RESUMO
Chondrosarcomas constitute the second-most-frequent malignant bone tumors, representing about 10% of all malignant bone tumors. The most frequent localizations comprise the trunk, pelvis and limbs. Metastatic disease usually occurs in the lung; metastases to other localizations are seen occasionally. Manifestation in the head and neck area, either as primary tumor or metastasis, is very rare. A case of parotid gland metastasis in multiple enchondromatosis secondary chondrosarcoma (CHOSA) G-III of the left femoral bone is presented. A 79-year-old male patient reported to our clinic with a rapidly progressing mass in the left parotid gland. A superficial parotidectomy was performed and the entire tumor resected. Histopathological examination revealed nodular infiltration of the parotid by chondrosarcoma consistent with metastatic disease. Review of the literature shows that this is the first report of such a case.
Assuntos
Neoplasias Ósseas/patologia , Condrossarcoma/secundário , Encondromatose/patologia , Neoplasias Parotídeas/secundário , Idoso , Neoplasias Ósseas/cirurgia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Diagnóstico Diferencial , Encondromatose/cirurgia , Humanos , Masculino , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/cirurgia , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , UltrassonografiaRESUMO
Despite several new urine markers urinary cytology remains the gold standard for the non-invasive detection of bladder carcinoma. The use of monoclonal antibodies against tumor associated antigens offers a promising approach to improve urinary cytology. The aim of this study was to compare fluorescence immunocytology (ImmunoCyt/Ucyt+ test), alone and in combination with the conventional cytology, with other urine markers. Urine samples from 126 patients undergoing cystoscopy were included in the study. Among them, 42 patients had urothelial carcinoma, two dysplasia, two other malignancies, and 78 had no evidence of bladder cancer. Urine samples were taken before any manipulation. We used the ImmunoCyt test and Papanicolaou staining for conventional cytology. The ImmunoCyt slides were examined under a fluorescence microscope. Evaluations of the tests were blinded to clinical and pathological data and were carried out by three independent observers. The results of cytology and ImmunoCyt were compared with the BTAstat, NMP22, Lewis X, 486p3/12, and Urovision tests. The sensitivity for the ImmunoCyt test was 78.3% and for conventional cytology 84.6%. The combination of ImmunoCyt and cytology showed a sensitivity of 89.1%. The specificity was 73.8% for the ImmunoCyt alone, 80.0% for the cytology, and 72.5% for the combination of ImmunoCyt and cytology. Sensitivities for the other tests were 68.8% for (FISH), 66.6% (BTA-Stat), 68.8% (486p3/12), 95.5% (Lewis X), and 71.1% for (NMP22). Specificity was 89.1% for (FISH), 78.2% (BTA-Stat), 76.4% (486p3/12), 32.8% (Lewis X), and 65.5% for (NMP22). Urinary cytology can be improved by immunostaining with monoclonal antibodies against tumor-associated antibodies. The combination of ImmunoCyt with conventional cytology offers a superior sensitivity to other commercial tests. The ImmunoCyt test provides a useful supplement to urinary cytology in the diagnosis of bladder cancer.