Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old ...Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old female patient with a localized well-differentiated adenocarcinoma that developed in a retrorectal cystic hamartoma. The patient was submitted to surgery (a Kraske procedure), with an R1 resection, followed by adjuvant radio-chemotherapy. After 23 months of follow up, the patient remains free from disease recurrence. Given the rarity of this entity, this case allows us to reflect on the differential diagnosis, therapeutic approach and patients’ follow-up.展开更多
Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challen...Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challenges of a case with multiple integrated diagnostic and therapeutic approaches and to bring to consideration the increasing prevalence of similar situations. Case Presentation: In this clinical case, the authors describe the evolution of an asymptomatic patient with several synchronous tumours (a GEJ primary adenocarcinoma, a low grade urothelial carcinoma in situ, a localized squamous cell lung carcinoma and 2 IPMNs). Conclusion: The challenge of this case lies in the difficult diagnostic approach, the assembly of a multidisciplinary and time-sensitive treatment plan and the individualized follow-up, due to lack of guidelines. More research is needed in this area.展开更多
Pancreatic adenocarcinoma is currently a major public health problem, being the 7th cause of death worldwide. Incidence is increasing and unfortunately nowadays the incidence is almost overlapping to mortality. The co...Pancreatic adenocarcinoma is currently a major public health problem, being the 7th cause of death worldwide. Incidence is increasing and unfortunately nowadays the incidence is almost overlapping to mortality. The cornerstone of curative treatment is still surgery, but adjuvant treatment is critical to decreasing the risk of recurrence.展开更多
The incidence of multiple primary tumours increases with age and due to multiple other factors as environmental and genetic predisposition. The authors describe a case of a 77-year-old female patient with diagnosis in...The incidence of multiple primary tumours increases with age and due to multiple other factors as environmental and genetic predisposition. The authors describe a case of a 77-year-old female patient with diagnosis in September 2009 of colon mucinous adenocarcinoma. She was submitted to surgery, considered R1 and adjuvant chemotherapy. Six months after treatment she had abdominal recurrence on a nodular lesion in peritoneal fat. The patient was submitted to surgery and did multiple courses of systemic treatment. She underwent cytoreductive surgery with hyperthermic chemotherapy, too. In December 2014 she presented a nodular lesion on the bladder and after excision, the histology confirmed a high-grade transitional cell carcinoma and she maintains treatment with endovesical BCG instillations. After that, she had no evidence of peritoneal disease progression. Besides the bad prognosis associated to peritoneal disease, our case report describes a long survival (5 years with no disease progression) in a patient with high risk at diagnosis to peritoneal recurrence. This case shows the importance of multimodal approach and the impact of locoregional treatment in localized metastatic disease.展开更多
文摘Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old female patient with a localized well-differentiated adenocarcinoma that developed in a retrorectal cystic hamartoma. The patient was submitted to surgery (a Kraske procedure), with an R1 resection, followed by adjuvant radio-chemotherapy. After 23 months of follow up, the patient remains free from disease recurrence. Given the rarity of this entity, this case allows us to reflect on the differential diagnosis, therapeutic approach and patients’ follow-up.
文摘Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challenges of a case with multiple integrated diagnostic and therapeutic approaches and to bring to consideration the increasing prevalence of similar situations. Case Presentation: In this clinical case, the authors describe the evolution of an asymptomatic patient with several synchronous tumours (a GEJ primary adenocarcinoma, a low grade urothelial carcinoma in situ, a localized squamous cell lung carcinoma and 2 IPMNs). Conclusion: The challenge of this case lies in the difficult diagnostic approach, the assembly of a multidisciplinary and time-sensitive treatment plan and the individualized follow-up, due to lack of guidelines. More research is needed in this area.
文摘Pancreatic adenocarcinoma is currently a major public health problem, being the 7th cause of death worldwide. Incidence is increasing and unfortunately nowadays the incidence is almost overlapping to mortality. The cornerstone of curative treatment is still surgery, but adjuvant treatment is critical to decreasing the risk of recurrence.
文摘The incidence of multiple primary tumours increases with age and due to multiple other factors as environmental and genetic predisposition. The authors describe a case of a 77-year-old female patient with diagnosis in September 2009 of colon mucinous adenocarcinoma. She was submitted to surgery, considered R1 and adjuvant chemotherapy. Six months after treatment she had abdominal recurrence on a nodular lesion in peritoneal fat. The patient was submitted to surgery and did multiple courses of systemic treatment. She underwent cytoreductive surgery with hyperthermic chemotherapy, too. In December 2014 she presented a nodular lesion on the bladder and after excision, the histology confirmed a high-grade transitional cell carcinoma and she maintains treatment with endovesical BCG instillations. After that, she had no evidence of peritoneal disease progression. Besides the bad prognosis associated to peritoneal disease, our case report describes a long survival (5 years with no disease progression) in a patient with high risk at diagnosis to peritoneal recurrence. This case shows the importance of multimodal approach and the impact of locoregional treatment in localized metastatic disease.
