Intestinal adenocarcinoma in a herd of farmed Sika deer (Cervus nippon): a novel syndrome.

Intestinal adenocarcinomas were identified in 76 adult deer from a closed herd of 193 breeding animals grazing pasture heavily infested with bracken fern (Pteridium aquilinum). Tumors were observed postmortem in 32 animals with rapid weight loss, and similar neoplasms were detected in a further 44 clinically normal deer at "cull." Tumors were located in distal ileum, cecum, and proximal colon and presented as single (26%) or multiple (74%), variably sized, pale-gray, firm, poorly circumscribed neoplasms with associated intestinal strictures. Histopathologically tumors were well-differentiated, locally infiltrative, low-grade adenocarcinomas of tubular (51%), mucinous (33.5%), or mixed (15.5%) types. Extraintestinal metastases were not observed. The high incidence of intestinal adenocarcinoma within this herd suggests a specific and novel syndrome, and genetic and/or environmental factors may be involved in the pathogenesis.

Sinonasal adenocarcinoma presented as a giant anterior cranial fossa mass: a case report and review of the literature.

BACKGROUND: Intestinal adenocarcinoma accounts for less than 0.1-4% of all malignancies in the region. It is common among woodworkers and leather workers. Sinonasal adenocarcinoma usually arises from the ethmoid sinus (40%) or nasal cavity (25%). Extension to nearby structures is common, but intracranial spread is very rare. These tumors are usually treated with surgery, with a reported 5-year survival rate of 59% to 80%. CASE PRESENTATION: This is a 60-year-old Black African male patient who presented with globalized headache, nasal obstruction with snoring during sleep, anosmia, change in mentation, sometimes agitation and left-side visual loss of one-year duration with worsening his above symptoms over the last one month. He couldn't smell soap bilaterally; in his left eye he could see only hand movement at nearly 30 cm. On brain magnetic resonance imaging, there was a T1 hypo- and T2 hyper-intense anterior cranial fossa mass arising from the left ethmoid sinuses and sphenoid sinuses and compressing the left optic structures, and brain computed tomography demonstrated heterogeneous hypo- to isodense mass. Complete tumor excision achieved and discharged with significant improvement and linked to oncology unit for radiotherapy. CONCLUSION: The management of these patients is multidisciplinary, involving neurosurgeons, otolaryngologists, oncologists, and maxillofacial surgeons. Surgical resection is the main treatment strategy, followed by radiotherapy, particularly intensity-modulated therapy. Chemotherapy is used in highly advanced, metastatic, and unresectable tumors.

Pure extracellular mucin-producing (colloid) myoepithelioma of the parotid gland.

Mucinous (secretory) myoepithelioma is a very uncommon variant of myoepithelioma characterized by the presence of intracellular mucin. We herein report the findings of a 51-year-old woman who presented with a mass in the right parotid region, which had been slowly growing over the previous year. Magnetic resonance imaging revealed a rounded mass with lobulated margins in the tail of the right parotid gland that showed heterogeneous uptake in the anterior margin of the mass. A clinical diagnosis of pleomorphic adenoma was made. Superficial parotidectomy revealed a 3.6 cm encapsulated, round-shaped, light brown, gelatinous, solid tumor. The neoplasm showed a reticular pattern forming pseudoglandular structures that were filled with abundant extracellular mucin secretion. Additionally, lakes of mucin of different sizes appeared to be scattered throughout the neoplasm. The epithelioid tumor cells were medium-sized with eosinophilic cytoplasm, centrally located, small, uniform nuclei, and inconspicuous nucleoli. Mitoses were not observed. Signet-ring or univacuolated cells, ductal, and glandular components were absent. The extracellular mucin was positive for mucicarmine and Alcian blue staining. Immunohistochemical staining revealed that the tumor cells were diffusely and strongly positive for S100 protein, cytokeratin AE1/AE3, SOX10, and DOG-1. Occasional compact solid clusters of epithelioid cells showed intense positivity for CK7 and high-molecular-weight CK. The diagnosis was pure extracellular mucin-producing (colloid) myoepithelioma. To our knowledge, this type of neoplasm has not been previously published. Knowledge of this new variant will avoid diagnostic difficulties.

Mucinous endometrial cancer: Clinical study of the eleven cases.

OBJECTIVE: In this study, we analyzed surgico-pathologic factors of mucinous type endometrial carcinoma and examined its frequency of recurrence. METHODS: In this study, eleven cases, definitely diagnosed as pure mucinous type endometrium carcinoma between January 1993 and May 2013, were reviewed. RESULTS: Of 1640 women with endometrium carcinoma, 11 (0.67%) of them had a mucinous cell type. Mean age of the study group was 55 years. According to the FIGO 2009, 10 (90.9%) cases were evaluated as stage I and 1 (9.1%) as stage IIIC1. The presence of lymph node metastasis was noticed in only one (12.5%) of eight patients who underwent lymphadenectomy. In this case, metastasis was detected in the pelvic lymph node. Four patients underwent adjuvant therapy as pelvic radiotherapy. Median follow-up time was 50 months (range, 5-84). Recurrence was observed in one (9.1%) patient with stage IIIC1 endometrial cancer in 30 months after primary surgery. The site of recurrence was only in the upper abdominal region. CONCLUSION: Based on our study, mucinous endometrial carcinoma has good prognostic factors, and long term survival can be achieved surgically alone in patients with stage I.

Clinicopathologic Characteristics of Mucinous Gastric Adenocarcinoma

PURPOSE: Clinicopathological characteristics of mucinous gastric adenocarcinomas (MGC) are unclear. Also, whether the surgical results of a MGC are unfavorable is still controversial. A tumor is defined as a MGC when more than 30% of the tumor area has mucin pools. Also, MGC are subdivided into the well-differentiated (WD) and poorly differentiated (PD) types, according to the degree of glandular formation of the tumor cells. To clarify the significance of MGC, the clinicopathological profiles and prognoses of patients were studied. METHODS: Thirty-four patients with MGC and 1, 036 with non-mucinous gastric adenocarcinomas (NMGC) who were operated on between 1992 and 2002 at the Department of Surgery, Hanyang University Hospital, were included. Patients were evaluated with regard to age, gender, tumor location, size, depth of wall invasion, lymph node status, distant metastasis, stage at presentation, lymphatic and vascular permeation, operative curability, and preoperative serum levels of CEA and CA19-9. RESULTS: MGC tumors, compared with NMGC tumors, had larger sizes (8.0 vs. 5.9 cm), more frequent incidences of T2 or more invasion (91 vs. 66%), positive lymph node metastasis (85 vs. 57%), distant metastasis (18 vs. 6%), stage III and IV (74 vs. 45%), noncurative surgery (32 vs. 10%), lymphatic permeation (88 vs. 63%), and abnormal serum CEA level (32 vs. 14%). However, the overall survival rate of those patients with a MGC was not significantly different from that of those with a NMGC. With a MGC, there was no significant correlation between the degree of mucin content and the prognosis. Conversely, the survival rate was higher in the WD than in the PD types (100 vs. 45%, P=0.0185). CONCLUSION: The mucinous histological type itself is of no prognostic significance in patients with gastric carcinomas. The biological behavior of MGC is determined by the degree of glandular formation of the tumor cellss (i.e., histologic differentiation).

Clinical Features and Prognostic Factors in Primary Adenocarcinoma of the Appendix / 대한소화기학회지

BACKGROUND/AIMS: Primary appendiceal adenocarcinoma is a rare neoplasm that constitutes less than 0.5% of all gastrointestinal neoplasm. The aim of this study was to figure out its clinicopathologic characteristics that are not well understood. METHODS: We reviewed the medical records of nineteen patients (9 males and 10 females) with histologically proven appendiceal adenocarcinoma. They had been treated at Asan Medical Center between June 1989 and December 2002. Their median follow-up duration was 72.5 months. RESULTS: Their median age was 56.5 (range, 33~80) years. Thirteen patients had mucinous variants and the other five had adenocarcinoma. Seven patients (36.8%) were diagnosed as acute appendicitis. In fact, none of the patients was diagnosed correctly before surgery. The operative procedure, included right hemicolectomy in 9 patients, appendectomy alone in 2 patients, and debulking of their tumors or a biopsy in 8 patients. The 5-year survival rate was 20.5%. The patients with mucinous type had better prognosis than those with the non-mucinous type (p<0.01). In the patients with mucinous type, the survival rate after debulking operation was similar to that after right hemicolectomy. CONCLUSIONS: The most important prognostic factor of primary appendiceal adenocarcinoma was histology. The outcome of debulking operation is being watched compared with that of right hemicolectomy in mucinous variant.