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Boonlikit S, Tangterdchanakit P. Multicentricity and the Risk of Recurrence/Persistence After Laser Vaporization for High-Grade Vulvar and Vaginal Intraepithelial Neoplasia. World J Oncol 2024; 15:90-99. [PMID: 38274717 PMCID: PMC10807919 DOI: 10.14740/wjon1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
Background The aim of the study was to assess the effect of multicentricity on the recurrence/persistence of high-grade vulvar intraepithelial neoplasia (VIN) and vaginal intraepithelial neoplasia (VAIN) after laser vaporization. Methods A retrospective cohort study was conducted on patients diagnosed with high-grade VIN/VAIN, who had undergone laser vaporization between 1997 and 2014. Recurrence/persistence rates and factors affecting recurrence/persistence were analyzed, and a life table analysis of recurrence-free intervals was conducted. Results Among the 65 patients, the recurrence/persistence rate following laser vaporization was 22.3 per 100 person-years, with a median time to recurrence/persistence of 31.2 months (95% confidence interval (CI): 0.0 - 71.9 months). Patients with multicentricity and unicentricity had a recurrence/persistence rate of 49.1 per 100 person-years, with a median time to recurrence/persistence of 11.4 months, and 7.4 per 100 person-years, with a median time to recurrence/persistence of 96.5 months, respectively (P = 0.0002). The difference in recurrence-free survival between the multicentricity and unicentricity groups was significant (P = 0.00035). Patients with multicentricity had a 4.7-fold higher risk of recurrence/persistence (hazard ratio (HR): 4.71, 95% CI: 1.87 - 11.88, P = 0.001). Multivariate analysis showed that multicentricity was an independent risk factor for recurrence/persistence (odds ratio (OR): 4.16, 95% CI: 1.56 - 11.06, P = 0.004). Conclusions Treatment of multicentric, high-grade VIN/VAIN with laser vaporization is strongly associated with treatment failure, with approximately half of patients experiencing recurrence/persistence.
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Affiliation(s)
- Sathone Boonlikit
- Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Punyacha Tangterdchanakit
- Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
- Department of Obstetrics and Gynecology, Pakkred Hospital, Nonthaburi, Thailand
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Sobrino Prados A, Eizaguirre Zarza B, Gimeno Esteras E, Del Agua Arias-Camisón C. [Multicentric secretory carcinoma of the breast: Case report and review of the literature]. Rev Esp Patol 2020; 53:117-120. [PMID: 32199593 DOI: 10.1016/j.patol.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/28/2019] [Accepted: 02/04/2019] [Indexed: 11/30/2022]
Abstract
Secretory carcinoma of the breast is a rare entity, characterized by the presence of intra- and extracellular, eosinophilic and acelular secretions. They are negative for hormone receptors and do not express human epidermal growth factor receptor HER-2/neu. However, the clinical outcome is favorable. Multicentricity is very unusual. We report a case of a 32-year-old woman with a multicentric secretory carcinoma of the breast. The main pathological features are discussed together with a review of the pertinent literature.
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Affiliation(s)
- Almudena Sobrino Prados
- Departamento de Anatomía Patológica, Hospital Universitario Miguel Servet, Zaragoza, Aragón, España.
| | - Beatriz Eizaguirre Zarza
- Departamento de Anatomía Patológica, Hospital Universitario Miguel Servet, Zaragoza, Aragón, España
| | - Esther Gimeno Esteras
- Departamento de Anatomía Patológica, Hospital Universitario Miguel Servet, Zaragoza, Aragón, España
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Iscan Y, Sormaz IC, Tunca F, Giles Senyurek Y. Multicentricity Is More Common in Thyroid Papillary Microcancer with a Preoperative Diagnosis Compared to Incidental Microcancer. Eur Thyroid J 2019; 8:256-261. [PMID: 31768336 PMCID: PMC6873002 DOI: 10.1159/000501613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/17/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Although multicentricity is a common feature of thyroid papillary microcancer, it might be difficult to predict this histopathological feature preoperatively. METHODS The records of 306 papillary microcancer patients who underwent thyroidectomy were evaluated. Papillary microcancer was diagnosed as an incidental histopathological finding in 242 (group 1), and by preoperative fine-needle aspiration biopsy in 64 (group 2). Demographic data and histopathological features were compared between the two groups. RESULTS Age (44 ± 11.4 vs. 43 ± 14 years) and male/female ratio (44/193 vs. 12/52) showed no significant difference between groups 1 and 2 (p > 0.05). Mean tumor size was significantly larger in group 2 (5.2 ± 2.8 mm) compared to group 1 (3.7 ± 2.4 mm) (p = 0.004). The frequency of thyroid capsule invasion (44 vs. 19%, p = 0.0001), microscopic extrathyroidal invasion (25 vs. 10%, p = 0.004) and multicentricity (44 vs. 29%, p = 0.04), and bilateral lobar involvement (22 vs. 10%, p = 0.0001) was significantly higher in group 2 compared to group 1. CONCLUSION Multicentricity with bilateral lobar involvement and aggressive histopathological features are more frequent in papillary microcancer patients diagnosed with preoperative fine-needle aspiration biopsy compared to papillary microcancer diagnosed as postoperative incidental histopathological finding.
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Affiliation(s)
- Yalin Iscan
- *Yalin Iscan, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Turgut Özal Cad., TR–34390 Fatih/Istanbul (Turkey), E-Mail
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Xian J, Righi A, Vanel D, Baldini N, Errani C. Epithelioid hemangioma of bone: A unique case with multifocal metachronous bone lesions. J Clin Orthop Trauma 2019; 10:1068-1072. [PMID: 31708630 PMCID: PMC6834962 DOI: 10.1016/j.jcot.2019.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/14/2019] [Indexed: 02/07/2023] Open
Abstract
Epithelioid hemangioma of bone is a rare vascular neoplasm with a ubiquitous distribution. To date, up to 25% epithelioid hemangioma of bone presents synchronous bone lesions. We report a unique case of epithelioid hemangioma with multifocal metachronous bone lesions without any fatal outcome observed after a long period. Importantly, a strong nuclear expression of FOSB antibody was detected by immunohistochemical analysis. In this case, the pathologic and radiologic findings are also described. We suggest that epithelioid hemangioma can present multifocal metachronous bone lesions without producing a fatal outcome.
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Affiliation(s)
- Jie Xian
- Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy,Department of Biomedical and Neuromotor Science, University of Bologna, Via Foscolo 7, 40132, Bologna, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Daniel Vanel
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Nicola Baldini
- Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy,Department of Biomedical and Neuromotor Science, University of Bologna, Via Foscolo 7, 40132, Bologna, Italy
| | - Costantino Errani
- Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy,Corresponding author. Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Rizzoli, via Pupilli n1, 40136, Bologna, Italy.
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Kageyama Y, Yamaguchi R, Watanabe S, Aizu K, Sato F, Arimoto A. Intraductal papillary neoplasm of the bile duct with rapidly progressive multicentric recurrence: A case report. Int J Surg Case Rep 2018; 51:102-106. [PMID: 30149325 PMCID: PMC6111009 DOI: 10.1016/j.ijscr.2018.08.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/13/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Knowledge on the pattern of recurrence and prognosis of intraductal papillary neoplasms of the bile duct (IPNB) is limited. Few studies have reported IPNB recurrence in the remnant intrahepatic bile duct, which is indicative of the true multicentricity of IPNB. Herein, we report a case of IPNB with rapidly progressive recurrence in the remnant intrahepatic bile duct and review the literature for discussing the prognosis of IPNB with multicentricity. CASE PRESENTATION A 72-year-old male was diagnosed with IPNB in the hepatic duct of segment 3 that had spread to the left hepatic duct. The patient underwent left hepatectomy, total caudate lobectomy, and extra-hepatic bile duct resection with biliary reconstruction. Histologically, the tumor was IPNB with noninvasive adenocarcinoma with a negative surgical margin. Although dilatation of B8 and biliary enzyme elevation were observed beginning at 7-10 months postoperatively, there was no evidence of recurrence. At 17 months postoperatively, the recurrent tumor diffusely spread throughout the remnant intrahepatic bile duct. Internal drainage stents were placed within the intrahepatic bile ducts with relapsed IPNB to relieve jaundice, and a course of chemotherapy was considered. However, the patient did not receive any therapies up to his death at 21 months postoperatively because of rapid disease progression. CONCLUSION According to a literature review, some cases of multicentric IPNB have shown rapidly progressive recurrence and poor prognosis. We should consider multicentricity of IPNB even a few months after curative resection, and narrow examinations should also be considered.
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Affiliation(s)
- Yumiko Kageyama
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan.
| | - Ryuzo Yamaguchi
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan
| | - Shinya Watanabe
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan
| | - Keiji Aizu
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan
| | - Fumiya Sato
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan
| | - Atsuki Arimoto
- Division of Surgery, Kasugai Municipal Hospital, Aichi, Japan
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Schröder L, Fricker R, Stein RG, Rink T, Fitz H, Blasius S, Wöckel A, Müller T. Evaluation of sentinel lymph node biopsy prior to axillary lymph node dissection: the role of isolated tumor cells/micrometastases and multifocality/ multicentricity-a retrospective study of 1214 breast cancer patients. Arch Gynecol Obstet 2018; 297:1509-15. [PMID: 29594495 DOI: 10.1007/s00404-018-4760-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Sentinel lymph node biopsy (SLNB) alone has thus become an accepted surgical approach for patients with limited axillary metastatic disease. We investigated to what extent isolated tumor cells (ITC) or micrometastasis in SLNBs is associated with proven tumor cells or metastasis in non-sentinel lymph nodes. Furthermore, we investigated the feasibility of SLNB in multifocal and multicentric tumors as both entities have been considered a contraindication for this technique. METHODS 1214 women suffering from T1 and T2 invasive breast cancer, with clinically and sonographically insuspect axillary status and undergoing primary breast cancer surgery including SLNB and axillary staging in case of SLN (sentinel lymph node) metastases, were recruited into this multicentered study. RESULTS ITC and micrometastases were found in 2.01 and 21.4% of patients with SLN metastases (n = 299). Among patients with sentinel micrometastases, 4.7% showed further axillary micrometastases, while only two patients (3.1%) had two axillary macrometastases. Multifocal and multicentric tumors were diagnosed in 9.3 and 2.6% of our patients who at least had one SLN resected, respectively. Detection rates of SLNs did not differ between the cohorts suffering from unicentric and multifocal or multicentric disease. Moreover, the portion of tumor-free SLNs, the number of SLNs with metastasis as well as the mean number of resected SLNs did not differ. CONCLUSIONS No patient with sentinel node micrometastases showed more than two axillary macrometastases. Multifocal and multicentric disease is no contraindication for SLNB.
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Karakas Y, Dizdar O, Aksoy S, Hayran M, Altundag K. The Effect of Total Size of Lesions in Multifocal/Multicentric Breast Cancer on Survival. Clin Breast Cancer 2017; 18:320-327. [PMID: 29183716 DOI: 10.1016/j.clbc.2017.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/28/2017] [Accepted: 11/02/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, we aimed to assess the prognostic performance of determining the T stage according to the total size of lesions compared with the size of the largest lesion in the breast in patients with multifocal/multicentric (MF/MC) breast cancer. PATIENTS AND METHODS The charts of the patients with MF/MC breast cancer who were diagnosed between 2003 and 2014 were reviewed. The T stage of MF/MC tumors was determined according to the largest lesion size (Tmax) as well as the sum of the longest diameters of the lesions (Tsum) in the breast. RESULTS Multifocal/multicentric tumors were identified in 323 of 3890 patients (8.3%) with breast cancer. Ten-year rates of overall survival (OS; 75% and 74%; P = .965) and disease-free survival (DFS; 66% and 61%; P = .817) were similar in patients with unifocal and MF/MC tumors, respectively. When the T stage was determined by summing the sizes of the lesions, the T stage of 67 (20.7%) and 63 (19.5%) patients advanced from T1 to T2 and from T2 to T3, respectively. Thus, the T stage increased in 130 patients (40.2%) according to American Joint Committee on Cancer. Discriminatory ability of Tsum was better than Tmax in terms of OS and DFS, as shown with higher Royston D and Harrel C statistics and Schemper V values. CONCLUSION The new T classification proposed in this report stands out as a better predictive classification particularly in patients with low disease burden.
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Affiliation(s)
- Yusuf Karakas
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Omer Dizdar
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Sercan Aksoy
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Kadri Altundag
- Mustafa Kadri Altundag (MKA) Breast Cancer Clinic, Ankara, Turkey.
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Garg P, Chufal SS, Gupta N, Pant P, Thapliyal NC. Multicentric aggressive mammary fibromatosis with cytological features and review of literature. J Clin Diagn Res 2014; 8:FD01-3. [PMID: 24995189 DOI: 10.7860/jcdr/2014/6056.4328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 02/13/2014] [Indexed: 11/24/2022]
Abstract
Fibromatosis is a fibroblastic lesion composed of uniform fibroblasts and collagen with an infiltrative growth pattern but lacking malignant cytological features. It is a rare entity and is even more unusual when found in the breast. Multicentricity in fibromatosis has been reported in 10% cases. Multicentricity in breast cancer has been defined as the presence of two or more tumor foci within different quadrants of the same breast. Considering this definition of multicentricity for fibromatosis, we herein report a case of recurrent multicentric aggressive mammary fibromatosis and its cytological features with review of literature because of limited literature of (FNAC) in mammary fibromatosis.
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Affiliation(s)
- Parul Garg
- Assistant Professor, Department of Pathology, Maharishi Markandeshwar Medical College and Hospital , Solan, India
| | - Sanjay Singh Chufal
- Assistant Professor, Department of Pathology, Government Medical College , Haldwani, India
| | - Nilakshi Gupta
- Junior Resident, Department of Pathology, Government Medical College , Haldwani, India
| | - Prabhat Pant
- Assistant Professor, Department of Pathology, Government Medical College , Haldwani, India
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Güdücü N, Sidar G, Başsüllü N, Türkmen I, Dünder I. Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia. Ann Diagn Pathol 2013; 17:345-6. [PMID: 23665088 DOI: 10.1016/j.anndiagpath.2013.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
Abstract
This study aimed to evaluate the rate of endocervical glandular involvement, positive surgical margins, multicentricity, and disease extent between low-grade and high-grade cervical intraepithelial lesions after loop electrosurgical excision procedure (LEEP). Pathology medical records of patients who underwent LEEP were reviewed retrospectively. Patients with negative LEEP results were excluded. Loop electrosurgical excision procedure reports of patients with cervical intraepithelial neoplasia (CIN) 1, 2, and 3 were compared. There was no statistically significant difference between patients with CIN 1 (n=24), CIN 2 (n=27), and CIN 3 (n=64) when age and surgical margin positivity were considered. Endocervical glandular involvement, multicentricity, and disease extent were higher in patients with CIN 3 (P=.001, P=.002, and P=.001, respectively). In conclusion, we recommend that patients with endocervical glandular involvement, lesions involving more than two-thirds of the LEEP specimen, and multicentricity be followed up more closely.
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Affiliation(s)
- Nilgün Güdücü
- Department of Obstetrics and Gynecology, İstanbul Bilim University, Istanbul, Turkey.
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