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3.
Anticancer Res ; 39(8): 3981-3989, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366479

RESUMO

Uterine sarcomas are rare but very aggressive. Uterine myomas, on the other hand, are the most common benign tumors of the uterus. Currently there is no diagnostic technique available to distinguish them with certainty. This study aimed to summarize the published literature concerning protein-based biomarkers in the peripheral blood that can assist in this difficult differential diagnosis. In total, 48 articles, published between 1990 and 2017, were included. Most studies (n=37) concerned soft tissue sarcomas, while 11 discussed uterine sarcomas specifically. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukins (IL), cancer antigen 125 (CA 125), lactate dehydrogenase, gangliosides (LDH) and growth differentiation factor 15 (GDF-15) are the most studied proteins in soft tissue sarcomas, including uterine sarcomas. Future research on improving sarcoma diagnosis should include these proteins.


Assuntos
Leiomioma/sangue , Neoplasias/sangue , Sarcoma/sangue , Neoplasias Uterinas/sangue , Biomarcadores Tumorais/sangue , Diferenciação Celular/genética , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Leiomioma/patologia , Neoplasias Musculares/sangue , Neoplasias Musculares/patologia , Neoplasias/patologia , Sarcoma/patologia , Neoplasias Uterinas/patologia
4.
Br J Radiol ; 92(1102): 20181051, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31322913

RESUMO

OBJECTIVE: To determine whether the apparent diffusion coefficient (ADC) on 3T MR imaging including diffusion-weighted MR imaging (DWI) correlate with the standardized uptake value (SUV) on 18F-FDG PET/CT in musculoskeletal tumours. METHODS: This retrospective cohort study included 57 patients (36 males, 21 females, mean age 54 years, range 12-90 years) with pathologically confirmed soft tissue (n = 32) and bone (n = 25) tumours who underwent 3T MR imaging including DWI and whole-body 18F-FDG PET/CT before treatment. 14 patients had follow-up MR imaging and 18F-FDG PET/CT after treatment. The minimum (ADCmin) and mean (ADCmean) ADCs of musculoskeletal tumour, ADC of normal skeletal muscle (ADCmus), SUVmax and SUVmean of musculoskeletal tumour were obtained. Correlation between ADCs and SUVs was assessed using Pearson correlation coefficients (r). ADCmin and SUVmax were compared between pretreatment and posttreatment by t-test. RESULTS: There was inverse correlation between SUVmax and the ratio ADCmin/ADCmus (r = - 0.505 to - 0.495, p ≤ 0.001) and between SUVmean and the ratio ADCmean/ADCmus (r = - 0.501 to - 0.493, p = 0.001). After treatment ADC was significantly increased whereas SUV was significantly decreased (p = 0.001). There was significant correlation in percent change between the initial and follow-up values of ADCmin and SUVmax (r = 0.750 to 0.773, p ≤ 0.005). The ADCmin was increased by 163% and SUVmax was decreased by 61% in 11 patients with treatment response. CONCLUSION: ADC at 3T MR DWI and SUV at 18F-FDG PET/CT have an inverse correlation in musculoskeletal tumours. ADVANCES IN KNOWLEDGE: Our study showed that ADC at 3T DWI and SUV at 18F-FDG PET/CT had an inverse correlation in musculoskeletal tumours.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/metabolismo , Imagem de Difusão por Ressonância Magnética/métodos , Fluordesoxiglucose F18/metabolismo , Neoplasias Musculares/diagnóstico por imagem , Neoplasias Musculares/metabolismo , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos/farmacocinética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/patologia , Criança , Feminino , Glucose/farmacocinética , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/patologia , Variações Dependentes do Observador , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
5.
Biomed Res Int ; 2019: 8275935, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360726

RESUMO

Musculoskeletal sarcomas are rare and aggressive human malignancies affecting bones and soft tissues with severe consequences, in terms of both morbidity and mortality. An innovative technique that combines photodynamic surgery (PDS) and therapy (PDT) with acridine orange has been recently suggested, showing promising results. However, due to the low incidence of sarcoma in humans, this procedure has been attempted only in pilot studies and stronger evidence is needed. Naturally occurring tumors in cats are well-established and advantageous models for human cancers. Feline injection-site sarcoma (FISS) shares with human musculoskeletal sarcomas a mesenchymal origin and an aggressive behavior with a high relapse rate. Furthermore, wide surgical excision is not always possible due to the size and site of development. We assessed the feasibility and the effectiveness of PDS and PDT with acridine orange to prevent FISS recurrence by treating a short case series of cats. For PDS, the surgical field was irrigated with an acridine orange solution and exposed to UV light to enlighten the residual tumor tissue, and the resultant fluorescent areas were trimmed. For PDT, before wound closure, the field was again irrigated with acridine orange solution and exposed to visible light to get the antitumoral cytocidal effect. The procedure was easy to perform and well tolerated, we did not observe any major complications, and all the surgical resection margins were free of disease. Finally, at follow-up, all treated patients did not show evidence of tumor recurrence and had a significantly higher event-free survival rate in respect to a control group treated only by surgery. In conclusion, by this study we demonstrated that, in FISS, PDS and PDT with acridine orange may improve local tumor control, granting a better outcome, and we laid the foundation to validate its effectiveness for the treatment of human musculoskeletal sarcomas.


Assuntos
Laranja Acridina/farmacologia , Neoplasias Musculares/terapia , Fotoquimioterapia , Sarcoma/terapia , Animais , Gatos , Feminino , Humanos , Masculino , Neoplasias Musculares/metabolismo , Neoplasias Musculares/patologia , Sarcoma/metabolismo , Sarcoma/patologia
6.
J Avian Med Surg ; 33(2): 171-178, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31251505

RESUMO

A captive, adult, male northern saw-whet owl (Aegolius acadicus) was examined for blepharospasm of the left eye. The owl was diagnosed with bilateral anterior uveitis and a corneal ulceration in the left eye. It was treated with oral and topical nonsteroidal anti-inflammatory medications and a topical antibiotic. Multiple recheck examinations and medication adjustments were performed over the next 4 months, at the end of which time the bilateral anterior uveitis was controlled with a topical nonsteroidal anti-inflammatory applied 3 times per week to both eyes. The owl was re-examined 2 months later after 2 suspected neurologic episodes. On physical examination, the owl was quiet and had difficulty standing and ambulating. Five firm multilobular and immobile masses were identified overlying the pectoral muscle and sternum. Fine-needle aspiration from 1 mass revealed neoplastic cells consistent with a sarcoma. The owl was euthanatized. On the basis of results of histopathologic examination, the mass was diagnosed as a pleomorphic spindle cell sarcoma with features of rhabdomyosarcoma, liposarcoma, and osteosarcoma. Numerous tumor cells were immunopositive for myoglobin and desmin, indicating striated muscle origin. Although a metastatic lesion was present in 1 adrenal gland, lesions of inflammation or neoplasia were absent in either eye on histopathologic examination. This report describes an apparent ocular manifestation of systemic disease in an avian species with clinically diagnosed recurrent anterior uveitis.


Assuntos
Doenças das Aves/diagnóstico , Mesenquimoma/veterinária , Neoplasias Musculares/veterinária , Estrigiformes , Uveíte Anterior/veterinária , Neoplasias das Glândulas Suprarrenais/secundário , Neoplasias das Glândulas Suprarrenais/veterinária , Animais , Doenças das Aves/patologia , Masculino , Mesenquimoma/patologia , Neoplasias Musculares/patologia , Uveíte Anterior/patologia
7.
Am J Case Rep ; 20: 828-832, 2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31186400

RESUMO

BACKGROUND Sarcomas account for less than 1% of all cancers. Spindle cell sarcomas are a rare form of soft tissue sarcomas classified as undifferentiated/unclassified based on their histomorphology. These tumors have a propensity for local recurrence and distant metastases are frequently found in the lungs. The risk for metastases increases with higher-grade malignancy and the size of the primary tumor. The often-painless nature of these tumors results in a delay in diagnosis, and physicians frequently overlook sarcomas in their differentials due to their rarity, complicating the disease process. CASE REPORT This article reports a case of a spindle cell sarcoma in the left paraspinal musculature in a 58-year-old Caucasian male; the tumor was excised in large pieces. There was an initial benign course, during which time the patient was undergoing regular imaging studies to evaluate for recurrence. Eight years later, the tumor metastasized to the lungs with an initial presentation of shortness of breath and pleural effusion on imaging. CONCLUSIONS Sarcomas are very rare soft tissue neoplasms, but they should not be overlooked in a physician's differentials, especially when evaluating an enlarging mass. Recommended treatment of choice is complete surgical excision with adequate resection margins of at least 1 cm or greater to a fascial barrier. Recurrence and late pulmonary metastases are common and metastatectomy is the recommended treatment choice if metastases are present.


Assuntos
Neoplasias Pulmonares/secundário , Neoplasias Musculares/patologia , Neoplasias Musculares/terapia , Músculos Paraespinais/patologia , Sarcoma/patologia , Quimioterapia Adjuvante , Seguimentos , Humanos , Neoplasias Pulmonares/cirurgia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Radioterapia Adjuvante , Medição de Risco , Sarcoma/cirurgia , Resultado do Tratamento
8.
Oncol Rep ; 42(2): 581-594, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31233191

RESUMO

The present study aimed to explore the mechanism by which the immune landscape of the tumor microenvironment influences bladder cancer. CIBERSORT and ssGSEA analyses revealed that M2 macrophages accounted for the highest proportion from 22 subsets of tumor­infiltrating immune cells and were enriched in higher histologic grade and higher pathologic stage bladder cancer and 'basal' subtype of muscle invasive bladder cancer (MIBC). Kaplan­Meier survival curve analysis indicated that patients with high numbers of infiltrating M2 macrophages had worse overall and disease­specific survival rates. RNA sequencing and immunohistochemistry results indicated that M2 macrophages were enriched in MIBC and promoted angiogenesis. M2 macrophage infiltration was higher in bladder cancer tissues with mutant TP53, RB transcriptional corepressor 1, phosphatidylinositol­4,5­bisphosphate 3­kinase catalytic subunit α, lysine methyltransferase 2A, lysine demethylase 6A and apolipoprotein B mRNA editing enzyme catalytic­polypeptide­like, but lower in tissues with mutant fibroblast growth factor receptor 3 (FGFR3), E74­like ETS transcription factor 3, PC4 and SFRS1 interacting protein 1 and transmembrane and coiled­coil domains 4. In addition, M2 macrophage infiltration was lower in the tissues with amplified FGFR3, erb­b2 receptor tyrosine kinase 2, BCL2­like 1, telomerase reverse transcriptase and tyrosine­3­monooxygenase/tryptophan­5­monooxygenase activation protein ζ, as well as in the tissues with deleted cyclin­dependent kinase inhibitor 2A, CREB binding protein, AT­rich interaction domain 1A, fragile histidine triad diadenosine triphosphatase, phosphodiesterase 4D, RAD51 paralog B, nuclear receptor corepressor 1 and protein tyrosine phosphatase receptor type D. Finally, seven micro (mi) RNAs (miR­214­5p, miR­223­3p, miR­155­5p, miR­199a­3p, miR­199b­3P, miR­146b­5p, miR­142­5p) which were expressed differentially in at least three mutant genes and were positively correlated with M2 macrophage infiltration as well as expressed highly in high grade bladder cancer were identified. Overall, the present study concluded that M2 macrophages are the predominant tumor­infiltrating immune cell in bladder cancer and differentially expressed miRNAs due to cancer­specific genomic alterations may be important drivers of M2 macrophage infiltration. These findings suggested that M2 macrophage infiltration may serve as a potential immunotherapy target in bladder cancer.


Assuntos
Biomarcadores Tumorais/genética , Variações do Número de Cópias de DNA , Macrófagos/imunologia , Neoplasias Musculares/patologia , Mutação , Microambiente Tumoral/imunologia , Neoplasias da Bexiga Urinária/patologia , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/genética , Neoplasias Musculares/imunologia , Invasividade Neoplásica , Prognóstico , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/imunologia
9.
Int J Surg Pathol ; 27(7): 722-728, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31208254

RESUMO

Patients often cite a history of trauma prior to the diagnosis of a sarcoma. Sparse literature suggests that there may be a link between sarcoma development and trauma. A 10-year review of academic tertiary-referral sarcoma center database was examined to identify patients who developed a sarcoma after having a history of a significant musculoskeletal trauma. A total of 501 patients were treated for a sarcoma during this time period. Six patients were identified as previously having a significant musculoskeletal trauma at the site of sarcoma development. Half of the sarcomas arose in bone and the other half in soft tissue. Five (83%) patients had multiple operations for the injury with 3 (50%) patients having a postoperative wound infection. The average time from injury to development of the sarcoma was 19.8 years. Survival after diagnosis was poor, and 4 (67%) of the patients died due to their metastatic disease within 3 years of diagnosis. Our findings suggest the possibility of post-traumatic sarcomas.


Assuntos
Neoplasias Ósseas/etiologia , Neoplasias Musculares/etiologia , Procedimentos Ortopédicos/efeitos adversos , Sarcoma/etiologia , Lesões dos Tecidos Moles/complicações , Infecção da Ferida Cirúrgica/complicações , Adulto , Idoso , Neoplasias Ósseas/patologia , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/patologia , Sistema Musculoesquelético/lesões , Sistema Musculoesquelético/patologia , Sistema Musculoesquelético/cirurgia , Estudos Retrospectivos , Sarcoma/patologia , Lesões dos Tecidos Moles/patologia , Lesões dos Tecidos Moles/cirurgia , Análise de Sobrevida , Centros de Atenção Terciária/estatística & dados numéricos
11.
J Coll Physicians Surg Pak ; 29(6): 553-557, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31133156

RESUMO

OBJECTIVE: To describe different types of primary extraocular muscle (EOM) tumours based on the results of imaging studies, peroperative clinical picture and their histopathological diagnosis. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Al-Shifa Trust Eye Hospital, Rawalpindi, from July 2001 to January 2017. METHODOLOGY: A retrospective analysis of 640 diagnosed orbital tumours was carried out using non-randomised sampling technique, and the prevalence of primary EOM tumours was determined. Based on the results of imaging studies, the clinical picture observed during surgery (orbitotomy) and the histopathological diagnosis, primary EOM tumours were divided into different types, accordingly. RESULTS: Nineteen (n=19) primary EOM tumours (frequency of 2.96%) had 12 types of histopathological diagnoses, and were categorised into inflammatory tumours (n=8, 42%), vascular tumours (n=4, 21%), lymphoproliferative tumours (n=3, 16%), neurogenic tumours (n=2, 10.5%) and myogenic tumours (n=2, 10.5%). The recti were involved more frequently than obliques (n=15, 78.94% and n=4, 21.06%, respectively). All the patients presented with proptosis of varying degree with some degree of globe rotation and had surgical excision/appropriate management. Visual acuity was not affected in any of the patients. Four (n=4, 21.05%) tumours were malignant (NHL, ASPS, myeloid sarcoma and rhabdomyosarcoma) and these patients underwent chemotherapy and/or radiotherapy. CONCLUSION: Biopsy-proven primary EOM tumours were devisable into five broad categories. Patients with primary EOM tumours presented with proptosis and impaired ocular motiliy. The primary EOM tumours involved both the recti and the obliques and were excised surgically with favourable outcomes in most cases.


Assuntos
Neoplasias Musculares/patologia , Músculos Oculomotores/patologia , Neoplasias Orbitárias/patologia , Adolescente , Adulto , Biópsia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/epidemiologia , Neoplasias Musculares/cirurgia , Músculos Oculomotores/cirurgia , Neoplasias Orbitárias/classificação , Neoplasias Orbitárias/epidemiologia , Neoplasias Orbitárias/cirurgia , Paquistão/epidemiologia , Prevalência , Rabdomiossarcoma/epidemiologia , Rabdomiossarcoma/patologia , Rabdomiossarcoma/cirurgia , Sarcoma Alveolar de Partes Moles/epidemiologia , Sarcoma Alveolar de Partes Moles/patologia , Sarcoma Alveolar de Partes Moles/cirurgia
12.
Indian J Cancer ; 56(1): 54-58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30950446

RESUMO

BACKGROUND: Bladder cancer (BCa) is the ninth most common cancer accounting for 3.9% of all cancer cases as per the Indian Cancer Registry data. There is a scarcity of data on urinary Bca from India. AIM: The aim of this study was to know demographic background, stage distribution, utilization of various treatment modalities, and oncological outcome in Indian patients presenting with bladder cancer to a tertiary care cancer center in Mumbai. METHODOLOGY: We performed a retrospective audit of all patients registered as urinary BCa in our hospital from January 1, 2013 to December 31, 2013. Electronic medical records of these patients were checked for most of the information gathered. RESULTS: Median age of patients at presentation was 59 years with a range of 18-88 years. There were 84% male and 16% female patients. Forty seven percent of patients had nonmuscle invasive bladder cancer (NMIBC), 36% had muscle invasive bladder cancer and locally advanced disease, and 17% had metastatic disease. Eight patients were treated with trimodality bladder preservation protocol. Recurrence was seen in 38 (22.6%) patients with NMIBC. Out of them. 44.7% and 55.3% were in low- and high-grade tumors, respectively. Overall survival and disease-free survival estimated for 3 years were 63% and 57%, respectively. CONCLUSION: Bladder cancer has a varied spectrum of presentation. Bladder cancer patients presenting to our hospital generally have a higher stage and grade of disease compared with that in the west.


Assuntos
Institutos de Câncer , Demografia , Neoplasias Musculares/patologia , Centros de Atenção Terciária , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Seguimentos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Neoplasias da Bexiga Urinária/terapia
14.
Ann Surg Oncol ; 26(8): 2631-2639, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31011905

RESUMO

BACKGROUND: Tumor human leukocyte antigen class I (HLA-I) expression plays an important role in T cell-mediated tumor rejection. Loss of HLA-I is associated with cancer progression and resistance to immunotherapy, including antibodies blocking programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) signaling. Our objective was to analyze a correlation between HLA-I, tumor immune infiltration, and PD-L1/PD-1 axis in bladder cancer in association with the clinicopathologic features of patients. METHODS: We analyzed 85 cryopreserved bladder tumors by immunohistochemistry to investigate the expression of HLA-I, PD-L1, PD-1, CD3, CD8, and CXC chemokine receptor 4 (CXCR4). The results were correlated with tumor stage and other clinicopathologic variables of patients. RESULTS: We found a strong positive correlation between tumor HLA-I expression and infiltration with CD3+ and CD8 + T cells. PD-L1 expression was positive in 15.5% of tumors and heterogeneous in 40.5%, and was linked to a more advanced tumor stage. The majority of HLA-I-positive/heterogeneous tumors also expressed PD-L1 and PD-1, which were significantly correlated with each other and with lymphocyte infiltration. Interestingly, the analysis of the simultaneous expression of both markers revealed that 85.2% of tumors with a positive/heterogeneous HLA-I phenotype and negative for PD-L1 were mostly non-invasive, representing a 'tumor rejection' immune phenotype. CONCLUSIONS: High tumor HLA-I expression with absence of PD-L1 provides bladder cancer with an immune rejection mechanism. Evaluation of PD-L1 and HLA-I together should be considered in bladder cancer and may provide a new predictive biomarker of tumor invasiveness and of the response to 'immune checkpoint' therapy.


Assuntos
Antígeno B7-H1/metabolismo , Linfócitos T CD8-Positivos/imunologia , Antígenos de Histocompatibilidade Classe I/metabolismo , Linfócitos do Interstício Tumoral/imunologia , Neoplasias Musculares/imunologia , Recidiva Local de Neoplasia/imunologia , Neoplasias da Bexiga Urinária/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígeno B7-H1/imunologia , Biomarcadores Tumorais/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Feminino , Seguimentos , Antígenos de Histocompatibilidade Classe I/imunologia , Humanos , Metástase Linfática , Linfócitos do Interstício Tumoral/metabolismo , Linfócitos do Interstício Tumoral/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/metabolismo , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Microambiente Tumoral , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
15.
J Cutan Pathol ; 46(8): 603-608, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31006896

RESUMO

Intramuscular hemangioma (IMH) represents less than 1% of all hemangiomas. In the head and neck region, it occurs mostly in the masseter, temporalis and sternocleidomastoid muscles. Despite its infiltrative growth pattern and several worrisome histological features, such as increased mitotic activity, plumpness of the nuclei, intraluminal papillary projections or perineural infiltration, the lesion is benign, and complete surgical excision is the preferred treatment for such oral lesions. Herein, we report three rare cases of IMH in the tongue and lip, discuss the clinical and histological aspects, and review the literature regarding this lesion.


Assuntos
Hemangioma , Neoplasias Bucais , Neoplasias Musculares , Idoso , Feminino , Hemangioma/metabolismo , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Neoplasias Musculares/metabolismo , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia
16.
Medicine (Baltimore) ; 98(15): e15147, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985689

RESUMO

RATIONALE: Malignant mesothelioma is a malignant tumor with poor prognosis, which usually originates in the pleura, peritoneum, and pericardial cavity. Mesotheliomas that originate from the diaphragm are very rare. Here, we report a case of primary malignant mesothelioma of the diaphragm with liver invasion. PATIENT CONCERNS: A 66-year-old woman was admitted to our hospital because of a "liver space-occupying lesion," without any special clinical symptoms. Imaging examinations suggested a cystic-solid mixed lesion in the right lobe of the liver. DIAGNOSIS: The tumor was diagnosed as epithelioid mesothelioma of the diaphragm with liver invasion. INTERVENTION: The patient underwent abdominal surgery in our hospital to remove the diaphragmatic mass, liver mass, and part of the diaphragm. OUTCOMES: The postoperative course was uneventful. LESSONS: Primary diaphragmatic malignant mesothelioma is very rare and may involve liver or lung tissue and be mistaken for liver or lung tumor. Accurate diagnosis depends on careful pathological examination. Immunohistochemical staining is very useful to distinguish this tumor from other liver or diaphragmatic tumors.


Assuntos
Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/patologia , Mesotelioma/patologia , Neoplasias Musculares/patologia , Idoso , Diagnóstico Diferencial , Diafragma , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Mesotelioma/diagnóstico , Mesotelioma/cirurgia , Neoplasias Musculares/diagnóstico , Neoplasias Musculares/cirurgia
18.
BMJ Case Rep ; 12(3)2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30872337

RESUMO

Paraneoplastic autoimmune encephalopathic syndromes have been described most often in association with small cell lung cancer or breast cancer, tumours of the ovaries, testes, lymphoma and thymoma. Antibodies associated with paraneoplastic encephalopathies are, among others, anti-Hu, anti-Ma2 and, in part, anti-N-methyl-D-aspartate(NMDA)-receptor antibodies. Here, we present the case of a 72-year-old patient hospitalised due to progressive cognitive decline and disorientation. Diagnostic workup revealed paraneoplastic anti-amphiphysin associated limbic encephalitis on the basis of an aortic angiosarcoma with metastases to kidney, muscle and bones. Highly aggressive chemotherapy as well as immunosuppressive therapy and cytoreductive laparoscopic nephrectomy were initiated. However, follow-up revealed further tumour progress and a worsening of neurological symptoms.


Assuntos
Doenças da Aorta/complicações , Encefalite Límbica/diagnóstico , Proteínas do Tecido Nervoso/antagonistas & inibidores , Idoso , Doenças da Aorta/patologia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/patologia , Neoplasias Ósseas/secundário , Tratamento Farmacológico/métodos , Evolução Fatal , Hemangiossarcoma , Humanos , Imunossupressores/uso terapêutico , Neoplasias Renais/complicações , Neoplasias Renais/patologia , Neoplasias Renais/secundário , Neoplasias Renais/cirurgia , Encefalite Límbica/complicações , Encefalite Límbica/tratamento farmacológico , Encefalite Límbica/imunologia , Masculino , Neoplasias Musculares/complicações , Neoplasias Musculares/patologia , Neoplasias Musculares/secundário , Metástase Neoplásica/patologia , Nefrectomia/métodos , Proteínas do Tecido Nervoso/metabolismo
19.
J Med Case Rep ; 13(1): 66, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30879467

RESUMO

BACKGROUND: Malignant peritoneal mesothelioma is a rare aggressive tumor of the peritoneum. We report a rare case of resection of multiple localized malignant peritoneal mesotheliomas. CASE PRESENTATION: A 55-year-old Japanese woman was admitted to our hospital because liver tumors were detected by abdominal ultrasonography during a screening examination. Blood examination findings, including tumor makers, were within normal ranges. She had no evidence of exposure to asbestos. Computed tomography showed four hypervascular, round liver tumors, one in the lateral liver segment adjacent to the hepatic hilus, and the other three on the liver surface. Computed tomography angiography revealed that the tumor in the lateral segment had strong enhancement and was fed from the left gastric artery. In contrast, the other tumors showed no enhancement, and were fed from the right inferior phrenic artery. Abnormal accumulation was identified in the four tumors only with 18F-fluorodeoxyglucose positron emission tomography. It was very difficult to obtain a definitive preoperative diagnosis, but surgical resection was performed because we considered potential malignancy. Laparotomy revealed the principal site of the tumor in the lateral segment was on the hepatoduodenal ligament, and all other tumors were on the diaphragm. A left lobectomy and partial diaphragmatic resection were performed. The final pathological diagnosis was multiple malignant epithelioid mesotheliomas. Our patient has had no recurrence for 20 months postoperatively. CONCLUSIONS: In general, malignant peritoneal mesotheliomas are classified as diffuse tumors, which are often unresectable and have a poor prognosis. However, early diagnosis and treatment, particularly with the localized type, as in our patient, could lead to long-term survival of the patient. We recommend that multiple malignant epithelioid mesotheliomas be included in the differential diagnosis for patients with subcapsular hepatic tumors.


Assuntos
Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/patologia , Mesotelioma/patologia , Neoplasias Musculares/patologia , Neoplasias Peritoneais/patologia , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Mesotelioma/diagnóstico por imagem , Mesotelioma/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/cirurgia , Tomografia Computadorizada por Raios X
20.
J Plast Reconstr Aesthet Surg ; 72(6): 941-945, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30926411

RESUMO

BACKGROUND: The vertical rectus abdominis myocutaneous (VRAM) and transverse rectus abdominis myocutaneous (TRAM) flaps have traditionally been excluded from consideration of reconstructions with functional potential, because of their segmental innervation. We present a case series that aimed to demonstrate that segmental innervation does not preclude successful neural anastomoses and can deliver a functional reconstruction of a total compartment in the anterior thigh. METHODS: This review included all patients who required total anterior thigh compartmentectomy and reconstruction between December 2009 and February 2016 were included from the first author's prospective database. RESULTS: Eleven cases were identified, with innervated rectus abdominis flaps used for anterior thigh reconstruction. During the median follow up period of 12 months, all patients had reinnervation of the rectus with six reaching M5, one M4+, one M4, two M3 and one M2, according to Medical Research Council power grades. CONCLUSION: All patients had successful functional reconstruction in the thigh using the rectus abdominis myocutaneous flap.


Assuntos
Neoplasias Musculares , Retalho Miocutâneo , Músculo Quadríceps/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Reto do Abdome/transplante , Sarcoma , Coxa da Perna , Idoso , Feminino , Humanos , Salvamento de Membro/métodos , Masculino , Pessoa de Meia-Idade , Denervação Muscular/métodos , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia , Retalho Miocutâneo/irrigação sanguínea , Retalho Miocutâneo/inervação , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Recuperação de Função Fisiológica , Reto do Abdome/inervação , Sarcoma/patologia , Sarcoma/cirurgia , Coxa da Perna/patologia , Coxa da Perna/cirurgia , Técnicas de Fechamento de Ferimentos
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