1/652. Lessons from an unusual case: malignancy associated hypercalcemia, pancreatitis and respiratory failure due to ARDS.A 37-year old woman, presenting with severe hypercalcaemia-associated pancreatitis with pseudocyst formation, was admitted to intensive care because she developed ARDS with respiratory failure. Skeletal metastasis from non-small cell bronchial carcinoma were subsequently diagnosed. After she developed arterial occlusion in the lower limb, supportive treatment was withdrawn. Severe pancreatitis is an exceedingly unusual presentation of non-small cell bronchial carcinoma. Concepts of diagnostic and therapeutic strategies in the context of suspected unusual pathology, and the concept of futility are briefly discussed.- - - - - - - - - - ranking = 1keywords = malignancy (Clic here for more details about this article) |
2/652. Pseudoanaplastic giant cell tumor of bone.Marked nuclear atypia can be found in a variety of benign mesenchymal tumors, including ancient schwannomas, symplastic leiomyomas, osteoblastomas, and chondromyxoid fibromas. Such nuclear atypia is believed to represent a degenerative phenomenon and does not indicate aggressive behavior. Separation of these pleomorphic but benign lesions from true sarcomas may be difficult. We are aware of only one prior description of such degenerative atypia in benign giant cell tumor of bone. We report a benign giant cell tumor of bone arising in the sacrum of a 21-year-old white female. Preoperative embolization of this lesion had been performed, and subsequent curetting revealed marked atypia suggestive of an anaplastic malignancy. However, only very rare mitotic figures were present, and the radiographs were consistent with a benign giant cell tumor. A diagnosis of benign giant cell tumor was made, and no recurrence or metastases have been observed during the 4-year postoperative period.- - - - - - - - - - ranking = 0.25keywords = malignancy (Clic here for more details about this article) |
3/652. Alveolar soft part sarcoma involving the ilium. A case report.A report of alveolar soft part sarcoma of the hip region with extension to the ilium is presented to highlight an unusual presentation for this sarcoma and to discuss the treatment options for limb salvage for large malignant neoplasma involving the periacetabular region of the pelvis. A review of the literature for reports of alveolar soft part sarcoma extending to bone is presented.- - - - - - - - - - ranking = 7.6546366420154keywords = neoplasm (Clic here for more details about this article) |
4/652. Bone giant cell tumour in neuropathological practice. A fifty year overview.We report a case of a 29-year-old female patient who suffered from visual disturbance, resulting from a lesion in the sphenoid bone which, histologically, proved to be a giant cell tumour. Reviewing our laboratory practice over a 50 year period, only 7 cases of true giant cell tumour were found and they were in two major locations, i.e. the skull and vertebrae. These few cases led us to focus on the problem raised by the lack of histological patterns of malignancy. In agreement with Mazabraud's theory, it seems that a vertebral location is associated with a good prognosis and that gene mapping of chromosome 17 in relation to p53 mutations could be a valuable tool in the diagnosis of potential malignant behaviour.- - - - - - - - - - ranking = 0.25keywords = malignancy (Clic here for more details about this article) |
5/652. bone marrow metastases in disseminated alveolar rhabdomyosarcoma: case report with ultrastructural study and review.A case of desseminated alveolar rhabdomyosarcoma in an 18-year-old male with leuco-erythroblastic anaemia is described. Numerous bizarre malignant cells, including frequent multinucleated giant cells, were seen in bone marrow aspirates, and osteolytic lesions appeared late in the clinical course. The primary site of the neoplasm remained undertermined during life and also at necropsy, which revealed minute pulmonary metastases and extensive lymph nodal, pleural and skeletal deposits. The diagnosis was confirmed on necropsy tissue by ultrastructural examination which demonstrated numerous thin (5 nm) and thick (15 nm) intracytoplasmic filaments in tumour cells, sometimes organized in bundles; scattered dense Z-band-like bodies, and rod-shaped structures were also seen. The fine structure of the rhabdomyosarcoma in the present case is compared with previous ultrastructural studies. Elongated, thick intracytoplasmic filaments whose diameter corresponds to that of myosin myofilaments are strong evidence for rhabdomyoblastic differentiation and are considered to be the sine qua non of a positive electron microscopic diagnosis of rhabdomyosarcoma. Orgaized bundles of filaments and Z-band-like dense bodies are usually present, and rod-shaped structures are found infrequently, but none of these are necessary for the ultrastructural diagnosis.- - - - - - - - - - ranking = 7.6546366420154keywords = neoplasm (Clic here for more details about this article) |
6/652. Endovascular papillary angioendothelioma (Dabska tumor) of bone.Endovascular papillary angioendothelioma, also known as Dabska tumor, is a rare vascular neoplasm that usually involves the skin or subcutaneous tissue of children. There have been no reported cases of this lesion occurring in bone. We report a Dabska tumor in the distal femur of a 45-year-old woman who, clinically and radiologically, was felt to have an osteoid osteoma. Histologic study of the lesion showed a hemangioma with budding fronds of endothelial cells, a feature characteristic of the Dabska tumor. We feel that the lesion arose in a pre-existing hemangioma, a hypothesis suggested in a few other case reports. Endovascular papillary angioendothelioma is a low-grade malignant neoplasm, although only one patient has died due to this lesion. Our patient is asymptomatic without evidence of recurrence 1 year post curettage.- - - - - - - - - - ranking = 15.309273284031keywords = neoplasm (Clic here for more details about this article) |
7/652. Vertebral osteoblastoma: are radiologic structural changes necessary for diagnosis?BACKGROUND: A case of osteoblastoma localized at the pedicle of the 10th thoracic vertebra is presented. CASE DESCRIPTION: The patient complained of nocturnal back pain not relieved by salycilates, a typical symptom of osteoblastoma. Bone scintigraphy showed a lower thoracic focus of increased osteoblastic activity; however, x-rays, computed tomography, and magnetic resonance images (MRI) were within normal limits, showing only obscure changes that were also noted in the rest of the spine. Repeat MRI with contrast revealed a focal enhancement. After pediculectomy, histopathologic examination confirmed the diagnosis of osteoblastoma. Fifteen months postoperatively, the patient is symptom-free. CONCLUSION: Our case demonstrates that some cases of osteoblastoma may not have the classical radiological appearance. Although non-contrast computed tomography and T1-weighted MRI are mildly positive in some instances, osteoblastoma is best visualized on MRI with gadolinium. Like any other neoplasm, osteoblastoma should be detected and removed early, before it can cause structural bony changes.- - - - - - - - - - ranking = 7.6546366420154keywords = neoplasm (Clic here for more details about this article) |
8/652. Bilateral sphenoid wing metastases of prostate cancer presenting with extensive brain edema.A 76-year-old man insidiously developed diffuse neurological symptoms: cognitive decline, dysphagia, dysphasia and mental disturbance. Computed tomography of the cranium revealed widespread bilateral brain edema and symmetrical bilateral sphenoid wing hyperostosis. Adjacent to the hyperostosis that resembled skull base meningiomas, two separate parenchymatous temporal lobe lesions enhancing with contrast medium were observed. The patient had earlier been diagnosed to have prostatic carcinoma. dexamethasone therapy resulted in discontinuation of the neurological symptoms. The diagnosis of metastasized adenocarcinoma of the prostate was confirmed histologically on autopsy after a sudden death from pneumonia. Intracranial metastases of prostate cancer may have a predilection site at the sphenoid wing, and can mimic a skull base meningioma. Intracranial spread of prostatic adenocarcinoma should be considered in elderly men as a treatable cause of gradual neurological deterioration, especially if cranial malignancy or hyperostosis is found.- - - - - - - - - - ranking = 0.25keywords = malignancy (Clic here for more details about this article) |
9/652. Hemorrhagic epithelioid and spindle cell hemangioma: a newly recognized, unique vascular tumor of bone.BACKGROUND: Epithelioid vascular tumors of bone are uncommon and include epithelioid hemangioma, epithelioid hemangioendothelioma, and epithelioid angiosarcoma. It is important to distinguish among them because they have significantly different biologic potential and require different forms of therapy. In the current study the authors describe six cases of a distinct benign epithelioid and spindle cell vascular tumor of bone that, because of their unusual morphology, were confused with aggressive vascular neoplasms. methods: Cases were retrieved from the surgical pathology files of the Department of pathology or from the consultation files of one of the authors. hematoxylin and eosin stained slides were examined. immunohistochemistry was performed on two cases and electron microscopy was performed on one case. RESULTS: The tumors arose in the small bones of the hands and feet and the tibia. Three patients had multifocal bone disease at the time of presentation. Histologically, all lesions were comprised of lobules of spindle cells that grew focally in a fascicular pattern and were associated with abundant hemorrhage. Plump epithelioid cells were intermixed and were present focally in the interlobular areas as well, in which they lined larger, more well developed vascular spaces, often protruding into the vascular lumen in a "tombstone" fashion. Immunohistochemically and ultrastructurally the neoplastic cells had features of endothelium. One case was treated by amputation, one by resection, three by curettage, and one by curettage plus radiation therapy. None of the lesions was locally aggressive nor did any metastasize. CONCLUSIONS: The authors believe that hemorrhagic epithelioid and spindle cell hemangioma of bone is a histologically benign bone tumor. It should be distinguished from malignant epithelioid vascular tumors of bone, which have metastatic potential and need to be treated more aggressively.- - - - - - - - - - ranking = 7.6546366420154keywords = neoplasm (Clic here for more details about this article) |
10/652. Undetectable serum thyroglobulin in a patient with metastatic follicular thyroid cancer.The case of a 54-year-old woman with metastatic follicular thyroid cancer and undetectable serum thyroglobulin is presented. Many years after the patient had a subtotal thyroidectomy for a large goiter that had no clear evidence of malignancy, metastatic bone disease developed. When the bone metastases were detected and during the follow-up period, serum thyroglobulin values remained undetectable, but radioiodine uptake in the metastases was abundant. This case indicates that the combination of 1-131 scintigraphy and serum thyroglobulin values is superior to the measurement of serum thyroglobulin alone in detecting well-differentiated, metastatic thyroid cancer.- - - - - - - - - - ranking = 0.25keywords = malignancy (Clic here for more details about this article) |
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