1/240. Microcystic adnexal carcinoma: collaborative series review and update.BACKGROUND: Microcystic adnexal carcinoma (MAC) is a malignant appendageal tumor first described in 1982. It can be clinically and histologically confused with other malignant and benign cutaneous neoplasms, leading to inadequate initial treatment. This neoplasm is locally aggressive and deeply infiltrating, characterized by high morbidity and frequent recurrence. Mohs micrographic surgery has been used to conserve tissue and improve the likelihood for cure. OBJECTIVE: We report our experience using Mohs micrographic surgery for the treatment of MAC and compare with earlier reports in the literature. In addition, we review the epidemiology, clinical and histologic characteristics, and optimal treatment of this rare neoplasm. We also describe a 15-year-old white male patient with MAC on the scalp occurring only 7 years after radiation exposure. methods: The medical records of 11 patients with MAC who were treated by Mohs micrographic surgery were reviewed at both departments, and follow-up data were obtained. RESULTS: In all patients treated with Mohs micrographic surgery, there were no recurrences after a mean follow-up of 5 years. CONCLUSION: Mohs technique enables the detection of clinically unrecognizable tumor spread and perineural invasion often encountered with MAC. Aggressive initial treatment by microscopically controlled excision appears to offer the greatest likelihood of cure for this neoplasm, while providing conservation of normal tissue. In addition, we describe the second youngest patient with MAC and readdress the issue of previous radiotherapy as an important predisposing factor.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/240. temporal bone tumours in patients irradiated for nasopharyngeal neoplasm.radiation-associated tumours are rare complications of radiotherapy. This study seeks to highlight and discuss the clinically challenging problem of radiation-associated tumours (rats) in the temporal bones of seven patients previously irradiated for nasopharyngeal neoplasm. Seven patients (six males and one female) with radiation-associated temporal bone tumours are presented (five squamous cell carcinomas, one osteogenic sarcoma and one chondrosarcoma). The initial nasopharyngeal disease for which radiotherapy was indicated was nasopharyngeal carcinoma (six patients) and nasopharyngeal lymphoma (one patient). The latency period between radiotherapy and presentation of temporal bone tumours ranged from five years to 30 years with a mean of 12.9 years. All the patients underwent surgical tumour resection. Three patients had post-operative radiotherapy and one patient underwent pre- and post-operative chemotherapy. Two patients died from the disease within three months of treatment with one patient surviving 36 months at the time of writing. One patient died from an unrelated medical condition three months after surgery. With refinement in radiotherapy techniques and the resultant increase in patient survival, there may be more patients with radiation-associated tumours in the future. It remains imperative for clinicians to be vigilant when patients previously irradiated for nasopharyngeal carcinoma present with otological symptoms as the key to the successful management of this condition lies in the early detection and expedient treatment of this difficult disease.- - - - - - - - - - ranking = 1.25keywords = neoplasm (Clic here for more details about this article) |
3/240. meningioma after radiotherapy for Hodgkin's disease.The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.- - - - - - - - - - ranking = 0.24055735071619keywords = breast (Clic here for more details about this article) |
4/240. Myelodysplastic syndrome as a complication of neo-adjuvant triple M chemotherapy and radiotherapy.Cases of myelodysplastic syndrome occurring after multi-drug chemotherapy are rare; they are more often associated with the use of alkylating agents. We report the case history of a patient with myelodyspasia occurring after neoadjuvant methotrexate, mitoxantrone and mitomycin C (triple M) chemotherapy with subsequent radiotherapy for locally advanced breast cancer. cytogenetic analysis of a bone marrow biopsy confirmed the typical chromosomal abnormalities associated with therapy related myelodysplasia. Few treatments for this disorder have been found to be of value. The aetiology, incidence and management options are briefly discussed.- - - - - - - - - - ranking = 0.24055735071619keywords = breast (Clic here for more details about this article) |
5/240. Postradiation neural sheath sarcoma of the brachial plexus: a case report.Sarcoma arising in the brachial plexus is a rare complication following radiation therapy, with only 7 patients reported in the literature. The absolute number of patients is likely to increase with the growth of radiation therapy to treat breast cancer. Because of its rarity, early diagnosis requires a high degree of suspicion. We present a patient with neural sheath sarcoma of the brachial plexus arising 18 years after external beam radiation for breast cancer. The interval between presentation and definitive therapy was prolonged by workup and treatment of carpal tunnel syndrome and cervical nerve root compression. The English language literature regarding postradiation sarcoma is reviewed and the clinical, radiological, and electrophysiological workup of postradiation brachial plexopathy is discussed.- - - - - - - - - - ranking = 0.48111470143238keywords = breast (Clic here for more details about this article) |
6/240. Benign lymphangiomatous papules of the skin following radiotherapy: a report of five new cases and review of the literature.AIMS: The aim of this report is to summarize the clinicopathological findings of five cases of a pseudosarcomatous vascular proliferation of the skin at the site of radiotherapy following surgery for carcinoma of the breast and carcinoma of the endometrium. To our knowledge, only five cases of this presumably rare pseudomalignant proliferation have been reported previously. methods AND RESULTS: All patients were females ranging in age from 44 to 70 years. The lesions appeared as solitary or multiple papules or vesicles localized to the field of radiation. Microscopically, they were composed of vascular spaces that exhibited atypical features without qualifying for a diagnosis of angiosarcoma. CONCLUSIONS: Our cases provide additional evidence supporting the benign nature of this atypical vascular proliferation, not recurring, never developing metastases and being cured readily by local excision. Clinical, histopathological and ultrastructural findings suggest a lymphatic origin. Whether these lesions represent a neoplastic or a reactive condition secondary to radiotherapy is unclear. The name 'benign lymphangiomatous papules of the skin following radiotherapy' is proposed.- - - - - - - - - - ranking = 0.24055735071619keywords = breast (Clic here for more details about this article) |
7/240. Malignant melanoma occurring within a previously irradiated area.The commonest radiation-induced neoplasms are sarcomas. Ionizing radiation is not usually associated with the development of malignant melanoma. We report two patients with malignant melanoma occurring within a previously irradiated area. There is evidence to support radiation in the pathogenesis of melanoma but the family histories, especially in one patient, suggest that genetic mutations may also have played a role, particularly in relation to the short latent period.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
8/240. Nonocular cancer in retinoblastoma survivors.From a review of the records of 2,302 patients with retinoblastoma collated from CPMC and AFIP, it was found that retinoblastoma patients who survived their original eye cancer have a high incidence of second nonocular malignancies. The second neoplasms occur almost exclusively (97.5%) in patients who have had bilateral retinoblastoma, although retinoblastoma is much more commonly unilateral. The second neoplasms have appeared between 1 and 42 years after the successful treatment of retinoblastoma and have been fatal in approximately 85% of cases. Seventy-one percent of patients develop tumors in the field of the radiation beam; many of these were following treatment with low doses of radiation and after short latent periods. Nineteen percent of patients develop tumors clearly out of the field of radiation (eg, osteogenic sarcoma of the femur). retinoblastoma patients appear to be unusually radio-sensitive to low doses of radiation and develop tumors in the field of radiation following treatment of 3,500 rads. They have a high incidence of nonocular tumors clearly distant from the radiation beam develop nonocular malignancies even if no radiation has been given. The incidence of multiple malignancies in patients successfully treated for retinoblastoma appears to be higher than for any other primary malignancy whether they receive radiation or not.- - - - - - - - - - ranking = 0.5keywords = neoplasm (Clic here for more details about this article) |
9/240. Fine-needle aspiration biopsy of postradiation epithelioid angiosarcoma of breast.Angiosarcoma of breast skin and parenchyma is a rarely reported complication of irradiation for breast carcinoma. We report a case of a subareolar epithelioid angiosarcoma arising 8 years subsequent to lumpectomy and irradiation of the ipsilateral breast for infiltrating carcinoma. The epithelioid appearance of the neoplastic cells on fine-needle aspiration biopsy (FNA) biopsy suggested a recurrence of the primary carcinoma. Careful attention to certain cytomorphologic features and cell block immunohistochemistry were useful in the distinction from recurrent carcinoma. Cytologic features that identified this neoplasm as an angiosarcoma included marked cell discohesiveness, elongate cytoplasmic processes or "pseudopodia," heterogeneous cell size, large nucleoli or macronucleoli, and cytoplasmic lumina. Immunohistochemical markers, including factor viii antigen, CD31, and CD34, were positive, confirming the vascular nature of the neoplasm. Other markers ruled out morphologically similar neoplasms such as recurrent carcinoma and melanoma. Epithelioid angiosarcoma should be included in the differential diagnosis of a suspected recurrence of breast carcinoma several years postirradiation therapy. Diagn. Cytopathol. 2000;22:172-175.- - - - - - - - - - ranking = 2.6744588057295keywords = neoplasm, breast (Clic here for more details about this article) |
10/240. Pancreatic carcinoma as a sequel to therapy of lymphoma.Development of a carcinoma in the pancreas of a young man who had five years previously undergone intensive radiotherapy and subsequent chemotherapy for treatment of a lymphoma suggests that induction of the second neoplasm occurred as the result of the therapy of the first. While definite proof of causality is lacking, a review of recent literature strongly suggests that the association noted in the patient described is more than serendipitous. Increased usage of high-dose radiotherapy, particularly in conjunction with chemotherapy, may be directly related, and it is imperative that such an association be kept in mind when such patients are seen in follow-up.- - - - - - - - - - ranking = 0.25keywords = neoplasm (Clic here for more details about this article) |
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