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11/655. Histologic transformation of polymorphous low-grade adenocarcinoma of salivary gland.

    Polymorphous low-grade adenocarcinoma of salivary gland origin (PLGA) was initially described in 1984 and has since become an established clinicopathologic entity. Owing to the indolent nature of PLGA and its relatively recent description, the full clinicopathologic spectrum of this entity has not been elucidated fully. Transformation to a histologically different-appearing lesion or progression to a higher histologic grade has not been reported. We describe 2 PLGAs arising in the palate and associated with multiple locoregional recurrences that were treated with excision and radiation therapy. This was followed by histologic transformation to a higher grade neoplasm after 17 and 26 years, respectively. The histologic appearance after transformation was characterized by a predominantly solid and cystic growth pattern, nuclear atypia with prominent nucleoli, and foci of necrosis. High-grade transformation of PLGA may occur after a protracted clinical course with multiple recurrences of typical PLGA. The possible role of radiation therapy as an initiator of this transformation merits further study. Tumors with these histologic features should not be included under the rubric of typical PLGA. Segregation of these neoplasms will allow further study of their biologic potential, particularly with regard to possible increased rates of local recurrence and metastasis.
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ranking = 1
keywords = metastasis
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12/655. Primary pulmonary malignant meningioma.

    Fewer than 20 cases of primary pulmonary meningioma have been reported. Most of these cases have been histologically and clinically benign. We report an unusual case of primary pulmonary malignant meningioma with atypical histologic features and malignant behavior. A computed tomography scan of the head did not show evidence of tumor. The right upper lobe mass was resected and showed features of an atypical meningioma with loss of architectural pattern, mild nuclear pleomorphism, increased mitotic counts (up to 15 mitotic figures per 10 high power fields), and focally prominent nucleoli. Focally, cells with rhabdoid features were identified. The tumor's immunohistochemical and ultrastructural profiles were consistent with a meningioma. The tumor stained negative for estrogen and focally positive for progesterone receptors and had a MIB-1 labeling index (marker of cell proliferation) of 9.2%. Approximately 5 months after the initial resection, the patient experienced a tumor recurrence with multiple lymph node metastases, spread to the middle and lower lobes of the right lung, and metastasis to the diaphragm. Rarely, primary pulmonary meningiomas may present as high-grade malignant lesions.
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ranking = 1
keywords = metastasis
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13/655. meningioma with sarcomatous change and hepatic metastasis.

    A 72-year-old patient had a meningotheliomatous meningioma that invaded through the skull and into temporalis muscle. One year following craniotomy for removal of the neoplasm, he developed headaches, diplopia, and proptosis of the left eye. biopsy of the orbital contents revealed a malignant supporting tissue neoplasm having a resemblance to the previous meningioma. No curative therapy was possible and the patient died 33 months after diagnosis. autopsy examination showed extensive residual intracranial neoplasm and a 3-cm metastasis in the liver. The metastatic tumor appeared similar to the meningioma and did not appear malignant histologically. The case illustrates the distinct histologic variations in meningiomas and the difficulties in predicting their biologic activity. Aggressive local behavior may indicate possible malignant areas in the neoplasm. Therefore, examination of the neoplasm should be thorough. Such a correlation may suggest malignant biologic potential.
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ranking = 5
keywords = metastasis
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14/655. Surgical management for lymph node recurrence of resected fibrolamellar hepatocellular carcinoma: a case report.

    Fibrolamellar hepatocellular carcinoma (FLHCC), which is quite uncommon in japan, is known to be frequently associated with lymph node metastasis in Western countries. Herein, we describe a case of a 25 year-old Japanese woman with recurrent FLHCC in the lymph nodes after undergoing right hepatic lobectomy. She underwent a second operation for removal of a recurrent celiac lymph node tumor 23 months after the initial operation. In japan, the frequency of lymph node metastasis in ordinary hepatocellular carcinoma is only 1.6%, whereas 3 out of 9 (33%) reported domestic FLHCCs including this case had lymph node metastasis. The surgical management of lymph node metastasis in FLHCC is discussed.
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ranking = 4
keywords = metastasis
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15/655. liposarcoma of the hypopharynx. A case report and review of the literature.

    A new case of well differentiated hypopharyngeal liposarcoma is reported. The author reviews the literature about the clinical and histologic features of these tumors. From the 93 head and neck liposarcomas reported 13 are located in the hypopharynx. The mean age of presentation is 61 years and males are largely predominant. Etiology is still unknown. Tumor size does not seem to affect the prognosis. Usually patients do not present with cervical lymph node metastasis nor distant metastasis. Histologic diagnosis according to Enzinger and Weis's classification could be difficult especially to distinguish between lipoma and well differentiated liposarcoma. The main prognostic factor is histologic grade but early recognition combined with a complete surgical excision can result in a decreased local recurrence rate and high survival rate. Low grade tumors often recur locally but distant metastases are rare. From the 8 well differentiated tumors reviewed 6 presented a local recurrence 2 months to 20 years after surgery but only 1 patient died without disease. High grade tumors are much more aggressive locally and metastasize frequently. radiotherapy and chemotherapy are proposed in selected cases without evidence to be of value.
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ranking = 2
keywords = metastasis
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16/655. A case of simultaneous presence of primary endometrial carcinoma and metastasis of a breast carcinoma to the ovary after 5 years of tamoxifen therapy.

    We report a case of a 43-year-old woman with the simultaneous presence of a primary uterine endometrial cancer and metastasis of breast cancer to the ovary after 5 years of tamoxifen therapy. tamoxifen therapy lengthens recurrence-free survival of the patient. However, the risk of endometrial cancer and the possibility of recurrence of breast cancer also must be considered.
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ranking = 5
keywords = metastasis
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17/655. Choroidal metastasis in men with metastatic breast cancer.

    PURPOSE: To report two cases of choroidal metastasis in metastatic breast cancer in men. METHOD: case reports of a 50-year-old man with an 8-year history of breast cancer who was initially examined with a solitary amelanotic choroidal tumor and a 62-year-old man with an 8-month history of breast cancer who was initially examined with numerous unilateral amelanotic choroidal tumors. RESULTS: Ophthalmoscopic and echographic characteristics of the choroidal tumors were typical for breast cancer metastasis. Systemic screening disclosed advanced metastatic disease in both patients. Choroidal metastasis could be effectively treated by external beam irradiation. CONCLUSIONS: Although breast cancer is a rare condition in men, it should be considered as a possible primary cancer in cases of choroidal metastasis.
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ranking = 8
keywords = metastasis
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18/655. Pulmonary metastasis of ameloblastoma: case report and review of the literature.

    Ameloblastomas are benign tumors of odontogenic epithelial origin. There is a high incidence of local recurrence associated with these tumors, and distant metastasis is rare. A review of the English literature shows that there have been 41 prior reports of pulmonary metastases from ameloblastomas of the oral cavity. We present another case of ameloblastoma metastatic to the lung and review the histopathology and mechanism of metastatic spread.
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ranking = 5
keywords = metastasis
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19/655. Bilateral primary mucinous carcinoma of the eyelid treated with mohs surgery.

    BACKGROUND: Primary mucinous carcinoma is an uncommon malignant cutaneous tumor which arises most commonly on the eyelid. While rarely causing death, recurrence following primary excision is common and widespread metastasis may occur. OBJECTIVE: We report the first case of bilateral primary mucinous carcinoma of the eyelid. methods: A lesion of the left lower eyelid had been resected three times previously with positive conventional margins. Both this lesion and a second primary lesion of the contralateral lower lid were removed with Mohs microscopically controlled excision without recurrence for more than 2 years. CONCLUSION: Multiple lesions of mucinous carcinoma of the eyelid do not necessarily connote metastasis. Mohs microscopically controlled excision may be a suitable form of therapy for primary mucinous carcinoma of the eyelid.
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ranking = 2
keywords = metastasis
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20/655. Unusual recurrence of ovarian carcinoma 9 years after initial diagnosis.

    Ovarian carcinomas typically metastasize to multiple sites via exfoliation, lymphatic spread, or direct invasion. gastrointestinal tract involvement is usually the result of exfoliation with direct invasion of tumor within the mesentery or through serosal surfaces. We present a case of late recurrence of ovarian carcinoma isolated to the sigmoid mucosa, heralded only by brief left lower quadrant pain with hematochezia in a patient otherwise disease free for 9 years. This unusual presentation illustrates the therapeutic dilemma faced by clinicians when a tumor is of uncertain origin and underscores the need for continued follow-up and close scrutiny of new symptoms in patients with stage I disease and for those who enjoy prolonged disease-free intervals.
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ranking = 0.020777082160761
keywords = lymphatic
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