Large Primary Neuroendocrine Tumor of the Liver in a 57-year-Old Female Presenting With MSSA Bacteremia

2021 ◽  
pp. 000313482110508
Author(s):  
Ilya Sakharuk ◽  
Andrew Harner ◽  
Janie McKenzie ◽  
Ahmed Arfa ◽  
Asad Ullah ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Neuroendocrine Tumor ◽  
Mass Effect ◽  
Positive Staining ◽  
Right Hepatectomy ◽  
Liver Mass ◽  
Nuclear Pleomorphism ◽  
Necrotic Tumor ◽  
Associated Mass ◽  
Large Primary

Primary neuroendocrine tumors (NETs) are rare forms of malignancy, representing just .5% of known cancers and having an overall incidence of 0.2/100,000. The most common sites of origin are bronchopulmonary and gastrointestinal, most commonly the appendix, pancreas, and ileum. We report the case of a 57-year-old female who was admitted for refractory MSSA bacteremia and several weeks of abdominal pain. CT imaging done on presentation demonstrated a 12.5 x 19.4 x 17.3 cm heterogeneous right liver mass with associated mass effect. The patient was taken to the operating room and a right hepatectomy and cholecystectomy were performed without complication. Histological examination revealed necrotic tumor in sheets and nests with marked nuclear pleomorphism. Immunohistochemistry demonstrated positive staining for pancytokeratin, synaptophysin, chromogranin, and TTF-1, consistent with undifferentiated NET. While rare, NETs can originate from a variety of organs outside the gastrointestinal and bronchopulmonary tract, including the liver.

scholarly journals Progress in the Pathogenesis, Diagnosis, and Treatment of TSH-Secreting Pituitary Neuroendocrine Tumor

2020 ◽  
Vol 11 ◽  
Author(s):  
Peiqiong Luo ◽  
Lin Zhang ◽  
Lidan Yang ◽  
Zhenmei An ◽  
Huiwen Tan
Keyword(s):  
Neuroendocrine Tumor ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
Mass Effect ◽  
Pituitary Hormones ◽  
Diagnosis And Treatment ◽  
Detection Methods ◽  
Thyroid Goiter ◽  
Magnetic Resonance Imaging Mri ◽  
Timely Treatment

TSH-secreting pituitary neuroendocrine tumor (PitNET) is one of the causes of central hyperthyroidism. The incidence of TSH PitNET is far lower than that of other PitNETs. The clinical manifestations of TSH PitNETs mainly include thyrotoxicosis or thyroid goiter, secretion disorders of other anterior pituitary hormones, and mass effect on the pituitary gland and its surrounding tissues. The application of high-sensitivity TSH detection methods contributes to the early diagnosis and timely treatment of TSH PitNETs. Improvements in magnetic resonance imaging (MRI) have advanced the noninvasive visualization of smaller PitNETs. Treatments for TSH PitNETs include surgery, drugs, and radiotherapy. This review focuses on the progress in pathogenesis, diagnosis, and treatment of TSH PitNETs to provide more information for the clinician.

Ampullary Neuroendocrine Tumor: A Rare Cause of Recurrent Abdominal Pain

2013 ◽  
Vol 108 ◽  
pp. S259
Author(s):  
Andrew Ofosu ◽  
Armando Sardi ◽  
Lakshmi Potakamuri ◽  
Lisa Turnbough ◽  
Sanjay Jagannath
Keyword(s):  
Abdominal Pain ◽  
Neuroendocrine Tumor ◽  
Recurrent Abdominal Pain

scholarly journals Intracranial Gliofibroma: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Patricia Gargano ◽  
Graciela Zuccaro ◽  
Fabiana Lubieniecki
Keyword(s):  
Who Classification ◽  
Clinical Symptoms ◽  
Mass Effect ◽  
World Health ◽  
Biological Behavior ◽  
Positive Staining ◽  
Immunohistochemical Examination ◽  
Collagenous Stroma ◽  
Health Organization

Gliofibroma is a rare tumor with biphasic morphology, commonly occurring in the first two decades of life. Currently, the tumor is not listed as a distinct entity in the current World Health Organization (WHO) classification of central nervous system tumors. As its biological behavior, histogenesis, and prognostic factors are still debated, the aim of this paper was to describe a case of a gliofibroma and to update the data about these lesions. Hence, we present here clinical symptoms, pathological findings, and evolution observed in a child with gliofibroma. A 10-year-old girl with seizures was referred for study. Neuroimaging showed a hemispheric hyperdense tumor with little peritumoral edema and no mass effect. The tumor was totally removed. Histologically, the tumor consisted of a mixture of glial cells and collagen-rich stroma. Immunohistochemical examination revealed positive staining for GFAP, CD 99, S100, and vimentin. EMA staining showed a paranuclear dot pattern in only few cells in isolated areas. These findings of a glial component with collagenous stroma were consistent with a desmoplastic glioma. Because of the rarity of this entity, we believe it is important to report every case in order to adequately analyze and categorize the tumor in the next WHO classification.

scholarly journals Genetic characterization of a case of sellar metastasis from bronchial carcinoid neuroendocrine tumor

2020 ◽  
Vol 11 ◽  
pp. 303
Author(s):  
. Hong Christopher S ◽  
Adam J. Kundishora ◽  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Jason M. Beckta ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Pituitary Tumors ◽  
Metastatic Tumor ◽  
Mass Effect ◽  
Endoscopic Endonasal ◽  
Primary Tumors ◽  
Visual Deficits ◽  
History Of

Background: Metastasis to the pituitary gland from neuroendocrine tumors is a rare occurrence that may originate from primary tumors the lung, gastrointestinal tract, thyroid, and pancreas, among others. Patients may present with signs of endocrine dysfunction secondary to pituitary involvement, as well as mass effect-related symptoms including headaches and visual deficits. Despite a small but accumulating body of literature describing the clinical and histopathological correlates for pituitary metastases from neuroendocrine tumors, the genetic basis underlying this presentation remains poorly characterized. Case Description: We report the case of a 68-year-old with a history of lung carcinoid tumor who developed a suprasellar lesion, causing mild visual deficits but otherwise without clinical or biochemical endocrine abnormalities. She underwent endoscopic endonasal resection of her tumor with final pathology confirming metastasis from her original neuroendocrine tumor. Whole-exome sequencing was performed on the resected sellar tumor and matching blood, revealing increased genomic instability and key mutations in PTCH1 and BCOR that have been previously implicated in both systemic neuroendocrine and primary pituitary tumors with potentially actionable therapeutic targets. Conclusion: This is the first genomic characterization of a metastatic tumor to the sella and reports potential genetic insight, implicating PTCH1 and BCOR mutations, into the pathophysiology of sellar metastasis from primary systemic tumors.

scholarly journals Hydatid Cyst Migration in Peritoneal Cavity: A Case Report

2019 ◽  
Vol 18 (2) ◽  
pp. 254-258
Author(s):  
Petar Markov ◽  
Ilija Milev ◽  
Aleksandar Mitevski
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Anaphylactic Shock ◽  
Mass Effect ◽  
Abdominal Organ ◽  
Hydatid Cysts ◽  
Simple Cyst ◽  
Cystic Formation ◽  
Abdominal Exploration

Introduction. Cystic echinococcosis is a zoonosis caused by the larval stage of Echinococcus granulosus. In most of cases hydatid cysts are found in the liver but in rare cases a migration of the hydatid cyst can occur following rupture of hepatal pericist.Case. A 38 year old female presented with abdominal pain, fatigue, weakness and fever for more than three months. Computed tomography show segment II and IV hepatic per-magna cystic formations with dimensions: No I: 80×60×74 mm and No. II: 70×60×58 mm. Per magna cystic formation in the Douglas space, with dimensions of 93×90×62 mm with clearly expressed mass effect on surrounding organ structures.Discussion. Active hydatid disease may show migration of cysts due to rupture of hepatal pericyst, pressure difference between the anatomic cavities, and by contribution of gravity. Sudden death, anaphylactic shock and dissemination of disease can be seen with cystic content spillage into the peritoneal cavity.Conclusion. Migrated hydatid cysts are very rare parasitic manifestation presenting with symptoms deriving from the neighboring organs. They are diagnosed typically by CT and managed with evacuation of cysts following abdominal exploration. Full abdominal organ ultrasonography, with accent on the liver, should be performed in any case of intraabdominal simple cyst presence.

scholarly journals Enormous haemangioma of the liver

2019 ◽  
Vol 12 (3) ◽  
pp. e226983 ◽  
Author(s):  
Rommel Zerpa ◽  
Eman Helmy Abdelghani ◽  
Gloria Iliescu ◽  
Carmen Escalante
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Surgical Management ◽  
Growth Mechanism ◽  
Vascular Endothelium ◽  
Growth Pattern ◽  
Mass Effect ◽  
Benign Tumours

Haemangiomas are the most common benign tumours of the liver. Their origin lies in the proliferation of the vascular endothelium. Their growth mechanism is by dilation. They are considered giant when they exceed 5 cm at their greatest diameter. Very uncommon presentations surpass 15 cm; these are known as enormous haemangiomas. We present a case of a 54-year-old woman with an enormous haemangioma of 30 cm in diameter. A mass was present in her right upper quadrant along with dull abdominal pain for several years. It is unknown for how long the tumour had been developing. She underwent surgical management due to evident mass effect. Clinicians should be aware of the importance of early diagnosis in these types of tumours. Its erratic growth pattern, mass effect-related complications and the capacity of producing haematological abnormalities makes it an entity to be considered.

scholarly journals Neurenteric Cyst of the Area Postrema

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Claire M. Miller ◽  
Bonnie H. Wang ◽  
Seong-Jin Moon ◽  
Eric Chen ◽  
Huan Wang
Keyword(s):  
Abdominal Pain ◽  
Area Postrema ◽  
Mass Effect ◽  
Cystic Mass ◽  
Neurenteric Cyst ◽  
Suboccipital Craniectomy ◽  
Acute Decompensation ◽  
Intracranial Lesions ◽  
Cranial Mri ◽  
One Year

Neurenteric cysts are CNS lesions most frequently occurring in the spinal cord. Intracranial neurenteric cysts are rarer, typically presenting with headache, mass effect, or location-specific symptoms. The area postrema is known as the emetic center of the brain; lesions can cause nausea and vomiting. Our case, featuring a neurenteric cyst of the area postrema, illustrates the importance of considering a neurological etiology for nonspecific symptoms that otherwise elude explanation. Our patient presented with acute decompensated hydrocephalus upon exploratory abdominal laparoscopy for unresolving abdominal pain. The patient had an eight-month history of unexplained intermittent nausea, vomiting, and abdominal pain. These bouts increased in frequency during the weeks before acute presentation, prompting exploratory abdominal laparoscopy. The acute decompensation was managed by ventriculostomy, and cranial MRI revealed a cystic mass by the floor of the fourth ventricle. After the patient stabilized and returned to neurological baseline, suboccipital craniectomy and resection were performed. The mass was histologically identified as a neurenteric cyst. The patient was free from neurological complaints at one-year follow-up, indicating that the successful resection of the area postrema-associated neurenteric cyst resolved her previous symptoms. Thus, some intracranial lesions can masquerade as nonspecific symptoms, presenting a challenge to accurate diagnosis.

scholarly journals An Unpleasant Surprise: Abdominal Presentation of Malignant Mesothelioma

2020 ◽  
Vol 8 ◽  
pp. 232470962095012
Author(s):  
Dustin J. Uhlenhopp ◽  
Ann Saliares ◽  
Vinaya Gaduputi ◽  
Tagore Sunkara
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Malignant Mesothelioma ◽  
Bowel Perforation ◽  
Asbestos Exposure ◽  
Stage Iv ◽  
Mass Effect ◽  
Diffuse Abdominal Pain ◽  
Atypical Presentations ◽  
The Right

Malignant mesothelioma is an aggressive cancer associated with asbestos exposure with median survival time of 8 to 14 months following diagnosis. Given that mesothelial cells also line the peritoneum and pericardium, malignant mesothelioma can present in unusual sites and in patients with nonrespiratory complaints. A 73-year-old male presented to the emergency department for worsening intermittent diffuse abdominal pain for the past 3 months with associated unintentional 40-pound weight loss, early satiety, and diarrhea. He denied exposure to asbestos. Computed tomography imaging revealed multiple masses concerning for malignancy including the primary retroperitoneal mass, a mass involving the terminal ileum, and a mass in the right upper lung. Esophagogastroduodenoscopy demonstrated significant mass effect within the stomach without signs of endoluminal infiltration. Computed tomography–guided biopsy of the retroperitoneal abdominal and intramuscular paraspinal masses was performed. Stage IV epithelioid mesothelioma was confirmed when hematoxylin and eosin staining revealed pleomorphic malignancy nuclei containing a vesicular chromatin pattern and prominent nucleoli and immunohistochemical staining was positive for CK Oscar, cytokeratin 7, GATA3, calretinin, EMA, and CK5/6. He was started on cisplatin, pemetrexed, and bevacizumab but developed severe abdominal pain with pneumoperitoneum and bowel perforation 1 month later and expired shortly thereafter. To our knowledge, this represents a highly atypical presentation of malignant mesothelioma considering the involvement of the retroperitoneum with diffuse lesions in the abdominopelvic cavity and thorax (sparing the lung pleurae). This case also calls attention to the occurrence of malignant mesothelioma in patients without known asbestos exposure and the crucial role of pathology in diagnosing atypical presentations.

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