ABSTRACT
BACKGROUND: The presence of anaplastic and sarcomatoid components in ovarian mucinous carcinoma is extremely rare. CASE: A 64-year-old woman underwent radical surgery for right ovarian cancer. Pathological examination showed mucinous adenocarcinoma with a focal mural nodule of anaplastic and sarcomatoid carcinoma (FIGO stage IIB). She underwent adjuvant chemotherapy but developed severe respiratory failure and died after 9 months. Autopsy showed that the bilateral pulmonary parenchyma was filled with a multinodular hemorrhagic mass, and the cardiac wall had a massive invasive lesion. Histopathological examination of the lung and myocardium revealed diffuse invasion of the anaplastic carcinoma component with infiltrating osteoclastic giant cells. CONCLUSION: This case is very rare, and the clinical management of anaplastic carcinoma arising in mucinous neoplasms remains challenging.
Subject(s)
Adenocarcinoma, Mucinous/pathology , Carcinoma/secondary , Heart Neoplasms/secondary , Lung Neoplasms/secondary , Neoplasms, Multiple Primary/pathology , Ovarian Neoplasms/pathology , Adenocarcinoma, Mucinous/surgery , Anaplasia , Appendectomy , Autopsy , Carcinoma/diagnostic imaging , Carcinoma/pathology , Chemotherapy, Adjuvant , Fatal Outcome , Female , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/pathology , Humans , Hysterectomy , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lymph Node Excision , Middle Aged , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/secondary , Neoplasms, Multiple Primary/surgery , Ovarian Neoplasms/surgery , Salpingo-oophorectomy , Tomography, X-Ray ComputedABSTRACT
Intraluminal tumor thrombus in the portal vein (PV) system originating from gastrointestinal (GI) tract cancer is a rare condition. There are two types of such thrombi, one arising indirectly from metastatic liver cancer and the other directly from the primary lesion. We report here three patients with the direct type and two with the indirect type; i.e., a total of five patients with gastric or large intestinal cancer with PV tumor thrombus. In all patients, the primary lesion was surgically resected; in two patients, the tumor thrombus was easily extirpated by direct opening of the PV. It is noteworthy that a patient whose tumor thrombus could not be treated died of cancer with liver failure, caused by expansive growth of the PV tumor thrombus, 4 months after the finding of the PV thrombus. Because PV tumor thrombus may, possibly, determine the patient's length of survival, in addition to causing cancer progression, surgical thrombectomy, combined with resection of the primary cancer and metastatic liver cancer, should be considered for prolongation of survival, if all macroscopic lesions can be controlled and if the tumor thrombus is a synchronous and recent one.
Subject(s)
Adenocarcinoma/surgery , Colonic Neoplasms/surgery , Stomach Neoplasms/surgery , Thrombosis/surgery , Adenocarcinoma/complications , Adenocarcinoma/diagnostic imaging , Aged , Aged, 80 and over , Colonic Neoplasms/complications , Colonic Neoplasms/diagnostic imaging , Fatal Outcome , Female , Humans , Male , Middle Aged , Neoplastic Cells, Circulating , Portal Vein/surgery , Radiography , Stomach Neoplasms/complications , Stomach Neoplasms/diagnostic imaging , Thrombosis/diagnostic imaging , Thrombosis/etiologyABSTRACT
We report a case of left adrenocortical carcinoma in a 23-year-old man. His chief complaints were spike fever attack and general malaise. Imaging examination revealed a heterogeneously enhanced mass at the site of the left adrenal gland. Non-functional adrenocortical carcinoma was suspected from hormonal studies. The mass was removed together with the left kidney because of severe adhesion to the renal pedicle. The histopathological findings showed adrenocortical carcinoma (pT3N0M0). Three months after surgery, local recurrence appeared and the tumor grew larger rapidly. Spike fever attack reappeared. No distant metastasis was detected. Two courses of systemic chemotherapy with o, p'-DDD, VP-16, adriamycin and cisplatinum were performed. Computed tomography after the chemotherapy showed progression. Although o, p'-DDD was administered continuously, the patient died of cancerous cachexia 8 months after the surgery. Autopsy could not be done.
