scholarly journals Malignant stromal tumor of the stomach with giant cystic liver metastases prior to treatment with imatinib mesylate

2013 ◽  
Vol 70 (2) ◽  
pp. 225-228 ◽  
Author(s):  
Radoje Colovic ◽  
Marjan Micev ◽  
Slavko Matic ◽  
Natasa Colovic ◽  
Nikica Grubor ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Imatinib Mesylate ◽  
Left Lobe ◽  
Uneventful Recovery ◽  
Gastrointestinal Neoplasms ◽  
Gastric Gist ◽  
Tissue Samples ◽  
Billroth Ii Gastrectomy ◽  
Cystic Liver ◽  
The Right

Introduction. Gastrointestinal stromal tumors (GISTs) are rare and account for 0.1%-3% of all gastrointestinal neoplasms. GISTs are most commonly located in the stomach (60%) and 20%-25% are malignant, with metastases involving the peritoneum or the liver. Cystic liver metastases are extremely rare. Only two previous cases of patients with cystic liver metastases, prior to treatment with imatinib mesylate, have been described so far. Case report. We reported a 52-year-old woman presented with a history of abdominal fullness and discomfort. Clinical examination revealed two palpable masses, first in the right upper abdomen and second left to the umbilicus. Examinations revealed 4 cystic metastases in the liver, 3 in the right lobe (including a huge one measuring 20.5 x 16 cm), and 1 in the left lobe, together with a primary tumor on the greater curvature of the stomach. Gastric tumor was removed with a Billroth II gastrectomy. Partial excision of the largest liver metastasis was performed for histopathology. Immunohistochemistry confirmed the diagnosis of a GIST in both tissue samples. After an uneventful recovery the patient was commenced on imatinib mesylate therapy. The patient remainsed symptom-free at 24 months follow-up. Conclusion. This was the third reported case of gastric GIST with giant cystic liver metastases present prior to treatment with imatinib mesylate. Although extremely rare, GISTs may present with cystic liver metastases prior to treatment with imatinib mesylate, and should be considered in the differential diagnoses of patients with liver cysts of uncertain aetiology.

scholarly journals Safety and Efficacy of Combined Yttrium 90 Resin Radioembolization with Aflibercept and FOLFIRI in a Patient with Metastatic Colorectal Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Andre De Souza ◽  
Kevin Pelham Daly ◽  
James Yoo ◽  
Muhammad Wasif Saif
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Bilateral Breast Cancer ◽  
Left Lobe ◽  
Subsequent Treatment ◽  
Metastatic Colon Cancer ◽  
Right Lobe ◽  
The Right ◽  
Yttrium 90

Background. When associated with isolated four or fewer liver foci, metastatic colorectal cancer is amenable to surgical resection. Alternative therapeutic methods for isolated liver metastases include radioembolization with yttrium 90 (Y90) and transarterial chemoembolization (TACE). We present here a case of a patient with two sites of liver metastatic disease from colorectal cancer who underwent Y90 radioembolization combined with aflibercept and FOLFIRI.Case Report. A 56-year-old female with history of bilateral breast cancer and metastatic colon cancer with prior hemicolectomy and 4 previous chemotherapy regimens developed liver metastasis. She was started on aflibercept and FOLFIRI and concurrently underwent two treatments of radioembolization with Y90, initially targeting the largest right lobe tumor, and then a subsequent treatment targeting the smaller left lobe tumor with retreatment of the right lobe tumor. Her liver metastases exhibited partial response on imaging utilizing the modified RECIST criteria. Interestingly, the patient CEA levels decreased after the procedure.Discussion. This is the first reported case of a patient managed with radioembolization with Y90 combined with aflibercept, an anti-VEGF treatment, and FOLFIRI. An ongoing randomized clinical trial aims to define the role of combined targeted therapy and chemotherapy with radioembolization with Y90.

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

scholarly journals Pulmonary hydatidosis genotypes isolates from human clinical surgery based on sequencing of mitochondrial genes in Fars, Iran

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Parviz Mardani ◽  
Ali Talebi Ezabadi ◽  
Bahareh Sedaghat ◽  
Seyed Mahmoud Sadjjadi
Keyword(s):  
Hydatid Cyst ◽  
Statistical Correlation ◽  
Left Lobe ◽  
Cox1 Gene ◽  
Fars Province ◽  
Study Population ◽  
Right Lobe ◽  
And Gender ◽  
The Right ◽  
Pulmonary Hydatid Cyst

Abstract Background Cystic echinococcosis (CE)/hydatidosis is an important neglected parasitic zoonotic disease caused by the metacestode of Echinococcus granulosus s.l. The present study was designed to identify the pulmonary CE species/genotypes in isolated human underwent to surgery in our center in Southern Iran. Methods The study population of this study were all patients in Fars province who were admitted to Namazi Hospitals for pulmonary hydatid cyst surgery. Thoracic surgery was performed in the thoracic ward and the cyst/s was removed by open surgery via posterolateral or lateral thoracotomy. DNA was extracted from the germinal layer or the protoscoleces. PCR technique was performed using the cytochrome C oxidase subunit1 (cox1) gene, and the products were sequenced. Results A total of 32 pulmonary hydatid cyst samples were collected from 9 (28%) female and 23 (72%) male aged from 4 to 74 years old. A total of 18(56%) cyst/s were in the left lobe and 14 (44%) cysts in the right lobe. Sequence analysis of the cysts showed that 24 samples (75%) were E. granulosus s.s (G1-G3) genotype and 8 (25%) were E. canadensis (G6/G7) genotype. Conclusion E.granulosus s.s genotype was the most prevalent genotype followed by E. canadensis (G6/G7) genotype. There was no significant statistical correlation between cysts’ size, location, genotype strain, and patients’ age and gender.

Spontaneous perforation of cervical oesophagus: a rare variant of Boerhaave's syndrome

2009 ◽  
Vol 123 (12) ◽  
pp. 1378-1380 ◽  
Author(s):  
S Mittal ◽  
A Rohatgi ◽  
R P Sutcliffe ◽  
A Botha
Keyword(s):  
Vocal Folds ◽  
Sudden Onset ◽  
Water Soluble ◽  
Uneventful Recovery ◽  
Oesophageal Perforation ◽  
Nasogastric Feeding ◽  
Computed Tomography Scanning ◽  
Difficulty Breathing ◽  
The Right ◽  
False Vocal

AbstractBackground:A 29-year-old man presented with sudden onset of severe pain in his throat, difficulty breathing and a hoarse voice, following an episode of vomiting.Investigations:Initial laboratory tests were normal. The patient underwent fibre-optic nasendoscopy, which demonstrated a haematoma in the piriform fossa. Lateral neck radiography and subsequent computed tomography scanning confirmed a 2 cm, loculated, gas-containing collection at the level of the vallecula in the right posterolateral wall, extending to the false vocal folds and communicating between the right parapharyngeal space and the right carotid sheath. Water-soluble contrast swallow confirmed the diagnosis.Diagnosis:Contained oesophageal perforation.Management:Conservative treatment was adopted involving nil orally, intravenous antibiotics and nasogastric feeding. The patient made an uneventful recovery.

Canine Synovial Sarcoma of the Stifle Joint with Pulmonary and Liver Metastases

2021 ◽  
Vol 38 ◽  
pp. 6-12
Author(s):  
R.J. Samson ◽  
F.H. Mpagike ◽  
A.K. Felix ◽  
A.B. Matondo ◽  
M. Makungu
Keyword(s):  
Soft Tissue ◽  
Lung Metastases ◽  
Synovial Cell ◽  
Proximal Region ◽  
Radiographic Examination ◽  
Tissue Samples ◽  
Stifle Joint ◽  
Mongrel Dog ◽  
Biopsy Examination ◽  
The Right

A seven-year-old female mongrel dog was presented at the Sokoine University of Agriculture Teaching Animal Hospital for second opinion regarding a progressive swelling of the right hind limb of two months duration. Clinical examination revealed a loss of body condition, tachypnea and tachycardia, a painful immobile solid mass of 20 cm x 14 cm x 10 cm located on the right stifle joint, leucocytosis, and anaemia. Radiographic examination of the joint revealed marked soft tissue swelling with amorphous areas of mineralization and complete destruction of the proximal tibia. Smooth and solid periosteal reaction was seen around the tibia and fibula with a Codman’s triangle. Multiple nodules and a mass with soft tissue opacity were seen in the lung fields. Post-mortem examination revealed separation of tibia and fibula, softening of the proximal parts of the tibia, and complete integration of the proximal region of the two bones and articular tissues into the surrounding muscular tissues. Multifocal nodular lesions of variable sizes were mostly found in the lungs and partly in the liver. Histologically, predominantly oval and round cells with variable nuclear sizes and moderate mitoses were observed in tissue samples from the joint, lungs and the liver although some parts of the lung metastases showed both round and spindle shaped tumor cells. Clinical profile is suggestive of aggressive biphasic (spindle and epithelial) type of synovial cell sarcoma with lung and liver metastasis. Early radiographic and biopsy examination of persistent musculoskeletal nodules is recommended for early diagnosis and interventions.

Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Ali Maarouf ◽  
Ali Haggag Ali ◽  
Mahmoud Abdelatif Onsy
Keyword(s):  
Tumor Staging ◽  
Left Lobe ◽  
Diagnostic Process ◽  
Liver Imaging ◽  
Focal Lesions ◽  
Focal Hepatic Lesions ◽  
Malignant Lesions ◽  
Hepatic Lesions ◽  
The Right

Abstract Background Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning. Aim of the Work To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions. Patients and Methods We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate. Results The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases. Conclusion The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.

Evaluation of Histopathological Heterogeneity After Preoperative Chemotherapy in Patients With Liver Metastases from Colorectal Cancer

2021 ◽  
Author(s):  
Nobuhisa matsuhashi ◽  
Hiroyuki Tomita ◽  
Takazumi Kato ◽  
Yoshinori Iwata ◽  
Satoshi Matsui ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Surgical Oncology ◽  
Resected Specimen ◽  
Histopathological Changes ◽  
School Of Medicine ◽  
Response To Chemotherapy ◽  
Grade 3 ◽  
The Right

Abstract Background: Patients with liver metastases from colorectal cancer (CRLMs) frequently receive chemotherapy prior to liver resection. Histopathological assessment of the resected specimen can evaluate the response to chemotherapy. This study analyzed the correlation between histopathological changes in the primary site and liver metastases. Patients and Methods: This study comprised 45 patients with resectable CRLMs at the Surgical Oncology Department of Gifu University School of Medicine from January 2006 to August 2015. Results: The study included 24 men and 21 women. The primary colonic tumor was located in the right side in 13 (28.9%) patients and the left side in 32 (71.9%) patients. We evaluated patients with metastatic colorectal cancer (31/45) after excluding those in whom histopathological heterogeneity between the primary and liver metastasis changed to grade 3 after chemotherapy. We compared the group which underwent hepatectomy after chemotherapy (n=25) with that underwent hepatectomy alone (n=6). In 16 (53.3%) out of 25 patients, histopathological heterogeneity of the liver metastasis was lost (p=0.04). Conclusion: Chemotherapy appears to change histopathological heterogeneity.Our study suggests that the change of intratumoral heterogeneity reflect by the response of chemotherapy.

scholarly journals Comorbidity between Klinefelter syndrome and diaphragmatic hernia. A case report

2014 ◽  
Vol 132 (5) ◽  
pp. 311-313
Author(s):  
Carolina Melendez Valdez ◽  
Stephan Philip Leonhardt Altmayer ◽  
Adyr Eduardo Virmond Faria ◽  
Aline Weiss ◽  
Jorge Alberto Bianchi Telles ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Ultrasound Examination ◽  
Klinefelter Syndrome ◽  
Age Groups ◽  
Left Lung ◽  
Left Lobe ◽  
Imaging Studies ◽  
Left Hemithorax ◽  
Prenatal Imaging ◽  
The Right

CONTEXT: Intrathoracic cystic lesions have been diagnosed in a wide variety of age groups, and the increasing use of prenatal imaging studies has allowed detection of these defects even in utero.CASE REPORT: A 17-year-old pregnant woman in her second gestation, at 23 weeks of pregnancy, presented an ultrasound with evidence of a cystic anechoic image in the fet al left hemithorax. A morphological ultrasound examination performed at the hospital found that this cystic image measured 3.7 cm x 2.1 cm x 1.6 cm. Polyhydramnios was also present. At this time, the hypothesis of cystic adenomatoid malformation was raised. Fet al echocardiography showed only a dextroposed heart. Fet al magnetic resonance imaging produced an image compatible with a left diaphragmatic hernia containing the stomach and at least the first and second portions of the duodenum, left lobe of the liver, spleen, small intestine segments and portions of the colon. The stomach was greatly distended and the heart was shifted to the right. There was severe volume reduction of the left lung. Fet al karyotyping showed the chromosomal constitution of 47,XXY, compatible with Klinefelter syndrome. In our review of the literature, we found only one case of association between Klinefelter syndrome and diaphragmatic hernia.CONCLUSIONS: We believe that the association observed in this case was merely coincidental, since both conditions are relatively common. The chance of both events occurring simultaneously is estimated to be 1 in 1.5 million births.

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