ABSTRACT
Angiomyolipomas (AML) are mesenchymal tumors belonging to the group of perivascular epithelioid cell tumors, which, rarely, can display a malignant behavior. They are composed of adipose tissue, vessels, and muscle tissue in different proportions, and constitute a differential diagnosis for other focal liver lesions. We report a 34-year-old woman in whom a focal hepatic lesion was discovered incidentally. The pathology report of an ultrasound guided biopsy informed an epithelioid angiomyolipoma, a rare variant of these lesions. During ten years of imaging follow, the size and features of the lesion has not changed. The patient rejected a surgical excision.
Subject(s)
Humans , Female , Adult , Angiomyolipoma/surgery , Angiomyolipoma/diagnostic imaging , Liver Neoplasms/surgery , Liver Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
Abstract Background: Ewing's Sarcoma (ES) is the second most common type of bone cancer, with an annual incidence of 2.9:100,000. Extraosseous cases represent 15%; however, there are no reported cases of ES located in the intestine in the pediatric population. Case report: We describe the case of a 14-year-old male patient, previously healthy, who started with an anemic syndrome, weight loss, and diaphoresis of 8 weeks of evolution. After visiting a physician, who documented the presence of anemia, the patient was referred to the National Institute of Pediatrics. Physical examination showed grade III-IV systolic murmur, splenomegaly, and pain in the left hemiabdomen with no irradiation. Computed axial tomography showed a mass-dependent on the peritoneum and intestinal loop. A biopsy of the lesion showed intestinal ES. The lesion was completely resected, and the patient was treated with chemotherapy and radiotherapy. Thirty months after diagnosis, the patient has no evidence of tumor activity. Conclusions: Extraosseous presentation of ES in pediatric age is rare. There are no reports of intestinal ES in the Latin American pediatric population, although eight case reports were found in adults. ES is curable by a combination of chemotherapy, radiotherapy, and surgery. The medical literature indicates that the extraosseous presentation should receive the same treatment as the osseous presentation, which can provide a survival rate of up to 70% if there is no evidence of metastasis (which most frequently is observed in the lung).
Resumen Introducción: El sarcoma de Ewing (SE) es el segundo tipo cáncer más común de hueso, cuya incidencia anual es de 2.9:100,000. Los casos extraóseos representan el 15%; sin embargo, no existen reportes en la literatura de casos de SE ubicados en el intestino en la población pediátrica. Caso clínico: Se describe el caso de un paciente de sexo masculino de 14 años, previamente sano, que inició con síndrome anémico, pérdida de peso y diaforesis de 8 semanas de evolución. Acudió con un médico, quien documentó la presencia de anemia y lo refirió al Instituto Nacional de Pediatría. A la exploración física presentaba soplo sistólico grado III-IV, esplenomegalia y dolor en hemiabdomen izquierdo sin irradiaciones. La tomografía axial computarizada mostró una masa dependiente del peritoneo y asa intestinal. La biopsia de la lesión reportó SE intestinal. Se resecó por completo la lesión y el paciente recibió tratamiento con quimioterapia y radioterapia. Después de 30 meses del diagnóstico, el paciente se encuentra sin datos de actividad tumoral. Conclusiones: La presentación extraósea del SE en edad pediátrica es rara. No existen reportes de presentación de SE intestinal en la población pediátrica latinoamericana, aunque se encontraron ocho reportes de caso en adultos. El SE es curable mediante la combinación de quimioterapia, radioterapia y cirugía. La literatura médica indica que la presentación extraósea debe recibir el mismo tratamiento que la ósea, lo cual puede proporcionar una sobrevida de hasta el 70% si no hay evidencia de metástasis (que ocurre más frecuentemente a pulmón).
ABSTRACT
Teratoma is a germ cell tumor seen mainly in neonates and young adults; it contains elements derived from all three germinal layers, with its usual site of occurrence being the ovary and testis and less common sites being several extragonadal locations. This case is of a 10-year-old boy who presented with an asymptomatic mass, heterogenous on ultrasonography and showing enhanced solid areas along with nonenhancing cystic areas on contrast enhanced computed tomography. Cytological diagnosis of malignant mesenchymal tumor was made; however, exact categorization could not be done. After surgical excision, histological and immunohistochemical studies yielded the diagnosis of immature teratoma with somatic malignancy – sarcoma. Teratomas with malignant transformation refer to a form of germ cell tumor in which a somatic teratomatous component becomes morphologically malignant and develops aggressively. These are associated with chromosomal abnormalities i (12p) reflecting germ cell tumor clonality. The occurrence of an identifiable sarcomatous component is a well recognized but distinctly uncommon phenomenon.
ABSTRACT
Hemangiopericytoma is an uncommon mesenchymal tumor that may be benign or malignant. This tumor is composed of proliferating capillaries and spindle-shaped cells known as the pericytes of Zimmermann. Since all capillaries have pericytes, hemangiopericytoma can be found anywhere In the body. We report a case of malignant hemangiopericytoma in the pelvic cavity which was treated by radical excision and adjutant radiotherapy and discuss the clinicopathological feature, prognosis, and therapy of this lesson.