Anal canal mixed adenoneuroendocrine carcinoma in a young patient misdiagnosed as anal abscess

2021 ◽  
Vol 14 (9) ◽  
pp. e244737
Author(s):  
Roberta Tutino ◽  
Enrico Battistella ◽  
Luca Bonariol ◽  
Marco Massani
Keyword(s):  
Gastrointestinal Tract ◽  
Anal Canal ◽  
Young Patient ◽  
Stable Disease ◽  
Radical Surgery ◽  
Neuroendocrine Neoplasms ◽  
Anal Abscess ◽  
Rare Tumours ◽  
Histological Specimen

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumours of gastrointestinal tract, extremely rare in anal canal. We report a case of misdiagnosed MiNEN in a 38-year-old woman initially conservatively treated for a supposed anal fistula. In a second proctological evaluation, biopsy of the anal neoformation was performed and the histological specimen diagnosed a MiNEN. The complete staging showed a disseminate disease and the patient started a chemotherapy schedule. After 6 months, stable disease was revealed at the last imaging performed and radical surgery was offered to the patient that is actually on oncological follow-up without recurrence at 1 year.

Ninety-one Cases of Tumors of the Anus and Anal Canal.

1967 ◽  
Vol 53 (6) ◽  
pp. 591-600
Author(s):  
Bruno Salvadori ◽  
Giangaspare Valentinis ◽  
Lorenzo Zingo
Keyword(s):  
Survival Rate ◽  
Anal Canal ◽  
National Cancer Institute ◽  
Radical Surgery ◽  
Pelvic Lymphadenectomy ◽  
Surgical Department ◽  
Perineal Resection ◽  
Advanced Tumors

Ninety-one cases of tumors of anus and anal canal, treated in the Surgical Department of the National Cancer Institute of Milan from 1930 to 1965, are discussed. The series consists of 56 females and 35 males; the age of the patients ranges from 31 to 84 years. The distribution of the cases in relation to the age of the patients shows that the highest frequency of tumors was observed in the group of patients of 61–70 years. Twenty-seven patients presented inguinal metastatic nodes; in 18 of them metastases were bilateral. Nineteen patients (20.19 %) presented advanced tumors and could not be radically treated; 33 (36.3 %) underwent radiological treatment; 37 (40.6 %) were amenable to radical surgery: of these, in 26 a perineal resection and in 10 cases an abdomino-perineal resection were performed. In 2 of the last 10 cases a pelvic lymphadenectomy was also performed; in 5 of the patients radically operated a dissection of inguinal nodes was done. A regular follow-up was possible for 29 of the 37 patients radically treated: the 5 years survival rate for the two groups, perineal and abdomino-perineal resection, was of 48 per cent and 50 per cent respectively.

scholarly journals Jejunojejunal Intussusception in an Adult- Secondary to Lipoma

2021 ◽  
Author(s):  
Annie Nitisha ◽  
. Shobana ◽  
Mary Lilly
Keyword(s):  
Abdominal Pain ◽  
Early Intervention ◽  
Gastrointestinal Tract ◽  
Female Patient ◽  
Jejunal Mucosa ◽  
Transabdominal Ultrasound ◽  
Histopathological Features ◽  
Rare Tumours ◽  
Hypoechoic Lesion

Gastric lipomas are very rare Tumours of Gastrointestinal Tract (GIT) accounting for about 2-3% of all benign gastric tumours. They are asymptomatic and discovered incidentally, most lipomas being submucosal. Authors hereby discuss a case of 50-year- old female patient who presented with abdominal pain and vomiting since four days. Transabdominal Ultrasound (TAUS) revealed long segment jejunojejunal intussusception and a hypoechoic lesion in the distal end of intussusception which was successfully treated by removing the lipoma along with the intussuscepted loop. Histopathological features revealed normal jejunal mucosa with a segment of intussusception and edematous submucosa which was thought to be submucosal lipoma or subserosal lipoma. As these lesions present at later dates, proper follow-up and early intervention is needed.

Operabilität und pathologisches Ansprechen des Lungenkarzinoms nach neoadjuvanter Therapie mit Immun-Checkpoint-Inhibitoren

2020 ◽  
Vol 41 (10) ◽  
pp. 695-701
Author(s):  
E. Lücke ◽  
C. Ganzert ◽  
S. Föllner ◽  
A. Wäsche ◽  
D. Jechorek ◽  
...  
Keyword(s):  
Stable Disease ◽  
Neoadjuvante Therapie ◽  
Checkpoint Inhibition ◽  
Pet Ct

Zusammenfassung Hintergrund Eine Blockade von Immun-Escape-Mechanismen (z. B. PD1 /PD-L1) mit Immun-Checkpoint-Inhibition (ICI) kann das Überleben von Patienten mit fortgeschrittenem NSCLC wesentlich verlängern und ausgeprägte Remissionen induzieren. Eine neoadjuvante ICI bei Patienten mit resektablem (UICC-Stadium III) oder oligometastasiertem (UICC-Stadium IVA) NSCLC wurde bisher kaum untersucht. Patienten/Methoden Es wurden Biopsien von Patienten mit lokal fortgeschrittenem oder oligometastasiertem NSCLC untersucht. Es erfolgte bei einer PD-L1-Expression > 50 %, gutem ECOG-Status und zu erwartender Operabilität die ICI-Applikation und nach ca. 4 Wochen die thoraxchirurgische OP. Alle Patienten erhielten ein komplettes Staging einschließlich PET-CT, cMRT und endobronchialem Ultraschall. Es wurden die Verträglichkeit, das radiologische und histologische Tumoransprechen und das chirurgische Outcome analysiert. Ergebnisse 4 Patienten (2 männlich, 2 weiblich, Alter 56–78 Jahre, n  =  3 Adenokarzinom, n  =  1 Plattenepithelkarzinom) erhielten präoperativ einen ICI. Alle Patienten hatten lokal fortgeschrittene Tumore, und die mediastinalen Lymphknoten waren in 3 Fällen positiv. Bei einem Patienten lag eine isolierte Hirnmetastase vor, welche stereotaktisch radiotherapiert wurde. Alle Patienten erhielten präoperativ komplikationslos 2–6 Zyklen eines ICI (3 × Pembrolizumab; 1 × Atezolizumab). Dies führte nicht zu einer Verzögerung der OP. Nach iRECIST zeigten 3 Tumore eine partielle response (PR), und ein Patient wies ein stable disease (SD) auf. Alle Tumore wurden komplett reseziert, und die OP erwies sich trotz inflammatorischer Veränderungen als technisch unproblematisch. Es gab keine behandlungsbezogene Morbidität oder Mortalität und keine perioperativen Komplikationen. In den Resektaten waren jeweils 2-mal ein komplettes pathologisches Ansprechen (CPR), Regressionsgrad III nach Junker, und 2-mal ein Regressionsgrad IIa nach Junker nachweisbar. Das mittlere Follow-up betrug 12 (1–24) Monate. Die PPR-Patienten entwickelten entweder Fernmetastasen nach 6 Monaten oder ein Lokalrezidiv nach 4 Monaten. Die CPR-Patienten sind bisher rezidivfrei. Schlussfolgerungen Eine neoadjuvante Therapie mit ICI ist gut verträglich und kann bei ausgewählten Patienten eine komplette Tumorremission induzieren. Die Behandlung hat keinen negativen Einfluss auf den chirurgischen Eingriff. Die Prognose ist vielversprechend bei CPR und eingeschränkt bei PPR.

scholarly journals A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuhisa Okada ◽  
Yasumitsu Hirano ◽  
Shintaro Ishikawa ◽  
Hiroka Kondo ◽  
Toshimasa Ishii ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Gastrointestinal Tract ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Clear Cell ◽  
Clear Cell Sarcoma ◽  
Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

Is salvage radiotherapy optimal to patients with occult cervical cancer undergoing inadvertent simple hysterectomy? A propensity score-matched analysis of a nationwide clinical oncology database

2021 ◽  
Author(s):  
Yanhong Wang ◽  
Yi Ouyang ◽  
Jingjing Su ◽  
Lihua Xiao ◽  
Zhigang Bai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Radical Surgery ◽  
Figo Stage ◽  
Salvage Radiotherapy ◽  
Radiotherapy Group ◽  
Surgery Group ◽  
Group Matching

Abstract Objective We used National Cancer Institute’s Surveillance, Epidemiology and End Result database to assess the role of salvage radiotherapy for women with unanticipated cervical cancer after simple hysterectomy. Methods Patients with non-metastatic cervical cancer and meeting inclusion criteria were divided into three groups based on treatment strategy: simple hysterectomy, salvage radiotherapy after hysterectomy and radical surgery. Parallel propensity score-matched datasets were established for salvage radiotherapy group vs. simple hysterectomy group (matching ratio 1: 1), and salvage radiotherapy group vs. radical surgery group (matching ratio 1:2). The primary endpoint was the overall survival advantage of salvage radiotherapy over simple hysterectomy or radical surgery within the propensity score-matched datasets. Results In total, 2682 patients were recruited: 647 in the simple hysterectomy group, 564 in the salvage radiotherapy group and 1471 in the radical surgery group. Age, race, histology, grade, FIGO stage, insured and marital status and chemotherapy were comprised in propensity score-matched. Matching resulted in two comparison groups with neglectable differences in most variables, except for black race, FIGO stage III and chemotherapy in first matching. In the matched analysis for salvage radiotherapy vs. simple hysterectomy, the median follow-up time was 39 versus 32 months. In the matched analysis for salvage radiotherapy vs. radical surgery, the median follow-up time was 39 and 41 months, respectively. Salvage radiotherapy (HR 0.53, P = 0.046) significantly improved overall survival compared with simple hysterectomy, while salvage radiotherapy cannot achieve similar overall survival to radical surgery (HR 1.317, P = 0.045). Conclusions This is the largest study of the effect of salvage radiotherapy on overall survival in patients with unanticipated cervical cancer. Salvage radiotherapy can improve overall survival compared with hysterectomy alone, while cannot achieve comparable survival to radical surgery.

Surgery of tympanosclerosis

1997 ◽  
Vol 111 (10) ◽  
pp. 917-923 ◽  
Author(s):  
Syed Akhtar Kamal
Keyword(s):  
Middle Ear ◽  
Radical Surgery ◽  
Stapes Surgery ◽  
Hearing Improvement ◽  
Short Term ◽  
Two Stage ◽  
Chi Square ◽  
Physiological Basis

AbstractEighty-five cases with tympanosclerosis of the middle ear were treated surgically in this series from 1984 to 1995. Twelve of them were associated with cholesteatoma and had radical surgery performed. An attempt is made here to classify the tympanosclerosis on a patho-physiological basis. A planned two-stage procedure was performed in 36 cases after an interval of 18 months. The majority of patients had stapes surgery carried out by a two-stage procedure. One of the patients who did not have stapes surgery developed anacusis after 18 months post-operatively and in another patient recurrence was observed. Post-operative hearing improvement was found to be satisfactory in the short-term follow-up period of two to five years. The hearing improvement was analysed by using Chi-square value (x2) and also plotted in the Glasgow Benefit Plot.

Bowen’s Disease of the Anal Canal Treated with Radiation Therapy: A Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
I. Mbarki Mbarki
Keyword(s):  
Anal Canal ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Intraepithelial Neoplasia ◽  
Bowen’S Disease ◽  
Bowen's Disease ◽  
Radiological Response ◽  
Slow Growing

Bowen’s disease, also known as intraepithelial neoplasia, is a very slow-growing carcinoma in situ. It can progress to an invasive squamous cell cancer and infiltrate mucosa or skin in 3 to 5% of cases. The anal localization of this disease is very rare. Surgical resection is the standard of treatment. Radiotherapy keeps its place in recurrent or unresectable cases. We report a case of Bowen’s anal canal disease in order to verify the effectiveness of Radiotherapy. He is a 59-years-old patient diagnosed with Bowen’s anal canal disease at the National Institute of Oncology in Rabat. He was treated with exclusive radiotherapy at a dose of 60 Gray in 30 fractions over 49 days. The evolution was marked by a complete clinical and radiological response and preservation of the anal sphincter with an 18 months follow-up.

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