1/34. Fusion of contrast-enhanced breast MR and mammographic imaging data.Increasing use is being made of Gd-DTPA contrast-enhanced magnetic resonance imaging for breast cancer assessment since it provides 3D functional information via pharmacokinetic interaction between contrast agent and tumour vascularity, and because it is applicable to women of all ages as well as patients with post-operative scarring. Contrast-enhanced MRI (CE-MRI) is complementary to conventional X-ray mammography, since it is a relatively low-resolution functional counterpart of a comparatively high-resolution 2D structural representation. However, despite the additional information provided by MRI, mammography is still an extremely important diagnostic imaging modality, particularly for several common conditions such as ductal carcinoma in situ (DCIS) where it has been shown that there is a strong correlation between microcalcification clusters and malignancy. Pathological indicators such as calcifications and fine spiculations are not visible in CE-MRI and therefore there is clinical and diagnostic value in fusing the high-resolution structural information available from mammography with the functional data acquired from MRI imaging. This paper presents a novel data fusion technique whereby medial-lateral oblique (MLO) and cranial-caudal (CC) mammograms (2D data) are registered to 3D contrast-enhanced MRI volumes. We utilise a combination of pharmacokinetic modelling, projection geometry, wavelet-based landmark detection and thin-plate spline non-rigid 'warping' to transform the coordinates of regions of interest (ROIs) from the 2D mammograms to the spatial reference frame of the contrast-enhanced MRI volume. Of key importance is the use of a flexible wavelet-based feature extraction technique that enables feature correspondences to be robustly determined between the very different image characteristics of X-ray mammography and MRI. An evaluation of the fusion framework is demonstrated with a series of clinical cases and a total of 14 patient examples.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/34. Salivary duct carcinoma in the submandibular region.A case of salivary duct carcinoma arising in the submandibular region of an 83-year-old man is presented. Histologically, the tumour consisted of solid cell nests with ductal structures. Tumour cell nests showed central comedonecrosis. Immunohistochemically, the tumour cells were positive for keratin and epithelial membrane antigen but negative for S-100 protein and calponin. Clinical features as well as pathological examinations based on haematoxylin-eosin and immunohistochemical stainings were important in the diagnosis of this case.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
3/34. Osteogenic sarcoma in the breast--case report of a diagnostic dilemma.breast cancer is the leading cancer in females worldwide, the vast majority being carcinomas, and only 0.2-0.3% being sarcomas. Of the mammary sarcomas, extra-osseous osteogenic sarcomas constitute a small heterogeneous group. This communication reports a case of primary extra-osseous osteogenic sarcoma occurring in the breast of a48-year-old female, and presents a literature review of this condition. A pre-requisite for the diagnosis of primary mammary osteogenic sarcoma is the exclusion of an osteogenic sarcoma arising from the underlying ribs or sternum. Like all other osteogenic sarcomas in general, these neoplasms are characterized by the direct formation of osteoid matrix by the tumour cells. Primary osteogenic sarcoma of the breast may arise from metaplastic sarcomatous transformation of neoplastic cells in a primary breast carcinoma, fibroadenoma, malignant phyllodes tumour, or may exceptionally represent a nonphyllodes sarcoma of the breast arising from the soft tissues of an otherwise normal or previously irradiated breast.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
4/34. Scirrhous colonic metastasis from ductal carcinoma of the breast: report of a case.Metastasis of breast cancer to the colon is rare. We report a case of a 49-year-old female who presented with a stenotic tumor of the descending colon five years after treatment of breast cancer with mastectomy and pedicled transverse rectus abdominis musculocutaneous flap. laparotomy showed a diffusely infiltrated tumor over the descending colon. Anterior resection with loop ileostomy was performed, and the pathology showed that the colonic wall and the mesentery were diffusely infiltrated with poorly differentiated adenocarcinoma, which stained strongly for cytokeratin 7. The histologic diagnosis is consistent with colonic metastasis from ductal carcinoma of breast origin. In a patient with a history of breast cancer, colonic metastasis from the breast primary cancer should be considered, especially if the colonic lesion is scirrhous in nature. The incision for laparotomy and the probable stoma site should be planned carefully in females after breast reconstructive surgery.- - - - - - - - - - ranking = 6keywords = carcinoma (Clic here for more details about this article) |
5/34. Salivary duct carcinoma of submandibular gland with trigeminal nerve invasion to intracranium.Salivary duct carcinoma is a rare and invasive malignant tumour with rapid distant metastasis and dismal prognosis. Clinically, perineural invasion of the salivary duct carcinoma is commonly noted. Here, we present a case of salivary duct carcinoma of submandibular gland origin with perineural invasion of the trigeminal nerve proximal to the intracranium, that was well demonstrated by a magnetic resonance image (MRI) and was consistent with the clinical presentation. This case received radical resection and radiotherapy with inclusion of the skull base within the field. There was no tumour recurrence and distant metastasis 24 months post-operatively.- - - - - - - - - - ranking = 7keywords = carcinoma (Clic here for more details about this article) |
6/34. Ductal carcinoma arising from a syringocystadenoma papilliferum in a nevus sebaceus of Jadassohn.We present an example of ductal carcinoma connected to a syringocystadenoma papilliferum situated in a nevus sebaceus of Jadassohn on the scalp of a 22-year-old woman. The ductal carcinoma involved the entire thickness of the dermis and extended to the subcutaneous fat. Because syringocystadenoma papilliferum is considered a hamartoma with apocrine differentiation, the ductal carcinoma here described was interpreted as an apocrine ductal carcinoma. Syringocystadenocarcinoma papilliferum is an exceedingly rare neoplasm, most examples of which seem to have arisen in its benign counterpart, syringocystadenoma papilliferum. From a histopathologic point of view, syringocystadenocarcinoma papilliferum usually shows a papillary configuration similar to that of syringocystadenoma papilliferum. In contrast, the case here described a ductal carcinoma superficially connected to a syringocystadenoma papilliferum, but mostly composed of small ductal structures embedded in a desmoplastic stroma and involving the full thickness of the dermis. We review the literature about the malignant neoplasms arising in the nevus sebaceus of Jadassohn.- - - - - - - - - - ranking = 11keywords = carcinoma (Clic here for more details about this article) |
7/34. Renal tumor causing haematuria and sepsis.A 28 year old female patient developed hematuria in the 32th week of her pregnancy. She was given antibiotic treatment, since a urinary tract infection was suspected. After delivery symptoms of acute pyelonephritis, then sepsis developed, and conservative therapy had no effect. Ultrasound examination showed unusual renal destruction, so nephrectomy was performed. Surgical intervention revealed the presence of an advanced tumor of the kidney, while histological examination confirmed a Bellini duct carcinoma of the kidney.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
8/34. Clinics in diagnostic imaging (88). Gynaecomastia of the right breast and carcinoma of the left breast.An 83-year-old man presented with a painless lump in his left breast for one year. Mammograms showed an ill-defined uncalcified high-density subareolar mass in the left breast and minimal fibroglandular density radiating beneath the nipple into the fatty tissue of the right breast. US showed an irregular, heterogeneously-hypoechoic mass with mild posterior transmission. The differential diagnosis of breast enlargement in men is discussed. Mammographical and US features of gynaecomastia and male breast carcinoma are presented.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
9/34. Successful adjuvant tamoxifen therapy for estrogen receptor-positive metastasizing sweat gland adenocarcinoma: need for a clinical trial?We report on successful adjuvant tamoxifen therapy for a metastasizing sweat gland adenocarcinoma of the scalp in a 64-year-old woman. Before the antihormonal therapy, the patient had undergone repeated surgery for ipsilateral intraparotid, soft tissue, and lymph node metastases and had had disease-free intervals of less than 5 months. As the immunohistochemical analysis of the tumor tissue revealed a 100% nuclear reactivity to estrogen and progesterone receptors, we started empirical tamoxifen citrate therapy, which dramatically changed the course of the disease. The patient has been in complete remission for 3 years. This is the third report in the literature of substantial therapeutic benefit of antiestrogen therapy in metastasizing eccrine gland adenocarcinoma with positive hormone receptor immunohistochemistry. We suggest examining the hormone receptor expression in these neoplasms regularly. A prospective study should be commenced to assess the benefit of adjuvant antihormonal therapy in eccrine gland adenocarcinomas.- - - - - - - - - - ranking = 7keywords = carcinoma (Clic here for more details about this article) |
10/34. Invasive ductal carcinoma of the breast with a microglandular adenosis pattern.Invasive breast carcinomas of special type are composed of up to 35% of all cases, such as tubular carcinoma, mucinous carcinoma, invasive cribriform carcinoma, lobular carcinoma, metaplastic carcinoma, medullary carcinoma, and other rare variants. They are recognized by their specific growth and morphologic patterns, glandular differentiation, and cytologic and nuclear features. These features are also present as a focal or minor component in many carcinomas of no special type. In addition, there are a number of lesions that are mimickers of invasive carcinoma, which can sometimes create diagnostic difficulties. It is important for pathologists to recognize these histologic variants and mimickers of breast carcinoma, particularly in evaluating needle or core biopsies. We report a case of a 64-year-old woman with breast carcinoma of no special type with areas having features with resemblance to microglandular adenosis. Differential diagnosis and their histologic features are discussed.- - - - - - - - - - ranking = 15keywords = carcinoma (Clic here for more details about this article) |
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