scholarly journals A Case of Cellular Fibrous Histiocytoma on the Right Elbow with Repeated Relapse within a Short Period

2015 ◽  
Vol 7 (1) ◽  
pp. 10-16
Author(s):  
Kanako Tsunoda ◽  
Hiroki Oikawa ◽  
Fumihiko Maeda ◽  
Kazuhiro Takahashi ◽  
Toshihide Akasaka
Keyword(s):  
Local Recurrence ◽  
Growth Pattern ◽  
Fibrous Histiocytoma ◽  
Resected Specimen ◽  
Wide Field ◽  
Ki 67 ◽  
Short Period ◽  
Cutaneous Tumor ◽  
The Right

Cellular fibrous histiocytoma, a variant of fibrous histiocytoma, is a designation used for lesions showing increased cellularity with a fascicular growth pattern and frequent extension into the subcutis. Here we describe a case of cellular fibrous histiocytoma showing repeated recurrence in a 36-year-old woman who initially presented with a 2-cm cutaneous tumor on her right elbow. Histopathologically, the first resected specimen demonstrated irregularly arranged collagen fibers mixed with scattered proliferating plump to spindle-shaped fibrohistiocytes. However, examination of the resected specimens obtained after recurrence showed that the cellularity had increased, the spindle-shaped cells showing monomorphic proliferation with a fascicular and storiform growth pattern extending into the subcutis, as well as an increase of Ki-67 positivity. Since the lesion showed repeated relapse within a short period, we performed wide-field resection of the tumor with a 3-cm margin. Currently, 48 months after surgery, there has been no local recurrence or metastasis, but continuous strict follow-up will be necessary.

scholarly journals A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Kotaro Terashima ◽  
Yoshiyuki Shioyama ◽  
Satoshi Nomoto ◽  
Saiji Ohga ◽  
Takeshi Nonoshita ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Short Interval ◽  
Primary Lung Cancer ◽  
Dorsal Side ◽  
Ct Guided ◽  
Radiation Fibrosis ◽  
Ct Guided Biopsy ◽  
Serum Cea ◽  
The Right

We report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 12 months, mass-like consolidation appeared around the irradiated area, and after 13 months, it had increased in size. FDG-PET revealed high uptake (SUVmax=5.61) for the consolidation. CT-guided biopsy was performed, but we could not confirm the diagnosis. Considering her poor respiratory function and her age, short-interval follow-up was performed. After 15 months, the consolidation enlarged at the dorsal side, and carcinoembryonic antigen (CEA) became elevated (14.6 ng/mL). Serum KL-6 (436 U/mL) and SP-D (204 ng/mL) were also elevated. However, after 16 months, serum CEA slightly decreased. The consolidation gradually retracted on follow-up CT images. CEA, KL-6, and SP-D were also decreased by degrees. After 40 months, there is no evidence of local recurrence.

Unusual presentation of early-onset X-linked retinoschisis: Report after 1 year of multimodal follow-up

2020 ◽  
pp. 112067212091672
Author(s):  
Andrea Lembo ◽  
Giacomo Maria Bacci ◽  
Massimiliano Serafino ◽  
Stefano Lucentini ◽  
Roberto Caputo ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Early Onset ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Retinal Dystrophy ◽  
Unusual Presentation ◽  
Macular Dystrophy ◽  
Wide Field ◽  
The Right

Purpose: To describe the unusual presentation, diagnosis, and clinical course of an early-onset X-linked infantile retinoschisis Case report: A 6-month-old infant presented with strabismus and poor fixation. After the detection of bilateral intraretinal hemorrhage and diffuse dystrophic retinal pattern at indirect ophthalmoscopy, the patient received a complete evaluation under anesthesia. Retinal wide-field imaging, spectral domain optical coherence tomography, and electroretinogram were performed and revealed a retinoschisis involving the posterior pole and the inferior periphery in the right eye. In the left eye, an inferior retinal detachment extending to the macula was detected. Blood sample and genetic counseling were required in the strong suspicion of an inherited retinal dystrophy. Genetic tests confirmed the diagnosis of X-linked retinoschisis (RS1 gene mutation). After consultation with a pediatric vitreoretinal surgeon, a wait and see strategy was chosen. The follow up visits showed a surprisingly good natural course of the disease. Conclusion: X-linked retinoschisis is a well-known inherited retinal disease potentially affecting young children as early as 3 months old. In this case, the stunning presentation (diffuse retinal pigment epithelium dystrophic changes resembling a macular dystrophy) and the positive course of the disease (resolution of macular retinal detachment in the left eye and stability of schisis in the right eye) arise some interesting considerations about the necessity of an early surgical treatment.

Malignant triton tumour (MTT) of the lung with metastasis to the proximal femur

2021 ◽  
Vol 14 (2) ◽  
pp. e237086
Author(s):  
Hany Elbardesy ◽  
Rehan Gul ◽  
Michael Bennett ◽  
Derek G Power
Keyword(s):  
Local Recurrence ◽  
Female Patient ◽  
Proximal Femur ◽  
Multidisciplinary Team ◽  
Pathological Fracture ◽  
Excisional Biopsy ◽  
History Of ◽  
The Right ◽  
Malignant Triton Tumour

A 65-year-old female patient has a history of malignant triton tumour of the right upper lobe of the lung. She underwent right upper lobectomy and lymphadenectomy in May 2018. She presented in November 2019 with pathological fracture of the left proximal femur. It was not associated with neurofibromatosis. We decided to do an excisional biopsy of the mass and proximal femoral replacement followed by radiotherapy. Four months later, she presented with local recurrence. We organised a multidisciplinary team between the orthopaedic, histopathology and oncology teams. Then, we decided to treat her with chemotherapy. After 2 months of follow-up, she responded well to the chemotherapy with no further deterioration of her condition.

Oligodendroglioma arising in the glial component of ovarian teratomas: a series of six cases and review of literature

2012 ◽  
Vol 65 (7) ◽  
pp. 631-634 ◽  
Author(s):  
Nasir Ud Din ◽  
Aisha Memon ◽  
Kanwal Aftab ◽  
Zubair Ahmad ◽  
Rashida Ahmed ◽  
...  
Keyword(s):  
Review Of Literature ◽  
Ki 67 ◽  
Who Grade ◽  
Long Term Follow Up ◽  
Grade Ii ◽  
The Right ◽  
Rule Out ◽  
Ovarian Teratomas

AimsTo report the exceedingly rare occurrence of oligodendroglioma in the glial component of ovarian teratomas.MethodsSix cases of oligodendrogliomas arising in the glial component of ovarian teratomas were studied and the literature was reviewed. Immunohistochemistry was performed by the Flex technique.ResultsThe ages of the patients ranged from 12 to 28 years (mean 21 years). Four tumours were located in the right and one in the left ovary. The size of the ovarian cysts ranged from 7 cm to 29 cm (mean 19.6 cm). Four cases arose in immature and two cases in mature teratomas. In all cases, oligodendroglioma was WHO grade II. On immunohistochemistry, glial fibrillary acidic protein stain was positive in all cases. The Mib 1 (Ki 67) proliferative index was low and the tumour cells were negative for synaptophysin. Follow-up was available in five patients and ranged from 1 to 42 months. Two patients died of disease after 1 and 36 months of diagnosis, respectively. In both these cases oligodendroglioma arose in an immature teratoma. The remaining three patients are alive with a follow-up of 4–42 months.ConclusionsOligodendroglioma arising in the glial component of ovarian teratomas is exceedingly rare. Ovarian teratomas should be extensively sampled and carefully evaluated to rule out the possibility of a glial tumour. This is the single and largest series of oligodendrogliomas arising in ovarian teratomas. The prognosis is good for oligodendrogliomas arising in mature teratomas compared with those arising in immature teratomas, although long-term follow-up is needed to determine the exact behaviour.

scholarly journals Denosumab: A potential new treatment option for recurrent Aneurysmal Bone Cyst of the spine

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 10 ◽  
Author(s):  
Arvind G. Kulkarni ◽  
Ankit Patel
Keyword(s):  
Local Recurrence ◽  
Human Monoclonal Antibody ◽  
Bone Cyst ◽  
Surgical Excision ◽  
Long Term Results ◽  
Osteolytic Lesions ◽  
Short Period ◽  
New Treatment

ABCs are expansile osteolytic lesions typically containing blood-filled spaces separated by fibrous septae. Standard treatment includes surgical resection or curettage and packing; however, for some spinal lesions, the standard approach is not optimal. One therapeutic strategy is to treat spinal ABC with an agent that targets a pathway that is dysregulated in a disease with similar pathophysiology. Denosumab, a human monoclonal antibody to RANKL is effective in the treatment of GCT's. Spinal ABCs are a therapeutic challenge and local recurrence is a concern. We report a case of aggressive recurrent ABC of dorsal spine in a 14-year old female with progressive neurologic deficit who underwent surgical excision and decompression with a recurrence in a short period for which a decompression and fixation was done. She had a recurrence after an asymptomatic period of 6 months and neurologic worsening. Having ruled out use of embolization and radiotherapy, a remission was achieved by treatment with Denosumab using the regimen for GCTs for a duration of 6 months. Follow-up MRI and CT scans at 24 months following inception of Denosumab depicted complete resolution and no recurrence. We conclude that Denosumab can result in symptomatic and radiological improvement in the recurrent locally aggressive ABC and may be useful in selected cases. Long-term results are mandatory to confirm the efficacy of Denosumab and to evaluate local recurrence after stopping Denosumab.

Cardiac Tumors: Surgical Experience in Thirty-Nine Cases

1996 ◽  
Vol 4 (1) ◽  
pp. 14-17
Author(s):  
Rajendar Krishan Suri ◽  
Raghuvir Singh Kanwar ◽  
Harjinder Singh ◽  
Rajinder Singh Dhaliwal ◽  
Sandeep Singh Rana ◽  
...  
Keyword(s):  
Malignant Fibrous Histiocytoma ◽  
Malignant Tumors ◽  
Fibrous Histiocytoma ◽  
Postoperative Radiotherapy ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Malignant Group ◽  
The Right

Over a period of 18 years, 39 cases of cardiac tumors were operated upon in the Department of Cardiothoracic Surgery at the Postgraduate Institute of Medical Education and Research, Chandigarh. These included 34 (87%) patients with benign tumors and 5 (13%) patients with primary malignant tumors. All the benign tumors were myxomas, of which 31 (91.2%) were in the left atrium and 3 (8.8%) in right atrium. Primary malignant tumors comprised 2 rhabdomyosarcomas, 1 angiosarcoma, 1 lymphoma and 1 case of pleomorphic malignant fibrous histiocytoma. The diagnosis was established by echocardiography, angiocardiography and computed tomography. In one case the diagnosis was made at autopsy. All myxomas, except tricuspid valve myxoma, were removed completely through right atrial or biatrial approach with the use of cardiopulmonary bypass. Four cases of primary malignant tumors were non-resectable. Near total resection of a malignant fibrous histiocytoma arising from the right middle pulmonary vein and left atrial junction was achieved. There were 2 operative deaths (5.1 %). The follow-up ranged from 3 months to 10 years with a mean of 5.7 years. There was 1 recurrence (2.9%) in the benign group. In the malignant group, 3 cases (60%) died within 5 to 8 months of surgery due to further local and metastatic spread of the tumor. The case of malignant fibrous histiocytoma was treated with postoperative radiotherapy to the right mediastinum and is doing well at follow-up 3 months after surgery.

scholarly journals Primary Extramedullary Plasmacytoma of the Kidney: A Case Report and Literature Review

2021 ◽  
Vol 1 (1) ◽  
pp. 30-35
Author(s):  
Yinyin Peng ◽  
Keyword(s):  
Extramedullary Plasmacytoma ◽  
Resected Specimen ◽  
Bone Lesions ◽  
Upper Respiratory Tract ◽  
Hematopoietic Stem ◽  
Systemic Control ◽  
Long Term Follow Up ◽  
Total Body ◽  
The Right

Extramedullary plasmacytomas (EMPs) usually occur in the upper respiratory tract, the occurrence in the kidney is extremely rare. The present study reported a case of primary renal plasmacytoma in a 46‑year‑old male patient with frequent and urgent urination, nocturia increased due to renal failure. Computed tomography (CT) imaging showed a 60×58mm enhanced mass at the lower pole of the right kidney. Following the radical nephrectomy, histopathological and immunohistochemistry analysis of the resected specimen supported the diagnosis of plasmacytoma. Bone marrow biopsy and total body skeletal survey was performed to demonstrate that there were no evidence of multiple myeloma (MM) and bone lesions. Consequently, a diagnosis of a primary renal EMP was proposed. Subsequently, the patient was treated with 4 course of chemotherapy VAD (vincristine, epirubicin and dexamethasone) + cyclophosphamide + thalidomide, and he was disease-free during 4 years’ follow-up time. The current study also presents a review of the literatures. Treatment of primary renal EMP is surgery, radiotherapy, chemotherapy or a combination of those, even hematopoietic stem cell transplantation may be also an option. Long-term follow-up is a necessity for systemic control due to the possibility to transform into MM.

Long-term outcomes in the treatment of pediatric skull base chordomas in the endoscopic endonasal era

2020 ◽  
pp. 1-10
Author(s):  
Michael M. McDowell ◽  
Nathan T. Zwagerman ◽  
Eric W. Wang ◽  
Carl H. Snyderman ◽  
Elizabeth C. Tyler-Kabara ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Skull Base ◽  
Medical Center ◽  
Spinal Metastases ◽  
Total Resection ◽  
Ki 67 ◽  
Endoscopic Endonasal ◽  
Increased Risk ◽  
Skull Base Chordomas

OBJECTIVEPediatric skull base chordoma is a rare entity that is traditionally considered to display aggressive behavior with an increased risk of recurrence. There is an absence of literature examining outcomes in the pediatric population in general and using the endoscopic endonasal approach (EEA).METHODSThe authors retrospectively reviewed all patients with skull base chordomas presenting by the age of 18 years to the Children’s Hospital of Pittsburgh or the University of Pittsburgh Medical Center from 2004 to 2019. Clinical outcomes, the number and location of recurrences, and progression-free survival time were determined.RESULTSTwenty patients met the study criteria. The most common presenting complaints were diplopia (n = 7), headache (n = 6), and swallowing difficulty (n = 4). Three cases were incidentally discovered. Twelve patients underwent single-stage EEA alone, 2 patients had two-stage EEA, and 6 patients had combined EEA with open far-lateral or extreme-lateral approaches. Fourteen patients underwent gross-total resection (GTR), and 6 patients had near-total resection. Larger tumors were more likely to require staging or a combined approach (86% vs 7%) and were less likely to receive GTR (33% vs 86%) but had comparable recurrence and mortality rates. Five patients developed CSF leaks requiring reoperation, 2 patients developed a permanent abducens nerve palsy, 1 patient suffered an internal carotid artery injury, 1 patient developed an epidural hematoma, and 1 patient developed a subdural empyema. Four (20%) patients had recurrence during follow-up (mean radiographic follow-up 59 months and mean time to local recurrence 19 months). Two patients with recurrence underwent further resection, and 1 patient elected to stop treatment. Both patients who underwent repeat resection experienced a second recurrence, one of whom elected to stop treatment. Both patients who died had an elevated Ki-67 (p = 0.039), one of whom developed de-differentiated histology. A third patient died of progressive spinal metastases without local recurrence and is one of 2 patients who developed postoperative spinal metastases. Both patients whose tumors became de-differentiated progressed from tumors with an initial Ki-67 of 15 or greater (p = 0.035) and received prior radiotherapy to the bulk tumor (p = 0.03).CONCLUSIONSThe majority of pediatric skull base chordomas, when managed at a specialized center with a goal of GTR, may have a better outcome than traditionally believed. Elevated Ki-67 rates may predict poor outcome and progression to de-differentiation.

Aggressive Cushing disease five years after the treatment of a nonfunctional pituitary adenoma

2016 ◽  
Vol 62 (5) ◽  
pp. 77-78
Author(s):  
Minodora Betivoiu ◽  
Sorina Martin ◽  
Iulia Soare ◽  
Alexandra Nila ◽  
Simona Fica
Keyword(s):  
Pituitary Adenoma ◽  
Gamma Knife ◽  
Pituitary Adenomas ◽  
Histopathological Examination ◽  
Case Reports ◽  
Dependent Diabetes Mellitus ◽  
Ki 67 ◽  
The Right ◽  
Gamma Knife Therapy

Introduction. Cushing's disease (CD) represents 10%–12% of all pituitary adenomas and is seen predominantly in women, with a female-to-male ratio of 8:1. Although most patients with ACTH-secreting adenomas present with benign, small tumors, some have invasive macroadenomas. Rarely, nonfunctional pituitary adenomas (NFPAs) may gain secretory function, but there have been a few case reports of metamorphosis to CD.Case report. We report the case of a 59-year-old female diagnosed in 2007 with a NFPA and panhypopituitarism. She had two transsphenoidal surgeries and Gamma Knife therapy and started replacement treatment with levothyroxine 75mcg/day and prednisone 5mg/day. The postoperative course was favorable and imagistic follow-up between 2007-2014 showed progressive reduction of the residual tumor and empty sella. From personal history we note noninsulin-dependent diabetes mellitus, postmenopausal osteoporosis treated with bisphosphonates. In January 2015 she suffered visual loss on the right eye. Pituitary MRI showed supra and parasellar tumor recurrence of 27/24/17mm, infiltrating the right side of the cavernous sinus, extending around the right internal carotid artery and optic nerve, compressing the optic chiasm. In March 2015 a third transsphenoidal partial excision of the tumor was performed and in August Gamma Knife therapy was repeated. The histopathological examination was consistent with a pituitary adenoma but immunohistochemical staining for ACTH was positive, with Ki-67=25%. She had no non-specific cushingoid features. Laboratory test: glucose=116mg/dl, HbA1c=7.5%, FSH=3.34mIU/ml, LH=0.585mIU/ml TSH=0.044mcIU/ml, FT4=1.13ng/dl. Prednisone replacement therapy was stopped and CD was confirmed: 8AMcortisol=13.3mcg/dl, 23PMcortisol=11.3mcg/dl, ACTH=70.2pg/ml, 8AMcortisol after 1mg dexamethasone overnight=13.8mcg/dl. Ophthalmic exam: blindness in the right eye, slightly decreased visual field in the left eye. Pituitary MRI 8-month postsurgery revealed a 28/31/28mm invasive tumor. We started treatment with Cabergoline 3mg/week and recommended closely biological and imagistic follow-up, hoping for a good response to radiotherapy.Conclusions: Our case stresses the importance of regular, lifelong follow-up of patients with NFPAs. Chiloiro et al have reported that pituitary adenomas with Ki-67≥1.5% have a higher risk of recurrence. Although the characteristics of patients with CD have been well known for decades, the diagnosis and management of this disease are often challenging.

Malignant Fibrous Histiocytoma of the Left Atrium

1996 ◽  
Vol 4 (4) ◽  
pp. 230-232
Author(s):  
Rajendar Krishan Suri ◽  
Ratna S Manjari ◽  
Neerod Kumar Jha ◽  
Vaiphei Kim ◽  
Rajnish Juneja ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Malignant Fibrous Histiocytoma ◽  
Left Atrial ◽  
Fibrous Histiocytoma ◽  
Giant Cells ◽  
Atrial Myxoma ◽  
Postoperative Course ◽  
Left Atrial Myxoma ◽  
The Right

A 25-year-old female presented with symptoms resembling those of critical mitral stenosis. Echocardiography revealed a left atrial mass without a stalk, which was suspected to be a left atrial myxoma. An irregular soft friable mass was found at surgery. It measured 10 × 8 cm, with finger-like extensions and occupied almost the entire left atrial cavity, extending into the three tributaries of the right pulmonary vein. Histopathology of the excised tumor including electron microscopy showed a pleomorphic cytology interlaced with bundles, areas of necrosis, and occasional bizarre tumor giant cells. Characteristic histiocytes containing lysosomes identified the tumor as malignant fibrous histiocytoma. A postoperative course of radiotherapy with a dose of 4,000 cGy/20 fractions was applied to the mediastinum. At follow-up 4 months later the patient was asymptomatic. This case is reported because of the extreme rarity of left atrial malignant fibrous histiocytoma.

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