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1.
Adv Exp Med Biol ; 1226: 51-56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030675

RESUMO

Cardiac tumors are found in less than 1% of adult and pediatric autopsies. More than three-fourths of primary cardiac neoplasms are benign, with myxomas and rhabdomyomas being the most common cardiac tumors seen in adults and children, respectively. Primary malignant cardiac tumors are extremely rare, whereas metastatic lesions can be seen in approximately 8% of patients dying from cancer. Attempting to understand why the heart is so resistant to carcinogenesis and which fail-safe mechanisms malfunction when cardiac tumors do develop is particularly challenging considering the rarity of these tumors and the fact that when relevant clinical studies are published, they rarely focus on molecular pathogenesis. Apart from cancer cells, solid tumors are comprised of a concoction of noncancerous cells, and extracellular matrix constituents, which along with pH and oxygen levels jointly constitute the so-called tumor microenvironment (TME). In the present chapter, we explore mechanisms through which TME may influence cardiac carcinogenesis.


Assuntos
Carcinogênese , Neoplasias Cardíacas/patologia , Microambiente Tumoral , Humanos , Mixoma/patologia , Rabdomioma/patologia
2.
Medicine (Baltimore) ; 98(51): e18386, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861001

RESUMO

RATIONALE: Pulmonary embolisms (PEs) are caused by emboli, which mostly originate from deep venous thrombi that travel to and suddenly block the pulmonary arteries. The emboli are usually thrombi, and right atrial myxoma emboli are rare. PATIENT CONCERNS: A 55-year-old man presented with shortness of breath and syncope. We proceeded with computed tomography pulmonary angiography (CTPA) and transthoracic echocardiogram (TTE), the results of which suggested that the diagnosis was a right atrial mass. DIAGNOSIS: A definitive diagnosis compatible with a right atrial myxoma (RAM) with tumoral pulmonary emboli after surgical excision was made. INTERVENTION: Right atrial and pulmonary artery embolectomy. OUTCOMES: The patient followed an uneventful course during the 6 years of follow-up after surgery. According to a review of the literature, RAMs are often not diagnosed in a timely manner or even go completely undiagnosed. TTE, transesophageal echocardiography (TEE), CT, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography may be helpful in the preoperative diagnosis. Surgical removal of the masses from the atrium and pulmonary arteries was relatively uneventful. LESSONS: RAMs should be considered unlikely reasons for fatal pulmonary embolisms.


Assuntos
Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Embolia Pulmonar/etiologia , Angiografia por Tomografia Computadorizada , Ecocardiografia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Embolia Pulmonar/cirurgia
3.
Heart Surg Forum ; 22(5): E317-E318, 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31596704

RESUMO

Cardiac myxoma typically is thought to be a slow-growing, benign primary. Atrial myxomas can lead to many complications and can also mimic mitral stenosis, infective endocarditis, and other vascular diseases associated with systemic embolization. A 75-year-old woman with a history of lung cancer (pT1cN1, adenocarcinoma), atrial fibrillation, and a cerebral infarction presented with dysarthria and visual disturbances. In our case, we had to consider some questionable issues with the left atrial mass, and whether the recurrence of cerebral events was due to the thrombotic material in the left atrium or from locally recurrent lung cancer from the stump margin of the previously resected left superior pulmonary vein. We present a case with a rapidly-growing left atrial myxoma with a growth rate of 12.60 mm/month, rather than a thrombus or local recurrence of tumor under a medication of non-VKA oral antagonists.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Cardíacas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Mixoma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Adenocarcinoma/cirurgia , Idoso , Fibrilação Atrial/etiologia , Infarto Cerebral/diagnóstico , Infarto Cerebral/etiologia , Diagnóstico Diferencial , Progressão da Doença , Endocardite/diagnóstico , Feminino , Átrios do Coração , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Neoplasias Pulmonares/cirurgia , Estenose da Valva Mitral/diagnóstico , Mixoma/patologia , Mixoma/cirurgia
5.
BMC Neurol ; 19(1): 249, 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31646971

RESUMO

BACKGROUND: Cardiac myxoma is the most common benign cardiac tumor. Brain metastases or multiple cerebral aneurysms are extremely rare, especially for the case of both complications. Brain metastases are usually found at the same time or few months after the diagnosis or surgical removal of cardiac myxoma CASE PRESENTATION: We describe a case of patient, operated for a cardiac myxoma, who presented multiple central nervous system metastases associated, cerebral aneurysms and subsequent intracerebral hemorrhage CONCLUSIONS: The long-term follow-up of the patients with atrial myxoma even after complete surgical excision is recommended, especially for the patient with central nervous system manifestations before atrial myxoma excision.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Cardíacas/patologia , Aneurisma Intracraniano/etiologia , Mixoma/patologia , Adulto , Hemorragia Cerebral/etiologia , Feminino , Átrios do Coração/patologia , Humanos
6.
Medicine (Baltimore) ; 98(42): e17423, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626099

RESUMO

RATIONALE: Smooth muscle tumors of the vulva are infrequent neoplasms with diverse histologic features and unclear biologic behavior. Herein, we report a very rare case of vulvar epithelioid leiomyoma and review of previous reported cases of these tumors. In addition, we have discussed the representative diagnostic criteria of vulvar smooth muscle tumors and prognostic significance of epithelioid morphology. PATIENT CONCERNS: We recently met a 45-year-old woman with complaint of painful vulvar mass. INTERVENTIONS: Excisional biopsy was performed. DIAGNOSES: Pathologic examination revealed a vulvar epithelioid leiomyoma with multinodular growth pattern. Mitotic activity was rare and cellular atypia was not identified. Based on histology and immunohistochemical staining results, the case was diagnosed as vulvar epithelioid leiomyoma. OUTCOMES: After mass excision, the patient was discharged with no complication and there was no evidence recurrence for 6 months. LESSONS: After reviewing previous papers and diagnostic criterion, we thought that vulvar smooth muscle tumors with predominant epithelioid morphology may be associated with unfavorable prognosis, Therefore, pathologists should examine the epithelioid component in vulvar smooth muscle tumors carefully.


Assuntos
Leiomioma Epitelioide/patologia , Mixoma/patologia , Tumor de Músculo Liso/patologia , Neoplasias Vulvares/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Vulva/patologia
7.
Medicine (Baltimore) ; 98(38): e17250, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567993

RESUMO

RATIONALE: Central retinal artery occlusion (CRAO) due to cardiac myxoma primarily occurs in elderly individuals. Early detection and surgical resection of myxoma are extremely important because CRAO causes complete blindness in most cases. However, due to the extremely low incidence of CRAO caused by cardiac myxoma in the pediatric age group, such condition is rarely reported. PATIENT CONCERNS: A 16-year-old female patient visited our hospital due to sudden onset of vision loss in the left eye, dysarthria, and right-sided hemiplegia. DIAGNOSES: She was diagnosed with CRAO via fundoscopy. Results showed a cherry-red spot, indicating CRAO. Brain magnetic resonance imaging (MRI) revealed multifocal diffusion-restricted foci, particularly in the left frontal lobe. Echocardiography revealed a left atrial mass measuring 4.21 cm × 2.25 cm. The mass was attached to the interseptum and moved along the inflow of the mitral valve. Cardiac computed tomography (CT) revealed an enhanced mass measuring 3 cm × 2.2 cm × 3 cm and with irregular margin on the anterior wall of the left atrium and the border of the fossa ovalis. INTERVENTIONS: The patient underwent surgical excision under general anesthesia. Intraoperative finding showed a huge, jelly-like, and extremely friable mass. Pathological examination confirmed myxoma. OUTCOMES: During a follow-up of 2 years after diagnosis, she did not present with other neurological deficits and no residual mass was observed on echocardiography. However, visual impairment of the left eye persisted. LESSONS: Most patients with CRAO may present with other mild symptoms that are often be neglected before CRAO development. We recommend that patients who present with frequent syncopal attack or symptoms of transient ischemic attack should undergo echocardiography.


Assuntos
Cegueira/etiologia , Átrios do Coração , Neoplasias Cardíacas/complicações , Mixoma/complicações , Adolescente , Ecocardiografia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Mixoma/diagnóstico por imagem , Mixoma/patologia , Oclusão da Artéria Retiniana/complicações , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/etiologia , Tomografia Computadorizada por Raios X
8.
Ann Clin Lab Sci ; 49(4): 468-473, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31471335

RESUMO

OBJECTIVE: To explore the clonal origin pattern of cardiac myxoma and its relationship with recurrence of the disease. METHODS: 20 female patients diagnosed with cardiac myxoma underwent appropriate surgery and were followed-up after the treatment. The DNA of tumor tissues and pairing normal tissues from 20 patients were taken, with polymerase chain reaction (PCR) assay being used to amplify the HUMARA gene on X-chromosome, which could hint the tumor cloning state. Cases were divided into a polyclonal origin group and monoclonal origin group, according to the PCR result. The recurrence rate in the two groups was compared using Fisher's exact probability method. RESULTS: All tumors were successfully removed. PCR assay showed that the hybrid rate in tumors was 90.0% (18/20). Among them, 88.9%(16/18) of cases were identified as polyclonal origin and 11.1%(2/18) were identified as monoclonal origin. After 4 years of follow-up, the recurrence rate was 12.5(2/16) in the polyclonal origin group and 0%(0/2) in monoclonal origin group, with significant difference between the two groups (P<0.05). CONCLUSION: Cardiac myxoma is mostly of polyclonal original, and its polyclonal origin characteristics may contribute to tumor recurrence.


Assuntos
Células Clonais/patologia , Neoplasias Cardíacas/patologia , Mixoma/patologia , Recidiva Local de Neoplasia/patologia , Feminino , Neoplasias Cardíacas/genética , Heterozigoto , Humanos , Mixoma/genética , Receptores Androgênicos/genética
9.
World Neurosurg ; 131: 32-37, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31369881

RESUMO

OBJECTIVE: We have described the integrated use of a neuronavigation-guided system for frameless stereotaxy (VarioGuide [Brainlab AG, Munich, Germany]) with intraoperative magnetic resonance imaging (iMRI) and 5-aminolevulinic acid (5-ALA) and report the advantages and disadvantages that the use of these tools together can have in the treatment of various types of intracerebral lesions. METHODS: After the skin incision, creation of a burr hole at the entry point, and dura opening, the VarioGuide procedure was started. Initially, the wizard software will require positioning of the stereotactic arm over the burr hole and provides feedback regarding the correct position. The procedure is performed in an iMRI theater furnished with a surgical microscope (Kinevo [Carl Zeiss AG, Oberkochen, Germany]) supplied with a violet-blue excitation light for 5-ALA fluorescence. At the end of the surgery, iMRI was performed. We present 2 exemplary cases to describe the application and workflow of these tools. RESULTS: When used for traditional biopsy, the possibility of performing a new iMRI scan could be of paramount importance because the brain shift can be compensated for and an alternative trajectory can be calculated from the new images and fiber tracking reconstruction. The fluorescence of the tissue sample examined under the microscope filter can provide immediate information about the nature of the lesion, allowing for the possibility of converting the procedure to open craniotomy and tumor removal. CONCLUSION: The use of combination frameless stereotaxy with iMRI and 5-ALA has shown benefits in terms of safety and precision. Moreover, the use of these tools can simplify tumor removal after simple biopsy, widening the spectrum of indications.


Assuntos
Neoplasias Encefálicas/cirurgia , Glioblastoma/cirurgia , Mixoma/cirurgia , Neuronavegação/métodos , Técnicas Estereotáxicas , Adulto , Idoso , Ácido Aminolevulínico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Feminino , Fluorescência , Glioblastoma/diagnóstico por imagem , Glioblastoma/patologia , Humanos , Cuidados Intraoperatórios , Imagem por Ressonância Magnética , Masculino , Mixoma/diagnóstico por imagem , Mixoma/patologia
10.
Int. j. morphol ; 37(2): 677-681, June 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1002275

RESUMO

El angiomixoma de la pelvis es un tumor mesenquimal inusual; que dado su alto potencial de recidiva es relevante que la exéresis quirúrgica sea lo más radical posible. Por su parte, la endometriosis infiltrativa profunda, es otra entidad poco frecuente que requiere de tratamientos complejos. La co-existencia de ambas patologías representa una situación absolutamente infrecuente; de los que hay muy pocos casos reportado en la literatura occidental. Se presenta el caso de una mujer de 41 años de edad que desarrolló ambas entidades nosológicas de forma concomitante y que fue tratada quirúrgicamente con buenos resultados.


Angiomyxoma of the pelvis is an unusual mesenchymal tumor; that given its high potential for recurrence, it is relevant that the surgical resection be as radical as possible. For its part, to deep infiltrative endometriosis is another rare entity that requires complex treatments. The co-existence of both pathologies represents an absolutely infrequent situation; of which there are very few cases reported in western literature. We present the case of a 41-year-old woman who developed both clinical entities concomitantly and who was treated surgically with good results.


Assuntos
Humanos , Feminino , Adulto , Neoplasias Pélvicas/patologia , Endometriose/patologia , Mixoma/patologia , Neoplasias Pélvicas/cirurgia , Neoplasias Pélvicas/complicações , Colectomia , Endometriose/cirurgia , Endometriose/complicações , Mixoma/cirurgia , Mixoma/complicações
11.
Zhonghua Bing Li Xue Za Zhi ; 48(4): 293-297, 2019 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-30955265

RESUMO

Objective: To study the clinicopathological characteristics of cardiac neoplasms. Methods: A total of 689 cases of cardiac neoplasms from January 1st 1992 to December 31th 2017 at Guangdong Provincial People's Hospital were collected. The clinical data and histologic features were analyzed along with a review of literature. The pathological diagnosis and classification were based on the criteria of WHO 4th edition(2015). Results: Among 689 cases of cardiac neoplasms, 259 were male and 430 were female patients, with age from 0 to 84 years (mean of 48 years). The peak incidence was between the fourth and sixth decade. Among patients younger than 20 years, there were 24 males and 12 females. 674 cases(674/689,97.8%)were primary cardiac tumors and 15 cases were secondary tumors (15/689,2.2%). Amongst the primary cardiac neoplasms, 625 cases were benign(625/674,92.7%), 7 cases were borderline (7/674, 1.0%), and 42 cases were malignant (42/674, 6.2%). The incidences of benign, borderline and malignancy heart tumors among patients below 20 years old were lower than those of patients over 20 years of age (4.8% vs. 95.2%; 3/9 vs. 6/9; 5.5% vs. 94.5%, respectively). Of the benign tumors, 406 cases were female and 219 cases were male. More male than female patients were seen in borderline and malignancy cardiac tumor categories (6∶3; 34∶21). Of 625 benign tumors, 577 cases were myxoma(85.6%), which mainly occurred in patients over 20 years of age(85.9% vs. 14.1%) with a female predominance. Non-myxomas mainly occurred in children and adolescent patients compared to adult (55.6% vs. 44.4%, P<0.01) with a male predominance. Overall, 524 tumors originated from the left atrium, 84 cases from the right atrium, 26 cases from the pericardium, 23 cases from the right ventricular, and 11 cases from the left ventricle. However, 21 cases were multicentric or involving cardiac valves. Benign tumors mainly involved left heart(76.3%) vs. right heart(81/625, 12.6%). The mostly common location of borderline tumors was right heart(5/9). Malignant tumors tended to involve the right heart(22/55,40.0%) and pericardium(18/55, 32.7%). Conclusions: Although the incidence of cardiac neoplasms is low,various tumor types can occur, most of which are myxoma with a female predominance. Non-myxomas mainly occur in children and adolescents with a male predominance.


Assuntos
Neoplasias Cardíacas/patologia , Mixoma/patologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Átrios do Coração/patologia , Neoplasias Cardíacas/epidemiologia , Ventrículos do Coração , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mixoma/epidemiologia , Distribuição por Sexo , Adulto Jovem
12.
Cardiovasc Pathol ; 41: 18-20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31005792

RESUMO

Most primary cardiac tumors are benign neoplasms, which generally can be differentiated from malignant neoplasms via certain radiological features. We present briefly a case of a 26-year-old man undergoing resection of a right atrial mass that based on preceding radiologic findings represent a myxoma. After pathologic examination, the lesion was determined to be an epithelioid angiosarcoma with unique frond-like architecture and multiple pedicular attachments to the atrial wall.


Assuntos
Células Epitelioides , Neoplasias Cardíacas/diagnóstico por imagem , Hemangiossarcoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Mixoma/diagnóstico por imagem , Adulto , Biomarcadores Tumorais/análise , Biópsia , Erros de Diagnóstico , Células Epitelioides/química , Células Epitelioides/patologia , Neoplasias Cardíacas/química , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma/química , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Mixoma/patologia , Valor Preditivo dos Testes
13.
Int J Mol Sci ; 20(8)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31018488

RESUMO

Histopathological findings of oral neoplasm cell differentiation and metaplasia suggest that tumor cells induce their own dedifferentiation and re-differentiation and may lead to the formation of tumor-specific histological features. Notch signaling is involved in the maintenance of tissue stem cell nature and regulation of differentiation and is responsible for the cytological regulation of cell fate, morphogenesis, and/or development. In our previous study, immunohistochemistry was used to examine Notch expression using cases of odontogenic tumors and pleomorphic adenoma as oral neoplasms. According to our results, Notch signaling was specifically associated with tumor cell differentiation and metaplastic cells of developmental tissues. Notch signaling was involved in the differentiation of the ductal epithelial cells of salivary gland tumors and ameloblast-like cells of odontogenic tumors. However, Notch signaling was also involved in squamous metaplasia, irrespective of the type of developmental tissue. In odontogenic tumors, Notch signaling was involved in epithelial-mesenchymal interactions and may be related to tumor development and tumorigenesis. This signaling may also be associated with the malignant transformation of ameloblastomas. Overall, Notch signaling appears to play a major role in the formation of the characteristic cellular composition and histological features of oral neoplasms, and this involvement has been reviewed here.


Assuntos
Adenoma Pleomorfo/patologia , Transformação Celular Neoplásica/patologia , Neoplasias Bucais/patologia , Mixoma/patologia , Tumores Odontogênicos/patologia , Receptores Notch/metabolismo , Transdução de Sinais , Adenoma Pleomorfo/metabolismo , Ameloblastoma/metabolismo , Ameloblastoma/patologia , Animais , Diferenciação Celular , Transformação Celular Neoplásica/metabolismo , Humanos , Neoplasias Bucais/metabolismo , Mixoma/metabolismo , Tumores Odontogênicos/metabolismo
14.
Echocardiography ; 36(5): 837-843, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30934139

RESUMO

INTRODUCTION: Cardiac myxomas are the most common primary intracardiac tumors. Although myxomas are histologically benign, they are potentially dangerous due to potential risk of systemic and cerebral embolism. In this study, we aimed to investigate the potential predictors of embolism in patients with left atrial myxoma. METHODS: This single-center retrospective study enrolled 93 patients (mean age: 52.9 ± 15.3 years, female: 70 [75.3%]) with left atrial myxomas between 2014 and 2018. The patients were classified into two groups (embolic vs nonembolic) to investigate possible predictors of embolism. Demographic, laboratory, and echocardiographic parameters were recorded into a dataset and compared between patients with and without embolism. RESULTS: The study population was composed of 13 (14%) patients in embolic (11 cerebrovascular and 2 peripheral) and 80 (86%) patients in nonembolic group. Demographic and laboratory parameters were similar between the groups. Tumor sizes were significantly higher in the embolic group than in the nonembolic group (5.59 ± 1.08 vs 4.29 ± 0.61; P = 0.001). By multivariate analysis, increased tumor size, increased left atrial diameter, and the presence of atrial fibrillation and irregular tumor surface were identified as independent predictors of embolism. In ROC curve analyses, tumor size above 4.6 cm predicted embolism with a sensitivity of 77% and a specificity of 73% (AUC: 0.858; 95% CI: 0.752-0.964; P < 0.001). CONCLUSION: The presence of atrial fibrillation, irregular tumor surface, increased tumor size, and increased left atrial diameter is associated with increased risk of embolism in patients with left atrial myxoma. Early surgery should be scheduled for such patients due to increased potential for embolism.


Assuntos
Ecocardiografia/métodos , Embolia/diagnóstico , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/complicações , Mixoma/diagnóstico por imagem , Adulto , Idoso , Fibrilação Atrial/complicações , Embolia/complicações , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/patologia , Estudos Retrospectivos , Fatores de Risco , Carga Tumoral
15.
J Med Case Rep ; 13(1): 108, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31023388

RESUMO

BACKGROUND: Oral focal mucinosis, the oral counterpart of cutaneous focal mucinosis, is a rare disease. As it has no characteristic clinical or radiological features, diagnosis is established by histopathological and immunohistological examination. We present three cases of oral focal mucinosis occurring in the retromolar (which is extremely rare) and gingival regions. CASE PRESENTATION: Case 1 involved a 26-year-old Japanese man with radiolucency in the right retromolar region on panoramic radiograph and computed tomography; no obvious protrusion was observed in the region. This finding was clinically diagnosed as a tumor of the retromolar region. Case 2 involved a 60-year-old Japanese woman. A tumor-like mass of tissue was identified on the buccal gingiva at the maxillary right canine and first premolar region. The lesion measured 7 × 6 mm and exhibited elastic hardness and healthy-colored mucosa. The lesion was diagnosed as an epulis. Case 3 involved a 47-year-old Japanese woman. A tumor-like mass of tissue was identified on the buccal gingiva at the maxillary right canine and first premolar region. The lesion measured 10 × 10 mm and exhibited elastic hardness and redness of the surface mucosa. This lesion was also diagnosed as an epulis. Resection was performed in all three cases, and the lesions were histopathologically diagnosed as oral focal mucinosis. Postoperative courses were uneventful and, thus far, there have been no recurrences. CONCLUSIONS: Although it is difficult to diagnose oral focal mucinosis based on clinical symptoms and imaging findings, the disease should be considered a possibility when diagnosing benign oral tumors. We believe that an emphasis on histopathologic study is essential to confirm the clinical suspicion.


Assuntos
Gengiva/patologia , Doenças da Gengiva/diagnóstico , Neoplasias Bucais/diagnóstico , Mucinoses/patologia , Mixoma/patologia , Adulto , Diagnóstico Diferencial , Feminino , Doenças da Gengiva/patologia , Doenças da Gengiva/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Mucinoses/terapia , Mixoma/terapia , Procedimentos Cirúrgicos Ortognáticos , Radiografia , Resultado do Tratamento
16.
Int J Surg Pathol ; 27(6): 693-696, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31006344

RESUMO

Myxomas are benign mesenchymal neoplasms of unknown etiology that most commonly occur in the cardiac atrium; however, other reported sites include the skin, joints, skeletal muscles, maxillofacial bones, and sinonasal tract. Myxomas involving the gastrointestinal (GI) tract are rare and are limited to a few published case reports. We are presenting, to our knowledge, the first case report of a mucosal myxoma in the colon presenting as a colonic polyp. A 49-year-old woman underwent a screening colonoscopy and was found to have a 0.2-cm sessile polyp in the cecum. Histologically, the polyp was composed of bland spindled cells in the lamina propria set in a hypocellular, myxoid stroma. The lesion was relatively well-demarcated from the surrounding mucosa. The overlying colonic epithelium showed no dysplasia. S-100 immunohistochemical stain showed only focal nonspecific positivity, while CD34, CD117, SMA, EMA, and desmin were all negative. Alcian blue special stain showed positive staining, supporting the diagnosis of myxoma. Myxomas in the GI tract are very rare, with this being the first reported case of a polypoid colonic mucosal myxoma. Previous reports of GI myxomas are limited to examples in the stomach, small bowel, and one recently reported case in the colon, all of which were submucosal lesions and not limited to the mucosa. In some of the prior reports, the patients had synchronous cardiac atrial myxomas. Mucosal colonic myxoma represents a newly identified mesenchymal polyp of the colon and pathologists should be aware of this diagnostic entity.


Assuntos
Neoplasias do Ceco/diagnóstico , Ceco/patologia , Mucosa Intestinal/patologia , Pólipos Intestinais/diagnóstico , Mixoma/diagnóstico , Biópsia , Neoplasias do Ceco/patologia , Ceco/diagnóstico por imagem , Colonoscopia , Feminino , Humanos , Mucosa Intestinal/diagnóstico por imagem , Pólipos Intestinais/patologia , Programas de Rastreamento , Pessoa de Meia-Idade , Mixoma/patologia
17.
J Cancer Res Clin Oncol ; 145(5): 1283-1295, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30900156

RESUMO

PURPOSE: Heart myxomas have been frequently considered as benign lesions associated with Carney's complex. However, after surgical removal, myxomas re-emerge causing dysfunctional heart. METHODS: To identify whether cardiac myxomas may develop a metastatic phenotype as occurs in malignant cancers, a profile of several proteins involved in malignancy such as oncogenes (c-MYC, K-RAS and H-RAS), cancer-associated metabolic transcriptional factors (HIF-1α, p53 and PPAR-γ) and epithelial-mesenchymal transition proteins (fibronectin, vimentin, ß-catenin, SNAIL and MMP-9) were evaluated in seven samples from a cohort of patients with atrial and ventricular myxomas. The analysis was also performed in: (1) cardiac tissue surrounding the area where myxoma was removed; (2) non-cancer heart tissue (NCHT); and (3) malignant triple negative breast cancer biopsies for comparative purposes. RESULTS: Statistical analysis applying univariate (Kruskal-Wallis and Dunn's tests) and multivariate analyses (PCA, principal component analysis) revealed that heart myxomas (7-15 times) and myxoma surrounding tissue (22-99 times) vs. NCHT showed high content of c-MYC, p53, vimentin, and HIF-1α, indicating that both myxoma and its surrounding area express oncogenes and malignancy-related proteins as occurs in triple negative breast cancer. CONCLUSIONS: Based on ROC (receiver operating characteristics) statistical analysis, c-MYC, HIF-1α, p53, and vimentin may be considered potential biomarkers for malignancy detection in myxoma.


Assuntos
Transformação Celular Neoplásica , Neoplasias Cardíacas/etiologia , Neoplasias Cardíacas/patologia , Mixoma/etiologia , Mixoma/patologia , Fenótipo , Animais , Biomarcadores Tumorais , Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Mixoma/diagnóstico por imagem , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Oncogenes , Proteoma , Proteômica/métodos , Curva ROC , Ratos
20.
Braz J Cardiovasc Surg ; 34(1): 22-27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30810670

RESUMO

OBJECTIVE: To disclose the relationships between the anatomic features of cardiac myxomas and plasma interleukin (IL)-6 levels. METHODS: Twelve patients undergoing cardiac myxoma resection at The First Hospital of Putian, Teaching Hospital, Fujian Medical University were enrolled into this study. Pre- and postoperative IL-6 levels were determined by an enzyme-linked immunosorbent assay method, and correlations between cardiac myxoma dimension or volume and plasma IL-6 levels were analyzed. C-reactive protein (CRP) levels were also evaluated. RESULTS: IL-6 and CRP levels were significantly decreased one month after cardiac myxoma resection in comparison to preoperative values. IL-6 and CRP levels did not differ between patients with a cardiac myxoma of irregular appearance and those with a myxoma of regular gross appearance, or between patients with a pedicled or a sessile myxoma. Decrement of IL-6 of patients with irregular cardiac myxomas was much higher than that of patients with regular ones, while no intergroup difference was noted in decrement of CRP. A close direct correlation was noted between IL-6 levels and maximal dimension (length) or volume of cardiac myxomas, whereas CRP levels only correlated with maximal dimension of cardiac myxomas. CONCLUSION: Anatomic features of cardiac myxomas (sessile, irregular appearance, maximal dimension, and volume) could be determinants of the patients' circulating IL-6 levels. IL-6 was likely to be a more sensitive biomarker than CRP in predicting the inflammatory status of patients with cardiac myxoma. Sessile and irregular cardiac myxomas might predict more severe inflammatory conditions for their more abundant endothelial cells and IL-6 overproduction.


Assuntos
Proteína C-Reativa/análise , Neoplasias Cardíacas/sangue , Interleucina-6/sangue , Mixoma/sangue , Idoso , Biomarcadores Tumorais/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Valores de Referência , Estudos Retrospectivos , Carga Tumoral
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