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1/7. Gastric adenocarcinoma associated with fundic gland polyps in a patient with attenuated familial adenomatous polyposis.

    Familial adenomatous polyposis (FAP) is a rare autosomal dominant precancerous condition of the colon caused by mutations in the adenomatous polyposis coli (APC) tumor suppressor gene. FAP is characterized by the appearance of innumerable adenomatous polyps throughout the large bowel. Fundic gland polyps are the most common gastric lesion in FAP. It is generally believed that fundic gland polyps have little or no potential for malignant transformation in the population at large, and only a few case reports describe the development of high grade dysplasia or gastric adenocarcinoma associated with diffuse fundic gland polyposis in patients with FAP. We report the second case of gastric adenocarcinoma intimately associated with fundic gland polyposis in a family with an attenuated form of FAP. The patient had undergone routine screening per current guidelines because of his known mutation in the APC gene. This suggests that malignant transformation of fundic gland polyps in patients with FAP occur more frequently than previously believed. Current screening recommendations may not be sufficient for patients with FAP or its attenuated forms.
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ranking = 1
keywords = precancerous
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2/7. Aplasia cutis congenita with precancerous transformation - the first case. Why do these scars never develop invasive tumors?

    The term aplasia cutis congenita characterizes a heterogeneous group of diseases which have in common a focal absence of the skin. The defect may be limited to the epidermis but often involves the full thickness of the skin including the underlying bone. At birth the lesions present as erosive patches and they heal rather rapidly with a residual scar. Although more than 200 publications on aplasia cutis congenita have appeared in the medical literature between 1966 and 1999, surprisingly no case of malignant degeneration has been described. We observed a 58-year-old male patient with aplasia cutis congenita who developed crusted changes within the scar over the past 10 years. Repeated biopsies over the years have always documented a precancerous lesion without solar elastosis. Invasion has never been observed in this patient. We hypothesize that for invasive malignancies dermal-epidermal interactions are necessary. Such a cell to cell communication seems to be impossible in patients with aplasia cutis congenita, as the dermal-epidermal unit is not developed. Aplasia cutis congenita might serve as an interesting model for further investigations on the importance of epidermal-dermal interactions.
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ranking = 5
keywords = precancerous
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3/7. Possible malignant transformation of benign lymphoepithelial parotid lesions in human immunodeficiency virus-infected patients: report of three cases.

    Benign lymphoepithelial parotid lesions (BLL) are intraparotid pathological changes that are commonly thought to be an early manifestation of human immunodeficiency virus (hiv) infection. It is not well known whether BLL may undergo malignant transformation into B cell lymphoma and may therefore be a sort of precancerous lesion. We report 3 cases of possible malignant transformation of BLL in hiv-infected patients.
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ranking = 1
keywords = precancerous
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4/7. Ovarian endometrioid adenocarcinoma arising from an endometriotic cyst in a postmenopausal woman under tamoxifen therapy for breast cancer: a case report.

    BACKGROUND: Ovarian cancer arising from an endometriotic cyst in a postmenopausal woman under tamoxifen therapy is rare. CASE: We herein report the case of a 67-year-old woman with a history of breast cancer, taking tamoxifen citrate 20 mg/day for 4 years, who underwent an operation for left ovarian tumor. The postoperative histological diagnosis was endometrioid adenocarcinoma in an endometriotic cyst with a gradual transition of the degree of cellular atypia noted from typical endometriotic epithelium, to atypical endometriosis, and finally to adenocarcinoma. CONCLUSION: tamoxifen may cause malignant transformation of endometriosis through atypical endometriosis even in the postmenopausal state. Atypical endometriosis may act as a precancerous lesion in the process of tamoxifen-induced malignant transformation of endometriosis.
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ranking = 1
keywords = precancerous
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5/7. Proliferative verrucous leukoplakia. Four cases with flow cytometric analysis.

    Proliferative verrucous leukoplakia is a slow-growing but highly aggressive precancerous form of leukoplakia of unknown cause. Proliferative verrucous leukoplakia is though to possess a continuous spectrum of clinical and histopathologic expression, ranging from simple hyperkeratosis to invasive squamous cell carcinoma. early diagnosis is difficult because of an initial innocuous character, but multiple and rapid multifocal warty recurrences are common. This article reports four additional archival cases of proliferative verrucous leukoplakia to determine if flow cytometric analysis can be useful in the early diagnosis of proliferative verrucous leukoplakia. Flow cytometric analysis was performed on available formalin-fixed paraffin-embedded specimens (N = 27). Flow cytometric analysis results showed dna aneuploid cell lines in each proliferative verrucous leukoplakia case studied (dna index range, 1.1 to 2.6). In all four patients the abnormal cell line dna index appeared to be maintained throughout the sampling period. The results suggest flow cytometric analysis could be a possible aid in early recognition of proliferative verrucous leukoplakia and might enable aggressive therapy at an earlier stage.
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ranking = 1
keywords = precancerous
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6/7. Congenital bile duct cyst: a premalignant lesion of the biliary tract associated with adenocarcinoma--a case report.

    The incidence of carcinoma arising in the wall of a congenital bile duct cyst is high and there is no doubt that these lesions represent a precancerous state of the biliary tract. In almost all cases congenital bile duct cysts are related to anomalous arrangements of the pancreaticobiliary duct system which seems to play a crucial role in the development of cystic bile ducts and biliary carcinogenesis. Bile stasis together with reflux of pancreatic juice causing longstanding inflammation and activation of bile acids might be the factors in carcinogenesis of the exposed bile duct epithelium in the cystic wall. In the case of primary or secondary extrahepatic bile duct cysts, primary excision is mandatory because of the high risk to develop biliary cancer with even nowadays poor prognosis despite advantages in biliary surgery during the last years. We report a case of a young woman in which bile duct cancer was found arising in the wall of a congenital bile duct cyst. Despite radical surgery the outcome was poor proving the high malignant potential of bile duct cancer. The question of possible tumor seeding in hepatobiliary surgery is discussed as a way of inducing hepatobiliary metastatic tumors.
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ranking = 1
keywords = precancerous
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7/7. Malignant transformation of leukoplakia three times in period of 11-years--case report.

    leukoplakia is a commonly occurring precancerous lesion. The following case report describes a patient who had multiple leukoplakia in this mouth. He had three sites of leukoplakia, the left hard palate, the gum of the right maxilla and the gum of the left mandible, all of which underwent malignant transformation during the period of 11-years after diagnosis.
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ranking = 1
keywords = precancerous
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