Peripheral nerve sheath malignancy with multiple metastasis: a rare clinical case

Background. Tumours of peripheral nervous system are represented by benign and malignant neoplasms with different clinical and biological traits. Malignant peripheral nerve sheath tumours of paraspinal localisation with the involvement of nerve structures are extremely rare and may occur isolated or comorbid with congenital neurofibromatosis. Current literature contains a few bioptic and selected autopsy clinical reports. Herewith, we present an own sectional observation of a rare malignant peripheral nerve sheath tumour with multiple metastasis supplemented with morphological and immunohistochemical descriptions.Clinical Case Description. An autopsy was performed on a 30-yo man’s cadaver. A tumour infiltrate was observed along Th5—Th9 of the spinal column intimately associated with thoracic vertebral bodies. Metastases were detected in the right lung, myocardium, peripancreatic and perirenal adipose tissue. Histological tumour examination revealed heterogeneous solid and rosette-like structures. Tumour immunophenotype: vimentin+, pancytokeratin-, CD45-, S-100+, NSE+, GFAP-, proliferative activity index (Ki-67 = 75-80%). This profile is descriptive of peripheral nerve sheath malignancy of high grade with multiple organic metastases.Conclusion. The sectional observation presented illustrates the difficulty to in vivo diagnose rare peripheral nerve sheath malignancies due to their infiltrative growth into spinal bone marrow and metastasis to organs (lungs, myocardium, peripancreatic and perirenal adipose tissue).

STUDY OF THE POSSIBILITIES OF PREOPERATIVE CHEMOTHERAPY IN MULTIPLE METASTASIS OF COLORECTAL CANCER IN THE LIVER

Preoperative chemotherapy (CT) in 35 patients with colorectal cancer (CRC) with liver metastases demonstrated a high frequency of objective effects - in 22 (62.9%) patients, stabilization was noted in 10 (28.6%) cases. With bilobar liver metastases and the use of oxaliplatin-containing regimens, partial regression was 62.9%. Side effects in most cases were clinically insignificant, no deaths were observed. The results obtained demonstrate the possibility of performing extended surgical operations in the majority of CRC patients with multiple liver metastases after preoperative CT.

Metastatic hepatocellular carcinoma to the parotid gland Associated with multiple metastasis: Case report

Introduction: The incidence of liver cancer is very high in China, and it is more common in patients with a history of hepatitis B.Most patients with liver cancer have distant metastasis at the time of visiting, but parotid metastasis is very rare. We report a patient with parotid enlargement who was diagnosed with multiple metastasis of liver cancer. Presentation of Case: A 52-year-old male presented with parotid enlargement for one month.after the right deep maxillofacial neck mass was cut and biopsied,Metastatic hepatocellular carcinoma of the parotid gland associated with multiple metastasis was diagnosed. Discussion: Metastasis of liver cancer to the parotid gland is very rare, to date, only 7 cases HCC metastasis to the parotid gland have been reported, this case is the first report in China. For patients with parotid enlargement at the first diagnosis, no history of hepatitis or liver cancer, and normal or slightly elevated AFP,It is very easy to misdiagnose and miss diagnosis.Pathological diagnosis and complete systemic examination are very important in the diagnosis of tumor.Although very rare, parotid metastases in HCC should be maintained with high suspicion.