ABSTRACT
Malignant eccrine poroma is a rare skin appendage tumor, originating from the intraepidermal and upper dermal eccrine ducts. It is a locally aggressive neoplasm with a high propensity to metastasize. A 47-year-old woman was admitted to the hospital because of dyspnea. One and half years before admission, she had been diagnosed porocarcinoma of left sole and treated with wide local excision. One months after excision, examination had revealed an inguinal lymph node metastasis and she had been treated with lymph node resection and radiotherapy. During the two weeks before admission, the patient had increasing exertional dyspnea, which was accompanied by Rt-sided chest wall pain. On admission right pleural effusion and multiple nodular densities were noted at initial chest radiograph. A computed tomographic (CT) scan of the chest showed lymphatic and hematogenous lung metastasis with pleural seeding of unknown primary tumor. Fine-needle aspiration biopsy of the pleura revealed typical cytologic findings of porocarcinoma. She was treated with therapeutic thoracentesis and pleurodesis with bleomycin. Because porocarcinoma is resistant to chemotherapy and radiotherapy, she has been treated with conservative treatment.
Subject(s)
Female , Humans , Middle Aged , Biopsy, Fine-Needle , Bleomycin , Drug Therapy , Dyspnea , Eccrine Porocarcinoma , Lung , Lymph Nodes , Neoplasm Metastasis , Neoplasms, Unknown Primary , Pleura , Pleural Effusion , Pleurodesis , Radiography, Thoracic , Radiotherapy , Skin , Thoracic Wall , ThoraxABSTRACT
BACKGROUND: CD44 is a cell surface adhesion molecule which has been implicated in various biologic functions as lymphocyte homing and activation, cellular migration and extracellular matrix adhesion. Over-expression of CD44v8- 10 has been found in several cancers and is considered to be associated with tumor progression and metastasis. Recently, a novel molecular method, CD44v8- 10/CD44v10 competitive reverse transcription-polymerase chain reaction(RT-PCR) has been developed for detecting cancer cells over-expressing CD44v8-10. METHODS: We analyzed from benign and malignant pleural effusion and ascites by CD44 competitive RT-PCR and compared to the conventional cytology. RESULTS: The CD44 competitive RT-PCR analysis showed that all the 24 samples associated with benign disease presented a predominant expression of the CD44v10 transcript (v8-10/v10 ratio: 0.126-0.948), whereas 6 of 7 malignant pleural samples associated with cytology positive cancer expressed the CD44v8-10 transcript (v8-10/v10 ratio > 1.00). CONCLUSION: These results indicate that CD44 competitive RT-PCR assay is a useful and adjunct to cytological examination in cancer diagnosis, especially in detecting exfoliated cancer cells in pleural effusion.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Hyaluronan Receptors/analysis , Ascites/pathology , Ascites/immunology , Base Sequence , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/immunology , Comparative Study , Gastrointestinal Neoplasms/pathology , Gastrointestinal Neoplasms/immunology , Lung Neoplasms/pathology , Lung Neoplasms/chemistry , Middle Aged , Molecular Sequence Data , Pleural Effusion, Malignant/pathology , Pleural Effusion, Malignant/chemistry , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Subject(s)
Female , Humans , Abdominal Pain , Actinomycosis , Diagnosis , Fibrosis , Intrauterine Devices , Rare Diseases , Vaginal DischargeABSTRACT
No abstract available.