影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水...影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水平的提升,MMBC患者的诊断、个体化治疗、接受保乳手术的安全性等焦点问题需重新被审视。本文将从MMBC流行病学特征、术前影像学评估、病理异质性与分子标志物、手术方式等多方面展开论述,以期加深临床认知。展开更多
Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring wi...Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring with a recurrent mucinous cystic neoplasm in a 38-year-old female. A 10-cm retroperitoneal cystic mass was pointed out in the first pregnancy and a probable diagnosis of mucinous cystic neoplasm was made in October 2000. She refused surgery first and delivered her baby uneventfully. During her second pregnancy in 2002, however, she presented hematemesis and underwent urgent distal pancreatectomy, splenectomy and partial resection of the gastric wall where the tumor perforated. A diagnosis of borderline-type mucinous cystic neoplasm with ovarian-like stroma was made. Nine months later, CT visualized a recurrent cystic tumor near the pancreatic stump, which was subsequently resected. Pathology revealed that the tumor was composed of two different components of borderline-type mucinous cystic neoplasm and anaplastic carcinoma. The latter was intensely positive for vimentin, CD68, p53 and focally for cytokeratin, suggesting both sarcomatous and carcinomatous differentiation. She survived four years after the second surgery without tumor recurrence. Although the origin of anaplastic carcinoma has not been determined yet, it should be remembered that anaplastic carcinoma can occur in association with mucinous cystic neoplasm of more benign histology.展开更多
文摘影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水平的提升,MMBC患者的诊断、个体化治疗、接受保乳手术的安全性等焦点问题需重新被审视。本文将从MMBC流行病学特征、术前影像学评估、病理异质性与分子标志物、手术方式等多方面展开论述,以期加深临床认知。
文摘Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring with a recurrent mucinous cystic neoplasm in a 38-year-old female. A 10-cm retroperitoneal cystic mass was pointed out in the first pregnancy and a probable diagnosis of mucinous cystic neoplasm was made in October 2000. She refused surgery first and delivered her baby uneventfully. During her second pregnancy in 2002, however, she presented hematemesis and underwent urgent distal pancreatectomy, splenectomy and partial resection of the gastric wall where the tumor perforated. A diagnosis of borderline-type mucinous cystic neoplasm with ovarian-like stroma was made. Nine months later, CT visualized a recurrent cystic tumor near the pancreatic stump, which was subsequently resected. Pathology revealed that the tumor was composed of two different components of borderline-type mucinous cystic neoplasm and anaplastic carcinoma. The latter was intensely positive for vimentin, CD68, p53 and focally for cytokeratin, suggesting both sarcomatous and carcinomatous differentiation. She survived four years after the second surgery without tumor recurrence. Although the origin of anaplastic carcinoma has not been determined yet, it should be remembered that anaplastic carcinoma can occur in association with mucinous cystic neoplasm of more benign histology.