ABSTRACT
Undifferentiated gastric carcinoma is a rare histopathological type of cancer that does not show any differentiation toward adenocarcinoma or squamous cell carcinoma. It is thought to be highly malignant, and is associated with a poor prognosis. However, its clinical behavior has not yet been fully analyzed because of its rarity. We herein review the clinical characteristics and prognoses of patients with undifferentiated gastric carcinoma treated at our institutions. Among 2,651 gastric cancer patients, four (0.2 %) were histopathologically diagnosed to have undifferentiated carcinoma. These four patients included three males and one female. The median age of the patients was 60-year old (range 47-75). Three cases had distant metastases at diagnosis. One of these three cases was treated with chemotherapy alone, and the other two were treated with palliative gastrectomy and chemotherapy. The patient with no distant metastasis underwent curative gastrectomy and adjuvant chemotherapy. All patients died of cancer at a median of 5.4 (range 3.5-7.1) months after their diagnoses.
Subject(s)
Carcinoma/therapy , Stomach Neoplasms/therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/diagnosis , Carcinoma/pathology , Chemotherapy, Adjuvant , Combined Modality Therapy , Fatal Outcome , Female , Gastrectomy , Humans , Male , Middle Aged , Palliative Care , Prognosis , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Time FactorsABSTRACT
Kaposiform hemangioendothelioma (KHE) is a rare tumor that occurs nearly exclusively during infancy and childhood. It has features common to both capillary hemangioma and Kaposi sarcoma and for that reason many terms have been used for these tumors including "Kaposi-like infantile hemangioendothelioma" and "hemangioma with Kaposi sarcoma-like features." KHE typically presents as an ill-defined, red to purple, indurated plaque and is often complicated by the Kasabach-Merritt phenomenon (KMP), a condition of severe thrombocytopenia and consumptive coagulopathy. Knowledge of the radiological findings of this uncommon tumor might be helpful for diagnosis. We present the MRI features of a case of KHE with neither typical skin lesions nor the Kasabach-Merritt phenomenon.
Subject(s)
Head and Neck Neoplasms/diagnosis , Antineoplastic Agents, Hormonal/therapeutic use , Deltoid Muscle/pathology , Deltoid Muscle/ultrastructure , Diagnosis, Differential , Disseminated Intravascular Coagulation , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/ultrastructure , Hemangioendothelioma/diagnosis , Hemangioendothelioma/drug therapy , Hemangioendothelioma/ultrastructure , Hemangioma, Capillary , Hemangioma, Cavernous/diagnosis , Hemangioma, Cavernous/drug therapy , Hemangioma, Cavernous/ultrastructure , Humans , Infant , Kasabach-Merritt Syndrome , Magnetic Resonance Imaging/methods , Male , Prednisolone/therapeutic use , Sarcoma, Kaposi/diagnosis , Sarcoma, Kaposi/drug therapy , Sarcoma, Kaposi/ultrastructure , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Skin Neoplasms/ultrastructure , Thrombocytopenia/diagnosis , Thrombocytopenia/drug therapy , Treatment Outcome , Vascular Neoplasms/diagnosis , Vascular Neoplasms/drug therapy , Vascular Neoplasms/ultrastructureABSTRACT
INTRODUCTION: Infantile hepatic hemangioma with consumptive hypothyroidism is a rare condition. CASE REPORT: A 4-month-old girl presented with diffuse hepatic hemangiomas during treatment of congenital hypothyroidism. Serum reverse triiodothyronine was elevated, and her hypothyroidism improved concomitant with involution of the hemangioma following prednisolone and interferon-alpha administration. At 20 months of age, 7 months after discontinuing prednisolone and interferon-alpha, a focal hemangioma regrew from one of the previous lesions and was surgically resected. The expression and activity of type 3 iodothyronine deiodinase (D3) were elevated in the resected tumor tissue compared with placenta. DISCUSSION: Here, we describe a patient with consumptive hypothyroidism and diffuse infantile hepatic hemangiomas, one of which regrew after involution following pharmacotherapy. The etiology of elevated D3 activity is also discussed. CONCLUSION: It is important to identify infantile hepatic hemangioma in patients with hypothyroidism refractory to hormone replacement therapy, who have low free triiodothyronine despite high thyrotropin and normal free thyroxine levels, and long-term follow-up will be needed for these patients.
