scholarly journals Therapeutic mammotome excisions: papillary lesions

2006 ◽  
Vol 9 (9) ◽  
pp. 1-3
Author(s):  
Liane Philpotts
Keyword(s):  
Surgical Intervention ◽  
Breast Biopsy ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Biopsy Specimens ◽  
Complete Surgical Excision ◽  
Reasonable Approach ◽  
Papillary Lesions ◽  
Benign Papilloma ◽  
The Cost

Papillary lesions of the breast are fairly common on imaging-guided breast biopsy, and the management remains controversial. Due to the heterogeneity of histological findings, papilloma can be a challenge to the pathologist when interpreting core biopsy specimens, so some may desire the entire lesion to be removed to be confident of the diagnosis of a benign papilloma. In appropriate cases, an attempt at removal with vacuum-assisted biopsy appears a reasonable approach with the hopes of establishing a diagnosis, relieving symptoms of nipple discharge, and avoiding the cost and morbidity of surgical intervention. The management of lesions with atypia on mammotome excision will remain controversial and the prudent approach is to recommend complete surgical excision.

scholarly journals Falx cerebri tuberculoma mimicking en plaque meningioma – case report

2016 ◽  
Vol 30 (2) ◽  
pp. 209-213
Author(s):  
A.I. Cucu ◽  
Dana Mihaela Turliuc ◽  
Anca Sava ◽  
Gabriela Florenţa Dumitrescu ◽  
Ş. Turliuc ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Histopathological Examination ◽  
Surgical Excision ◽  
Antituberculous Therapy ◽  
Falx Cerebri ◽  
Clinical Imaging ◽  
Complete Surgical Excision ◽  
Histopathologic Diagnosis ◽  
History Of ◽  
Cerebral Tuberculosis

Abstract Background: The involvement of falx cerebri in tuberculosis is extremely rare, with only three cases reported so far in the literature. The diagnosis is most often difficult to establish, given the location of the lesion, making surgical intervention necessary for a definite histopathologic diagnosis. Methods: We present the case of a 49-year old female patient who was admitted for a right jacksonian seizure, followed by a right crural monoparesis, without a history of tuberculosis. The lesion mimicked a falx cerebri en plaque meningioma in the imaging tests. Results: A complete surgical excision was performed through a left fronto-parietal parasagittal approach. The histopathological examination revealed a case of cerebral tuberculosis. The surgical treatment was complemented postoperatively with antituberculous therapy. Conclusion: In this article, we emphasize the rarity of the lesion at this level and also presenting similar cases from the literature. Moreover, we also discuss epidemiological, clinical, imaging, therapeutic as well as pathological aspects of en-plaque dural tuberculoma.

Papillary Breast Lesions: Association with Malignancy and Upgrade Rates on Surgical Excision

2017 ◽  
Vol 83 (11) ◽  
pp. 1294-1297 ◽  
Author(s):  
Hanh-tam Tran ◽  
Asma Mursleen ◽  
Sahar Mirpour ◽  
Omar Ghanem ◽  
Maen J. Farha
Keyword(s):  
Carcinoma In Situ ◽  
Breast Lesion ◽  
Ductal Carcinoma ◽  
Surgical Excision ◽  
Intraductal Papilloma ◽  
Breast Lesions ◽  
Aggressive Approach ◽  
Papillary Lesions ◽  
Benign Papilloma

Intraductal papilloma falls under the category of benign breast mass. However, recent studies show that it can harbor occult carcinoma. The management of benign intraductal papilloma remains controversial because of its nonspecific radiologic and histological findings, as well as its association with surrounding malignant pathology. The purpose of this study is to investigate upgrade rates of a benign intraductal papilloma on surgical excision and the need for surgical excision of papillary lesions diagnosed at core needle biopsy. A retrospective review of a single institution's pathology database between 2011 and 2015 identified 43 core biopsies with benign papilloma. We followed the upgrade rates of these lesions on surgical excision. There were 90 biopsies with the diagnosis of benign intraductal papilloma. The average age was 55.2 (range from 24–87 years old). Forty-three had benign intraductal papilloma; 28 of the 43 core biopsies had surgical excision. Two (7.1%) had an upgrade from benign intraductal papilloma to intraductal papilloma with atypia. One (3.6%) had an upgrade to ductal carcinoma in situ. None had invasive cancer. Surgical findings were in agreement with core biopsies in 25 (89.3%) of 28 cases (κ = 0.80, P < 0.0001). Core biopsies have a statistically significant correlation with pathologies on surgical excision in detecting atypia in breast lesion as demonstrated by κ = 0.80. However, the study shows benign intraductal papillomas on core biopsy have an upgrade rate of 10.7 per cent after undergoing surgical excision. As such, we recommend a more aggressive approach including surgical excision of all benign intraductal papillary lesions.

Papillary Lesions Initially Diagnosed at Ultrasound-guided Vacuum-assisted Breast Biopsy: Rate of Malignancy Based on Subsequent Surgical Excision

2011 ◽  
Vol 18 (9) ◽  
pp. 2506-2514 ◽  
Author(s):  
Jung Min Chang ◽  
Wonsik Han ◽  
Woo Kyung Moon ◽  
Nariya Cho ◽  
Dong-Young Noh ◽  
...  
Keyword(s):  
Breast Biopsy ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Papillary Lesions ◽  
Biopsy Rate

scholarly journals Atypical papillary lesions after core needle biopsy and subsequent breast carcinoma

2011 ◽  
Vol 5 (2) ◽  
pp. 243-248
Author(s):  
Tuenchit Khamapirad ◽  
Caitlin Andrews ◽  
Jenjeera Prueksadee ◽  
Morton Leonard ◽  
Louisea Bonoan-Deomampo ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Papillary Lesion ◽  
Architectural Distortion ◽  
Core Needle ◽  
Multiple Imaging ◽  
Papillary Lesions ◽  
Benign Papilloma

Abstract Background: Papillary lesions of the breast cause diagnostic problem because papillary structures are found in benign and malignant processes. Core needle biopsy is important to make an initial diagnosis, but it still has potential pitfalls. Comparison between core needle biopsy and excisional biopsy can predict the possibility of malignant change in atypical papillary lesions. Objective: Evaluate the concordance between core needle biopsy and excisional results in atypical papillary lesions of the breast. Materials and methods: The pathology database of University of Texas Medical Branch at Galveston, USA was searched for patients with atypical papillary lesions at core needle biopsy who subsequently underwent surgical excision. Pathology reports from the excisional biopsies was also examined to assign each case to one of three categories, downgrade to benign papilloma, no change (remained atypical papillary lesion), and upgrade to carcinoma. The mammograms and ultrasounds were reviewed for each case. They characterized the lesions according to multiple imaging criteria. Results: Twenty-four patients with atypical papillomas at core biopsy subsequently underwent surgical excision. The lesions were downgraded to benign papilloma in 25%, remained atypical papillary lesion in 33%, and upgraded to carcinoma in 42%. On mammographic presentations (n = 23), masses were in 61%, architectural distortion in 4.3%, mass with calcifications in 9%, mass with architectural distortion and calcifications in 4.3%, calcifications alone in 17.4%, and architectural distortion and calcifications in 4.3%. On ultrasound findings (n = 21), solid masses were in 90%, intracystic masses in 10%, peripheral in locations in 81%, and subareolar in location in 19%. Conclusion: Due to the high upgrade rate of atypical papillary lesions to carcinoma (42%), excision of all atypical papillary lesions with wide excision margin is recommended for cases with pathologic diagnosis of atypical papillary lesion on core-needle biopsy.

scholarly journals Papillary Lesion of the Breast in a Young Girl Suspicious to Juvenile Papillomatosis, Clinical Decision Making in a Multi-disciplinary Team and Review of the Literature

2020 ◽  
pp. 100-103
Author(s):  
Marzieh Mohammadi Zavieh ◽  
Farid Azmude Ardalan ◽  
Farnaz Karimi ◽  
Nahid Sedighi ◽  
Ramesh Omranipour ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Decision Making ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Clinical Decision ◽  
Papillary Lesion ◽  
Pathology Report ◽  
Papillary Lesions ◽  
The Right ◽  
Multi Disciplinary Team

Background: Papillary lesions of the breast are a heterogeneous group of neoplasms, the diagnosis and treatment of which is challenging. Typically surgical excision is recommended for papillary lesions after core needle biopsy (CNB) to rule out concurrent malignancy when a diagnosis of papilloma with atypia is yielded on CNB. For papilloma without atypia, however, making a decision about excision versus observation is challenging.Case Presentation: A 14-year-old female with nipple discharge, and a 2 cm mass in the right breast, with the pathology of intra-ductal papilloma without atypia on CNB presented. The question to be answered by multi-disciplinary team was the best management of this papillary lesion and whether the follow up was adequate or excision was mandatory.Question: What is the best plan for management of the young patient according to the primary pathology report of Juvenile Papillomatosis?Conclusion: Histoathology review of CNB specimen in rare and high risk lesions may have some advantages. On the other hand, in high risk circumstances, the excision of the lesion is recommended. Thus, in this case, the multi-disciplinary team recommended excision of the lesion.

scholarly journals Schwannoma Misdiagnosed as Adrenal Adenoma: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mussa H. AlMalki ◽  
Metib Alotaibi ◽  
Mohammad Maswood Ahmad ◽  
Muhammad Amin ur Rahman ◽  
Turki Alharthi
Keyword(s):  
Immunohistochemical Staining ◽  
Surgical Intervention ◽  
Adrenal Adenoma ◽  
Surgical Excision ◽  
Flank Pain ◽  
Review Of The Literature ◽  
Postoperative Course ◽  
Large Size ◽  
Complete Surgical Excision ◽  
Neural Sheath

Schwannoma is a benign neurogenic tumor originating from the neural sheath of Schwann cells. It is an extremely rare cause of adrenal adenoma which is very difficult to diagnose preoperatively. We report the case of a right adrenal schwannoma discovered incidentally in a 62-year-old woman during evaluation of right flank pain. The biochemical and hormonal evaluations were unremarkable. Radiological examination revealed a 4.8 cm lesion keeping with right adrenal adenoma. Surgical intervention was done due to the large size of the tumor, and laparoscopic right adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma, which was further confirmed by immunohistochemical staining. In conclusion, adrenal schwannoma is extremely rare and can be misdiagnosed as nonsecreting adrenal adenoma. Complete surgical excision is the treatment of choice which is associated with favorable outcome and also helps in clarifying its histopathological nature.

Papillary Lesions on Core Breast Biopsy: Excisional Biopsy for All Patients?

2013 ◽  
Vol 79 (12) ◽  
pp. 1238-1242 ◽  
Author(s):  
Lee J. McGhan ◽  
Barbara A. Pockaj ◽  
Nabil Wasif ◽  
Marina E. Giurescu ◽  
Ann E. McCullough ◽  
...  
Keyword(s):  
Papillary Carcinoma ◽  
Breast Biopsy ◽  
Lobular Carcinoma ◽  
Significant Proportion ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Lesion Size ◽  
Papillary Lesions

Excisional biopsy has been recommended for papillary lesions diagnosed on core needle biopsy (CNB) because a significant proportion of cases are upstaged to in situ/invasive cancer after surgical excision. The study goals were to identify patients at lowest risk of upstaging in whom excisional biopsy may potentially be avoided. We retrospectively evaluated 46 patients with a papillary lesion on CNB. Six patients were upstaged overall (13%), to intraductal papillary carcinoma (7%), invasive papillary carcinoma (4%), and mixed invasive ductal/lobular carcinoma (2%). The upstaging rate for patients with atypia on CNB was higher than for patients without atypia (33 vs 3%, P = 0.011). No patient younger than 65 years was upstaged to in situ or invasive carcinoma, and the mean lesion size was also higher among patients who were upstaged ( P > 0.05). Patients younger than 65 years with small papillary lesions lacking atypia on CNB may therefore represent a low-risk group that may be offered close clinical and radiologic follow-up.

scholarly journals Surgical excision: an effective initial therapeutic option in the management of giant macrocystic lymphatic malformations in children

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Moaied A. Hassan ◽  
Hasan K. Gatea ◽  
Thura K. Ja’afar
Keyword(s):  
Therapeutic Option ◽  
Surgical Excision ◽  
Functional Results ◽  
The Body ◽  
Lymphatic Malformations ◽  
Therapeutic Modalities ◽  
Complete Surgical Excision ◽  
Cystic Tumors ◽  
Cystic Cavity ◽  
Embryologic Development

Abstract Background Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results. The study is designed to assess the effectiveness and safety of surgical excision as an initial therapeutic option in the management of these malformations. Results Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them. Conclusion Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.

scholarly journals Resolution of Metastatic Subungal Eccrine Porocarcinoma Treated with Intralesional Interleukin-2

2020 ◽  
Vol 28 (1) ◽  
pp. 220-225
Author(s):  
Ashley Drohan ◽  
Jennifer Melvin ◽  
Joanne Murphy ◽  
Carman Giacomantonio ◽  
Lucy Helyer
Keyword(s):  
Interleukin 2 ◽  
Standard Of Care ◽  
Surgical Excision ◽  
Distant Recurrence ◽  
Unique Case ◽  
Cutaneous Malignancy ◽  
Complete Surgical Excision ◽  
Locally Recurrent ◽  
Eccrine Porocarcinoma

Eccrine porocarcinoma is a rare aggressive cutaneous malignancy. Complete surgical excision is the standard of care, although there are high rates of local and distant recurrence. We present a unique case of locally recurrent and metastatic subungal porocarcinoma successfully treated with intralesional interleukin-2.

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