Phyllodes tumours are rare and account for 0.4% of all breast tumours. The majority of them tend to be less than 5 cms in size with giant tumours larger than 10 cms being about 20% of these cases. They display a broad...Phyllodes tumours are rare and account for 0.4% of all breast tumours. The majority of them tend to be less than 5 cms in size with giant tumours larger than 10 cms being about 20% of these cases. They display a broad range of clinical and pathological behavior and are regarded as falling within the spectrum of fibroepithelial neoplasms. Surgery has been the primary modality of treatment. However the extent of resection and the role of adjuvant radiotherapy and chemotherapy are still controversial. The risk of recurrence is (4.7% - 30%) for benign phyllodes tumour and (30% - 65%) for borderline and malignant phyllodes tumour. A case of giant phyllodes tumour measuring 36 × 30 cm and weighing 6.8 kg is presented, which had recurred following a previous resection 5 years back. The literature is reviewed with regards to pathology, the role of investigations, nature of resection and the risk factors for recurrence and展开更多
Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report exp...Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report experience with the treatment of GCTs, and reviews the relationship between surgical management and clinical outcome. Methods：A retrospective review was performed with 70 patients （32 males and 38 females） who presented to our institution between 1991 and 2001 with GCT of bone. An evaluation of the oncological and functional results was conducted and patients were divided into three groups according to the treatment method; Group Ⅰ ：（46 patients） intralesional curettage and adjuvant therapy and packing with filling materials. Group Ⅱ ：（18 patients） en-bloc resection and arthrodesis or reconstruction. Group Ⅲ ：（6 patients） amputation. Results：The mean follow-up period was 10 years （range, 5-15 years）. The overall rate of local recurrence was 14%, 22% in Group Ⅰ, and only 4% in Group Ⅱ and Group Ⅲ. According to the Musculoskeletal Tumour Society（MSTS） score for functional outcome, the mean overall score for Group I was 27.9 （out of 30）, 15.9 for Group Ⅱ. Of note, the 9 patients within Group Ⅱ who received endoprosthetic reconstruction, the mean overall MSTS functional score was 25.5. Conclusion：Intralesional curettage with adjuvant therapies and filling agents is often associated with a relatively high recurrence rate, however joint function is well preserved. Patients with more extensive, biologically aggressive, and/or recurrent tumours are best treated with en-bloc resection.展开更多
Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdomi...Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdominal mass. He was found to have a large gastric GIST that penetrated through the mesocolon. Resection of the GIST was technically challenging but facilitated by a new generation ultrasonic scalpel device. In resection of gastric cancer the use of ultrasonic scalpels has been shown to reduce operating time, blood loss and length of stay. We feel that in technically challenging cases of gastric GIST the use of an ultrasonic scalpel device may be justified as well.展开更多
文摘Phyllodes tumours are rare and account for 0.4% of all breast tumours. The majority of them tend to be less than 5 cms in size with giant tumours larger than 10 cms being about 20% of these cases. They display a broad range of clinical and pathological behavior and are regarded as falling within the spectrum of fibroepithelial neoplasms. Surgery has been the primary modality of treatment. However the extent of resection and the role of adjuvant radiotherapy and chemotherapy are still controversial. The risk of recurrence is (4.7% - 30%) for benign phyllodes tumour and (30% - 65%) for borderline and malignant phyllodes tumour. A case of giant phyllodes tumour measuring 36 × 30 cm and weighing 6.8 kg is presented, which had recurred following a previous resection 5 years back. The literature is reviewed with regards to pathology, the role of investigations, nature of resection and the risk factors for recurrence and
文摘Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report experience with the treatment of GCTs, and reviews the relationship between surgical management and clinical outcome. Methods：A retrospective review was performed with 70 patients （32 males and 38 females） who presented to our institution between 1991 and 2001 with GCT of bone. An evaluation of the oncological and functional results was conducted and patients were divided into three groups according to the treatment method; Group Ⅰ ：（46 patients） intralesional curettage and adjuvant therapy and packing with filling materials. Group Ⅱ ：（18 patients） en-bloc resection and arthrodesis or reconstruction. Group Ⅲ ：（6 patients） amputation. Results：The mean follow-up period was 10 years （range, 5-15 years）. The overall rate of local recurrence was 14%, 22% in Group Ⅰ, and only 4% in Group Ⅱ and Group Ⅲ. According to the Musculoskeletal Tumour Society（MSTS） score for functional outcome, the mean overall score for Group I was 27.9 （out of 30）, 15.9 for Group Ⅱ. Of note, the 9 patients within Group Ⅱ who received endoprosthetic reconstruction, the mean overall MSTS functional score was 25.5. Conclusion：Intralesional curettage with adjuvant therapies and filling agents is often associated with a relatively high recurrence rate, however joint function is well preserved. Patients with more extensive, biologically aggressive, and/or recurrent tumours are best treated with en-bloc resection.
文摘Gastrointestinal stroma tumours(GIST) are the most common mesenchymal tumour in the digestive tract and commonly found in the stomach. The patient described in this report presented with collapse and a palpable abdominal mass. He was found to have a large gastric GIST that penetrated through the mesocolon. Resection of the GIST was technically challenging but facilitated by a new generation ultrasonic scalpel device. In resection of gastric cancer the use of ultrasonic scalpels has been shown to reduce operating time, blood loss and length of stay. We feel that in technically challenging cases of gastric GIST the use of an ultrasonic scalpel device may be justified as well.
