ABSTRACT
OSNA is a molecular assay for the detection of sentinel node metastasis. TTL emerged as a concept that seems to accurately predict the status of the NSN. Authors tried to confirm this motion. This is a retrospective and multicentric study that analyzed 2164 patients, 579 of whom had positive SN and completion AD. Logistic regression models were performed in order to identify a suitable cutoff to identify patients who benefit from AD. Univariate and multivariate regression analysis showed a relationship between TTL>30000 and the presence of NSN metastasis (OR 2.84, CI 1.99-4.08, p < 0.001). Logistic regression indicated that the cutoff of 30000 copies/µL better discriminates patients with NSN positivity and allows wide use of these criteria. This cutoff value may safely assist clinicians and patients to decide to proceed or not with an AD.
Subject(s)
Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/secondary , Carcinoma, Lobular/secondary , Lymph Nodes/pathology , Sentinel Lymph Node Biopsy , Adult , Aged , Aged, 80 and over , Breast Neoplasms/metabolism , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/metabolism , Carcinoma, Ductal, Breast/surgery , Carcinoma, Lobular/metabolism , Carcinoma, Lobular/surgery , Female , Follow-Up Studies , Humans , Lymph Nodes/metabolism , Lymph Nodes/surgery , Lymphatic Metastasis , Middle Aged , Prognosis , Receptor, ErbB-2/metabolism , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Retrospective Studies , Young AdultABSTRACT
Cotyledonoid dissecting leiomyoma, also known as Sternberg tumor, is a rare benign uterine tumor with a gross and radiological appearance that may suggest the possibility of a malignancy. We report a case of a thirty-eight-year-old female patient who presented with menorrhagia and abdominal pain one month after delivery by cesarean section. An ultrasound scan showed a heterogeneous pelvic mass, near the isthmic region, with 25 x 24 x 23 mm without vascularization so the possibility of placenta accreta could not be excluded. During hysterectomy, we also removed a small grey mass in the right ovary. Microscopic examination revealed a proliferation of a sparsely cellular tissue with extensive hyalinization and coagulative necrosis, composed of spindle shaped muscle cells without cellular atypia or mitoses. The patient is without evidence of recurrence one year and six months post-surgery.
O leiomioma cotiledonóide dissecante, também conhecido como tumor de Sternberg, é uma forma rara de tumor uterino benigno com uma aparência macroscópica e radiológica sugestiva de malignidade. Reportamos o caso de uma doente de trinta e oito anos que se apresentou com menorragia e dor abdominal, um mês após um parto por cesariana. Na ecografia visualizava-se uma massa heterogénea, próxima da região ístmica, com 25 x 24 x 23 mm e sem vascularização, pelo que não foi excluída a possibilidade de placenta acreta. Aquando da histerectomia, foi também excisada uma pequena massa cinzenta do ovário direito. A análise microscópica das peças cirúrgicas, revelou uma proliferação de tecido celular esparso, com extensas áreas de hialinização e necrose coagulativa, compostas por células fusiformes musculares sem atipia ou mitoses. A doente apresenta-se sem evidência de recorrência um ano e meio após a cirurgia.
