RESUMO
For intraoperative consultation of mucinous adenocarcinoma involving the ovary, it would be useful to have approaching methods in addition to the traditional limited microscopic findings in order to determine the nature of the tumors. Mucinous adenocarcinomas involving the ovaries were evaluated in 91 cases of metastatic mucinous adenocarcinomas and 19 cases of primary mucinous adenocarcinomas using both an original algorithm (unilateral > or =10 cm tumors were considered primary and unilateral or =15 cm were primary, respectively. The diagnostic algorithm using size and laterality, in addition to clinical history, preoperative image findings, and operative findings, is a useful adjunct tool for differentiation of metastatic mucinous adenocarcinomas from primary mucinous adenocarcinomas of the ovary.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Adenocarcinoma Mucinoso/classificação , Algoritmos , Estadiamento de Neoplasias , Neoplasias Ovarianas/classificaçãoRESUMO
El carcinoma mucinoso (colide/mucoso) de la glándula mamaria masculina es una neoplasia poco frecuente. Se describe el caso de un hombre de 74 años de edad que presentó tumor retroareolar de crecimiento rápido. Se realizó mastectomía radical modificada. Microscópicamente el tumor estaba bien delimitado y con consistencia gelatinosa. Histológicamente la neoplasia correspondió a carcinoma mucinoso puro, tumor que representa menos del 1% de los carcinomas que afectan la glándula mamaria en el hombre.
Pure mucinous (colloid, mucous) carcinoma of the male breast is an extremely rare neoplasm. We report the case of a 74-year-old male who displayed a rapidly growing retroareolar tumor of the left breast. The patient underwent modified radical mastectomy. The tumor was well demarcated, had a soft consistency with a glistening gelatinous appearance. Histologically, the neoplasm corresponded to a pure mucinous carcinoma which is one of the most unusual subtYpes, accounting for less than 2% of male breast carcinomas.
Assuntos
Humanos , Masculino , Idoso , Adenocarcinoma Mucinoso/classificação , Neoplasias da Mama Masculina/classificaçãoRESUMO
OBJECTIVE: This study aims to evaluate the degree of inter- and intraobserver agreement when characterizing breast abnormalities using the Breast Imaging Reporting and Data System (BI-RADS)-ultrasound (US) lexicon, as defined by the American College of Radiology (ACR). MATERIALS AND METHODS: Two hundred ninety three female patients with 314 lesions underwent US-guided biopsies at one facility during a two-year period. Static sonographic images of each breast lesion were acquired and reviewed by four radiologists with expertise in breast imaging. Each radiologist independently evaluated all cases and described the mass according to BI-RADS-US. To assess intraobserver variability, one of the four radiologists reassessed all of the cases one month after the initial evaluation. Inter- and intraobserver variabilities were determined using Cohen's kappa (k) statistics. RESULTS: The greatest degree of reliability for a descriptor was found for mass orientation (k = 0.61) and the least concordance of fair was found for the mass margin (k = 0.32) and echo pattern (k = 0.36). Others descriptive terms: shape, lesion boundary and posterior features (k = 0.42, k = 0.55 and k = 0.53, respectively) and the final assessment (k = 0.51) demonstrated only moderate levels of agreement. A substantial degree of intraobserver agreement was found when classifying all morphologic features: shape, orientation, margin, lesion boundary, echo pattern and posterior feature (k = 0.73, k = 0.68, k = 0.64, 0.68, k = 0.65 and k = 0.64, respectively) and rendering final assessments (k = 0.65). CONCLUSION: Although BI-RADS-US was created to achieve a consensus among radiologists when describing breast abnormalities, our study shows substantial intraobserver agreement but only moderate interobserver agreement in the mass description and final assessment of breast abnormalities according to its use. A better agreement will ultimately require specialized education, as well as self-auditing practice tests.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Adenocarcinoma/classificação , Adenocarcinoma Mucinoso/classificação , Biópsia , Neoplasias da Mama/classificação , Carcinoma Ductal de Mama/classificação , Carcinoma Intraductal não Infiltrante/classificação , Seguimentos , Variações Dependentes do Observador , Valor Preditivo dos Testes , Radiologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Sociedades Médicas , Terminologia como Assunto , Ultrassonografia Doppler em Cores/estatística & dados numéricos , Ultrassonografia Mamária/estatística & dados numéricosRESUMO
Sao apresentados alguns aspectos referentes a classificacao histogenetica dos tumores de ovario, tais como a participacao do estroma no grupo das neoplasias epiteliais, agora denominadas "tumores epiteliais-estromais da superficie ovariana e peritonio", a definicao dos carcinomas de baixo potencial de malignidade ("borderline"), a inclusao dos subtipos intestinal e mulleriano nos tumores mucinosos e os carcinomas de celulas transicionais, entidade distinta dos carcinomas de Brenner. Sao discutidos criterios diagnosticos dos tumores de baixo potencial de malignidade e as caracteristicas histologicas dos implantes peritoneais