ABSTRACT
The case involves a 10-year-old child who underwent a left radical nephrectomy for what was believed to be a Wilms' tumor. Histopath examination indicated a benign vascular lesion, subsequently determined to be an anastomosing hemangioma of the kidney. A comparison with the previously cited pediatric patients with renal vascular tumors is provided, and the inconsistent diagnostic terminologies for these conditions are highlighted. The therapeutic implications of these predominantly benign renal tumors, in the context of the much more frequently encountered malignant neoplasms in children, are additionally discussed.
Subject(s)
Hemangioma/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Vascular Neoplasms/diagnostic imaging , Child , Hemangioma/pathology , Humans , Kidney/pathology , Kidney Neoplasms/pathology , Male , Vascular Neoplasms/pathologyABSTRACT
BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. Optimal treatment remains controversial and, because of a long natural history, may not be evident for many years. We undertook this study to identify markers of disease recurrence. METHODS: We studied 131 pure DCIS patients with a 100-month mean follow-up. We performed a complete histologic review, immunohistochemical staining for p53 and vascular endothelial growth factor expression, and enumerated microvessel density/mm2 using factor VIII-Ab. Statistical analysis was performed by using an SAS software package (Cary, NC). RESULTS: Eleven patients (8%) developed ipsilateral recurrence at a mean of 55 months (11-137 months) after initial treatment. Three were DCIS, and 8 were invasive cancer. Recurrence was significantly predicted by p53 overexpression (in 55% of tumors that recurred versus 22% of those that did not, P = .02) but not other factors. CONCLUSIONS: These data suggest that biologic factors may have an important role in predicting recurrence in DCIS patients.
