RESUMEN
Multilocular cystic renal cell carcinoma is a rare subtype of renal cell carcinoma with multiple variable sized, non-communicating fluid-filled cystic spaces. It is often very difficult to differentiate multilocular cystic renal cell carcinoma from non-neoplastic, and other malignant neoplastic mass clinically and radiologically. The tumor is usually shown in low grade and low stage. Surgical treatment results in good prognosis. We report a case of multilocular cystic renal cell carcinoma which was presumptively diagnosed preoperatively, confirmed intraoperatively by frozen section examination of tissue, and treated with wedge resection in a 43-year-old man.
Asunto(s)
Adulto , Humanos , Carcinoma de Células Renales , Secciones por Congelación , Riñón , PronósticoRESUMEN
PURPOSE: Although the conventional clinical, histopathological, and moleculobiological factors of bladder tumor provide a certain degree of stratification of tumor biological potential, it is difficult to make an accurate and reliable prediction of tumor recurrence with known prognostic factors due to tumor heterogeneity. So we attempted to devise a scoring system reflecting various prognostic factors to predict tumor recurrence more accurately in superficial bladder carcinoma. MATERIALS AND METHODS: We reviewed retrospectively the clinical records and pathological specimens of 46 patients with superficial bladder cancer, who underwent transurethral resection of bladder tumor and intravesical Bacillus Calmette-Guerin (BCG) instillation between September, 1991 and December, 1996. The mean follow-up was 29 months. We examined the prognostic parameters such as tumor stage, grade, tumor with or without CIS, size, number, p53 expression and investigated the relation between the prognostic factors and the tumor recurrence. We assigned 1 and 2 for Ta and T1; 1 and 2 for tumor size( or =3cm); 1 and 2 for tumor number( or =3); 1, 2 and 3 for grades( I, II and III); 2 if CIS is found and 1 if not; 2 if p53 is expressed more than 20%(strong positive) and 1 if p53 is not expressed or less than 20%(weakly positive). We summed the points assigned to all categories for each patient, and investigated tumor recurrence according to total points by the scoring system. We corrected the scoring system by deleting the insignificant prognostic factors in this study which was named the corrected scoring system. We recounted the points based on it. RESULTS: Tumor recurred in 15 out of 46 patients(32.6%). Recurrence rate in patients with p53(strong positive) and with p53(weakly positive) was 47.3 and 18.5%, respectively (p0.05) and that of grades I, II and III was 0, 20.8 and 55.6%(p or =3cm and0.05). Patients with number of tumors or =3(53.3%)(p or =3) were considered as prognostic factors that affected the recurrence. For patients with summed points 4 to 9 based on the corrected scoring system, the recurrence rate was zero%(0/16) in patients with lower score(4 or 5), 31.8%(8/21) in those with intermediate score(6 or 7), and 77.8%(7/9) in those with higher score(8 or 9)(lower and intermediate score vs higher score: p<0.005). CONCLUSIONS: The results suggested that this scoring system reflecting various prognostic factors can be a reliable method predicting the tumor recurrence. This scoring system awaits its application to more cases of bladder tumor and its refinement, if necessary.
Asunto(s)
Humanos , Bacillus , Estudios de Seguimiento , Características de la Población , Recurrencia , Estudios Retrospectivos , Neoplasias de la Vejiga Urinaria , Vejiga UrinariaRESUMEN
Liposarcoma of spermatic cord is a rare malignant tumor. Because preoperative clinical diagnosis is very difficult, final diagnosis is made by postoperative pathologic examination. This tumor grows slowly and tends to recur locally. Therefore radical inguinal orchiectomy with wide local excision appears to be adequate treatment. We report a case of myxoid liposarcoma of right spermatic cord in 35 year-old male with a brief review of the literatures.