RESUMO
Although surgical resection is the only available treatment to achieve long-term survival in biliary tract cancer, many cases are often identified at an advanced stage at the time of diagnosis. Radiotherapy may be an alternative option to prolong survival in cases with locally advanced unresectable disease. While there are some reports of long-term survival after radiotherapy for unresectable biliary tract cancer, it is rare that clinical symptoms are exhibited by peritoneal dissemination more than 8 years after radiotherapy and that resection can be performed. Our case was a 55-year-old female who had visited with a complaint of jaundice and was diagnosed with primary unresectable hilar cholangiocarcinoma. She received definitve chemoradiotherapy, and repeated receiving maintenance chemotherapy thereafter until clinical manifestation. During follow-up, she was diagnosed with stenosis of the sigmoid colon, which was attributed to peritoneal dissemination of cholangiocarcinoma. We herein report a rare case of primary unresectable hilar cholangiocarcinoma after chemoradiotherapy which was followed by chemotherapy that was controlled for more than 8 years but eventually caused colonic obstruction attributed to peritoneal dissemination.
Assuntos
Neoplasias dos Ductos Biliares , Neoplasias do Sistema Biliar , Colangiocarcinoma , Tumor de Klatskin , Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/terapia , Ductos Biliares Intra-Hepáticos/patologia , Neoplasias do Sistema Biliar/patologia , Colangiocarcinoma/complicações , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/terapia , Feminino , Humanos , Tumor de Klatskin/patologia , Tumor de Klatskin/cirurgia , Pessoa de Meia-IdadeAssuntos
Neoplasias da Mama Masculina/patologia , Mama/anormalidades , Carcinoma Ductal de Mama/patologia , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Axila , Neoplasias Ósseas , Neoplasias Encefálicas/secundário , Neoplasias da Mama Masculina/metabolismo , Neoplasias da Mama Masculina/cirurgia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/cirurgia , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , TrastuzumabRESUMO
BACKGROUND: It has been described that the etiology of epidermal cysts on acral skin is different from that on non-acral skin; however, no papers have been published regarding the detailed histological differences between acral and non-acral epidermal cysts. In this study, we compared the clinicopathologic findings of epidermal cysts of the sole with those of traditional epidermal cysts and trichilemmal cysts. METHODS: The cases studied were 12 epidermal cysts of the sole, 35 traditional (non-acral) epidermal cysts, and 12 trichilemmal cysts. The age and sex of the patients and the site, size, and microscopic findings of the lesions were evaluated. The pattern of keratinization was specifically focused on the evaluation of microscopic findings. RESULTS: Microscopically, most of the epidermal cysts of the sole showed the presence of parakeratosis and focal lack of a granular layer at least at the upper portion of the cyst wall. The cyst content of the epidermal cysts of the sole was predominantly compact orthokeratotic material. These pathological findings could be explained by the pathogenesis of epidermal cysts of the sole, namely invagination of the surface epidermis. CONCLUSION: Our study indicates that most cases of the epidermal cyst of the sole are considered to be a true traumatic epidermal inclusion cyst.
