1/352. Microvascular reconstruction of the skull base: indications and procedures.PURPOSE: The aim of the current study was to review the use of free tissue transfer for reconstruction of the skull base and for coverage of intracranial contents. patients AND methods: From 1990 until 1996, revascularized flaps were transferred to the skull and the skull base in 11 patients in whom intracranial/extracranial resection of tumors of the skull base was performed in cooperation with the Department of neurosurgery. The defects resulted from removal of squamous cell carcinomas (n = 4), basal cell carcinomas (n = 4), malignant melanoma, malignant schwannoma, and malignant meningioma. Defect repair was accomplished by revascularized transfer of latissimus dorsi muscle flaps in seven cases and rectus abdominis flaps and forearm flaps in two cases each. In five patients with extensive intracranial tumor spread, reconstruction was performed for palliative reasons. RESULTS: A safe soft tissue closure of the intracranial and intradural space was achieved in all patients, whereas the contour of the facial skull and the neurocranium was satisfactorily restored at the same time. By using the entire length of the grafted muscle, the vascular pedicle could be positioned next to the external carotid artery and conveniently connected to the cervical vessels. The mean survival time of the patients with palliative treatment was 8.4 months, with an average duration of hospital stay of 24.5 days. CONCLUSIONS: Despite the increased surgical effort of revascularized tissue transfer, microvascular reconstruction of large skull base defects appears to be justified, even as a palliative measure.- - - - - - - - - - ranking = 1keywords = carcinoma, squamous cell (Clic here for more details about this article) |
2/352. Cytologic diagnosis of metastatic ovarian adenocarcinoma in the urinary bladder: a case report and review of the literature.A 53-yr-old woman with a 13-mo history of recurrent ovarian papillary serous adenocarcinoma presented with persistent microscopic hematuria. The patient was undergoing chemotherapy for her recurrent ovarian tumor when she was referred to the urology service for microscopic hematuria. An intravenous pyelogram was normal. cystoscopy was performed, as well as a urinary bladder washing and mucosal biopsies for examination. adenocarcinoma similar to the patient's primary ovarian tumor was detected in both cytology and histopathology specimens. Ovarian carcinoma comprises 1.3-4.0% of all metastatic neoplasms to the urinary bladder and is an important consideration in the differential diagnosis of a cytologic finding of adenocarcinoma in urine specimens of female patients, where it accounts for an even higher percentage of cases (1 of 3 adenocarcinoma diagnoses in a series of 4,677 urine specimens from female patients).- - - - - - - - - - ranking = 4.3018309163708keywords = carcinoma (Clic here for more details about this article) |
3/352. Paraneoplastic opsoclonus-myoclonus secondary to malignant melanoma.Opsoclonus-myoclonus is a well-described paraneoplastic syndrome that most often occurs in association with small cell carcinoma of the lung and breast carcinoma. To the best of our knowledge, we describe the first reported case of paraneoplastic opsoclonus-myoclonus occurring is association with malignant melanoma. Antineuronal antibodies were not identified despite repeated testing. No therapeutic benefit was observed following corticosteroid administration.- - - - - - - - - - ranking = 0.95596242586017keywords = carcinoma (Clic here for more details about this article) |
4/352. Intraosseous epithelioid malignant peripheral nerve sheath tumor of the phalanx. Case report.We report the first case of intraosseous epithelioid malignant peripheral nerve sheath tumor (MPNST) occurring in the phalanx. The patient was a 50-year-old Japanese man with an intramedullary lytic lesion of the proximal phalanx. Microscopically, the tumor was composed of epithelioid cells or polygonal cells, forming large cell nests with central necrosis. Most tumor cells were diffusely and strongly immunopositive for S-100 protein and vimentin, and negative for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, alpha-smooth muscle actin, and HMB-45. laminin-positive material was discontinuously demonstrated between the individual tumor cells. Electron microscopy showed prominent external lamina. Our case indicated that laminin is useful for differentiating epithelioid MPNST from metastatic carcinoma and malignant melanoma.- - - - - - - - - - ranking = 0.47798121293008keywords = carcinoma (Clic here for more details about this article) |
5/352. blindness as a consequence of a paraneoplastic syndrome in a woman with clear cell carcinoma of the ovary.BACKGROUND: paraneoplastic syndromes are rare conditions associated with cancer that result in serious disease states at unique sites. In 1982, a report of bilateral diffuse uveal melanocytic proliferation associated with nonocular cancers which resulted in blindness was reported. We present a case of a woman with recurrent ovarian cancer who developed this paraneoplastic syndrome. CASE: A 55-year-old woman had been diagnosed in 1990 with an ocular melanoma of her right eye and in 1994 with clear cell carcinoma of the ovary. With recurrence of ovarian cancer, new eye lesions were identified in both eyes. After enulcleation of her right eye, an ocular melanoma and diffuse bilateral melanocytic proliferation (BDUMP) were found. The sight in her left eye continued to deteriorate as other signs of BDUMP occurred in the eye. Within 1 month of diagnosis, the patient was blind. She subsequently succumbed to progression of ovarian cancer. CONCLUSION: Recurrent ovarian cancer is usually an intraabdominal disease that results in gastrointestinal dysfunction. This case illustrates a rare paraneoplastic syndrome associated with ovarian cancer that mimics metastatic disease to the eye, but has a different pathophysiology.- - - - - - - - - - ranking = 2.3899060646504keywords = carcinoma (Clic here for more details about this article) |
6/352. xeroderma pigmentosum variant associated with multiple cancers.A 62-year-old Japanese man with xeroderma pigmentosum (XP) variant is reported. The patient had developed at least 6 basal cell carcinomas, a squamous cell carcinoma, and a malignant melanoma on sun-exposed areas, and an atypical carcinoid on the right lung. In vivo phototesting showed a normal response. The minimal erythema dose of ultraviolet B (UVB) was not lowered and no delayed peaking of the erythema reaction was observed. His skin fibroblasts exhibited higher sensitivity to UV irradiation, but a normal level of unscheduled dna and rna synthesis. Cell fusions with XP group A, C, D, E, F, and G cells after UV irradiation were all complemented. Previous reports together with this case suggest that older XP variant patients have a high frequency of not only skin cancers, but also internal malignancies.- - - - - - - - - - ranking = 1keywords = carcinoma, squamous cell (Clic here for more details about this article) |
7/352. pancreaticoduodenectomy for metastatic tumors to the periampullary region.Although operative resection of metastatic lesions to the liver, lung, and brain has proved to be useful, only recently have there been a few reports of pancreaticoduodenectomies in selected cases of metastases to the periampullary region. In this report we present four cases of proven metastatic disease to the periampullary region in which the lesions were treated by pancreaticoduodenectomy. Metastatic tumors corresponded to a melanoma of unknown primary site, choriocarcinoma, high-grade liposarcoma of the leg, and a small cell cancer of the lung. All four patients survived the operation and had no major complications. Two patients died of recurrence of their tumors, 6 and 63 months, respectively, after operation; the other two patients are alive 21 and 12 months, respectively, after operation. It can be inferred from this small but documented experience, as well as a review of the literature, that pancreaticoduodenectomy for metastatic disease can be considered in selected patients, as long as this operation is performed by experienced surgeons who have achieved minimal or no morbidity and mortality with it.- - - - - - - - - - ranking = 0.47798121293008keywords = carcinoma (Clic here for more details about this article) |
8/352. breast carcinoma diverging to aberrant melanocytic differentiation: a case report with histopathologic and loss of heterozygosity analyses.A case of primary breast cancer showing differentiation to malignant melanoma is reported. To obtain insight into the clonal relationship between the two components of the tumor, polymerase chain reaction-based microsatellite analysis to detect loss of heterozygosity on chromosome arms 1p, 1q, 3q, 4q, 6q, 8p, 9p, 10q, 11q, 13q, 16q, 17p, 17q, and 18q with microdissected tissues of both components was performed in addition to histologic, histochemical, immunohistochemical, and ultrastructural techniques. The tumor consisted of a combination of carcinoma and melanoma with morphologic transition. Metastases in the lymph nodes and thoracic spinal bone marrow showed dual tissue structure. One of the metastatic lung tumors showed melanomatous tissue structure. The abundant pigment in the cells was positive for Fontana-Masson staining and bleached with potassium permanganate. The carcinoma component was positive for epithelial membrane antigen and CA19-9, but the melanoma component was negative. Conversely, the melanoma component was positive for HMB45 and vimentin, but the carcinoma component was negative. Electron microscopic analysis showed premelanosomes and melanosomes in the melanoma component. Microsatellite analysis showed the same genetic alterations with loss of heterozygosity on chromosome arms 1p, 3q, 4q, 6q, 9p, 10q, 11q, 13q, 16q, 17p, and 17q in in situ, invasive, and metastatic foci. We concluded that the carcinoma and melanoma components had arisen from the same clone and that this breast carcinoma might have diverged to aberrant malignant melanoma through multiple genetic alterations in the early period of ductal carcinoma in situ.- - - - - - - - - - ranking = 4.7798121293008keywords = carcinoma (Clic here for more details about this article) |
9/352. Primary melanocarcinoma of stomach.Melanomas of the gastrointestinal tract are infrequent. Among primary melanomas, melanoma of the stomach is a rarity. We report a patient with primary melanocarcinoma of the stomach.- - - - - - - - - - ranking = 2.3899060646504keywords = carcinoma (Clic here for more details about this article) |
10/352. Subungual malignant melanoma mimicking a squamous cell carcinoma.When a suspicious lower-extremity lesions is encountered, an appropriate biopsy should be performed. The lesion must then be excised with the proper margins and submitted for pathologic evaluation to ensure complete removal.- - - - - - - - - - ranking = 2.0880751482797keywords = carcinoma, squamous cell (Clic here for more details about this article) |
| | Next -> |