Presentación tumoral de actinomicosis pélvica / Tumor Presentation of Pelvic Actinomycosis

La actinomicosis es una enfermedad crónica granulomatosa poco común causada por bacterias gram positivas, anaeróbicas, microaerófilas principalmente del género Actynomices. Se presenta el caso de una mujer de 49 años de edad, con cuadro clínico de aproximadamente 4 meses de evolución dado por estreñimiento, asociado a tenesmo rectal durante la defecación y pérdida de peso, portadora de dispositivo intrauterino desde hace 7 años. En el examen físico se encontró la presencia de una masa, de bordes mal definidos, en flanco y fosa iliaca derechos, y en hipogastrio, no dolorosa a la palpación. El ultrasonido abdominal reportó una masa en lóbulo caudado hepático y una estructura de contornos mal definidos en íntimo contacto con techo vesical y fundus uterino. La biopsia de lesión reveló actinomicosis. Se confirma la actinomicosis en una paciente con masa palpable en hipogastrio y dispositivo intrauterino colocado(AU)

Actinomycosis is an uncommon granulomatous chronic disease caused by gram-positive, anaerobic, microaerophilic bacteria, mainly of the genus Actynomices. We present the case of a 49-year-old woman with a clinical condition of approximately 4 months of evolution due to constipation, associated with rectal tenesmus during defecation and weight loss, carrier of an intrauterine device for 7 years. In the physical examination, the presence of a mass was found, with poorly defined edges, flank anda iliac fossa right, and hypogastrium, not painful on palpation. Abdominal ultrasonography reported a mass in the hepatic caudate lobe and a structure of ill-defined contours in intimate contact with the bladder roof and uterine fundus. The lesion biopsy revealed actinomycosis. It was confirmed in a patient with palpable mass in hypogastrium and intrauterine device placed(AU)

The negative prognostic impact of bone metastasis with a tumor mass

OBJECTIVE: Typically, bone metastasis causes osteolytic and osteoblastic lesions resulting from the interactions of tumor cells with osteoclasts and osteoblasts. In addition to these interactions, tumor tissues may grow inside bones and cause mass lesions. In the present study, we aimed to demonstrate the negative impact of a tumor mass in a large cohort of patients with bone metastatic cancer. METHODS: Data from 335 patients with bone metastases were retrospectively reviewed. For the analysis, all patients were divided into three subgroups with respect to the type of bone metastasis: osteolytic, osteoblastic, or mixed. The patients were subsequently categorized as having bone metastasis with or without a tumor mass, and statistically significant differences in median survival and 2-year overall survival were observed between these patients (the median survival and 2-year overall survival were respectively 3 months and 16% in patients with a tumor mass and 11 months and 26% in patients without a tumor mass; p<0.001). RESULTS: According to multivariate analysis, the presence of bone metastasis with a tumor mass was found to be an independent prognostic factor (p=0.011, hazard ratio: 1.62, 95% confidence interval: 1.11–1.76). Bone metastasis with a tumor mass was more strongly associated with osteolytic lesions, other primary diseases (except for primary breast and prostate cancers), and spinal cord compression. CONCLUSION: Bone metastasis with a tumor mass is a strong and independent negative prognostic factor for survival in cancer patients. .

Reporte de caso clínico: hemangioendotelioma esplénico de células epitelioide. Primer reporte latinoamericano / Clinical case report: splenic hemangioendothelioma of epithelioid cells

El Hemangioendotelioma esplénico es una rara neoplasia sarcomatosa de etiología idiopática y malignidad intermedia, entre el hemangioma y el hemangioendoteliosarcoma. Se presenta el caso de un paciente de sexo masculino de 54 años que acude a consulta por presentar dolor postraumático y una masa tumoral esplénica palpable. Diagnóstico prequirúrgico compatible con una lesión quística vascular. Histológicamente está compuesto por células redondas atípicas epitelioides con núcleos grandes y nucléolos prominentes, acompañado por proliferación de canales vasculares y, en ciertas áreas, con células fusiformes elongadas. En estudio de inmunohistoquímica se muestra células tumorales positivas para el antígeno CD34 (FLEX 2x5 DAB) y anticuerpos de vimentina. El componente estromal muestra evidente diferenciación miofibroblástica. A pesar de tratarse de una patología sumamente infrecuente (solo siete casos reportados a nivel mundial) posee un buen pronóstico y no se han documentado recidivas. Se han descrito tres variantes histopatológicas: epitelioide, kaposiforme y retiforme. Se realiza el diagnóstico diferencial con el tipo kaposiforme por cuanto es evidente la ausencia de luces vasculares en media luna, así como los respectivos depósitos de hemosiderina y se descarta angiosarcoma al no observarse células anaplásicas.

The splenic hemangioendothelioma is a rare sarcomatous neoplasm of idiopathic etiology and intermediate malignancy, between hemangioma and hemangioendothelioma. This is the case of a 54-year-old male patient who goes to the doctor with post-traumatic pain disorder and a palpable splenic tumor. The preoperative diagnosis was compatible with a vascular cystic lesion. Histologically, it is composed of atypical epithelioid round cells with large nuclei and prominent nucleoli, accompanied by a proliferation of vascular channels and, in some areas, by elongated spindle cells. An immunohistochemistry study shows tumor cells that are positive for the CD34 antigen (FLEX 2x5 DAB) and Vimentin antibodies. The stromal component clearly shows myofibroblastic differentiation. Despite being a extremely rare disease (only seven cases reported worldwide) it has a good prognosis and recurrence has not been documented. Three histopathological variants have been described: epithelioid, kaposiform and retiform. A differential diagnosis is made with the kaposiform type because of the evident absence of “half-moon” vascular lumina, as well as the respective reservoirs of hemosiderin; angiosarcoma is ruled out because of the absence of anaplastic cells.

The Effects of the Tumor Mass Size Inoculated in Immunologically Competent Balb/c Mice on Delayed-type Hypersensitivity Response

BACKGROUND: Based on outstanding progresses in animal experiments, vaccines for some human tumors have been developed. However, clinical effects of these vaccines have been far below than expected. This discrepancy might come from differences between animal models and human patients with respect to immunocompetency. The immune status of mice after tumor inoculation has not been well studied, which make us cautious in interpreting and applying the results from mice to human. We evaluated cell-mediated immune responses in mice after tumor cell inoculation. METHODS: Mice were inoculated with TA3Ha, CT26, or 4T1. Delayed-type hypersensitivity (DTH) responses were induced 2-4 weeks after inoculation using 2,4-dinitro-1-fluorobenzene as an antigen. The relationships between the severity of DTH responses and the duration of tumor inoculation or the size of tumor mass were analyzed. RESULTS: In TA3Ha groups, DTH response was elevated 2 weeks after inoculation, but depressed after 4 weeks, compared to the control group. When analyzed based on the sizes of tumor masses elicited, DTH responses were inversely related to the mass size, especially in those greater than 10 mm in diameter. In CT26 groups, while the duration after inoculation did not affect the severity of DTH responses, those with large mass showed depressed responses regardless the duration of inoculation. 4T1 cells grew so slowly that the size of tumor mass was small even 4 weeks after inoculation, and this group showed much higher DTH responses compared to that of tumor-free group. CONCLUSION: At least in an experimental setting where tumor model was induced by inoculating tumor cell lines into immunologically competent mice, the host immune response was elevated in early stage, and then depressed in late stage when the mass grew over a critical size.

A Case of Congenital Self-Healing Reticulohistiocytosis / 대한피부과학회지

We report a case of congenital self-healing reticulohistiocytosis in a newborn male, who showed numerous reddish brown papulonodules on the whole of his body and an extremely large tumor mass on the left sole. No extracutaneous involvement was found. All lesions involuted spontaneously within two months. Histopathologically, multiple histiocytes with abundant eosinophilic cytoplasm, multinucleated cells, and eosinophils were observed in the dermis. Immunohistochemical staining with S-100 protein showed positive.

Prostaglandin E_2 in peripheral blood and tumor mass of patients with gastric cancer / 第三军医大学学报

Objective To assess the prostaglandin E2 (PGE2) levels in tumor mass and peripheral blood of patients with gastric cancer and explore their clinical significance. Methods The PGE2 levels in tumor mass, tumor margins of excision and peripheral blood of 40 patients with gastric cancer were measured by a kit of PGE2 ELISA. Results The PGE2 levels were higher in the tissues of gastric cancer than in tumor margins of excision [(8.225?2.425) vs (1.669?0.287) ng/g, P

A Case of Multiple Myeolma with Huge Tumor Mass in Clavicle / 대한정형외과학회잡지

Multiple myeloma is considered to be the most common primary malignant bone tumor which has the flat bone as a predilection site in old ages. We experienced a case of an unsual multiple myeloma which formed a huge tumor mass on medial end of left clavicle. The tumor mass together with medial half of the clavicle was excised completely. We have discussed the rationale for the excision of the clavicle.