scholarly journals EP.TH.664Breast lump recurrence - malignancy or iatrogenic disease process?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katherine Fox ◽  
Lucy Khan
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Kinase Inhibitors ◽  
Treatment Options ◽  
Current Trend ◽  
Disease Process ◽  
High Recurrence Rate ◽  
Breast Lump ◽  
Current Trends ◽  
Active Observation

Abstract Backgound Fibromatosis is a rare disease, accounting for 0.2% of breast tumours and 3% of soft tissue tumours. Due to its rarity there is a lack of multi centre trials and therefore evidence and guidance on the best treatment options. Likewise, many clinicians are unfamiliar with how to best manage these patients, even in specialist centres. Methods We present the case of a patient presenting with a suspicious breast lump, diagnosed as fibromatosis. Literature search enabled review of current trends and opinions in the management of such patients. Results We discuss the case of a 70 year old patient with a right breast lump, presenting 3 years following wide local excision and radiotherapy for DCIS. Imaging and examination were suspicious for malignancy. Biopsy demonstrated fibromatosis, for which the patient is currently being managed with active observation. Discussion and Conclusion Desmoid tumours of the breast are a rare but important differential in patients presenting with a breast lump. The aetiology remains poorly understood but they have been linked to genetic conditions, and trauma. As with this case, trauma may be iatrogenic in the form of surgery or radiotherapy. Due to the destructive nature of fibromatosis, the current trend in the management of these patients advocates wide local excision where possible. However, there is a high recurrence rate. There has been some success with medical therapies such as NSAIDs and tyrosine kinase inhibitors. These may be viable options in patients in whom surgery is not suitable.

Phyllodes Tumour of Breast: BSMMU Experience

1970 ◽  
Vol 25 (2) ◽  
pp. 70-72
Author(s):  
Saif Uddin Ahmed ◽  
Md. Atiar Rahman ◽  
Khandker Manzoor Murshed ◽  
Laila Shirin
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Standard Treatment ◽  
Malignant Lesion ◽  
Breast Tumour ◽  
Rapid Onset ◽  
Breast Lump ◽  
Phyllodes Tumour ◽  
Simple Mastectomy ◽  
Medical University

This study was done is Banghabandu sheik mujib medical university, Dhaka. Bangladesh from January 2000 to December 2003 to see the presentation different options of management - & out come of treatment. Total 11 Patients of Phylloides Tumour were included in the study. Most Patients (55%) were above the age of 51 Years & well circumscribed non-tender firm mobile breast lump was the commonst (55%) presentation 73% Patients were treated by wide local excision & 18% needed mastectomy. About 18% cases had recurrence after 15 months followup. Any large painless mobile breast tumour of rapid onset should ra se the suspicion of phyllodes tumour. Benign tumour can be tracked by wide local excisions simple mastectomy is the standard treatment for malignant lesion. (J Bangladesh Coll Phys Surg 2007; 25 : 70-72)

scholarly journals Anterior mandibular ameloblastoma

2012 ◽  
Vol 2 (1) ◽  
pp. 30 ◽  
Author(s):  
Ajay H. Bhandarwar ◽  
Girish D. Bakhshi ◽  
Ashok D. Borisa ◽  
Amol Wagh ◽  
Rajat Kapoor ◽  
...  
Keyword(s):  
Case Report ◽  
Recurrence Rate ◽  
Local Excision ◽  
Wide Local Excision ◽  
Surgical Excision ◽  
High Recurrence Rate ◽  
Review Of Literature ◽  
Immediate Reconstruction ◽  
Large Size ◽  
Mandibular Region

Ameloblastoma is a benign odontogenic tumor. These are usually asymptomatic until a large size is attained. Ameloblastoma has tendency to spread locally and has a high recurrence rate. Majority of ameloblastomas (80%) arise from the mandible. Ameloblastoma arising from anterior mandibular region (symphysis- menti) is rare. Very few cases of midline anterior ameloblastomas are reported in the literature. They often require wide local excision. Reconstruction of mandible in these cases is challenging. We present a case of mandibular ameloblastoma arising from symphysis- menti. Patient underwent wide surgical excision of the tumor followed by immediate reconstruction using free fibular vascular flap, stabilized with titanium reconstructive plates. A brief case report ands review of literature is presented.

scholarly journals Axillary Paget disease with a visible satellite: a case report and literature review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wu-Yang Ji ◽  
Bin Luo ◽  
Xue-Wei Wang ◽  
Ying Xiao ◽  
Jin-Yi Tian
Keyword(s):  
Motor Function ◽  
Local Excision ◽  
Wide Local Excision ◽  
Surgical Margin ◽  
High Recurrence Rate ◽  
Surgical Removal ◽  
Erythematous Plaque ◽  
Paget Disease ◽  
Satellite Lesion ◽  
The Right

Abstract Background Extramammary Paget disease (EMPD) is an uncommon malignancy affecting apocrine gland–bearing skin, such as vulvar, perianal, axillary and penoscrotal areas. Paget cells are sometimes detected outside clinical border in a phenomenon called subclinical extension. Satellite is one of the patterns of subclinical extension which is likely to be invisible. The standard management strategy for EMPD without distant metastasis is a complete surgical removal, sometimes called wide local excision. However, there is no consensus regarding surgical margin width to decrease the high recurrence rate. Here we describe the first macroscopically visible satellite of axillary EMPD and wide local excision of both main lesion and the satellite lesion with only 0.5 cm margin, succeeded by a short review of the literature. Case presentation A 48-year-old female with a red macule in the right axilla was presented to our clinic. A well-demarcated 4 cm × 3 cm erythematous plaque was observed in the right axilla, and a similar lesion measuring 0.5 cm × 0.3 cm was found 3.5 cm away from the primary site. Breast and axillary node examination was unremarkable. Biopsy of the large plaque revealed Paget disease, then we performed a local extended excision of both lesions with a 0.5 cm margin, all margins negative indicated, by frozen pathology. Pathology revealed the nature of the satellite beside the main lesion also as Paget disease. The patient is currently followed-up for 20 months and has shown no signs of recurrence, with normal shoulder motor function. Conclusion We have report the first visible satellite of extramammary Paget disease, indicating the necessity of an extended local resection of both the main leision and the satellite lesion. Considering the anatomical structure of axillary Paget disease, a 0.5 cm negative surgical margin indicated by frozen pathology might be sufficient to sustain the shoulder motor function.

scholarly journals WIDE LOCAL EXCISION OF BREAST LUMP AND EXCISION OF GLUTEAL LIPOMA

2014 ◽  
Vol 3 (2) ◽  
pp. 188-189
Author(s):  
Masyitah Binti Ishak ◽  
Amer Hayat Khan ◽  
Andee Dzulkarnaen Zakaria ◽  
Syed Hassan ◽  
Syed Azhar Syed Sulaiman ◽  
...  
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Breast Lump

scholarly journals Axillary Paget Disease with a Visible Satellite: A Case Report and Literature Review

2021 ◽  
Author(s):  
Wuyang Ji ◽  
Bin Luo ◽  
Xue-Wei Wang ◽  
Ying Xiao ◽  
Jin-Yi Tian
Keyword(s):  
Motor Function ◽  
Local Excision ◽  
Wide Local Excision ◽  
Surgical Margin ◽  
High Recurrence Rate ◽  
Surgical Removal ◽  
Erythematous Plaque ◽  
Paget Disease ◽  
Satellite Lesion ◽  
The Right

Abstract Background : Extramammary Paget disease is an uncommon malignancy affecting apocrine gland–bearing skin, such as vulvar, perianal, axillary and penoscrotal areas. Paget cells are sometimes detected outside the clinical border in a phenomenon called subclinical extension. Satellite is one of the patterns of subclinical extension which is likely to be invisible. The standard management strategy for EMPD without distant metastasis is a complete surgical removal, sometimes called wide local excision. However, there is no consensus regarding surgical margin width to decrease the high recurrence rate. Here we describe the first macroscopically visible satellite of axillary EMPD and wide local excision of both main lesion and the satellite lesion with only 0.5cm margin, succeeded by a short review of the literature. Case presentation: A 48-year-old female with a red macule in the right axilla was presented to our clinic. A well-demarcated 4 cm×3 cm erythematous plaque was observed in the right axilla, and a similar lesion measuring 0.5 cm×0.3 cm was found 3.5 cm away from the primary site. Breast and axillary node examination was unremarkable. Biopsy of the large plaque revealed Paget disease, then we performed a local extended excision of both lesions with a 0.5cm margin, all margins negative indicated, by frozen pathology. Pathology revealed the nature of the satellite beside the main lesion also as Paget disease. The patient is currently followed-up for 20 months and has shown no signs of recurrence, with normal shoulder motor function. Conclusion: We have report the first visible satellite of extramammary Paget disease, indicating the necessity of an extended local resection of both the main leision and the satellite lesion. Considering the anatomical structure of axillary Paget disease, a 0.5cm negative surgical margin indicated by frozen pathology might be sufficient to sustain the shoulder motor function.

scholarly journals Characteristics and Treatment Challenges of Non-Clear Cell Renal Cell Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3807
Author(s):  
Pierangela Sepe ◽  
Arianna Ottini ◽  
Chiara Carlotta Pircher ◽  
Andrea Franza ◽  
Melanie Claps ◽  
...  
Keyword(s):  
Renal Cell ◽  
Kinase Inhibitors ◽  
Clear Cell ◽  
Case Reports ◽  
Treatment Options ◽  
Single Agent ◽  
Growth Factor Receptor ◽  
Mtor Inhibitors ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cell Rcc

Non-clear cell renal cell carcinomas (RCC) comprise several rare and poorly described diseases, often characterized by bad prognosis and with no standard treatments available. The gap in their clinical management is linked to the poor molecular characterization in handling the treatment of non clear-cell RCC with untailored therapies. Due to their rarity, non-clear RCC are in fact under-represented in prospective randomized trials. Thus, treatment choices are based on extrapolating results from clear cell RCC trials, retrospective data, or case reports. Over the last two decades, various options have been considered as the mainstay for the treatment of metastatic RCC (mRCC), including angiogenesis inhibitors, vascular endothelial growth factor receptor inhibitors, other tyrosine kinase inhibitors (TKIs), as well as MET inhibitors and mammalian targeting of rapamycin (mTOR) inhibitors. More recently, the therapeutic armamentarium has been enriched with immunotherapy, alone or in combination with targeted agents that have been shown to significantly improve outcomes of mRCC patients, if compared to TKI single-agent. It has been widely proven that non-clear cell RCC is a morphologically and clinically distinct entity from its clear cell counterpart but more knowledge about its biology is certainly needed. Histology-specific collaborative trials are in fact now emerging to investigate different treatments for non-clear cell RCC. This review summarizes pathogenetic mechanisms of non-clear cell RCC, the evolution of treatment paradigms over the last few decades, with a focus on immunotherapy-based trials, and future potential treatment options.

scholarly journals A Review of Genetic Abnormalities in Unicentric and Multicentric Castleman Disease

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 251
Author(s):  
Alexandra Butzmann ◽  
Jyoti Kumar ◽  
Kaushik Sridhar ◽  
Sumanth Gollapudi ◽  
Robert S. Ohgami
Keyword(s):  
Plasma Cells ◽  
Treatment Options ◽  
Disease Process ◽  
Castleman Disease ◽  
Mitogen Activated Protein Kinase ◽  
Human Herpes Virus 8 ◽  
Multicentric Castleman Disease ◽  
Molecular Abnormalities ◽  
Genetic Abnormalities ◽  
Mitogen Activated Protein

Castleman disease (CD) is a rare lymphoproliferative disorder known to represent at least four distinct clinicopathologic subtypes. Large advancements in our clinical and histopathologic description of these diverse diseases have been made, resulting in subtyping based on number of enlarged lymph nodes (unicentric versus multicentric), according to viral infection by human herpes virus 8 (HHV-8) and human immunodeficiency virus (HIV), and with relation to clonal plasma cells (POEMS). In recent years, significant molecular and genetic abnormalities associated with CD have been described. However, we continue to lack a foundational understanding of the biological mechanisms driving this disease process. Here, we review all cases of CD with molecular abnormalities described in the literature to date, and correlate cytogenetic, molecular, and genetic abnormalities with disease subtypes and phenotypes. Our review notes complex karyotypes in subsets of cases, specific mutations in PDGFRB N666S in 10% of unicentric CD (UCD) and NCOA4 L261F in 23% of idiopathic multicentric CD (iMCD) cases. Genes affecting chromatin organization and abnormalities in methylation are seen more commonly in iMCD while abnormalities within the mitogen-activated protein kinase (MAPK) and interleukin signaling pathways are more frequent in UCD. Interestingly, there is a paucity of genetic studies evaluating HHV-8 positive multicentric CD (HHV-8+ MCD) and POEMS-associated CD. Our comprehensive review of genetic and molecular abnormalities in CD identifies subtype-specific and novel pathways which may allow for more targeted treatment options and unique biologic therapies.

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