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1.
Medicine (Baltimore) ; 99(12): e19553, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195964

RESUMO

New endoscopic resection techniques are constantly being developed for gastric adenoma, which can be classified as low or high grade according to the Vienna classification. However, long-term data on gastric adenoma (e.g., removal or follow-up after resection via endoscopy) remain lacking.We retrospectively analyzed 133 cases with gastric adenoma that underwent endoscopic resection from January 2010 to November 2018. We analyzed the risk factors and frequency of patients with synchronous and metachronous lesions after endoscopic resection for gastric adenoma and followed them for more than 2 years.One hundred six (79.7%) and 27 patients (20.3%) received endoscopic resection (ER) once and more than twice, respectively. Compared with the initial endoscopic biopsy pathological results, the upgraded and downgraded histological discrepancy rates were 10.5% (n = 14) and 3.0% (n = 4) after resection, respectively. The mean time to synchronous/metachronous recurrence was 2.23 years. The average lesion size at first procedure was larger in the multiple ER group than in the single ER group (2.00 vs 1.10 cm; P = .040). Eleven (8.3%) and 16 patients (12.0%) had recurred synchronous and metachronous lesions, respectively. In the multivariate Cox analysis of the recurrence group, intestinal metaplasia (hazard ratio, 2.761; 95% confidence interval, 1.117-6.820; P = .028) and lesion size (hazard ratio, 1.607; 95% confidence interval, 1.082-2.385; P = .019) were independent factors for receiving endoscopic resection more than twice.If patients have severe intestinal metaplasia or large size of lesion at endoscopic resection for gastric adenoma, periodic observation is necessary.


Assuntos
Adenoma/cirurgia , Ressecção Endoscópica de Mucosa/métodos , Neoplasias Gástricas/patologia , Adenoma/classificação , Idoso , Feminino , Seguimentos , Humanos , Incidência , Intestinos/patologia , Masculino , Metaplasia , Pessoa de Meia-Idade , Recidiva , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgia
3.
Urology ; 136: 238-240, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31758979

RESUMO

Menkes disease, or Kinky Hair Syndrome, is a rare disorder of copper metabolism that causes fatal neurodegenerative disease in infancy. This X-linked disorder results from mutations in the ATP7A gene. Along with neurological decline, characteristic coarse appearance of the hair is seen. Urological issues are prevalent in this patient population, with bladder diverticula being the most common. Herein, we describe a unique male patient with genetic mosaicism and osseous metaplasia found in a ruptured bladder diverticulum.


Assuntos
Doenças Ósseas/etiologia , Doenças Ósseas/patologia , Osso e Ossos/patologia , Divertículo/complicações , Síndrome dos Cabelos Torcidos/complicações , Bexiga Urinária/anormalidades , Criança , Humanos , Masculino , Síndrome dos Cabelos Torcidos/genética , Metaplasia/etiologia , Mosaicismo
7.
Arq Gastroenterol ; 56(4): 419-424, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800739

RESUMO

BACKGROUND: Helicobacter pylori infection is the most important risk factor for gastric atrophy and intestinal metaplasia, both considered gastric cancer precursor lesions. Therefore, the investigation of the occurrence of H. pylori infection, precursor lesions and associated factors guides the adoption of specific strategies for the control this type of cancer. OBJECTIVE: To evaluate the prevalence of H. pylori infection in patients undergoing upper digestive endoscopy, as well as the prevalence of intestinal metaplasia, atrophy and chronic inflammation and their association with H. pylori infection. METHODS: A retrospective study was performed based on reports of gastric endoscopic biopsies performed in a private laboratory affiliated to the Brazilian Public Health System (SUS). Patients were evaluated for age, gender and type of health service. The samples were evaluated for the presence of H. pylori, and also of chronic inflammation, intestinal metaplasia and glandular atrophy. RESULTS: Of a total of 4,604 patients (mean age 51±16.6), 63.9% were female and 63.1% coming from private health care service. The prevalence of H. pylori infection was 31.7% (n=1,459), and the percentage of infection was significantly higher in patients from public health service (42.0%) in relation to patients from private health service (25.6%). Among H. pylori (+) patients, a higher percentage of intestinal metaplasia (17.7% vs 13.3%) and glandular atrophy (17.6% vs 6.9%) were observed when compared to those H. pylori (-) (P<0.01). From the patients H. pylori (+) with at least one type of precursor lesion (n=418), 161 (38.5%) had metaplasia and chronic inflammation, 160 (38.3%) had atrophy and chronic inflammation and finally 97 (23.2%) presented metaplasia, atrophy and chronic inflammation simultaneously. CONCLUSION: The present study reinforces the association of H. pylori infection with gastric cancer precursor lesions in a Brazilian population, emphasizing the importance of infection prevention measures, as well as the treatment of infected patients, especially in regions with lower socioeconomic levels that show a higher prevalence of infection by H. pylori.


Assuntos
Infecções por Helicobacter/patologia , Helicobacter pylori , Neoplasias Gástricas/microbiologia , Adulto , Idoso , Atrofia/microbiologia , Biópsia , Doença Crônica , Feminino , Gastroscopia , Humanos , Masculino , Metaplasia/microbiologia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/microbiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/patologia
8.
Pol J Pathol ; 70(3): 174-182, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31820860

RESUMO

Breast carcinosarcoma is a rare and aggressive subtype of metaplastic breast cancer. Data focusing on breast carcinosarcoma is limited. The purposes of this study are to describe the clinicopathological features of breast carcinosarcoma and to evaluate post-surgical outcomes. MATERIAL AND METHODS: All case reports about breast carcinosarcoma in China were collected from eligible papers published in Chinese core periodicals between 1990 and 2015 with key words of breast carcinosarcoma, breast cancer, carcinosarcoma, or metaplastic carcinoma. The survival rates, clinical behaviour, and pathological characteristics were analysed. RESULTS: The mean age of the cohort of 215 patients was 53 years (range, 25-82 years). The tumour size ranged from 2.5 cm to 18 cm. The incidence of pathologically confirmed lymph node metastases was 30.81%. The epithelial component in a tumour may be composed of invasive ductal carcinoma (84.21%), squamous cell carcinoma (7.89%), lipid-rich carcinoma (6.58%), or adenocarcinoma (1.31%). Mesenchymal components may contain different elements ranging from fibrosarcoma (63.16%) to chondrosarcoma (19.73%), osteosarcoma (9.21%), liposarcoma (3.95%), or leiomyosarcoma (3.95%). The five-year survival of the breast carcinosarcoma in 149 patients is 62.6% (CI: 54.9%~0.703%). CONCLUSIONS: Breast carcinosarcoma is a rare subtype of metaplastic breast cancer. It is characterised by large tumour size, higher rates of axillary nodal involvement, higher rates of both local and distant recurrence, and is difficult to diagnose with preoperative core needle biopsies. Adjuvant treatment after surgical operation may improve the five-year OS of patients with breast carcinosarcoma.


Assuntos
Neoplasias da Mama/patologia , Carcinossarcoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Metástase Linfática , Metaplasia , Pessoa de Meia-Idade , Taxa de Sobrevida
9.
Arq Bras Cir Dig ; 32(4): e1480, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31859933

RESUMO

BACKGROUND: The presence of intestinal metaplasia in the distal esophagus (Barrett's esophagus) is an important precursor of adenocarcinoma. Knowledge of the risk factors and the process by which the Barrett develops is very important and Helicobacter pylori (HP) can contribute to this development. AIM: To analyze the impact of HP in the gastric mucosa with intestinal metaplasia in the distal esophagus in areas of columnar epithelialization smaller than 10 mm in length and epidemiological data on prevalence. METHOD: A retrospective study in which were included 373 consecutive patients diagnosed with columnar epithelium in the distal esophagus was done. In all, HP was investigated by urease and histology, exclusion and inclusion factors were applied and patients were divided into two groups: the first grouping the ones without histological diagnosis of Barrett's esophagus (235-63%) and the second with it (138-37%). RESULTS: There was no significant difference between HP and non-HP patients in relation to the probability of having intestinal metaplasia (p=0.587). When related to the general group, there was an inverse association between the bacterium and the columnar epithelia in the distal esophagus. Age (p=0.031), gender (p=0.013) and HP (p=0.613) when related together to intestinal metaplasia showed no significant relation. In isolation, when related to age and gender, regardless of HP, results confirmed that patients in more advanced age and women present a higher incidence of intestinal metaplasia. CONCLUSION: There is an inverse relation between HP and the areas of columnar epithelization in the distal esophagus, regardless of the presence or absence of intestinal metaplasia. Age and gender, regardless of HP, showed higher prevalence in women and in older the number of cases with intestinal metaplasia in the distal esophagus.


Assuntos
Esôfago de Barrett/patologia , Epitélio/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori , Adulto , Fatores Etários , Idoso , Esôfago de Barrett/microbiologia , Epitélio/microbiologia , Feminino , Humanos , Masculino , Metaplasia/microbiologia , Metaplasia/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais
10.
PLoS One ; 14(12): e0226427, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851694

RESUMO

BACKGROUND: Gastric cancer (GC) is categorized as diffuse- and intestinal-type adenocarcinoma. Intestinal-type GC is associated with chronic gastritis, atrophic gastritis (AG), and intestinal metaplasia (IM), precursors of dysplastic changes. Diffuse-type GC is generally known to undergo de novo carcinogenesis and is not associated with chronic mucosal changes. However, clinically, AG and IM are frequently observed surrounding diffuse-type GC. This study aimed to evaluate the role of AG and IM in diffuse-type GC. METHODS: We retrospectively reviewed the data of patients undergoing surgery for early GC. We divided patients with diffuse-type GC into two groups according to the presence of AG and IM based on Kyoto classification of gastritis. The clinicopathological characteristics were compared between the groups. RESULTS: Among patients with diffuse-type GC, 52.5% patients had AG and 18.4% had severe AG. With regard to IM, 42.1% patients had IM and 17.1% had severe IM. Diffuse-type GC combined with severe AG or IM showed larger tumor size and higher submucosal invasion rate than that without severe AG or IM. However, the lymph node metastasis (LNM) rate was not significantly different between the two groups. In multivariate analysis, severe AG or IM was not an independent risk factor for LNM. CONCLUSIONS: Severe AG or IM surrounding diffuse-type gastric cancer suggests a collapse of normal mucosal barriers and leads to the spread of cancer cells. Although the association between chronic mucosal changes and LNM is unclear, more caution is needed during endoscopy especially for complete resection of diffuse-type GC with these features.


Assuntos
Carcinogênese , Gastrite Atrófica/complicações , Neoplasias Gástricas/complicações , Idoso , Doença Crônica , Feminino , Gastrite Atrófica/patologia , Humanos , Masculino , Metaplasia/complicações , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
12.
Anticancer Res ; 39(11): 6259-6263, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704855

RESUMO

BACKGROUND/AIM: Kita-Kyushu lung cancer antigen-1 (KK-LC-1) is a known cancer/testis antigen. Our group has previously shown KK-LC-1 gene expression in gastric cancer. However, could not be detected the KK-LC-1 protein due to the lack of an appropriate antibody. Here, we assessed our original monoclonal antibody (Kmab34B3) and, using it, assessed the expression of KK-LC-1 in gastric cancer. PATIENTS AND METHODS: We evaluated an original monoclonal antibody against KK-LC-1 (Kmab34B3), and used this antibody to compare KK-LC-1 protein expression in tumour and non-tumour stomach cells from gastric cancer patients. RESULTS: Kmab34B3 stained testicular germ cells, and tumour cells in nine out of 11 (82%) specimens. In non-tumorous areas, Kmab34B3 stained 13 out of 29 (45%) pyloric gland specimens. Furthermore, Kmab34B3 also stained intestinal metaplasia positive and negative areas. CONCLUSION: Kmab34B3 was able to detect KK-LC-1 protein within tumour cells and the pyloric gland where the gene has been shown to be expressed. Therefore, it might be an attractive tool for detecting KK-LC-1 expression in precancerous and cancerous stomach cells.


Assuntos
Anticorpos Monoclonais , Antígenos de Neoplasias/análise , Neoplasias Gástricas/imunologia , Estômago/imunologia , Antígenos de Neoplasias/genética , Expressão Gênica , Humanos , Metaplasia/imunologia , Lesões Pré-Cancerosas/imunologia , Piloro/imunologia
13.
Pan Afr Med J ; 33: 147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558944

RESUMO

Pleomorphic Adenoma (PA) is the most common salivary gland tumor and accounts for about 60% of all salivary gland neoplasms. Intraorally, the hard palate is the most common presenting site (50-60%) followed by upper lip (15-20%) and rarely buccal mucosa (8-10%). Histopathologically, PA shows diverse morphology resulting from amalgamation of cellular and stromal components. The PA may show changes in the stromal and epithelial components, such as sebaceous, lipocytic and oncocytic metaplasia. A rare characteristic of PA is to show extensive squamous and mucous differentiation which poses diagnostic dilemma to the pathologist. Here, we present an unusual case of PA of buccal minor salivary gland with squamous and mucous metaplasia. The localization, gender and microscopic features of the presented case are unusual.


Assuntos
Adenoma Pleomorfo/diagnóstico , Mucosa Bucal/patologia , Neoplasias das Glândulas Salivares/diagnóstico , Glândulas Salivares Menores/patologia , Adenoma Pleomorfo/patologia , Adulto , Humanos , Masculino , Metaplasia , Neoplasias das Glândulas Salivares/patologia
14.
Rev Med Suisse ; 15(660): 1502-1505, 2019 Aug 28.
Artigo em Francês | MEDLINE | ID: mdl-31496174

RESUMO

In 2019, gastric cancer still has high mortality. Gastric intestinal metaplasia (IGM) is an intermediate step in the process of carcinogenesis of intestinal adenocarcinoma. Gastroscopy with biopsies can detect the presence of MIG. Characterization in terms of intensity and distribution allows to stratify the risks and to target the population in which surveillance endoscopies are indicated for the purpose of detecting endoscopic resectable neoplasia in endoscopy.


Assuntos
Adenocarcinoma , Gastroscopia , Metaplasia , Lesões Pré-Cancerosas , Neoplasias Gástricas , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Biópsia , Humanos , Metaplasia/complicações , Metaplasia/diagnóstico , Lesões Pré-Cancerosas/complicações , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico
15.
Medicine (Baltimore) ; 98(34): e16923, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441877

RESUMO

RATIONALE: There are already several reports concerning the occurrence of urethral diverticulum (UD) in female patients, but only rarely has a article describing UD combined with UD calculi or squamous carcinoma been published. Moreover, a case with squamous carcinoma and UD calculi at the same time has never been reported, making this the first case report about this condition. PATIENT CONCERNS: A 43-year-old woman presented to the gynaecology department with a complaint of a hard mass beneath the anterior vaginal wall. DIAGNOSES: Transvaginal ultrasound (TVU) revealed a UD. INTERVENTIONS: We performed a standard urethral diverticular excision. Intraoperatively, we identified and removed a stone from the diverticulum. The intraoperative finding of a stone challenged the diagnosis of UD, with subsequent histological examination of biopsy tissue from the mass demonstrating broadly squamous metaplasia. OUTCOMES: The broadly squamous metaplasia predominantly originated from the stone, and the stone was entirely removed. No complications occurred during the whole follow-up period. Moreover, after the 12-month follow-up, there was no diverticular recurrence or carcinoma metastasis. LESSONS: UD calculi may be considered a risk factor for female urethra squamous metaplasia, which with the potential of squamous carcinoma, so patients will be advised to treat this condition immediately.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Uretrais/diagnóstico , Adulto , Biópsia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Divertículo/complicações , Divertículo/diagnóstico por imagem , Divertículo/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Metaplasia , Neoplasias Uretrais/complicações , Neoplasias Uretrais/patologia , Neoplasias Uretrais/cirurgia , Cálculos Urinários/complicações , Cálculos Urinários/diagnóstico por imagem , Cálculos Urinários/cirurgia
16.
World J Surg Oncol ; 17(1): 150, 2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31445511

RESUMO

BACKGROUND: Spinal psammomatous meningioma with calcification is commonly observed, but distinctive osseous differentiation rarely occurs. CASE PRESENTATION: Here, we described a 52-year-old female complaining of chronic back pain for 5 years. CT and MRI examinations revealed an intradural extramedullary mass at the T4 level. The tumor was meticulously excised en bloc. Under the microscope, the tumor was found to be composed of conspicuous calcified psammoma bodies with remarkable immature bone formation. A primary diagnosis of psammomatous meningioma was made based on the recent WHO classification of tumors of the CNS, whereas other pathologists focused on the osseous components and preferred metaplastic meningioma as the proper subtype. A literature review was conducted, and only five cases have been reported with the same histopathological condition. Experts finally reached a consensus based on the acknowledged notion of the preferential diagnosis of psammomatous meningioma, as well as the current evidence and popular opinion that ossification is generated from osteogenic differentiation of pluripotent cells rather than the accumulation of psammoma bodies. CONCLUSIONS: A final diagnosis of psammomatous meningioma with osseous metaplasia was made. The rigid and adherent features complicate total resection of the tumor and increase the risk of neurologic deficits.


Assuntos
Calcinose/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Metaplasia/diagnóstico , Ossificação Heterotópica/diagnóstico , Neoplasias Torácicas/diagnóstico , Calcinose/complicações , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Meníngeas/complicações , Meningioma/complicações , Metaplasia/complicações , Pessoa de Meia-Idade , Ossificação Heterotópica/complicações , Prognóstico , Neoplasias Torácicas/complicações
17.
Pathology ; 51(6): 600-604, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445809

RESUMO

Oncocytic metaplastic lesions of the nasopharynx are rare benign entities which are divided into melanotic and non-melanotic forms. Less than 40 non-melanotic and 30 melanotic cases have been reported in the literature. We present the largest known case series to date of melanotic oncocytic metaplasia and more than 20 cases of non-melanotic oncocytic metaplasia. Clinical, endoscopic, histological and immunohistochemical features were reviewed. Most cases presented in males starting from their late adulthood. Compared to its non-melanotic counterpart, all cases of melanotic oncocytic metaplasia had a smoking history (p=0.041). All cases of melanotic oncocytic metaplasia were negative to melanocytic markers (S100, HMB-45, Melan-A and MiTF). Although no disease-related mortality was recorded, concurrent melanoma and nasopharyngeal carcinoma were seen in two cases.


Assuntos
Melanócitos/patologia , Nasofaringe/patologia , Células Oxífilas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Metaplasia/patologia , Pessoa de Meia-Idade
18.
World J Gastroenterol ; 25(30): 4105-4124, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31435167

RESUMO

Gastric cancer remains the third leading cause of mortality from cancer worldwide and carries a poor prognosis, due largely to late diagnosis. The importance of the interaction between Helicobacter pylori (H. pylori) infection, the main risk factor, and host-related genetic factors has been studied intensively in recent years. The genetic predisposition for non-hereditary gastric cancer is difficult to assess, as neither the real prevalence of premalignant gastric lesions in various populations nor the environmental risk factors for cancer progression are clearly defined. For non-cardiac intestinal-type cancer, identifying the factors that modulate the progression from inflammation toward cancer is crucial in order to develop preventive strategies. The role of cytokines and their gene variants has been questioned in regard to non-self-limiting H. pylori gastritis and its evolution to gastric atrophy and intestinal metaplasia; the literature now includes various and non-conclusive results on this topic. The influence of the majority of cytokine single nucleotide polymorphisms has been investigated for gastric cancer but not for preneoplastic gastric lesions. Among the investigated gene variants onlyIL10T-819C, IL-8-251, IL-18RAP917997, IL-22 rs1179251, IL1-B-511, IL1-B-3954, IL4R-398 and IL1RN were identified as predictors for premalignant gastric lesions risk. One of the most important limiting factors is the inhomogeneity of the studies (e.g., the lack of data on concomitant H. pylori infection, methods used to assess preneoplastic lesions, and source population). Testing the modifying effect of H. pylori infection upon the relationship between cytokine gene variants and premalignant gastric lesions, or even testing the interaction between H. pylori and cytokine gene variants in multivariable models adjusted for potential covariates, could increase generalizability of results.


Assuntos
Citocinas/genética , Mucosa Gástrica/patologia , Infecções por Helicobacter/epidemiologia , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/patologia , Atrofia/epidemiologia , Atrofia/etiologia , Atrofia/patologia , Progressão da Doença , Mucosa Gástrica/microbiologia , Predisposição Genética para Doença , Infecções por Helicobacter/patologia , Helicobacter pylori/isolamento & purificação , Humanos , Metaplasia/epidemiologia , Metaplasia/etiologia , Metaplasia/patologia , Polimorfismo de Nucleotídeo Único , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/etiologia , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/etiologia
19.
Int J Colorectal Dis ; 34(10): 1801-1803, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31463556

RESUMO

BACKGROUND: Osseous metaplasia of the gastrointestinal tract is exceedingly rare. Associated with colorectal cancer, juvenile polyps , and inflammatory polyps, the exact etiology is still unknown. We present a case report on a young male with recurrent rectal polyps and rectal bleeding. Histopathology revealed an inflammatory polyp with focal osseous metaplasia. CASE PRESENTATION: A 30-year-old male without significant past medical history but with a significant smoking history of 10 pack-years. He initially presented to the colorectal clinic approximately 8 months prior with complaints of rectal pain and bleeding. The patient subsequently underwent colonoscopy which demonstrated a friable 2-cm mass at the dentate line. He was taken to the operating room for a transanal mass excision which, at the time, pathologic examination demonstrated a hyperplastic polyp with no evidence of dysplasia or malignancy. The patient returned to the clinic 8 months later with similar complaints of rectal bleeding. He denied any constitutional symptoms, weight loss, abdominal pain, diarrhea, or constipation. Upon rectal examination, he was noted to have a soft palpable mass blood on digital rectal exam. The patient was taken for repeat colonoscopy and was found to have a recurrent mass at the dentate line. Given the recurrent mass, the patient was taken for a re-excision in the operating room. Histopathology returned showing a 1.8 × 1.5 × 1.5 cm inflammatory polyp with focal osseous metaplasia. CONCLUSION: Osseous metaplasia of the gastrointestinal tract is a rare occurrence that can be associated with benign polyps or malignancy. Certain markers have been shown to be linked to this process and polypectomy remains the gold standard of treatment; however, further research is warranted.


Assuntos
Ossificação Heterotópica/patologia , Reto/patologia , Adulto , Humanos , Pólipos Intestinais/patologia , Masculino , Metaplasia , Recidiva
20.
Diagn Pathol ; 14(1): 75, 2019 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-31299983

RESUMO

BACKGROUND: The bone formation within bladder tumors could be encountered in 3 conditions. These might consist of malignant bone formation in mesenchymal tumors; mixed mesenchymal and epithelial tumors; and epithelial tumors with stromal osseous metaplasia (SOM). This last is relatively rare. According to the English literature, only 12 cases have been reported in primary tumor and 7 in metastatic deposits of bladder primaries. Herein, we presented an additional case. CASE PRESENTATION: An 83-year-old man was admitted 13 years ago for prostatic adenocarcinoma, treated with radical prostatectomy. Biochemical recurrence was detected 2 years after surgery (prostate-specific-antigen (PSA) level: 4.60 ng/mL) and progressively normalized (<1.0 ng/mL) after adjuvant radiotherapy and annual injection of leuprorelin (enantoneR). He was referred after 8 years for hematuria, PSA level having slightly increased (0.60 ng/ml). Cystoscopy showed a nodular growth in the bladder wall, visualized as a calcified tumor on computed tomography (CT) and removed with transurethral resection. Histologically, the tumor consists of a non-muscle-invasive high grade papillary urothelial carcinoma with metaplastic bone within the stroma. Immunohistochemical analysis particularly demonstrated positive expression of respectively CD56 on osteoblasts, and CD68 on osteoclasts. MDM2 and CDK4 were negatives on osteoid and bone tissue. Six courses of Bacillus Calmette-Guerin (BCG) therapy have been administered. Two local recidives have occurred during an 8-month follow-up period after immunotherapy and were treated with six further courses of BCG therapy. At one-month follow-up, the patient was well without remaining symptoms. CONCLUSION: SOM is a rare benign condition whose pathogenesis remains uncompletely defined. Sarcomatoïd carcinoma represents the main differential diagnosis that influences therapeutic procedures. Prognosis depends essentially on the extent of the carcinomatous component .


Assuntos
Carcinoma Papilar/diagnóstico , Metaplasia/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias Urológicas/diagnóstico , Idoso de 80 Anos ou mais , Carcinoma Papilar/patologia , Diagnóstico Diferencial , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Metaplasia/patologia , Prognóstico , Células Estromais/patologia , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias Urológicas/patologia , Urotélio/patologia
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