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Aldrink JH, Glick RD, Baertschiger RM, Kulaylat AN, Lautz TB, Christison-Lagay E, Grant CN, Tracy E, Dasgupta R, Brown EG, Mattei P, Rothstein DH, Rodeberg DA, Ehrlich PF. Update on pediatric testicular germ cell tumors. J Pediatr Surg 2022; 57:690-699. [PMID: 33975708 DOI: 10.1016/j.jpedsurg.2021.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Testicular germ cell tumors are uncommon tumors that are encountered by pediatric surgeons and urologists and require a knowledge of appropriate contemporary evaluation and surgical and medical management. METHOD A review of the recommended diagnostic evaluation and current surgical and medical management of children and adolescents with testicular germ cell tumors based upon recently completed clinical trials was performed and summarized in this article. RESULTS In this summary of childhood and adolescent testicular germ cell tumors, we review the initial clinical evaluation, surgical and medical management, risk stratification, results from recent prospective cooperative group studies, and clinical outcomes. A summary of recently completed clinical trials by pediatric oncology cooperative groups is provided, and best surgical practices are discussed. CONCLUSIONS Testicular germ cell tumors in children are rare tumors. International collaborations, data-sharing, and enrollment of patients at all stages and risk classifications into active clinical trials will enhance our knowledge of these rare tumors and most importantly improve outcomes of patients with testicular germ cell tumors. LEVEL OF EVIDENCE This is a review article of previously published and referenced level 1 and 2 studies, but also includes expert opinion level 5, represented by the American Pediatric Surgical Association Cancer Committee.
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Affiliation(s)
- Jennifer H Aldrink
- Department of Surgery, Division of Pediatric Surgery, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States.
| | - Richard D Glick
- Division of Pediatric Surgery, Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY, United States
| | - Reto M Baertschiger
- Division of General and Thoracic Surgery, The Hospital for Sick Kids, University of Toronto, Toronto, Ontario, Canada
| | - Afif N Kulaylat
- Division of Pediatric Surgery, Department of Surgery, Penn State Children's Hospital, Hershey, PA, United States
| | - Timothy B Lautz
- Division of Pediatric Surgery, Department of Surgery, Ann and Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL, United States
| | - Emily Christison-Lagay
- Department of Surgery, Division of Pediatric Surgery, Yale-New Haven Children's Hospital, Yale School of Medicine, New Haven, CT, United States
| | - Christa N Grant
- Division of Pediatric Surgery, Department of Surgery, Penn State Children's Hospital, Hershey, PA, United States
| | - Elisabeth Tracy
- Department of Surgery, Division of Pediatric Surgery, Duke University Medical Center, Durham, NC, United States
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Medical Center, University of Cincinnati, Cincinnati OH, United States
| | - Erin G Brown
- Division of Pediatric Surgery, Department of Surgery, University of California Davis, Sacramento, CA, United States
| | - Peter Mattei
- General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - David H Rothstein
- Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - David A Rodeberg
- Department of Surgery, Division of Pediatric Surgery, East Carolina University, Greenville, NC, United States
| | - Peter F Ehrlich
- Department of Surgery, Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
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Elenes EY, Mehta JN, Hsu FC, Whitlow CT, Debinski W, Rossmeisl J, Tatter S, Rylander CG. Convection-Enhanced Arborizing Catheter System Improves Local/Regional Delivery of Infusates Versus a Single-Port Catheter in Ex Vivo Porcine Brain Tissue. JOURNAL OF ENGINEERING AND SCIENCE IN MEDICAL DIAGNOSTICS AND THERAPY 2021; 4:011003. [PMID: 35832263 PMCID: PMC8597548 DOI: 10.1115/1.4048935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/19/2020] [Indexed: 06/15/2023]
Abstract
Standard treatment for glioblastoma is noncurative and only partially effective. Convection-enhanced delivery (CED) was developed as an alternative approach for effective loco-regional delivery of drugs via a small catheter inserted into the diseased brain. However, previous CED clinical trials revealed the need for improved catheters for controlled and satisfactory distribution of therapeutics. In this study, the arborizing catheter, consisting of six infusion ports, was compared to a reflux-preventing single-port catheter. Infusions of iohexol at a flow rate of 1 μL/min/microneedle were performed, using the arborizing catheter on one hemisphere and a single-port catheter on the contralateral hemisphere of excised pig brains. The volume dispersed (Vd) of the contrast agent was quantified for each catheter. Vd for the arborizing catheter was significantly higher than for the single-port catheter, 2235.8 ± 569.7 mm3 and 382.2 ± 243.0 mm3, respectively (n = 7). Minimal reflux was observed; however, high Vd values were achieved with the arborizing catheter. With simultaneous infusion using multiple ports of the arborizing catheter, high Vd was achieved at a low infusion rate. Thus, the arborizing catheter promises a highly desirable large volume of distribution of drugs delivered to the brain for the purpose of treating brain tumors.
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Affiliation(s)
- Egleide Y. Elenes
- Department of Biomedical Engineering, University of Texas at Austin, 301 E. Dean Keeton Street C2100, Austin, TX 78712-2100
| | - Jason N. Mehta
- Department of Mechanical Engineering, University of Texas at Austin, 204 E. Dean Keeton Street, Stop C2200, Austin, TX 78712-1591
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest Baptist Medical Center Comprehensive Cancer Center, 1 Medical Center Boulevard, Winston-Salem, NC 27157
| | - Christopher T. Whitlow
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Wake Forest Baptist Medical Center Comprehensive Cancer Center, 1 Medical Center Boulevard, Winston-Salem, NC 27157;Department of Neurosurgery, Wake Forest Baptist Medical Center, 1 Medical Center Boulevard, Winston-Salem, NC 27157
| | - Waldermar Debinski
- Wake Forest Baptist Medical Center Comprehensive Cancer Center, 1 Medical Center Boulevard, Winston-Salem, NC 27157
| | - John Rossmeisl
- School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, 325 Kelly Hall, Stanger Street, Blacksburg, VA 24061; Virginia-Maryland Regional College of Veterinary Medicine, 215 Duckpond Drive, Virginia Tech, Blacksburg, VA 24061
| | - Stephen Tatter
- Department of Neurosurgery, Wake Forest Baptist Medical Center, 1 Medical Center Boulevard, Winston-Salem, NC 27157
| | - Christopher G. Rylander
- Department of Mechanical Engineering, University of Texas at Austin, 204 E. Dean Keeton Street, Stop C2200, Austin, TX 78712-1591
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Tsivian M, Rampersaud EN, del Pilar Laguna Pes M, Joniau S, Leveillee RJ, Shingleton WB, Aron M, Kim CY, DeMarzo AM, Desai MM, Meler JD, Donovan JF, Klingler HC, Sopko DR, Madden JF, Marberger M, Ferrandino MN, Polascik TJ. Small renal mass biopsy - how, what and when: report from an international consensus panel. BJU Int 2014; 113:854-63. [DOI: 10.1111/bju.12470] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Matvey Tsivian
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | - Edward N. Rampersaud
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | | | | | | | - William B. Shingleton
- Section of Urology; Department of Surgery; Georgia Health Sciences University; Augusta GA USA
| | - Monish Aron
- Department of Urology; University of Southern California; Los Angeles CA USA
| | - Charles Y. Kim
- Department of Radiology; Duke University Medical Center; Durham NC USA
| | - Angelo M. DeMarzo
- Department of Pathology; Johns Hopkins University Medical Center; Baltimore MD USA
| | - Mihir M. Desai
- Department of Urology; University of Southern California; Los Angeles CA USA
| | - James D. Meler
- Department of Radiology; Baylor University Medical Center; Dallas TX USA
| | - James F. Donovan
- Division of Urology; Department of Surgery; University of Cincinnati; Cincinnati OH USA
| | | | - David R. Sopko
- Department of Radiology; Duke University Medical Center; Durham NC USA
| | - John F. Madden
- Department of Pathology; Duke University Medical Center; Durham NC USA
| | | | - Michael N. Ferrandino
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | - Thomas J. Polascik
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
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4
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Factors influencing the opinion of individuals in determining tumour spread after biopsy. BMC Res Notes 2011; 4:548. [PMID: 22185569 PMCID: PMC3280331 DOI: 10.1186/1756-0500-4-548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 12/20/2011] [Indexed: 11/29/2022] Open
Abstract
Background People often have concerns regarding tumour spread after biopsy which leads to a delay in seeking expert medical advice. The data regarding this perception is scanty. Therefore, we conducted this cross sectional study to explore the beliefs and perceptions of individuals regarding tumour spread after biopsy and the basis of those beliefs. Methods The survey was conducted in outpatient areas of two different tertiary care hospitals of Karachi namely Aga Khan University Hospital Karachi (AKUH) and Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). We interviewed 600 individuals and documented their responses on a questionnaire. There were 400 responders from Aga Khan's Consulting Clinic and 100 each from Aga Khan's Oncology Clinic and KIRAN. Results Only 50% of the respondents chose biopsy as the best test for diagnosis of cancer. The level of education was statistically significant in making this choice of answer (p = 0.02) only in univariate analysis. Those individuals who were involved in the work up of cancer patients irrespective of their educational status gave more intelligent answers (p = 0.003). The tumour disturbance after biopsy was regarded as a major factor among 127 respondents (53%) who believed that biopsy could lead to spread of tumour. Conclusions Our study revealed that awareness regarding cancer diagnosis and biopsy is lacking among general public and it does not co-relate well with the level of formal education. These misconception and taboos need to be addressed in public seminars and in the media in order to increase the awareness which could facilitate prompt diagnosis.
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5
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Stigliano R, Marelli L, Yu D, Davies N, Patch D, Burroughs AK. Seeding following percutaneous diagnostic and therapeutic approaches for hepatocellular carcinoma. What is the risk and the outcome? Seeding risk for percutaneous approach of HCC. Cancer Treat Rev 2007; 33:437-47. [PMID: 17512669 DOI: 10.1016/j.ctrv.2007.04.001] [Citation(s) in RCA: 208] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 03/30/2007] [Accepted: 04/03/2007] [Indexed: 02/06/2023]
Abstract
BACKGROUND Tumour biopsy is usually considered mandatory for patient management by oncologists. Currently percutaneous ablation is used therapeutically for cirrhotic patients with small hepatocellular carcinoma (HCC), not suitable for resection or waiting for liver transplantation. However malignant seeding is a recognized complication of both diagnostic and therapeutic procedures in patients with HCC. Although percutaneous therapy whether with or without biopsy of a suspected HCC nodule may minimize the risk of seeding, this has not been confirmed. AIM To evaluate the risk of seeding, defined as new neoplastic disease occurring outside the liver capsule, either in the subcutaneous tissue or peritoneal cavity following needle biopsy and/or local ablation therapy (LAT). METHODS A literature search resulted in 179 events in 99 articles between January 1983 and February 2007: 66 seedings followed liver biopsy, 26 percutaneous ethanol injection (PEI), 1 microwave, 22 radiofrequency ablation (RFA), and 64 after combined biopsy and percutaneous treatment (5 microwave; 33 PEI; 26 RFA). RESULTS In 41 papers specifying the total number of patients biopsied and/or treated, the median risk of seeding was 2.29% (range 0-11%) for biopsy group; 1.4% (1.15-1.85%) for PEI when used with biopsy and 0.61% (0-5.56%) for RFA without biopsy, 0.95% (0-12.5%) for RFA with biopsy and 0.72% (0-10%) for liver nodules (including non-HCC nodules) biopsied and ablated. CONCLUSION Risk of seeding with HCC is substantial and appears greater with using diagnostic biopsy alone compared to therapeutic percutaneous procedures. This risk is particularly relevant for patients being considered for liver transplantation.
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Affiliation(s)
- R Stigliano
- Liver Transplantation and Hepatobiliary Medicine Unit, Royal Free Hospital, Pond Street, NW3 2QG London, UK.
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6
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Aldahham A, Boodai S, Alfuderi A, Almosawi A, Asfer S. Abdominal wall implantation of hepatocellular carcinoma. World J Surg Oncol 2006; 4:72. [PMID: 17026774 PMCID: PMC1617093 DOI: 10.1186/1477-7819-4-72] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Accepted: 10/08/2006] [Indexed: 12/30/2022] Open
Abstract
Background Percutaneous fine needle aspiration cytology (FNAC) became a popular method for diagnosis of hepatic masses. Abdominal wall implantation from FNAC is rare. Case presentation We report a female patient who presented with a right upper abdominal wall mass 3 years following a fine needle aspiration cytology (FNAC) and resection of a solitary hepatocellular carcinoma (HCC) from the liver. The mass proved to be a metastatic HCC; it was locally resected with safety margins. To date (20 months later) she remains well with no recurrence. Conclusion Implantation of tumor cells after FNAC for HCC is rare, but can happen. The availability of dynamic imaging of the liver should reduce the need for this technique in the diagnostic workup of patients suspected of having HCC
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Affiliation(s)
- Ali Aldahham
- The Liver Unit, Departments of Surgery, Mubarak Al-Kabeer Hospital, Kuwait
| | - Shurooq Boodai
- Department of Pathology, Mubarak Al-Kabeer Hospital, Kuwait
| | - Adel Alfuderi
- The Liver Unit, Departments of Surgery, Mubarak Al-Kabeer Hospital, Kuwait
| | - Ahmad Almosawi
- The Liver Unit, Departments of Surgery, Mubarak Al-Kabeer Hospital, Kuwait
| | - Sami Asfer
- The Liver Unit, Departments of Surgery, Mubarak Al-Kabeer Hospital, Kuwait
- Department of Surgery, Faculty of Medicine, P.O.Box 24923, Safat-13110, Kuwait
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Stigliano R, Burroughs AK. Should we biopsy each liver mass suspicious for HCC before liver transplantation?--no, please don't. J Hepatol 2005; 43:563-8. [PMID: 16120469 DOI: 10.1016/j.jhep.2005.07.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- R Stigliano
- Liver Transplantation and Hepatobiliary Medicine Unit, Royal Free Hospital, Pond Street NW3 2QJ, London, UK
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8
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St Peter SD, Nguyen CC, Mulligan DC, Moss AA. Subcutaneous metastasis at a surgical drain site after the resection of pancreatic cancer. ACTA ACUST UNITED AC 2004; 33:111-5. [PMID: 14716058 DOI: 10.1385/ijgc:33:2-3:111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aggressive nature of pancreatic cancer makes surgical control of disease an arduous challenge. Tumor seeding during resection is a feared complication during operations performed for this disease. Recurrence within the peritoneal cavity commonly occurs after resection for curative intent. Cutaneous metastasis, however, is a rare event. The majority of skin metastasis reported in the literature occurred after palliative procedures, in which the tumor burden remains. In this report, we describe an unusual case of cutaneous recurrence at the site of a surgical drain after resection for curative intent and discuss the impact of surgery on tumor-growth characteristics.
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Affiliation(s)
- Shawn D St Peter
- Division of Transplant Surgery, Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic Scottsdale, Scottdale, AZ 85054, USA
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9
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Bosniak MA. Should We Biopsy Complex Cystic Renal Masses (Bosniak Category III)? AJR Am J Roentgenol 2003; 181:1425-6; author reply 1426. [PMID: 14573452 DOI: 10.2214/ajr.181.5.1811425] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Schlatter M, Rescorla F, Giller R, Cushing B, Vinocur C, Colombani P, Cullen J, London W, Davis M, Lauer S, Olson T. Excellent outcome in patients with stage I germ cell tumors of the testes: a study of the Children's Cancer Group/Pediatric Oncology Group. J Pediatr Surg 2003; 38:319-24; discussion 319-24. [PMID: 12632342 DOI: 10.1053/jpsu.2003.50101] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE The aim of this study was to correlate outcomes in patients with stage I testicular germ cell tumors with compliance to surgical guidelines and to confirm previous single-institution experiences that show excellent disease-free survival rates when treated with orchiectomy alone. METHODS Sixty-three patients were entered into this intergroup study (Children's Cancer Group 8881/Pediatric Oncology Group 9048) between 1990 and 1996. Surgical guidelines for orchiectomy included an inguinal approach, early vascular control of the cord structures, and a hemiscrotectomy if a transscrotal violation occurred. Failure of tumor marker normalization or subsequent elevation suggested advanced disease requiring further surgery and chemotherapy. Survival curves were compared using the log-rank test. RESULTS The median age was 16 months (range, 1 month to 5.6 years). Progression of disease occurred in 11 patients. The 6-year event-free survival (EFS) was 78.5% + 7%. The overall 6-year survival rate was 100%. Adherence to all guidelines was confirmed in only 43 patients (69%). Overall, there was no statistical significance in event-free survival rates between patients who had a correct surgical approach and all patients who had surgical violations; however, 4 patients with transscrotal violations showed a significantly higher rate of disease recurrence. CONCLUSIONS Patients with stage I germ cell tumors of the testes have excellent survival rates when treated with surgery alone. Despite numerous surgical guideline violations, event-free survival in this multiinstitutional study was similar to previous single-institution reports. All patients with relapse or progression of their disease appear to be cured with further surgical excision and chemotherapy.
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Affiliation(s)
- Marc Schlatter
- DeVos Children's Hospital, 330 Barclay, Suite 202, Grand Rapids, Michigan 49503, USA
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de Sio I, Castellano L, Calandra M, Del Vecchio-Blanco C. Subcutaneous needle-tract seeding after fine needle aspiration biopsy of pancreatic liver metastasis. EUROPEAN JOURNAL OF ULTRASOUND : OFFICIAL JOURNAL OF THE EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY 2002; 15:65-8. [PMID: 12044855 DOI: 10.1016/s0929-8266(02)00008-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case of subcutaneous neoplastic seeding after fine needle aspiration biopsy of a pancreatic liver metastasis is reported. Neoplastic seeding is a rare complication after fine needle biopsy (FNB). The seeding appeared 3 months after the biopsy with a subcutaneous hypoechoic nodule; diagnosis was confirmed by fine needle aspiration of the nodule. The neoplastic seeding did not change the outcome of the patient.
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Affiliation(s)
- I de Sio
- Gastroenterology Unit-Ultrasonography Section 11, University of Naples, Naples, Italy.
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12
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Ojalehto M, Tikkakoski T, Rissanen T, Apaja-Sarkkinen M. Ultrasound-guided percutaneous thoracoabdominal biopsy. Efficacy, cost-effectiveness and safety. Acta Radiol 2002. [DOI: 10.1034/j.1600-0455.2002.430210.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lechevallier E, André M, Barriol D, Daniel L, Eghazarian C, De Fromont M, Rossi D, Coulange C. Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 2000; 216:506-10. [PMID: 10924578 DOI: 10.1148/radiology.216.2.r00au01506] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the feasibility, accuracy, and clinical role of fine-needle percutaneous biopsy of renal masses, with helical computed tomographic (CT) guidance. MATERIALS AND METHODS In 63 patients (mean age, 62 years), 73 biopsies were performed. The median tumor size was 4.0 cm. Tumor biopsy was performed with an 18-gauge needle by using helical CT guidance in an outpatient setting. Two to four cores per tumor were obtained. RESULTS Biopsy material was insufficient for analysis in 15 (21%) procedures. The median tumor size of failed or successful biopsies was 3.0 or 4.8 cm, respectively (P =.03). A benign lesion was found at eight biopsies. Two samples were suspicious for renal cell carcinoma (RCC). RCC was found in 38 biopsy samples. The remainder were transitional cell carcinoma, metastasis, lymphoma, or sarcoma. Twenty-six patients underwent nephrectomy. The accuracies of biopsy for histopathologic and Fuhrman nuclear grade evaluation were 89% and 78%, respectively. For tumors of 3.0 cm or smaller or larger than 3.0 cm, 37% (11 of 30) or 9% (four of 43) had failure of biopsy, respectively (P =.006). No substantial morbidity occurred. CONCLUSION Fine-needle biopsy with helical CT guidance is accurate for the histopathologic evaluation of renal masses without morbidity. Indications are renal lesions that do not have the typical radiologic features of RCC, Bosniak category III or IV cystic lesions, and locally advanced or metastatic RCC.
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Affiliation(s)
- E Lechevallier
- Departments of Urology, Hôpital Salvator, 249 Blvd Ste Marguerite, 13274 Marseille, France.
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Rogers DA, Rao BN, Meyer WH, Pappo A, Lobe TE, Fleming ID, Kauffman WM. Indications for hemiscrotectomy in the management of genitourinary tumors in children. J Pediatr Surg 1995; 30:1437-9. [PMID: 8786482 DOI: 10.1016/0022-3468(95)90400-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In the last 30 years at St Jude Children's Research Hospital, 10 boys have undergone hemiscrotectomy for primary testicular tumors or paratesticular rhabdomyosarcoma. Indications for this procedure were scrotal contamination and positive or uncertain surgical margins. Residual tumor was found in only one specimen. There were four complications in the study group. Two patients had complications directly attributable to the hemiscrotectomy, and in one patient this caused a delay in treatment. Preoperative imaging was performed in three patients. This has not been helpful in evaluating residual masses and is not indicated. Based on the authors' experience and a review of the literature, there are a number of indications for hemiscrotectomy in the management of genitourinary tumors in children. Controversies regarding some of these indications should be discussed with the families of these patients during preoperative counseling.
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Affiliation(s)
- D A Rogers
- Department of Surgery, St Judge Children's Research Hospital, Memphis TN 38105, USA
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15
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Quecedo E, Febrer I, Martínez-Escribano JA, Navarro-Iváñez R, Aliaga A. Tumoral seeding after pericardiocentesis in a patient with a pulmonary adenocarcinoma. J Am Acad Dermatol 1994; 31:496-7. [PMID: 8077480 DOI: 10.1016/s0190-9622(09)80009-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- E Quecedo
- Department of Dermatology, Hospital General Universitario, Valencia, Spain
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16
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Slywotzky C, Maya M. Needle tract seeding of transitional cell carcinoma following fine-needle aspiration of a renal mass. ABDOMINAL IMAGING 1994; 19:174-6. [PMID: 8199555 DOI: 10.1007/bf00203498] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 64-year-old man presented with recurrence of transitional cell carcinoma attributed to needle tract seeding of tumor 8 months following fine-needle aspiration of a lower pole renal mass.
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Affiliation(s)
- C Slywotzky
- Department of Radiology, Lenox Hill Hospital, New York, NY 10021
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17
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Lundstedt C, Stridbeck H, Andersson R, Tranberg KG, Andrén-Sandberg A. Tumor seeding occurring after fine-needle biopsy of abdominal malignancies. Acta Radiol 1991; 32:518-520. [PMID: 1742134 DOI: 10.1177/028418519103200615] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Percutaneous fine-needle aspiration biopsy is a commonly used diagnostic procedure with a high accuracy and a low complication rate. However, tumor seeding in the biopsy tracts has been recorded with a frequency of one in 20,000-40,000 biopsies. We report 5 cases of percutaneous tumor seeding recorded after 5,000 fine-needle biopsies of abdominal malignancies at our institution. The risk of implantation metastases induced by fine-needle biopsy warrants consideration in patients with abdominal malignancies since it may compromise the outcome of radical surgery. It should only be performed when the result of the procedure has a direct impact on the choice of therapy.
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Affiliation(s)
- C Lundstedt
- Department of Diagnostic Radiology, University Hospital, Lund, Sweden
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Affiliation(s)
- J M Nankhonya
- Department of Medicine/Geriatrics, Arrowe Park Hospital, Wirral, U.K
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