1/65. acanthosis nigricans and wart-like lesions associated with metastatic carcinoma of the stomach.A 63-year-old white man developed malignant acanthosis nigricans one year after a hemigastrectomy for adenocarcinoma of the stomach. Multiple "wart-like" lesions involving the dorsa of the hands, arms and trunk were also present. The malignant acanthosis nigricans in the patient appears to have paralledled the course of the metastatic gastric adenocarcinoma. Discrete verrucous lesions can occur in malignant acanthosis nigricans which histopathologically may show either squamous or basal cell hyperplasia.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
2/65. Uterine metastasis from a heterologous metaplastic breast carcinoma simulating a primary uterine malignancy.OBJECTIVE: To describe the first distant metastasis of a heterologous metaplastic breast carcinoma in the uterus and discuss its differential diagnosis. methods: light microscopy, immunohistochemistry, and flow cytometry were used to evaluate the tumor. RESULTS: A 58-year-old woman underwent mastectomy for metaplastic breast carcinoma confined to the breast. She presented 4 years later with vaginal bleeding. The endometrial curettage showed a poorly differentiated carcinoma. She underwent hysterectomy and bilateral salpingo-oophorectomy as well as pelvic and periaortic lymphadenectomy. Clinical and intraoperative findings favored a primary uterine malignancy. The uterus was markedly distorted with multiple gray-white, solid subserosal, and intramural tumor nodules. The tumor diffusely infiltrated the endometrium sparing benign endometrial glands. The tumor nodules were distributed full thickness of the myometrium. These nodules were composed of high-grade malignant epithelial cells with areas of chondroid metaplasia. Extrauterine microscopic tumor was present in left ovary, pelvic, and periaortic lymph nodes. The histologic features and estrogen/progesterone receptors (ER/PR) as well as dna ploidy analysis of the uterine tumor showed striking similarity with those of the primary metaplastic breast carcinoma. A diagnosis of metastatic metaplastic breast carcinoma in the uterus was rendered. CONCLUSION: A metastatic heterologous metaplastic breast carcinoma with cartilaginous metaplasia should be considered in the differential diagnosis of heterologous uterine malignant mixed mesodermal tumor (MMMT) and high-grade endometrioid carcinoma with rare foci of cartilage.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
3/65. B-cell-type malignant lymphoma with placental involvement.We present here a case of B-cell-type mediastinal malignant lymphoma during pregnancy complicated by placental involvement. In this case, some nodular high-echo patterns were recognized in the placenta by ultrasonography. A cesarean section and resection of the mediastinal tumor were performed at 33 weeks and 6 days of gestation due to the deterioration of the dyspnea. A female infant weighing 1,868 g was delivered and she is now a healthy 2-year-old. The mother, however, died of the disease 1 month after surgery, due to progression of the tumor. The placenta showed numerous white firm nodules varying from 3 mm to 3 cm in diameter. The pathologic findings of both the mediastinal tumor and the placenta indicated primary mediastinal (thymic) B-cell lymphoma.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
4/65. Malignant fibrous mesothelioma. Metastatic to brain and liver.A malignant fibrous mesothelioma in a 52 year old white man arising from the left parietal pleura associated with lupus erythematosus with metastases to brain and liver is reported. asbestos bodies were found in digested pulmonary tissue but none in the primary or metastatic lesions. light microscopic and ultrastructural studies suggest that this tumor contains mesothelial or endothelial cells, some of which revealed fibroblastic features while others disclosed epitheloid characteristics.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
5/65. Malignant solitary fibrous tumor of the pleura with liposarcomatous differentiation.Pleural solitary fibrous tumors (SFTs) are uncommon tumors. Although these tumors have been well characterized, malignant pleural SFTs with liposarcomatous differentiation have not been reported. We report an unusual malignant pleural SFT intermixed with foci of well-differentiated liposarcoma. The patient was a 66-year-old, white man with a large, solid right pleural mass that measured 13.5 x 10.3 x 8.5 cm. The tumor was composed of spindle-shaped and plump cells embedded in dense collagenous stroma. The tumor cells were arranged in interlacing fascicles or in a patternless pattern. Marked nuclear atypia, a high mitotic rate (21 mitoses per 10 high-power fields), and areas of prominent necrosis were evident. In addition, numerous adipocytes mixed with typical lipoblasts were seen scattered throughout portions of the tumor. immunohistochemistry revealed the tumor cells were strongly positive for CD34 and vimentin and negative for cytokeratin, desmin, smooth muscle actin (IA4), and S100. To the best of our knowledge, this case represents the first example of a malignant SFT with liposarcomatous differentiation.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
6/65. hypokalemia, metabolic alkalosis, and hypertension: Cushing's syndrome in a patient with metastatic prostate adenocarcinoma.Ectopic adrenocorticotropic hormone (ACTH) and/or corticotropin-releasing hormone (CRH) are associated with a growing list of tumors. We report a 69-year-old white man with a history of high-grade prostate carcinoma and widely metastatic adenocarcinoma who presented with metabolic alkalosis, hypokalemia, and hypertension secondary to ectopic ACTH and CRH secretion. Laboratory values were consistent with hypokalemia and metabolic alkalosis. Markedly elevated serum cortisol (135 microg/dL), ACTH (1,387 pg/dL), CRH (69 pg/dL), and urine free cortisol (16,276 microg/24 h) levels were found. Chest computed tomographic (CT) scan showed small noncalcified parenchymal densities; however, bronchoscopy and bronchoalveolar lavage washings were unremarkable for a neoplastic process. Abdominal CT scan and magnetic resonance imaging showed multiple small liver lesions and multiple thoracic and lumbar intensities consistent with diffuse metastatic disease. Histological analysis of a biopsy specimen from the thoracic spine showed an undifferentiated adenocarcinoma consistent with a prostate primary tumor. The severe metabolic alkalosis secondary to glucocorticoid-induced excessive mineralocorticoid activity was treated with potassium supplements, spironolactone, and ketoconazole. In this case report, we describe an unusual tumor associated with ectopic ACTH and CRH production and the pharmacodynamic relationship of plasma cortisol levels and urinary cortisol excretion with ketoconazole treatment.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
7/65. Regression of pulmonary metastatic disease associated with intralesional BCG therapy of intracutaneous melanoma metastases.A 77-year-old white man with 64 intracutaneous melanoma metastases and a pulmonary metastatic deposit was treated with immunotherapy. Over an 8-month period, 17 intracutaneous lesions were inoculated with BCG. All 17 injected lesions and all 47 uninjected intracutaneous lesions resolved; no new nodules appeared and the pulmonary metastasis regressed (greater than 50%). This is the first documented case of a pulmonary metastatic focus responding to intralesional BCG therapy of intracutaneous metastases.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
8/65. Metastases to the products of conception from a maternal bronchial carcinoma. A case report and review of literature.The association of mother's malignancy with metastases to the products of conception is rarely reported. We present 8th case reported in the literature of oat-cell lung carcinoma complicated by an aggressive clinical course and documented placental metastases. review of all published cases of lung cancer metastasizing to the placenta is also presented. A 44-year-old white pregnant woman at an estimated gestational age of 30 weeks presented with cervical incompetence symptoms and multiple tumors of 2-4 cm in diameter located in the subcutaneous tissue of the chest, including both breasts. The biopsy revealed a metastatic oat-cell carcinoma. cesarean section was performed immediately. During the procedure, micronodular metastatic infiltration of the liver was noted. Microscopic examination of placenta showed clusters of oat-cell carcinoma calls within the intervillous spaces; no infiltration of villi themselves was noted. The malignant cells were morphologically identical as those of the subcutaneous metastases. The woman succumbed to cancer and died on the 16th postoperative day. lung cancer metastasizing to the placenta is relatively rarely reported. In all cases only placental metastases were found; the fetus in all cases was spared. Only in one out of 8 reported cases outcome of mother was not fatal. It should be emphasized that not in all cases of maternal malignancy the histological examination of the placental was made Therefore it is possible that the incidence of placental involvement is more often than it is reported.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
9/65. Metastatic carcinoma of the iris.Of three women and one man with metastatic carcinoma of the iris, the average age of the four was 50.2 years. Two of the tumors originated in the breast and two in the lungs. The average survival from time of diagnosis of the iris lesion was less than six months. Each patient presented with characteristic grayish-white translucent nodules on the iris or in the anterior chamber angle. The patients displayed other features of iris metastases such as secondary glaucoma, rubeosis iridis, iris atrophy, anterior uveitis, hypopyon, and hyphema. As an aid in the clinical evaluation, anterior segment fluorescein angiography was performed, revealing vascular details not seen clinically. Leakage of dye was a constant feature of the angiogram.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
10/65. breast-like cancer of the vulva: primary or metastatic? A case report and review of the literature.A 45-year-old white female presented a polypoid nodule in the vulva, one year after she was operated on for breast cancer. Histologic examination showed a poorly differentiated carcinoma that closely resembled the primary breast tumor. Eight similar cases have been previously described in the literature. This very rare event should be differentiated from primary adenocarcinoma of the mammary-like glands of the vulva. The recognition of such a lesion as primary or metastatic is very important, since it greatly influences management and prognosis.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
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