We report a rare case involving a 52-year-old female diagnosed with an atypical bronchial carcinoid tumor with metastases to the mediastinum, hilar lymph nodes, breast, and pancreas. In additional, the patient had met...We report a rare case involving a 52-year-old female diagnosed with an atypical bronchial carcinoid tumor with metastases to the mediastinum, hilar lymph nodes, breast, and pancreas. In additional, the patient had metastases to the iris and ciliary body, resulting in progressive vision loss in her left eye. Treatment was successful by intravitreal injections of anti-vascular endothelial growth factor.展开更多
A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography ...A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography showed a hemangioma and a mosaic echoic lesion in the ventromedian with poor blood-flow signal and linear hyperechoic part inside, and a clear border to the surroundings. Dynamic computed tomography revealed a highly enhanced effect from the portal-venous phase continuing to the equilibrium phase. T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase that continued to the next phase. On the other hand, it contained a low intensity area by a fat suppression of that image. In addition, a T2-weighted image did not show a high intensity effect. Laparotomy was performed on the second day of hospitalization. The tumor had arisen from the ligamentum teres of the liver, and no metastasis or invasion of other organs was noted. It consisted of a lipid component of mature adipocytes and a fibrous component of deep dyeing pleomorphic or multinuclear atypical stromal cells. Immunohistochemical study of the atypical stromal cells demonstrated that they were positive for MDM2 and CDK4. A pathological diagnosis of atypical lipomatous tumor(ALT) was made, and the patient was discharged on the eighth day following the procedure. At the 6-mo follow-up dynamic CT, the patient was free of recurrence or metastasis. We experienced a patient with ALT in the ligamentum teres of the liver. This case suggests the need for a careful and detailed examination when encountering patients presenting with a mass; when neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is the most important.展开更多
Atypical teratoid/rhabdoid tumor (AT/RT) is an embryonic central nervous system tumor. It has a low incidence with a high degree of malignancy and a poor prognosis. Five years ago, we successfully treated a child with...Atypical teratoid/rhabdoid tumor (AT/RT) is an embryonic central nervous system tumor. It has a low incidence with a high degree of malignancy and a poor prognosis. Five years ago, we successfully treated a child with AT/RT. Treatment comprised total tumor resection, 6 MV X 3D conformal radiotherapy (DT: 36Gy/18FX) and six courses of chemotherapy, including teniposide 25 mg (qd × 5d), ACNU 25 mg (qd × 1d), vincristine 1 mg (qd × 1d). There was no tumor recurrence after 5 years of follow-up. We adjusted the previous AT/RT regimen to make it more suitable for the individual treatment of this patient, and now the patient has achieved a cure. So we think this regimen is effective and it is worthy of recommendation.展开更多
Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunoc...Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunocompromised or previously irradiated patients. These are part of a spectrum of more aggressive fibro-histiocytic neoplasms. In the older literature, these have been termed aggressive or metastatic AFX, but currently these have been reclassified as pleomorphic dermal sarcomas (PDS) and systemic undifferentiated pleomorphic sarcoma (UPS, formerly malignant fibrohistiocytic sarcoma, MFH). We present the case of a 64-year old woman who developed a deeply invasive PDS on the vertex of her scalp invading to the galea, with in-transit scalp metastases. Very little information is available about optimal treatment of metastatic PDS lesions. The patient was initially treated with 2 cycles of epirubicin/ifosfamide chemotherapy, resulting in life-threatening complications. A pretreatment peripheral blood sample was sent for CTC-derived colony assay. This sample grew 8 colonies from 10 ml blood. The tumor failed to respond to epirubicin and ifosfamide, and after several months of hospitalization, a second peripheral blood CTC-derived colony assay grew >376 colonies. The patient could not tolerate additional chemotherapy. She was therefore treated with the oral targeted agent pazopanib. The patient developed a dramatic biopsy-confirmed complete response. After 11 months of pazopanib treatment, a repeat CTC-derived culture sample grew only 8 colonies/10 ml blood. The complete response to pazopanib is still ongoing at over 41 months. To our knowledge, this is the first demonstration of clinical complete response of a PDS tumor following targeted therapy. An additional novel feature was the demonstration that CTC-derived colonies could be grown from the blood of a PDS patient. The number of colonies appeared to correlate with the clinical treatment response and seemed to function as a potential prognostic marker.展开更多
<strong>Introduction:</strong> Kidney cancer represents 2% to 3% of malignant tumors, with an incidence of 5.8/100,000 in Western countries, a very specific subgroup of renal tumors that are cystic tumors....<strong>Introduction:</strong> Kidney cancer represents 2% to 3% of malignant tumors, with an incidence of 5.8/100,000 in Western countries, a very specific subgroup of renal tumors that are cystic tumors. In fact, almost 50% of the population over 50 has a renal cyst. <strong>Materials and Methods:</strong> The objective of this study is to establish a correlation between the preoperative Bosniak score and the postoperative anatomopathological analysis in order to answer this question, the use of contrast ultrasound or MRI should be systematically performed before an atypical renal cyst? This is a retrospective study of 50 patients treated for renal cysts between January 2010 and March 2016. All patients have an abdominopelvic ultrasound and an abdominal scanner. Cysts have been classified according to the Bosniak classification. We treated our patients based on the radiological examination urocsanner and we classified our patients according to the classification of Bosniak, and uro MRI was performed in cases of atypical cysts or diagnostic doubt before considering a therapeutic attituderding to the classification of Bosniak. <strong>Results:</strong> In our work, the Uro MRI was sharper for atypical cysts (type IIF and Type III cyst) with sensitivity greater than that of the scanner but with a specificity similar to that of the scanner. And therefore be a key examination in the atypical kidney cysts. <strong>Conclusions:</strong> URO MRI is currently in 2020 a key examination of atypical bonsiak IIf and III cysts before management of the therapeutic load.展开更多
OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis(AEM),and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs.The chan...OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis(AEM),and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs.The changes in the glandular epithelium,stroma,and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4%(163/3,724)of the endometriosis(EM)cases.Of 172 AEM foci of 163 patients,168 were in the ovary,and the other 4 were in the fallopian tube,cervix and uterine serosa.Of the cases of ovarian EM,6.8%were AEM.All of the 27 cases(15.7%)of the AEMs associated with a tumor were found in the ovaries,of which 15 were malignant, 9 borderline,and 3 benign.Of the ovary AEMs,14.9%were associated with a borderline or malignant tumor.The AEM epithelia were mainly arranged in the form of surface epithelia,with only a few glands.Present were characteristic features of moderate to marked pleomorphism,epithelial tufting,bud or firework-like structures on microscopy.Epithelial metaplastic changes were observed in 86 cases(50%)of the 172 AEM foci.Epithelium,endometrioid stroma,and fibrotic-col agen formed a three-layer structure in the wal of the AEM cysts.The endometrioid stroma were usually thin compared to the fibro-collagen tissue.The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM.AEMs have a relative higher potential for tumorigenesis and canceration,especial y for ovarian cancer. The process of damage,repair,and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.展开更多
Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentatio...Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentation. Although focal and scattered calcifications are not uncommon within the primary tumor mass, heavy calcification within a GIST is rarely described in the literature and the clinical-biological meaning of this feature remains unclear. Cases with such an atypical presentation are challenging and may be associated with diagnostic pitfalls. Herein, we report a gastric GIST with the unusual presentation of prominent calcifications that was identified incidentally on imaging during a post-trauma diagnostic work-up. The patient underwent laparoscopic surgery with a radical resection of the mass, which was subsequently characterized by histological analysis as spindle-shaped tumor cells, positive for CD117/c-KIT, CD34 and DOG1, and with calcified areas. Given the intermediate risk of recurrence, no adjuvant therapy was recommended andthe patient underwent regular follow-up for 22 mo, with no evidence of relapse. Our case can be considered of interest because of the rarity of clinical presentation and the uniquely large size of the GIST at diagnosis(longest diameter exceeding 9 cm). In closing, we discuss the pathophysiology and clinical implications of calcifications in GISTs by reviewing the most up-to-date relevant literature.展开更多
Biliary cyst tumors(cystadenoma and cystadeno-carcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver,but differential diagnosis with multiloculated or co...Biliary cyst tumors(cystadenoma and cystadeno-carcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver,but differential diagnosis with multiloculated or complicated biliary cysts,atypical hemangiomas,hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography(CT) and magnetic resonance imaging(MRI) are often not diagnostic and in these cases fine needle aspiration(FNA) is used to confirm the presence of atypical biliary cells. FNA,however,lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation of cystadenoma from cystadenocarcinoma is impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma,it is important to exclude liver metastasis,of which colonic cancer is the most common primary site. Multiple biliary hamartomas(von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic,but occasionally a percutaneous biopsy may be required.展开更多
BACKGROUND Ileocecal intussusception caused by two different tumors is rare,according to a literature review.We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon obse...BACKGROUND Ileocecal intussusception caused by two different tumors is rare,according to a literature review.We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon observed by colonoscopy before surgery.It was considered to be intussusception caused by colon cancer.However,a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery,which posed a challenge in the preoperative diagnosis.CASE SUMMARY We report a 72-year-old male patient with intussusception.The patient underwent right hemicolectomy and cholecystectomy in our hospital on April 29,2019.During operation,the ileum was inserted into the ascending colon by about 15 cm,and a tumor with a diameter of approximately 3.0 cm was observed in the distal part of the intestine.An atypical liposarcoma/highly differentiated liposarcoma in the adipose tissue was suspected in the postoperative pathology,and a lipoma was diagnosed after MDM2 gene testing.A 4.0 cm×5.0 cm polypoid mass was seen immediately adjacent to the mass,and the postoperative pathology report suggested a high-level tubular adenoma.The patient was eventually cured and discharged with an uneventful follow-up.CONCLUSION Intussusception caused by two different types of masses is extremely rare.At present,surgery is the best treatment once intussusception is diagnosed.展开更多
Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the commonest malignant neoplasms of the diaphragm; however, only a few(less than 20) cases have ...Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the commonest malignant neoplasms of the diaphragm; however, only a few(less than 20) cases have been reported to date. We present the case of an extremely rare tumor of the diaphragm mimicking a liver mass. The patient, a young 28-year-old woman, presented with an 8-month-history of mildly progressive upper abdominal pain and early fullness after meals. Computed tomography scan of the abdomen revealed a mass located in the region of the left lobe of the liver with non visualized left lobe and partial vascular supply of the mass from the left hepatic artery. The tumor was also seen to draw its vascularity from bilateral internal mammary arteries. Surgical excision and hepatectomy was planned, keeping in mind the diagnosis of an atypical left hepatic mass. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen, compressing and splaying the liver along the left medial surface where the tumorwas virtually adherent to it. Successful excision of the mass and subsequent histopathological and immunochemistry examination of the specimen revealed low grade fibromyxoid sarcoma of the diaphragm. This case highlights the unusual presentation of a diaphragmatic mesenchymal tumor and how it can be mistaken as an atypical liver mass. It also emphasizes the tumoral vascular supply as an indicator of its organ of origin.展开更多
Oncologic staging of many solid organ malignancies involves an understanding of how cancers spread via the lymphatic system, and ultimately may involve evaluation of the primary nodal drainage basin by performing a se...Oncologic staging of many solid organ malignancies involves an understanding of how cancers spread via the lymphatic system, and ultimately may involve evaluation of the primary nodal drainage basin by performing a sentinel lymph node biopsy. In the adult population, there are well established indications for sentinel lymph node biopsy in diseases like melanoma and breast cancer. However, its use and relevance in the pediatric population is less defined. This review details the history and development of sentinel lymph node biopsy technique, advanced lymph node mapping techniques currently under investigation, and the applications of sentinel node biopsy towards childhood cancers.展开更多
文摘We report a rare case involving a 52-year-old female diagnosed with an atypical bronchial carcinoid tumor with metastases to the mediastinum, hilar lymph nodes, breast, and pancreas. In additional, the patient had metastases to the iris and ciliary body, resulting in progressive vision loss in her left eye. Treatment was successful by intravitreal injections of anti-vascular endothelial growth factor.
文摘A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography showed a hemangioma and a mosaic echoic lesion in the ventromedian with poor blood-flow signal and linear hyperechoic part inside, and a clear border to the surroundings. Dynamic computed tomography revealed a highly enhanced effect from the portal-venous phase continuing to the equilibrium phase. T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase that continued to the next phase. On the other hand, it contained a low intensity area by a fat suppression of that image. In addition, a T2-weighted image did not show a high intensity effect. Laparotomy was performed on the second day of hospitalization. The tumor had arisen from the ligamentum teres of the liver, and no metastasis or invasion of other organs was noted. It consisted of a lipid component of mature adipocytes and a fibrous component of deep dyeing pleomorphic or multinuclear atypical stromal cells. Immunohistochemical study of the atypical stromal cells demonstrated that they were positive for MDM2 and CDK4. A pathological diagnosis of atypical lipomatous tumor(ALT) was made, and the patient was discharged on the eighth day following the procedure. At the 6-mo follow-up dynamic CT, the patient was free of recurrence or metastasis. We experienced a patient with ALT in the ligamentum teres of the liver. This case suggests the need for a careful and detailed examination when encountering patients presenting with a mass; when neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is the most important.
文摘Atypical teratoid/rhabdoid tumor (AT/RT) is an embryonic central nervous system tumor. It has a low incidence with a high degree of malignancy and a poor prognosis. Five years ago, we successfully treated a child with AT/RT. Treatment comprised total tumor resection, 6 MV X 3D conformal radiotherapy (DT: 36Gy/18FX) and six courses of chemotherapy, including teniposide 25 mg (qd × 5d), ACNU 25 mg (qd × 1d), vincristine 1 mg (qd × 1d). There was no tumor recurrence after 5 years of follow-up. We adjusted the previous AT/RT regimen to make it more suitable for the individual treatment of this patient, and now the patient has achieved a cure. So we think this regimen is effective and it is worthy of recommendation.
文摘Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunocompromised or previously irradiated patients. These are part of a spectrum of more aggressive fibro-histiocytic neoplasms. In the older literature, these have been termed aggressive or metastatic AFX, but currently these have been reclassified as pleomorphic dermal sarcomas (PDS) and systemic undifferentiated pleomorphic sarcoma (UPS, formerly malignant fibrohistiocytic sarcoma, MFH). We present the case of a 64-year old woman who developed a deeply invasive PDS on the vertex of her scalp invading to the galea, with in-transit scalp metastases. Very little information is available about optimal treatment of metastatic PDS lesions. The patient was initially treated with 2 cycles of epirubicin/ifosfamide chemotherapy, resulting in life-threatening complications. A pretreatment peripheral blood sample was sent for CTC-derived colony assay. This sample grew 8 colonies from 10 ml blood. The tumor failed to respond to epirubicin and ifosfamide, and after several months of hospitalization, a second peripheral blood CTC-derived colony assay grew >376 colonies. The patient could not tolerate additional chemotherapy. She was therefore treated with the oral targeted agent pazopanib. The patient developed a dramatic biopsy-confirmed complete response. After 11 months of pazopanib treatment, a repeat CTC-derived culture sample grew only 8 colonies/10 ml blood. The complete response to pazopanib is still ongoing at over 41 months. To our knowledge, this is the first demonstration of clinical complete response of a PDS tumor following targeted therapy. An additional novel feature was the demonstration that CTC-derived colonies could be grown from the blood of a PDS patient. The number of colonies appeared to correlate with the clinical treatment response and seemed to function as a potential prognostic marker.
文摘<strong>Introduction:</strong> Kidney cancer represents 2% to 3% of malignant tumors, with an incidence of 5.8/100,000 in Western countries, a very specific subgroup of renal tumors that are cystic tumors. In fact, almost 50% of the population over 50 has a renal cyst. <strong>Materials and Methods:</strong> The objective of this study is to establish a correlation between the preoperative Bosniak score and the postoperative anatomopathological analysis in order to answer this question, the use of contrast ultrasound or MRI should be systematically performed before an atypical renal cyst? This is a retrospective study of 50 patients treated for renal cysts between January 2010 and March 2016. All patients have an abdominopelvic ultrasound and an abdominal scanner. Cysts have been classified according to the Bosniak classification. We treated our patients based on the radiological examination urocsanner and we classified our patients according to the classification of Bosniak, and uro MRI was performed in cases of atypical cysts or diagnostic doubt before considering a therapeutic attituderding to the classification of Bosniak. <strong>Results:</strong> In our work, the Uro MRI was sharper for atypical cysts (type IIF and Type III cyst) with sensitivity greater than that of the scanner but with a specificity similar to that of the scanner. And therefore be a key examination in the atypical kidney cysts. <strong>Conclusions:</strong> URO MRI is currently in 2020 a key examination of atypical bonsiak IIf and III cysts before management of the therapeutic load.
文摘OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis(AEM),and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs.The changes in the glandular epithelium,stroma,and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4%(163/3,724)of the endometriosis(EM)cases.Of 172 AEM foci of 163 patients,168 were in the ovary,and the other 4 were in the fallopian tube,cervix and uterine serosa.Of the cases of ovarian EM,6.8%were AEM.All of the 27 cases(15.7%)of the AEMs associated with a tumor were found in the ovaries,of which 15 were malignant, 9 borderline,and 3 benign.Of the ovary AEMs,14.9%were associated with a borderline or malignant tumor.The AEM epithelia were mainly arranged in the form of surface epithelia,with only a few glands.Present were characteristic features of moderate to marked pleomorphism,epithelial tufting,bud or firework-like structures on microscopy.Epithelial metaplastic changes were observed in 86 cases(50%)of the 172 AEM foci.Epithelium,endometrioid stroma,and fibrotic-col agen formed a three-layer structure in the wal of the AEM cysts.The endometrioid stroma were usually thin compared to the fibro-collagen tissue.The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM.AEMs have a relative higher potential for tumorigenesis and canceration,especial y for ovarian cancer. The process of damage,repair,and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.
文摘Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentation. Although focal and scattered calcifications are not uncommon within the primary tumor mass, heavy calcification within a GIST is rarely described in the literature and the clinical-biological meaning of this feature remains unclear. Cases with such an atypical presentation are challenging and may be associated with diagnostic pitfalls. Herein, we report a gastric GIST with the unusual presentation of prominent calcifications that was identified incidentally on imaging during a post-trauma diagnostic work-up. The patient underwent laparoscopic surgery with a radical resection of the mass, which was subsequently characterized by histological analysis as spindle-shaped tumor cells, positive for CD117/c-KIT, CD34 and DOG1, and with calcified areas. Given the intermediate risk of recurrence, no adjuvant therapy was recommended andthe patient underwent regular follow-up for 22 mo, with no evidence of relapse. Our case can be considered of interest because of the rarity of clinical presentation and the uniquely large size of the GIST at diagnosis(longest diameter exceeding 9 cm). In closing, we discuss the pathophysiology and clinical implications of calcifications in GISTs by reviewing the most up-to-date relevant literature.
文摘Biliary cyst tumors(cystadenoma and cystadeno-carcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver,but differential diagnosis with multiloculated or complicated biliary cysts,atypical hemangiomas,hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography(CT) and magnetic resonance imaging(MRI) are often not diagnostic and in these cases fine needle aspiration(FNA) is used to confirm the presence of atypical biliary cells. FNA,however,lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation of cystadenoma from cystadenocarcinoma is impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma,it is important to exclude liver metastasis,of which colonic cancer is the most common primary site. Multiple biliary hamartomas(von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic,but occasionally a percutaneous biopsy may be required.
基金Supported by the National Natural Science Foundation of China,No.81572360the Liaoning Provincial Department of Education Science Research Project,No. L2014299
文摘BACKGROUND Ileocecal intussusception caused by two different tumors is rare,according to a literature review.We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon observed by colonoscopy before surgery.It was considered to be intussusception caused by colon cancer.However,a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery,which posed a challenge in the preoperative diagnosis.CASE SUMMARY We report a 72-year-old male patient with intussusception.The patient underwent right hemicolectomy and cholecystectomy in our hospital on April 29,2019.During operation,the ileum was inserted into the ascending colon by about 15 cm,and a tumor with a diameter of approximately 3.0 cm was observed in the distal part of the intestine.An atypical liposarcoma/highly differentiated liposarcoma in the adipose tissue was suspected in the postoperative pathology,and a lipoma was diagnosed after MDM2 gene testing.A 4.0 cm×5.0 cm polypoid mass was seen immediately adjacent to the mass,and the postoperative pathology report suggested a high-level tubular adenoma.The patient was eventually cured and discharged with an uneventful follow-up.CONCLUSION Intussusception caused by two different types of masses is extremely rare.At present,surgery is the best treatment once intussusception is diagnosed.
文摘Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the commonest malignant neoplasms of the diaphragm; however, only a few(less than 20) cases have been reported to date. We present the case of an extremely rare tumor of the diaphragm mimicking a liver mass. The patient, a young 28-year-old woman, presented with an 8-month-history of mildly progressive upper abdominal pain and early fullness after meals. Computed tomography scan of the abdomen revealed a mass located in the region of the left lobe of the liver with non visualized left lobe and partial vascular supply of the mass from the left hepatic artery. The tumor was also seen to draw its vascularity from bilateral internal mammary arteries. Surgical excision and hepatectomy was planned, keeping in mind the diagnosis of an atypical left hepatic mass. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen, compressing and splaying the liver along the left medial surface where the tumorwas virtually adherent to it. Successful excision of the mass and subsequent histopathological and immunochemistry examination of the specimen revealed low grade fibromyxoid sarcoma of the diaphragm. This case highlights the unusual presentation of a diaphragmatic mesenchymal tumor and how it can be mistaken as an atypical liver mass. It also emphasizes the tumoral vascular supply as an indicator of its organ of origin.
文摘Oncologic staging of many solid organ malignancies involves an understanding of how cancers spread via the lymphatic system, and ultimately may involve evaluation of the primary nodal drainage basin by performing a sentinel lymph node biopsy. In the adult population, there are well established indications for sentinel lymph node biopsy in diseases like melanoma and breast cancer. However, its use and relevance in the pediatric population is less defined. This review details the history and development of sentinel lymph node biopsy technique, advanced lymph node mapping techniques currently under investigation, and the applications of sentinel node biopsy towards childhood cancers.
