RESUMO
Adult-onset Xp11.2 translocation renal cell carcinoma is a rare malignancy that has an aggressive clinical course and poor prognosis. The reasons for this include the fact that most patients have an advanced clinical stage at diagnosis and also that there is a lack of effective systemic therapy. We herein present the case of a 32-year-old woman suffering from node-positive Xp11.2 translocation renal cell carcinoma who underwent radical nephrectomy with an extensive retroperitoneal lymph node dissection, followed by two times of surgical resection for recurrent nodal disease. The patient has experienced no recurrent disease 4.5 years after the last operation and remains free of disease. Surgical approach to recurrent disease, if the recurrent site can be judged to be limited, might be one of the feasible treatment options in patients with Xp11.2 translocation renal cell carcinoma.
Assuntos
Carcinoma de Células Renais/genética , Aberrações Cromossômicas , Cromossomos Humanos X , Neoplasias Renais/genética , Translocação Genética , Adulto , Carcinoma de Células Renais/terapia , Intervalo Livre de Doença , Feminino , Fluordesoxiglucose F18/farmacologia , Humanos , Neoplasias Renais/terapia , Linfonodos/patologia , Nefrectomia/métodos , Compostos Radiofarmacêuticos/farmacologia , Recidiva , Resultado do TratamentoAssuntos
Vírus JC/fisiologia , Leucoencefalopatia Multifocal Progressiva/virologia , Proteína de Replicação A/fisiologia , Antígenos Virais de Tumores/fisiologia , Encéfalo/metabolismo , Encéfalo/virologia , Núcleo Celular/metabolismo , Células Cultivadas , Humanos , Fosforilação , Ligação Proteica , Proteína de Replicação A/metabolismo , Replicação Viral/genéticaRESUMO
We report a case of a 71-year-old man who presented with cerebellar dysfunction. He was diagnosed as having squamous cell carcinoma of the lung (T2N3M0, Stage IIIB). No anti-onconeural antibodies were found in his serum. Cerebral spinal fluid (CSF) examination showed mild mononuclear pleocytosis alone. Magnetic resonance imaging (MRI) of the brain and spinal cord revealed no abnormalities. At autopsy, there was complete disappearance of Purkinje cells with reactive astrocytosis. These findings are compatible with paraneoplastic cerebellar degeneration (PCD). To our knowledge, no case of PCD has been reported previously in patients with squamous cell carcinoma of the lung.
Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Degeneração Paraneoplásica Cerebelar/complicações , Degeneração Paraneoplásica Cerebelar/patologia , Idoso , Autopsia , Biópsia por Agulha , Evolução Fatal , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Estadiamento de Neoplasias , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios XRESUMO
Five cases of pilomyxoid astrocytoma (PmA) characterized by a monophasic pattern with a myxoid background were selected for a clinicopathological study from 23 cases previously diagnosed as pilocytic astrocytoma (PA). All PmA patients were either infants or young children (mean age 2.1 years), and all tumors were located in the optic chiasm/hypothalamus region. All cases received chemotherapy, which reduced tumor size, and the location of the tumor became confined to the optic chiasm. In two cases, tumor recurrence occurred 3 and 7 years after chemotherapy. Histology of the recurrent tumors showed the biphasic pattern of classical PA. Hence, we conclude that PmA might be an infantile form of PA and speculate that a subset of PmA in the optic pathway/hypothalamus originates from the optic chiasm, possibly derived from radial glia existing in the embryonic optic chiasm.
Assuntos
Astrocitoma/patologia , Neoplasias Hipotalâmicas/patologia , Quiasma Óptico/patologia , Neoplasias do Nervo Óptico/patologia , Astrocitoma/terapia , Criança , Pré-Escolar , Tratamento Farmacológico , Feminino , Humanos , Neoplasias Hipotalâmicas/terapia , Lactente , Imageamento por Ressonância Magnética/métodos , Masculino , Neoplasias do Nervo Óptico/terapia , Coloração e Rotulagem , Fatores de TempoAssuntos
Carcinoma Hepatocelular/cirurgia , Equinococose Hepática/complicações , Hepatectomia , Neoplasias Hepáticas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/diagnóstico , Diagnóstico Diferencial , Equinococose Hepática/diagnóstico , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Radiografia Intervencionista , Tomografia Computadorizada por Raios XRESUMO
Sarcomatoid differentiation in renal cell carcinoma is thought to be the result of the dedifferentiation of the parent tumor, and it can be found in the chromophobe renal cell carcinoma just as other subtypes. We report a case of chromophobe renal cell carcinoma, which showed osteosarcoma-like differentiation. This is the first known case ever to be clearly identified as such. The patient was a 74-year-old man, and the CT scan revealed a huge retroperitoneal mass, which protruded from the lower half of the kidney and directly invaded the colon. Intraabdominal dissemination and metastases to the liver and lungs were also found. The resected tumor histologically showed sarcoma-like spindle cell proliferation and partly produced massive osteoid, which simulated the osteosarcoma. In addition, a typical histology of chromophobe renal cell carcinoma was found in part of the tumor. Immunohistochemically, spindle cells were reactive for epithelial membrane antigen, cytokeratin, and vimentin. The cell nests that were labeled by epithelial membrane antigen and cytokeratin were also found in the osteosarcoma-like area. We think that these phenomena were the result of "dedifferentiation" and metaplasia of the chromophobe renal cell carcinoma.
