Urachal Carcinoma with Peritoneal Dissemination Treated with Chemotherapy and Surgical Resection Leading to Prolonged Survival with No Recurrence

A 56-year-old man was admitted to our hospital for urachal carcinoma with peritoneal dissemination. He received first-line chemotherapy with gemcitabine and cisplatin. After the fifth cycle, a computed tomography (CT) scan revealed abdominal fluid, and his serum tumor marker levels were increased. The patient was started on second-line therapy with FOLFIRI. After 11 cycles, his tumor decreased in size and no new metastatic lesions were detected. The patient underwent complete tumor resection with partial cystectomy and pelvic lymph node dissection. The tumor was removed, along with adhering surrounding organs, including the omentum, peritoneum, abdominal rectus muscle, and vermiform appendix. Although pathological examination confirmed peritoneal dissemination, his tumor markers normalized soon after surgery. The patient has survived 62 months after surgery without any adjuvant therapy and with no evidence of recurrence. To our knowledge, this is the longest duration of survival without recurrence of a patient with urachal carcinoma with peritoneal dissemination who received multimodal therapy.

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Peritoneal dissemination of breast cancer diagnosed by laparoscopy

International Cancer Conference Journal ◽

10.1007/s13691-020-00456-w ◽

2020 ◽

Author(s):

Tsuyoshi Nakagawa ◽

Goshi Oda ◽

Akifumi Kikuchi ◽

Toshifumi Saito ◽

Tomoyuki Fujioka ◽

...

Keyword(s):

Breast Cancer ◽

Peritoneal Dissemination ◽

Imaging Techniques ◽

High Serum ◽

Primary Lesion ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Metastatic Lesions ◽

Laparoscopic Biopsy ◽

Systemic Symptoms

AbstractThe accuracy of modern imaging techniques for the diagnosis of peritoneal carcinomatosis is poor. A breast cancer patient with a high serum CA15-3 level did not receive a definitive diagnosis of peritoneal dissemination by imaging examination and then underwent laparoscopy. Pathological examination showed peritoneal dissemination of breast cancer, but the biological markers were different from the primary lesion: ER(−), PgR(−), and Her2:3 +. T-DM1 therapy was very effective, and her systemic symptoms disappeared. Since biomarkers of metastatic lesions may sometimes change, laparoscopic biopsy is very important and useful.

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Primary Pulmonary Synovial Sarcoma in Pregnancy

Case Reports in Obstetrics and Gynecology ◽

10.1155/2012/326031 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

K. Bunch ◽

S. H. Deering

Keyword(s):

Synovial Sarcoma ◽

Poor Prognosis ◽

Tumor Resection ◽

Postoperative Management ◽

Pathological Examination ◽

Complete Tumor Resection ◽

Rare Malignancy ◽

Primary Pulmonary Synovial Sarcoma ◽

Complete Tumor ◽

In Pregnancy

Background. Primary pulmonary synovial sarcoma is a rare malignancy with a poor prognosis. Surgical resection and postoperative management of these tumors has not been previously described in pregnancy.Case. A 38-year-old pregnant woman was admitted for evaluation of a right thoracic mass found on chest radiography at 26 weeks of gestation. A computed tomography-guided biopsy was subsequently completed and demonstrated a high-grade neoplasm. A right pneumonectomy was performed at 28 weeks of gestation due to pulmonary decompensation, and pathological examination revealed a pulmonary synovial sarcoma. The patient developed a postpartum pulmonary embolism and expired 6 weeks after delivery.Conclusion. Aggressive intervention for pulmonary malignancies during pregnancy may be necessary. Complete tumor resection is the most important prognostic factor in primary pulmonary synovial sarcoma.

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Osteosarcoma of the jaws: a literature review

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200806173948 ◽

2020 ◽

Vol 16 ◽

Author(s):

Francesco Ricotta ◽

Massimo Bassi ◽

Nicola Tomasetti ◽

Angelo Campobassi ◽

Vincenzo Maiolo ◽

...

Keyword(s):

Treatment Guidelines ◽

State Of The Art ◽

Bone Erosion ◽

Tumor Resection ◽

Bone Destruction ◽

Cell Type ◽

Complete Tumor Resection ◽

Predominant Cell Type ◽

Bone Changes ◽

Complete Tumor

: Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma, it is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. : The lesion is characterized by sarcomatous cells which produces a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. : Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today there is no a general consensus in the treatment guidelines for the OSJ though surgery represents the key of the treatment. The main prognostic factor deeply influencing the patient's prognosis remains the complete tumor resection with negative surgical margins. : The aim of the present review is to describe the state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.

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RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa222.795 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii460-iii460

Author(s):

Mayuko Miyata ◽

Masahiro Nonaka ◽

Akio Asai

Keyword(s):

Radiation Necrosis ◽

Tumor Resection ◽

Pathological Examination ◽

Secondary Cancer ◽

Brain Necrosis ◽

Cerebellar Medulloblastoma ◽

Cerebellar Peduncle ◽

The Right ◽

The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

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Diagnosis and Management of Extracranial Head and Neck Schwannomas: A Review of 27 Cases

International Journal of Otolaryngology ◽

10.1155/2013/973045 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 40

Author(s):

Ryuji Yasumatsu ◽

Torahiko Nakashima ◽

Rina Miyazaki ◽

Yuichi Segawa ◽

Shizuo Komune

Keyword(s):

Head And Neck ◽

Postoperative Morbidity ◽

Tumor Resection ◽

Clinical History ◽

Needle Aspiration ◽

Vagus Nerves ◽

Surgical Data ◽

Needle Aspiration Cytology ◽

Clinical Records ◽

Complete Tumor

Objectives. Clinical records of 27 patients with extracranial head and neck schwannoma were retrospectively reviewed.Methods. Ultrasonography (US) was performed in all cases. Seven patients underwent CT. Twenty-five patients underwent MRI. Fine needle aspiration cytology (FNAC) was performed for 12 of the 27 patients. Clinical history, surgical data, and postoperative morbidity were analyzed.Results. The images of US showed a well-defined, hypoechoic, primarily homogeneous solid mass. At CT, only one of 7 cases (14%) was able to suggest the diagnosis of schwannoma. At MRI, twenty of 25 cases (80%) suggested the diagnosis of schwannoma. Only three of 12 cases (25%) displayed a specific diagnosis of schwannoma rendered on FNAC. The distribution of 27 nerves of origin was 10 (37%) vagus nerves, 6 (22%) sympathetic trunks, 5 (19%) cervical plexuses, 3 (11%) brachial plexuses, 2 (7%) hypoglossal nerves, and 1 (4%) accessory nerve. Complete tumor resection was performed in 11 patients, and intracapsular enucleation of the tumor was performed in 16 patients. The rate of nerve palsy was 100 (11/11) and 31% (5/16).Conclusions. MRI is sensitive and specific in the diagnosis of schwannoma. Intracapsular enucleation was an effective and feasible method for preserving the neurological functions.

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Real-time surveillance of surgical margins via ICG-based near-infrared fluorescence imaging in patients with OSCC

10.21203/rs.3.rs-19925/v1 ◽

2020 ◽

Author(s):

Jiongru Pan ◽

Han Deng ◽

Shiqi Hu ◽

Chengwan Xia ◽

Yongfeng Chen ◽

...

Keyword(s):

Near Infrared ◽

Tumor Resection ◽

Animal Experiments ◽

Surgical Margins ◽

Pathological Examination ◽

Primary Tumors ◽

Near Infrared Fluorescence ◽

Normal Tissues ◽

Imaging And Spectroscopy ◽

Complementary Value

Abstract Background Local recurrence is the main cause of death among patients with oral squamous cell carcinoma (OSCC). This study assessed near-infrared fluorescence (NIF) imaging and spectroscopy to monitor surgical margins intraoperative for OSCC. Methods Cytological and animal experiments were first performed to confirm the feasibility of monitoring surgical margins with NIF imaging and spectroscopy. Then, 20 patients with OSCC were included in the clinical trials. At 6–8 hours after 0.75 mg/kg indocyanine green (ICG) injection, all patients underwent surgery with NIF imaging. During the surgery, both NIF images and quantified fluorescence intensity were acquired to monitor the surgical margins. Results In cytological and animal experiments, the results showed it is feasible to monitor surgical margins with NIF imaging and spectroscopy. Fluorescence was detected in primary tumors in all patients. The fluorescence intensities of the tumor, peritumoral, and normal tissues were 398.863±151.47, 278.52±84.89, and 274.5±100.93 arbitrary units (AUs), respectively (P<0.05). The SBR of tumor to peritumoral tissue and normal tissues was computed to be 1.45±0.36 and 1.56±0.41 respectively. After primary tumor excision, the wounds showed abnormal fluorescence in four patients (4/20), and residual cancer cells were confirmed by pathological examination in two patients (2/20). Conclusion These findings confirmed the complementary value of NIF imaging during radical tumor resection of OSCC.

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Management of a primary cardiac leiomyosarcoma in a young woman

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2021.21040 ◽

2021 ◽

Vol 29 (2) ◽

pp. 267-270

Author(s):

Mehmet Akif Önalan ◽

Ahmet Demirkaya ◽

Kemal Behzatoglu ◽

Ersin Erek

Keyword(s):

Pulmonary Veins ◽

Tumor Resection ◽

Complete Tumor Resection ◽

The Right ◽

Tumor Remnant ◽

Invasive Techniques ◽

Right Lower Lobectomy ◽

Pathological Confirmation ◽

Complete Tumor

Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.

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Brain metastasis from gallbladder neuroendocrine carcinoma

BMJ Case Reports ◽

10.1136/bcr-2020-238114 ◽

2020 ◽

Vol 13 (11) ◽

pp. e238114

Author(s):

Hanako Sasaki ◽

Takayoshi Goto ◽

Motohiro Hirao ◽

Yasunori Fujimoto

Keyword(s):

Neuroendocrine Carcinoma ◽

Peritoneal Metastases ◽

Pathological Examination ◽

Tubular Adenocarcinoma ◽

First Line ◽

Pathological Analysis ◽

Metastatic Lesions ◽

Significant Regression ◽

Line Drug ◽

Line Chemotherapy

A 52-year-old woman was diagnosed with unresectable gallbladder neuroendocrine carcinoma (GB-NEC) exhibiting lymph node and peritoneal metastases, and received eight courses of chemotherapy with irinotecan plus cisplatin. Radiological examinations revealed significant regression of the GB tumour and disappearance of metastatic lesions, so the patient underwent laparoscopic cholecystectomy. However, the patient presented with multiple haemorrhagic brain metastases (BMs) and died 13 months after the initial diagnosis despite neurosurgical interventions. Pathological examination of the resected gallbladder demonstrated an extensive fibrous scar along with tubular adenocarcinoma components, which may indicate that the chemotherapy eliminated a pre-existing neuroendocrine carcinoma (NEC) component. Furthermore, pathological analysis confirmed that the BMs comprised NEC. In patients with advanced GB-NEC, conversion surgery may be a reasonable option if a first-line chemotherapy leads to downstaging of the tumour. Second-line drug therapy and systemic screening might also be considered in cases with BMs.

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The largest reported intrathoracic lipoma: a case report and current perspectives review

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1030-8 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Mohammed Aldahmashi ◽

Abdalmotaleb Elmadawy ◽

Mahmoud Mahdy ◽

Mohamed Alaa

Keyword(s):

Single Case ◽

Tumor Resection ◽

Pathological Examination ◽

Complete Excision ◽

Case Presentation ◽

Medical Checkup ◽

Excellent Outcome ◽

The Right ◽

Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

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Fulminant Hepatic Failure Caused by Diffuse Liver Metastases following Gastrointestinal Stromal Tumor Resection

Clinical Medicine Gastroenterology ◽

10.4137/cgast.s3221 ◽

2009 ◽

Vol 2 ◽

pp. CGast.S3221

Author(s):

Abdel-Rauf Zeina ◽

Alicia Nachtigal ◽

Eugene Vlodavsky ◽

Jochanan E. Naschitz

Keyword(s):

Liver Metastases ◽

Gastrointestinal Stromal Tumor ◽

Fulminant Hepatic Failure ◽

Hepatic Failure ◽

Tumor Resection ◽

Stromal Tumor ◽

Prognostic Features ◽

Elevated Liver Enzymes ◽

Complete Tumor

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was diagnosed. The mass exhibited unfavorable prognostic features: mitotic index 18/50 high-power fields, large primary tumor size and male sex. Complete tumor resection with negative margins was achieved and metastases were not detected. The patient presented six months later with jaundice, asterixis and elevated liver enzymes. Computerized tomography showed multiple liver hypodense lesions representing metastases. Treatment with imatinib mesylate was of no avail and the patient died 3 days later as the result of hepatic failure. Massive liver metastases can, even though rarely, be responsible for fulminant hepatic failure. Clinical and radiological follow-up are crucial in patients with GIST even after surgical resection.

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