1/12. 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 = 1keywords = neoplasm, soft (Clic here for more details about this article) |
2/12. 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 = 1.9856655766176keywords = neoplasm (Clic here for more details about this article) |
3/12. A case of chest wall recurrence of breast cancer treated with paclitaxel weekly, 5'-deoxy-5-fluorouridine, arterial embolization and chest wall resection.Chest wall resection and reconstruction has proved to be a safe surgical procedure for local recurrence of breast cancer. Recently, as second- or third-line chemotherapy for the patients with recurrent breast cancer or ovarian cancer, weekly paclitaxel has provided a significant response rate in those patients, and generated much clinical interest. We report here a case of chest wall recurrence of breast cancer successfully treated by a combination of weekly paclitaxel, 5'-deoxy-5-fluorouridine, arterial embolization, and chest wall resection. A 56-year-old woman presented with a large mass in the left anterior chest. A recurrent tumor developed and enlarged one-and-half years after undergoing modified radical mastectomy for advanced breast cancer (T4N2M0, stage III B) at another hospital. The mass had enlarged while the patient underwent chemotherapy with cyclophosphamide, doxorubicin, 5-fluorouracil, and anastozole, followed by low-dose cisplatin, 5-fluorouracil, and goserelin. To reduce the mass and inflammatory changes of the skin, weekly paclitaxel and 5'-deoxy-5-fluorouridine was given. Furthermore, to obtain hemostasis and promote the mass reduction, arterial embolization of the supply arteries was performed. Chest wall resection, reconstruction of the bony chest wall with polypropylene mesh folded 8 times, and soft tissue reconstruction with a contralateral myocutaneous flap were carried out successfully. The patient was discharged from the hospital ten weeks after the operation without any major morbidity, and remained well for ten months. A multimodal approach with chemotherapy and arterial embolization was effective in this case in treating chest wall recurrence of breast cancer. Reconstruction of the chest wall bone with polypropylene mesh folded 8 times and soft tissue reconstruction with a contralateral myocutaneous flap was a useful procedure after chest wall resection, even after chemotherapy and arterial embolization.- - - - - - - - - - ranking = 0.014334423382387keywords = soft (Clic here for more details about this article) |
4/12. 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 = 1keywords = neoplasm, soft (Clic here for more details about this article) |
5/12. Intraepithelial G3 adenocarcinoma of the endometrium after tamoxifen treatment.CASE REPORT: In this paper we describe a case of endometrial carcinoma observed in a post-menopausal patient who was treated with tamoxifen for 5 years after a mastectomy for cancer. She came to our department because of vaginal bleeding 2 years after the end of tamoxifen treatment.TREATMENT: She underwent hysteroscopy and a D and C. A polypoid endometrium completely filled the uterine cavity and was carefully removed by curettage; histology showed a highly undifferentiated neoplasia with a component of serous adenocarcinoma, which was likely to originate from endometrial polyps.OUTCOME: The patient underwent radical hysterectomy, but no residual tumor was found in the uterus or in the tubes, ovary, or pelvic nodes, in spite of its low differentiation grade and high potential aggressiveness, and even though the patient was already symptomatic. Two years after surgery the patient is disease free, which is consistent with the evaluation of the surgical specimen, but unusual in poorly differentiated neoplasms.- - - - - - - - - - ranking = 0.99283278830881keywords = neoplasm (Clic here for more details about this article) |
6/12. Intraductal papillary mucinous adenoma that arises from pancreatic heterotopia within a meckel diverticulum.Neoplasia is an unusual complication of meckel diverticulum. Most tumors of meckel diverticulum are neuroendocrine or mesenchymal in origin. Adenocarcinomas represent a minority of the tumors that arise in meckel diverticulum and are generally thought to develop from either endogenous small intestinal epithelium or heterotopic gastric epithelium. Despite the presence of ectopic pancreas in a small fraction of Meckel diverticula, convincing evidence of tumors that arise from heterotopic pancreatic exocrine tissue has not been described in this setting. Intraductal papillary mucinous neoplasms are relatively uncommon tumors of pancreatic ductal epithelial cells that line the main pancreatic duct or its major side branches. We present an unusual case of an intraductal papillary mucinous neoplasm that arose in a heterotopic pancreas within a meckel diverticulum.- - - - - - - - - - ranking = 1.9856655766176keywords = neoplasm (Clic here for more details about this article) |
7/12. Sarcomatoid salivary duct carcinoma.The so-called sarcomatoid salivary duct carcinoma (SSDC) is one of the variants of salivary duct carcinoma (SDC). This neoplasm is characterized by the presence of both a carcinomatous and a sarcomatoid tumor component. The histology and nomenclature of such neoplasms has been a matter of debate for many years. The histologic, immunohistochemical, and electron microscopic findings including those of 4 previously described cases of SSDC are defined and the different attitudes concerning their etiology will be discussed. In addition, the fine-needle aspiration biopsy of such a case is presented for the first time. In analogy to typical SDC there seems to be a predilection for elderly men and a location in major salivary glands. The resected SSDC tumors measured between 1.5 and 3.5 cm. Histologically, each case was a composite of SDC and sarcomatoid carcinoma. Immunohistochemical positivity for epithelial membrane antigen (EMA) and cytokeratins (AE1/AE3, CAM 5.2) was shown in the sarcomatoid tumor component. The important cytomorphologic feature of SSDC is the presence of cohesive clusters and flat sheets of cells with a cribriform pattern, in combination with an atypical spindle cell component. The use of the term SSDC seems more appropriate than the term carcinosarcoma , as the immunohistochemical, electron microscopic, and recent molecular findings in this and other biphasic neoplasms imply a monoclonal origin.- - - - - - - - - - ranking = 2.9784983649264keywords = neoplasm (Clic here for more details about this article) |
8/12. Primary ductal adenocarcinoma of the lacrimal gland.OBJECTIVE: To report the case of a 59-year-old man with a right lacrimal gland mass, subsequently diagnosed as primary ductal adenocarcinoma of the lacrimal gland. DESIGN: Interventional case report. methods: We report the clinical presentation, histopathologic and immunohistochemical features, and treatment of a patient with primary ductal adenocarcinoma of the lacrimal gland. The current literature regarding this uncommon neoplasm also is reviewed. RESULTS: Excisional biopsy revealed primary ductal adenocarcinoma of the lacrimal gland. The patient subsequently underwent extensive local resection of the tumor and is awaiting radiotherapy to the orbit and neck. A literature search revealed only 3 prior reports of primary ductal adenocarcinoma of the lacrimal gland. CONCLUSIONS: Although uncommon, primary ductal adenocarcinoma of the lacrimal gland displays characteristic histologic and immunohistochemical findings that allow its distinction from the other primary lacrimal gland adenocarcinomas. awareness and recognition of this rare malignancy may aid in further delineation of its biologic behavior, management, and prognosis.- - - - - - - - - - ranking = 0.99283278830881keywords = neoplasm (Clic here for more details about this article) |
9/12. Increased serum carbohydrate antigen 19-9 in relapsed ductal breast carcinoma.Increased serum carbohydrate antigen (CA) 19-9 is a quite uncommon manifestation of breast cancer both on early disease and on relapse. A 53-year-old woman with invasive ductal breast carcinoma underwent left-sided mastectomy. Two years later she palpated a subcutaneous mass at the mastectomy scar, arousing suspicion of local relapse. Surgery and histopathology revealed infiltration by breast adenocarcinoma and she was treated with chemotherapy. At that time serum tumor markers, carcinoembryonic antigen (CEA) and CA 15-3 were within normal range. Over the next six months she displayed an increase of serum CEA while serum CA 15-3 remained within normal range. In an attempt to search for a second neoplasm possibly of gastrointestinal (GI) origin, abdominal computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangio-pancreatography (MRCP), endoscopy of the upper GI tract and colonoscopy were performed, as well as measurement of serum CA 19-9. While no indication of a GI neoplasm was detected, she displayed an over 10-fold increase of serum CA 19-9. The patient had also an X-ray mammography and technetium-99m hexakis-2-methoxyisobutylisonitrile ((99m)Tc-MIBI) scintimammography (SM). Whilst mammography was negative for contralateral disease recurrence, SM was suggestive of axillary lymph node involvement. Axillary lymph node dissection confirmed an extensive metastatic infiltration of these nodes by breast adenocarcinoma. Three months later serum CA 19-9 and CEA became normal. The interest of this case lies on the unexpected high serum CA 19-9 values found in a breast relapsed adenocarcinoma and in the important contribution of SM in diagnosing the axillary lymph node metastatic infiltration.- - - - - - - - - - ranking = 1.9856655766176keywords = neoplasm (Clic here for more details about this article) |
10/12. skin adnexal neoplasm closely resembling adenomatoid tumor: a unique occurrence.We describe a primary skin neoplasm located in the left chest wall that closely resembled adenomatoid tumor of male and female genital tract. It occurred in a 52-year-old woman who had undergone a left quadrantectomy with regional lymphadenectomy for invasive ductal carcinoma of the breast 7 years previously. The tumor involved the dermis and subcutaneous tissue and measured 0.7 cm in greatest diameter. Immunohistochemical evaluation showed strong positivity for cytokeratin pool and negativity for CD31, calretinin, WT-180, and for estrogen and progesterone receptors. We are unaware of a previous description of this morphologic pattern in a primary skin tumor, which we have interpreted as of skin adnexal and specifically of eccrine sweat gland origin.- - - - - - - - - - ranking = 4.964163941544keywords = neoplasm (Clic here for more details about this article) |
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