ABSTRACT
We report the case of a 79-year-old male who presented with altered bowel habit. Subsequent endoscopy and radiological investigations suggested the diagnosis of a likely sigmoid colon malignancy. Surgery was performed to remove the suspected tumour and post-surgical histology showed only inflammatory change in an area of underlying sigmoid diverticulosis with an associated impacted dental prosthesis.
ABSTRACT
Carcinosarcoma (CS) is a rare mixed mesodermal malignancy most commonly affecting the female reproductive organs, respiratory tract, head, and neck. Though infrequent, it may affect the gastrointestinal tract, most often the oesophagus and only very rarely the rectum. Histologically, it is composed of two distinct elements of epithelial and mesenchymal origin. Clinically, it is a very aggressive tumour with many patients presenting with metastatic lymph nodes or distant metastases at the time of diagnosis. Prognosis is poor despite intervention with the majority of patients dying within six months. Due to the rarity of this condition, there are no specific treatment guidelines presently available. We describe the case of an 80-year-old patient with carcinosarcoma of the rectum with discussion of the immunohistochemistry and review the available literature pertaining to this rare presentation.
ABSTRACT
Amyloidoma of soft tissues is rare, and no previously published reports describe it in relation to hip prostheses. This article presents the case of a 78-year-old woman with a medical history of myelodysplasia and mild renal failure who underwent a right-sided metal-on-polyethylene total hip arthroplasty in 2003. She presented to the outpatient clinic with a 1-year history of right anterior thigh pain. On examination, a large proximal anteromedial lump was palpable and was nontender, nonpulsatile, and firm. She had a positive Trendelenburg test but good hip range of motion. Plain radiographs showed signs of osteolysis around the hip prosthesis. Serology showed mildly raised liver function and renal function but a normal erythrocyte sedimentation rate and white blood cell count. Magnetic resonance imaging revealed a large mixed-signal soft tissue mass directly opposing the anterior cortex of the right femur, related to the hip prosthesis, measuring 16×10×7 cm. Associated destruction of the underlying cortex existed. Histological staining of a biopsy of the mass confirmed that the mass contained AL-type amyloid seen in primary amyloidosis. Mean patient age at diagnosis for amyloid tumors of soft tissues is 66 years. By definition, they start as solitary lesions. The types are important: AA type is related to infection and AL type is a primary process. Patients with AL amyloidomas have a poorer prognosis because they have a higher chance of malignancies. Early diagnosis can prevent long-term serious consequences of this condition.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Femoral Neoplasms/diagnosis , Femoral Neoplasms/etiology , Hip Prosthesis/adverse effects , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/etiology , Aged , Diagnosis, Differential , Female , HumansABSTRACT
Optimized menus for a bioregenerative life support system have been developed based on measures of crop productivity, food item acceptability, menu diversity, and nutritional requirements of crew. Crop-specific biomass requirements were calculated from menu recipe demands while accounting for food processing and preparation losses. Under the assumption of staggered planting, the optimized menu demanded a total crop production area of 453 m2 for six crew. Cost of the bioregenerative food system is estimated at 439 kg per menu cycle or 7.3 kg ESM crew-1 day-1, including agricultural waste processing costs. On average, about 60% (263.6 kg ESM) of the food system cost is tied up in equipment, 26% (114.2 kg ESM) in labor, and 14% (61.5 kg ESM) in power and cooling. This number is high compared to the STS and ISS (nonregenerative) systems but reductions in ESM may be achieved through intensive crop productivity improvements, reductions in equipment masses associated with crop production, and planning of production, processing, and preparation to minimize the requirement for crew labor.