Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.757
Filtrar
1.
Magy Seb ; 72(3): 98-102, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31544482

RESUMO

Introduction: Authors present their 7-year experience since the introduction of minimal-invasive (VATS) lobectomies for lung cancer in regard to their surgical technique, results and oncological follow-up. Method: 173 VATS lobectomies were performed between June 2011 and December 2017, 105 men and 68 women. The mean age of patients was 64.1 years. Duration of surgery was 130 minutes on average. Results: Conversion to thoracotomy was required in 8 cases (3 bleedings, 3 pulmonary vessel lymph node infiltrations, 2 bronchial suture insufficiencies). Twenty persistent air leaks developed postoperatively, requiring 10 re-drainages and 10 re-operations: 7 re-VATS and 3 thoracotomies. Two hematomas were evacuated by re-VATS, 1 postoperative atrial fibrillation required cardioversion. There were no perioperative deaths. The 164 malignant cases were: 110 adenocarcinomas, 32 squamous cell carcinomas, 6 small cell neuroendocrine carcinomas, 4 undifferentiated carcinomas, 4 carcinoid tumours, 1 synchronous adenocarcinoma and squamous cell carcinoma, 1 synchronous adenocarcinoma and small cell carcinoma, 1 carcinosarcoma and 5 metastasis from other primary tumours. 118 patients received adjuvant chemotherapy. Tumour staging distribution was: IA 40, IB 53, IIA 29, IIB 16 and IIIA 21 cases. During an average follow-up time of 19.5 months, 9 local tumour recurrence and 27 distant metastasis evaluated, of which 11 were pulmonary (3 multiplex), 10 bone, 6 cerebral, 3 hepatic (1 multiplex), and 3 suprarenal gland. Conclusion: Our results correlate with published literature. During the period of this review, VATS lobectomies became a routine surgical technique in our department. Our experience proved that axillary thoracotomy is an advantage to learn the anterior VATS lobectomy technique.


Assuntos
Tumor Carcinoide/cirurgia , Carcinoma de Células Pequenas/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Pulmonares/cirurgia , Pulmão/cirurgia , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/estatística & dados numéricos , Toracotomia/métodos , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/cirurgia , Analgesia Controlada pelo Paciente , Tumor Carcinoide/patologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Quimioterapia Adjuvante , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/patologia , Masculino , Recidiva Local de Neoplasia , Duração da Cirurgia , Reoperação/estatística & dados numéricos , Cirurgia Torácica Vídeoassistida/métodos , Resultado do Tratamento
2.
Virchows Arch ; 475(3): 325-334, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31201506

RESUMO

Spread through air spaces (STAS) have been recently recognized as a prognostic factor for adenocarcinoma and squamous cell carcinoma of the lung. Pulmonary neuroendocrine neoplasms (NENs) include tumors with different morphology and a heterogeneous clinical behavior. Among atypical carcinoids (ACs), new prognostic factors able to refine prognosis are needed. In the present study, a retrospective series of 91 surgically resected ACs was investigated, in parallel with 191 control cases of typical carcinoids (TCs) and of high-grade small- and large-cell neuroendocrine carcinomas, to assess the presence and potential prognostic role of STAS. STAS was defined by the presence of neoplastic nests or single cells in air spaces beyond the tumor edge. Clinicopathological parameters and survival were correlated by univariate and multivariate analyses. STAS was identified in 48% of ACs (44/91) compared to 20.5% of TCs and 71-88% of high-grade large- and small-cell carcinomas in the control group. In the carcinoid group, presence of STAS was significantly correlated with unfavorable parameters, such as high tumor stage, positive nodal status, high Ki-67 index, presence of angioinvasion, and with adverse disease outcome, shorter overall survival, and time to progression. In conclusion, the presence of STAS is an additional relevant adverse prognostic factor in pulmonary AC that currently has the most unpredictable outcome and the most controversial treatment strategy.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Adenocarcinoma de Pulmão/patologia , Tumor Carcinoide/patologia , Adenocarcinoma/patologia , Adulto , Tumor Carcinoide/metabolismo , Carcinoma de Células Escamosas/patologia , Estudos de Casos e Controles , Intervalo Livre de Doença , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
3.
Anticancer Res ; 39(5): 2513-2517, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31092447

RESUMO

BACKGROUND/AIM: The aim of the study was to assess the clinical outcome of patients with malignant transformation of an ovarian mature teratoma. PATIENTS AND METHODS: This study was conducted on 23 patients who underwent primary surgery at three Italian Gynecological Centers. Histologically, nine (39.1%) patients had squamous cell carcinoma, five (21.7%) had a thyroid carcinoma, six (26.1%) had a carcinoid, one (4.3%) patient had papillary renal carcinoma, one (4.3%) had medulloblastoma and one (4.3%) had intestinal-type mucinous adenocarcinoma. RESULTS: All six patients with stage I squamous cell carcinoma had no evidence of disease (NED) after a median time of 141 months. Of the three patients with stage IIb-IIIc squamous cell carcinoma, two had NED after 119 and 154 months, and one died of the disease 9 months after diagnosis. All five women with stage I thyroid carcinoma had NED after a median of 60 months. Of the six patients with stage I carcinoid, five had NED after a median of 168 months, whereas one died due to carcinoid heart disease. The three patients with stage I renal carcinoma, medulloblastoma and mucinous adenocarcinoma had NED after 24, 141 and 149 months, respectively. CONCLUSION: The clinical outcome of early-stage malignancies associated with mature ovarian teratomas is excellent following treatment.


Assuntos
Tumor Carcinoide/epidemiologia , Neoplasias Ovarianas/patologia , Teratoma/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/epidemiologia , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Meduloblastoma/diagnóstico , Meduloblastoma/epidemiologia , Meduloblastoma/patologia , Meduloblastoma/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/classificação , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Estudos Retrospectivos , Teratoma/diagnóstico , Teratoma/epidemiologia , Teratoma/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/cirurgia
4.
Eur J Endocrinol ; 181(1): K1-K9, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31048558

RESUMO

Context: Cabergoline has been shown to have some effect in the treatment of moderate Cushing's disease, but its effectiveness in Cushing's syndrome of ectopic or occult origin remains to be investigated. Case series: In this case series, cabergoline was used in combination with steroidogenesis inhibitors in nine patients with severe Cushing's syndrome of ectopic or occult origin. Cabergoline's effectiveness enabled rapid withdrawal of the steroidogenesis inhibitors and long-term control of the hypercortisolism in three of the cases. Review of the literature: In the literature, we found only 11 cases of ectopic or occult Cushing's syndrome treated with dopamine receptor agonists, alone or in combination. Yet of these 11 cases, 10 responded. Conclusions: Although limited, the existing experience highlights the potential value of cabergoline in the treatment of ectopic or occult Cushing's syndrome.


Assuntos
Cabergolina/uso terapêutico , Síndrome de Cushing/tratamento farmacológico , Agonistas de Dopamina/uso terapêutico , Síndrome de ACTH Ectópico/complicações , Síndrome de ACTH Ectópico/diagnóstico , Adulto , Idoso , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/patologia , Síndrome de Cushing/etiologia , Síndrome de Cushing/metabolismo , Feminino , Humanos , Hidrocortisona/metabolismo , Cetoconazol/uso terapêutico , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Neoplasias Intraductais Pancreáticas/complicações , Neoplasias Intraductais Pancreáticas/diagnóstico por imagem , Neoplasias Intraductais Pancreáticas/patologia , Neoplasias Retais/complicações , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Inibidores da Síntese de Esteroides/uso terapêutico , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/patologia , Resultado do Tratamento
5.
Clin Nucl Med ; 44(7): 602-603, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31021915

RESUMO

Neuroendocrine tumors are slow-growing indolent tumors and often present with metastatic disease at the outset. We hereby discuss the Ga DOTANOC PET-CT findings of a 48-year-old man who has underwent lobectomy for bronchial carcinoid and developed multiple metastatic disease thereafter with event-free survival for the last 12 years.


Assuntos
Neoplasias Brônquicas/diagnóstico por imagem , Tumor Carcinoide/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Brônquicas/patologia , Tumor Carcinoide/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Compostos Organometálicos , Compostos Radiofarmacêuticos
6.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936334

RESUMO

A 52-year-old woman with a background of vaginal hysterectomy for heavy menstrual bleeding underwent an elective laparoscopic adhesiolysis, left salpingo-oophorectomy for left-sided pelvic pain, and a right salpingectomy. Despite a grossly normal appearance, histology revealed a rare presentation of mature teratoma with insular carcinoid tumour arising from the left fallopian tube. Even though the salpingectomy was thought to be curative, the patient underwent a second operation to remove her remaining right ovary as a precaution against malignant spread. In light of limited information in such rare cases, counselling on best management and discussion of risks to guide patient decision making remains challenging.


Assuntos
Tumor Carcinoide/diagnóstico , Tubas Uterinas/patologia , Neoplasias Ovarianas/diagnóstico , Teratoma/diagnóstico , Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Feminino , Humanos , Histerectomia , Laparoscopia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Dor Pélvica/etiologia , Cuidados Pré-Operatórios , Salpingo-Ooforectomia , Teratoma/patologia , Teratoma/cirurgia , Resultado do Tratamento
7.
Clin Nucl Med ; 44(6): e404-e405, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30985430

RESUMO

Incidental findings on PET CT studies are common. The distribution of Ga-DOTATATE is dependent on cell surface expression of somatostatin receptors, which may be pathologic or physiologic. Osteoporosis circumscripta is the early lytic phase of Paget disease associated with well-defined osteopenia, most commonly seen within the skull on imaging. The appearance has been well demonstrated on Tc HDP/MDP bone scans. Here, we present the case of a 76-year-old man with a small bowel carcinoid tumor who underwent staging imaging with Ga-DOTATATE PET CT with the incidental finding of osteoporosis circumscripta.


Assuntos
Achados Incidentais , Compostos Organometálicos , Osteíte Deformante/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Tumor Carcinoide/patologia , Humanos , Neoplasias Intestinais/patologia , Masculino , Estadiamento de Neoplasias , Osteíte Deformante/complicações , Osteíte Deformante/patologia
8.
J BUON ; 24(1): 256-266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941978

RESUMO

PURPOSE: Neuroendocrine lung tumors (NET) include typical carcinoids (TC), atypical carcinoids (AC), large cell NE carcinoma (LCNEC) and small-cell carcinoma (SCLC), with different clinicopathological profiles and relative grades of malignancy. Although differences between carcinoids and high grade carcinomas are recognized, precise differences and behavior of TC and AC have not been clearly defined. The aim of this study was to better define the differences in the clinical behavior of TC and AC, and to establish new prognostic factors of overall survival (OS), by determining the levels of genetic expression of IGF1R, ERCC1, Bax, p53, Bcl2 and Bcl2/Bax ratio. METHODS: The histopathological diagnosis of 52 surgically resected pulmonary carcinoid tumors was made according to the WHO classification. Gene expressions were evaluated by quantitative real-time PCR. RESULTS: The confirmed prognostic factors for overall survival (OS) were pTNM T (p<0.01), pTNM N (p<0.05), clinical stage (p<0.05), type of surgery (p<0.01) and histopathological (HP) tumor type (p<0.05). Bcl2 mRNA level and Bcl2/Bax ratio were found to have a potential for discrimination of the HP type of tumor (AC vs TC, Receiver Operating Characteristics (ROC) cut-off values 0.1451 and 0.3015, respectively), but without statistically significant impact on OS. CONCLUSIONS: In patients with NETs, smaller primary tumor, absence of positive lymph nodes, and TC type of tumor predicted longer OS. Type of resection has influence on OS. Bcl2 expression and Bcl2/Bax ratio might be valuable as independent diagnostic parametars in lung carcinoids. Therapeutic approaches using attenuation of Bcl2 or upregulation of Bax might prove useful in lung NETs.


Assuntos
Tumor Carcinoide/mortalidade , Proteínas de Ligação a DNA/metabolismo , Endonucleases/metabolismo , Neoplasias Pulmonares/mortalidade , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Receptores de Somatomedina/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Proteína X Associada a bcl-2/metabolismo , Adolescente , Adulto , Idoso , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Tumor Carcinoide/genética , Tumor Carcinoide/metabolismo , Tumor Carcinoide/patologia , Proteínas de Ligação a DNA/genética , Endonucleases/genética , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Proto-Oncogênicas c-bcl-2/genética , Receptores de Somatomedina/genética , Taxa de Sobrevida , Proteína Supressora de Tumor p53/genética , Adulto Jovem , Proteína X Associada a bcl-2/genética
9.
World J Gastroenterol ; 25(10): 1259-1265, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30886508

RESUMO

BACKGROUND: Local endoscopic resection is an effective method for the treatment of small rectal carcinoid tumors, but remnant tumor at the margin after resection remains to be an issue. AIM: To evaluate the efficacy and safety of resection of small rectal carcinoid tumors by endoloop ligation after cap-endoscopic mucosal resection (LC-EMR) using a transparent cap. METHODS: Thirty-four patients with rectal carcinoid tumors of less than 10 mm in diameter were treated by LC-EMR (n = 22) or endoscopic submucosal dissection (ESD) (n = 12) between January 2016 and December 2017. Demographic data, complete resection rates, pathologically complete resection rates, operation duration, and postoperative complications were collected. All cases were followed for 6 to 30 mo. RESULTS: A total of 22 LC-EMR cases and 12 ESD cases were enrolled. The average age was 48.18 ± 12.31 and 46.17 ± 12.57 years old, and the tumor size was 7.23 ± 1.63 mm and 7.50 ± 1.38 mm, respectively, for the LC-EMR and ESD groups. Resection time in the ESD group was longer than that in the LC-EMR group (15.67 ± 2.15 min vs 5.91 ± 0.87 min; P < 0.001). All lesions were completely resected at one time. No perforation or delayed bleeding was observed in either group. Pathologically complete resection (P-CR) rate was 86.36% (19/22) and 91.67% (11/12) in the LC-EMR and ESD groups (P = 0.646), respectively. Two of the three cases with a positive margin in the LC-EMR group received transanal endoscopic microsurgery (TEM) and tumor cells were not identified in the postoperative specimens. The other case with a positive margin chose follow-up without further operation. One case with remnant tumor after ESD received further local ligation treatment. Neither local recurrence nor lymph node metastasis was found during the follow-up period. CONCLUSION: LC-EMR appears to be an efficient and simple method for the treatment of small rectal carcinoid tumors, which can effectively avoid margin remnant tumors.


Assuntos
Tumor Carcinoide/cirurgia , Ressecção Endoscópica de Mucosa/instrumentação , Neoplasias Intestinais/cirurgia , Complicações Pós-Operatórias/epidemiologia , Proctoscopia/instrumentação , Neoplasias Retais/cirurgia , Adulto , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/patologia , Ressecção Endoscópica de Mucosa/efeitos adversos , Ressecção Endoscópica de Mucosa/métodos , Feminino , Seguimentos , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Mucosa Intestinal/cirurgia , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/patologia , Ligadura/efeitos adversos , Ligadura/instrumentação , Ligadura/métodos , Metástase Linfática/prevenção & controle , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/prevenção & controle , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Proctoscopia/efeitos adversos , Proctoscopia/métodos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Reto/diagnóstico por imagem , Reto/patologia , Reto/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
10.
BMC Pulm Med ; 19(1): 41, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30767776

RESUMO

BACKGROUND: Pulmonary carcinoids are included in the group of neuroendocrine tumors (NET) and derive from pulmonary neuroendocrine cells. The incidence of these tumors is increasing, but disease awareness remains low among clinicians. The synchronous presentation of lung cancer and mycobacterial infection is well known but the combination of pulmonary carcinoid and mycobacterial infection is rare. CASE PRESENTATION: We treated a 45-year-old female who presented with recurrent pneumonia. Chest X-ray showed a consolidation in the left upper lobe. The patient was treated with various courses of antibiotics without full recovery after six months. Computed tomography (CT) scan demonstrated a central mass in the left upper lobe. Bronchoscopy revealed an endobronchial, well-defined lesion that totally obstructed the left upper lobe bronchus. Bronchial biopsy showed typical carcinoid tumor. Rigid bronchoscopy with electrocautery was attempted, but we were unable to radically remove the tumor. Therefore lobectomy was performed. The surgical pathology specimen showed atypical bronchial carcinoid and consolidations in the lung parenchyma with granulomatous inflammation distally of the bronchial obstruction. Ziehl-Neelsen staining demonstrated acid fast bacilli indicative of mycobacterial infection. CONCLUSIONS: This case history illustrates the importance of careful surgical pathologic examination, not only of the resected tumor, but also of the postobstructive lung parenchyma. Specific postobstructive infections such as tuberculosis or nontuberculous mycobacteria (NTM) can have clinical implications.


Assuntos
Obstrução das Vias Respiratórias/patologia , Neoplasias Brônquicas/patologia , Tumor Carcinoide/patologia , Infecções por Mycobacterium/patologia , Pneumonia Bacteriana/patologia , Obstrução das Vias Respiratórias/etiologia , Biópsia , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/cirurgia , Broncoscopia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/cirurgia , Feminino , Humanos , Pulmão/patologia , Pessoa de Meia-Idade , Mycobacterium , Infecções por Mycobacterium/complicações , Pneumonectomia , Pneumonia Bacteriana/complicações , Tomografia Computadorizada por Raios X
11.
Clin Nucl Med ; 44(3): e154-e157, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30624269

RESUMO

Atypical lung carcinoids frequently metastasize to mediastinal nodes, liver, bone, lungs, and brain and rarely to ovaries, pancreas, subcutaneous, and skin. Solitary peritoneal metastasis is extremely rare and unreported previously. We present a case of a 36-year-old woman with cough, hemoptysis, dyspnea with detection of lung mass, and incidental detection of pelvic mass. Fine needle aspiration cytology failed to reveal the true nature of both the lesions. FDG PET/CT showed intensely avid mediastinal nodes, left lung, and rectouterine masses. Core biopsy from lung mass revealed atypical carcinoid without appreciable uptake on Ga-DOTANOC scan. Subsequent postchemotherapy CT scan shows significant regression in lung and peritoneal masses.


Assuntos
Brônquios/patologia , Tumor Carcinoide/patologia , Fluordesoxiglucose F18 , Neoplasias Pulmonares/patologia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adulto , Biópsia por Agulha Fina , Feminino , Humanos
12.
Adv Anat Pathol ; 26(2): 75-83, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30601149

RESUMO

Goblet cell carcinoid (GCC) or goblet cell carcinoma is a unique mixed endocrine-exocrine neoplasm that is almost exclusively seen in the appendix. The hallmark of GCC is the concentric infiltration of the appendiceal wall by small tight clusters, nests or cords of tumor cells that exhibit a goblet cell morphology with a small compressed nucleus and conspicuous intracytoplasmic mucin. The coexistence of high-grade adenocarcinoma with GCC has been increasingly recognized as a common finding, which has been called adenocarcinoma ex GCC or mixed GCC-adenocarcinoma. A number of studies have shown that it is the high-grade adenocarcinomatous component that dictates the prognosis. Several histologic classification/grading systems have been proposed, which correlate with overall patient survival. Treatment options are primarily based on tumor stage and the presence or absence of a high-grade adenocarcinomatous component.


Assuntos
Adenocarcinoma/patologia , Neoplasias do Apêndice/patologia , Tumor Carcinoide/patologia , Células Caliciformes/patologia , Neoplasias Complexas Mistas/patologia , Adenocarcinoma/química , Adenocarcinoma/mortalidade , Adenocarcinoma/terapia , Neoplasias do Apêndice/química , Neoplasias do Apêndice/mortalidade , Neoplasias do Apêndice/terapia , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Biópsia , Tumor Carcinoide/química , Tumor Carcinoide/mortalidade , Tumor Carcinoide/terapia , Células Caliciformes/química , Humanos , Imuno-Histoquímica , Técnicas de Diagnóstico Molecular , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias Complexas Mistas/química , Neoplasias Complexas Mistas/mortalidade , Neoplasias Complexas Mistas/terapia , Resultado do Tratamento
13.
Kyobu Geka ; 71(13): 1097-1101, 2018 12.
Artigo em Japonês | MEDLINE | ID: mdl-30587750

RESUMO

A 17-year-old girl was referred to our hospital with atelectasis of left lung due to tumor occlusion. Clearance of the tumor was performed by mechanical removal and application of Nd-YAG laser or electrocautery. The histopathological diagnosis was typical carcinoid. Chest computed tomography showed extraluminal residual lesions. Left upper lung sleeve lobectomy was performed 1 year after initial treatment. Interestingly, the histology of the resected specimen showed that the tumor cells exist only on the outer side of the bronchial cartilage and not in the bronchial luminal surface, suggesting the effectiveness of the initial bronchoscopic treatment.


Assuntos
Neoplasias Brônquicas/cirurgia , Tumor Carcinoide/cirurgia , Pneumonectomia/métodos , Adolescente , Neoplasias Brônquicas/patologia , Broncoscopia , Tumor Carcinoide/patologia , Eletrocoagulação , Feminino , Humanos , Lasers de Estado Sólido/uso terapêutico , Atelectasia Pulmonar/etiologia , Reoperação , Fatores de Tempo
14.
Medicine (Baltimore) ; 97(51): e13867, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30572559

RESUMO

RATIONALE: Malignant struma ovarii is extremely rare in the clinic. The diagnosis and modalities of treatment are still controversial. Here we describe a case of extensive peritoneal implant metastasis originating from malignant struma ovarii discovered 14 years after ovariectomy and chemotherapy. PATIENT CONCERNS: A 48-year-old female was admitted to our clinic due to hematochezia with a past history of left malignant struma ovarii. Enhanced computed tomography (CT) examination suggested multiple metastasis nodules in the abdomen and pelvic cavity. DIAGNOSES: Laparoscopy biopsy results of intraperitoneal nodules showed a metastasis of papillary thyroid carcinoma. While pathological examination after total thyroidectomy showed no definite malignant tumor component in the thyroid tissue. Finally, combined with the patient's past history of malignant struma ovarii, peritoneal implantation metastasis derived from the malignant struma ovarii was diagnosed. INTERVENTIONS: The patient was treated by total thyroidectomy and iodine 131 (I) therapy. Post-therapy iodine scan and the single-photon emission computed tomography/computed tomography (SPECT/CT) fusion image showed iodine uptake in the distal descending colon, sigmoid colon, rectal lesions, and a larger lesion in the liver. OUTCOME: After treatment, although the thyroid globulin remained at a high level 3 months after treatment, the patient's hematochezia was relieved. LESSONS: Therefore, thyroidectomy followed by adjuvant I treatment should be recommended in patients with malignant struma ovarii as metastatic risk is difficult to predict based on histopathologic examination.


Assuntos
Tumor Carcinoide/patologia , Neoplasias Hepáticas/secundário , Neoplasias Ovarianas/patologia , Neoplasias Esplênicas/secundário , Estruma Ovariano/secundário , Câncer Papilífero da Tireoide/secundário , Neoplasias da Glândula Tireoide/patologia , Feminino , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Pessoa de Meia-Idade , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Esplênicas/terapia , Estruma Ovariano/terapia , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/terapia , Tomografia Computadorizada por Raios X
15.
Drugs Today (Barc) ; 54(8): 457-465, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30209440

RESUMO

Carcinoid tumors are rare and usually slow-growing. Some patients with advanced metastatic disease however can develop symptoms of carcinoid syndrome, which results in debilitating diarrhea and flushing. Many treatments including chemotherapy were tried unsuccessfully in the past to treat this syndrome. The symptoms of carcinoid syndrome are thought to be related to the ability of the tumors to produce serotonin. The discovery that the production of this hormone can be inhibited by somatostatin led to the development of somatostatin analogues octreotide and lanreotide, which differ from native somatostatin in that they have a longer half-life. These compounds have shown dramatic responses in symptom control and reduction of serotonin metabolites including urinary 5-hydroxyindoleacetic acid (5-HIAA) levels. This review researches the origins of carcinoid tumors, the development of lanreotide as a treatment and future directions for the treatment of carcinoid syndrome.


Assuntos
Antineoplásicos/uso terapêutico , Tumor Carcinoide/tratamento farmacológico , Síndrome do Carcinoide Maligno/tratamento farmacológico , Octreotida/uso terapêutico , Peptídeos Cíclicos/uso terapêutico , Somatostatina/análogos & derivados , Antineoplásicos/efeitos adversos , Tumor Carcinoide/epidemiologia , Tumor Carcinoide/patologia , Humanos , Síndrome do Carcinoide Maligno/diagnóstico , Síndrome do Carcinoide Maligno/epidemiologia , Estadiamento de Neoplasias , Octreotida/efeitos adversos , Peptídeos Cíclicos/efeitos adversos , Somatostatina/efeitos adversos , Somatostatina/uso terapêutico , Resultado do Tratamento
16.
Eur J Pediatr ; 177(12): 1845-1850, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30255450

RESUMO

The tendency of non-operative management of appendicitis let us explore the natural history of appendiceal carcinoids, compare them with appendicitis patients, and determine the possibility of deciding the extent of the surgery and post-operative follow-up on behalf of the intraoperative findings. A retrospective review was performed of patients with appendicitis between 2009 and 2017. Of 2781 patients, 10 (0.36%) were diagnosed with appendiceal carcinoids. Sixty percent were female with an average age of 13.10 ± 1.73. The mean tumor size was 0.97 ± 0.34 cm with 70% located at the tip. Majority had an insular pattern (n = 9), six had subserosal fat tissue invasion, one had extension to mesoappendix, one had vascular invasion, and two had lymphatic invasion. The average mitotic index was 3.20 ± 1.40/50HPF, and Ki 67 activity was 3 ± 1.7%. The mean follow-up period was 66.40 ± 25.92 months. Patients were further evaluated with ultrasonography (n = 10), CT (n = 3), and MRI (n = 10). Serum markers including chromogranin (n = 9), NSE (n = 6), and 5-HIAA (n = 6) were normal. None required further treatment and had any symptoms of carcinoid syndromes or recurrences post-operatively.Conclusion: Other than appendectomy, no additional surgery or follow-up is required in appendiceal carcinoids less than 1.5 cm in size, regardless of the lymphoid or vascular invasion. What is Known: • The treatment of patients with a 1-2-cm tumor is not clear in both the pediatric and adult populations, and additional resection is needed. • Patients are monitored post-operatively with radiological and/or biochemical testing. What is New: • Appendectomy is curative for tumors less than 2 cm. • No additional surgery or follow-up is required in appendiceal carcinoids less than 1.5 cm in size regardless of the lymphoid or vascular invasion.


Assuntos
Apendicectomia/estatística & dados numéricos , Neoplasias do Apêndice/cirurgia , Apendicite/cirurgia , Tumor Carcinoide/cirurgia , Neoplasias Intestinais/cirurgia , Adolescente , Apêndice/patologia , Apêndice/cirurgia , Tumor Carcinoide/patologia , Criança , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Neoplasias Intestinais/patologia , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Turquia
17.
J Clin Pathol ; 71(11): 1030, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30154130

RESUMO

CLINICAL QUESTION: A 45-year-old woman presented with painless vaginal bleeding for 2 months. A biopsy was taken from the uterine cervix, and poorly differentiated adenocarcinoma was suspected. After three cycles of neoadjuvant chemotherapy treatment, the patient underwent radical hysterectomy with bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy.Review the high quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2018-205081-1/ and consider your diagnosis. WHAT IS YOUR DIAGNOSIS?: Typical carcinoid.Poorly differentiated adenocarcinoma.Atypical carcinoid.Small cell neuroendocrine carcinoma.Sex cord-stromal tumours of the uterine cervix.-The correct answer is after the discussion. DISCUSSION: Neuroendocrine tumours of the uterine cervix are a rare cancer of the female reproductive system, accounting for approximately 1% of all female cervical malignancies.1 2 In 1997, a consensus workshop suggested four types of neuroendocrine tumours of the uterine cervix: typical and atypical carcinoid tumours, small cell neuroendocrine carcinomas, and large cell carcinomas.1 Among all the categories, small cell neuroendocrine carcinomas are of the highest incidence. A PubMed search revealed that only 15 cases of atypical carcinoid tumours of the uterine cervix have been reported.3 4 Because of infrequency, the clinical and pathological features of atypical carcinoid tumours of the uterine cervix remain unknown.Atypical carcinoids are characterised by great cytological atypia, which means abundant or scanty cytoplasm and visible nucleoli with granular chromatin. Tumour cells lined up in insular, trabecular, columnar and nested organoid patterns; they are epithelioid in appearance, but can be spindled (figure 1A). Necrosis could be observed in some areas and mitotic activity is up to 10 mitotic figures/10 high-power field (figure 1B). On immunohistochemistry, atypical carcinoids are diffuse and positive for Syn, CgA and CD56 (figure 2). An electron microscopic test was done, and several neuroendocrine granules were distributed in the tumour cell plasma (figure 3).jclinpath;71/11/1030/F1F1F1Figure 1(A) Insular, trabecular and columnar patterns of tumour cells were focally observed in the deep stroma of the cervix (H&E ×200). (B) Tumour cells showed small-sized, scanty cytoplasm, enlarged and deeply stained nuclei with condensed chromatin, obvious atypia, and increased mitotic activity (H&E ×400). (C) The cervical gland has shown atypical hyperplasia and adenocarcinoma in situ (H&E ×200).jclinpath;71/11/1030/F2F2F2Figure 2Immunohistochemical study findings: (A-C) The neuroendocrine markers Syn, CgA and CD56 were diffuse with strong expression in the tumour cell plasma. (D-E) P63 and CK5/6 for the squamous cell carcinomas showed no expression. (F-G) P16 for atypical carcinoid and adenocarcinoma in situ, respectively, had strong diffuse expression. (H-I) Ki67 had low expression in both atypical carcinoid and adenocarcinoma in situ (×200).jclinpath;71/11/1030/F3F3F3Figure 3Several neuroendocrine granules were distributed in the tumour cell plasma.Neuroendocrine tumours of the uterine cervix are sometimes combined with adenocarcinoma (figure 1C); their cytological and immunohistochemical features showed the neuroendocrine and adenomatous components shared the same origin.


Assuntos
Adenocarcinoma in Situ/patologia , Tumor Carcinoide/patologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma in Situ/química , Adenocarcinoma in Situ/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/análise , Biópsia , Tumor Carcinoide/química , Tumor Carcinoide/terapia , Quimioterapia Adjuvante , Feminino , Humanos , Histerectomia , Imuno-Histoquímica , Excisão de Linfonodo , Microscopia Eletrônica , Pessoa de Meia-Idade , Terapia Neoadjuvante , Salpingo-Ooforectomia , Neoplasias do Colo do Útero/química , Neoplasias do Colo do Útero/terapia
18.
Zhonghua Bing Li Xue Za Zhi ; 47(7): 517-521, 2018 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-29996316

RESUMO

Objective: To describe the clinicopathologic features, diagnosis and differential diagnosis of ovarian carcinoid tumors. Methods: A retrospective chart review was performed of all patients diagnosed with primary ovarian carcinoid tumors at Fudan University Shanghai Cancer Centre from 2007 to 2017. Results: The histologic analysis of these carcinoid tumors revealed 3 were insular, 1 was trabecular, 1 was mucinous, and 10 were strumal. Histologic features of insular and trabecular carcinoid were similar to other parts of the neuroendocrine tumor. Strumal carcinoid was composed of thyroid tissue intimately admixed with carcinoid tumor, showing trabecular pattern. Mucinous carcinoid was resembles Krukenberg tumor. Most ovarian carcinoid tomours were diffusely positive with at least one neuroendocrine marker, especially synaptophysin (14/14) and CD56(9/10). The median follow-up time was 53 months, 1 patient with squamous-cell carcinoma of cervixrecur rence in vaginal after 37 months, and only 1 patient died of disease. The remaining patients were disease-free survival. Conclusions: Primary carcinoid of the ovary is a very rare low grade malignant monodermal teratomas and somatic-type tumours arising from a dermoid. The diagnosis and differential diagnosis mainly relies on the histopathologic characteristics and the immuno-phenotype. Primary ovarian carcinoid almost always exhibit a benign clinical behavious except mucinous carcinoid.


Assuntos
Tumor Carcinoide/patologia , Neoplasias Ovarianas/patologia , Estruma Ovariano/patologia , Tumor Carcinoide/química , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , China , Diagnóstico Diferencial , Intervalo Livre de Doença , Feminino , Humanos , Tumor de Krukenberg/patologia , Neoplasias Ovarianas/química , Estudos Retrospectivos , Estruma Ovariano/química , Sinaptofisina/análise , Teratoma/química , Teratoma/patologia , Glândula Tireoide/patologia
19.
J Laryngol Otol ; 132(7): 568-574, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29909787

RESUMO

OBJECTIVE: This review aimed to critically analyse data pertaining to the clinical presentation and treatment of neuroendocrine carcinomas of the larynx. METHOD: A PubMed search was performed using the term 'neuroendocrine carcinoma'. English-language articles on neuroendocrine carcinoma of the larynx were reviewed in detail.Results and conclusionWhile many historical classifications have been proposed, in contemporary practice these tumours are sub-classified into four subtypes: carcinoid, atypical carcinoid, small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma. These tumours exhibit a wide range of biological behaviour, ranging from the extremely aggressive nature of small and large cell neuroendocrine carcinomas, which usually have a fatal prognosis, to the less aggressive course of carcinoid tumours. In small and large cell neuroendocrine carcinomas, a combination of irradiation and chemotherapy is indicated, while carcinoid and atypical carcinoid tumour management entails conservation surgery.


Assuntos
Carcinoma Neuroendócrino/genética , Carcinoma Neuroendócrino/terapia , Neoplasias Laríngeas/genética , Neoplasias Laríngeas/terapia , Fenótipo , Protocolos Antineoplásicos , Tumor Carcinoide/genética , Tumor Carcinoide/patologia , Tumor Carcinoide/terapia , Carcinoma Neuroendócrino/patologia , Carcinoma de Células Pequenas/genética , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/terapia , Tratamento Conservador/métodos , Humanos , Neoplasias Laríngeas/patologia , Laringe/patologia , Laringe/cirurgia , Prognóstico
20.
BMJ Case Rep ; 20182018 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-29903775

RESUMO

Extragonadal germ cell tumours (GCTs) are uncommon neoplasms comprising approximately 2%-5% of all GCTs. Of these, approximately 30%-40% occurs as primary retroperitoneal GCTs. This case report details the presentation, diagnosis and management of a 53-year-old man presenting with an incidental finding of a primary extragonadal retroperitoneal teratoma with carcinoid transformation.


Assuntos
Tumor Carcinoide/patologia , Carcinoma Neuroendócrino/patologia , Células Germinativas/patologia , Neoplasias Retroperitoneais/patologia , Teratoma/patologia , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Humanos , Achados Incidentais , Laparotomia/métodos , Masculino , Pessoa de Meia-Idade , Doenças Raras , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Teratoma/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA