Widely Infiltrating Epithelioid Malignant Peripheral Nerve Sheath Tumour of Skull Base

The epithelioid variant of malignant peripheral nerve sheath tumours is a rare histological entity, and the occurrence of a malignant peripheral nerve sheath tumour in the skull base is even more unusual. We report a case of a 52-year-old man who presented with reduced hearing in the left ear, giddiness and left-sided facial weakness of short duration. He was a known hypertensive. On examination, left-sided 7th to 12th cranial nerve palsies were noted. Computed tomography (CT) and brain magnetic resonance imaging (MRI) were reported as an ill-defined heterogeneously enhancing mass left skull base suggestive of chondrosarcoma. Left tympanotomy and biopsy of the lesion were carried out. On light microscopy and immunohistochemical examination of the biopsy, a diagnosis of epithelioid malignant peripheral nerve sheath tumour was established. The patient underwent left extended modified radical mastoidectomy and selective neck dissection. Histopathological study of the resected surgical specimen confirmed left-sided extensive tumour involvement of skull base structures, as well as neck nodal metastases.

Benign and malignant neoplasias in 261 necropsies for HIV-positive patients in the period of 1989 to 2008 / Neoplasias benignas e malignas em 261 necropsias de pacientes HIV positivos no período de 1989 a 2008

Considering that there are some studies with autopsies from AIDS describing only malignant neoplasias and that changes can occur after the introduction of Highly Active Antiretroviral Therapy (HAART), our objectives were to analyze the frequency of benign and malignant neoplasms in AIDS patients in the periods of both pre- and post-HAART. This is a retrospective study with 261 autopsies of HIV-positive patients between 1989 and 2008 in Uberaba, Brazil. Sixty-six neoplasms were found (39 benign, 21 malignant and six premalignant) in 58 patients. The most frequent malignant neoplasms were lymphoid, in 2.7 percent (four Non-Hodgkin lymphoma, one Hodgkin, one multiple myeloma and one plasmablastic plasmacytoma), and Kaposi's Sarcoma, in 2.3 percent (six cases). The most frequent benign neoplasms were hepatic hemangiomas in 11 (4.2 percent) of 261 cases and uterine leiomyoma in 11 (15.7 percent) of 70 woman. In the pre-HAART period eight (9.8 percent) benign neoplasias and four (4.9 percent) malignant occurred in 82 patients; in the post-HAART period, 29 (16.2 percent) benign and 17 (9.5 percent) malignant were present; however, the differences were not significant. We conclude that the introduction of HAART in our region doesn't look to have modified the frequency of neoplasms occurring in patients with HIV.

Tendo em vista que trabalhos sobre necropsias de AIDS analisam apenas neoplasias malignas e que ocorreram alterações após a terapia antiretroviral altamente eficaz (HAART), este estudo foi feito com objetivo de avaliar a frequência de neoplasias benignas e malignas nos períodos pré e pós-HAART. Estudo retrospectivo de 261 necropsias de HIV positivos entre 1989 e 2008 em Uberaba - Brasil. Foram encontradas 66 neoplasias (39 benignas, 21 malignas e seis lesões pré-invasivas) em 58 pacientes. As neoplasias malignas mais frequentes foram linfóides, em 2,7 por cento (quatro linfomas não Hodgkin, um Hodgkin, um mieloma múltiplo e um plasmocitoma plasmoblástico) e, sarcoma de Kaposi, em 2,3 por cento (seis casos). As benignas mais frequentes foram hemangiomas hepáticos em 11 (4,2 por cento) dos 261 casos e leiomiomas uterinos em 11 (15,7 por cento) das 70 mulheres. No período pré-HAART ocorreram oito (9,8 por cento) neoplasias benignas e quatro (4,9 por cento) malignas em 82 pacientes; no pós-HAART, 29 (16,2 por cento) benignas e 17 (9,5 por cento) malignas; entretanto, essas diferenças não foram estatisticamente significantes. Concluímos que a introdução da HAART em nossa região não parece ainda ter alterado a frequência de neoplasias em pacientes HIV.

Percutaneous Placement of Metallic Stent for Palliation of Malignant Biliary Obstruction:A Report of 53 Cases / 介入放射学杂志

Purpose:To study the clinical value of percutaneous placement of biliary stents tbr treatment of malignant biliary obstruction.Materials and methods:A total of 58 stents were placed pereutaneously in 53 patients for palliative of malignant biliary obstruction. Results:The success rate of stent implantation was 98.1%(52/53).The difference between post-and pre-operation in the serum total bilirubin level of 52 patients was 182?67 ? mol/L,P