scholarly journals Proliferações Melanocíticas de Potencial Maligno Incerto: Um Estudo Retrospetivo de 23 Doentes

2020 ◽  
Vol 77 (4) ◽  
pp. 305-309
Author(s):  
Jorge Lopes ◽  
Cristina Sousa ◽  
Diogo Teixeira ◽  
David Tente ◽  
Armando Baptista ◽  
...  
Keyword(s):  
Lymph Node Biopsy ◽  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
Diagnostic Uncertainty ◽  
Melanocytic Lesions ◽  
The Subject ◽  
The Mean ◽  
Dichotomous Classification

Introduction: Diagnostic uncertainty is an inseparable component of medical practice. The dichotomous classification of melanocytic lesions as benign or malignant has been replaced in recent years by a more flexible approach in which diagnostic uncertainty is recognized and accepted. Methods: In order to characterize the population of melanocytic proliferations of uncertain malignant potential diagnosed at our center between 2007 and 2017, histopathological reports of melanocytic lesions classified, in this period, as either dysplastic or malignant were analyzed. Results: Twenty-three lesions (4.3%) with borderline histopathological features or uncertain malignant potential were identified. The mean patient age was 34.8 years. Sixteen lesions (69.6%) were observed by a second pathologist. The most frequently performed treatment was wide excision. A sentinel lymph node biopsy was performed on 2 patients, both being negative. The median follow-up time was 22 months, and there was no recurrence of any treated lesion. Discussion: The controversy of the subject extends from the nature and classification of these lesions to their treatment. In this work we perform a statistical review of the population of melanocytic proliferations of uncertain malignant potential diagnosed in our department.

Clinical and Pathological Features of Prostatic Stromal Tumor of Uncertain Malignant Potential: A Retrospective Study of 23 Chinese Cases

2020 ◽  
pp. 1-9
Author(s):  
Qi Shen ◽  
Zhaohui Zhou ◽  
Zhenhua Liu ◽  
Shuai Hu ◽  
Zhiyong Lin ◽  
...  
Keyword(s):  
Disease Progression ◽  
Rare Disease ◽  
Subgroup Analysis ◽  
Specific Antigen ◽  
Malignant Potential ◽  
Stromal Tumor ◽  
Uncertain Malignant Potential ◽  
Stromal Sarcoma ◽  
The Mean

<b><i>Introduction:</i></b> Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare disease that may coexist with prostate stromal sarcoma (PSS). We aimed to analyze the histological and clinical features of STUMP. <b><i>Methods:</i></b> Twenty-three patients diagnosed with STUMP from 2008 to 2019 were included. Clinicopathological and follow-up information was collected. In the subgroup analysis, we divided the patients into a pure STUMP group (<i>N</i> = 18) and a mixed STUMP (STUMP coexisting with PSS) group (<i>N</i> = 5). Student’s <i>t</i> test was used to compare the 2 groups. <b><i>Results:</i></b> Patients had a mean age of 55.5 ± 19.4 years and an average follow-up time of 42.3 months. The mean prostate volume was 109.2 ± 73.5 cm<sup>3</sup>, and the mean prostate-specific antigen was 8.03 ± 10.5 ng/mL. In the subgroup analysis, 16.7% (2/12) of pure STUMP patients had disease progression, while 100% (3/3) of mixed STUMP patients suffered from recurrence. Compared with the pure STUMP group, the mixed STUMP group was younger (37.2 vs. 60.6 years, <i>p</i> = 0.013) and had lower expression of estrogen receptor and progesterone receptor (<i>p</i> = 0.004 and <i>p</i> &#x3c; 0.001, respectively). <b><i>Conclusion:</i></b> STUMP is a rare disease with a relatively good prognosis. However, there is still a possibility of disease progression or coexistence with stromal sarcoma. Timely diagnosis and regular monitoring may be helpful in improving treatment outcomes.

scholarly journals Minimally invasive treatment options to borderline ovarian tumors

2016 ◽  
Author(s):  
Punita Bhardwaj ◽  
T. K. Das ◽  
S. Batra ◽  
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Malignant Potential ◽  
Ovarian Tumors ◽  
Conservative Approach ◽  
Uncertain Malignant Potential ◽  
Invasive Treatment ◽  
Younger Women ◽  
Borderline Ovarian Tumors

Borderline Ovarian tumors are tumors of uncertain malignant potential. They have favour able prognosis. They occur in younger women and present at an early stage. They are difficult to diagnose preoperatively as macroscopic picture is a combination of benign and invasive ovarian tumors. Over the years surgical treatment has changed from radical to conservative approach without overlooking oncologic safety. Follows up is essential. Prolonged follow up (>10 yrs) is required because of later recurrences. Special attention is to be paid to the conserved ovary in follow up.

scholarly journals Glomus Tumor of Uncertain Malignant Potential: A Rare Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 14-17
Author(s):  
Mehta Shailee ◽  
◽  
Dabral Ritwika ◽  
Trivedi Priti ◽  
◽  
...  
Keyword(s):  
Soft Tissues ◽  
Glomus Tumor ◽  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
Current Case ◽  
Glomus Tumors ◽  
Large Size ◽  
Rare Case Report ◽  
Mitotic Figures

Glomus tumor is usually a small, benign tumor and typically occurs in the dermis or subcutis or soft tissues of the extremities and rarely in the visceral locations. Its bronchopulmonary origin is exceedingly rare clinical condition. The current case reported a 51-year-old male with dyspnea on exertion and obstructive pneumonia; he had a glomus tumor which has large size, deep location and exhibits an infiltrative margin as well as atypical mitotic figures. These characteristic suggests malignant behavior. Therefore diagnosis of glomus tumor of uncertain malignant potential was favored. Recently, the histopathological diagnostic criteria for malignant glomus tumors were defined in the WHO classification of soft tissue and bone tumors 4th edition. Here we also reviewed the literature on primary bronchopulmonary glomus tumors with special attention to the current concept of malignancy grade estimation.

scholarly journals Cystic renal diseases: role of ultrasound. Part II, genetic cystic renal diseases

2020 ◽  
Author(s):  
Adnan Kabaalioglu ◽  
Nesrin Gunduz ◽  
Ayse Keven ◽  
Emel Durmaz ◽  
Mine Aslan ◽  
...  
Keyword(s):  
Renal Cysts ◽  
The Other ◽  
Renal Diseases ◽  
Intravenous Contrast ◽  
Pictorial Essay ◽  
The Subject ◽  
Key Features

Kidney cysts are quite common in adults. Though small simple renal cysts in an adult over 30-40 years of age are not too unusual, however, if the same cysts are seen in a child, and especially if there are additional findings, then several diagnostic possibilities may come to mind. The role of ultrasound, together with the help of intravenous contrast agents and Doppler mode, are very critical in describing the morphologic features and follow-up of the complex or multiple and bilateral renal cysts. These sonographic signs are occasionally specific for diagnosis, but in many cases sonographic clues should be evaluated together with the other genetic and clinical data to reach diagnosis.The first part of this pictorial essay included the introduction into the subject and the classification of non-genetic cystic renal diseases. The key features for the non-genetic cystic renal diseases are illustrated. In the second part, eye-catching features of genetic cystic renal diseases are demonstrated.

Secondary intra-arterial chemotherapy and/or intravitreal chemotherapy as salvage treatment for retinoblastoma

2020 ◽  
pp. 112067212095758
Author(s):  
Ibadulla Mirzayev ◽  
Ahmet Kaan Gündüz ◽  
Kıvılcım Yavuz ◽  
Mehmet Zahid Şekkeli ◽  
Funda Seher Özalp Ateş ◽  
...  
Keyword(s):  
Survival Rates ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
External Radiotherapy ◽  
Intravitreal Chemotherapy ◽  
The Mean ◽  
Group B ◽  
Group D

Purpose: To evaluate the results of secondary intra-arterial chemotherapy (IAC) and/or intravitreal chemotherapy (IVC) as a salvage treatment for retinoblastoma (RB). Materials and Methods: The medical records of 31 (20 male, 11 female) cases (with 38 eyes) who underwent secondary IAC and/or IVC between February 2010 and June 2019 were retrospectively reviewed. Results: Thirteen (41.9%) cases had unilateral and 18 (58.1%) had bilateral RB. According to the International Classification of RB, 6 (15.8%) eyes had group B, 9 (23.7%) eyes had group C, 16 (42.1%) eyes had group D, and 7 (18.4%) eyes had group E RB at diagnosis. All patients underwent six-cycle intravenous chemotherapy as primary treatment and 8 eyes received external radiotherapy before IAC/IVC. Secondary IAC was performed in 21 (55.3%) eyes, IVC in 10 (26.3%) eyes, and IAC + IVC in 7 (18.4%) eyes. External radiotherapy was applied in 2 (5.3%) eyes after IAC/IVC, one of which was later enucleated. In total, 17 (44.7%) eyes undergoing secondary IAC/IVC treatments were enucleated. Metastasis and death were not observed in any case during the mean follow-up period of 59.3 (median 61, range: 10–98) months. Discussion: Although 60.5% of the eyes undergoing IAC/IVC consisted of groups D and E RB, globe salvage and survival rates were 55.3% and 100.0%, respectively. External radiotherapy was required in 5.3% of the eyes after IAC/IVC. In conclusion, IAC and IVC are safe and effective treatment methods in eyes with RB unresponsive to other eye-preserving treatments and those demonstrating recurrence.

scholarly journals A long-term prospective observational study in 31 patients with hemicrania continua

2019 ◽  
Vol 2 ◽  
pp. 251581631882469 ◽  
Author(s):  
Sanjay Prakash ◽  
Chaturbhuj Rathore ◽  
Kaushik Rana ◽  
Hemant Joshi ◽  
Jay Patel ◽  
...  
Keyword(s):  
Hemicrania Continua ◽  
Background Pain ◽  
Headache Diary ◽  
The Mean ◽  
Drug Leads ◽  
Observation Period ◽  
Structured Questionnaire

Introduction: Till date, there is no prospective study in patients with hemicrania continua (HC). Methods: Patients fulfilling the international classification of headache disorders criteria for HC were evaluated prospectively. All patients were subjected to a detailed clinical interview, based on a structured questionnaire. Before starting indomethacin, all patients were instructed to fill a headache diary for at least 5 days. Gradual tapering of indomethacin was done at regular intervals. Results: We enrolled 41 patients over 4.5 years, 31 of whom met the criteria after confirming the indomethacin response. The mean age was 41 years, and 55% were female. The mean duration of headache was 43.6 months. All patients had continuous strictly unilateral pain with episodic exacerbations. At least one cranial autonomic feature was noted in 81% of patients. Twenty-five patients (81%) felt a sense of restlessness during exacerbations. The mean follow-up was 2.5 years. Three-fourths of patients noted a reduction in indomethacin dose after an average 2.5 of years follow-up. The mean reduction of the dose in the follow-up was statistically significant (172 mg vs. 110 mg, p < 0.001). All patients missed the drug for various reasons over the observation period. The headache reappeared within 48 h in 97% of patients. Conclusion: Misdiagnosis of HC is still very common. Patients may not volunteer about the background pain and will focus only on the exacerbations. HC rarely remits, but indomethacin requirements may decrease over time. Skipping of the effective drug leads to the immediate reappearance of pain.

Incidental Prostatic Stromal Tumor of Uncertain Malignant Potential (STUMP): Histopathological and Immunohistochemical Findings

2012 ◽  
Vol 79 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Ettore De Berardinis ◽  
Gian Maria Busetto ◽  
Gabriele Antonini ◽  
Riccardo Giovannone ◽  
Mariarosaria Di Placido ◽  
...  
Keyword(s):  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Radical Retropubic Prostatectomy ◽  
Malignant Potential ◽  
Stromal Tumor ◽  
Uncertain Malignant Potential ◽  
Transperineal Prostate Biopsy ◽  
Stromal Sarcoma ◽  
Long Term Follow Up

Stromal prostate tumors are rare neoplastic proliferative lesions that have been classified into prostatic stromal tumor of uncertain malignant potential (STUMP) and prostatic stromal sarcoma (SS) based on these criteria: stromal cellularity, presence of mitotic figures, necrosis, and stromal overgrowth. A prostatic stromal tumor of uncertain malignant potential (STUMP) is a non-epithelial, mesenchymal spindle-cell tumor that can be classified as a specialized stromal tumor of the prostate. STUMPs have the capability to diffusely infiltrate the prostate gland and extend into adjacent tissues. Furthermore, they often recur and this is why they are considered as neoplastic entities. STUMPs usually tend to be not aggressive, but occasional cases have been reported with an extension into adjacent tissues. A few cases develop a sarcomatous dedifferentiation. A 67-year-old male referred to the Department of Urology, Sapienza Rome University, with acute urinary retention (AUR) and bladder overdistention. Digital rectal examination (DRE) showed the presence of a severe prostatic hyperplasia and a transvesical prostatic adenomectomy (TVPA) was performed. The pathological evaluation performed at the Department of Pathology, Sapienza Rome University, revealed an incidental diagnosis of prostatic STUMP. The patient's follow-up is made every year with transrectal ultrasonography and nuclear magnetic resonance with spectroscopy, and every two years with a transperineal prostate biopsy to exclude a progression to a stromal sarcoma. After 5 years of follow-up the STUMP is still detectable but there is no sign of sarcoma. As a result of its relative rarity and lack of long-term follow-up, the prognosis of STUMP is unclear. Therapy varies from a wait-and-see approach to a radical retropubic prostatectomy.

Gestational trophoblastic syndrome and human immunodeficiency virus (HIV) infection: A retrospective analysis

2003 ◽  
Vol 13 (6) ◽  
pp. 875-878 ◽  
Author(s):  
M. Moodley ◽  
J. Moodley
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Case Reports ◽  
Hiv Positive ◽  
Risk Category ◽  
Immunodeficiency Virus ◽  
The Subject ◽  
The Mean ◽  
Sub Saharan

The appropriate management of gynecological malignancies in association with human immunodeficiency virus (HIV) infection is not established. To date the reported literature on the subject consists mainly of case reports. Due to the increasing prevalence of HIV infection, especially in sub-Saharan countries, the chances of finding both conditions in the same patient has produced management and ethical dilemmas. This retrospective study describes the management of 12 HIV-infected patients and compares their outcome with 29 non HIV-infected patients. The mean age of the non HIV-infected patients was 30 years (range 16–56 years), while the mean age of the HIV-infected patients was 32 years (range 20–47 years). In terms of risk factors, there were 72% of non HIV-infected women in the high-risk category compared to 50% of HIV-infected women (P = 0.468). All patients who received treatment had CD4 counts greater than 200 cells/μl. Two HIV-infected women who did not receive any form of chemotherapy due to low CD4 counts (41 cells/μl and 84 cells/μl) demised of their disease. The majority of women (86% non HIV-infected & 90% HIV-infected) received lfewer than 10 cycles of chemotherapy to attain cure. Most side effects were minor. None of the HIV-infected patients who received chemotherapy demised of their disease. In total, irrespective of risk category, there were 38 patients (93%) who were cured of their disease by chemotherapy including 10 HIV-positive patients. All patients were alive and free of disease at their last follow-up visit. Although the numbers are small, it is proposed that HIV-infected patients with choriocarcinoma and a reasonable degree of CD4 counts (>200cells/μl) should receive standard therapy.

Adrenocortical neoplasm of uncertain malignant potential with a myelolipomatous component

2020 ◽  
Vol 13 (6) ◽  
pp. e234591
Author(s):  
Adithya Balasubramanian ◽  
Jason Scovell ◽  
Adam E Dowell ◽  
Wesley Mayer
Keyword(s):  
Adrenal Mass ◽  
Benign Neoplasm ◽  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
The Third ◽  
Potentially Malignant ◽  
Indeterminate Lesion ◽  
Fatty Component ◽  
Oncocytic Neoplasm

Macroscopic fat inside an adrenal lesion on CT is pathognomonic for myelolipoma, a benign neoplasm. Without macroscopic fat, it can be difficult to discern the nature of an indeterminate adrenal mass on imaging. One possible diagnosis for an indeterminate lesion without macroscopic fat is an adrenal oncocytic neoplasm (AON). Despite its typical benign presentation cases of malignant AON have been reported. Patients with malignant AON are often not surgical candidates and survival for unresected disease is 20%–35%. We present the third report of an AON of uncertain malignant potential (AONUMP) associated with a macroscopic fatty component with the largest reported size and longest duration of follow-up in the literature. This report details diagnostic and therapeutic challenges posed by AONUMP. This case highlights how pathognomonic radiographical findings associated with benign myelolipoma might mask rare, potentially malignant, lipomatous tumours.

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