1/11. Gigantic jejunal leiomyosarcoma.Jejunal leiomyosarcoma is a rare neoplasm. We report a case of gigantic leiomyosarcoma of the jejunum in a 30-year old man who presented with abdominal distension, pain and constipation. Computerized tomography scan revealed a giant tumor filling the entire abdominal cavity. Fine needle aspiration cytology was suspicious. At laparotomy, a huge jejunal leiomyosarcoma measuring 30 x 25 x 19 cm and weighing 13 kg was completely excised. To the best of our knowledge, this is the first case of a giant jejunal leiomyosarcoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/11. Jejunoileal alveolar rhabdomyosarcoma. A case report.Intestinal localization of rhabdomyosarcoma is exceptional, this case is the first to be published in the world literature. A 35-year-old patient with abdominal pain, fever, was found to have an infiltrative white-grey tumour, involving 20 cm the jejunoileal wall and also the surrounding mesenterium up to the origin of upper mesenterical vessels and lymph nodes. Histologic examination showed an alveolar type of rhabdomyosarcoma intricated with solid undifferentiated tumoral cells. The presence of multinucleated giant cells and the positivity of protein s 100 reaction was important for differential diagnosis, given the alveolar soft part sarcoma, malignant mesothelioma, malignant melanoma or papillary carcinoma.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
3/11. Sarcomatoid carcinoma of the small intestine: a case report and review of the literature.Sarcomatoid carcinoma of the small bowel is rare; to our knowledge, 19 cases have been reported to date in the English literature under several names. We report an additional case occurring in the jejunum of a 55-year-old man. The tumor was a polypoid 7.5-cm mass, which infiltrated the full thickness of the intestinal wall and the serosa of an adhesed loop of small bowel. On microscopic examination, the neoplasm was composed of sheets of spindle cells; focally, an anaplastic component was present, including tumor giant cells with bizarre nuclei. On immunohistochemical stains, tumor cells were positive for cytokeratin 7, cytokeratin AE1/AE3, vimentin, and focally, epithelial membrane antigen. No staining for cytokeratin 20 was found. Sarcomatoid carcinoma must be kept in mind in the differential diagnosis of malignant spindle cell tumors of the small bowel. As consensus regarding the terminology of these rare tumors is being reached, immunohistochemical stains are essential for accurate diagnosis.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
4/11. Primary lung cancer arising from the wall of a giant bulla.We report a 58-year-old man who underwent surgical treatment of primary lung cancer arising from the wall of a giant bulla. Chest roentgenography and computed tomography revealed multiple emphysematous bullae in the bilateral upper lobes, and a right upper giant bulla with a mass measuring 6 cm arising on the bulla wall. Right upper lobectomy was performed, the postoperative pathological diagnosis was large cell carcinoma arising from the wall of a giant bulla. Although the postoperative course was uneventful and he was discharged, he underwent partial resection of the jejunum for recurrence of carcinoma in the jejunum, and postoperative chemotherapy, and he was alive 20 months after that operation. In general, patients with both pulmonary bullous disease and primary lung cancer have a very poor prognosis, because they receive treatment when the tumor is at an advanced stage. On the basis of our review of the literature, we recommend that middle-age male patients with a giant bulla who smoke should have annual chest roentgenography and/or chest computed tomography to screen for lung cancer arising in or close to the bullous disease, and that a giant bulla should be resected in patients older than 50 years because of the high incidence of coexisting cancer and bulla, to improve the prognosis of this disease.- - - - - - - - - - ranking = 4.5keywords = giant (Clic here for more details about this article) |
5/11. Double jejunal intussusception in an adult with chronic subileus due to a giant lipoma: a case report.We present a case of a 40-year-old male with a clinical history of intermittent intestinal occlusion, abdominal pain and moderate weight loss. physical examination and laboratory tests were unremarkable. diagnostic imaging including CT, MR and small-bowel barium x-rays provided evidence of a jejunal lesion of an unknown nature downstream of the ligament of Treitz. Only at surgery was it possible to identify a double intussusception due to a giant stalked polyp which the histological examination revealed to be a submucosal lipoma.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
6/11. Clear cell sarcoma-like tumor with osteoclast-like giant cells in the small bowel: further evidence for a new tumor entity.Most mesenchymal neoplasms of the gastrointestinal tract belong to the category of gastrointestinal stromal tumors (GISTs) and are characterized by the immunohistochemical expression of KIT receptor. In cases without detectable KIT receptor expression several differential diagnoses have to be taken into consideration. Here, we report a case of a 41-year-old man with a tumor of the small bowel composed of large epithelioid tumor cells arranged in solid and alveolar sheets including scattered osteoclast-like multinucleated giant cells. Immunohistochemically, the tumor cells expressed strongly S-100 protein, vimentin, and to a lesser extent, bcl-2. HMB-45, melan-A, KIT receptor, desmin, smooth-muscle actin, and CD-34 were not detectable. Ki-67 index was 20%. The diagnosis was established by 2 different FISH strategies demostrating the presence of a t(12;22)(q13;q12) translocation, the diagnostic hallmark of clear cell sarcoma of soft parts. Our results provide further evidence for the existence of a new tumor entity designated gastrointestinal clear cell sarcoma with osteoclast-like giant cells. The diagnosis of this entity should be considered in the presence of S-100-positive tumors of the gastrointestinal tract containing multinucleated giant cells and can be established by FISH analysis.- - - - - - - - - - ranking = 3.5keywords = giant (Clic here for more details about this article) |
7/11. Primary liposarcoma of the jejunum.The rare case of a primary liposarcoma of the jejunum in a 52-year-old man is described. The main tumor mass was located within the submucosa and caused chronic subileus by subtotal obstruction of the jejunum. The histology showed a mixed type liposarcoma. In the main mass features of well differentiated lipoma-like and sclerosing liposarcoma predominated. In the tumor periphery they were combined with areas of pleomorphic liposarcoma, consisting of tightly packed giant lipoblasts. After an incomplete resection well differentiated sclerosing and pleomorphic liposarcoma recurred within the intestinal wall and in the mesentery near the primary anastomosis. The unusual primary site and pattern of spread of the tumor are discussed and the literature is reviewed.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
8/11. leiomyoma of the small intestine with giant cyst formation. Case report.A case of small-intestinal leiomyoma presenting as a large intra-abdominal cyst is reported. Cystic degeneration is a common feature of leiomyoma, but presentation of this tumour as a giant cyst is uncommon.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
9/11. Malignant neuroendocrine tumor of the jejunum with osteoclast-like giant cells. Enzyme histochemistry distinguishes tumor cells from giant cells.We report a case of a neuroendocrine tumor of the jejunum metastatic to the liver in a 26-year-old woman. light and electron microscopy of this tumor revealed a poorly differentiated neoplasm composed of clusters of round to polygonal cells compatible with a diagnosis of neuroendocrine tumor. In the absence of identifiable silver-staining granules or immunocytochemical demonstration of a specific hormone product in tumor cells, this tumor cannot be further classified among the various neuroendocrine tumors that may arise in this location. However, interspersed among tumor cells was a distinct population of multinucleate giant cells having an appearance similar to benign osteoclasts. Enzyme histochemistry for 5'-nucleotidase, acid phosphatase, and nonspecific esterase each showed a dichotomous staining pattern for the small tumor cells and giant cells and suggest that the giant cells are not tumor derived, but represent a second, presumably reactive, cell population.- - - - - - - - - - ranking = 5.5keywords = giant (Clic here for more details about this article) |
10/11. Small intestinal carcinoma with osteoclast-like giant cells.An elderly woman underwent jejunectomy for a large, stenosing neoplasm. Histologically, we found an undifferentiated carcinoma with scattered mononuclear and multinuclear macrophages in the intestine and lymph node metastases. The multinuclear cells, being acid phosphatase-positive and CD68-immunoreactive, are referred to as osteoclast-like giant cells. Hepatic secondaries were discovered 6 months postoperatively. The patient succumbed to a chemotherapy-related septic event. We suggest that intratumoral infiltration by mononuclear and multinuclear macrophages expresses one of the body's defense mechanisms against cancer.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
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