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Gao J, Ma ZM. Multiple primary colonic carcinomas with lung small-cell neuroendocrine carcinoma: A case report. Asian J Surg 2024; 47:2050-2051. [PMID: 38220530 DOI: 10.1016/j.asjsur.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024] Open
Affiliation(s)
- Jian Gao
- Department of Gastrointestinal Nutrition and Hernia Surgery, Second Hospital of Jilin University, Changchun, 130041, China
| | - Zhi-Ming Ma
- Department of Gastrointestinal Nutrition and Hernia Surgery, Second Hospital of Jilin University, Changchun, 130041, China.
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2
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Chen Y, Fang C, Huang J, Pan H, He L, Zhuang C, Zheng X. The correlation between the main and minor lesions of synchronous multiple gastric neoplasms assessed gastroscopically and microscopically. Surg Endosc 2024; 38:1211-1221. [PMID: 38092970 DOI: 10.1007/s00464-023-10624-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/29/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Patients with early gastric cancer (EGC) are at high risk of developing synchronous multiple gastric neoplasms (SMGNs) after undergoing endoscopic submucosal dissection (ESD). However, most previous studies have had small sample sizes, and few have focused on association studies. AIMS This study aimed to analyze the associations between SMGN lesion data from patients with EGC treated with ESD and their correlation coefficients. METHODS The clinical ESD data from two hospitals from January 2008 to January 2021 were retrospectively analyzed. The main lesions were defined as those with a significant depth of infiltration. The larger tumor diameter was considered the main lesion if the lesions had the same infiltration depth. RESULTS Of the 1013 post-ESD cases examined, 95 cases (223 lesions) had SMGN, and 25 patients had more than three lesions. For the correlation analysis, 190 lesions were included. The study revealed a similarity in pathological type between main and minor lesions (rs = 0.37) and a positive correlation in infiltration depth (rs = 0.58). The mean diameter sizes of the main and minor lesions were 20.7 ± 8.3 mm and 13.1 ± 6.4 mm, respectively, with statistically significant differences (P < 0.001). A linear correlation was observed between the diameter size and a linear regression model was constructed, producing r = 0.38 [95% confidence interval (CI) 0.19-0.54], b = 0.29 (95% CI 0.14-0.44), t = 3.94, P < 0.001]. A correlation was identified between the vertical distribution of the main and minor lesions, the horizontal distribution, and the gross endoscopic morphology (ϕc = 0.25, P = 0.02; ϕc = 0.32, P < 0.001; ϕc = 0.60, P < 0.001). CONCLUSIONS The correlation coefficients for microscopic characteristics were higher than those for gastroscopy. There is a significant positive correlation between the main and minor lesions regarding pathological stage and depth of infiltration, respectively. The spatial distribution of the lesions and the gastroscopic morphology were similar.
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Affiliation(s)
- Yudai Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Chaoying Fang
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Jianmin Huang
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Hui Pan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Liping He
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Chenlin Zhuang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Department of Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China.
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350028, China.
| | - Xiaoling Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Department of Digestive Endoscopy, Fujian Provincial Hospital, Fuzhou, 350001, China.
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350028, China.
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Samadzadeh Tabrizi N, Gallant B, Harris E, Arnold BN, Fabian T. Contemporary Incidence of Synchronous Multiple Primary Lung Cancers and Survival in the Era of Lung Cancer Screening. Innovations (Phila) 2024; 19:23-29. [PMID: 38018766 DOI: 10.1177/15569845231210242] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Up to 15% of lung cancer patients have multiple suspicious nodules. While some of these nodules may represent metastatic lung cancer, others represent synchronous multiple primary lung cancer (SMPLC). The incidence of SMPLC ranges from 0.8% to 8.4% and appears to be increasing. Inconsistent identification of SMPLC can be detrimental for patients who are misdiagnosed as having intrapulmonary metastasis and not offered stage-based treatment. We sought to identify the contemporary incidence of SMPLC at a tertiary institution. METHODS From January 2018 to September 2019, patients who underwent lung cancer resection were retrospectively reviewed. Patients with SMPLC were identified using the modified Martini-Melamed criteria. RESULTS During the 21-month period, 227 patients underwent lung cancer resection. There were 47 patients (20.7%) who had 119 pathologically confirmed SMPLC. Most patients had ipsilateral tumors (n = 24, 51.1%) with at least 1 adenocarcinoma (n = 40, 85.1%). Considering histologic subtyping, 38 (80.9%) had histologically distinct tumors. Overall and cancer-specific survival at 4 years was 86% and 90%, respectively. Only patients with 3 or more SMPLC had poor 4-year overall (P = 0.002) and cancer-specific survival (P = 0.043) compared with those with 2 SMPLC. Patient demographics, histology, tumor location, and highest pathologic staging did not affect survival outcomes. CONCLUSIONS Using a strict inclusion criterion, the incidence of SMPLC is higher than previously reported. SMPLC patients have favorable survival outcomes, suggesting that they behave like primary lung cancer, not intrapulmonary metastasis. Awareness of SMPLC by thoracic surgeons is critical in optimizing outcomes in this patient population.
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Affiliation(s)
| | - Ben Gallant
- Department of Thoracic Surgery, Albany Medical Center, NY, USA
| | - Erin Harris
- Department of Thoracic Surgery, Albany Medical Center, NY, USA
| | - Brian N Arnold
- Department of Thoracic Surgery, Albany Medical Center, NY, USA
| | - Thomas Fabian
- Department of Thoracic Surgery, Albany Medical Center, NY, USA
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Huang C, Tong H. Two-stage minimally invasive pulmonary resections with intraoperative localization technique for bilateral multiple primary lung cancers: A case report. Thorac Cancer 2024; 15:192-197. [PMID: 38018514 PMCID: PMC10788464 DOI: 10.1111/1759-7714.15183] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
Multiple primary lung cancers (MPLCs) are becoming more and more common and these patients can benefit from minimally invasive surgery. Here, we report a case of a patient diagnosed with synchronous MPLCs who underwent bilateral thoracoscopic pulmonary resections in a two-stage strategy, and achieved a good surgical outcome and high quality of life. A 66-year-old female was found to have one major ground-glass nodule (GGN) in the right upper lobe and eight minor GGNs in the left upper and lower lobes. The patient underwent right upper lobe resection and systematic mediastinal lymph node dissection via single-utility port thoracoscopic surgery in September 2018. Pathology was lepidic predominant adenocarcinoma pT1bN0M0, IA2. Regular high-resolution computed tomography examination during 36 months after right upper lobectomy showed gradually increasing diameter and solid component of multiple GGNs in left lung. The patient underwent thoracoscopic multiple pulmonary resections using an intraoperative localization technique in a hybrid operating room in October 2021 and all eight nodules in the left lung were resected. Two segmentectomies and four wedge resections were performed, and the pathological results of the eight nodules included four adenocarcinomas, three adenocarcinomas in situ, and one alveolar epithelial hyperplasia. The two operations were successful with no intra- or postoperative 90-day complications. During more than 20 months of follow-up after the second operation, the patient had well recovered pulmonary function and physical status with a Karnofsky performance status score of 90 and no local recurrence or metastasis. A two-stage surgical strategy for synchronous MPLCs is therefore feasible. The surgical strategy, timing of intervention, and extent of pulmonary resection should be individually designed according to the location and characteristics of each nodule. Intraoperative localization of small GGNs is very important to ensure that all nodules are completely and accurately resected during the operation.
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Affiliation(s)
- Chuan Huang
- Department of Thoracic Surgery, Beijing Hospital, National Center of GerontologyInstitute of Geriatric Medicine, Chinese Academy of Medical SciencesBeijingChina
| | - Hong‐Feng Tong
- Department of Thoracic Surgery, Beijing Hospital, National Center of GerontologyInstitute of Geriatric Medicine, Chinese Academy of Medical SciencesBeijingChina
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Shi PJ, Li YB, Xiao HP. [Etiological analysis of a patient with multiple primary malignant neoplasms]. Zhonghua Yi Xue Za Zhi 2023; 103:3848-3851. [PMID: 38123227 DOI: 10.3760/cma.j.cn112137-20230925-00541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
To investigate the etiology of multiple primary malignant neoplasms occurred in one patient. Retrospective analysis was performed on a 52-year-old female patient who was admitted to the Department of Endocrinology, the First Affiliated Hospital of Sun Yat-Sen University on October 7, 2021, due to "thyroid occupying lesion for one week". A complete systemic positron emission tomography examination of the patient indicated that the metabolic characteristics of the left thyroid nodules were consistent with medullary thyroid carcinoma, those of the right thyroid nodules were consistent with papillary thyroid carcinoma, and the metabolic characteristics of the T6-7 level were consistent with meningioma, and teratoma was found in the right ovarian region. Intradural subdural mass resection was performed on October 20, 2021, and bilateral total thyroidectomy, isthmus thyroidectomy, bilateral central lymph node dissection and left cervical lymph node dissection were performed on November 2, 2021. The postoperative pathologic diagnosises were meningioma (WHO Grade 1), medullary thyroid carcinoma (left side), and papillary thyroid carcinoma (right side).Whole exon gene sequencing revealed the presence of mutations in the ACAN and FLNB genes, which are associated with dysplasia, as well as mutations in the DDX41 and JAK2 genes, which are linked to active pro-proliferation signaling and tumor susceptibility. In this study, a gene mutation pattern which could lead to multiple primary malignant neoplasms was found.
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Affiliation(s)
- P J Shi
- Department of Endocrinology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y B Li
- Department of Endocrinology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - H P Xiao
- Department of Endocrinology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Liu X, Wu R, Tang Z, Li L. Synchronous thymic carcinoma and lung adenocarcinoma: A rare case report. Asian J Surg 2023; 46:5915-5916. [PMID: 37718208 DOI: 10.1016/j.asjsur.2023.08.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023] Open
Affiliation(s)
- Xiangjin Liu
- First Clinical Medical College, The Gannan Medical University, Ganzhou, China
| | - Rongqian Wu
- First Clinical Medical College, The Nanchang University, Nanchang, China
| | - Zhixian Tang
- Department of Thoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
| | - Ling Li
- Department of Pathology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
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Li M, Lu Y, Ji Y, Ding N. Coexistence of primary pulmonary meningioma and adrenal pheochromocytoma: A rare case report. Asian J Surg 2023; 46:5813-5814. [PMID: 37673747 DOI: 10.1016/j.asjsur.2023.08.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Mengjuan Li
- Department of Radiology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Yan Lu
- Department of Radiology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Yiding Ji
- Department of Radiology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Ning Ding
- Department of Radiology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China.
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Wang H, Fei J, Yu X. Synchronous renal pelvic urothelial carcinoma and oncocytoma: A case report. Asian J Surg 2023; 46:5952-5953. [PMID: 37696701 DOI: 10.1016/j.asjsur.2023.08.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
MESH Headings
- Humans
- Carcinoma, Transitional Cell/diagnostic imaging
- Carcinoma, Transitional Cell/surgery
- Carcinoma, Transitional Cell/pathology
- Adenoma, Oxyphilic/diagnostic imaging
- Adenoma, Oxyphilic/surgery
- Adenoma, Oxyphilic/pathology
- Urinary Bladder Neoplasms
- Kidney Neoplasms/diagnostic imaging
- Kidney Neoplasms/surgery
- Kidney Neoplasms/pathology
- Carcinoma, Renal Cell/pathology
- Kidney Pelvis/diagnostic imaging
- Kidney Pelvis/surgery
- Kidney Pelvis/pathology
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Multiple Primary/pathology
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Affiliation(s)
- He Wang
- Department of Radiology, Zhuhai Hospital Affiliated with Jinan University(Zhuhai People's Hospital), Jinan University, Zhuhai, 519000, Guangdong Province, China
| | - Jia Fei
- Department of Radiology, Zhuhai Hospital Affiliated with Jinan University(Zhuhai People's Hospital), Jinan University, Zhuhai, 519000, Guangdong Province, China
| | - Xiangrong Yu
- Department of Radiology, Zhuhai Hospital Affiliated with Jinan University(Zhuhai People's Hospital), Jinan University, Zhuhai, 519000, Guangdong Province, China.
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Fan H, Wen R, Zhou L, Gao X, Lou Z, Hao L, Meng R, Gong H, Yu G, Zhang W. Clinicopathological features and prognosis of synchronous and metachronous colorectal cancer: a retrospective cohort study. Int J Surg 2023; 109:4073-4090. [PMID: 37737848 PMCID: PMC10720868 DOI: 10.1097/js9.0000000000000709] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/14/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND To investigate the clinicopathological features and prognosis of synchronous and metachronous multiple primary colorectal cancer. MATERIALS AND METHODS Patients who underwent operation for synchronous and metachronous colorectal cancer at the colorectal surgery department of Shanghai Changhai Hospital between January 2000 and December 2021 were included. Perioperative indicators were comprehensively compared and included in the survival analyses. RESULTS In total, 563 patients with synchronous ( n =372) and metachronous ( n =191) colorectal cancer were included. Patients with synchronous colorectal cancer were more likely to have a long onset time, positive carcinoembryonic antigen, advanced TNM stage, large tumor, perineural invasion, p53 high expression, and mismatch repair proficient. Compared with metachronous colorectal cancer, patients with synchronous colorectal cancer showed worse 5-year overall survival (68.6±3.0% vs 81.9±3.5%, P =0.018) and 5-year disease-free survival (61.2±3.1% vs 71.0±3.9%, P =0.022). In the subgroup analysis, segmental resection was an independent risk factor for the long-term outcomes of bilateral synchronous colorectal cancer. CONCLUSIONS Clinicopathological and molecular features were different between synchronous and metachronous colorectal cancer. Patients with synchronous colorectal cancer showed a worse prognosis than those with metachronous colorectal cancer. Bilateral synchronous colorectal cancer requires extended resection to achieve improved long-term outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Haifeng Gong
- Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Guanyu Yu
- Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Wei Zhang
- Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China
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Ma T, Wang R, Zhou X, Liu L, Pan A, Wang H, Huang L. Case reports of collision and composite carcinomas of the thyroid: an insight into their origin and clinical significance. BMC Endocr Disord 2023; 23:173. [PMID: 37580706 PMCID: PMC10424338 DOI: 10.1186/s12902-023-01409-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/06/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Collision and composite carcinomas of the thyroid are extremely rare, and their clinical and biological characteristics are poorly understood. CASE PRESENTATION The first case was a 41-year-old female patient with a right thyroid nodule. Pathological diagnosis was papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma composite carcinoma. Surgical treatment was right thyroid lobectomy + left partial thyroidectomy + right central neck lymph node dissection. The second case was a 60-year-old female with bilateral thyroid nodules. Total thyroidectomy was performed, and the pathological diagnosis was thyroid collision carcinoma involving follicular thyroid carcinoma on the left side and PTC on the right side. The clinical, histological and gene changes of collision and composite carcinomas of the thyroid are poorly described. With different biological invasion characteristics, the ideal treatment and the prognosis is currently unknown and individualized treatment is necessary. CONCLUSIONS It is recommended that in composite carcinoma, each cancer is evaluated and treated according to the most severe tumor. Collision carcinoma should be treated as two separate synchronous primary tumors. For both collision and composite carcinomas of the thyroid, the follow-up after treatment should be extensive.
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Affiliation(s)
- Tao Ma
- Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Ruixiao Wang
- Pathological Department, General Hospital of Ningxia Medical University, No.804 Shengli South Street, Xingqing District, Yinchuan, 750000, Ningxia Province, China
| | - Xu Zhou
- Ultrosound Department, General Hospital of Ningxia Medical University, Ningxia Province, Yinchuan, 750000, China
| | - Liqiang Liu
- Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Aijing Pan
- Clinical Medical College, Ningxia Medical University, Yinchuan, 750000, Ningxia Province, China
| | - Hongmei Wang
- Department of Pharmacology, School of Medicine, Southeast University, Dingjiaqiao 87, Nanjing, 210009, Jiangsu, China.
| | - Lingyan Huang
- Pathological Department, General Hospital of Ningxia Medical University, No.804 Shengli South Street, Xingqing District, Yinchuan, 750000, Ningxia Province, China.
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Giulioni C, Maggi M, Pirola GM, Martorana E, Cormio A, Teoh JYC, Gauhar V, Galosi AB, Castellani D. The current evidence on surgical management for synchronous bilateral renal tumors: results from a scoping review. World J Urol 2023; 41:2107-2118. [PMID: 37405465 PMCID: PMC10415478 DOI: 10.1007/s00345-023-04503-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE Synchronous bilateral renal masses (SBRM) account for a low percentage of kidney tumors, and there is no current recommendation for their management. The objective was to review evidence regarding the best surgical approach for SBRM in terms of type and timing of surgery. METHODS A broad literature search was performed on 28th January 2023 using Scopus, PubMed, and EMBASE. Only English papers dealing with adults were included. Meeting abstracts were excluded. RESULTS Twenty-four papers were accepted and included. SBRM behave less aggressively than metachronous tumors, and partial nephrectomy (PN) is the preferred therapeutic option to preserve renal function. Open, laparoscopic, and robot-assisted approaches were found to be similar in oncological outcomes, though robot-assisted surgery resulted in lower comorbidities. Same-sitting PN was demonstrated to be a safe approach, particularly in the robotic-assisted one. Finally, the same-siting and staged NSS were similar in preserving renal function. CONCLUSIONS PN should be the desirable treatment for SBRM whenever feasible and if patients are fit, but surgeon expertise should also be taken into the account.
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Affiliation(s)
- Carlo Giulioni
- Urology Unit, Department of Urology, Azienda Ospedaliero-Universitaria Delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | | | - Eugenio Martorana
- Department of Urology, Nuovo Ospedale Civile Di Sassuolo, Modena, Italy
| | - Angelo Cormio
- Urology Unit, Department of Urology, Azienda Ospedaliero-Universitaria Delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy
| | - Jeremy Yuen-Chun Teoh
- Faculty of Medicine, S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Vineet Gauhar
- Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Andrea Benedetto Galosi
- Urology Unit, Department of Urology, Azienda Ospedaliero-Universitaria Delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy
| | - Daniele Castellani
- Urology Unit, Department of Urology, Azienda Ospedaliero-Universitaria Delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy
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12
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Teke Z, Rencuzogullari A, Yalav O, Erdogan O, Gumus S, Doran F. Synchronous and metachronous neoplasms of different histogenesis with gastrointestinal stromal tumor (GIST): 10 years experience of a single institution. Ann Ital Chir 2023; 94:358-366. [PMID: 37794785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
AIM Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract. Significant advances have been made in its pathogenesis, diagnosis, and treatment over the past few decades. However, little is known about the occurrence of synchronous or methacronous tumors with other histogenesis in addition to GISTs. The aim of this study was to present a series of 15 patients diagnosed with a second primary neoplasm in addition to GIST. MATERIAL AND METHODS Patients who were diagnosed with both GIST and other primary neoplasm between January 2010 and December 2019 were included in the study. Demographic, clinicopathologic and immunohistochemical parameters of the patients were analyzed along with the follow-up results RESULTS: This study included 12 men and 3 women with a median age of 68 years (range: 57-83 years). Of the GISTs, 93.3% were localized in the stomach and 73.3% were at very low / low risk category. Of the second primary tumors, 66.6% were in the gastrointestinal tract. Detection of the GIST was synchronous in 9 cases, metachronous in 2 cases and preceded the GIST diagnosis in 4 cases. GIST was incidentally found intra-operatively in 3 of the cases. The mean size of the synchronous GISTs was 20 mm while the most common GIST-associated malignancy was gastric adenocarcinoma. The median follow-up times was 62 months (range: 13-129 months). CONCLUSIONS The prevalence of secondary malignancies in GIST patients is significantly higher than the healthy population. The high occurrence rate of additional primary tumors in GIST patients has focused the attention of surgeons on this problem. While it is not yet clear if there is a causal association or a common genetic mechanism for the concomitant occurrence of GIST with other malignancies, a closer surveillance of GIST patients is needed due to their proved increased prevalence of a second primary tumor especially during the first year after diagnosis. KEY WORDS Gastrointestinal stromal tumor, Coexistence, Synchronous malignancy, Second neoplasm, Gastric adenocarcinoma.
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Wen JL, Wang XY, Gu SJ, Li TT, Shi LC, Kong H, Qi X. [Progress in clinical diagnosis and treatment of multiple primary lung cancer]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:826-834. [PMID: 35927054 DOI: 10.3760/cma.j.cn112147-20211209-00870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
With the application of high-resolution chest imaging system and lung cancer screening program, patients with multiple primary lung cancer (MPLC) are becoming a growing population in clinical practice. However, the diagnostic criteria of MPLC and its differentiation from intrapulmonary metastasis of lung cancer (IM) are still controversial, especially in cases with similar histology. On the basis of reviewing the existing literature, this paper discusses the changes of the diagnostic criteria of MPLC and the differential diagnosis methods of imaging, histology and molecular genetics of MPLC and IM, and briefly introduces the application of multidisciplinary diagnosis, algorithm, predictive model and artificial intelligence in the differential diagnosis of MPLC. In addition, we also discuss the latest progress in the treatment of MPLC. Radical surgery is the main method for the treatment of MPLC. Stereotactic body radiation therapy (SBRT) is safe and feasible for inoperable MPLC patients, and targeted therapy and immunotherapy can also be used in MPLC after appropriate patient selection.
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Affiliation(s)
- J L Wen
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X Y Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - S J Gu
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - T T Li
- Department of Respiratory and Critical Care Medicine, Xuzhou Central Hospital, Xuzhou 221009, China
| | - L C Shi
- Department of Respiratory and Critical Care Medicine, Affiliated Geriatric Hospital of Nanjing Medical University, Nanjing 210024, China
| | - H Kong
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X Qi
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Hou Q, Zhang W, Niu J, Tian M, Liu J, Cui L, Li Y. Synchronous occurrence of gastrointestinal stromal tumor, pancreatic intraductal papillary mucinous neoplasm, and intrahepatic cholangiocarcinoma: Case report. Medicine (Baltimore) 2022; 101:e29460. [PMID: 35839023 DOI: 10.1097/md.0000000000029460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Gastrointestinal stromal tumor (GIST) is the most common primary mesenchymal tumors in gastrointestinal tract. Synchronous occurrence of GIST and tumors in other organs is rare. We first report an exceedingly rare case of synchronous occurrence of gastric GIST, pancreatic intraductal papillary mucinous neoplasm (IPMN) and intrahepatic cholangiocarcinoma. PATIENT CONCERNS A 70-year-old male presented to our hospital because of abdominal pain and dyspepsia. Tumor markers and liver function were abnormal. Abdomen computed tomography showed concurrent tumors in stomach, pancreas, and liver. DIAGNOSIS Pathology confirmed synchronous occurrence of gastric GIST, pancreatic IPMN and intrahepatic cholangiocarcinoma. INTERVENTIONS Mass excision, partly gastrectomy, wedge resection of VIII liver segments, and pancreatic-oduodenectomy were performed. OUTCOMES During the 18-month follow-up, both laboratory tests and computed tomography examination revealed no sign of recurrence or metastasis. Currently, the patient is free of clinical symptoms such as abdominal discomfort, jaundice, and fever. CONCLUSION As yet, no cases simultaneously with gastric GIST, pancreatic IPMN and intrahepatic cholangiocarcinoma have been described in literatures. This report increases the knowledge to avoid misdiagnosis and delayed therapy for coexistence of the described 3 types of neoplasm.
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Affiliation(s)
- Qiaoru Hou
- Diagnostic Imaging Center of Weihai Central Hospital, Weihai, Shandong, China
| | - Wenjun Zhang
- Diagnostic Imaging Center of Weihai Central Hospital, Weihai, Shandong, China
| | - Jiazeng Niu
- Hepatological Surgery Department of Weihai Central Hospital, Weihai, Shandong, China
| | - Minghua Tian
- Obstetrics Department of Weihai Central Hospital, Weihai, Shandong, China
| | - Jie Liu
- Diagnostic Imaging Center of Weihai Central Hospital, Weihai, Shandong, China
| | - Linyang Cui
- Diagnostic Imaging Center of Weihai Central Hospital, Weihai, Shandong, China
| | - Yingming Li
- Pathology Department of Weihai Central Hospital, Weihai, Shandong, China
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Murta MCB, Ferreira GDSA, Watanabe ALC, Trevizoli NC, Figueira AVF, Caja GON, Ferreira CA, Couto CDF. Incidental Finding of Multiple Synchronous Neoplasms in Explanted Liver After Transplantation: A Case Report. Transplant Proc 2022; 54:1380-1383. [PMID: 35760627 DOI: 10.1016/j.transproceed.2022.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022]
Abstract
Liver transplantation is the only potentially curative treatment for patients with end-stage liver disease. After the procedure, histopathologic analysis of the liver explant may reveal neoplasms that were not previously diagnosed in preoperative imaging examinations. This incidental finding of primary liver neoplasms in the explant is not an uncommon situation in liver transplant, and hepatocarcinomas and cholangiocarcinomas are the types of tumors most frequently encountered in this scenario. These are the most common primary neoplasms of the liver, and liver transplantation is often a curative treatment for these types of tumors when they are in their earlier stages. In contrast, liver plasmacytoma is a rare type of plasma cell neoplasm, consisting of a single mass of monoclonal plasma cells, which is treated primarily by radiotherapy and is seldom encountered in the setting of liver transplant. We report the case of a patient who underwent liver transplantation for the treatment of cryptogenic cirrhosis, with no preoperative diagnosis of liver tumors. Analysis of the liver explant revealed the presence of three synchronous neoplasms with different histologic origins: a 27-mm hepatocellular carcinoma, a 17-mm intrahepatic cholangiocarcinoma, and a 25-mm solitary hepatic plasmacytoma. The patient received no further adjuvant treatment and remained well and with no signs of disease recurrence over an observation period of 44 months. We found no previous report in the literature of the synchronous presence of these three types of liver neoplasms.
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Affiliation(s)
| | | | | | | | | | | | - Clara Antunes Ferreira
- General Surgery Department, Hospital Metropolitano Dr Célio de Castro, Belo Horizonte, Brazil
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16
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Huo JW, Luo TY, He XQ, Gong JW, Lv FJ, Li Q. Radiological classification, gene-mutation status, and surgical prognosis of synchronous multiple primary lung cancer. Eur Radiol 2022; 32:4264-4274. [PMID: 34989846 DOI: 10.1007/s00330-021-08464-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the radiological classification, gene-mutation status, and surgical prognosis of synchronous multiple primary lung cancer (sMPLC). METHODS From January 2013 to October 2019, 192 consecutive patients with sMPLC were investigated. The clinical, CT, molecular, and pathological features of all patients were analyzed. Furthermore, the prognosis of 89 patients who only underwent surgical resection was evaluated. RESULTS Among 192 patients, all lesions pathologically confirmed or highly suspected as tumors based on radiological findings were retrospectively analyzed, and the CT findings of sMPLC were classified into three types: (I) all lesions manifested as solid nodules/masses (14.06%, 27/192), (II) all lesions manifested as subsolid nodules/masses (43.23%, 83/192), and (III) tumor lesions manifested as a combination of ≥ 2 of the following patterns: solid nodules/masses, subsolid nodules/masses, cystic airspace, and focal consolidation (42.71%, 82/192). For 252 tumors undergoing epidermal growth factor receptor (EGFR)-mutation testing, the EGFR-mutation rate was higher in subsolid tumors than that in solid tumors (p < 0.05). Among 19 patients with all tumors undergoing surgery and driver-gene testing, genetic heterogeneity was prevalent among the multiple tumors (63.16%,12/19). The highest clinical stage of non-I, ipsilateral distribution of tumors, and CT classification of I indicated a poor prognosis for patients with sMPLC (all p < 0.05). CONCLUSION Subsolid lesions are the most common presentation of sMPLC. Genetic heterogeneity in driver mutations among sMPLC may be present. Prognosis in patients with sMPLC is determined by the highest clinical TNM stage, distribution, and radiological classification among the multiple tumors. KEY POINTS • Synchronous multiple primary lung cancer (sMPLC) has three types of CT findings. • Genetic heterogeneity may be prevalent among the multiple tumors. • Prognosis in patients with sMPLC is associated with the highest clinical TNM stage, distribution, and radiological classification among the multiple tumors.
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Affiliation(s)
- Ji-Wen Huo
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China
| | - Tian-You Luo
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China
| | - Xiao-Qun He
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China
| | - Jun-Wei Gong
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China
| | - Fa-Jin Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China
| | - Qi Li
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 1 Youyi Road, Chongqing, 400016, China.
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Colangeli W, Facchini V, Kapitonov A, Zappalà M, Belli E. Multiple synchronous bilateral neoplasms of the parotid glands. Clin Ter 2022; 173:203-206. [PMID: 35612330 DOI: 10.7417/ct.2022.2418] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this paper we report the rare case of a patient who came to our attention with three synchronous Warthin tumours affecting both the right and left parotid glands. The patient was a 68-year-old female, heavy smoker, with a seven-year history of painless growing nodules in both pre-auricular areas. Left-sided subtotal parotidectomy and contralateral superficial parotidectomy were performed at two differ-ent surgical times. Multiple, simultaneous and bilateral Warthin tumours represent a rare pathological entity of the salivary glands. Careful preoperative examination and radiological evaluation of the salivary glands are critical for the early diagnosis of bilateral synchronous tumours.
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Affiliation(s)
- W Colangeli
- U.O. Maxillofacial Surgery, S. Andrea Hospital, Faculty of medicine and psychology, University of Rome "Sapienza", Roma, Italy
| | - V Facchini
- U.O. Maxillofacial Surgery, S. Andrea Hospital, Faculty of medicine and psychology, University of Rome "Sapienza", Roma, Italy
| | - A Kapitonov
- U.O. Maxillofacial Surgery, S. Andrea Hospital, Faculty of medicine and psychology, University of Rome "Sapienza", Roma, Italy
| | - M Zappalà
- U.O. Maxillofacial Surgery, S. Andrea Hospital, Faculty of medicine and psychology, University of Rome "Sapienza", Roma, Italy
| | - E Belli
- U.O. Maxillofacial Surgery, S. Andrea Hospital, Faculty of medicine and psychology, University of Rome "Sapienza", Roma, Italy
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18
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Harada H, Nie Y, Araki I, Soeno T, Chuman M, Washio M, Sakuraya M, Ushiku H, Niihara M, Hosoda K, Kumamoto Y, Naitoh T, Sangai T, Hiki N, Yamashita K. Haploinsufficiency by minute MutL homolog 1 promoter DNA methylation may represent unique phenotypes of microsatellite instability-gastric carcinogenesis. PLoS One 2021; 16:e0260303. [PMID: 34936649 PMCID: PMC8694418 DOI: 10.1371/journal.pone.0260303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022] Open
Abstract
Promoter DNA methylation of MutL homolog 1 (MLH1) is considered to play a causative role in microsatellite instability (MSI) carcinogenesis in primary gastric cancer, and a high MSI status is associated with treatment sensitivity to human cancers. Nevertheless, clinicopathological analysis is defective for MLH1 methylation status in a quantitative manner. We newly developed quantitative methylation specific PCR using a TaqMan probe and applied it to 138 patients with primary gastric cancer who underwent gastrectomy in addition to basic molecular features such as MSI, Epstein Barr virus, and other DNA methylation status. (1) In primary gastric cancer, median methylation value was 0.055, ranging from 0 to 124.3. First, MLH1 hypermethylation was strongly correlated with MSI-High/MSI-Low status and suppressed immunostaining (P < 0.0001). (2) The MLH1 hypermethylation was associated with advanced age (P = 0.0048), antral location (P = 0.0486), synchronous multiple gastric cancer (P = 0.0001), and differentiated histology (P = 0.028). (3) Log-rank plot analysis identified the most relevant cut-off value (0.23) to reflect gentle phenotypes in MLH1 hypermethylation cases (P = 0.0019), especially in advanced gastric cancer (P = 0.0132), which are designated as haploinsufficiency of MSI (MSI-haplo) phenotype in this study. (4) In synchronous multiple gastric cancer, MLH1 hypermethylation was not necessarily confirmed as field cancerization. (5) MSI-haplo defined by MLH1 methylation status represented distinct prognostic phenotype even after molecular classifications. MLH1 hypermethylation designated as MSI-haplo may represent unique prognostic phenotype during gastric carcinogenesis.
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Affiliation(s)
- Hiroki Harada
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Yusuke Nie
- Department of General, Pediatric and Hepatobiliary-Pancreatic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Ippeita Araki
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takafumi Soeno
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Motohiro Chuman
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Marie Washio
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Mikiko Sakuraya
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hideki Ushiku
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Masahiro Niihara
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kei Hosoda
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Yusuke Kumamoto
- Department of General, Pediatric and Hepatobiliary-Pancreatic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takeshi Naitoh
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takafumi Sangai
- Department of Breast and Thyroid Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Naoki Hiki
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Keishi Yamashita
- Department of Upper-gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
- Division of Advanced Surgical Oncology, Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
- * E-mail:
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19
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Ikeda A, Aoki K, Terashima T, Itokawa Y, Kokuryu H. A fat containing combined neuroendocrine carcinoma and hepatocellular carcinoma in the liver: A case report. Ann Hepatol 2021; 22:100183. [PMID: 32111487 DOI: 10.1016/j.aohep.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/20/2020] [Accepted: 01/23/2020] [Indexed: 02/04/2023]
Abstract
A 79-year-old man was admitted to our hospital because of increased hepatobiliary enzyme levels. Dynamic computed tomography and magnetic resonance imaging showed a liver tumor measuring 60mm containing fat foci at the cranial aspect of the tumor. We diagnosed the patient with hypovascular hepatocellular carcinoma (HCC) and fat deposition, and performed a caudate lobe resection. Pathology examination revealed two intermingled components: moderately differentiated HCC with fat deposition and neuroendocrine carcinoma (NEC). Primary combined NEC and HCC is extremely rare. To our knowledge, this is the first report of combined NEC and HCC including a fat component. HCC is the most common primary hepatic malignancy with fat. HCC might include fat, even if HCC coexists with another type of cancer. The imaging characteristics of and HCC with another type of cancer vary depending on the amount of each component. We should not simply diagnose such tumors as HCC, but think about the possibilities of HCC with another type of cancer, because there is a fat component.
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Affiliation(s)
- Atsuyuki Ikeda
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan.
| | - Kentaro Aoki
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | | | - Yoshio Itokawa
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Hiroyuki Kokuryu
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
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Abstract
Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated intramural/submucosal mass in the gastric antrum and prepyloric area. It was considered as a benign tumor that exhibited no recurrence, metastasis, or tumor-related mortality. In this study, we reported 2 cases of gastric PF. The first case was a PF patient coexisting with gastric adenocarcinoma. The second case occurred in the gastric upper body close to gastric fundus. They underwent distal gastrectomy and laparoscopic partial gastric resection, respectively. Both of them exhibited a plexiform growth pattern in the submucosa, muscularis propria, and subserosal adipose tissues. The nodules were composed of abundant myxoid or fibromyxoid matrix riching in small thin-walled blood vessels and bland-looking spindle cells. The first case partially showed staggered growth pattern of PF and adenocarcinoma. Immunohistochemically, the spindle cells were diffusely immunoreactive for SMA and vimentin, and focally immunoreactive for CD10. It was important to distinguish the PF from other spindle cell tumors involving the stomach.
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Affiliation(s)
- Min Lin
- Department of Pathology, Tai’an City Central Hospital, Tai’an, China
| | - Lu Song
- Department of Breast Surgery, Tai’an City Central Hospital, Tai’an, China
| | - Shuming Qin
- Department of Pathology, Tai’an City Central Hospital, Tai’an, China
| | - Daosheng Li
- Department of Pathology, Tai’an City Central Hospital, Tai’an, China
| | - Gang Hou
- Department of Pathology, Tai’an City Central Hospital, Tai’an, China
| | - Xiaomei Li
- Department of Pathology, Tai’an City Central Hospital, Tai’an, China
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21
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Schlanger D, Popa C, Rusu I, Seicean A, Hajjar NA. Synchronous Pancreatic Tumours: Intraductal Papillary Mucinous Neoplasm with Pancreatic Ductal Adenocarcinoma and Neuroendocrine Tumour: A Case Presentation and Review of Literature. Chirurgia (Bucur) 2021; 116:1-9. [PMID: 34463245 DOI: 10.21614/chirurgia.116.ec.2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/23/2022]
Abstract
Synchronous tumours of the pancreas are rare encounters, with few reported cases. Thus, new information can be brought about the diagnosis, proper management, and prognosis of cases. We believe that the presentation of this case can help to establish relevant conclusions. We report the case of a 54-year-old man, with the preoperative diagnosis of a cephalic intraductal papillary mucinous neoplasm (IPMN), who underwent a planned cephalic pancreatoduodenectomy with completion to total pancreatectomy based on the intraoperative extemporaneous histopathological examination of the resection margin. The final histopathological diagnosis was cephalic IPMN associated with invasive ductal adenocarcinoma (PDAC) and a small well-differentiated neuroendocrine tumour (NET) in the tail of the pancreas. No recurrence was detected in the 3 years of follow-up. We conducted a review of the literature to illustrate the particularities of the presented case; it identified 4 articles about the association of PDAC and NET and 8 articles regarding the association of IPMN with NET. Only 2 patients had a histopathological diagnosis of three synchronous tumours (IPMN, PDAC, and NET). We present a rare case of three synchronous pancreatic tumours, with a favourable evolution after a total pancreatectomy, only two other similar cases being reported in medical literature.
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22
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Hussain SA, Dubil EA, De Luca-Johnson JN, Johnston M. Occult symptomatic bilateral pure Leydig cell tumors in a postmenopausal woman: a case report. Gynecol Endocrinol 2021; 37:672-675. [PMID: 34137345 DOI: 10.1080/09513590.2021.1934443] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Pure Leydig cell tumors (LCTs) represent 0.1% of ovarian masses. Postmenopausal patients typically present with virilization. Although LCTs can be challenging to locate on conventional imaging, positron emission tomography (PET) has been demonstrated to be effective. CASE A 64-year-old postmenopausal woman presented with alopecia, facial hirsutism, and clitoromegaly. Laboratory findings included elevated testosterone and androstenedione. Ultrasound, computed tomography, and magnetic resonance imaging showed no adnexal masses. PET did not demonstrate ovarian fludeoxyglucose-avidity. Histopathology after bilateral salpingo-oophorectomy revealed bilateral Leydig cell tumors. Her testosterone normalized 2 weeks postoperatively. CONCLUSION We describe the occult, symptomatic, bilateral ovarian Leydig cell tumors, an occurrence that has not been described in the literature. Virilizing tumors must be considered in patients with evidence of hyperandrogenism, even without pelvic masses on imaging.
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Affiliation(s)
- S Ahmed Hussain
- Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - Elizabeth A Dubil
- Division of Gynecologic Oncology, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | | | - Michael Johnston
- Division of Surgical Oncology, Naval Medical Center Portsmouth, Portsmouth, VA, USA
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Cho YY, Chung YJ. A germline c.1546dupC MEN1 mutation in an MEN1 family: A case report. Medicine (Baltimore) 2021; 100:e26382. [PMID: 34160414 PMCID: PMC8238345 DOI: 10.1097/md.0000000000026382] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/02/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Multiple endocrine neoplasia type 1 (MEN1) is a rare tumor syndrome with an autosomal dominant inheritance, and genetic testing for MEN1 gene is important for both affected individuals and their relatives. We present a 2-person family affected by a germline c.1546dupC MEN1 mutation, and one of them had a full-spectrum of MEN-related endocrine tumors. PATIENT CONCERNS A female patient aged 32 years presented with jejunal ulcer perforation due to gastrinoma. DIAGNOSES We conducted genetic analysis and extensive biochemical/radiological evaluation for detecting other endocrine tumors. Multiple pancreatic neuroendocrine tumors (NETs), prolactinoma and primary hyperparathyroidism were diagnosed, and a frame-shift mutation, NM_130799.1:c.1546dupC (p.Arg516Profs∗15), was detected. One daughter of the proband, aged 12 years, had the same mutation for MEN1. INTERVENTION She underwent pancreatic surgery for pancreatic NETs and total parathyroidectomy for primary hyperparathyroidism. OUTCOMES After pancreatic surgery, long-term symptoms of epigastric soreness, acid belching, sweating, and palpitation in fasting were improved. Hypercalcemia was improved after parathyroidectomy and she was supplemented with oral calcium and vitamin D. Her daughter showed normal biochemical surveillance until 15 years of age. LESSONS We report 2 people in a family affected by MEN1 with the heterozygous germline c.1546dupC mutation, a variant that should be surveilled for early development of full-blown MEN1-associated endocrine tumors.
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Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon
| | - Yun Jae Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung-Ang University, College of Medicine, Seoul, Korea
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Watanabe H, Tomita S, Ikoma Y, Kohno M, Masuda R, Iwazaki M. A surgical Case of Synchronous Multiple Primary Lung Cancers with Small Cell Carcinoma and Squamous Cell Carcinoma. Tokai J Exp Clin Med 2021; 46:29-32. [PMID: 33835473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
The incidence of synchronous multiple primary lung cancers has increased in recent years, however, there are few reports of cases involving small cell carcinoma. A 72-year-old man was referred to our department because of an abnormal shadow on chest radiography. He was receiving treatment for pulmonary fibrosis, emphysema, rheumatoid arthritis, and prostate cancer. Computed tomography revealed two lung nodules in the left lower lobe. A definitive diagnosis was unable to be made based on transbronchial lung biopsy. Positron emission tomography demonstrated abnormal fluorodeoxyglucose uptake in the two lung nodules and lung cancer (cT3N0M0) was suspected. Thoracoscopic partial resection of the left lower lobe was performed. As primary lung cancer was diagnosed using the frozen specimen, we performed left lower lobectomy with lymph node dissection. Pathological examination of the S9 and S6 tumors revealed combined small cell carcinoma and squamous cell carcinoma, respectively. Both tumors were separated and diagnosed as synchronous multiple primary lung cancers. No lymph node metastasis was found. We report a rare case of synchronous multiple primary lung cancers, including small cell carcinoma.
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Affiliation(s)
- Hajime Watanabe
- Division of Thoracic Surgery, Tokai University Oiso Hospital, 21-1 Gakkyo, Oiso, Kanagawa 259-0198, Japan.
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Nozawa H, Ishizawa T, Yasunaga H, Ishii H, Sonoda H, Emoto S, Murono K, Sasaki K, Kawai K, Akamatsu N, Kaneko J, Arita J, Hasegawa K, Ishihara S. Open and/or laparoscopic one-stage resections of primary colorectal cancer and synchronous liver metastases: An observational study. Medicine (Baltimore) 2021; 100:e25205. [PMID: 33726015 PMCID: PMC7982201 DOI: 10.1097/md.0000000000025205] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
One-stage resections of primary colorectal cancer and liver metastases have been reported to be feasible and safe. Minimally invasive approaches have become more common for both colorectal and hepatic surgeries. This study aimed to investigate outcomes of these combined surgical procedures among different approaches.We retrospectively analyzed patients diagnosed as having primary colorectal cancer with synchronous liver metastases and who underwent 1-stage primary resection and hepatectomy with curative intent in our hospital. According to the surgical approach for the primary tumor and hepatic lesions, namely open laparotomy (Op) or laparoscopic approach (Lap), patients were classified into Op-Op, Lap-Op (laparoscopic colorectal resection plus open hepatectomy), and Lap-Lap groups, respectively. Clinicopathological factors were reviewed, and short- and long-term outcomes were compared among the groups.The Op-Op, Lap-Op, and Lap-Lap groups comprised 36, 18, and 17 patients, respectively. The superior/posterior hepatic segments were more frequently resected via an open approach. There was no laparoscopic major hepatectomy. The median volume of intraoperative blood loss was smaller in the Lap-Lap and Lap-Op groups (290 and 270 mL) than in the Op-Op group (575 mL, P = .008). The hospital stay after surgery was shorter in the Lap-Lap and Lap-Op groups (median: 17 days and 15 days, vs 19 days for the Op-Op group, P = .033). The postoperative complication rates and survivals were similar among the groups.Application of laparoscopy to 1-stage resections of primary colorectal cancer and liver metastases may offer advantages of enhanced recovery from surgical treatment, given appropriate patient selection.
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Affiliation(s)
| | - Takeaki Ishizawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | | | | | | | | | | | | | - Nobuhisa Akamatsu
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine
| | - Junichi Kaneko
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine
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Lancellotti F, Solinas L, Telesco D, Sagnotta A, Belardi A, Balsamo G, Mancini S. A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET. Clin J Gastroenterol 2021; 14:115-122. [PMID: 33044637 PMCID: PMC7886727 DOI: 10.1007/s12328-020-01255-9] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/19/2020] [Indexed: 01/17/2023]
Abstract
Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.
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Affiliation(s)
| | - Luigi Solinas
- Department of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome, Italy
| | - Davide Telesco
- Department of General Surgery, Surgical Specialities “Paride Stefanini”, Sapienza University of Rome, Rome, Italy
| | - Andrea Sagnotta
- Department of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome, Italy
| | - Augusto Belardi
- Department of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome, Italy
| | - Giuseppina Balsamo
- Department of Clinical Pathology, San Filippo Neri Hospital, Rome, Italy
| | - Stefano Mancini
- Department of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome, Italy
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Usuda J, Matsumoto M, Suzuki K, Tomioka Y, Sonokawa T, Inoue T, Enomoto Y. [Therapeutic Strategies for Metachronous Multiple Primary Lung Cancer]. Kyobu Geka 2021; 74:18-21. [PMID: 33550314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUNDS It is not uncommon to encounter metachronous primary lung cancer after surgical treatment along with the increase in the elderly patients. In consideration of increasing number of such patients, it is necessary to take various treatment strategies. METHODS In order to establish a treatment strategy for multiple lung cancer, we retrospectively examined multiple lung cancer cases operated for primary lung cancer in our department from January 2013 to December 2019, and the future treatment strategy was examined. RESULTS Of 821 patients who underwent surgery for primary lung cancer, 61 were multiple lung cancers, 31 were synchronous multiple lung cancers, and 30 were metachronous multiple lung cancers. Among the cases of metachronous multiple lung cancer, 28 cases had undergone lobectomy or more in the first operation, 1 case of segmental resection, and 1 case of partial resection. As for the treatment of secondary lung cancer lesions, 21 lesions were performed surgery( lobectomy;2, segmental resection;2, partial resection;17), 6 lesions of photodynamic therapy (PDT), and 3 lesions of stereotactic body radiation therapy (SBRT). Among the surgical cases, there were three cases on the same side as the first cancer and 18 cases on the opposite side. The three cases underwent partial resection. Among 21 patients, postoperative home oxygen therapy was introduced in 2 patients. Regarding the prognosis, three patients who had surgical resection, died of recurrence of the first lesion. One of the six PDT patients died of recurrence of the first lung cancer and another died of other disease. All three patients who underwent SBRT are alive without recurrence. CONCLUSIONS If early detection and early diagnosis are made as a treatment strategy for metachronous multiple lung cancer, it may be possible to preserve lung function by reducing surgery or SBRT, PDT, and to cure without damaging the quality of life.
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Affiliation(s)
- Jitsuo Usuda
- Department of Thoracic Surgery, Nippon Medical School, Tokyo, Japan
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Tsunezuka Y, Fujimori H, Tanaka N. [Surgical Treatment to Bilateral Multiple Primary Lung Cancer Patients]. Kyobu Geka 2021; 74:49-53. [PMID: 33550319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Multiple primary lung cancer( MPLC) has increased due to the extensive detection survey and patient's life-prolonging, but the treatment strategy remains disputable. There is no consensus on the surgical treatment strategy, especially for bilateral multiple primary lung cancer (BMPLC) among MPLC. This paper aimed to discuss the surgical strategy in patients with bilateral multiple lung cancer by our experiences of surgical outcomes. METHODS Patients who underwent curative operations for BMPLC based on the Martini-Melamed criterion and oncogene mutation analysis between January 2007 and May 2019 in Ishikawa Prefectural Central Hospital were reviewed retrospectively. RESULTS We studied 53 patients( 26 males and 27 females, from 64~84 years of age) with MPLC, 43 patients with metachronous lesions, and 10 patients with synchronous lesions. The type of resection for the first tumor was lobectomy 35( 66.0%) and segmentectomy or wedge, 18( 34.0%), and for the second tumor was lobectomy 5( 9.4%) and segmentectomy or wedge, 17( 32.1%) respectively. Bilateral lobectomies underwent in four cases. Histologic classification was similar in 62.3% of patients. Overall survival at five years after the second operation was 75.1%, respectively. There was no difference in subgroups of lobectomy and limited resection (wedge or segmentectomy). Respiratory function in four patients performed with bilobectomy is enough before the second surgery( % vital capacity:84~136%, forced expiratory volume in one second:1,490~3,400 ml, DLco:82~151%). There was no postoperative complication, but one patient suffered from low respiratory function and indications for oxygen therapy at 99 days after the second operation. CONCLUSIONS We selected the surgical procedures that preserve much lung tissues for BMPLC. Bilateral lobectomy did not usually perform in most cases. However, bilobectomy was no contraindication for BMPLC if a preoperative respiratory function was enough for the second tumor.
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Affiliation(s)
- Yoshio Tsunezuka
- Department of General Thoracic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
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Matsubara T, Okamoto T. [Surgical Role for Multiple Primary Lung Cancer]. Kyobu Geka 2021; 74:40-47. [PMID: 33550318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To explore the clinicopathological and surgical characteristics and to determine the prognostic outcome of patients who underwent second pulmonary resection for secondary primary lung cancer(SPLC). PATIENTS We retrospectively examined 35 patients who underwent second pulmonary resection for secondary primary non-small cell lung cancer from 2009 to 2016. RESULTS The median age was 67 years and 54% of patients were male. Twenty-one patients were resected for synchronous disease and 14 were resected for metachronous disease. The median interval between first and second surgery was 9.8 months. Six patients underwent lobectomy twice for both lung cancers. Sublober resection was significantly performed at second surgery, and tumor size of SPLC was significantly smaller than that of first cancer. There was no significant difference for pathological stage between first and second cancer:27 patients were diagnosed as stageⅠat first surgery, and 33 were diagnosed as stageⅠat second surgery. The five-year recurrence free survival (RFS) rate was 74.1%, and five-year overall survival (OS) rate was 85.7%. There were no significant survival differences between synchronous and metachronous secondary cancer groups for RFS and OS. Surgical pro cedures and secondary cancer profile (synchronous or metachronous) were not associated with postoperative survival by univariate and multivariate analyses. CONCLUSIONS Surgical resection for SPLC may be tolerable if lobectomy is required for curative resection.
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Affiliation(s)
- Taichi Matsubara
- Department of Thoracic Oncology, Kyushu Cancer Center, Fukuoka, Japan
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Kikunaga S, Fujimori S, Suzuki S, Nagano M, Ohtsuka R, Hamada Y. [The Strategy and Outcome of Three-port Thoracoscopic Surgery for Synchronous and Metachronous Multiple Lung Cancer]. Kyobu Geka 2021; 74:33-39. [PMID: 33550317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The treatment contents and the outcome of three-port thoracoscopic surgery for multiple lung cancer are studied and discussed in this report. 239 cases of synchronous or metachronous multiple lung cancer (11.5%) out of 2,076 cases of primary lung cancer resected in our department from the year of 2010 to 2018 are subjected to this study. There are 158 cases of synchronous multiple lung cancer and 81 cases of the metachronous. The pathological findings for both synchronous and metachronous multiple lung cancer are adenocarcinoma for 194 cases. The pathological stages for the both are stageⅠfor 208 cases. For the synchronous group, there are 156 cases, in which the patients underwent one-stage surgery was performed. For metachronous group, lobectomy was performed for the first surgery in 69 cases. For the second surgery, bilateral lobectomy was performed in the 13 cases, and there was one case of right completion pneumonectomy. There was no intraoperative death or critical postoperative complication. The five-year survival rates are 84.9% for the synchronous group, and 75.2% for the metachronous group. Above all, three-port thoracoscopic surgery for multiple lung cancer was carried out safely. Bilateral lobectomy and completion pneumonectomy are also possible for metachronous multiple lung cancer if a patient has a decent lung function and good performance status. Especially for stageⅠcases, we could expect a good prognosis, and therefore surgical treatment should actively be performed.
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Affiliation(s)
- Shinichiro Kikunaga
- Department of Thoracic Surgery, Respiratory Center, Toranomon Hospital, Tokyo, Japan
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Huang W, Liu T, Duan R, Yuan Y, Qu M, Zhang M, Shang D, Yu X. Primary multiple angiosarcoma of vertebra: A case report. Medicine (Baltimore) 2020; 99:e23587. [PMID: 33327321 PMCID: PMC7738032 DOI: 10.1097/md.0000000000023587] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Angiosarcoma is a rare malignant tumors. The objective of this study is to report a patient who suffered from a progressive low back pain and left lower extremities radiation pain for about 8 months, After diagnoses, this was identified as an extremely rare case of primary multiple angiosarcoma of vertebra. PATIENT CONCERNS A 54-year-old man with a history of 2-year hypertension and 8-year diabetes, both of which were well controlled by drug management. Lately, he suffered from a progressive low back pain and left lower extremities radiation pain for about 8 months. DIAGNOSES Magnetic resonance imaging of lumbar showed a clear pathological fracture and primary multiple angiosarcoma of all vertebra. Postoperative pathology and High-throughput sequencing confirmed the diagnosis of primary multiple angiosarcoma of vertebra. INTERVENTIONS The patient underwent minimally invasive pedicle screw fixation combined with bone cement augmentation for the purpose of stabilizing the damaged vertebrae. Following operation, he received both radiotherapy and chemotherapy for a period of time. OUTCOMES The operation has achieved positive results in relieving pain and stabilizing the spine. No wound problem or operative complications occurred after operation. The patient reported an obvious remission of low back pain and was only capable to perform restricted physiological activities. A long-term palliative radiotherapy and chemotherapy were performed after operation. Unfortunately, the patient died 18 months later. CONCLUSION This article emphasizes primary multiple angiosarcoma of vertebra. Despite being rare, it should be part of the differential when the patient manifested back pain and radiculopathy. We recommended the minimally invasive pedicle screw fixation for angiosarcoma of vertebra. Osteoplasty by bone cement augmentation was also an ideal choice for surgical treatment. It also advocates the use of specific targeted radiotherapy drugs based on gene analysis of tumors.
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Affiliation(s)
- Wei Huang
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, 523000, China
| | - Tao Liu
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Ruimeng Duan
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Yashuai Yuan
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Mingjia Qu
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Meng Zhang
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Depeng Shang
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Xiaobing Yu
- Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China
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Wada Y, Koshiishi H, Kato H, Hoshino M, Ishibashi N, Adachi M, Sasaki M, Tomii C, Watanabe Y, Ohshima N, Gotoh H, Yoshimura T, Tanaka K. [A Case of Synchronous Double Lung Cancer Including Intestinal Adenocarcinoma Complicated with Colonic Adenoma]. Gan To Kagaku Ryoho 2020; 47:1857-1859. [PMID: 33468852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The patient was a 73-year-old man who was referred to our hospital for increasing bilateral lung nodules. Video-assisted left S9-10 segmentectomy and right S1, S3 partial resection were performed separately for suspect of synchronous double lung cancer. Colonoscopy was performed because left lung tumor was difficult to distinguish between primary lung cancer and metastatic lung cancer. Colonoscopy did not find advanced cancer lesion. We diagnosed the left lung tumor as pT1b, cN0, cM0, Stage ⅠA2 intestinal adenocarcinoma. The right lung tumor was diagnosed as pT1c, cN0, cM0, Stage ⅠA3 papillary adenocarcinoma. Intestinal adenocarcinoma is a rare tissue subtype of lung adenocarcinoma and colonoscopy is useful modality for ruling out metastatic colorectal cancer.
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Affiliation(s)
- Yoshiki Wada
- Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital
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Kyriakou G, Gialeli E, Vryzaki E, Balasis S, Georgiou S. Multiple Primary Melanomas in a Young Patient. Acta Dermatovenerol Croat 2020; 28:238-239. [PMID: 33834998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 45-year-old HIV-negative Caucasian man with no reported past medical history was referred to our Department with a large (7 cm in diameter) oozing nodule on the occipital region of the scalp with spontaneous periodical bloody or purulent discharge. The lesion had appeared over a period of six months, had an irregular color, non-specific dermoscopic features, and resembled squamous cell carcinoma. The physical examination revealed three more atypical melanocytic lesions (on the abdomen, back, and buccal mucosa), and multiple swollen occipital, postauricular, as well as superficial and deep cervical lymph nodes. After clinical evaluation, the patient reported having another in situ melanoma (submammary region) excised 7 years ago. All the lesions were excised and sent for histopathologic examination, which was compatible with primary cutaneous melanoma. Total body computed tomography revealed the presence of multiple visceral metastases, and the patient was referred to an oncologist. He did not consent to proceed to genetic testing. The occurrence of multiple primary melanomas (MPM) is a rare but recognized phenomenon. The estimated incidence of a second primary tumor ranges from 0.2% to 8.7% in large retrospective reviews. While 63% to 88% of patients with MPM are reported to have two primary tumors, the occurrence of more than four primary melanomas is considered exceedingly rare (1-2). Whether the presence of multiple primary melanomas is a function of increased genetic susceptibility of the individual, consistent exposure to a common exogenous promoter of malignancy, or a combination of these two factors remains to be elucidated. These patients should undergo intensive dermatologic screening for the rest of their lives and should consider genetic testing.
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Affiliation(s)
- Georgia Kyriakou
- Georgia Kyriakou, MD, MsC, cPhD., Department of Dermatology, University General Hospital of Patras, University General Hospital of Patras, Rion 265 04, Greece;
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Abstract
RATIONALE Double primary clear cell carcinomas of the liver (PCCCL) and kidney are extremely rare; moreover, there have been no reported cases of adrenal metastasis from primary clear cell tumors of the liver. PATIENT CONCERNS A 47-year-old male patient was admitted to our clinic with space-occupying lesions in the left kidney and liver during a regular medical examination. DIAGNOSES The tumors in the kidney and liver were diagnosed as primary clear cell carcinoma by histopathological examination. INTERVENTIONS The patient subsequently underwent nephron-sparing surgery of the left kidney and radical partial excision of the right liver lobe by laparoscopic surgery. Transcatheter arterial chemoembolization (TACE) was performed for the patient 2 weeks after tumor resection. One month after the operation, the patient started adjuvant therapy with sorafenib (400 mg twice per day orally). However, follow-up CT imaging revealed a solid mass measuring 1.9 × 2.0 × 2.0 cm in the right adrenal gland at 2 months postoperatively, and then the patient underwent radiofrequency ablation (RFA) for the right adrenal tumor. OUTCOMES The patient remained cancer free for 2 years following the diagnosis despite early right adrenal metastasis. LESSONS Hepatocyte immunostaining is sufficient for the diagnosis of PCCCL.
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Affiliation(s)
- Hua Jiang
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai
| | - Shanchao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University/The First School of Clinical Medicine, Southern Medical University, Guangzhou
| | - Ganhong Li
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
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Nie Y, Wang X, Yang F, Zhou Z, Wang J, Chen K. Surgical Prognosis of Synchronous Multiple Primary Lung Cancer: Systematic Review and Meta-Analysis. Clin Lung Cancer 2020; 22:341-350.e3. [PMID: 33243621 DOI: 10.1016/j.cllc.2020.10.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND We evaluated the long-term prognosis of synchronous multiple primary lung cancer (SMPLC) patients after surgical treatment and explored prognostic factors for overall survival (OS). MATERIALS AND METHODS A systematic review and meta-analysis was performed regarding the surgical prognosis of SMPLC. A literature search was performed using online databases. All studies were rigorously categorized following the 8th edition of the tumor, node, metastasis classification (TNM) staging rules for multiple lung cancers: SMPLC and multifocal ground-glass/lepidic (GG/L) lung cancers. Five-year OS after surgery was pooled, and hazard ratios (HRs) for prognostic factors were synthesized. Specific subgroup analysis and sensitivity analysis were conducted (PROSPERO registration CRD42019142420). RESULTS An analysis of 26 studies including 1788 patients was performed. The pooled 5-year OS was 45% (95% confidence interval [CI], 37-53) of true SMPLC patients and 62% (95% CI, 57-67) of patients with pathologic stage I disease, which was different from the 5-year OS of 93% (95% CI, 85-100) of patients with multifocal GG/L lung cancers. Poor prognostic factors for SMPLC were lymph node metastasis (HR = 2.36; 95% CI, 1.75-3.20; P < .001) and pneumonectomy (HR = 2.96; 95% CI, 1.36-6.45; P = .006], whereas histology (HR = 1.11; 95% CI, 0.82-1.50; P = .508), laterality (HR = 1.16; 95% CI, 0.93-1.44, P = .190), sublobar resection (HR = 1.29; 95% CI, 0.90-1.84; P = .159), and adjuvant therapy (HR = 1.07; 95% CI, 0.64-1.80; P = .791) were not found to influence the outcome. CONCLUSION The long-term prognosis of SMPLC patients after surgery is acceptable, especially in patients with early-stage disease. Sublobar resection can be applied, although pneumonectomy should be avoided. Advanced criteria are needed to diagnose SMPLC and distinguish it from multifocal GG/L lung cancer to perform accurate surgical evaluation.
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Affiliation(s)
- Yuntao Nie
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Xun Wang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Zuli Zhou
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Jun Wang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
| | - Kezhong Chen
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
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Lupuşoru I, Ciobanu D, Ursaru M, Bălan GG, Grigorovici A. Difficulties in Treating a Patient with Multiple Cancers in the COVID-19 Pandemic. Chirurgia (Bucur) 2020; 115:670-676. [PMID: 33138905 DOI: 10.21614/chirurgia.115.5.670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 11/23/2022]
Abstract
In the actual pandemic context, cancer patients are at additional risk, and protocols are always changing. We present the case of a 62-year-old patient who develops three types of cancer over four years and who was admitted to the hospital in the Emergency Room for hematemesis, melena, and abdominal pain. We know from the pathological antecedents that he was operated in 2017 for a left scapular tumour (basal cell carcinoma). The current clinical examination reveals another right scapular tumour (malignant melanoma), and the hematemesis comes from a gastro-esophageal junction tumour (squamous cell carcinoma). SARS CoV2 infection changes the rules of treatment in such a case. Thus, the patient is operated for the right scapular tumour, the gastrectomy being delayed due to the lung lesions given by SARS CoV2. Finally, the patient undergoes surgery for the gastric tumour, the RT-PCR retest being negative.
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Abstract
RATIONALE Anaplastic thyroid carcinoma (ATC) is a rare highly aggressive thyroid malignancy. Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia is also a rare low grade malignant thyroid neoplasm. To date, comorbidity of these 2 tumors in the thyroid gland has not been reported in the English literature. PATIENT CONCERNS Here, we present a case of a 67-year-old women with a 6-month history of mass of left neck. She complained of a painless mass in the right neck. DIAGNOSES Based on histopathological examination of H&E stained sections, immunohistochemical staining assay and molecular tests, the patient was diagnosed with ATC combined with sclerosing mucoepidermoid carcinoma with eosinophilia. INTERVENTIONS The patient underwent radical surgery for thyroid cancer. OUTCOMES No complications, local recurrence or metastases were observed during a 1 year and 3 months follow-up after surgery. LESSONS To the best of our knowledge, this is the first case report on ATC combined with sclerosing mucoepidermoid carcinoma with eosinophilia in the English literature. This condition can be easily misdiagnosed during thyroid fine needle cytology. Clinicians should perform morphological examination, immunohistochemistry and molecular tests on resected specimen to make a definitive diagnosis.
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Gaillard V, Tricard T, Garnon J, Cazzato RL, Dalili D, Gangi A, Lang H. Repeat ablative therapy in hereditary or multifocal renal cancer: Functional and oncological outcomes. Urol Oncol 2020; 38:797.e15-797.e20. [PMID: 32778477 DOI: 10.1016/j.urolonc.2020.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 06/28/2020] [Accepted: 07/13/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To report managing renal tumors in patients at greater risk of repeated interventions (genetic predisposition, multifocal tumors) with thermoablative treatments (AT). A known significant challenge in these patients is the balance between nephron preservation and oncologic outcome. MATERIAL AND METHODS This retrospective, single-center study was based on data from patients treated with one or more AT for hereditary or multifocal renal tumors between 2007 and 2017. All medical records were systematically reviewed, and 10 patients meeting inclusion criteria were selected. Six patients had confirmed von Hippel-Lindau disease, 1 Bird-Hogg-Dubé syndrome, 1 chromosome 3 translocation, and 2 had a presumed genetic predisposition. RESULTS Median age at cancer diagnosis was 39.5 years (±8.9). Fifty-seven tumors, including 41 de novo tumors that appeared during follow-up, were treated with 32 AT sessions (cryotherapy or radiofrequency) with an average tumor size of 13.5 mm (±9) and a median RENAL score of 6 [5; 7]. One patient underwent concomitant partial nephrectomy for a 55 mm lesion which was close to the bowel. Treatment was unsuccessful in 2 cases, subsequently managed successfully by retreatment with AT. Median delay of appearance of de novo tumor after the first AT was 18 months [6 ; 24]. One patient had metastatic progression. Overall and cancer specific survival was 90% and 100%, respectively, with a mean follow-up of 7.5 years (±4.9). The mean decrease in Chronic Kidney Disease - Epidemiological Collaboration equation-estimated glomerular filtration rate at the end of follow-up was 5.5 ml/min/1.73 m2 (±24). CONCLUSION This study suggests that AT allows to meet the oncological objectives whilst preserving renal function in patients with renal cancer at greater risk of repeated treatments.
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Affiliation(s)
- Victor Gaillard
- Department of Urology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France.
| | - Thibault Tricard
- Department of Urology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France
| | - Julien Garnon
- Department of Interventional Radiology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France
| | - Roberto Luigi Cazzato
- Department of Interventional Radiology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France
| | - Danoob Dalili
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Afshin Gangi
- Department of Interventional Radiology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France
| | - Herve Lang
- Department of Urology, University Hospital Of Strasbourg, 1place de l'Hôpital, Strasbourg, France
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Chen X, Hu W, Huang C, Liang W, Zhang J, Wu D, Lv Z, Li Y, Luo Y, Liang Z, Wang M, Wang J, Yao X. Survival outcome of palliative primary tumor resection for colorectal cancer patients with synchronous liver and/or lung metastases: A retrospective cohort study in the SEER database by propensity score matching analysis. Int J Surg 2020; 80:135-152. [PMID: 32634480 DOI: 10.1016/j.ijsu.2020.06.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/09/2020] [Accepted: 06/13/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a great matter of controversies whether some of these synchronous metastatic colorectal cancer patients can benefit from palliative primary tumor resection (pPTR) and there is still no reported randomized control trial to address this issue. METHODS Patients with microscopically proven metastatic colorectal cancer were identified within the SEER database (2010-2016). Patients were propensity matched 1:1 into pPTR and non-surgery groups and among the matched cohort, the univariable and multivariable Cox proportional hazards regression models were performed to identify predictors of survival. Median survival was calculated by using the Kaplan-Meier method. RESULTS Of 21,405 colorectal cancer patients diagnosed with synchronous liver and/or lung metastases, 7386 were identified in the matched cohort. The median overall survival was 12.0 months, 22.0 months in the non-surgery, surgery groups, respectively (p < 0.001) and the corresponding median cancer-specific survival was 13.0 months, 22.0 months, respectively (p < 0.001). Multivariable Cox regression analysis demonstrated that surgery was independently associated with improved overall survival (hazard ratio, 0.531) as well as cancer-specific survival (hazard ratio, 0.516). In stratified analyses by primary site and patterns of distant metastases, those patients with pPTR had better prognosis. In addition, stratified analysis revealed that trimodality therapy was linked with the greatest therapeutic effect followed by addition of chemotherapy to pPTR. CONCLUSIONS pPTR may offer some therapeutic benefits among carefully selected patients, and surgery-based multimodality therapy was associated with better survival.
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Affiliation(s)
- Xianzhe Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Weixian Hu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Chengzhi Huang
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
| | - Weijun Liang
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Medical College of Shantou University, Shantou, Guangdong, 515000, China.
| | - Jie Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Deqing Wu
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Zejian Lv
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Yong Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Medical College of Shantou University, Shantou, Guangdong, 515000, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
| | - Yuwen Luo
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Zongyu Liang
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Medical College of Shantou University, Shantou, Guangdong, 515000, China.
| | - Minjia Wang
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
| | - Junjiang Wang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China.
| | - Xueqing Yao
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Medical College of Shantou University, Shantou, Guangdong, 515000, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
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Abstract
RATIONALE Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare. PATIENT CONCERNS A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day. DIAGNOSIS Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0-3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0-35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition. INTERVENTIONS The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well. LESSONS We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.
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Affiliation(s)
| | - Guoliang Liu
- Operating Theater and Department of Anesthesiology
| | - Yu Mu
- Department of General Surgery
| | - Hongyu He
- Operating Theater and Department of Anesthesiology
| | - Shuang Wang
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, Jilin, China
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Sato S, Nakamura M, Shimizu Y, Goto T, Kitahara A, Koike T, Tsuchida M. Impact of postoperative complications on outcomes of second surgery for second primary lung cancer. Surg Today 2020; 50:1452-1460. [PMID: 32488477 DOI: 10.1007/s00595-020-02038-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/05/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The best surgical approach for second primary lung cancer remains a subject of debate. The purpose of this study was to review the postoperative complications after second surgery for second primary lung cancer and to investigate the outcomes based on these complications. METHODS The clinical data of 105 consecutive patients who underwent pulmonary resection for multiple primary lung cancers between January, 1996 and December, 2017, were reviewed according to the Martini-Melamed criteria. RESULTS After the second surgery, low body mass index (BMI) (< 18.5 kg/m2) (P = 0.004) and high Charlson comorbidity index (CCI) (P = 0.002) were independent predictors of postoperative complications. Survival analysis revealed the 5-year overall survival rates of 74.5% and 61.4% for patients without postoperative complications and those with postoperative complications (P = 0.044), respectively, but the 5-year cancer-specific survival rates of 82.5% and 80.0% (P = 0.926), respectively. During this period, there were significantly more respiratory-related deaths of patients with complications than of those without complications (P = 0.011). CONCLUSION Surgical intervention is feasible and potentially effective for second primary lung cancer but may not achieve positive perioperative and long-term outcomes for patients with a low BMI or a high CCI. Treatment options should be considered carefully for these patients.
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Affiliation(s)
- Seijiro Sato
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Masaya Nakamura
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
- Division of General Thoracic Surgery, Niigata Prefectural Central Hospital, Niigata, Japan
| | - Yuki Shimizu
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Tatsuya Goto
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Akihiko Kitahara
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
- Division of General Thoracic Surgery, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Terumoto Koike
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Masanori Tsuchida
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
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Wang X, Wang W, Ma X, Lu X, Li S, Zeng M, Xu K, Yang C. Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance? Eur Radiol 2020; 30:5337-5347. [PMID: 32385649 PMCID: PMC7476977 DOI: 10.1007/s00330-020-06861-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/13/2020] [Accepted: 04/02/2020] [Indexed: 02/07/2023]
Abstract
Objectives To explore which preoperative clinical data and conventional MRI findings may indicate microvascular invasion (MVI) of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and have clinical significance. Methods The study enrolled 113 patients with histopathologically confirmed cHCC-CCA (MVI-positive group [n = 56], MVI-negative group [n = 57]). Two radiologists retrospectively assessed the preoperative MRI features (qualitative analysis of morphology and dynamic enhancement features), and each lesion was assigned according to the LI-RADS. Preoperative clinical data were also evaluated. Logistic regression analyses were used to assess the relative value of these parameters as potential predictors of MVI. Recurrence-free survival (RFS) rates after hepatectomy in the two groups were estimated using Kaplan–Meier survival curves and compared using the log-rank test. Results The majority of cHCC-CCAs were categorized as LR-M. On multivariate analysis, a higher serum AFP level (OR, 0.523; 95% CI, 0.282–0.971; p = 0.040), intratumoral fat deposition (OR, 14.368; 95% CI, 2.749–75.098; p = 0.002), and irregular arterial peritumoral enhancement (OR, 0.322; 95% CI, 0.164–0.631; p = 0.001) were independent variables associated with the MVI of cHCC-CCA. After hepatectomy, patients with MVI of cHCC-CCA showed earlier recurrence than those without MVI (hazard ratio [HR], 0.402; 95% CI, 0.189–0.854, p = 0.013). Conclusion A higher serum AFP level and irregular arterial peritumoral enhancement are potential predictive biomarkers for the MVI of cHCC-CCA, while intratumoral fat detected on MRI suggests a low risk of MVI. Furthermore, cHCC-CCAs with MVI may have worse surgical outcomes with regard to early recurrence than those without MVI. Key Points • Higher serum levels of AFP combined with irregular arterial peritumoral enhancement are independent risk factors for the MVI of cHCC-CCA, while fat deposition might be a protective factor. • cHCC-CCA with MVI may have a higher risk of early recurrence after surgery. • Most cHCC-CCAs were categorized as LR-M in this study, and no significant difference was found in MVI based on LI-RADS category.
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MESH Headings
- Adult
- Aged
- Bile Duct Neoplasms/blood supply
- Bile Duct Neoplasms/diagnostic imaging
- Bile Duct Neoplasms/pathology
- Bile Duct Neoplasms/surgery
- Bile Ducts, Intrahepatic/pathology
- Biomarkers, Tumor/blood
- Carcinoma, Hepatocellular/blood supply
- Carcinoma, Hepatocellular/diagnostic imaging
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/surgery
- Cholangiocarcinoma/blood supply
- Cholangiocarcinoma/diagnostic imaging
- Cholangiocarcinoma/pathology
- Cholangiocarcinoma/surgery
- Disease-Free Survival
- Female
- Hepatectomy
- Humans
- Liver Neoplasms/blood supply
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/pathology
- Liver Neoplasms/surgery
- Magnetic Resonance Imaging
- Male
- Microcirculation
- Middle Aged
- Neoplasm Invasiveness
- Neoplasms, Multiple Primary/blood supply
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Recurrence
- Retrospective Studies
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Affiliation(s)
- Xiaolong Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, China
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu Province, China
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wentao Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Xijuan Ma
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, Jiangsu Province, China
| | - Xin Lu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu Province, China
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Shaodong Li
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu Province, China
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Kai Xu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu Province, China.
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
| | - Chun Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, China.
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Okamoto H, Kikuchi H, Naganuma H, Kamei T. Multiple carcinosarcomas of the esophagus with adeno-carcinomatous components: A case report. World J Gastroenterol 2020; 26:2111-2118. [PMID: 32536778 PMCID: PMC7267695 DOI: 10.3748/wjg.v26.i17.2111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Carcinosarcoma (spindle cell carcinoma) of the esophagus is an extremely rare event; the etiology and origins of this neoplasm have not yet been determined. Epithelial-mesenchymal transition (EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor.
CASE SUMMARY We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-IIc lesions located 35 cm from the incisors toward the esophago-gastric junction. Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-IIc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adeno-carcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor. The patient was diagnosed with multiple carcinosarcomas, staged at pT1b (SM3), pN1 (#110, #7), cM0, Stage II (sarcomatous metastasis to the lymph nodes). Spindle cells did not express E-cadherin but were positive for EMT markers, including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery.
CONCLUSION This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT.
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Affiliation(s)
- Hiroshi Okamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Hiroshi Kikuchi
- Department of Surgery, South Miyagi Medical Center, Miyagi 989-1253, Japan
| | - Hiroshi Naganuma
- Department of Pathology, Sendai City Hospital, Sendai 982-8502, Japan
| | - Takashi Kamei
- Department of Gastroenterological Surgery, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
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Bteich F, El Khoury L, Nohra G, Trak V, Yazbek S, Akiki M. Pituitary Adenoma and Papillary Craniopharyngioma: A Rare Case of Collision Tumor and Review of the Literature. World Neurosurg 2020; 139:63-69. [PMID: 32298831 DOI: 10.1016/j.wneu.2020.03.088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pituitary adenomas are the most common lesion of the sellar region. Very few cases in the literature have described their association with craniopharyngiomas in the same anatomic compartment, an entity defined as collision tumors of the sella. CASE DESCRIPTION A 35-year-old man presented with headaches and progressive visual disturbances. Radiographic imaging initially highlighted the presence of a pituitary craniopharyngioma. An endoscopic transsphenoidal pituitary approach was performed, during which the tumor was partially resected. The pathology report was positive for 2 entities: a nonfunctioning pituitary adenoma and a papillary craniopharyngioma. This was an unexpected diagnosis based on the surgical and initial radiologic findings. CONCLUSIONS To our knowledge, this is the first documented case of a collision tumor of the sella comprising a pituitary adenoma and a craniopharyngioma of the papillary type.
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Affiliation(s)
- Fred Bteich
- Neurosurgery Department, Hotel-Dieu de France Hospital, Achrafieh, Lebanon; Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon.
| | - Lea El Khoury
- Pathology Departments, Hotel-Dieu de France Hospital, Achrafieh, Lebanon; Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon
| | - Georges Nohra
- Neurosurgery Department, Hotel-Dieu de France Hospital, Achrafieh, Lebanon; Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon
| | - Viviane Trak
- Pathology Departments, Hotel-Dieu de France Hospital, Achrafieh, Lebanon; Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon
| | - Sandrine Yazbek
- Neurosurgery Department, Hotel-Dieu de France Hospital, Achrafieh, Lebanon; Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon
| | - Mira Akiki
- Pathology Departments, Hotel-Dieu de France Hospital, Achrafieh, Lebanon
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KRAJEWSKI P, CHLEBICKA I, HRYNCEWICZ-GWÓZDZ A, SZEPIETOWSKI JC. Non-syndromic Unilateral Basal Cell Carcinomas: A Case Report and Literature Review. Acta Derm Venereol 2020; 100:adv00101. [PMID: 32189006 PMCID: PMC9128874 DOI: 10.2340/00015555-3462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Piotr KRAJEWSKI
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland. E-mail:
| | - Iwona CHLEBICKA
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland. E-mail:
| | - Anita HRYNCEWICZ-GWÓZDZ
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland. E-mail:
| | - Jacek C. SZEPIETOWSKI
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland. E-mail:
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Kebudi R, Sezer A, Eliçevik M, Ocak S, Çomunoğlu N, Birgen D, Kervancıoğlu ME, Kuruğoğlu S. Bilateral Synchronous Testicular Germ Cell Tumors in Children: Case Report and Review of the Literature. Urology 2020; 140:155-158. [PMID: 32199873 DOI: 10.1016/j.urology.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022]
Abstract
Bilateral testicular tumors are very rare in pediatric patients and only a few case reports have been reported. These patients have a high risk of sterility due to bilateral orchiectomy and subsequent gonadotoxic treatments. Therefore, if possible, testis-sparing surgery should be performed in patients with benign masses and testicular tissue preservation may be recommended in order to maintain fertility in later life. We present a 23 months old boy with synchronous bilateral testicular tumor managed with unilateral orchiectomy and testis-sparing surgery and testicular tissue cryopreservation performed to the controlateral side. We also review the literature on bilateral testis tumors in children.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Department of Pediatrics, Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ali Sezer
- Department of Pediatric Surgery, Division of Pediatric Urology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Eliçevik
- Department of Pediatric Surgery, Division of Pediatric Urology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Süheyla Ocak
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Çomunoğlu
- Department of Pathology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Dilek Birgen
- Division of Pediatric Oncology, Burhan Nalbantgil Hospital, Nicosia, Cyprus
| | - Mehmet Ertan Kervancıoğlu
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sebuh Kuruğoğlu
- Department of Radiology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
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Zong Z, Zhou TC, Tang FX, Tian HK, Wang A, Yi CH. Impact of Site-Specific Metastases on Surgical Value and Survival among Metastatic Colorectal Cancer Patients. Am Surg 2020; 86:220-227. [PMID: 32223801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We aimed to explore the potential prognostic impact of the metastatic site on the management approach and prognosis of stage IV colorectal cancer patients with synchronous metastases. Synchronous metastatic colorectal cancer patients reported to the Surveillance, Epidemiology, and End Results Program database between 2010 and 2013 were included in this study. Overall survival (OS) was compared between patients with different treatment options using risk-adjusted Cox proportional hazard regression models. Overall, 17,776 patients with stage IV colorectal cancer were identified. Of these patients, 2,052 (11.5%) underwent surgical resection for tumors at both the primary and metastatic sites. Patients who underwent surgical resection of both primary and metastatic sites with liver, lung, and simultaneous liver and lung metastases had a longer median OS (P < 0.001) than patients who underwent nonsurgical treatments. Cox regression analysis revealed that surgical resection of both primary and metastatic sites was associated with a significantly enhanced OS (P < 0.001). Colorectal cancer patients with hepatic or pulmonary metastases, who underwent metastasectomy, even in selected patients with both hepatic and pulmonary metastases after multidisciplinary evaluation, could have a better survival benefit than patients who underwent nonsurgical treatments.
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Affiliation(s)
- Zhen Zong
- From the *Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, P. R. China; and
| | - Tai-Cheng Zhou
- †Department of Gastrointestinal Surgery and Hernia Center, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China
| | - Fu-Xin Tang
- †Department of Gastrointestinal Surgery and Hernia Center, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China
| | - Hua-Kai Tian
- From the *Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, P. R. China; and
| | - Anan Wang
- From the *Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, P. R. China; and
| | - Cheng-Hao Yi
- From the *Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, P. R. China; and
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Arboleda C, Wang Z, Jefimovs K, Koehler T, Van Stevendaal U, Kuhn N, David B, Prevrhal S, Lång K, Forte S, Kubik-Huch RA, Leo C, Singer G, Marcon M, Boss A, Roessl E, Stampanoni M. Towards clinical grating-interferometry mammography. Eur Radiol 2020; 30:1419-1425. [PMID: 31440834 PMCID: PMC7033145 DOI: 10.1007/s00330-019-06362-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, as several research works have demonstrated in a pre-clinical setting, since it is able to provide attenuation, differential phase contrast, and scattering images simultaneously. In order to translate this technique to the clinics, it has to be adapted to cover a large field-of-view within a clinically acceptable exposure time and radiation dose. METHODS We set up a grating interferometer that fits into a standard mammography system and fulfilled the aforementioned conditions. Here, we present the first mastectomy images acquired with this experimental device. RESULTS AND CONCLUSION Our system performs at a mean glandular dose of 1.6 mGy for a 5-cm-thick, 18%-dense breast, and a field-of-view of 26 × 21 cm2. It seems to be well-suited as basis for a clinical-environment device. Further, dark-field signals seem to support an improved lesion visualization. Evidently, the effective impact of such indications must be evaluated and quantified within the context of a proper reader study. KEY POINTS • Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, since it is sensitive to refraction and scattering and thus provides additional tissue information. • The most straightforward way to do grating-interferometry in the clinics is to modify a standard mammography device. • In a first approximation, the doses given with this technique seem to be similar to those of conventional mammography.
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MESH Headings
- Breast Density
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Female
- Humans
- Interferometry/methods
- Mammography/methods
- Mastectomy
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Radiation Dosage
- Tumor Burden
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Affiliation(s)
- Carolina Arboleda
- ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Paul Scherrer Institute, Forschungstrasse 111, 5232, Villigen, Switzerland.
| | - Zhentian Wang
- ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
- Paul Scherrer Institute, Forschungstrasse 111, 5232, Villigen, Switzerland
| | - Konstantins Jefimovs
- ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
- Paul Scherrer Institute, Forschungstrasse 111, 5232, Villigen, Switzerland
| | - Thomas Koehler
- Philips Research Hamburg, Röntgenstrasse 24-26, 22335, Hamburg, Germany
| | | | - Norbert Kuhn
- Philips Research Hamburg, Röntgenstrasse 24-26, 22335, Hamburg, Germany
| | - Bernd David
- Philips Research Hamburg, Röntgenstrasse 24-26, 22335, Hamburg, Germany
| | - Sven Prevrhal
- Philips Research Hamburg, Röntgenstrasse 24-26, 22335, Hamburg, Germany
| | - Kristina Lång
- ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
- Paul Scherrer Institute, Forschungstrasse 111, 5232, Villigen, Switzerland
| | - Serafino Forte
- Department of Radiology, Kantonsspital Baden, Im Ergel 1, 5404, Baden, Switzerland
| | | | - Cornelia Leo
- Interdisciplinary Breast Center, Kantonsspital Baden, Im Ergel 1, 5404, Baden, Switzerland
| | - Gad Singer
- Department of Pathology, Kantonsspital Baden, Im Ergel 1, 5404, Baden, Switzerland
| | - Magda Marcon
- Institute for Diagnostic and Interventional Radiology, Universitätspital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Andreas Boss
- Institute for Diagnostic and Interventional Radiology, Universitätspital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Ewald Roessl
- Philips Research Hamburg, Röntgenstrasse 24-26, 22335, Hamburg, Germany
| | - Marco Stampanoni
- ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
- Paul Scherrer Institute, Forschungstrasse 111, 5232, Villigen, Switzerland
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Copur MS, Lackner R, Wedel W, Lintel N, Lintel MS, Gnatra K. Synchronous Bilateral Lung Cancer With Discordant Histology. Oncology (Williston Park) 2020; 34:55-60. [PMID: 32645196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Synchronous multiple primary lung cancer (SMPLC) is a rare occurrence affecting 0.5% to 2% of patients with lung cancer. Synchronous discordant histology with small cell and non-small cell lung carcinoma is an even less common entity. There have been several presentations of synchronous or metachronous multiple primary lung cancers in the literature. However, reports discussing treatment options and prognosis in patients with SMPLC of discordant histology with small cell and non-small cell carcinoma in the same patient are scarce. We report a case of SMPLC presenting with a limited stage left upper lobe small cell lung cancer and an operable right upper lobe non-small cell lung adenocarcinoma. Diagnostic, surgical, and medical treatment options for the patient along with a review of SMPLC topics are presented.
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Affiliation(s)
| | - Rudy Lackner
- Section of Thoracic Surgery, University of Nebraska Medical Center, Omaha, NE
| | - Whitney Wedel
- Department of Pathology, Mary Lanning Healthcare, Hastings, NE
| | - Nikki Lintel
- Department of Pathology, Mary Lanning Healthcare, Hastings, NE
| | | | - Kalpesh Gnatra
- Hastings Pulmonary and Sleep Clinic, Mary Lanning Healthcare, Hastings, NE
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50
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Giuliani A, Romano L, Romanzi F, Giubbolini G, Coletti G, Di Stefano N, Le'Clerc JN, Schietroma M, Carlei F, Di Stefano L. A case of three rare uterine neoplasms in the same surgical specimen. Ann Ital Chir 2020; 9:S2239253X20031527. [PMID: 32129176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Uterine sarcomas are mesenchymal tumors; they are rare, representing less than 2-3% of all uterine malignancies. Among them, we can define four types: leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), Adenosarcoma and Carcinosarcoma. This last type was recently reclassified by FIGO as a Mullerian type of the endometrial adenocarcinoma. Therefore, today only the first three types are histologically considered. METHODS In this paper, we reported a case of simultaneous presence of three different rare neoplasms in the same surgical specimen, resulting from a hysterectomy of a premenopausal woman. The woman presented to the ED with a six-months history of vaginal bleeding. Given the complexity of the clinical picture, we suggested hospitalization in our Department of Gynecology, to perform appropriate diagnostic tests. Because of the persistent hemorrhage and the absence of required fertility preservation, a laparotomic hysterectomy with bilateral annessiectomy was performed. RESULTS The postoperative histology of the specimen described the myoma at the fundus as a leiomyosarcoma. The myoma of the uterine anterior wall appeared as an endometrial stromal sarcoma of low-grade. Moreover, an intramural cavernous hemangioma of 3 cm in diameter was reported at the uterine corpus. CONCLUSION All these described pathologies have no specific clinic characteristics; the most common symptom is abnormal uterine bleeding. To date, hysterectomy and bilateral salpingo-oophorectomy are the standards of care in the management of all early stage uterine sarcomas. To our knowledge, cases of LMS, ESS and cavernous haemangioma coexisting in the same patient have not been reported in literature to date. The pathogenesis of this combination remains to be elucidated. Key words: Cavernous hemangioma, Endometrial stromal sarcoma, Leiomyosarcoma, Uterine sarcomas.
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