1/233. An unusual case of epithelial-myoepithelial carcinoma of the liver.The authors present an unusual case of an epithelial-myoepithelial carcinoma of the liver in a 67-year-old man who was admitted for resection of a gastric adenocarcinoma. At operation, a 3 x 3 cm mass in the right liver lobe was also removed. This mass consisted of duct-like structures with dual differentiation. The inner layer was composed of an epithelial lining, and the outer layer consisted of clear cells, all unrelated to the moderately well-differentiated gastric adenocarcinoma. The clear cells were positive for S-100 and alpha-smooth muscle actin, suggesting myoepithelial origin. The mass was considered to be low-grade epithelial-myoepithelial carcinoma. However, the patient had a history of an oral nodule present since childhood, resected 10 years previously. These slides were reviewed and revealed a mixture of clear cells and basal cells with squamous differentiation. In addition, there were duct-like structures with the two-layer pattern found in the liver tumor. This tumor had numerous mitotic figures and showed perineural invasion, suggesting a high grade of malignancy. These findings led to an interpretation of the oral tumor as also being epithelial-myoepithelial carcinoma, which had remained as "benign" for more than 50 years and subsequently underwent malignant transformation. During this long period, liver metastases may have occurred and remained low-grade. Alternatively, the liver and oral tumors may have arisen separately in the foregut during embryologic development, remaining low-grade until malignant transformation occurred.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
2/233. Progression of a Nelson's adenoma to pituitary carcinoma; a case report and review of the literature.A 25-year-old woman developed Nelson's syndrome, 3 years after successful bilateral adrenalectomy for Cushing's disease. Despite pituitary surgery and radiotherapy the tumour showed invasive growth, leading to visual disturbance, paresis of the oculomotor nerve and, 34 years after adrenalectomy, to death by widespread purulent leptomeningitis. autopsy revealed a large adenohypophyseal carcinoma with a metastasis attached to the dura, both tumours showing immunocytochemical staining for ACTH and TSH. We review the literature on metastatic adenohypophyseal carcinoma in Cushing's disease and Nelson's syndrome and discuss the role of proliferation markers as indicators of malignant progression.- - - - - - - - - - ranking = 1149.7416871251keywords = pituitary (Clic here for more details about this article) |
3/233. Parasitic nodule of the thyroid in a patient with Graves' disease.We report a case of a parasitic nodule of the thyroid in a patient with Graves' disease, which mimicked a lymph node metastasis from a primary occult thyroid carcinoma. The patient was a 67-year-old Japanese woman with a past history of subtotal thyroidectomy for Graves' disease, who was referred to our hospital because of a right cervical mass. A lymph node-like lesion measuring 1.5 cm in diameter was palpable, distinct from the remnant of the right thyroid lobe. Thyroid scintigraphy using 123I-Na revealed a hot lesion at the upper lateral portion of the right thyroid lobe, and this was resected. Microscopically, the mass showed thyroid follicles with lymphocytic infiltration and lymphoid follicles. Clear ground glass nuclei, nuclear grooving and intranuclear inclusions were not observed. No morphological evidence of the lymph node was found in the mass by reticulin staining. Parasitic nodules of the thyroid in patients with Graves' disease may mimic a metastatic carcinoma of the thyroid.- - - - - - - - - - ranking = 2keywords = lobe (Clic here for more details about this article) |
4/233. Pituitary metastasis from carcinoma of the urinary bladder mimicking pituitary apoplexy--case report.A 70-year-old male presented with pituitary metastasis from transitional cell carcinoma of the urinary bladder manifesting as sudden headache, transient unconsciousness, and visual disturbance mimicking apoplexy of pituitary adenoma. Computed tomography showed a suprasellar tumor with intratumoral and intraventricular hemorrhage. magnetic resonance imaging demonstrated an intra- and suprasellar mass lesion mimicking pituitary adenoma. diabetes insipidus developed soon after. The tumor was subtotally removed. Histological examination revealed transitional cell carcinoma. An intratumoral hemorrhage may be associated with a pituitary metastasis if the patient presents with symptoms such as pituitary apoplexy.- - - - - - - - - - ranking = 2069.5350368252keywords = pituitary (Clic here for more details about this article) |
5/233. A case of synchronous double primary lung cancer with neuroendocrine features.We report a case of unique double primary lung cancers with neuroendocrine features in a 63-year-old male smoker. The mass in the left lower lobe (LLL) was a small cell/large cell carcinoma with spindle cell sarcomatous areas and organoid structure. The mass in the left upper lobe (LUL) was a tubular adenocarcinoma with neuroendocrine features including organoid nests showing occasional rosette formation, nuclear palisading in the periphery of the nests and positive immunoreaction for CD56, chromogranin a and synaptophysin. The difference in histological structures between the two masses led us to diagnose double primary lung cancer. The combination of small cell lung carcinoma and spindle cell carcinoma is very uncommon. The relationship between LLL and LUL tumors remains unclear. Multiple lung cancers with neuroendocrine features have only rarely been reported in the literature. The patient in our case died of widespread cancer 2 years and 4 months after the surgery without adjuvant chemotherapy, a longer postoperative survival time than in cases of ordinary extensive small cell lung cancer. Multiple lung cancers with neuroendocrine features are extremely rare and similar cases have not been reported in the literature. Neuroendocrine differentiation has attracted widespread attention and, therefore, examining neuroendocrine features in lung cancers is important.- - - - - - - - - - ranking = 2keywords = lobe (Clic here for more details about this article) |
6/233. A patient with brain metastasis from ovarian cancer who showed complete remission after multidisciplinary treatment.We describe a case with brain metastasis from ovarian cancer who showed complete remission after multidisciplinary treatment. The case was diagnosed as epithelial ovarian cancer, FIGO stage IIIc. She underwent cisplatin-based chemotherapy after optimal cytoreductive surgery and achieved clinical complete remission. Thirty-two months after surgery for ovarian cancer, a solitary metastasis occurred in the left frontal lobe of the brain. No recurrent lesions were observed outside the brain. The metastatic tumor was resected. Five days after operation, adjuvant chemotherapy comprising carboplatin and cisplatin was initiated (a total of three courses at 4-week intervals), and whole brain irradiation at 55 Gy was added. After these treatment methods, complete remission of the brain metastasis has been observed for 57 months with good quality of life.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
7/233. Giant adrenal cortical carcinoma, clinically "nonfunctional": report of a case containing cytoplasmic hyaline globules of vimentin.Adrenal cortical carcinoma (ACC) is a rare neoplasm that affects all age groups, with a bimodal peak of incidence, in young individuals in the first decade or two of life and in older subjects in the fifth to seventh decades. It may be clinically "functional" with Cushing's syndrome, virilization, or feminization, or it may be "nonfunctional." We report on the case of a 42-yr-old woman who complained of abdominal pain and a large adrenal tumor measuring 20 cm in size. No endocrine symptoms were observed. Laboratory tests showed increased levels of adrenocorticotropic hormone (ACTH), serum cortisol, and urinary free cortisol. Cytohistologic features were typical of ACC. A striking presence of hyaline cytoplasmatic globules was seen in cytologic smears and histologically, being immunoreactive for vimentin, consistent with an intracellular store of intermediate filaments. The tumor showed high proliferative activity (40%) with Ki-67 and negativity for p53, cerbB2, and bcl-2. Although hyaline globules are more frequent in pheochromocytomas and other neoplasms, they may also be present in ACC. These globules may be observed in cytologic smears. Also, the identification and immunohistochemical characterization of these hyaline globules in metastases may be useful in determining the origin of primary occult tumors. Diagn. Cytopathol. 1999;21:394-397.- - - - - - - - - - ranking = 125.90577461248keywords = intermediate (Clic here for more details about this article) |
8/233. In situ demonstration of parathyroid hormone-related protein mRNA in sclerosing hepatic carcinoma.A 69-year-old man had a hepatic tumour occupying the left and half of the right lobe, with portal vein thrombus. There were hypercalcaemia and hypophosphataemia with increased nephrogenous cyclic adenosine monophosphate; bone metastases were excluded. serum parathyroid hormone-related protein (PTHrP) was elevated, but no increase in intact parathyroid hormone (PTH) or vitamin D3 metabolites was found. At autopsy the histological features were typical of sclerosing hepatic carcinoma. By immunohistochemistry PTHrP was detected in cancer cell nests but not in the fibrous stroma. PTHrP transcripts were demonstrated by in situ hybridization using a polymerase chain reaction (PCR)-derived single-stranded dna probe. Tumour cells expressed AE1 and CA19-9 (markers for cholangioepithelium) and CEA (for bile canaliculi). Electron microscopy revealed microvilli on the apical surface, and secretory granules 100 nm in diameter were observed. These findings indicate that this case is one of cholangiocellular sclerosing hepatic carcinoma. The interaction between cancer and stromal cells may be the cause of PTHrP overexpression.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
9/233. Pituitary carcinoma containing gonadotropins: treatment by radical excision and cytotoxic chemotherapy: case report.OBJECTIVE AND IMPORTANCE: Pituitary carcinomas are extremely rare. Cases reported in the medical literature in the 20th century included tumors that produced adrenocorticotropic hormone, prolactin, growth hormone, and/or thyrotropin. CLINICAL PRESENTATION: Here we present a 22-year-old woman with a pituitary carcinoma that was immunohistochemically positive for luteinizing hormone and follicle-stimulating hormone at both the primary and metastatic sites. The patient exhibited elevated serum levels of alpha-subunit. INTERVENTION: The patient had experienced failure of previous treatments, including standard surgery and radiotherapy, and presented to us for radical resection of the tumor, with exenteration of the involved cavernous sinus. She was pretreated with cytotoxic chemotherapy and continued to receive this therapy after surgery. CONCLUSION: This is the only documented case of a gonadotropin-staining pituitary carcinoma for which hormone production was proven in both the primary and metastatic tumors. Many benign "nonsecreting" pituitary adenomas actually produce subclinical amounts of gonadotropins, and malignant nonfunctional pituitary neoplasms may do the same.- - - - - - - - - - ranking = 919.7933497001keywords = pituitary (Clic here for more details about this article) |
10/233. Functional magnetic resonance image-guided surgery of tumors in or near the primary visual cortex.OBJECTIVE: To assess the accuracy of functional magnetic resonance imaging (fMRI) of the primary visual cortex in patients undergoing surgery for tumors in the occipital lobe. methods: Two patients with nondominant occipital lobe tumors were studied, one with a solitary lung metastasis and another with radiation necrosis after radiosurgery for a low-grade astrocytoma. At surgery, visual evoked potentials (VEPs) were stimulated using light-emitting-diode goggles and recorded using cortical grids placed immediately after brain exposure. The location of the peak VEP was compared to that predicted by the registered functional scan. RESULTS: In each case, the epicenter of visual activation as represented on the registered fMRI corresponded to the site of peak VEP recording. Prediction error for the visual cortex, measured in patient 1, was 1.0 mm. Visual confirmation showed the registration in the second patient to be accurate as well. CONCLUSION: As previously demonstrated for sensorimotor fMRI, visual fMRI accurately predicts the location of the primary visual cortex. Additional confirmation is expected with more clinical experience.- - - - - - - - - - ranking = 2keywords = lobe (Clic here for more details about this article) |
| | Next -> |