1/61. Malignant fibrothecomatous tumour of the ovary: diagnostic value of anti-inhibin immunostaining.Malignant ovarian tumours of the fibrothecoma group are rare. The clinicopathological features of a case of ovarian malignant fibrothecoma in which there was metastatic disease in the small intestine and peritoneum at presentation are described. A number of differential diagnoses were considered but positive immunohistochemical staining of the resected ovarian and small intestinal neoplasms with anti-inhibin was of value in confirming a sex cord-stromal tumour and in excluding other lesions. The two tumours were also ultrastructurally identical. Classical malignant fibrothecomas are said to show four or more mitotic figures per 10 high power fields (HPF). Although the intestinal secondary was mitotically active, the primary ovarian tumour contained only one to two mitoses per 10 HPF, showing that formal mitotic counts are not an absolute indicator of malignant behaviour in this group of tumours.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/61. Inflammatory myofibroblastic tumor with extensive involvement of the bowel in a 7-year-Old child.We present a case of unusual localization of inflammatory fibroblastic tumor in the terminal ileum, cecum, and ascending colon in a 7-year-old child. Segmental resection of the terminal ileum, cecum, and ascending colon with a tumor mass up to 6 cm in diameter was performed. Pathohistological examination of biopsy specimen was performed on routine hematoxylin-eosin sections, as well as immunohistochemically with primary antibodies to CD3, CD20, CD68, factor viii, vimentin, smooth muscle actin, desmin, cytokeratin and S-100 protein, and k and l light chains. The tumor was composed of highly vascularized tissue with interlacing fascicles of elongated spindle cells admixed with plasma cells, histiocytes, lymphocytes, and eosinophils. The diagnosis of inflammatory myofibroblastic tumor was confirmed by immunohistochemistry. Inflammatory myofibroblastic tumor cannot be distinguished clinically from highly malignant neoplasm or some other conditions. Surgical resection and careful pathohistological analysis are needed, and a long-term follow-up is recommended.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/61. Gastro-intestinal stromal tumor (GIST): case report.Gastro-intestinal stromal tumors (GISTs), as currently defined, represent the largest category of primary non epithelial neoplasms of the gastrointestinal tract. They arise from mesenchymal cells located in the wall of the organ and show a remarkable variability in their differentiation pathways. For this reason there is relevant degree of confusion in their interpretation. On the basis of immunohistochemical and ultrastructural studies these neoplasms are divided into several categories: leiomyomas, schwannomas and less differentiated tumors referred as GIST. In the small bowel GIST are uncommon. Usually asymptomatic, they could be the cause of surgical emergencies like massive bleeding, obstruction, intussusception or perforation. Generally benign, an higher percentage of malignant cases are described in the small bowel. The Authors report a case of malignant GIST of the small intestine presented with bowel obstruction by ileal invagination. In this case, as usually it happens in malignant GIST, the final diagnosis was obtained by an abdominal surgical exploration.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
4/61. Malignant fibrous histiocytoma of the ileum at a site of previous surgery: report of a case.Sarcomas rarely arise in the intestinum, and leiomyosarcoma represents the majority of cases. With only seven cases reported in the available English literature up to now, malignant fibrous histiocytoma of the small intestine is exceedingly rare. Moreover, follow-up data are almost completely unavailable. We present herein the unique case of a malignant fibrous histiocytoma arising in a postoperatively adherent intestinal loop. To the best of our knowledge, this is the first such case ever to be described. The clinical history and the intraoperative findings suggested that chronic postoperative repair processes might have been a promoting factor in the tumorigenesis of this neoplasm, on the analogy of malignant fibrous histiocytoma arising at different sites. The patient recovered well but 9.5 years after surgical removal, a solitary recurrent tumor developed in the urinary bladder and progressed rapidly, highlighting the need for long-term, possibly life-long, surveillance of patients with this rare type of intestinal cancer.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/61. Ileal intussusception due to intestinal metastases from primary malignant melanoma of the lung.Primary malignant melanoma of the lung (PMML) is an uncommon tumor with very few cases reported in the literature that satisfy the required criteria to establish a primary bronchial origin. We report a case of a 44-year-old man with acute abdominal distress and a right pulmonary roentgenographic opacity. A cranial-thoracic-abdominal CT scan confirmed the presence of a pulmonary nodule with bilateral cerebral metastases and marked dilatation of intestinal loops. At laparotomy an ileal intussusception was noted and an ileal resection was done. The resected intestinal segment contained three endoluminal polypoidal formations. Histological and immunohistochemical analyses showed the presence of multiple sites of melanoma. These lesions as well as the brain lesions clearly appeared metastatic. The patient underwent further evaluation to identify a primary site of melanoma; bronchoscopy was performed with biopsy of the pulmonary nodule. pathology revealed a neoplastic process of fusiform cells, with focal presence of melanic inter- and extracellular pigment. The immunohistochemical analysis confirmed the diagnosis of PMML. We discuss the criteria for diagnosis and histogenesis of PMML along with this unusual presentation.- - - - - - - - - - ranking = 0.00013368912874237keywords = brain (Clic here for more details about this article) |
6/61. adenocarcinoma with extensive neuroendocrine differentiation arising in an ileal diverticulum: report of a case.A 62-year-old man presented with right-sided abdominal pain. Radiologic examinations disclosed a solid tumor in the ileocecal mesentery that obstructed the right ureter, thus resulting in urinary extravasation. An en bloc tumor resection with the ascending colon, the terminal ileum, and a portion of the right ureter was performed. Histopathologically, the tumor was adenocarcinoma with extensive neuroendocrine differentiation which had arisen in an ileal diverticulum. The patient developed metastases to the lymph nodes, liver, and brain, and died 18 months after surgery.- - - - - - - - - - ranking = 0.00013368912874237keywords = brain (Clic here for more details about this article) |
7/61. intussusception as the initial manifestation of AIDS associated with primary Kaposi's sarcoma: a case report.Kaposi's sarcoma (KS) is the most common AIDS-associated neoplasm. It involves the gastrointestinal tract, skin and lymph nodes with about equal frequency. However, most cases of gastrointestinal KS are clinically silent and found incidentally. We report the case of a 31-year-old homosexual man who developed intussusception in association with a primary ileal KS. He was admitted due to abdominal pain lasting 2 hours. Flat abdominal roentgenogram revealed small bowel ileus in the central abdomen. Abdominal sonography and computerized tomography revealed an intraluminal soft tissue mass in the small intestine with an intussusception. Exploratory laparotomy found an ileal tumor mass 90 cm proximal to the ileocecal valve. Pathologic examination of the resected intestine showed KS. hiv-1 infection was confirmed by Western blot. The CD4 T-cell count was 59/mm3. In conclusion, intussusception by enteric KS may present as the initial AIDS-associated neoplasm in patients with HIV infection.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
8/61. Stromal tumor in a perforated Meckel's diverticulum: a case report.Stromal tumors are rare neoplasms of the small bowel that locate in Meckel's diverticulum with high preference. Perforation of those tumors is very uncommon. There are 96 cases reported in current literature, including only 6 perforations. The diagnosis of that kind of tumor is very difficult because of lack of pathognomonic signs and symptoms. The clinical presentation include abdominal pain, intestinal bleeding, abdominal mass, intestinal obstruction and less commonly, acute perforation. We report the case of a 61-years old patient with a poorly differentiated stromal tumor in a perforated Meckel's diverticulum. The difficulty of identifying a stromal tumor preoperatively and the therapeutic options are emphasised. It is suggested that an aggressive attitude should be taken in the preoperative management of any patient over 50 years of age who presents with melena and abdominal pain.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/61. carcinoid tumor in a Meckel's diverticulum: hypothesis on mutual embryological origin.Congenital defects presenting at an adult age are subject to diagnostic errors because of their relative rarity and often odd clinical presentation. We illustrate a 63-year-old male patient with multiple ileal carcinoid tumors along with a carcinoid tumor in Meckel's diverticulum. The Meckel's diverticulum is a congenital abnormality arising from a patent vitelline duct and is found at the anti-mesenteric side of the ileum. In the Meckel's diverticulum, ectopic tissue or neoplasms are sometimes found, which may lead to intussusception, hemorrhage, or inflammation. The carcinoid tumor is a neuroendocrine neoplasm originating from the neural crest and is diagnosed at virtually all ages. It may exhibit malignant behavior but generally has a mild clinical course. It is most often found in endodermally derived organs, especially the digestive and pulmonary tracts, and coexists frequently with malignant tumors, predominantly of endodermal origin such as colorectal carcinoma. The carcinoid tumor and Meckel's diverticulum are known to coincide, whereas the carcinoid is not really considered to be an embryologically determined defect. We hypothesize that both lesions are derived from local erroneous interaction among the neural crest and the endoderm.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
10/61. Mantle zone lymphoma in a gastric glomus tumor.A 61-year-old man had an ileocolectomy for resection of an obstructing lesion of the terminal ileum, which proved to be a mantle zone variant of intermediate lymphocytic lymphoma. At laparotomy, an intramural nodule in the gastric antrum was observed; on resection, this was found to be a typical gastric glomus tumor, focally infiltrated by lymphoma. This combined tumor has not been described previously, to the knowledge of the authors, and could be misdiagnosed easily, although both components should be considered in the differential diagnosis of small cell gastric neoplasms and can be identified readily by immunohistochemical studies.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
| | Next -> |