Unresectable Hepatocellular Carcinoma with a Solitary Metastasis to the Mandible

2008 ◽  
Vol 74 (4) ◽  
pp. 346-349
Author(s):  
Ryan Li ◽  
Rohan R. Walvekar ◽  
Michael A. Nalesnik ◽  
T. Clark Gamblin
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ct Scan ◽  
Health Resources ◽  
Immunohistochemical Analysis ◽  
Metastatic Tumor ◽  
The United States ◽  
The Body ◽  
Hepatitis C Infection ◽  
Solitary Metastasis ◽  
The Right

Hepatocellular carcinoma (HCC) continues to pose a worldwide burden on health resources with an occurrence of 1.4 million cases annually. It represents the fifth most common cancer in men and eighth most common in women worldwide. Eighty per cent of patients have a background cirrhotic liver, most commonly in the United States, resulting from chronic hepatitis C infection, whereas alcoholism also commonly contributes to the development of cirrhosis. Fifty per cent of patients diagnosed with HCC present with metastatic disease. Sites of metastasis commonly include the lungs, vertebral bones, and abdominal lymph nodes. Metastasis to the oral region is very rare. We report a 55-year-old man with metastatic HCC to the mandible. The patient was previously diagnosed with unresectable HCC and had undergone six cycles of chemoembolization therapy. Although the lesion remained stable in size, he did not qualify for liver transplantation because of active alcohol use. He presented to the emergency room for evaluation of recent-onset jaw pain. There was no history of trauma and an oral examination did not reveal any mucosal lesions. Mild swelling and tenderness of the right jaw was noted, and a subsequent CT scan revealed a right-sided mass centered around a fracture of the body of the mandible and surrounded by the masseter muscle. A biopsy of the mass revealed a metastatic hepatocellular carcinoma and a CT scan of the chest, abdomen, and pelvis confirmed it to be a solitary metastasis. The patient underwent surgical resection of a segment of the right mandible and the metastatic tumor. He continues to receive regional chemoembolization and is currently pain-free. Solitary metastasis to the mandible in the setting of HCC is exceedingly rare. Fine needle aspiration biopsy of the lesion with immunohistochemical analysis is useful in characterizing the lesion and identifying the primary site. Radiotherapy has been used to palliate mandibular metastases; however, surgical intervention proved to be very effective in managing this patient's disease.

Intracranial and Orbital Metastasis of Hepatocellular Carcinoma: Report of Two Cases

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 863-866 ◽  
Author(s):  
Shinichiro Wakisaka ◽  
Manabu Tashiro ◽  
Shinichi Nakano ◽  
Toshihiro Kita ◽  
Hiroto Kisanuki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Primary Tumor ◽  
Relevant Literature ◽  
Occipital Lobe ◽  
Metastatic Tumor ◽  
Orbital Tumors ◽  
Primary Hepatoma ◽  
Orbital Metastasis ◽  
Left Orbit ◽  
The Right

Abstract Two cases of rare intracranial and orbital metastasis of hepatocellular carcinoma are presented. A 61-year-old woman was found to have a metastatic tumor in the right temporo-occipital lobe 1 year after undergoing treatment for a primary hepatoma. An osteolytic tumor was removed from the left orbit of a 58-year-old man and the primary tumor, a hepatoma, was discovered postoperatively. The intracranial and orbital tumors were verified to be hepatocellular carcinoma. Both patients died within 1 year of surgery. The relevant literature is briefly reviewed.

scholarly journals SAT-364 Brown Tumor of the Mandible in Severe Uncontrolled Primary Hyperparathyroidism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Suruchi K Gupta ◽  
Runhua Hou ◽  
Harold Rosen
Keyword(s):  
Primary Hyperparathyroidism ◽  
Ct Scan ◽  
The United States ◽  
Osteitis Fibrosa ◽  
Brown Tumor ◽  
Osteitis Fibrosa Cystica ◽  
Hypercalcemia Of Malignancy ◽  
Brown Tumors ◽  
The Right ◽  
Pth Level

Abstract Background: Brown tumors are a part of the complex “osteitis fibrosa cystica” which is a diffuse resorptive process of the bone resulting from uncontrolled hyperparathyroidism. Although these brown tumors were fairly common in the past1, the incidence of brown tumors is now extremely rare in the United States due to early diagnosis and treatment of hyperparathyroidism. Here we describe an unusual presentation for osteitis fibrosa cystica. Clinical Case: A 38 year old woman was admitted to the hospital with rapidly growing facial swelling in June 2019. The swelling initially appeared in January 2019 and had rapidly increased in size since April 2019. The mass was malodorous, painful and interfered with oral intake. The patient smoked 1 pack per day for 13 years. A CT scan of the head and neck with contrast showed a 3.6 x 4.5 x 3.3 cm mass destroying the right mandibular body, involving the right platysma muscle and displacing the central and lateral incisor teeth and was concerning for malignancy. The initial impression was that this was likely a squamous cell carcinoma with local and perhaps distant metastases, complicated by humoral hypercalcemia of malignancy and she was admitted for management. Upon admission, her calcium level was 14 mg/dL, albumin 4.1 g/dL, phosphorus 1.4 mg/dL PTH level was 890 pg/mL and vitamin D level was 22 ng/mL. Since the high PTH did not fit with hypercalcemia of malignancy, further evaluation was undertaken. A thyroid ultrasound showed a 4.6 x 1.8 x 1.5 cm isoechoic, heterogeneous lesion in the left lower pole, and Tc-99 sestamibi scan suggested parathyroid origin. The biopsy of the mouth lesion showed fibro histiocytic proliferation with multiple giant cells, negative for malignancy and consistent with a brown tumor. CT scan of the chest, abdomen and pelvis did not reveal any other masses or lytic lesions. . A skeletal survey showed another 2 cm lytic lesion in the proximal left humeral metaphysis which was not biopsied. On parathyroidectomy, the patient was found to have an enlarged left inferior parathyroid gland measuring 3.3 x 3.0 x 0.8 cm weighing 7.093 grams. Intraoperatively PTH level decreased from 890 pg/mL to 69 pg/mL. Her calcium levels returned to normal post-operatively and she was discharged home. Pathologic examination report revealed the mass to be a parathyroid adenoma. The patient reports a reduction in the size of her mandible mass since the surgery. Conclusion: Although uncommon, brown tumors can be seen in uncontrolled primary hyperparathyroidism. The mandible is a common site, though, as in this case, it is less common for it to be the only site affected Reference: 1. Rosenberg, E. H. (1962). Hyperparathyroidism. A review of 220 proved cases with special emphasis on findings in the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 15(2), 84–94.

scholarly journals http://medcraveonline.com/JNSK/case-on-venous-sinus-thrombosis-the-unexpected-should-be-expected.html

2020 ◽  
Vol 10 (1) ◽  
pp. 58-59
Author(s):  
Rafael Ferreira Nascimento ◽  
Fabiana Gouveia ◽  
João Miguel Freitas ◽  
João Patrício Freitas ◽  
Rafael Rafael Freitas
Keyword(s):  
Ct Scan ◽  
Sinus Thrombosis ◽  
Vascular Diseases ◽  
Duplex Ultrasound ◽  
Transverse Sinus ◽  
The Body ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Neurological Exam ◽  
The Right

ntroduction: The authors present a venous sinus thrombosis that started in a woman 10 days after labour. Case Report: A 34-year old woman, who had gone into labor 10 days before her admission, presented to the emergency department with paresthesia on the right side of the body and dysarthria which started that day. The neurological exam showed predominant right brachial paresis associated with a diminished sensitivity in the right arm and leg. The CT-Scan revealed a venous thrombosis that reached the straight, superior and transverse sinus, with a greater extension on the right side involving multiple tributary veins. The admission in the cerebral vascular diseases unit was followed by heparin perfusion. Ten days after the onset of the episode the patient was submitted to another CT-Scan that showed resolution of the thrombosis. Goldman campimetry was considered normal. The patient was discharged from the unit and started an etiologic search, which pointed to the pregnancy as the main reason for the event. The echocardiogram and cervical duplex ultrasound were normal. Currently, the patient does not show any sequels and maintains follow-up in the cerebrovascular disease consult. Conclusion: The authors highlight the role of the physician in the diagnosis of a rare entity in a woman, 10 days after labour, without any relevant past medical history.

scholarly journals Colonic metastasis of hepatocellular carcinoma with repeated retroperitoneal bleeding: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Wataru Miyauchi ◽  
Manabu Yamamoto ◽  
Makinoya Masahiro ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Muscularis Propria ◽  
Metastatic Tumor ◽  
Radical Resection ◽  
Right Hemicolectomy ◽  
Pathological Examination ◽  
Ascending Colon ◽  
Colonic Metastasis ◽  
Case Presentation ◽  
The Right

Abstract Background Colonic metastasis is uncommon in patients with hepatocellular carcinoma (HCC). In the past, extrahepatic metastasis of HCC was not treated aggressively because of its poor prognosis. Herein, we describe the case of a patient with HCC who survived for 30 months following resection of a metastatic tumor in the ascending colon. Case presentation An 80-year-old man presented at our hospital with symptoms of abdominal pain on the right side and fever. He had undergone transcatheter arterial chemoembolization and posterior segment resection of the liver because of HCC, followed by radiofrequency ablation for a recurrent intrahepatic lesion 5 and 3 years, respectively, prior to the visit. He was diagnosed with retroperitoneal hematoma, which was thought to be associated with diverticulitis and an extramural tumor in the ascending colon. A definitive diagnosis could not be reached; however, a right hemicolectomy of the colon was performed because of progression to anemia. A pathological examination revealed a metastatic tumor in the ascending colon extending from the subserosal layer to the muscularis propria layer. The patient was treated with lenvatinib after surgery, but presented with intrahepatic recurrence, lymph node metastasis, and peritoneal dissemination metastasis 15 months later. The progression of the disease could not be controlled and his postoperative survival time was 30 months. Conclusion Resection of metastasis of HCC might contribute to prolonged survival in cases, where radical resection is possible.

scholarly journals The Borowski Case

2019 ◽  
Vol 20 (2) ◽  
pp. 299-324
Author(s):  
Morris C. Shumiatcher
Keyword(s):  
Physical Disabilities ◽  
The United States ◽  
Criminal Code ◽  
The Body ◽  
West Germany ◽  
Trial Court ◽  
Canadian Charter ◽  
Living State ◽  
The Right ◽  
The Impact

The Borowski case first establishes Borowski's status and right to represent the unborn in his action to have the provisions of the Criminal Code concerning abortion declared a violation of the Canadian Charter of Rights and Freedoms. The author, Borowski's lawyer, then presents his arguments in favor of the rights of the unborn: Sections 7 and 15 of the Canadian Charter, confirm his rights by guaranteeing the right of “everyone” to “life, liberty and security” and by protecting his against “discrimination based upon mental or physical disabilities”. In spite of the testimonies of the world's outstanding authorities in the fields of perinatology, neonatalogy, embryology, gynecology, neurosurgery and abortion, the Trial court, turning to Section 206 of the Criminal Code, concluded that until a child leaves the body of his or her mother in a living state, he or she is not a human being. Moreover, the unborn is not “someone” encompassed in the word “everyone” of Section 7 of the Charter. English and Canadian jurisprudence is then reviewed by the author. He proceeds to analyze the impact of important decisions rendered in Spain, West-Germany and the United States and examines the consequences of the Morgentaler decision.

scholarly journals GAMBARAN CT SCAN TUMOR PARU DI BAGIAN / SMF RADIOLOGI FK UNSRAT RSUP PROF. DR. R. D. KANDOU MANADO PERIODE OKTOBER 2014-SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Meidianty Tandi ◽  
Vonny N. Tubagus ◽  
Martin L. Simanjuntak
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Lung Tumor ◽  
Malignant Tumors ◽  
Smoking Habit ◽  
The Body ◽  
Epithelial Tissue ◽  
Computed Tomography Scan ◽  
The Right ◽  
Tomography Scan

Abstract: Lung tumor has become one of the most common tumors in the world. Lung tumor is the growth of abnormal lumps on lung tissue that could be benign or malignant, derived from malignant tumors of primary epithelial tissue in respiratory tract especially bronchus that could invade nearby tissue structures, and potentially spread throughout the body by bloodstream and lymphatic system. Approximately 1.59 billion people worldwide died from lung malignancy resulting from the increasing of smoking habit which is one of the risk factors of lung tumor. CT scan is the chosen modality on diagnosing the suspicion of lung tumor and also to evaluate the tumor itself. The aim of this study is to identify the CT scan images on patients with lung tumor. Retrospective descriptive study was conducted on November 2015. The data was obtained from thorax CT scan examination request forms and eventually 41 cases of lung tumor were found eligible according to inclusion criteria. Based on radiologic diagnosis there were 41 cases (39,4%) of lung tumor. The patients were mostly male with 35 patients (85.4%), the largest age group is middle aged adults with 30 patients (73.2%), and the most common site of tumor was the right lung with 22 cases (53.7%), moreover the most complication of lung tumor is pleural effusion with 13 cases (31.7%). Conclusion: Lung tumor is one of malignancies that become risk factor of deaths worldwide.Keywords: lung tumor, computed tomography scan. Abstrak: Tumor paru menjadi salah satu tumor yang paling banyak ditemui di dunia. Tumor paru adalah tumbuhnya benjolan abnormal pada jaringan paru yang dapat bersifat jinak atau ganas, serta berasal dari tumor ganas epitel primer saluran nafas terutama bronkus yang dapat menginvasi struktur jaringan disekitarnya dan berpotensi menyebar ke seluruh tubuh melalui aliran darah dan sistem limfatik. Terdapat sekitar 1,59 miliar orang di dunia meninggal dunia akibat keganasan pada paru-paru karena tingginya kebiasaan merokok yang merupakan salah satu faktor resiko terjadinya tumor pada paru. CT scan menjadi modalitas terpilih untuk menegakkan diagnosis kecurigaan tumor paru dan untuk mengevaluasi tumor paru tersebut. Penelitian ini bertujuan untuk mengetahui gambaran CT scan pada penderita tumor paru dan menggunakan jenis penelitian deskriptif retropektif yang dilakukan pada bulan November 2015. Data diperoleh melalui lembaran permintaan pemeriksaan CT scan toraks dan didapatkan sebanyak 41 kasus tumor paru yang masuk dalam kriteria inklusi.Terdapat 41 kasus (39,4 %) tumor paru berdasarkan diagnosis radiologis. Penderita terbanyak adalah laki-laki 35 orang (85,4%), golongan umur terbanyak adalah umur 41-65 tahun yaitu 30 orang (73,2%), lokasi tumor paru terbanyak pada pulmo dextra yaitu 22 kasus (53,7%) dan komplikasi terbanyak adalah tumor paru dengan efusi pleura saja sebanyak 13 kasus (31,7%). Simpulan: Tumor paru merupakan salah satu penyakit keganasan yang menjadi faktor resiko kematian di seluruh dunia.Kata kunci: tumor paru, computed tomography scan.

scholarly journals Morphological parallels of communications between the circumventricular system in adolescents

2016 ◽  
Vol 7 (1) ◽  
pp. 37-42
Author(s):  
T. S. Komshuk
Keyword(s):  
Magnetic Resonance ◽  
Ct Scan ◽  
Lateral Ventricle ◽  
Ventricular System ◽  
The Body ◽  
Anterior Horn ◽  
Clinical Hospital ◽  
Iii Ventricle ◽  
The Right ◽  
The Brain

This article presents, based on the example of morphometric study of magnetic resonance tomograms of persons of various ages, the complex of vital characteristics of the cerebrospinal system of the brain in adolescents. The study tested gender characteristics and inter hemispheric asymmetry of the analyzed indexes. An asymmetry of anatomical structures of the right and left hemispheres with the tendency to increase in their sizes in the right hemisphere was found both for males and for females. Females had some age differences in the longitudinal dimension of the III ventricle (this index was lower in older females), the width and index of the IV ventricle was significantly lower in the 18 and 20 year old girls. Objective and methods. The research was conducted on the base of the radiation diagnosis department of Rivne Regional Clinical Hospital on the CT scan General Electric Healthcare Signa MRI 1.5 T and in the office of magnetic resonance imaging of Lutsk City Clinical Hospital on the CT scan Signa Profile Ce Medical System – 1,5 Tl in standard anatomic planes (sagittal, frontal andaxial). Measurements were carried out in persons without visual signs of organic lesions of the brain and skull. Analysis was made of 11 tomograms (males 17–21 years old – 6 persons, females 16–20 years old – 5 persons). In comparing pairs of parameters (of lateral ventricles) the factor of asymmetry was calculated, which is equal to the difference between the right and left lateral ventricles divided by the sum of right and left ventricles indexes (%). The results were processed by methods of descriptional statistics. In young males of this age group a significant increase in the following indicators was identified: the length of the anterior horn of the lateral ventricle on the right side, the length of the body of the lateral ventricle on both sides and the height of the III ventricle. Females had significantly increases in the following parameters: the width of the anterior horn of the lateral ventricle on the right side and the width of the posterior horn of the lateral ventricle on the left side. Consequently, in male adoles cents a parallelism in the formation of various structures of the ventricular system was traced. Since this is a single system, morphological and functional connections between its different components are stored. Mathematical analysis of the values of the structures of ventricular system in females characterize a hormonal influence on its development in adolescents. We can assume that organs which are the part of the circumventricular system (subcommisural organ, subfornical organ, median rise etc.), definitely have the character of anatomical connections between these components. Their functional unity in maintaining the homeostasis of the body is undeniable.

scholarly journals Lung Cancer Presenting as Skin Metastasis of the Back and Hand: A Case Series and Literature Review

2019 ◽  
Vol 12 (2) ◽  
pp. 480-487 ◽  
Author(s):  
Misbahuddin Khaja ◽  
Daniel Mundt ◽  
Rizwan Ahmed Dudekula ◽  
Umair Ashraf ◽  
Shehriyar Mehershahi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Ct Scan ◽  
Left Lung ◽  
Case Series ◽  
The United States ◽  
Middle Lobe ◽  
Skin Metastasis ◽  
Smoking History ◽  
Poorly Differentiated ◽  
The Right

Lung cancer has the highest mortality of all cancers in the United States. The incidence of lung cancer with metastases to the skin varies between 1–12%, with the highest incidence seen in men. Here, we present two cases of lung cancer presenting as skin metastasis. The first patient was an 80-year-old African American male who presented to the hospital for evaluation of a right upper back mass. A few months prior to admission, he was found to have a left lung mass on CT scan of the chest, he underwent biopsy which showed poorly differentiated SCC of the lung. He also had a skin biopsy which showed poorly differentiated carcinoma in the dermis consistent with metastatic SCC. He was started on chemotherapy, but could not tolerate it. He was accepted to hospice. The second patient was a 78-year-old Hispanic female who presented to the hospital with dyspnea, and a dry cough. Upon physical examination, a 2 × 2 cm ulcerated, wart-like nodule on the right palm was noted. Subsequent CT scan of the chest showed a partial collapse of the right middle lobe. A biopsy of the hand mass revealed well-to-moderately differentiated metastatic SCC favoring lung origin. A bronchoscopy biopsy showed invasive SCC. Subsequently her condition worsened and she passed away. Metastasis to the skin is an unusual presenting symptom of lung cancer. It is therefore essential to consider metastasis as a diagnosis in a patient with both a skin lesion and a smoking history.

scholarly journals Primary Pleural Angiosarcoma in a 63-Year-Old Gentleman

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed Abu-Zaid ◽  
Shamayel Mohammed
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Histopathological Examination ◽  
Case Reports ◽  
Immunohistochemical Analysis ◽  
Whole Body ◽  
Cytologic Examination ◽  
Ct Guided ◽  
Positron Emission ◽  
The Right

Primary pleural angiosarcomas are extremely rare. As of 2010, only around 50 case reports have been documented in the literature. Herein, we report the case of a 63-year-old gentleman who presented with a 3-month history of right-sided chest pain, dyspnea, and hemoptysis. Chest X-ray showed bilateral pleural effusion with partial bibasilar atelectasis. Ultrasound-guided thoracocentesis showed bloody and exudative pleural fluid. Cytologic examination was negative for malignant cells. An abdominal contrast-enhanced computed tomography (CT) scan showed two right diaphragmatic pleural masses. Whole-body positron emission tomography/computed tomography (PET/CT) scan showed two hypermetabolic fluorodeoxyglucose- (FDG-) avid lesions involving the right diaphragmatic pleura. CT-guided needle-core biopsy was performed and histopathological examination showed neoplastic cells growing mainly in sheets with focal areas suggestive of vascular spaces lined by cytologically malignant epithelioid cells. Immunohistochemical analysis showed strong positivity for vimentin, CD31, CD68, and Fli-1 markers. The overall pathological and immunohistochemical features supported the diagnosis of epithelioid angiosarcoma. The patient was scheduled for surgery in three weeks. Unfortunately, the patient died after one week after discharge secondary to pulseless ventricular tachycardia arrest followed by asystole. Moreover, we also present a brief literature review on pleural angiosarcoma.

The future is in front, to the right, or below: Development of spatial representations of time in three dimensions

2021 ◽  
Author(s):  
Ariel Starr ◽  
Mahesh Srinivasan
Keyword(s):  
Individual Differences ◽  
The United States ◽  
The Body ◽  
Three Dimensions ◽  
English Speakers ◽  
Personal Factors ◽  
The Past ◽  
The Future ◽  
Future Events ◽  
The Right

Across cultures, people frequently communicate about time in terms of space. English speakers in the United States, for example, might “look forward” to the future or gesture toward the left when talking about the past. As shown by these examples, different dimensions of space are used to represent different temporal concepts. Here, we explored how cultural factors and individual differences shape the development of two types of spatiotemporal representations in 6- to 15-year-old children: the horizontal/vertical mental timeline (in which past and future events are placed on a horizontal or vertical line that is external to the body) and the sagittal mental timeline (in which events are placed on a line that runs through the front-back axis of the body). We tested children in India because the prevalence of both horizontal and vertical calendars there provided a unique opportunity to investigate how calendar orientation and writing direction might each influence the development of the horizontal/vertical mental timeline. Our results suggest that the horizontal/vertical mental timeline and the sagittal mental timeline are constructed in parallel throughout childhood and become increasingly aligned with culturally-conventional orientations. Additionally, we show that experience with calendars may influence the orientation of children’s horizontal/vertical mental timelines, and that individual differences in children’s attitudes toward the past and future may influence the orientation of their sagittal mental timelines. Taken together, our results demonstrate that children are sensitive to both cultural and personal factors when building mental models of time.

Sign in / Sign up

Export Citation Format

Share Document