Cases reported "Adenocarcinoma"

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1/38. Hysteroscopic endometrial resection and high-dose-rate brachytherapy: treatment of endometrial cancer in a medically compromised patient.

    OBJECTIVE: The use of a combined treatment option for endometrial cancer in a medically compromised patient is outlined. methods/RESULTS: A case of a 49-year-old severely medically compromised patient with endometrial cancer is described. A complete hysteroscopic endometrial resection with insertion and suturing in place of an endocervical cannula allowed weekly outpatient delivery of high-dose-rate intracavitary radiation without anesthetic or repeat dilatation of the endocervical canal. CONCLUSION: The use of hysteroscopic endometrial resection with adjuvant high-dose-rate radiation therapy is a feasible treatment option for patients with endometrial cancer in whom surgery is contraindicated.
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2/38. En bloc surgery for colon cancer: report of a case.

    We report herein the case of a 57-year-old woman in whom successful en bloc surgery was performed for locally advanced colon cancer. A fixed tumor was palpable in the right subcostal region, and computed tomography (CT) showed that it originated in the ascending colon and invaded the right kidney, duodenum, head of the pancreas, and liver. A right hemicolectomy with D3 lymphadenectomy was performed combined with resection of the right kidney, duodenum, head of the pancreas, and liver. On microscopic examination, well-differentiated adenocarcinoma of the ascending colon widely invaded the parenchyma of the kidney, the parenchyma of the pancreatic head, and the duodenal wall. Lymph node metastasis was found in one paracolic node. This case report outlines the procedures involved in this extended surgery.
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3/38. scoliosis associated with typical Mayer-Rokitansky-Kuster-Hauser syndrome.

    Disorders that cause congenital scoliosis include Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. We present the case of a 46-year-old karyotypical (XX) woman with mullerian agenesis (MRKH type A, typical form), a rudimentary bicornate uterus, a blind vaginal pouch, and adenocarcinoma of both ovaries with subsequent bilateral salpingo-oophorectomy. She also had scoliosis of the thoracic and lumbar spine, an association thus far seen only among patients with type B (atypical) MRKH. We describe typical and atypical forms of MRKH and emphasize how these various anomalies associated with mullerian agenesis have affected the classification of the syndrome. We also outline possible embryologic etiologies of mullerian agenesis.
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4/38. Carcinoma of temporal bone, base of the skull: diagnosis by needle aspiration cytology.

    We report on a 68-yr-old male with a destructive bone lesion involving the temporal bone at the skull base extending to surrounding osseous structures and the infratemporal fossa, defined by needle aspiration cytology as carcinoma in association with inflammatory reaction, bacterial type, and bone destruction. The technique of the aspiration, which was performed by a cytopathologist directing a spinal needle into the region of the destroyed temporal bone as outlined in the radiographs of prior magnetic resonance imaging (MRI), is discussed. The application of this technique in the cytologic sampling of deeper lesions usually of soft or osseous tissues not accessible to ordinary fine-needle aspiration is presented. There is also a brief discussion of neoplastic lesions involving the temporal bone at the skull base and the anatomic concerns in sampling lesions in this difficult-to-approach region of the body.
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5/38. aquaporins and the surgeon: cautionary tales.

    Nephrogenic diabetes insipidus (NDI) presents an uncommon but formidable clinical challenge in the surgical patient. Two recent cases of NDI with differing aetiology are presented. These cases and a review of the literature illustrate well the diagnosis, fluid and electrolyte imbalances seen and the strategy of treatment required in the post-operative setting. The central role of the recently discovered aquaporin channels in this condition is briefly outlined. Nephrogenic diabetes insipidus has a diverse aetiology and many of the hazards of the condition are peculiar to the surgical setting. The importance of management in a high dependency environment is highlighted.
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6/38. endolymphatic sac tumours.

    endolymphatic sac tumours (ELST) are rare tumours of the petrous temporal bone. They may arise sporadically or be associated with von hippel-lindau disease. Their differential diagnosis is discussed. We present the clinical and histopathological features of two new patients with ELST and outline the management of their condition. In addition, we review a third case previously reported as a choroid plexus papilloma in which the histology has been re-assessed and the diagnosis changed to ELST. The controversy regarding the cellular origins of adenomatous tumours of the temporal bone is highlighted.
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7/38. The evaluation of malignant gastric neoplasms by ultrasonic B-scanning.

    The results of ultrasonic B-scanning of 11 patients with malignant neoplasms of the stomach are presented, and the diagnostic accuracy of this technique and its advantages and limitations are discussed and illustrated with specific case reports. The use of ultrasound to complement other techniques in evaluating malignant gastric neoplasms prior to consideration for surgery or chemotherapy is outlined.
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8/38. Metastatic carcinoma: an unusual cause of focal brain lesions in hiv infection.

    The most common causes of focal brain lesions (FBLs) in patients with hiv infection are cerebral toxoplasmosis, primary central nervous system lymphoma (PCNSL), and progressive multifocal leukoencephalopathy. neoplasms other than PCNSL are uncommon. We report a rare case of metastatic carcinoma causing an FBL in a patient with hiv infection. The diagnostic workup and further management of FBLs in hiv are outlined in this review. The standard approach includes a lumbar puncture and cerebrospinal fluid (CSF) analysis for cytology and Epstein-Barr virus (EBV) dna testing by polymerase chain reaction. Empiric therapy for PCNSL is justifiable for patients with positive CSF EBV-dna test results and a positive single-photon emission computed tomography (SPECT) scan, especially if there has been no response to antitoxoplasmosis therapy. brain biopsy may be indicated, however, in select cases that do not meet these criteria in order to identify potentially treatable infections and PCNSL.
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9/38. Complex adnexal tumor of the primary epithelial germ with distinct patterns of superficial epithelioma with sebaceous differentiation, immature trichoepithelioma, and apocrine adenocarcinoma.

    A 60-year-old man came for treatment of a sharply outlined erythematous plaque on the gluteal area (45 x 20 mm) of 20 years' duration. Eccentrically located on the plaque was a nodule, 20 mm in diameter. Histological study of the plaque showed a superficial platelike tumor with basaloid bland cytology and sebaceous gland differentiation. Histologic study of the nodule found an undifferentiated adenocarcinoma whose ductlike glandular structures opened to the skin surface and infiltrated the whole depth of the dermis. Study of other areas of the lesion detected two more neoplasms. A nodule of squamous cell carcinoma was found within the superficial band of the benign sebaceous tumor. The fourth neoplastic pattern consisted of epithelial islands composed of basaloid cells within a fibroblastic stroma. There was prominent palisading of epithelial cell nuclei at the periphery of the islands, which usually were surrounded by a sheath of mesenchymal cells. In this complex adnexal tumor of the primary epithelial germ, sebaceous and follicular differentiation both simulate neoplastic patterns recently described as separate entities: superficial epithelioma with sebaceous differentiation and immature trichoepithelioma. The undifferentiated adenocarcinoma may represent differentiation toward the third component of the germ, that is, the apocrine gland.
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10/38. Gangrenous cholecystitis as a complication of hepatic artery embolization: case report.

    Ischemic injury to the gallbladder has been described after hepatic artery embolization but has not been considered a clinically significant complication of this procedure. We present three cases in which therapeutic embolization resulted in symptomatic gangrenous cholecystitis requiring urgent surgical intervention. Clinical parameters that distinguish this infrequent ischemic septic process from the more common postembolization syndrome are discussed and recommendations concerning the diagnosis and management of these complicated patients are outlined.
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