Síndrome do Hamartoma Múltiplo/diagnóstico , Síndrome do Hamartoma Múltiplo/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/etiologia , Neoplasias Bucais/patologia , Mutação , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia
8.
Fetal Pediatr Pathol ; 38(6): 490-495, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31154875

RESUMO

Introduction: Lipofibromatosis is a benign pediatric soft tissue tumor arising preferentially in the distal extremities. Histologically, the tumor shows abundant adipose tissue admixed with a spindle cell component, often concentrated in septal and perimysial locations. The index case is being presented to discuss the histopathological and immunohistochemical clues to differentiate it from other fibrofatty tumors of childhood.Case report: An 11-month-old male child presented with a slowly growing mass on the upper back. MRI findings were suggestive of an adipocytic tumor. Microscopy revealed a lesion composed of mature adipocytes and intervening fibrous bands with infiltration into the adjacent skeletal muscle, features of lipofibromatosis.Conclusion: Lipofibromatosis should be considered in the differential diagnosis of a pediatric fibrofatty tumor. Accurate diagnosis is essential for proper patient management as incomplete removal of the tumor may result in recurrence.


Assuntos
Tecido Adiposo/patologia , Fibroma/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias de Tecidos Moles/patologia , Diagnóstico Diferencial , Extremidades/patologia , Fibroma/diagnóstico , Humanos , Lactente , Imagem por Ressonância Magnética/métodos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico
9.
Eur Radiol ; 29(7): 3441-3449, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31041564

RESUMO

PURPOSE: The clinical and imaging characteristics of fibromas of the tendon sheath (FTS) closely resemble those of giant cell tumors of the tendon sheath (GCTTS). We aimed to study MRI features of FTS and GCTTS to distinguish the two entities and improve their differential diagnosis. MATERIALS AND METHODS: We retrospectively analyzed data from 18 patients (9 men, 9 women; age, 17-62 years) and 24 patients (13 men, 11 women; age, 15-67 years) treated between May 2011 and May 2016, with histologically confirmed FTS and GCTTS, respectively. Specific MRI features of the two groups were compared using the independent sample t tests and chi-square tests. RESULTS: FTS exhibited round or oval shapes. Proton-weighted images (PDWI) showed heterogeneous hypointensity that appeared striped or disordered and was located in the lesion center. Enhanced scans demonstrated asymmetrical signal in the foci. GCTTS mostly exhibited a lobulated or casting mold pattern, with a hypointense ring on PDWI. The hypointense components appeared granular/flaky or separated, sometimes behaving as a uniform signal on PDWI. Significant differences in the following features were observed between the two groups: lesion morphology (p < 0.001); imaging features on PDWI, including whether the signal is homogeneous (p < 0.001); the presence of a hypointense ring (p = 0.006); the location and morphology of hypointensity (p < 0.001); bone absorption (p = 0.008); enhancing pattern (p = 0.008); and whether the tumor crossed the joint (p = 0.026). CONCLUSIONS: FTS and GCTTS demonstrate distinctive MRI features, which can be used for differential diagnosis with sensitivities, specificities, and diagnostic accuracies of 83-100%, 29-79%, and 60-89%, respectively. KEY POINTS: • Fibromas and giant cell tumors of the tendon sheath have distinct features on MRI, including differences in lesion morphology and intensity patterns, which can be used for differential diagnosis. • Among other signs, GCTTS are more uniform than FTS, and FTS have a striped or disordered pattern. • Tumors were classified with 90% accuracy into either FTS or GCTTS based on a combination of two features: homogenous signal and hypointensity shape on PDWI.


Assuntos
Fibroma/diagnóstico , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico , Imagem por Ressonância Magnética/métodos , Tendões/diagnóstico por imagem , Adolescente , Adulto , Idoso , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
10.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 43-47, maio/ago. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1006564

RESUMO

O objetivo deste estudo é descrever o diagnóstico e conduta clínica no tratamento do Fibroma Traumático (FT). O FT é uma lesão proliferativa de natureza benigna que surge na cavidade bucal devido à traumas de repetição, que desencadeiam reações inflamatórias em tecido conjuntivo, causando uma hiperplasia tecidual, geralmente assintomática, podendo interferir na mastigação e na fala causando desconforto ao paciente. Sua prevalência é alta, geralmente em mucosa jugal, linha oclusal, mucosa labial, língua e gengiva. O tratamento consiste na excisão cirúrgica e a confirmação do diagnóstico é dado através de envio para exame histopatológico. Paciente do gênero masculino, 46 anos de idade, procurou atendimento por apresentar nódulo único, exofítico, unilateral de aproximadamente 3 cm em seu diâmetro, localizado na mucosa jugal do lado direito, com bordas regulares e indolor a palpação, apresentando há cerca de 12 meses. Foi submetido a remoção cirúrgica total da lesão e encaminhamento ao laboratório para análise histopatológica para confirmação diagnóstica, além de proservação do caso em 7, 30 e 60 dias. Desta forma, foi possível concluir que a excisão cirúrgica da lesão promove maior conforto, melhora na fala e mastigação, além de um bom reparo tecidual, devolvendo assim, condições de saúde a mucosa bucal e mínimas chances de recidiva(AU)


The objective of this study is to describe the diagnosis and clinical management in the treatment of Traumatic Fibroma (FT). FT is a proliferative lesion of benign nature that arises in the buccal cavity due to repetitive traumas, which trigger inflammatory reactions in connective tissue, causing a tissue hyperplasia, usually asymptomatic, that can interfere in chewing and speech causing discomfort to the patient. Its prevalence is high, usually in jugal mucosa, occlusal line, labial mucosa, tongue and gingiva. The treatment consists of surgical excision and confirmation of the diagnosis is given by sending for histopathological examination. A 46-year-old male patient sought care for having a single, exophytic, unilateral nodule of approximately 3 cm in diameter, located on the right side of the jugal mucosa, with regular borders and painless palpation, presenting about 12 months. He was submitted to total surgical removal of the lesion and sent to the laboratory for histopathological analysis for diagnostic confirmation, in addition to case proservation at 7, 30 and 60 days. In this way, it was possible to conclude that the surgical excision of the lesion promotes greater comfort, improvement in speech and chewing, besides a good tissue repair, thus returning health conditions to the oral mucosa and minimal chances of relapse(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fibroma/cirurgia , Cirurgia Bucal , Fibroma , Fibroma/diagnóstico , Fibroma/terapia , Hiperplasia , Mucosa Bucal/patologia
12.
Medicine (Baltimore) ; 98(16): e15262, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31008967

RESUMO

RATIONALE: Fibroma of tendon sheath is a rare entity that is typically attached to the tendon sheath. PATIENT CONCERNS: A 43-year-old man presented with a painful mass in his right wrist, which was initially misdiagnosed as an enchondroma. DIAGNOSIS: Fibroma embedded into carpal bones, which exhibited lytic radiographic features similar to those of enchondroma. Excisional biopsy demonstrated spindle-shaped cells and collagen-like stroma. INTERVENTIONS: The patient underwent lesion resection surgery. OUTCOMES: The patient recovered well and showed no signs of recurrence at 6-month follow-up. LESSONS: This case provides valuable insights for hand surgeons. While radiograph is helpful in multiple diseases, histological examination is indispensable for establishment of final diagnosis.


Assuntos
Neoplasias Ósseas/diagnóstico , Ossos do Carpo/patologia , Condroma/diagnóstico , Fibroma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Tendões , Adulto , Ossos do Carpo/diagnóstico por imagem , Ossos do Carpo/cirurgia , Diagnóstico Diferencial , Erros de Diagnóstico , Fibroma/diagnóstico por imagem , Fibroma/patologia , Fibroma/cirurgia , Humanos , Masculino , Radiografia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Tendões/diagnóstico por imagem , Tendões/patologia , Tendões/cirurgia
14.
J Surg Res ; 239: 76-82, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30822694

RESUMO

Through a multicenter study, we collected seven cases of gastric plexiform fibromyxoma including four females and three males, 21 to 79 y old (46.1 ± 10.1). All cases showed a unilocular lesion measuring 0.3 to 17 cm (5.3 ± 2.4), arising from antrum (5/7) or body (2/7). Six of the seven cases had intraoperative frozen sections and/or endoscopic ultrasound fine needle aspiration (EUS-FNA), and all of them were preoperatively or intraoperatively diagnosed as gastrointestinal stromal tumor (GIST). EUS-FNA material showed markedly elongated spindle cells with streaming oval to elongated nuclei with rounded ends. Histologically, the tumors exhibited a plexiform growth pattern and were composed of a rich myxoid stroma and cytologically bland uniform spindle cells without mitotic figures, with the exception of one case which displayed nuclear pleomorphism and increased mitosis. Immunostains showed the tumor cells to be focally positive for SMA (6/6), focally and weakly positive for desmin (3/6) and caldesmon (2/3), negative for CD117 (0/7), CD34 (0/7), DOG1 (0/4), and S100 (0/5). No mutations were identified on Next-Generation Sequencing test, and no loss of SDHB immunoreactivity was identified in the tumor with nuclear pleomorphism. One case was treated with Gleevec because of the initial diagnosis of GIST. All patients had a follow-up for up to 11 y, with no tumor recurrence or metastasis reported. Our results suggest that gastric plexiform fibromyxoma is rare and may be underrecognized and misinterpreted as GIST during intraoperative frozen section or preoperative EUS-FNA diagnosis without immunostains leading to inappropriate treatment.


Assuntos
Biomarcadores Tumorais/análise , Fibroma/diagnóstico , Tumores do Estroma Gastrointestinal/diagnóstico , Neoplasias Gástricas/diagnóstico , Estômago/patologia , Adulto , Idoso , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Fibroma/patologia , Fibroma/cirurgia , Seguimentos , Gastrectomia , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Estômago/cirurgia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Adulto Jovem
17.
Rev. clín. med. fam ; 12(1): 28-31, feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182886

RESUMO

El diagnóstico diferencial de las lesiones dermatológicas supone un gran reto en las consultas diarias de Atención Primaria. Un ejemplo de ello son las lesiones digitales, cuya etiología más frecuente es la verruga vulgar, denominadas como tal aquellas que son causadas por el virus del papiloma humano (VPH). A pesar de ello, hay otras causas que deben ser tenidas en cuenta como el fibroqueratoma acral adquirido, debido a su relativa frecuencia. Se trata de un tumor fibroso y benigno cuyo diagnóstico se basa en la histología y cuyo tratamiento consiste en la exéresis completa


The differential diagnosis of dermatological lesions is a great challenge in primary care daily consultations. An example of this is digital lesions, whose most frequent etiology is verruca vulgaris, which are those caused by the human papillomavirus (HPV). However, there are other causes, like acquired digital fibrokeratoma, that must be taken into account due to its relative frequency. This is a fibrous and benign tumor whose diagnosis is based on its histology and whose treatment consists only in complete excision


Assuntos
Humanos , Feminino , Idoso , Verrugas/diagnóstico , Neoplasias Cutâneas/diagnóstico , Fibroma/diagnóstico , Dedos/patologia , Ceratose/diagnóstico , Cistos Glanglionares/diagnóstico , Diagnóstico Diferencial , Atenção Primária à Saúde/estatística & dados numéricos
19.
Medicine (Baltimore) ; 98(2): e14115, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30633226

RESUMO

RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission. DIAGNOSES: A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor. INTERVENTIONS: The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively. OUTCOMES: The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence. LESSONS: Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.


Assuntos
Abdome Agudo/etiologia , Fibroma/diagnóstico , Doenças do Íleo/etiologia , Perfuração Intestinal/etiologia , Mesentério , Neoplasias Peritoneais/diagnóstico , Adolescente , Feminino , Fibroma/complicações , Humanos , Doenças do Íleo/diagnóstico , Perfuração Intestinal/diagnóstico , Neoplasias Peritoneais/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA