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Görgülü G, Doğan Özdaş E, Özdaş E, Sayhan S, Kuru O, Gökçü M, Sancı M. Analysis of vanishing endometrial cancer by pathological types. J Obstet Gynaecol Res 2022; 48:2175-2179. [PMID: 35686358 DOI: 10.1111/jog.15294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/25/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We asked why endometrial cancer sometimes vanishes. METHODS A total of 454 patients diagnosed with endometrioid-type endometrial cancer (EC) (via endometrial sampling) and treated in our clinic over the past 5 years were enrolled. The patients were divided into two groups: vanishing and residual, depending on whether a tumor was detected in the postoperative hysterectomy specimen. Patient age, numbers of pregnancies and deliveries, menopausal status, systemic disease status, hemogram parameters, International Federation of Gynecology and Obstetrics (FIGO) grade, and invasion status (evident on magnetic resonance imaging [MRI]) were compared between the groups. RESULTS ECs vanished in 42 (9.25%) patients. The vanishing rates were 19.7% (37/187) in FIGO grade 1 patients, 2.1% (5/238) in grade 2 patients, and 0% (0/29) in grade 3 patients. The average age was lower in the vanishing than the residual group, but the premenopausal status and grade 1 tumor rates were higher (both p < 0.001). An absence of invasion (as revealed by MRI) was more common in the vanishing group (p < 0.001). No recurrence developed in the vanishing group, but recurrences were noted in 3.3% (14/412) of the residual group. There were no significant between-group differences in any of the numbers of pregnancies or births, systemic disease status, or hemogram parameters (all p > 0.05). CONCLUSION Vanishing EC is more likely in premenopausal women with endometrioid grade 1 EC (as revealed by endometrial biopsy) who lack myometrial invasion on MRI.
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Affiliation(s)
- Gökşen Görgülü
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
| | - Emel Doğan Özdaş
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
| | - Erol Özdaş
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
| | - Sevil Sayhan
- İzmir Tepecik Training and Research Hospital, Pathology Clinic, University of Health Sciences, İzmir, Turkey
| | - Oğuzhan Kuru
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
| | - Mehmet Gökçü
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
| | - Muzaffer Sancı
- İzmir Tepecik Training and Research Hospital, Gynecologic Oncology Clinic, University of Health Sciences, İzmir, Turkey
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Chaturvedi A, Klionsky NB, Saul D. Ultrasound with Doppler evaluation of congenital hepatic vascular shunts. Pediatr Radiol 2018; 48:1658-1671. [PMID: 30194461 DOI: 10.1007/s00247-018-4247-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/19/2018] [Accepted: 08/24/2018] [Indexed: 12/17/2022]
Abstract
Congenital aberrant hepatic vascular communications result from intrahepatic or extrahepatic errors in vascular development or involution during the transition from fetal to newborn hepatic circulation. These hepatic vascular shunts can be fortuitously discovered and asymptomatic, or can cause symptoms of varying severity, often presenting diagnostic dilemmas. Some hepatic vascular shunts resolve spontaneously while others require interventional radiologic or surgical closure. Affected patients are often first studied with real-time and Doppler ultrasound, so radiologists should familiarize themselves with the expected ultrasound findings of these vascular shunts for effective diagnosis, triage and management. In this review, the authors focus on ultrasound and Doppler findings of hepatic vascular shunts with underlying embryology, clinical features and management strategies. Broadly, these aberrant hepatic vascular communications include portosystemic venous shunts (which can be intra- or extrahepatic and include persistent patent ductus venosus), arterioportal, arteriovenous or mixed shunts.
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Affiliation(s)
- Apeksha Chaturvedi
- Pediatric Imaging Section, Department of Imaging Sciences, Golisano Children's Hospital, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.
| | - Nina B Klionsky
- Pediatric Imaging Section, Department of Imaging Sciences, Golisano Children's Hospital, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA
| | - David Saul
- Department of Pediatric Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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3
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Lewis D, Hachey K, Fitzgerald S, Vaidya R. Rapidly involuting congenital haemangioma of the liver. BMJ Case Rep 2018; 2018:bcr-2018-224337. [PMID: 29871961 DOI: 10.1136/bcr-2018-224337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Rapidly involuting congenital haemangiomas (RICHs) are rare benign vascular tumours of infancy. They are generally asymptomatic, but can present with thrombocytopaenia and coagulopathy. Significant complications including life-threatening bleeding, high-output heart failure and liver failure, though rare, can occur. RICHs generally regress by 12-14 months of age and can be managed clinically with symptomatic treatment, watchful waiting and close monitoring of the size of the haemangioma. Medical management (corticosteroids, propranolol) has not shown to be effective, in contrast to infantile haemangioma which will not regress spontaneously and has been noted to respond to medical therapy. Awareness of this diagnosis is important to prevent unnecessary medical and surgical intervention. Here, we present a case of a full-term infant with RICH who presented with thrombocytopaenia and abnormal coagulation profile. The coagulopathy was treated symptomatically, while the lesion was observed with serial ultrasounds and gradually decreased in size.
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Affiliation(s)
- Deirdre Lewis
- Internal Medicine and Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
| | - Kevin Hachey
- Internal Medicine and Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
| | - Shannon Fitzgerald
- Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
| | - Ruben Vaidya
- Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
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4
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Fuchino M, Tajiri K, Minemura M, Sugiyama T. Vanishing Tumor in a Liver Graft from a Hepatitis B Virus Surface Antigen-Positive Donor. Case Rep Gastroenterol 2017; 11:610-615. [PMID: 29118691 PMCID: PMC5662982 DOI: 10.1159/000481164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/29/2017] [Indexed: 02/05/2023] Open
Abstract
We report a case of vanishing tumor considered as inflammatory pseudotumor (IPT) found in the liver after living donor liver transplantation (LDLT) from a hepatitis B virus surface antigen-positive donor. The radiological findings were similar to those of hepatocellular carcinoma (HCC). However, the tumor disappeared completely within several months and was suggested to have been an IPT. IPT is known to be associated with biliary duct operation or biliary infection, and it can show various enhancement patterns in radiological studies, sometimes resembling HCC. It should be considered in the differential diagnosis of a liver tumor in patients with LDLT.
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Affiliation(s)
| | - Kazuto Tajiri
- *Kazuto Tajiri, MD, PhD, Department of Gastroenterology, Toyama University Hospital, 2630 Sugitani, Toyama 930-0194 (Japan), E-Mail
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5
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Typical and atypical benign liver lesions: A review. Clin Imaging 2017; 44:79-91. [PMID: 28486156 DOI: 10.1016/j.clinimag.2017.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/10/2017] [Accepted: 05/01/2017] [Indexed: 02/06/2023]
Abstract
Focal liver lesions are routinely encountered by clinical radiologists and represent a wide spectrum of pathology. Majority of these lesions are likely to be benign in nature, especially in the absence of chronic liver disease or primary cancer. A radiologist must be aware of common and uncommon imaging features of benign lesions across the various imaging modalities. This review discusses pathognomonic imaging features of common benign focal liver lesions seen on ultrasound, computed tomography and magnetic resonance, and adds to existing knowledge with the recent updates to have emerged in this area.
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6
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Kholová I. Vanishing thyroid gland tumors: Infarction as consequence of FNA? Diagn Cytopathol 2016; 44:568-73. [DOI: 10.1002/dc.23479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/09/2016] [Accepted: 03/19/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Ivana Kholová
- Pathology, Fimlab Laboratories, Tampere University Hospital; Tampere Finland
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7
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Cases of spontaneous tumor regression in hepatobiliary cancers: implications for immunotherapy? J Gastrointest Cancer 2016; 46:161-5. [PMID: 25662892 DOI: 10.1007/s12029-015-9690-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Durmus T, Kamphues C, Blaeker H, Grieser C, Denecke T. Inflammatory myofibroblastic tumor of the liver mimicking an infiltrative malignancy in computed tomography and magnetic resonance imaging with Gd-EOB. Acta Radiol Short Rep 2014; 3:2047981614544404. [PMID: 25298878 PMCID: PMC4184414 DOI: 10.1177/2047981614544404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 06/26/2014] [Indexed: 12/23/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMT) are a benign tumor entity, which rarely develop in the liver. Surgery is the most common treatment for these lesions as it is difficult to distinguish them from malignant liver tumors and local recurrent growth may occur. IMT is a diagnostic challenge for imaging. Only a limited number of reports of single cases or small number of patients described the imaging features on computed tomography. Reports on IMT appearance on magnetic resonance imaging are scarce. We present a case of IMT of the liver with infiltration of the abdominal wall treated with surgery and describe the imaging features with the use of the hepatobiliary contrast agent, gadoxetic acid (Gd-EOB).
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Affiliation(s)
- Tahir Durmus
- Institut für Radiologie und Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Germany
| | - Carsten Kamphues
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Germany
| | - Hendrik Blaeker
- Institut für Pathologie, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Christian Grieser
- Institut für Radiologie und Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Germany
| | - Timm Denecke
- Institut für Radiologie und Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Germany
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Biolato M, Barbaro B, Siciliani L, Grieco A. Vanishing-recurrent benign liver lesions. Liver Int 2014; 34:1126. [PMID: 24134727 DOI: 10.1111/liv.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 10/13/2013] [Indexed: 02/13/2023]
Affiliation(s)
- Marco Biolato
- Internal Medicine, Policlinico Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy
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Takahashi Y, Iwata J, Shima Y, Sumiyoshi T, Kozuki A, Ishibashi A, Takao T, Yamamoto M, Yamamoto M. Necrotic hepatocellular carcinoma occurring within an inflammatory pseudotumor-like nodule. Intern Med 2013; 52:551-4. [PMID: 23448763 DOI: 10.2169/internalmedicine.52.9109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatocellular carcinoma (HCC) and inflammatory pseudotumor of the liver (IPL) are often difficult to differentiate before surgery. To date, colocalization of IPL and HCC has not been reported. We experienced a case of necrotic HCC surrounded by IPL-like tissue. The raised levels of alpha-fetoprotein and PIVKA-II declined to within the normal ranges after resection of the tumor. The IPL-like nodule most likely developed as a process of an inflammatory reaction such as abscess formation after the spontaneous destruction of the HCC. Our case is a warning that the presence of a 'pseudotumor' does not rule out the possible simultaneous presence of carcinoma.
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11
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Huz JI, Melis M, Sarpel U. Spontaneous regression of hepatocellular carcinoma is most often associated with tumour hypoxia or a systemic inflammatory response. HPB (Oxford) 2012; 14:500-5. [PMID: 22762397 PMCID: PMC3406346 DOI: 10.1111/j.1477-2574.2012.00478.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spontaneous regression of hepatocellular carcinoma (HCC) is well documented, although the aetiology of this phenomenon remains unknown. METHODS A review of the English literature was performed for reports of spontaneous regression of HCC. Reports were classified by mechanism based on the available information. RESULTS Spontaneous regression of HCC has been identified in 75 patients. The most common mechanisms of regression identified were tumour hypoxia (n= 21, 28.0%), a systemic inflammatory response (n= 25, 33.3%) and unknown (n= 29, 38.7%). In patients where tumour hypoxia was described as the aetiology, mechanisms included spontaneous hepatic artery thrombosis and sustained systemic hypotension. In patients where a systemic inflammatory response was the aetiology, mechanisms included cholangitis, trauma and elevated cytokine levels. DISCUSSION Spontaneous regression of HCC is most commonly associated with tumour hypoxia or a systemic inflammatory response. Determining the aetiology of spontaneous regression may identify potential therapeutic pathways. Tumour hypoxia is already the basis of treatment modalities such as hepatic artery embolization and the anti-angiogenic agent sorafenib. However, treatment modalities for HCC do not currently include immune-directed therapies; this may prove to be a worthy target for future research.
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Affiliation(s)
- Jonathan I Huz
- Department of Surgery, New York University School of Medicine, NY 10029, USA
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Roebuck D, Sebire N, Lehmann E, Barnacle A. Rapidly involuting congenital haemangioma (RICH) of the liver. Pediatr Radiol 2012; 42:308-14. [PMID: 22302317 DOI: 10.1007/s00247-011-2268-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 08/14/2011] [Accepted: 08/28/2011] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rapidly involuting congenital haemangioma (RICH) is a benign neoplasm that may occur in many locations in the body. When RICH occurs in the liver, it may be confused with other lesions. OBJECTIVE To present a case series from a single institution. MATERIALS AND METHODS Retrospective review of pathological and imaging findings in infants with biopsy-proven hepatic RICH treated at a single hospital. RESULTS Four children (2 days to 6 weeks of age) presented between 2002 and 2007 with a solitary hepatic lesion. Needle biopsy excluded the alternative possibility of infantile haemangioma by showing negativity for GLUT1. Serial imaging confirmed rapid involution in each child. CONCLUSION RICH should be suspected in neonates who present with a solitary liver lesion and normal-for-age serum alpha-fetoprotein. Serial US scans should be used to confirm a progressive shrinkage of the lesion. Corticosteroids and β2-adrenergic antagonists have no proven effect in treating RICH. If the lesion grows, percutaneous needle biopsy is recommended to exclude a malignant tumour and to direct further management. Infants with cardiac failure should be treated medically. Embolization (with or without needle biopsy) should only be performed when this strategy fails.
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Affiliation(s)
- Derek Roebuck
- Department of Radiology, Great Ormond Street Hospital for Sick Children, Great Ormond Street, London WC1N 3JH, UK.
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Yamamoto S, Tokuhara T, Nishikawa M, Nishizawa S, Nishioka T, Nozawa A, Takahashi A, Watanabe Y, Wada R, Wakasa K, Kubo S. Spontaneous regression of hepatocellular carcinoma after improving diabetes mellitus: possibly responsible for immune system. ACTA ACUST UNITED AC 2012. [DOI: 10.2957/kanzo.53.164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chong A, Jeong SY, Min JJ. Inflammatory pseudotumours resembling multiple hepatic metastases and their complete regression, as revealed by 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging 2009; 36:1199-200. [PMID: 19415271 DOI: 10.1007/s00259-009-1132-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 03/23/2009] [Indexed: 12/21/2022]
Affiliation(s)
- Ari Chong
- Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
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