1/9. Intra-axial dermoid/epidermoid tumors of the brainstem in children.BACKGROUND: Epidermoid and dermoid cysts are rare intracranial space-occupying lesions, which account for about 1% of all intracranial tumors; they are even rarer in the pediatric age group. Among the various locations, that inside the brain stem is quite exceptional (only 12 cases reported to date in the literature). We report two additional cases occurring in children, underlining their clinical characteristics, the difficulties faced in the diagnostic work-up, and the surgical treatment adopted (which consisted of removal of the cyst contents and partial resection of the cyst membrane, because of its adherence to the surrounding nervous and vascular structures). methods: We report two cases of intraaxial dermoid/epidermoid cysts observed within the last 5 years. Both patients complained of cervico-nuchal pain, with a remittent/intermittent character in one of them; this patient also exhibited transient 6th and 7th cranial nerve deficit. One lesion was approached through the floor of the fourth ventricle, the second one through the ventrolateral aspect of the brainstem. RESULTS: Subtotal tumor resection was achieved in both cases. Both patients had a smooth postoperative course without permanent neurological deficits. In the first patient residual tumor remains stable on follow-up MRI. In the second one, early tumor regrowth necessitated a second operation, after which the residual tumor has remained stable. CONCLUSIONS: Based on our experience we suggest that a cautious surgical approach ("conservative" resection) to these lesions is the best choice. In fact, attempts at radical removal carry unacceptably high morbidity and mortality rates.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/9. Huge corneal dermoid in a well-formed eye: a case report and review of the literature.A 25-day-old boy presented with a left corneal mass and left nasal obstruction. The mass involved the entire cornea with a skin-like surface and protruded outside the palpebral fissure. CT of the orbits disclosed a large cyst coating the entire left cornea, in an eye with a well-formed anterior chamber and a clearly evident lens. CT also revealed left nasal meningo-encephalocele. The eye with the mass was excised. The histopathologic report confirmed the diagnosis of corneal dermoid in an otherwise normally developed eye. This report of a huge dermoid involving the entire corneal diameter and extending into the sclera without ocular alteration posterior to Descemet's membrane is the first such report in the literature. The literature on corneal dermoids is also reviewed.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/9. Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary.Pure sebaceous neoplasms arising in dermoid cysts of the ovary are exceedingly rare. A 63-year-old female with abdominal swelling and pain underwent a right salpingo-oophorectomy that showed a unilocular cyst weighing 830 g and measuring 15x12x10 cm, filled with sebaceous material containing a few hair shafts. The cyst wall exhibited plaques protruding into the cavity of the cyst. microscopy revealed a dermoid cyst with nests and lobules of atypical and infiltrating sebaceous cells surrounded by basaloid cells. The tumor cells stained diffusely for high-molecular-weight cytokeratins and focally for cytokeratin 7, cytokeratin 19, epithelial membrane antigen and carcinoembryonic antigen in the immunohistochemistry study. Low-molecular-weight cytokeratins, cytokeratin 20, vimentin, S100, p63, estrogen receptor, progesterone receptor, p53 and c-erbB-2 were negative in tumoral cells. The proliferative labeling index (Ki67 and proliferating cell nuclear antigen) was low. Basal cell carcinoma with sebaceous differentiation and sebaceoma must be considered in the differential diagnosis. However, the presence of obvious malignant sebaceous differentiation in nearly every tumor nest and lack of peripheral palisading and peri-tumoral myxoid stroma excluded these diagnoses. Some histogenetic concepts relevant to this case are discussed along with a brief review of this neoplasm. To our knowledge, this is the sixth case report of a sebaceous carcinoma arising in a mature cystic teratoma of the ovary.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/9. Small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst.A rare small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst with 7 years survival after conservative surgery and adjuvant chemotherapy with cisplatin, adriamycin, and cyclophosphamide is described. light microscopy showed the typical uniformly small cells with hyperchromic nuclei and scanty basophilic cytoplasm within the mature cystic teratoma. Although none of the immunohistochemical stains were reactive, electron microscopy demonstrated the membrane-bound neurosecretory granules in some tumor cells. The related literature is reviewed and the issues concerning treatment options in this unusual malignancy are discussed.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/9. Two dermoid cysts developing in an accessory ovary and an eutopic ovary.Accessory ovary is a rare gynecologic condition, and tumors arising in accessory ovaries are extremely rare. Accessory ovary may result from separation of migrating ovaries during embryogenesis and injuries such as inflammation and operation on normal ovary. Congenital malformations, most frequently malformations of the genitourinary organ, are seen in connection with the accessory ovary. We experienced the first case of two dermoid cysts developing in an accessory ovary located in the left infundibulopelvic ligament and another in the eutopic ovary at the same side concurrently. Here, we present this extremely rare case with a review of the literature.- - - - - - - - - - ranking = 188.53753269831keywords = ligament (Clic here for more details about this article) |
6/9. Extramammary Paget's disease arising in mature cystic teratoma of the ovary.We report a case of extramammary Paget's disease in ovarian mature cystic teratoma. The patient was a 70-year-old Japanese woman who complained of lower abdominal pain. Examination showed elevation of carcinoembryonic antigen and CA 19-9. ultrasonography and computer tomography revealed a cystic tumor of the left ovary. The gross appearance of the resected ovary was typical for mature cystic teratoma. Microscopic observation revealed a lesion of Paget's disease within the squamous epithelium. The tumor cells had intracytoplasmic mucin and positive immunoreactivity for carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin; but they were negative for S-100 protein and vimentin. On multiple and serial sections, underlying adenocarcinomas were not found either in the ovary or other primary sites. From these pathological findings, we concluded that the disease was an intraepithelial adenocarcinoma, possibly derived from multipotential cells in squamous epithelium of ovarian mature cystic teratoma. This is the first reported case, to our knowledge, of extramammary Paget's disease arising in mature cystic teratoma of the ovary.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/9. Squamous cell carcinoma in situ developing in dermoid cyst of the ovary. Report of a case with laminin immunohistochemical staining demonstrating basement membrane integrity.Among malignancies arising in dermoid cyst of the ovary, squamous cell carcinoma in situ is very unusual and set a problem of diagnosis and prognosis. In fact this diagnosis is very difficult and here we report the case of a 30-year-old woman with a squamous cell carcinoma in a dermoid cyst of the right ovary for which laminin immunohistochemical staining allowed us to prove beyond any doubt the in situ character. This demonstration is of great importance because the prognosis of a squamous cell carcinoma in dermoid cyst depends on the degree of penetration of the tumor; so in this young patient a conservative surgery could be carried out. Four years later the very good evolution confirms the accuracy of the diagnosis of squamous cell carcinoma in situ in dermoid cyst and emphasizes the benefit of laminin labelling in order to rule out the possibility of invasive carcinoma.- - - - - - - - - - ranking = 4keywords = membrane (Clic here for more details about this article) |
8/9. Laparoscopic surgical therapy and staging in a case of early malignant granulosa cell tumor of the ovary.An early right granulosa cell tumor was removed without rupture through the vaginal route after laparoscopic division of the ovarian ligament. Staging biopsies, peritoneal cytology, infracolic omentectomy, pelvic and right infrarenal para-aortic dissection were completed laparoscopically. The patient was discharged on the third day, and she is doing well 22 months postoperatively.- - - - - - - - - - ranking = 188.53753269831keywords = ligament (Clic here for more details about this article) |
9/9. The role of ultrasound biomicroscopy in surgical planning for limbal dermoids.PURPOSE: Limbal dermoids usually involve corneal stroma and more rarely might extend into the anterior chamber. Depending on the size and amount of penetration of the lesion, different therapeutic approaches are indicated. Depth information is difficult to obtain by slit-lamp examination because the structure is opaque. We investigated the use of ultrasound biomicroscopic (UBM) examination for surgical planning in limbal dermoids. methods: The UBM (Zeiss Humphrey) with its 50-MHz probe was used for preoperative evaluation of the depth of penetration in two cases of infantile limbal dermoid. histology specimens of the lesion corresponding to the UBM images were obtained. RESULTS: UBM was able to distinguish normal cornea from the more sonolucent lesion. Presence or absence of Descemet's membrane could be identified. Depth of involvement of limbal dermoids could be assessed. CONCLUSION: UBM is able to assess depth involvement of opaque corneal lesions such as limbal dermoids. Because planning of the surgical approach in these cases is facilitated by preoperative knowledge about the depth of penetration of these opaque lesions, UBM can be regarded as a helpful tool in the clinical management.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |