scholarly journals Primary Hepatic Osteosarcoma: A Rare Cause of Primary Liver Tumor

2016 ◽  
Vol 9 ◽  
pp. CCRep.S38384 ◽  
Author(s):  
Tsering Gyalpo Lama Tamang ◽  
Marina Shuster ◽  
Abhinav B. Chandra

Introduction Extraosseous osteosarcomas are rare, accounting for approximately 4% of all osteosarcomas. A literature review yields very few cases of osteosarcoma primarily arising from the hepatic parenchyma. Case Report This report describes a case of a man in his 50s with a history of hepatitis C and cirrhosis who presented with 5 days of progressive right upper quadrant pain. Magnetic resonance imaging of the abdomen and pelvis demonstrated a 4.4 cm X 4.8 cm X 4.8 cm right hepatic lobe mass with a large area of necrosis and peripheral enhancement. The subsequent liver biopsy showed few cores of tumor composed of fibroblastic malignant cells producing lace-like osteoid matrix. Osteosarcomatous foci in other parts of the body were excluded by performing extensive physical examination, radiologic imaging, and biopsy. Hence, a primary osteosarcoma was diagnosed. The patient underwent portal vein embolization in preparation for a surgical resection of the right liver lobe. He was admitted six weeks after the embolization for dyspnea and abdominal distension and expired due to abdominal hematoma and pulmonary embolism. Conclusion Based on the rarity, lack of consensus in treatment, and dismal prognosis, extraosseous osteosarcoma should be considered a separate entity from osseous osteosarcoma. More data and research are needed in this rare and understudied malignancy.

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Xiaotong Peng ◽  
Zhi Duan ◽  
Hongling Yin ◽  
Furong Dai ◽  
Huining Liu

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.


2017 ◽  
Vol 26 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Louis Tsun Cheung Chow ◽  
Michael Ho Ming Chan ◽  
Simon Kwok Chuen Wong

Extra-adrenal paraganglioma has never been described in the extremities. A 34-year-old woman complained of an enlarging mass in the right forearm for 18 months. Imaging showed a circumscribed vascular tumor attached to the ulnar nerve; biopsy revealed features of paraganglioma. The resected tumor consisted of zellballen pattern of chief cells staining positively for chromogranin with surrounding S100-positive sustentacular cells. The chief cells contained many neurosecretory granules and mitochondria, whereas the sustentacular cells contained a large amount of rough endoplasmic reticulum and some microfilaments. There was adjacent extensive glomus cell hyperplasia and tumorlet formation. The intraoperative blood pressure dropped abruptly on tumor removal. The serum normetanephrine level decreased from a preoperative level of 1987 pg/mL (normal < 149 pg/mL) to normal after operation. The patient admitted on questioning to a history of paroxysmal attacks of transient palpitation, hand tremors, and sweating; imaging showed no evidence of tumor in other parts of the body, and there was no family history of similar tumor; she remained well 33 months after the operation. This occurrence of functional ulnar nerve paraganglioma with the hitherto undescribed associated glomus cell hyperplasia and tumorlet formation attests to the probable existence of normal sympathetic paraganglia in the extremity and their intimate functional relationship with glomus bodies.


2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.


2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.


2020 ◽  
Vol 13 (2) ◽  
pp. e232812
Author(s):  
Syed Tausif Ahmed ◽  
Matthew Barvo ◽  
Nayana Kamath ◽  
Richard Alweis

A 75-year-old man presented to the emergency department with 1-day history of right lower limb pain and 3-month history of vague abdominal pain. In the emergency department a thrombus was discovered in the right popliteal artery. CT scan of the abdomen and pelvis revealed high-density material in the pelvis, multiple hypodensities on the liver, ascites with omental nodularity, and high-density material along the stomach wall. He underwent thrombectomy and was started on anticoagulation therapy. The core needle biopsy revealed primary omental mesothelioma. There was no history of any known asbestos exposure. He also had to undergo therapeutic paracentesis twice due to abdominal distension. Mesothelioma treatment of carboplatin and pemetrexed was started, and the patient is currently receiving this chemotherapy treatment regimen.


2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.


1955 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
MJ Mackerras ◽  
DF Sandars

Adult Angiostrongylus cantonensis live in the pulmonary arteries. Unsegmented ova are discharged into the blood stream, and lodge as emboli in the smaller vessels. First-stage larvae break through into the respiratory tract, migrate up the trachea, and eventually pass out of the body in the faeces. Slugs (Agriolimax laevis) act as intermediate hosts. Two moults occur in the slug, and third-stage larvae appear about the 17th day. The larvae remain within the two cast skins until freed in the stomach of the rat by digestion. They then pass quickly along the small intestine as far as the lower ileum, where they leave the gut and become blood-borne. They congregate in the central nervous system, and have been found there 17 hr after ingestion. The anterior portion of the cerebrum is the most favoured site, and here the third moult takes place on the sixth or seventh day and the final one between the 11th and 13th days. Young adults emerge on the surface of the brain from the 12th to 14th day, and spend the next 2 weeks in the subarachnoid space. From the 28th to 31st days they migrate to the lungs via the venous system, passing through the right side of the heart to their definitive site in the pulmonary arteries. The prepatent period in the rat usually lies between 42 and 45 days.


2013 ◽  
Vol 821-822 ◽  
pp. 735-745
Author(s):  
Alttabi Furat Jamal Hassan ◽  
Xiang Yang Bian ◽  
Xiao Yu Xin

There were signs of the first civilization known to humanity for more than 6000 years BC in the north of Iraq have disappeared this civilization to appear after 500 years in southern Iraq, the Sumerian civilization, which was considered as the opinion of scientists or civilizations, exceeds the impact to Asia and the countries that had been in contact (Sumerians) and see them today in other towns and villages. In subsequent periods of time appeared distinct personalities to their nature, religious, social, special clothing with clothes seem especially long. And usually dress is made from raw wool material making them in the Sumerian era. Put the garment on the body and leaves the top of the right shoulder with the survival of an open hand. There are of special clothing used by the clergy in the exercise of religious mourning rituals .There are traditional clothes to the clergy of other faiths. The clothing we see in the beginning of the third millennium BC has gained status in society in general, and was also the head cover. The animals have for centuries symbolized the signs of a divinity that we see hanging on the walls of some temples in northern Iraq. Centuries have been mentioned in the history of the Arabian were animal horns in Sumerian times to symbolize the moon in the Sumerian language .


2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
İhsan Yıldız ◽  
Yavuz Savaş Koca ◽  
Gökhan Avşar ◽  
İbrahim Barut

Introduction. Unintentional foreign body ingestion commonly occurs accidentally in children aged between 3 months and 6 years and at advanced ages or results from psychiatric disorders such as hallucination in patients with mental retardation. Most of the ingested foreign bodies are naturally discharged from the body but some of them may require surgical intervention.Presentation of Case. A 29-year-old mentally retarded female patient was admitted to the emergency service with a two-day history of abdominal pain, nausea, and vomiting. Physical examination revealed abdominal tenderness, defense, and rebound on palpation. Radiological examination revealed diffuse air-fluid levels and a radiopaque impression of a metal object in the right upper quadrant. The metal teaspoon causing ileal perforation was extracted by emergency laparotomy. On postoperative day 7, the patient was uneventfully discharged following a psychiatric consultation.Discussion. Foreign body ingestion can occur intentionally in children at developing ages and old-age patients, or adults and prisoners, whereas it may occur unintentionally in patients with mental retardation due to hallucination. However, repeated foreign body ingestion is very rare in individuals other than mentally retarded patients.Conclusion. Mentally retarded patients should be kept under close surveillance by surgeons and psychiatrists due to their tendency to ingest foreign bodies.


2016 ◽  
Vol 1 (3) ◽  
pp. 178-184
Author(s):  
Krishna P. Wicaksono ◽  
Aziza G. Icksan

Mediastnal abscess is rare, yet it could be a life threatening infecton. A precise diagnosis followed by adequate treatments need to be quickly established. Clinical informaton is usually not diagnostc. Therefore, radiological examinatons have important role.We report a ffy-one years old female with clinical history of sore throat, cough and neck-facial edema since fve days before admission. Laboratory examinatons revealed leukocytosis and ESR elevaton. Chest x-ray depicted a homogenous consolidaton in the right paratracheal region which deviated trachea to the lef. On enhanced chest CT examinaton, we found a cystc mass in the right paratracheal region, extending to the right supero-anterior mediastnum, with peripheral enhancement, air-?uid level and minimal right pleural e?usion, suggestve for mediastnal abscess. Bronchoscopy found no abnormality.Several days later, mediastnal abscess was confrmed surgically and drained through thoracotomy. Although culture of pus failed to grow any bacteria, histopathological examinaton confrmed a non-specifc chronic in?ammaton with no sign of malignancy. The main purpose of this report is to emphasize the importance of enhanced chest CT in evaluatng patent with tumor mimicking mediastnal abscess.


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