RESUMO
Two children developed hepatoblastoma concurrent with congenital portosystemic shunts (PSSs) (Abernethy malformations). Both underwent operative ligation of their PSSs. One received concurrent tumor resection, whereas the other was deemed initially unresectable and underwent biopsy followed by neoadjuvant chemotherapy. Although benign hepatic masses, such as focal nodular hyperplasia and nodular regenerative hyperplasia, are common in patients with Abernethy malformations, malignant tumors have also been documented and should always be considered in the differential diagnosis of a patient with a congenital PSS and a hepatic mass.
Assuntos
Malformações Arteriovenosas/complicações , Anormalidades do Sistema Digestório/complicações , Hepatoblastoma/complicações , Neoplasias Hepáticas/complicações , Sistema Porta/anormalidades , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/patologia , Malformações Arteriovenosas/cirurgia , Biópsia , Quimioterapia Adjuvante , Chicago , Pré-Escolar , Anormalidades do Sistema Digestório/diagnóstico , Anormalidades do Sistema Digestório/patologia , Anormalidades do Sistema Digestório/cirurgia , Evolução Fatal , Feminino , Hepatoblastoma/diagnóstico , Hepatoblastoma/patologia , Hepatoblastoma/terapia , Hospitais Pediátricos , Hospitais de Ensino , Humanos , Fígado/anormalidades , Fígado/irrigação sanguínea , Fígado/patologia , Fígado/cirurgia , Circulação Hepática/efeitos dos fármacos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Masculino , Terapia Neoadjuvante , Sistema Porta/efeitos dos fármacos , Sistema Porta/patologia , Sistema Porta/cirurgia , Resultado do Tratamento , Carga Tumoral/efeitos dos fármacosAssuntos
Tumores do Estroma Gastrointestinal/diagnóstico , Achados Incidentais , Neoplasias Intestinais/diagnóstico , Laparoscopia/métodos , Neoplasias Gástricas/diagnóstico , Biópsia , Colonoscopia , Diagnóstico Diferencial , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Neoplasias Intestinais/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: The matrix metalloproteinases (MMPs) have been implicated in the aggressive course of non-small cell lung cancer (NSCLC). However, there are a large number of MMP subtypes with diverse proteolytic substrates and different induction pathways. This study tested the hypothesis that a differential MMP profile would exist between NSCLC and normal lung and that MMP patterns would differ between NSCLC histologic types. METHODS: NSCLC samples and remote normal samples were obtained from patients with stage I or II NSCLC with either squamous cell (n = 22) or adenocarcinoma (n = 19) histologic characteristics. Absolute concentrations for each of the MMP subclasses were determined by a calibrated and validated multiplex suspension array: collagenases (MMP-1, -8, and -13), gelatinases (MMP-2 and -9), lysins (MMP-2 and -7), and elastase (MMP-12). RESULTS: Overall, MMP levels were significantly increased in NSCLC compared with normal. For example, MMP-1 and MMP-7 increased by approximately 10-fold in NSCLC (P < .05). Moreover, a different MMP portfolio was observed between NSCLC histologic types. For example MMP-1, -8, -9, and -12 increased by more than 4-fold in squamous cell versus adenocarcinoma (P < .05). In those patients who had recurrence within 3 years of resection, 3-fold higher levels of MMP-8 and -9 were observed (P < .05). CONCLUSION: Increased levels of a number of MMP types occur with NSCLC, but the MMP profile was distinctly different between histologic types and in those patients with recurrence. These different MMP profiles may be important in the mechanistic basis for the natural history of different NSCLC types, as well as identifying potential prognostic and therapeutic targets.
