ABSTRACT
RESUMEN Objetivo: Evaluar la concordancia entre el diagnóstico clínico inicial y el histopatológico de tumores palpebrales malignos. Métodos: Se realizó un estudio observacional, descriptivo y retrospectivo de pacientes portadores de diferentes tumores palpebrales, atendidos en el Servicio de Cirugía Plástica Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el periodo comprendido de enero a diciembre del año 2016, en el que se describieron las características clínicas y anatomopatológicas, y la concordancia entre ambos diagnósticos. Resultados: Predominó el grupo de 60-79 años de edad (46,1 por ciento), el sexo femenino (51,7 por ciento) y el color de piel blanco (92,6 por ciento) . Las lesiones se presentaron fundamentalmente en el párpado inferior (77,0 por ciento) y las telangectasias constituyeron el signo de malignidad más consistente (56,8 por ciento), con predominio del carcinoma basocelular, seguido del carcinoma espinocelular (81,4 por ciento y 15,2 por ciento, respectivamente). La concordancia entre el diagnóstico clínico y el histopatológico fue de 69,2 por ciento para el carcinoma basocelular; 9,7 por ciento para el espinocelular y 30 por ciento para el sebáceo (índice de Kappa de 0,338; 0,262 y 0,357, respectivamente). Conclusiones: Existe la mayor concordancia entre diagnóstico clínico e histopatológico en el carcinoma basocelular; no así en el resto de los tumores estudiados(AU)
ABSTRACT Objective: To assess the concordance between the initial and histopathological clinical diagnosis of malignant palpebral tumors. Methods: An observational, descriptive and retrospective study of patients with different eyelid tumors was performed. The patients were treated in the Ocular Plastic Surgery Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology, in the period from January to December of 2016, during which the clinical and pathological characteristics were described, together with the concordance between both diagnoses. Results: The age group of 60-79 years predominated (46.1 percent), as it was with the female sex (51.7 percent) and the white skin color (92.6 percent). The lesions occurred mainly in the lower eyelid (77.0 percent) and telangiectasia constituted the most consistent sign of malignancy (56.8 percent), with a predominance of basal cell carcinoma, followed by spinocellular carcinoma (81.4 percent and 15, 2 percent, respectively). The concordance between the clinical and histopathological diagnosis was 69.2 percent for basal cell carcinoma; 9.7 percent for the spinocellular carcinoma; and 30 percent for the sebaceous carcinoma (Kappa index of 0.388, 0.262 and 0.357, respectively). Conclusions: There is the greatest concordance between the clinical and histopathological diagnosis in basal cell carcinoma, but not in the rest of the tumors studied(AU)
Subject(s)
Humans , Female , Aged , Eyelid Neoplasms/diagnosis , Neoplasms/pathology , Epidemiology, Descriptive , Retrospective Studies , Observational Studies as TopicABSTRACT
Uno de los agentes causales de las alteraciones de las estructuras y partes externas de la cara y el cuero cabelludo es el carcinoma basal o basocelular. Al respecto, los cirujanos maxilofaciales son capaces de reparar y reconstruir aquellas áreas del complejo bucomaxilofacial que se encuentren deformadas o que se han perdido parcial o totalmente; así, en este artículo se describen e ilustran algunas técnicas reparadoras de los defectos quirúrgicos por carcinoma basal, entre ellas: el colgajo bilobulado, el colgajo nasogeniano y una modificación del colgajo de Mustardé, con las cuales se observaron buenos resultados estéticos y funcionales, teniendo en cuenta la localización y extensión de las lesiones.
One of the causative agents of the disorders of structures and external parts of the face and scalp is the basal carcinoma or basal cell carcinoma. In this respect, maxillofacial surgeons are able to repair and reconstruct those areas of the oral maxillofacial complex that are deformed or that have been partially or totally lost; this way, in this work some reparative techniques of the surgical defects due to basal carcinoma are described and illustrated, among them: bilobed flap, nasogenien flap and a modification of the Mustardé flap, with which good cosmetic and functional results were observed, taking into account the localization and extension of the injuries.
Subject(s)
Humans , Male , Female , Surgical Flaps/surgery , Therapeutics , Carcinoma, Basal Cell/therapy , Esthetics, Dental , Surgical Procedures, Operative , Homeopathic Therapeutic Approaches , EstheticsABSTRACT
Purpose To study the clinicalpathologic features,diagnosis,differential diagnosis and prognosis of cervical adenoid basal carcinoma (ABC) for improving further recognition and avoiding the likelihood of unnecessarily aggressive treatment to this disease.Methods Clinical presentations and pathological features of 4 cases of cervical ABC were analyzed by hematoxylin and eosin staining,immunohistochemical EnVision staining and in situ hybridization technology.The relevant literatures were reviewed.Results The age of 4 cases with cervical ABC ranged from 53 to 67 years (mean:61.5 years).All of the 4 patients underwent hysterectomy with bilateral salpingo-oophorectomy.Microscopically,the tumors were composed of small,well-differentiated and uniform basaloid cells and the tumor cells formed rounded nests or cords.The tumor cells arranged in palisading at the periphery of the nests.Some of the nests had central cystic spaces and there may also be focal glandular or squamous differentiation in the centre of the nests.Cervical intraepithelial neoplasia (CIN) lesions were observed in all 4 cases.Immunohistochemically,all the tumor cells were negative for CK7,ER,CEA,CD117 and S-100,while CK5/6,CK8/18,CK19,p16,p53,BCL-2 and p63 were positive.HPV 16/18 DNA were positive by in situ hybridization.The patients remained alive without recurrence and metastasis after follow-up 19 to 62 months.Conclusion ABC of the uterine cervix is a rare neoplasm with excellent prognosis.Differentiation of ABC from adenoid cystic carcinoma,basaloid squamous carcinoma,neuroendocrine carcinoma and adenosquamous carcinoma is important due to their different prognosis.Treatment is predominantly hysterectomy or laser electrocantery excision procedure (Leep).Radiotherapy or chemotherapy is not recommeded.
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BACKGROUND: Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) are rare in the uterine cervix. ACC is more aggressive than ABC, thus accurate differential diagnosis is important. In this study, we identified cytologic features useful in distinguishing these two tumors for diagnosis. METHODS: Three cases of ACC and five cases of ABC were selected for this study. Cervicovaginal smear slides were reviewed retrospectively, and the area, circumference, major axis, and minor axis of nuclei were measured using an image analyzer. RESULTS: ACC displayed three-dimensional clusters with a small acini pattern. ABC displayed peripheral palisading without an acini pattern. The nuclei of ACC were more irregular and angulated than those of ABC, and the former showed a coarsely granular chromatin pattern. The nucleic area, circumference, major axis, and minor axis were 18.556+/-8.665 microm2, 23.320+/-11.412 microm, 5.664+/-1.537 microm, and 4.127+/-1.107 microm in ACC and 11.017+/-4.440 microm2, 15.920+/-5.664 microm, 4.612+/-1.025 microm, and 3.088+/-0.762 microm in the cases of ABC. All measured values showed statistically significant difference (p < .001). CONCLUSIONS: Although the nuclei of both of these tumor types were oval shaped, inferred from the ratio of minor axis to major axis (0.728 in ACC and 0.669 in ABC), the area of nuclei was approximately 1.7 times larger in ACC than in ABC. Distinguishing nucleic features, including area, morphology, and chromatin pattern, may be helpful in making a correct diagnosis.
Subject(s)
Female , Adenoids , Axis, Cervical Vertebra , Carcinoma, Adenoid Cystic , Cervix Uteri , Chromatin , Diagnosis , Diagnosis, Differential , Papanicolaou Test , Retrospective Studies , Vaginal SmearsABSTRACT
Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.
ABSTRACT
Adenoid basal carcinoma of the uterine cervix is rare tumors that have often been regarded as a single entity. 14 cases with adenoid basal carcinoma of the uterine cervix have been reported in the literature. We experienced a case of 36-year female with adenoid basal carcinoma of the uterine cervix. We report this case with a brief review of the literature.
Subject(s)
Female , Humans , Adenoids , Cervix UteriABSTRACT
We report a case of adenoid basal carcinoma of the uterine cervix unexpectedly found in a 68-year-old female. She was diagnosed with a high-grade squamous intraepithelial lesion (HSIL) on a cervical smear and subsequent cervical punch biopsy. Total abdominal hysterectomy was performed, and there were no significant gross findings in the uterine cervix. Microscopically, the epithelial surface showed a HSIL with glandular extension. Below the neoplastic epithelial lesion were numerous small nests of uniform small cells, which extended to the parametrium. These tumor cells contained hyperchromatic nuclei, inconspicuous nucleoli, and scant cytoplasm. Peripheral palisading and gland-like or acinar structures in the nests were noted. The latter were positive for mucicarmine stain. Foci of squamous differentiation exhibiting occasional mitoses and large atypical cells were seen in the small nests. Stromal reaction was not obvious. Immunohistochemically, the HSIL lesion and adenoid basal carcinoma lesion were negative for human papillowa virus. The tumor cells forming nests were positive for carcinoembryonic antigen, S-100 protein, and high molecular weight cytokeratin, but were negative for -smooth muscle actin and chromogranin A.
Subject(s)
Aged , Female , Humans , Actins , Adenoids , Biopsy , Carcinoembryonic Antigen , Cervix Uteri , Chromogranin A , Cytoplasm , Hysterectomy , Keratins , Mitosis , Molecular Weight , S100 Proteins , Vaginal SmearsABSTRACT
Adenoid basal carcinoma and adenoid cystic carcinoma of the uterine cervix are rare tumors that have often been regarded as a single entity. But adenoid basal and adenoid cystic carcinomas of the cervix differ from each other in their histology, treatment, and prognosis. We experienced 2 cases of these neoplasms, with 1 case in each category. Whereas adenoid basal carcinoma is a slow-growing, locally invasive lesion amenable to simply hysterectomy, adenoid cystic carcinoma is an aggressive tumor associated with regional lymph node involvement and late distant metastases. This study reviews the literature and formulates a program for the management of these rare lesions.
Subject(s)
Female , Adenoids , Carcinoma, Adenoid Cystic , Cervix Uteri , Hysterectomy , Lymph Nodes , Neoplasm Metastasis , PrognosisABSTRACT
We report a rare case of adenoid basal carcinoma in uterine cervix. The patient was a 43-year-old Korean female. She received neoadjuvant chemotherapy with Quick Cis-VP16 (cisplatin and VP16 with 7-10 days interval), three times and radical hysterectomy with pelvic lymph nodes dissection under the diagnosis of cervical cancer stage IIa. After the neoadjuvant chemotherapy, the mass size was 3 x 2.5 Cm and which was protruded in exocervical region. Microscopically, scattered small nests of uniformed small cells with dark nuclei and scant cytoplasm were observed. Peripheral palisading as well as the formation of gland-like or acinar structures were noted. There were also foci of squamous differentiation in same portion of the small nests. The epithelial surface in other portions showed squamous cell carcinoma, large cell non-keratinizing cell type. Distribution between adenoid basal carcinoma of the cervix and other disease, such as adenoid cystic carcinoma and squamous cell carcinoma with basaloid features, is important for clinical management because the clinical behavior of adenoid basal carcinoma is less malignant than adenoid cystic carcinoma.
Subject(s)
Adult , Female , Humans , Adenoids , Carcinoma, Adenoid Cystic , Carcinoma, Squamous Cell , Cervix Uteri , Cytoplasm , Diagnosis , Drug Therapy , Etoposide , Hysterectomy , Lymph Nodes , Uterine Cervical NeoplasmsABSTRACT
Adenoid basal carcinoma of the cervix is very rare tumor. It is slow-growing and locally invasive tumor amenable to simply hystrectomy. It is common to be associated with severe dysplasia and carcinoma in situ(CIS) of cervix Occasionally, concommitant microinvasive squamous cell carcinoma or adenocarcinoma may also be seen. Differential diagnosis includes adenoid cystic carcinoma, which is more aggressive tumor associated with regional lymph node involvement and late pulmonary metastasis. We have recently experienced a case of adenoid basal carcinoma of the cervix in 61 years-old woman, which is presented with a brief review of the literature.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Adenoids , Carcinoma, Adenoid Cystic , Carcinoma, Squamous Cell , Cervix Uteri , Diagnosis, Differential , Lymph Nodes , Neoplasm MetastasisABSTRACT
Adenoid basal carcinoma of the uterine cervix is a rare neoplasm that accounts for less than 1% of cervical adenocarcinomas. Though it has been confused with adenoid cystic carcinoma, it is now distinctly recognized by better prognosis and different histologic and immunohistochemical findings. We have experienced a case of adenoid basal carcinoma associated with invasive squamous cell carcinoma of the uterine cervix in a 52-year-old woman. The tumor was composed of small, round to oval nests of basaloid cells with peripheral palisading. Some of the nests showed central cystic spaces, or cribriform pattern, and central squamous differentiation with cytological atypia. Invasive squamous cell carcinoma was located adjacent to the adenoid basal carcinoma without any transition between these two lesions. Immunohistochemically, the tumor cells disclosed positive staining for cytokeratin, but negative reaction for CEA, EMA, and S-100 protein.