1/22. Cystadenomas of the liver: a spectrum of disease.OBJECTIVES: To describe the wide variation in presentation of cystadenomas of the liver and to delineate useful tests for diagnosis and effective surgical treatment. DESIGN: A case series. SETTING: A university-affiliated hospital. patients: Four patients (3 women, 1 man) having cystadenoma of the liver, 2 of whom had associated mesenchymal stroma. MAIN OUTCOME MEASURES: serum and cyst fluid carcinoembryonic antigen (CEA) and CA19-9 levels, type of surgery, morbidity and recurrence rates. RESULTS: cyst fluid CEA and CA19-9 levels were elevated. One patient had resection, 2 had complete enucleation and 1 had partial enucleation. There were no deaths. morbidity included 1 wound infection; there were no biliary fistulas. The patient with partial enucleation had a radiologically confirmed recurrence. CONCLUSIONS: Analysis of cyst fluid CEA and CA19-9 is useful for diagnosis; besides hepatic resection, complete enucleation should be considered as a reasonable treatment for patients with this disease.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/22. pseudomyxoma peritonei-nonoperative management and biochemical findings. A case report.The treatment of choice for pseudomyxoma peritoneai is surgical resection and removal of free mucus. Massive intra-abdominal reaccumulation of viscous mucus has usually been managed by repeat celiotomies. We characterized the mucus of one patient and showed large amounts of immunoglobulins and carcinoembryonic antigens. Intraperitoneal instillation of 5% dextrose and water made the mucus less viscous and easy to remove by paracentesis. The need for repeat celiotomies was obviated.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/22. Giant multilocular cystadenoma of the prostate responsive to GnRH antagonists.Giant multilocular cystadenoma of the prostate is a rare, benign, but locally recurrent, tumor that is usually treated by surgery. We report a case initially treated by surgical resection and followed by evaluation of serum prostate-specific antigen values. After evidence of biochemical failure, pathologic recurrence was confirmed and treated by the gonadotropin-releasing hormone antagonist Lupron, with excellent results. The patient was stable without biochemical or radiologic evidence of progression during the last 2.5 years. This result offers a new treatment option for patients with this rare tumor.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/22. Hepatobiliary cystadenoma with mesenchymal stroma in a patient with chronic hepatitis c.Hepatobiliary cystadenoma was suggested to be uncommon and it is often difficult to make a differential diagnosis. We report a case of a 65-year-old woman who presented with changes in the structure of a cyst that had been observed for the previous 10 years. diagnostic imaging revealed a 7-cm-diameter cystic lesion with internal septations and papillary projections in her liver. All laboratory test results were normal; however, cystic fluid carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 were raised, at 160 ng/ml andover 200,000 U/ml, respectively. Owing to changes in the structure of the cyst and the difficulty of differential diagnosis from cystadenocarcinoma, a complete surgical excision was performed. The histological findings indicated that the tumor consisted of a multilocular cyst lined by glandular cells (with cuboidal or tall columnar cystoplasm), which were immunohistochemically positive for cytokeratin, CEA, epithelial membrane antigen, and CA 19-9. The underlying stroma was composed of proliferating primitive spindle cells which were immunoreactive for vimentin, alpha-smooth muscle actin, muscle-specific actin, and desmin, and resembled ovarian stroma. From these findings, this tumor was diagnosed as hepatobiliary cystadenoma with mesenchymal stroma. Even though the tumor was previously diagnosed as a simple liver cyst, it was necessary to pay special attention to the changes in the structure of the cyst, using ultra sonography and/or computed tomography, bearing in mind hepatobiliary cystadenoma with mesenchymal stroma. The malignant potential of this tumor is stressed, and complete surgical resection is the recommended therapy.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
5/22. Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Two case reports with immunohistochemical confirmation.Hepatobiliary cystadenomas with mesenchymal stroma (CMS) are rare tumors. Two cases are reported that illustrate many features of CMS, including polypoid involvement of the common hepatic duct in one case. Both tumors were associated with elevated serum levels of the tumor-associated antigen CA 19-9 but normal levels of carcinoembryonic antigen and alpha-fetoprotein. Immunohistochemical analysis confirmed the presence of CA 19-9 in the epithelial component of the tumor. The implications of these findings are discussed, both in relation to the histogenesis of CMS and its preoperative diagnosis. A minimally elevated level of CA 19-9 was found in only one of five patients with hydatid disease of the liver, an important differential diagnosis in clinical management.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
6/22. Giant multilocular cystadenoma of the prostate: a rare differential diagnosis of benign prostatic hyperplasia.We report a case of giant multilocular cystadenoma of the prostate in a 43-year-old man. This is a rare benign entity of the prostate imitating symptoms of benign prostatic hyperplasia and originates from the prostate with extensive spread into the pelvis. Histologically, prostatic glands and cysts lined by cuboid to columnar epithelial cells with basally located nuclei are characteristic. Immunohistochemical staining is positive for prostate-specific antigen in the epithelial cells. Giant multilocular prostatic cystadenoma should be taken into account in the differential diagnosis in any case of a large cystic mass originating from the prostate.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/22. Giant multilocular prostatic cystadenoma: a distinctive lesion of the retroperitoneum in men. A report of two cases.Two examples of large, multiloculated, cystic tumors that arose within the pelvis in men of 28 and 37 years of age are described. The tumors were composed of glands and cysts lined by prostatic-type epithelium lying in a hypocellular fibrous stroma. The prostatic nature of the lesions was confirmed by immunohistochemical staining of the epithelium for prostate-specific antigen and prostatic acid phosphatase. Two apparently similar lesions were found in the literature; one tumor was attached to the prostate by a pedicle, and the other arose in the retrovesical space. These tumors, for which we propose the designation "giant multilocular prostatic cystadenoma," appear to be benign, although they may recur if incompletely excised. They may pose considerable diagnostic difficulty if the prostatic nature of the epithelium is not appreciated, an error that is likely if a relationship to the prostate is not recognized. This lesion should be included in the differential diagnosis of retroperitoneal cystic tumors in men.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/22. Polycystic kidneys, pancreatic cysts, and cystadenomatous bile ducts in the oral-facial-digital syndrome type I.Oral-facial-digital syndrome type I is a group of X-linked dominant conditions, lethal in utero in male individuals. Internal anomalies are less well documented than are external findings. We report a case of typical phenotype and absent family history of kidney disease in a 15-year-old white girl (46,XX) who died of renal failure and massive cerebral hemorrhage. At necropsy, the kidneys were greatly enlarged but of fairly normal shape. The cortex was replaced by thin-walled spherical cysts, 0.5 to 2.0 cm in diameter; the majority of the smaller cysts were located deep in the cortex, and the medulla contained lesser numbers of larger cysts. No distal urinary tract obstruction was present. microdissection revealed cysts and diverticula located in all segments of the nephrons and collecting ducts. Uninvolved nephrons showed diffuse hypertrophy. These findings were correlated with immunoperoxidase stains using peanut lectin, lotus tetragonolobus agglutinin, antibodies to cytokeratins, stage-specific embryonic antigen-1, Tamm-Horsfall protein, and epithelial membrane antigen. Other visceral anomalies included biliary cystadenomatous proliferation in the liver and pancreatic cysts. The renal changes are similar to those of autosomal dominant (adult-type) polycystic disease.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
9/22. Papillary eccrine adenoma--a light-microscopic and immunohistochemical study.We report a case of papillary eccrine adenoma. This benign cutaneous tumour had a diagnostic microscopic appearance that consisted of multiple dilated ducts lined by two or more layers of cells. The inner layer often formed intraluminal papillary projections of variable complexity. The lumina were filled by eosinophilic amorphous material. Immunoperoxidase studies showed carcino-embryonic antigen in the luminal border of the ducts, but S-100 protein was absent for tumoral ducts. We discuss the eccrine and apocrine differentiation of this neoplasm on the basis of the immunoperoxidase results. The differential diagnosis includes other cutaneous neoplasms with intraductal papillary proliferation.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/22. Characterization of newly established human ovarian carcinoma cell line--special reference of the effects of cis-platinum on cellular proliferation and release of CA125.The cell line HTOA was established from a well-differentiated human ovarian serous cystadenocarcinoma. This line grew well and without interruption for 51 months and was subcultivated over 130 times. The cells were epithelial in shape, and neoplastic and pleomorphic features, a jigsaw puzzle-like arrangement, desmosomal junctional complexes, and multilayering without contact inhibition. The chromosome number was stable at a hypertetraploid range. The culture cells transplanted into BALB/c nude mice and or hamster cheek pouch produced serous cystadenocarcinomas. The cells were found to produce an antigen (CA125) of ovarian cancer, both in vitro and in vivo. The CA125 levels correlated with cellular proliferation in vitro and also with tumor growth, in the nude mouse. These results indicate that the amount of CA125 in the serum is a good marker for detecting early stages of ovarian cancer and in particular for the evaluation of anticancer drugs.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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