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Background: Accurate diagnosis of ovarian tumours is a diagnostic challenge. Multiple modes are used for the early detection of ovarian tumours. Early detection provides a survival advantage. Ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI) are important imaging modalities in this regard. This study aims to compare the diagnostic accuracy of USG and CT imaging in the detection of malignant ovarian tumours.Materials: An observational cross-sectional study is conducted in the department of radiodiagnosis of Narayan medical college and hospital, Bihar over a period of 18 months from August 2021 to March 2024. Fifty-three patients with suspected ovarian malignancy who were not pregnant or had contraindications for administration of contrast media were included in the study. USG, CT and histopathology reports were compared for diagnostic accuracy with respect to different components.Results: Mean age of the patients was seen to be 49.6�.8 years. Abdominal pain was the most common presentation Majority of the patients had vascular lesions with a well-differentiated margin, heterogenous enhancement and septations. USG and CT agree almost perfectly in, identifying septations, calcification, and in differentiating margin of the tumours and very poorly for the identification of lymphadenopathy. CT had better sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) when compared to USG for diagnosis of ovarian malignanciesConclusions: CT has superior diagnostic accuracy compared to USG for diagnosis of ovarian tumours. However, USG provides similar diagnostic accuracy for identifying septations, calcification, and in differentiating margins of tumours.
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Background: Ovarian cancer is the most lethal gynecological malignancy. The present study was therefore designed to determine the accuracy of IL-6 and CA-125 in the early diagnosis of malignant ovarian tumors. The aim of the study was to evaluate the predictive value of pre-operative serum IL-6 and CA-125 levels in identifying malignant ovarian tumors.Methods: This cross-sectional study took place at BSMMU and NICRH in Dhaka, Bangladesh, from February 2022 to January 2023. It involved 94 women undergoing surgery for suspected ovarian tumors. The Mann-Whitney test was used to compare IL-6 and CA-125 levels between groups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated to correlate serum markers with histopathological diagnoses. Statistical analysis used SPSS version 23.0 with significance set at p<0.05.Results: The study involved 94 patients with ovarian tumors, where the mean age was higher in those with malignant tumors. The most common malignant histopathological finding was serous carcinoma (34%), while benign tumors often included endometriotic cysts (12.8%) and mucinous cystadenomas (10.6%). Elevated levels of IL-6 and CA-125 were significantly associated with malignant tumors (p<0.05). Both IL-6 and CA-125 showed high diagnostic accuracy in identifying malignant ovarian tumors when used alone or in combination, as indicated by receiver-operator characteristic curves.Conclusions: Serum IL-6 shows higher sensitivity and specificity for detecting malignant ovarian tumors, both epithelial and non-epithelial, making it a valuable diagnostic tool alongside CA-125 in assessing suspicious ovarian masses.
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Background: Thyroid nodules, common clinical occurrences, often require diagnostic assessment. Ultrasonography (USG) is primary non-invasive method for detection, with advancing technology enhancing detection capabilities. Fine needle aspiration cytology (FNAC) remains standard but poses risks and expenses. American college of radiology-thyroid image reporting and data system (ACR-TIRADS), introduced in 2017, offers a systematic scoring system based on ultrasound features. This study aims to evaluate USG guided by ACR-TIRADS for accurate nodule classification. Methods: A 1.5-year study at department of radio-diagnosis of BSMCH evaluated thyroid nodules using high-resolution USG based on ACR-TIRADS criteria, followed by FNAC for selected cases, comparing results for concordance. Results: Out of 47 thyroid nodules evaluated, 19.1% were malignant and 80% benign. ACR-TIRADS demonstrated sensitivity, specificity, and accuracy of 66.7%, 87.8%, and 82.9%, respectively. Higher ACR-TIRADS categories correlated with an increased risk of malignancy. Suspicious USG features such as hypo-echogenicity, taller-than-wide shape, lobulated margin, and punctate echogenic foci exhibited significant predictive value for malignancy, with varying levels of sensitivity and specificity. Overall, USG parameters demonstrated notable accuracy in identifying malignant nodules. Conclusions: ACR-TIRADS 2017 reliably predicts thyroid nodule malignancy, reducing unnecessary FNAC procedures, minimizing patient discomfort, and optimizing healthcare resources.
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Cervical cancer severely impacts women's health, especially in low- and middle-income nations. Patients experience significant symptoms at every stage of this cancer course, from diagnosis to treatment and beyond. Palliative care (PC) integration becomes crucial, even if oncological therapies have historically focused on disease-centric methods. PC is a multifaceted field that addresses end-of-life care as well as psychological, social, and spiritual issues in addition to physical illnesses. To improve patient satisfaction, treatment adherence, and overall quality of life, early PC initiation within the context of multimodality care is essential. Advanced patients require heightened PC and a smooth transfer to hospice care as they approach terminal disease. This emphasises how crucial it is for oncology and PC teams to work together to provide comprehensive cervical cancer management. Healthcare practitioners can improve results and maintain the overall health of women affected by this condition through combined efforts. This review article emphasises the importance of early PC integration and collaboration in the cervical cancer management continuum to offer comprehensive care and enhance patient outcomes.
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Mantle cell lymphoma (MCL) is a type of non-Hodgkin (B-cell) lymphoma (NHL) with manifestations ranging from indolent to aggressive disease. It arises from mantle zone or primary follicle lymphocytes and is associated with translocation t (11;14) which is seen in almost all cases. Most of the cases present at stage III/IV with hepatospenomegaly, generalized lymphadenopathy, bone marrow involvement or lymphoid polyposis. Rate of relapse is high occurring in 50-60% patients and 5-year survival rates are low ~27-30%. Median overall survival is 3.5 years. Age >60 years, raised serum LDH, high mitotic count, Ki67>30%, blastoid or pleomorphic variants, TP53 mutation, gains in 3q,11q and deletions of 13q as well as 17p are important prognostic factors associated with worst outcome. Treatment involves conventional chemo-immunotherapy and stem cell transplantation (SCT). In our case the elderly patient had an atraumatic splenic rupture with no past medical history of trauma. The patient presented to the emergency department with severe abdominal pain in left upper quadrant. Thus emergency splenectomy was executed successfully, and the patient was stabilized. After receiving initial cycle of R-CHOP regime, he was lost to follow up. In this case report, we will discuss the clinical presentation, as well as current treatment guidelines for atraumatic splenic rupture.
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Background: Approximately 22% of gynaecologic cancers are of ovarian origin, but 47% of all gynaecologic cancer deaths occur in women who have ovarian cancer. Ovarian cancer is usually diagnosed at an advanced stage because most of the symptoms are nonspecific, hence, the difficulty in diagnosis at early stages. In general, there is no effective screening test for ovarian cancer. Aim was to evaluate the ability of risk of malignancy index 4 (ROMI 4) to differentiate benign from malignant ovarian tumors.Methods: A prospective observational study was conducted in April 2019 to march 2020.Results: In the present study the ROMI 4 score at cut-off ? 450 had sensitivity, specificity, PPV and NPV of 74.3%, 65.3%, 42.6% and 88% respectively for malignant ovarian tumor.Conclusions: Preoperative ROMI 4 score ?450 will lead to rational basis for further referral to higher centre or gynaecology oncologist timely for appropriate surgical intervention/ management.
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Los tumores de músculo liso que no pueden ser clasificados según su histología como leiomiomas o leiomiosarcomas se denominan tumores de músculo liso de comportamiento maligno incierto. La localización nasal de estos tumores es muy infrecuente y la extensión adecuada de la cirugía para tratar estas neoplasias no está bien definida. Se describe el caso clínico de una adolescente de 16 años, que consultó por padecer un tumor de aspecto vascular en la cavidad nasal derecha y que fue tratada con éxito mediante cirugía intranasal. El diagnóstico histológico fue tumor de músculo liso de comportamiento maligno incierto. Por la rareza de estas neoplasias, su infrecuente localización nasal y la falta de evidencia que soporte cuál debe ser la extensión de la cirugía, es relevante la descripción y discusión del caso clínico.
Smooth muscle tumors that cannot be histologically classified as leiomyomas or leiomyosarcomas are defined as smooth muscle tumors of uncertain malignant potential. The location of these tumors in the nose is very rare, and the appropriate surgical extent to manage these neoplasms has not been adequately defined. Here we describe the case of a 16-year-old female adolescent who consulted due to a vascular-like tumor in the right nasal cavity who was successfully treated with intranasal surgery. The histological diagnosis was smooth muscle tumor of uncertain malignant potential. Given that these neoplasms are rare, the uncommon location in the nose, and the lack of evidence indicating the extent of surgery, it is relevant to describe and discuss this clinical case.
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Humanos , Femenino , Adolescente , Tumor de Músculo Liso/cirugía , Tumor de Músculo Liso/diagnóstico , Tumor de Músculo Liso/patología , Leiomioma/patología , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/patologíaRESUMEN
RESUMEN Los tumores malignos de la vaina del nervio periférico se asocian con frecuencia a neurofibromatosis tipo 1. Se localizan habitualmente en las extremidades o en la zona axial. Su ubicación visceral es muy rara y el origen hepático infrecuente. Suelen ser agresivos con pobre repuesta a la quimioterapia y radioterapia, por lo que el manejo quirúrgico es la mejor opción de tratamiento. Presentamos el caso de un joven con neurofibromatosis tipo 1, quien cursó con hemoperitoneo como complicación de un tumor maligno de la vaina del nervio periférico ubicado en el hígado.
ABSTRACT Malignant peripheral nerve sheath tumors are frequently associated with neurofibromatosis type 1. They are usually located in the extremities or in the axial area. Its visceral location is very rare and its hepatic origin is infrequent. They tend to be aggressive with a poor response to chemotherapy and radiotherapy, so surgical management is the best treatment option. We present the case of a young man with neurofibromatosis type 1, who presented with hemoperitoneum as a complication of a malignant tumor of the peripheral nerve sheath located in the liver.
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El tumor neuroectodérmico maligno del tracto gastrointestinal es una neoplasia rara con pocos casos reportados en la literatura, especialmente en América Latina. Descrito por primera vez en 2003, se trata de una entidad sin tratamiento estandarizado y de pobre pronóstico. Se presenta el caso de una paciente de 22 años de edad que acude a la consulta por dolor abdominal, anemia y masa abdominal palpable. Luego de estudios pertinentes se decide la conducta resectiva y el posterior tratamiento oncológico. (AU)
Malignant gastrointestinal neuroectodermal tumor (GNET), formerly known as clear cell sarcoma of the gastrointestinal tract, is an extremely rare tumor of mesenchymal origin, which presents great microscopic and molecular similarity to clear cell sarcoma found in other parts of the body, such as tendons and aponeurosis. It is characterized by its rapid evolution, high recurrence rate and frequent diagnosis as metastatic disease.1,2 (AU)
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Humanos , Femenino , Adulto Joven , Sarcoma de Células Claras/patología , Tumores Neuroectodérmicos/patología , Neoplasias Gastrointestinales/diagnóstico , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Inmunohistoquímica , Proteínas S100/análisis , Neoplasias Gastrointestinales/cirugía , Íleon/cirugíaRESUMEN
Florid cemento-osseous dysplasia (COD) represents a rare group of benign fibro-osseous disorders, while osteogenic sarcoma (OS) on the other hand, is a malignant tumour of ominous prognosis. The malignant transformation of a benign fibro-osseous lesion of the jaw is quite uncommon and has few reported cases. The clinico-radiological findings and histopathological analysis of a lesion present in all four quadrants of the jaw of a patient who reported at the outpatient department of a regional dental college is presented here. The lesion underwent sarcomatous transformation over two months and the findings were confirmed by histopathological evaluation. Although florid cemento-osseous dysplasia is a benign lesion of the jaw with a very low propensity for malignant transformation, it should be closely monitored in patients with tumour predisposition syndromes. Further research and molecular studies are required for better understanding of inadvertent changes.
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Granular cell tumour (GCT) is rare and accounts for approximately 0.5% of all soft tissue tumours. The malignant GCT (MGCT) especially cutaneous malignant granular cell tumour is extremely rare constituting 1-2% of all granular cell tumours and mostly found in the subcutaneous soft tissues of lower exrtremities, especially thighs. The uncommon occurrence of cutaneous MGCT and their histopathological similarities with other entities make diagnosis difficult in some cases. Here we report a case of 36 years old male patient who presented with a mass in the skin of right lower abdominal wall which has been increased gradually over the last one year without pain. The size of the mass is approximately 6.5 cm in greatest dimension, firm in consistency with surface irregularity and ulceration diagnosed as malignant GCT at the histopathological examination showing focal ulceration and lined by keratinized stratified squamous epithelium revealing acanthosis and pseudoepitheliomatous hyperplasia. The dermis show neoplastic epithelioid cells arranged in sheets and nests with vesicular chromatin, conspicuous to prominent nucleoli, and abundant amount of fine granular eosinophillic cytoplasm. Mitosis is more than 2/10HP. Immunohistochemical stains for S-100, CD 68 and vimentin were positive in the lesional cells.
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Resumen El tumor maligno de la vaina nerviosa periférica (TMVNP) es un sarcoma de alto grado de malignidad. Es poco frecuente, agresivo y generalmente se localiza en tronco y miembros inferiores. Se presenta mayormente en pacientes con neurofibormatosis tipo 1, aunque no siempre se encuentra esta asociación. Este tumorcomparte características histológicas e inmunohistoquímicas con el melanoma, lo que puede dificultar el diagnóstico. Presentamos el caso de un paciente con TMVNP, en el cual los hallazgos histológicos iniciales condujeron a un diagnósticoerróneode melanoma.
Abstract Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma. It is rare, aggressive and generally located on the trunk and lower limbs. It occurs in a high percentage of patients with neurofibormatosis type 1, although this association is not always found. This tumor shares histological and immunohistochemical characteristics with melanoma, which can make diagnosis difficult. We present the case of a patient with MPNST, in whom the initial histological findings led to an erroneous diagnosis of melanoma.
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By analysing the similarity between defense qi and leukocytes in terms of function, site of action, and circadian rhythm, it is proposed that in traditional Chinese medicine (TCM), the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics, it is believed that the original qi in lower jiao (焦) is the source of defense qi, while the water and grain qi in middle jiao enriches defense qi, and the upper jiao transmits and distributes defense qi to the whole body. Therefore, when treating leukopenia after chemotherapy with TCM, Guilu Erxian Gelatin (龟鹿二仙胶) and Yougui Pill (右归丸) are often used to tonify the kidney and supplement essence, and moxibustion at Guanyuan (CV 4) and Qihai (CV 6) is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction (归脾汤), Buzhong Yiqi Decoction (补中益气汤), Shenling Baizhu Powder (参苓白术散), and Sijunzi Decoction (四君子汤) are often suggested to strengthen spleen and replenish qi, in combination with moxibustion at Zhongwan (CV 12) and Zusanli (ST 36) to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction (桂枝汤) to harmonize nutrient and defensive aspects is often used, and moxibustion at Dazhui (GV 14) and Feishu (BL 13) or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi, it is suggested to choose the most appropriate treatment modality flexibly, and combine internal treatment with external treatment, in order to provide ideas for the treatment of leukopenia in tumour patients.
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Objective@#To explore the photodynamic treatment method and therapeutic effect of oral verrucous carcinoma and to provide a reference for the clinic.@*Methods@#This study follows the requirements of medical ethics. This paper summarized the photodynamic treatment of an oral verrucous carcinoma with a diameter of approximately 2.5 cm in the right buccal mucosa and retrospectively analyzed the characteristics and treatment of oral verrucous carcinoma and the photodynamic treatment of potential malignant lesions of the oral mucosa through a review of the literature.@*Results@#After four rounds of photodynamic therapy, the size of the right buccal lesion was significantly reduced. After 6 months of follow-up, the white verrucous hyperplasia of the right buccal mucosa had completely subsided, and there was no obvious scar formation. Three years after treatment, there was no recurrence of the lesion in the right buccal mucosa and no obvious scar formation in the treated area. The degree of mouth opening was 3 fingers, and there was no lymph node enlargement in the bilateral submandibular, submental or neck. The literature review shows that oral verrucous carcinoma is a rare subtype of squamous cell carcinoma with the characteristics and biological behaviors of slow growth, low malignancy, and rare metastasis. Surgery is the preferred treatment, but there are some limitations. Photodynamic therapy is a minimally invasive, repeatable treatment with mild adverse reactions. In recent years, photodynamic therapy has been gradually applied for the treatment of potential malignant disorders of the oral mucosa and early oral squamous cell carcinoma and has achieved positive results, but it has not been reported for the treatment of oral verrucous cancer@*Conclusion@#Photodynamic therapy is a new option for nonsurgical resection of oral verrucous carcinoma.
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@#Objective To explore the key points and difficulties of intraoperative frozen section diagnosis of pulmonary diseases. Methods The intraoperative frozen section and postoperative paraffin section results of pulmonary nodule patients in Beijing Chaoyang Hospital, Capital Medical University from January 2021 to January 2022 were collected. The main causes of misdiagnosis in frozen section diagnosis were analyzed, and the main points of diagnosis and differential diagnosis were summarized. Results According to the inclusion criteria, a total of 1 263 frozen section diagnosis results of 1 178 patients were included in the study, including 475 males and 703 females, with an average age of 58.7 (23-86) years. In 1 263 frozen section diagnosis results, the correct diagnosis rate was 95.65%, and the misdiagnosis rate was 4.35%. There were 55 misdiagnoses, including 18 (3.44%) invasive adenocarcinoma, 17 (5.82%) adenocarcinoma in situ, 7 (35.00%) mucinous adenocarcinoma, 4 (2.09%) minimally invasive adenocarcinoma, 3 (100.00%) IgG4 related diseases, 2 (66.67%) mucinous adenocarcinoma in situ, 1 (16.67%) atypical adenomatous hyperplasia, 1 (14.29%) sclerosing pulmonary cell tumor, 1 (33.33%) bronchiolar adenoma, and 1 (100.00%) papillary adenoma. Conclusion Intraoperative frozen section diagnosis still has its limitations. Clinicians need to make a comprehensive judgment based on imaging examination and clinical experience.
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Malignant tumors have surpassed stroke and coronary heart disease to become the main cause of death before the age of 70 in the world. The incidence of malignant tumors is increasing year by year, which seriously affects the living standards and social and economic development of Chinese people. Surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy are the main means of Western medicine to intervene in tumors, which are of great significance for prolonging the survival time of patients. However, there are many disadvantages such as adverse reactions and drug resistance. Traditional Chinese medicine has become a research hotspot in recent years because of its definite curative effect and wide application in tumor treatment. Xiao Chaihutang is derived from the Treatise on Febrile and Miscellaneous Diseases. It is composed of Bupleuri Radix, Scutellariae Radix, Ginseng Radix, Pinelliae Rhizoma, Glycyrrhizae Preparata Radix, Ginger, and Jujube. It has the effects of reconciling Shaoyang, reconciling cold and heat Yin and Yang, soothing the liver, and relieving depression. This prescription and the prescriptions based on it are widely used in various stages of tumors. This study summarized the Chinese and foreign research of Xiao Chaihutang in the field of tumors in the past 10 years and explored the role and mechanism of Xiao Chaihutang in blocking precancerous lesions, controlling the development of malignant tumors, reducing the occurrence of adverse reactions after intervention, and alleviating common complications, with a view to expanding the clinical medication ideas.
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Objective To study the effect of microRNA-192(miR-192)on the proliferation,migration and invasion ability of colorectal cancer(CC)cell lines.Methods Group A(SW1116 CC transfected with physio-logical saline),group B(SW1116 CC transfected with miR-192 mimics)and group C(SW1116 CC transfected with miR-192 inhibitor)were set up,respectively.Cell proliferation was detected by MTT assay,cell apoptosis was detected by flow cytometry,cell migration ability was detected by scratch assay,and cell invasion ability was detected by Transwell assay.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the mRNA expression levels of miR-192 and WNT family member 2B(WNT2B)in each group.Results The survival rate and monoclonal number of SW1116 CC cells in group B were(57.32± 6.19)%and(284.59±15.08),which were lower than(76.21±8.23)%and(601.47±23.16)in group A and(89.52±10.62)%and(2 150.68±34.79)in group C,while the apoptosis rate in group B was(20.52± 2.52)%,which was higher than(13.78±1.62)%in group A and(11.62±1.41)%in group C.The survival rate and number of monoclonal formation of SW1116 CC cells in group C were higher than those in group A,while the apoptosis rate was lower than that in group A(all P<0.05).The scratch width of SW1116 CC cells in group B was(785.10±46.18)mm,which was higher than(601.32±33.21)mm in group A and(326.99± 17.48)mm in group C,while the scratch width in group C was lower than that in group A.The number of per-forating cells in group B was(624.67±19.05),which was lower than(875.23±27.30)in group A and(1 204.17±34.59)in group C,and the number of perforating cells in group C was higher than that in group A(all P<0.05).The relative expression level of miR-192 mRNA in SW1116 CC cells in group B was(3.01± 0.26),which was higher than(1.87±0.20)in group A and(0.97±0.23)in group C,and the relative expres-sion level of miR-192 mRNA in group C was lower than that in group A.The expression level of WNT2B mR-NA in group B was(2.16±0.26),which was lower than(4.11±0.50)in group A and(6.08±0.72)in group C,and the expression level of WNT2B mRNA in group C was higher than that in group A(all P<0.05).Con-clusion miR-192 could inhibit the malignant evolution of CC,and one of its main mechanisms may be related to the regulation of WNT2B expression.
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Methylthioadenosine phosphorylase (MTAP) is a rate-limiting enzyme in the methionine and purine salvage pathway, and is closely related to polyamine metabolism, adenine metabolism and methionine metabolism. MTAP is frequently deleted in malignant mesothelioma (MM) and plays an important role in the diagnosis and differential diagnosis of MM. At the same time, metabolic reprogramming caused by MTAP deletion creates new therapeutic strategies for MM. Besides, MTAP gene is also associated with the prognosis of MM, therefore MTAP is a significant biomarker for the diagnosis, treatment and prognosis of MM.
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Malignant tumors continue to pose a significant threat to human life and safety and their development is primarily due to the activation of proto-oncogenes and the inactivation of suppressor genes.Among these,the activation of proto-oncogenes possesses greater potential to drive the malignant transformation of cells.Targeting oncogenes involved in the malignant transformation of tumor cells has provided a novel approach for the development of current antitumor drugs.Several preclinical and clinical studies have revealed that the development pathway of B cells,and the malignant transformation of mature B cells into tumors have been regulated by oncogenes and their metabolites.Therefore,summarizing the key oncogenes involved in the process of malignant transformation of mature B cells and elucidating the mechanisms of action in tumor development hold significant importance for the clinical treatment of malignant tumors.
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The normal esophageal mucosa specific 1 gene(NMES1)is considered as a tumor suppressor gene which significantly reduces expression of various malignant tumors.The NMES1 can affect various cellular biological behaviors such as proliferation,apoptosis and migration of tumor cells.These findings provide new strategies for searching early biomarkers or therapeutic targets of malignant tumors and support the evaluation of disease progres-sion and prognosis.