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1.
Rev. chil. obstet. ginecol. (En línea) ; 87(1): 81-86, feb. 2022. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388714

ABSTRACT

INTRODUCCIÓN: Aproximadamente un 4% de mujeres embarazadas presentan tumoraciones anexiales en el primer trimestre de gestación, siendo la mayoría quistes anexiales simples. Solo el 1,5% persisten tras el primer trimestre y en torno al 0,9% son malignos. CASO CLÍNICO: Paciente de 31 años que consultó en urgencias por sangrado y amenorrea de 5 semanas. La ecografía transvaginal evidenció un saco gestacional intraútero y una tumoración anexial izquierda compleja de 68 mm, multilocular, sólida, de ecogenicidad mixta, con septos gruesos y un área sólida vascularizada de 40 mm, sospechosa de neoplasia de ovario. Se realizó manejo quirúrgico conservador mediante anexectomía bilateral laparoscópica en la octava semana de gestación. El diagnóstico fue de adenocarcinoma mucinoso infiltrante bien diferenciado en ovario derecho, coexistente con tumor mucinoso borderline en ovario izquierdo (etapa IC FIGO). El embarazo cursó con normalidad, a excepción de feto pequeño para la edad gestacional en la semana 39. Se finalizó la gestación en la semana 40 mediante parto vaginal. Debido al deseo de la paciente, la cirugía se realizó en el primer trimestre de embarazo en lugar de en el segundo como se recomienda. La cirugía se completó meses después del parto, con histerectomía y apendicectomía laparoscópica. DISCUSIÓN: El cáncer de ovario es el segundo tumor ginecológico más diagnosticado durante el embarazo. Suele diagnosticarse en el primer trimestre debido al cribado ecográfico gestacional. Ocurre en mujeres con baja paridad y en sus últimos años de edad reproductiva. Esto podría verse reflejado en un aumento de su incidencia debido al retraso de la edad materna al primer embarazo. Normalmente se diagnostica en etapa I, siendo entonces la supervivencia superior al 90% a los 5 años. En etapas iniciales en mujeres embarazadas, la laparoscopia es tan válida como la laparotomía.


INTRODUCTION: Approximately 4% of pregnant women present adnexal tumors in the first trimester of gestation, the majority being simple adnexal cysts. Only 1.5% persist after the first trimester and around 0.9% are malignant. CASE REPORT: 31-year-old patient who came to the emergency room because of spotting and 5-week amenorrhea. A transvaginal ultrasound revealed an intrauterine gestational sac and a 69 mm complex multiocular-solid left adnexal tumor, with thick septa and a solid vascularized area of 40 mm, with suspicion of ovarian neoplasia. Conservative surgical management was performed through laparoscopic bilateral salpingo-oophorectomy in eighth week of gestation. The diagnosis was a well-differentiated infiltrating mucinous adenocarcinoma in the right ovary, and a coexisting borderline mucinous tumor in the left ovary (FIGO stage IC). The pregnancy proceeded normally except for a small for gestational age fetus at week 39 and pregnancy was completed at week 40 by vaginal delivery. Due to the patients wishes, the surgery was performed in the 1st trimester of pregnancy instead in the 2nd as is recommended. Final surgery was completed after giving birth, with laparoscopic hysterectomy and appendectomy. DISCUSSION: Ovarian cancer is the second most diagnosed gynecological tumor during pregnancy. It is usually diagnosed during the first trimester with gestational ultrasound screening. It occurs in women with low parity and in their later years of reproductive age. This could be reflected in an increase in its incidence due to the delay in the age of first pregnancy. Normally it is diagnosed in stage I, when the survival rate is superior to 90% after 5 years. In early stages, laparoscopic surgery in pregnant women is as valid as laparotomy.


Subject(s)
Humans , Female , Pregnancy , Adult , Ovarian Neoplasms/surgery , Pregnancy Complications, Neoplastic , Adenocarcinoma, Mucinous/surgery , Neoplasms, Multiple Primary/surgery , Ovarian Neoplasms/pathology , Ovarian Neoplasms/diagnostic imaging , Pregnancy Trimester, First , Laparoscopy , Adenocarcinoma, Mucinous/pathology , Adenocarcinoma, Mucinous/diagnostic imaging , Hysterectomy/methods , Neoplasms, Multiple Primary/pathology
2.
Autops. Case Rep ; 11: e2021335, 2021. graf
Article in English | LILACS | ID: biblio-1345354

ABSTRACT

Mucinous adenocarcinoma of the appendix is a rare neoplasm with a low propensity for lymph node metastasis. The present case refers to an appendicular mucinous adenocarcinoma with inguinal lymph node metastasis. A 71-year-old woman underwent an appendectomy due to a clinical presentation of acute appendicitis. However, the histological examination of the surgical specimen revealed a mucinous adenocarcinoma of the appendix. After staging, the patient underwent a right hemicolectomy and was proposed for adjuvant chemotherapy. At the 3rd year of follow-up, inguinal lymphadenopathy was diagnosed, which biopsy confirmed inguinal node metastases from primary colorectal cancer, with areas of extracellular mucin. Restaging revealed liver and peritoneal metastasis, and the patient was proposed for palliative chemotherapy. Appendicular neoplasms, due to their rarity, represent a diagnostic and therapeutic challenge. This clinical case depicts an unusual metastasis pathway for an unusual neoplasm.


Subject(s)
Male , Female , Aged , Appendiceal Neoplasms/pathology , Adenocarcinoma, Mucinous/pathology , Lymphatic Metastasis/pathology , Appendectomy , Lymphadenopathy/complications
3.
Rev. bras. ginecol. obstet ; 42(2): 114-119, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1098851

ABSTRACT

Abstract Several factors trigger the development of genetic mutations that are responsible for causing a neoplasm. Medulloblastoma is a malignant and invasive cerebellar neoplasm, that affects children and young adults. Mucinous carcinoma is a special type of breast cancer. Being a special atypical subtype of invasive carcinoma, it most frequently affects women of advanced age and represents 1 to 7% of all breast cancers. The reported case aims to show the rarity of the occurrence of desmoplastic medulloblastoma and mammary mucinous carcinoma in a young patient in a short period of time, in different sites, without direct anatomical attachment and without occurrence of metastasis. Initially, this patient had a desmoplastic medulloblastoma and was treated with lumpectomy and radiotherapy. After 13 months, the patient was diagnosed with a mucinous breast carcinoma, underwent mastectomy, adjuvant chemotherapy and is currently undergoing endocrinotherapy. We conclude, based on the metachronous characteristic of the neoplasia and clinical characteristics, that the patient is likely to have Li-Fraumeni syndrome, an autosomal dominant disease with mutation of the TP53 gene, which is the the main involved. Because the patient does not present all the characteristics of the phenotype of the syndrome, she can thus be classified as having Li-Fraumeni variant or Li-Fraumeni-like syndrome.


Resumo Diversos fatores desencadeiam o desenvolvimento de mutações genéticas que são responsáveis por originar uma neoplasia. O meduloblastoma é uma neoplasia cerebelar maligna e invasiva que acomete crianças e adultos jovens. O carcinoma mucinoso é um tipo de câncer de mama especial por ser um subtipo atípico de carcinoma invasivo, que acomete com maior frequência mulheres de idade avançada e representa entre 1 a 7% do total de neoplasias mamárias. O caso relatado tem como objetivo mostrar a raridade da ocorrência do meduloblastoma desmoplásico e carcinoma mucinoso mamário em uma paciente jovem em um curto período de tempo, em diferentes sítios sem ligação anatômica direta e sem ocorrência de metástase. Inicialmente, esta paciente possuía um meduloblastoma desmoplásico e foi tratada com tumorectomia e radioterapia. Após 13 meses, a paciente foi diagnosticada com carcinoma mucinoso de mama, sendo submetida a mastectomia, quimioterapia adjuvante e atualmente está sendo tratada com endocrinoterapia. Concluímos, com base na característica metacrônica da neoplasia e características clínicas, que a paciente apresenta a síndrome de Li-Fraumeni, doença autossômica dominante com mutação do gene TP53, que é o principal gene envolvido nesta síndrome. Por não apresentar as características completas do fenótipo da síndrome, a paciente pode assim ser classificada como portadora de uma variante da síndorme de Li-Fraumeni ou síndrome do tipo Li-Fraumeni.


Subject(s)
Humans , Female , Adult , Li-Fraumeni Syndrome/diagnosis , Breast Neoplasms/diagnosis , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Magnetic Resonance Imaging , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/genetics , Cerebellar Neoplasms/pathology , Cerebellar Neoplasms/diagnostic imaging , Li-Fraumeni Syndrome/genetics , Combined Modality Therapy , Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Mucinous/genetics , Adenocarcinoma, Mucinous/pathology , Diagnosis, Differential , Medulloblastoma/diagnosis , Medulloblastoma/genetics , Medulloblastoma/pathology , Medulloblastoma/diagnostic imaging , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/genetics , Neoplasms, Multiple Primary/pathology
4.
Rev. gastroenterol. Perú ; 38(4): 370-373, oct.-dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1014111

ABSTRACT

Se presenta el caso de una paciente mujer de 53 años procedente de Piura con un tiempo de enfermedad de 20 meses, caracterizado por dolor en sitio de herida quirúrgica por colecistectomía abierta realizada hace 3 años, asociado a presencia de una masa en dicha zona, posteriormente se absceda y comienza a drenar secreción alimentaria. Los estudios de imágenes revelaron una masa dependiente de colon transverso en contacto con estómago y pared abdominal que presentaba fistulas hacia piel. Dicha masa fue extraída durante la cirugía con resultado anatomopatológico de adenocarcinoma mucinoso de colon. El caso representó un reto diagnóstico para el equipo médico y en vista de las diversas manifestaciones clínicas del cáncer de colon, sugerimos mantenerlo presente como diagnóstico diferencial en cuadros de absceso de pared abdominal y fistulizaciones entéricas.


We present the case of a 53-year-old woman with a time of illness of 20 months, characterized by pain at the site of surgical intervention for opened cholecystectomy 3 years ago, associated with a presence of a mass in said area, with the following abscess formation and fistulization of food content. Imaging studies revealed a mass dependent of the transverse colon, in contact with stomach and abdominal wall and presenting fistulas to the skin. Said mass was extracted during surgery with anatomopathological result of mucinous colon adenocarcinoma. The case represented a diagnostic challenge for the medical team and in view of the variaty of clinical manifestations of colonic cancer, we suggest that it should be consider as a differential diagnosis in cases of abdominal wall abscess and enteric fistulas.


Subject(s)
Female , Humans , Middle Aged , Stomach Neoplasms/pathology , Colonic Neoplasms/pathology , Adenocarcinoma, Mucinous/pathology , Abdominal Wall , Neoplasms, Multiple Primary/pathology , Stomach Neoplasms/surgery , Stomach Neoplasms/complications , Gastric Fistula/etiology , Intestinal Fistula/etiology , Colonic Neoplasms/surgery , Colonic Neoplasms/complications , Cutaneous Fistula/etiology , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/complications , Abdominal Abscess/etiology , Neoplasm Invasiveness , Neoplasms, Multiple Primary/surgery , Neoplasms, Multiple Primary/complications
5.
Rev. Assoc. Med. Bras. (1992) ; 64(2): 195-199, Feb. 2018. graf
Article in English | LILACS | ID: biblio-896435

ABSTRACT

Summary Introduction: Pseudomyxoma peritonei (PMP) is a rare clinical condition, with an incidence of 1-2 cases per million, characterized by the dissemination of mucinous implants on the peritoneal surface and progressive gelatinous ascites. Although it usually presents an indolent behavior, its non-specific clinical presentation contributes to many cases remaining undiagnosed until a laparotomy is performed. With late diagnosis, performed after a long period of clinical deterioration and disease progression, it is common to find complications such as the formation of intestinal fistulas and obstruction. Method: Review of the medical record and search for references in the Medline, Lilacs, SciELO and MD Consult databases. Results: There are rare case reports found in the literature demonstrating atypical PMP presentations. Our report is that of a 17-year-old adolescent with a sporadic tumor diagnosed in a primary site in the transverse colon, contrary to data commonly found in the literature that mention a more frequent occurrence in women in the fifth decade of life and with a primary site in the ovary and appendix. The development of mucinous adenocarcinoma is rare in the pediatric population, and topography in the transverse colon and non-familial sporadic pattern are unusual. Conclusion: The case reported not only raises awareness about the atypical presentations of the disease, but also emphasizes the use of imaging examinations for diagnosis, which has an important impact on prognosis and survival if performed timely.


Resumo Introdução: O pseudomixoma peritoneal (PMP) é uma condição clinica rara, com incidência de 1-2 casos por milhão, caracterizada pela disseminação de implantes de natureza mucinosa pela superfície peritoneal e acúmulo progressivo de ascite gelatinosa. Embora apresente geralmente um comportamento indolente, a apresentação clínica inespecífica contribui para que muitos casos permaneçam sem diagnóstico até a realização de laparotomia. Com o diagnóstico tardio, realizado após um longo período de deterioração clínica e progressão de doença, é comum encontrar complicações, como a formação de fístulas e obstruções intestinais. Método: Revisão do prontuário médico e pesquisa bibliográfica nas bases de dados Medline, Lilacs, SciELO e MD Consult. Resultados: São raros os relatos de caso encontrados na literatura que demonstram apresentações atípicas do PMP. O presente estudo apresenta o caso de um adolescente com 17 anos ao diagnóstico e sítio primário no colón transverso com tumor esporádico, contrário aos dados comumente encontrados na literatura, que referem acometimento mais comum em mulheres na quinta década de vida e com sítio primário em ovário e apêndice. O desenvolvimento de adenocarcinoma mucinoso é raro na população pediátrica e a topografia no cólon transverso e padrão esporádico não familial também são pouco usuais. Conclusão: O caso relatado alerta para as apresentações atípicas da doença e enfatiza o uso de exames de imagem para o diagnóstico, que, se realizado precocemente, impacta de maneira importante o prognóstico e a sobrevida.


Subject(s)
Humans , Male , Adolescent , Peritoneal Neoplasms/diagnostic imaging , Pseudomyxoma Peritonei/diagnostic imaging , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/therapy , Pseudomyxoma Peritonei/pathology , Pseudomyxoma Peritonei/therapy , Magnetic Resonance Imaging , Tomography , Fatal Outcome , Adenocarcinoma, Mucinous/pathology , Colon, Transverse/pathology
6.
Gut and Liver ; : 685-688, 2015.
Article in English | WPRIM | ID: wpr-216099

ABSTRACT

Cases of pancreatic ductal adenocarcinoma with multiple masses accompanying underlying pancreatic diseases, such as intraductal papillary mucinous neoplasm, have been reported. However, synchronous invasion without underlying pancreatic disease is very rare. A 61-year-old female with abdominal discomfort and jaundice was admitted to our hospital. Abdominal computed tomography (CT) revealed cancer of the pancreatic head with direct invasion of the duodenal loop and common bile duct. However, positron emission tomography-CT showed an increased standardized uptake value (SUV) in the pancreatic head and tail. We performed endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for the histopathologic diagnosis of the pancreatic head and the evaluation of the increased SUV in the tail portion of the pancreas, as the characteristics of these lesions could affect the extent of surgery. As a result, pancreatic ductal adenocarcinomas were confirmed by both cytologic and histologic analyses. In addition, immunohistochemical analysis of the biopsy specimens was positive for carcinoembryonic antigen and p53 in both masses. The two masses were ultimately diagnosed as pancreatic ductal adenocarcinoma, stage IIB, based on EUS-FNB and imaging studies. In conclusion, the entire pancreas must be evaluated in a patient with a pancreatic mass to detect the rare but possible presence of synchronous pancreatic ductal adenocarcinoma. Additionally, EUS-FNB can provide pathologic confirmation in a single procedure.


Subject(s)
Adenocarcinoma, Mucinous/pathology , Carcinoma, Pancreatic Ductal/pathology , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Female , Humans , Middle Aged , Neoplasms, Multiple Primary/pathology , Pancreas/pathology , Pancreatic Neoplasms/pathology
7.
Article in English | WPRIM | ID: wpr-50480

ABSTRACT

Pulmonary tumor embolism is commonly discovered at autopsy, but is rarely suspected ante-mortem. Microangiopathy is an uncommon and distinct form of simple tumor pulmonary embolism. Here, we present a 52-year-old male with tumor thrombotic microangiopathy and pulmonary infarction, which might have originated from intraductal papillary mucinous tumor of the pancreas. Multiple wedge-shaped consolidations were found initially and aggravated with cavitation. These CT features of pulmonary infarction were pathologically confirmed to result from pulmonary tumor thrombotic microangiopathy.


Subject(s)
Adenocarcinoma, Mucinous/pathology , Humans , Lung/pathology , Lung Neoplasms/pathology , Male , Middle Aged , Pancreas/pathology , Pancreatic Neoplasms/complications , Papilloma, Intraductal/pathology , Pulmonary Embolism/pathology , Pulmonary Infarction/pathology , Thrombotic Microangiopathies/diagnosis , Tomography, X-Ray Computed
8.
Clinics ; 69(10): 660-665, 10/2014. tab, graf
Article in English | LILACS | ID: lil-730460

ABSTRACT

OBJECTIVE: Ovarian mucinous metastases commonly present as the first sign of the disease and are capable of simulating primary tumors. Our aim was to investigate the role of intratumoral lymphatic vascular density together with other surgical-pathological features in distinguishing primary from secondary mucinous ovarian tumors. METHODS: A total of 124 cases of mucinous tumors in the ovary (63 primary and 61 metastatic) were compared according to their clinicopathological features and immunohistochemical profiles. The intratumoral lymphatic vascular density was quantified by counting the number of vessels stained by the D2-40 antibody. RESULTS: Metastases occurred in older patients and were associated with a higher proportion of tumors smaller than 10.0 cm; bilaterality; extensive necrosis; extraovarian extension; increased expression of cytokeratin 20, CDX2, CA19.9 and MUC2; and decreased expression of cytokeratin 7, CA125 and MUC5AC. The lymphatic vascular density was increased among primary tumors. However, after multivariate analysis, the best predictors of a secondary tumor were a size of 10.0 cm or less, bilaterality and cytokeratin 7 negativity. Lack of MUC2 expression was an important factor excluding metastasis. CONCLUSIONS: The higher intratumoral lymphatic vascular density in primary tumors when compared with secondary lesions suggests differences in the microenvironment. However, considering the differential diagnosis, the best discriminator of a secondary tumor is the combination of tumor size, laterality and the pattern of expression of cytokeratin 7 and MUC2. .


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Adenocarcinoma, Mucinous/pathology , Adenocarcinoma, Mucinous/secondary , Lymphatic Vessels/pathology , Ovarian Neoplasms/pathology , Adenocarcinoma, Mucinous/chemistry , /analysis , Diagnosis, Differential , Immunohistochemistry , Keratins/analysis , Lymphatic Metastasis , Lymphatic Vessels/chemistry , Membrane Glycoproteins/analysis , Membrane Proteins/analysis , Mucins/analysis , Ovarian Neoplasms/chemistry , Reference Values , Tissue Array Analysis , Tumor Burden , Biomarkers, Tumor/analysis
9.
Rev. argent. coloproctología ; 25(2): 77-79, Jun. 2014. ilus
Article in Spanish | LILACS | ID: biblio-908235

ABSTRACT

Objetivo: presentar un caso de una patología de muy baja incidencia y realizar una revisión bibliográfica de la misma. Paciente y método: paciente femenina de 87 años de edad que ingresa por guardia por cuadro compatible con hernia inguinal atascada, por lo que se decide cirugía de urgencia. En el acto operatorio se identifica un saco herniario de paredes engrosadas, con contenido intestinal con buena vitalidad, sin signos de necrosis, identificando además abundante secreción mucinosa en el saco herniario y proveniente de la cavidad abdominal. Se decide terminar con la hernioplastia y realizar estudios complementarios diferidos. Luego de los mismos, el comité de tumores decide la realización de nueva cirugía (hemicolectomía derecha con ileotransverso anastomosis por tumor mucinoso de apéndice), durante la cual se constata ascitis gelatinosa. La paciente evoluciona favorablemente y es dada de alta a las 72 horas del post operatorio. La anatomía patológica informa adenocarcinoma mucinoso de apéndice bien diferenciado. Discusión: el Pseudomixoma Peritoneal es una entidad muy poco frecuente, que hace referencia a la diseminación peritoneal de un tumor cuyas células producen gran cantidad de mucina. La supervivencia global de los pacientes es de aproximadamente 75 y 68% durante 5 y 10 años. La clasificación más aceptada es la de Ronnet. Tradicionalmente, el tratamiento ha sido la cirugía de citoreducción, aunque hay autores que proponen procedimientos más agresivos como la peritonectomía más quimioterapia hipertérmica intraoperatoria.


Objective: to present a case of a very low incidence disease and a bibliographic review of it. Patient and method: 87 years old female patient with a compatible history and physical exam for a stuck inguinal hernia, for which we decided to perform emergency surgery. During the surgical procedure, we find a thickened hernia sac, with mucus in it and in the abdominal cavity. The small intestine was vital and not complicated. We finished the hernioplasty, and decided to perform complementary ambulatory studies to the patient. After having them done, we decided, in an interdisciplinary committee, to perform an exploratory surgery, (hemicolectomy with ileum transverse anastomosis for an appendix tumor), during which gelatinous ascites was noticed. The patient evolve favorably and was discharged 72 hours post operation. The surgical biopsy informed an appendix mucinous adenocarcinoma well differentiated. Discussion: the peritoneal pseudomyxoma is a very infrequent entity. The overall survival is 75 and 68% for 5 and 10 years, respectively. Ronnet had published the most accepted histological classification. The accepted treatment is the cytoreductive surgery, although some authors proposed a more aggressive treatment such peritonectomy with hyerthermic intraperitoneal chemotherapy.


Subject(s)
Female , Humans , Aged, 80 and over , Adenocarcinoma, Mucinous/pathology , Adenocarcinoma, Mucinous/surgery , Hernia, Inguinal/surgery , Pseudomyxoma Peritonei/mortality , Pseudomyxoma Peritonei/surgery , Postoperative Care , Sphincterotomy, Endoscopic/methods
10.
Biol. Res ; 47: 1-5, 2014. ilus, tab
Article in English | LILACS | ID: biblio-950739

ABSTRACT

BACKGROUND: Pure mucinous adenocarcinoma of the breast is a rare entity characterized by the production of variable amounts of mucin comprising 1% to 6% of breast carcinomas. Some mucinous adenocarcinomas have shown expression of intestinal differentiation markers such as MUC-2. This study examines the expression of intestinal differentiation markers in this type of breast carcinoma. RESULTS: Twenty-two cases of pure mucinous adenocarcinoma of the breast were assessed. Immunochemistry was performed for beta-catenin, CDX-2 and MUC-2. All cases were positive for B-catenin. MUC-2 positivity was observed in all cases; 63. 6% were 3 plus positive. All cases were negative for CDX-2. CONCLUSIONS: These results suggest that mucinous breast carcinomas express some markers of intestinal differentiation, such as MUC-2 and beta-catenin; however, future studies with a larger series of cases and using molecular techniques that help affirm these results are needed.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Breast Neoplasms/chemistry , Biomarkers, Tumor/analysis , Trans-Activators , Adenocarcinoma, Mucinous/chemistry , Homeodomain Proteins/analysis , beta Catenin/analysis , Mucin-2/analysis , Intestinal Mucosa/chemistry , Breast Neoplasms/pathology , Immunohistochemistry , Antigens, Differentiation/analysis , Retrospective Studies , Adenocarcinoma, Mucinous/pathology , CDX2 Transcription Factor
11.
Gut and Liver ; : 13-23, 2014.
Article in English | WPRIM | ID: wpr-208927

ABSTRACT

BACKGROUND/AIMS: A single gene mutation alone cannot explain the poor prognosis of colorectal cancer. This study aimed to establish a correlation between the expression of six proteins and the prognosis of colorectal cancer patients. METHODS: Tissue samples were collected from 266 patients who underwent surgery for colorectal cancer at our institution from January 2006 to December 2007. The expression of six proteins were determined using immunohistochemical staining of specimens. RESULTS: Cathepsin D, p53, COX-2, epidermal growth factor receptor, c-erbB-2, and Ki-67 expression were detected in 38.7%, 60.9%, 37.6%, 35.7%, 30.1%, and 74.4% of the samples, respectively. The expression of cathepsin D was significantly correlated with reduced cancer-free survival (p=0.036) and colorectal cancer-specific survival (p=0.003), but the other expression levels were not. In a multivariate analysis, cathepsin D expression was found to be an independent prognostic factor for poorer colorectal cancer-specific survival (hazard ratio, 8.55; 95% confidence interval, 1.07 to 68.49). Furthermore, patients with tumors expressing four or more of the proteins had a significantly decreased cancer-free survival rate (p=0.006) and colorectal cancer-specific survival rate (p=0.002). CONCLUSIONS: Patients with cathepsin D positivity had a poorer outcome than patients who were cathepsin D-negative. Thus, cathepsin D may provide an indicator for appropriate intensive follow-up and adjuvant chemotherapy.


Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma, Mucinous/pathology , Adult , Aged , Cathepsin D/analysis , Colorectal Neoplasms/pathology , Cyclooxygenase 2/analysis , Female , Humans , Ki-67 Antigen/analysis , Male , Middle Aged , Prognosis , ErbB Receptors/analysis , Receptor, ErbB-2/analysis , Survival Analysis , Biomarkers, Tumor/analysis , Tumor Suppressor Protein p53/analysis
12.
Korean Journal of Urology ; : 690-692, 2014.
Article in English | WPRIM | ID: wpr-192658

ABSTRACT

Renal cell carcinoma (RCC) with mucin production is extremely rare. We present the case of a previously healthy 76-year-old woman who underwent a robotic-assisted laparoscopic right nephrectomy for a 5-cm heterogeneously enhancing right renal mass. Pathology revealed mucin-producing epithelial RCC. We discuss the presentation and pathological features of this case and comment on its definitive treatment.


Subject(s)
Adenocarcinoma, Mucinous/pathology , Aged , Carcinoma, Renal Cell/pathology , Female , Humans , Kidney Neoplasms/pathology , Nephrectomy/methods , Robotic Surgical Procedures/methods , Tomography, X-Ray Computed
13.
Rev. chil. dermatol ; 29(3): 274-276, 2013. ilus
Article in Spanish | LILACS | ID: biblio-997813

ABSTRACT

El carcinoma mucinoso ecrino primario de la piel es infrecuente, existen cerca de 100 casos publicados en la literatura. Fue descrito por primera vez por Lennox y colaboradores el año 1952. Presentamos un caso de carcinoma mucinoso ecrino primario de la piel, en un hombre de 82 años de edad, quien consultó por una masa cutánea retroauricular de 10 años de evolución, sin evidencias de enfermedad sistémica ni recurrencia local al año del control postoperatorio


The primary mucinous eccrine carcinoma of skin is infrequent, nearby 100 cases are published in the literature. It was described by the first time by Lennox and cols. at 1952. We present a case of primarily mucinous eccrine carcinoma of the skin, in an 82 year old man, who consulted for a retroauricular cutaneous mass of 10 years of evolution, without evidences of systemic disease or local recurrence at the year of the after surgery.


Subject(s)
Humans , Male , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Mucinous/pathology , Skin Neoplasms/surgery , Adenocarcinoma, Mucinous/surgery , Diagnosis, Differential
14.
Rev. chil. cir ; 64(3): 289-291, jun. 2012.
Article in Spanish | LILACS | ID: lil-627113

ABSTRACT

We report a 73 years old woman presenting with a right ovarian tumor. Preoperative carcinoembryonic antigen and CA-125 levels were above normal levels. The patient was operated, performing a bilateral oopho-rectomy an appendectomy. The pathological study of the surgical piece reported a mucinous ovarian cystic adenocarcinoma that infiltrated the wall but did not reach the capsule. A mucinous cystadenoma was found in the contralateral ovary. A mucinous adenocarcinoma was detected in the appendix, involving the wall but sparing the serosa. The patient was subjected to chemotherapy and six months after the first operation a tumor relapse was detected. A new excision was carried out and the patient continues with adjuvant chemotherapy. The ovarian an appendiceal tumors could be synchronic or a primary and secondary localization.


Introducción: El cistoadenocarcinoma de apéndice es una neoplasia poco frecuente. La asociación de tumores apendiculares y ováricos es conocida cuando existe pseudomixoma peritoneal. Sin embargo, la relación de la patogénesis entre los tumores es todavía desconocida. Caso clínico: Mujer de 73 años con clínica de plenitud postprandial y dispepsia de un año de evolución. La RMN abdómino-pélvica demuestra una gran tumoración de 15x13x9 cm, politabicada, con origen en ovario derecho. Presenta un CEA preoperatorio de 50 y un CA-125 de 30. Se realizó laparotomía infraumbilical con anexectomía bilateral y apendicectomía. El resultado anátomo-patológico informa de cistoadenocarcinoma mucinoso de ovario bien diferenciado que infiltra casi toda la pared, abierta, sin alcanzar la cápsula ovárica; el ovario contralateral presenta un cistoade-noma mucinoso; el apéndice cecal presenta adenocarcinoma mucinoso bien diferenciado, con infiltración de casi toda la pared, respetando la serosa. Discusión: Presentamos el caso de una tumoración pélvica con diagnóstico anátomo-patológico de cistoadenocarcinoma mucinoso de ovario. Asimismo se demuestra afectación de apéndice cecal por adenocarcinoma mucinoso. Nos planteamos, por tanto, la posibilidad de que se trate de una infiltración metastásica o dos tumores sincrónicos. Revisamos el concepto de cistoadenocarcinoma apendicular y ovárico, y analizamos los posibles mecanismos de asociación entre ellos. Conclusión: Destacamos la necesidad de una exhaustiva revisión de la cavidad abdominal ante este tipo de patología, dada su asociación con otros procesos neoplásicos intraabdominales.


Subject(s)
Humans , Female , Aged , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/pathology , Ovarian Neoplasms/surgery , Ovarian Neoplasms/pathology , Appendiceal Neoplasms/surgery , Appendiceal Neoplasms/pathology , Appendectomy , Neoplasm Metastasis , Neoplasms, Multiple Primary , Pseudomyxoma Peritonei
15.
KMJ-Kuwait Medical Journal. 2012; 44 (1): 56-59
in English | IMEMR | ID: emr-118248

ABSTRACT

The incidence of lung cancer continues to rise among young females. The pulmonary mucinous cystic tumor is very rare with few reported cases and it is an uncommon histological type of primary lung adenocarcinoma. The cystic nature of this type of carcinoma makes it unique radiologically. We report a very rare case of bilateral diffuse mucinous cystic adenocarcinoma of the lungs in a young pregnant woman


Subject(s)
Humans , Female , Adult , Adenocarcinoma, Mucinous/pathology , Lung Neoplasms/pathology , Lung Neoplasms/complications , Pneumothorax/etiology
16.
Yonsei Medical Journal ; : 106-110, 2012.
Article in English | WPRIM | ID: wpr-95037

ABSTRACT

PURPOSE: Accurate indications and the extent of surgery for branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debatable. In particular, small tumor is located at the head portion of pancreas presents a dilemma. The purpose of this study is to compare the efficacy of enucleation (EN) with that of pancreaticoduodenectomy (PD) in patients with small (2 cm

Subject(s)
Adenocarcinoma, Mucinous/pathology , Aged , Carcinoma, Pancreatic Ductal/pathology , Carcinoma, Papillary/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pancreatectomy/methods , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy/methods , Retrospective Studies , Treatment Outcome
17.
Rev. cuba. cir ; 50(4): 576-583, oct.-dic. 2011.
Article in Spanish | LILACS | ID: lil-614991

ABSTRACT

Se presenta una paciente femenina de 29 años, operada de urgencia por presentar un gran tumor que incluía cuerpo gástrico y colon trasverso, con una perforación gástrica. Se realizó una gastrectomía subtotal con colectomía trasversa en bloque que incluyó el epiplón mayor. El diagnóstico histológico fue adenocarcinoma túbulo papilar mucoproductor de origen colónico, que infiltra hasta la serosa y pared gástrica. Se realizó tratamiento adyuvante con poliquimioterapia. Diez meses después presenta un tumor en hipogastrio, que al tacto vaginal, correspondía a los órganos genitales, sospecha clínica que confirman el ultrasonido abdominal y la tomografía axial computarizada. El hallazgo transoperatorio fueron tumores voluminosos de ambos ovarios, y otro tumor que afectaba la unión rectosigmoide. Se realizó una histerectomía radical con ooforectomía bilateral y sigmoidectomía, se reseca la porción proximal del recto, y se cierra tipo Hartman. El diagnóstico histológico final fue metástasis en serosa uterina e intestinal, y en ambos ovarios de adenocarcinoma mucoproductor, túbulo papilar de intestino previamente diagnosticado (tumor de Krukenberg). Se complementó el tratamiento con poliquimioterapia adyuvante(AU)


This is the case of a woman aged 29 operated on of emergency due to a tumor involving gastric body and transverse colon with gastric perforation. A subtotal gastrectomy with block transverse colectomy including the greater omentum was carried out. The histological diagnosis was a mucoproducing papillary tubular adenocarcinoma of colonic origin infiltrating to serosa and gastric wall. An adjuvant treatment was applied with poly-chemotherapy. Ten months later appears a hypogastric tumor which at vaginal manual examination corresponding to genital organs, clinical suspicion confirmed by abdominal ultrasound and computerized axial tomography. The transoperative findings were bulky tumors of both ovaries and another tumor involving the rectosigmoid joint. A radical hysterectomy with bilateral oophorectomy and sigmoidectomy was carried out with resection of proximal rectal portion with type Hartman closure. The final histological diagnosis was a metastasis in uterine and intestinal serosa and in both ovaries a mucoproducing adenocarcinoma, previous papillary tubule was also diagnosed (Krukenberg's tumor). Treatment was applied using adjuvant poly-chemotherapy(AU)


Subject(s)
Humans , Female , Adult , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/pathology , Adenocarcinoma, Mucinous/secondary , Ovarian Neoplasms/surgery , Ovarian Neoplasms/secondary , Krukenberg Tumor/surgery
18.
Article in English | WPRIM | ID: wpr-188469

ABSTRACT

Prediction of malignancy or invasiveness of branch duct type intraductal papillary mucinous neoplasm (Br-IPMN) is difficult, and proper treatment strategy has not been well established. The authors investigated the characteristics of Br-IPMN and explored its malignancy or invasiveness predicting factors to suggest a scoring formula for predicting pathologic results. From 1994 to 2008, 237 patients who were diagnosed as Br-IPMN at 11 tertiary referral centers in Korea were retrospectively reviewed. The patients' mean age was 63.1 +/- 9.2 yr. One hundred ninty-eight (83.5%) patients had nonmalignant IPMN (81 adenoma, 117 borderline atypia), and 39 (16.5%) had malignant IPMN (13 carcinoma in situ, 26 invasive carcinoma). Cyst size and mural nodule were malignancy determining factors by multivariate analysis. Elevated CEA, cyst size and mural nodule were factors determining invasiveness by multivariate analysis. Using the regression coefficient for significant predictors on multivariate analysis, we constructed a malignancy-predicting scoring formula: 22.4 (mural nodule [0 or 1]) + 0.5 (cyst size [mm]). In invasive IPMN, the formula was expressed as invasiveness-predicting score = 36.6 (mural nodule [0 or 1]) + 32.2 (elevated serum CEA [0 or 1]) + 0.6 (cyst size [mm]). Here we present a scoring formula for prediction of malignancy or invasiveness of Br-IPMN which can be used to determine a proper treatment strategy.


Subject(s)
Adenocarcinoma, Mucinous/pathology , Adult , Aged , Aged, 80 and over , Carcinoembryonic Antigen/blood , Carcinoma, Pancreatic Ductal/pathology , Carcinoma, Papillary/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multivariate Analysis , Neoplasm Invasiveness , Neoplasm Staging , Pancreatic Neoplasms/pathology , Predictive Value of Tests , ROC Curve , Tomography, X-Ray Computed
19.
J. bras. patol. med. lab ; 46(2): 99-104, abr. 2010. ilus, tab
Article in Portuguese | LILACS | ID: lil-552253

ABSTRACT

A biópsia por agulha grossa (BAG), ou core biopsy, é uma técnica utilizada para retirar pequenos cilindros de tecido mamário. Além de lesões palpáveis, o desenvolvimento de técnicas radiológicas acuradas de localização de lesões mamárias difundiu o uso da BAG como primeira abordagem histológica de lesões não palpáveis. O diagnóstico diferencial do carcinoma mucinoso com lesões mucinosas benignas por BAG pode ser desafiador, principalmente se a lesão apresentar extravasamento de mucina. A acurácia do diagnóstico nesses casos é de extrema relevância para determinar o tipo de procedimento a ser realizado e o tratamento a ser seguido. Este estudo traz revisão e atualização da literatura sobre carcinoma mucinoso invasor da mama e seus diagnósticos diferenciais, com ênfase nos desafios para diagnóstico por intermédio da BAG. Entre os diagnósticos diferenciais estão alterações fibrocísticas com mucina luminal, lesões mucinosas papilares e mucocele-símile (que variam desde as benignas até aquelas associadas a hiperplasia ductal atípica e carcinoma ductal in situ). Alterações mucinosas também podem ser encontradas em uma variedade de lesões, como fibroadenoma e tumor phyllodes, adenoma pleomórfico e mucinose nodular. Conclui-se que a BAG é uma técnica confiável para diagnóstico de carcinoma mucinoso da mama e seus diagnósticos diferenciais, porém, em casos de dúvida ou de escassez de material, é prudente realizar biópsia excisional para melhor esclarecimento do diagnóstico.


The needle core biopsy is a technique applied to remove small cylinders of breast tissue. The development of accurate radiological techniques for location of breast lesions has spread the use of core biopsy as the first histological approach to non-palpable lesions. The differential diagnosis of mucinous carcinoma and benign mucinous lesions by core biopsy may be challenging, mainly when the lesion shows mucin extravasation. The accuracy of diagnosis in these cases is extremely important to determine the type of procedure to be performed, as well as the treatment choice. This study shows a review and an update of the literature as to invasive mucinous carcinoma of the breast and its differential diagnosis, with emphasis on the challenges of diagnosis by core biopsy. Among the differential diagnoses are fibrocystic changes with luminal mucin, mucinous papillary lesions, mucocele-like lesions that range from benign to those associated with atypical ductal hyperplasia and ductal carcinoma in situ. Mucinous changes may also be found in a variety of lesions such as fibroadenoma, phyllodes tumor, pleomorphic adenoma and nodular mucinosis. In conclusion, core biopsy is a reliable technique for the diagnosis of mucinous carcinoma of the breast and its differential diagnosis, however, in doubtful cases or when the sample is scarce, it is advisable to perform an excisional biopsy to clarify the diagnosis.


Subject(s)
Humans , Adenocarcinoma, Mucinous/diagnosis , Biopsy, Needle/methods , Breast Neoplasms/diagnosis , Adenocarcinoma, Mucinous/pathology , Diagnosis, Differential , Breast Neoplasms/pathology
20.
Rev. venez. oncol ; 21(2): 92-98, abr.-jun. 2009. ilus
Article in Spanish | LILACS | ID: lil-549465

ABSTRACT

Los tumores testiculares y paratesticulares del tipo epiteliales son raros. Existe poca preferencia en la literatura de la variedad mucinosa. Se plantea controversia en la histogénesis debido a su asociación con teratomas, y establecer origen germinal. Se presenta el caso de paciente masculino de 38 años con clínica de dolor lumbar, masa abdominal palpable, aumento de volumen testicular izquierdo de 2 años de evolución. Se le practicó orquidectomía izquierda con hallazgo de tumor quístico de 7 cm x 6 cm x 3,5 cm, de contenido mucoide; se reportó como tumor mucinoso de bajo grado de malignidad para testicular (limítrofe). En vista de síntomas abdominales compresivos, se realiza laparotomía exploradora, encontrándose tumor lobulado de 21 cm x 19 cm x 12 cm en el retroperitoneo, que correspondió a carcinoma mucinoso variedad intestinal desarrollado en teratoma quístico maduro. Se concluyó que ambos tumores no guardaban relación entre sí, se consideraron sincrónicos.


Testicular and par testicular tumors of type epithelial are rare. There is little reference in literature of mucinous variety; the vast majorities are serous. In this article we discussed the case of 38 year old male who presented with a two year history of left low quadrant pain, abdominal mass and enlarged left testicle. Left orchiectomy was performed finding a mucoid cystic tumor, measuring 7 cm x 6 cm x 3.5 cm which was reported as a low grade malignancy par testicular mucinous (tumor Borderline). Consequently, since compressive symptoms persisted,the patient underwent exploratory laparotomy. A lobular tumor measuring 21 cm x 19 cm x 12 cm was found in the retroperitoneum. It corresponded to mucinous carcinoma of the intestinal variety within a mature cystic teratoma. Based on these findings and after reviewing the literature it was concluded that both tumors were independent from each other, considering them synchronous tumors.


Subject(s)
Humans , Male , Adult , Pain/diagnosis , Testicular Neoplasms/surgery , Testicular Neoplasms/pathology , Orchiectomy/methods , Adenocarcinoma, Mucinous/pathology , Low Back Pain/diagnosis , Medical Oncology , Palpation/methods
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