1/94. Rapid progression of squamous cell carcinoma of the cervix after hyperbaric oxygenation.The role of hyperbaric oxygenation in the treatment of radiation-induced sequelae and chronic ulcer is well established. On the contrary, a possible cancer-causing or growth-enhancing effect by hyperbaric oxygenation was highly controversial. Herein, we present a 55-year-old Chinese woman with recurrent squamous cell carcinoma of the cervix on her left inguinal area. She received concurrent chemoradiation therapy followed by radical inguinal lymphadenectomy due to persistent tumor mass. The patient was complicated with severe radiation fibrosis and unhealed wounds, so she was treated with hyperbaric oxygenation (HBO). However, the patient died of complications of the disease after completing HBO therapy I month later and autopsy of the patient showed carcinomatosis of the abdominal cavity and lower abdominal wall. Because previous studies have been inconclusive regarding the effect of HBO on tumor cells, we reviewed the possible relation between the HBO and tumor cells.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/94. Carcinoma in villous adenoma of ascending colon associated with sarcoid reaction in the regional lymph nodes.A 79-year-old woman was admitted to our hospital due to continuous anal bleeding. colonoscopy showed a huge villous tumor on the middle area of the ascending colon. A typical right colectomy and lymph node dissection were performed. The resected specimen showed a villous type tumor located on the ascending colon. The histopathologic investigation demonstrated a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma and extending to the submucosa. Although there was no evidence of metastatic carcinoma in the dissected lymph nodes, epithelioid cell granulomas with multinucleated giant cells lacking in the central caseous necrosis suggested sarcoid reaction.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
3/94. A case of resectable lung adenocarcinoma associated with sarcoidosis.A 71-year-old woman with uveitis was referred to our hospital for further examination of the possible underlying diseases. In roentgenological examination with plain X-ray and CT scan, hilar and mediastinal lymphadenopathy and a mass shadow in the right upper lung field was observed, whereas fibrotic changes were not obvious in both lung fields. Transbronchial lung biopsy with fiberoptic bronchoscope revealed granulomatous interstitial pneumonia. CD4-positive lymphocytes were increased in bronchoalveolar lavage. The patient was diagnosed as having sarcoidosis. Subsequently, right upper lobectomy was performed, and Stage I lung adenocarcinoma was diagnosed. The patient is under follow up without medication and the disease has been stable for two years. A relationship between epithelioid granulomatosis and malignant diseases is discussed and a review of the literature is given. Since it is still controversial as to the incidence of malignant diseases in sarcoidosis patients, it is important to accumulate data on these associations.- - - - - - - - - - ranking = 0.83333333333333keywords = carcinoma (Clic here for more details about this article) |
4/94. An unusual late radiotherapy-related complication requiring surgery in anal canal carcinoma.We herein describe an unusual late radiation-related complication requiring surgery in a 60-year-old male affected by anal epidermoid carcinoma. The patient presented with obstructed defecation and ulcerated perianal lesions. The perianal biopsies were positive for anal squamous carcinoma. Transanal diagnostic investigations could not be performed because of anal stenosis. Computed tomography detected left inguinal lymphadenopathy and a nonhomogeneous presacral mass, infiltrating the rectal wall, the coccyx, and the sacrum. The patient underwent a colostomy, infusion of cisplatin and 5-fluorouracil, and irradiation of the pelvis, perianal region, and inguinal lymph nodes. In June 1997 the patient complained of the onset of continuous pain at the genitalia, and for penis necrosis he underwent penis amputation. The histologic examination was conclusive for postradiotherapy thrombosis. This complication could strengthen the hypothesis of vasculoconnective damage as the origin of long-term effects of radiotherapy. Probably the minimal dose in transit volume could not be achieved. Careful evaluation in choosing the treatment scheme is necessary if different options are available.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
5/94. Primary neuroendocrine carcinoma with ganglion cell differentiation in a crural lymph node.A primary neuroendocrine carcinoma with ganglion cell differentiation is described in a crural lymph node. The patient, a 48-year-old woman, presented a palpable lymph node of the crural region in March 1994. Histologically, the lesion was composed mostly of small cells immunoreactive for cytokeratins, neuron specific enolase and synaptophysin. The small cells merged gradually with areas containing ganglion cells immersed in a fibrillar matrix resembling neuropil. Ganglion cells expressed neuron-specific enolase, synaptophysin, neurofilament proteins and S-100 protein. Moreover, a minority of them featured cytokeratin expression. Electron microscopy was performed in the small cell component. These cells featured attenuated desmosomes and electron dense granules with an average size of 120 nm within bundles of intermediate filaments. Clinically, no tumour was found elsewhere despite extensive work-up over the 76-month follow-up period. Although similarities with previous cases of primary neuroendocrine carcinoma of lymph node, ganglion cell differentiation has never been described.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
6/94. Clinical implications and value of immunohistochemical staining in the evaluation of lymph node infarction after fine-needle aspiration.We report on a series of 3 patients who underwent fine-needle aspiration (FNA) for clinically apparent lymphadenopathy. In all 3 cases, a diagnosis of malignancy was rendered based on cytologic findings (two metastatic squamous-cell carcinomas and one melanoma). However, initial follow-up surgical pathology reported only "extensive coagulative necrosis, no viable tumor seen." Subsequent immunohistochemical stains (cytokeratins (AE1/AE3), HMB45, S100, and Melan A) demonstrated the presence of metastatic tumor in the area of infarction in each case, thus establishing the presence of metastatic tumor and correct interpretation of the initial FNA. We conclude, based on our own experience and a few previously reported cases, that total infarction of the lymph nodes following FNA can occur, and immunohistochemistry can be helpful in clinical management.- - - - - - - - - - ranking = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
7/94. Unusual case of metastatic thyroid nodule: nonpalpable breast mass as origin.OBJECTIVE: To document a case of thyroid cancer metastatic from the breast. methods: We present the clinical, laboratory, radiologic, and biopsy findings in our patient and review the related literature. RESULTS: A 47-year-old female patient was referred to our clinic because of dyspnea and generalized bone pain. physical examination revealed a diffusely enlarged nodular goiter, and fine-needle aspiration biopsy demonstrated intrathyroidal anaplastic cells. Total thyroidectomy was done, and the histopathologic diagnosis was anaplastic carcinoma. Unexpected rapid progression of the disease with cervical and intrathoracic lymphadenopathies and osteoblastic metastatic lesions without radioiodine uptake prompted us to attempt to rule out a primary nonthyroidal malignant lesion metastatic to the thyroid gland. The plasma level of CA 15-3 was profoundly increased (388 U/mL). Detailed reassessment of the patient disclosed a small mass in the right mammary gland with histopathologic features similar to those of the thyroidectomy material. Reevaluation of the thyroid specimens resulted in a final diagnosis of primary breast carcinoma in conjunction with metastatic carcinoma of the thyroid. CONCLUSION: Thorough systemic clinical assessment of a patient with a thyroid nodule and careful study of biopsy specimens should be done to ascertain whether the nodule is a primary or a metastatic lesion.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
8/94. leiomyomatosis of mesenteric lymph nodes associated with duodenal adenocarcinoma.leiomyomatosis of lymph nodes is an extremely rare disease. Only a few cases have previously been reported in pelvic lymph nodes. They were related to a benign uterine leiomyoma, a metastasizing uterine leiomyoma, an endometrial adenocarcinoma, and an ovarian endometrioid carcinoma. We report on a case of leiomyomatosis of the mesenteric lymph nodes associated with a duodenal adenocarcinoma with no history of uterine leiomyoma or any gynecological malignancy. The patient, a 56-year-old woman, was found to have an adenocarcinoma of the duodenum. All mesenteric lymph nodes removed showed leiomyomatosis, which was verified by immunohistochemical study showing positive immunostaining for smooth muscle actin, desmin, and vimentin, but negative staining for HMB-45. It is necessary to make a differential diagnosis from other examples of spindle cell proliferation involving lymph nodes such as a hemorrhagic spindle cell tumor with amianthoid fibers (palisade myofibroblastoma), angiomyolipoma, lymphangiomyomatosis, inflammatory pseudotumor, and Kaposi's sarcoma.- - - - - - - - - - ranking = 1.3333333333333keywords = carcinoma (Clic here for more details about this article) |
9/94. Metastatic basal cell carcinoma presenting as unilateral axillary lymphadenopathy: report of a case and review of the literature.BACKGROUND: Although basal cell carcinoma (BCC) is one of the most common forms of cancer worldwide, the incidence of metastatic basal cell carcinoma (MBCC) is exceedingly low. Of reported cases, it is estimated that up to 85% arise in the head and neck region. OBJECTIVE: Case presentation of a BCC measuring 1.1 cm arising in a nonfacial site that presented with unilateral axillary lymphadenopathy. methods: Case presentation with literature review. RESULTS: risk factors which should lead to a higher index of suspicion among clinicians for identifying these patients include large tumor size, previous irradiation, local invasion, and recurrence. The lymph nodes, lungs, bones, and skin are among the most common sites in which metastases arise. CONCLUSION: We report an unusual case of MBCC arising from a small, nonfacial primary BCC that presented with unilateral axillary lymphadenopathy.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
10/94. Generalized lymphadenopathy: a rare presentation of disseminated prostate cancer.Prostate cancer most often metastases to regional lymph nodes and bones by hematogenous or lymphatic spread. Metastases to the supradiaphragmatic nodes are rare. A 56-yr-old male smoker with generalized lymphadenopathy was referred to our center with the complaints of weight loss of 15 kg and severe back and leg pain. On computed tomography of the thorax and abdomen, massive mediastinal, intra-abdominal, retroperitoneal, and inguinal lymphadenopathies with hydroureteronephrosis of the left kidney were noted. Excisional biopsy of left cervical lymph node revealed metastasis of prostatic adenocarcinoma and transrectal biopsy of the prostate disclosed poorly differentiated adenocarcinoma. bone marrow aspiration biopsy, done for the differential diagnosis of anemia, also showed infiltration with prostate-specific antigen positive neoplastic cells. Supradiaphragmatic spread of prostate cancer has been postulated to be by a hematogenous route via the vertebral venous system, or Batson's plexus, accessible via direct extension from the primary cancer site.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
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