Trichoblastic Carcinosarcoma Arising From the Vagina: A Case Report With Comprehensive Immunophenotypic Analysis

2019 ◽  
Vol 28 (4) ◽  
pp. 440-446 ◽  
Author(s):  
Joshua Jing Xi Li ◽  
Joanna Ka Man Ng ◽  
Paul Cheung Lung Choi ◽  
Jacqueline Ho Sze Lee ◽  
Mei-yung Yu
Keyword(s):  
Hair Follicle ◽  
Side Wall ◽  
Resonance Imaging ◽  
Vaginal Mass ◽  
Gynecology And Obstetrics ◽  
First Case ◽  
The Difference ◽  
And Behavior ◽  
Disease Free

A 54-year-old woman presented with abdominal pain. Magnetic resonance imaging revealed an upper vaginal mass with no pelvic side wall involvement, nodal, or distant metastasis. Radical hysterectomy was performed. Histology showed trichoblastic carcinoma with hair follicle structures and malignant sarcomatous and carcinomatous components. Hair follicular differentiation was confirmed by positivity to hair follicle markers (Bcl-2, TLE1, CD56/NCAM, and TDAG51) and presence of CD10-positive trichogenic stroma. The tumor involved the vaginal muscularis only (FIGO [International Federation of Gynecology and Obstetrics] stage I) and was excised with clear margins. The patient remained disease free at 3-month follow-up. This is the first case of cutaneous-type carcinosarcoma reported in the vagina, highlighting the difference in histology, immunophenotype, and behavior compared with gynecologic carcinosarcomas.

scholarly journals Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Ponsian Patrick Paul ◽  
Anita Makins
Keyword(s):  
Service Providers ◽  
International Federation ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Gynecology And Obstetrics ◽  
Intrauterine Contraceptive ◽  
The Difference

Abstract Background The insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge which can help them in counselling their PPIUD clients. Objective Establish impact of postpartum TCu380A on amount and duration of lochia. Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6th week. Lochia was estimated by Likert Scale 0–4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired 20% difference in the proportion of women with prolonged lochia discharges among the Exposed and Unexposed groups. Data analysis was by SPSS. Results Two hundred sixty women were analysed, 127 Exposed and 133 Unexposed. Medical complaints were reported by 41 (28.9%) Exposed and 37 Unexposed (27.8%), p = 0.655. Lack of dryness by end of 6th week was to 31 (23.3%) Exposed and 9 (7.1%) Unexposed, p < 0.001. Exposed had higher weekly mean lochia scores throughout with the difference most marked in 5th week (3.556 Versus 2.039, p < 0.001) and 6th week (1.44 Versus 0.449, p<0.001). Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ needs to be informed about the possibility of delayed dryness of lochia at time of counseling are discussed.

scholarly journals Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sofia Amante ◽  
Filipa Santos ◽  
Teresa Margarida Cunha
Keyword(s):  
Ovarian Cancer ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Resonance Imaging ◽  
Clinicopathologic Characteristics ◽  
Borderline Tumour ◽  
Molecular Features ◽  
Serous Epithelial Ovarian Cancer ◽  
The Difference

AbstractLow-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.

Patients in Australian Memory Clinics: baseline characteristics and predictors of decline at six months

2011 ◽  
Vol 23 (7) ◽  
pp. 1086-1096 ◽  
Author(s):  
Henry Brodaty ◽  
Michael Woodward ◽  
Karyn Boundy ◽  
David Ames ◽  
Robert Balshaw
Keyword(s):  
Late Onset ◽  
Marked Change ◽  
Rate Of Change ◽  
Memory Clinics ◽  
Baseline Characteristics ◽  
The Difference ◽  
And Behavior ◽  
Assessment Scales ◽  
State Examination

ABSTRACTBackground: The Prospective Research In MEmory clinics (PRIME) is a three-year non-prescriptive, observational study identifying and measuring relationships among predictor and outcome variables.Methods: Patients from nine memory clinics, diagnosed with dementia or mild cognitive impairment (MCI), living in the community with <40 hours/week nursing care were divided into diagnostic groups defined at baseline as Alzheimer's disease (AD) early or late onset, frontotemporal dementia (FTD), vascular dementia (VaD), mixed (AD and VaD) and other dementia. To achieve outcome measures, baseline and change over six months in all measures by diagnostic group, and predictors of change at six months were examined.Results: Of the 970 patients enrolled, 967 were eligible for analysis. The most common disorder was AD (late onset) accounting for 46.5% of this population. Patients had an overall slight worsening on all assessment scales over the six-month period. Patients with FTD had a more marked change (decline) in cognition, function and behavior over six months compared to other diagnostic groups. However, in the regression analysis the difference was not significant between groups. Predictors of decline in Mini-Mental State Examination (MMSE) scores were not robust at six months, and longer follow-up is required. Patients with FTD were more likely to be prescribed psychotropics.Conclusion: The PRIME study is continuing and will provide important data on predictors of decline along with differences between diagnosis groups on the rate of change.

Randomized Trial of Radiotherapy Versus Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy in Patients With American Joint Committee on Cancer/International Union Against Cancer Stage III and IV Nasopharyngeal Cancer of the Endemic Variety

2005 ◽  
Vol 23 (27) ◽  
pp. 6730-6738 ◽  
Author(s):  
Joseph Wee ◽  
Eng Huat Tan ◽  
Bee Choo Tai ◽  
Hwee Bee Wong ◽  
Swan Swan Leong ◽  
...  
Keyword(s):  
Distant Metastasis ◽  
Nasopharyngeal Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
The Difference ◽  
Intent To Treat ◽  
To Receive ◽  
Disease Free ◽  
Treat Analysis

Purpose The Intergroup 00-99 Trial for nasopharyngeal cancer (NPC) showed a benefit of adding chemotherapy to radiotherapy. However, there were controversies regarding the applicability of the results to patients in endemic regions. This study aims to confirm the findings of the 00-99 Trial and its applicability to patients with endemic NPC. Patients and Methods Between September 1997 and May 2003, 221 patients were randomly assigned to receive radiotherapy (RT) alone (n = 110) or chemoradiotherapy (CRT; n = 111). Patients in both arms received 70 Gy in 7 weeks using standard RT portals and techniques. Patients on CRT received concurrent cisplatin (25 mg/m2 on days 1 to 4) on weeks 1, 4, and 7 of RT and adjuvant cisplatin (20 mg/m2 on days 1 to 4) and fluorouracil (1,000 mg/m2 on days 1 to 4) every 4 weeks (weeks 11, 15, and 19) for three cycles after completion of RT. All patients were analyzed by intent-to-treat analysis. The median follow-up time was 3.2 years. Results Distant metastasis occurred in 38 patients on RT alone and 18 patients on CRT. The difference in 2-year cumulative incidence was 17% (95% CI, 14% to 20%; P = .0029). The hazard ratio (HR) for disease-free survival was 0.57 (95% CI, 0.38 to 0.87; P = .0093). The 2- and 3-year overall survival (OS) rates were 78% and 85% and 65% and 80% for RT alone and CRT, respectively. The HR for OS was 0.51 (95% CI, 0.31 to 0.81; P = .0061). Conclusion This report confirms the findings of the Intergroup 00-99 Trial and demonstrates its applicability to endemic NPC. This study also confirms that chemotherapy improves the distant metastasis control rate in NPC.

scholarly journals Quantitative Volumetric Analysis Post Transsphenoidal Pituitary Adenoma Surgery

2012 ◽  
Vol 39 (5) ◽  
pp. 600-604 ◽  
Author(s):  
Alireza Mansouri ◽  
Sean Symons ◽  
Michael Schwartz ◽  
Joseph Chen ◽  
Farhad Pirouzmand
Keyword(s):  
Pituitary Adenoma ◽  
Volumetric Analysis ◽  
Point Of View ◽  
Size Difference ◽  
Resonance Imaging ◽  
Residual Mass ◽  
Postoperative Assessment ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Background:Computed tomogram (CT) imaging is often used for immediate postoperative assessment of transsphenoidal pituitary adenoma resection while magnetic resonance imaging (MRI) is used for follow-up. The residual mass is known to decrease in size over time but the difference between the two imaging modalities has not been quantified. Our objective was to quantify the size difference of the residual mass on immediate postoperative CT compared with delayed MRI.Methods:Retrospective analysis of 69 patients who had undergone pituitary adenoma resection at our institution between 2004-2010. Sellar and suprasellar diameter, along with the overall volume of the residual mass were measured on both the immediate postoperative CT and delayed MRI.Results:Average preoperative sellar and suprasellar diameter was 22.2 ± 4.6mm and 20.9 ± 5.9mm, respectively. Average sellar residual diameter on immediate postoperative CT (16.5 ± 5.4 mm, 25% reduction) was significantly larger than delayed MRI (10.6 ± 6.2mm, 52% reduction). The average suprasellar component on CT (15.5±6.5mm, 26% reduction) was also significantly larger than that on MRI (3.3 ± 5.4 mm, 84% reduction). The postoperative CT showed a 46% reduction in volume while a 71% reduction was noted on the delayed MRI.Conclusion:A significant reduction in residual mass is noted on delayed MR imaging compared with immediate postoperative CT. Therefore, from a resource management and prognostication point of view, CT should be used for immediate postoperative assessment while delayed MRI should be used to assess operative success and for communication with patients.

scholarly journals Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania

2020 ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Patrick Ponsian Paul ◽  
Anita Makins
Keyword(s):  
Service Providers ◽  
International Federation ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Gynecology And Obstetrics ◽  
Intrauterine Contraceptive ◽  
The Difference

Abstract BackgroundThe insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge which can help them in counselling their PPIUD clients. ObjectiveEstablish impact of postpartum TCu380A on amount and duration of lochia.Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6th week. Lochia was estimated by Likert Scale 0-4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired 20% difference in the proportion of women with prolonged lochia discharges among the Exposed and Unexposed groups. Data analysis was by SPSS. Results 260 women were analysed, 127 Exposed and 133 Unexposed. Medical complaints were reported by 41 (28.9%) Exposed and 37 Unexposed (27.8%), p=0.655. Lack of dryness by end of 6th week was to 31 (23.3%) Exposed and 9 (7.1%) Unexposed, p<0.001. Exposed had higher weekly mean lochia scores throughout with the difference most marked in 5th week (3.556 Versus 2.039, p<0.001) and 6th week (1.44 Versus 0.449, p˂0.001) . Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ needs to be informed about the possibility of delayed dryness of lochia at time of counseling are discussed.

A positive urine pregnancy test (UPT) with adnexal mass; ectopic pregnancy is not the ultimate diagnosis

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohd Faizal Ahmad ◽  
Muhammad Azrai Abu ◽  
Kah Teik Chew ◽  
Kun Leng Sheng ◽  
Mohd Asyraf Zakaria
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Case Reports ◽  
First Trimester ◽  
Pregnancy Test ◽  
First Case ◽  
Positive Urine ◽  
Disease Free ◽  
Urine Pregnancy Test

Abstract A positive urine pregnancy test (UPT) with adnexal mass in ectopic pregnancy is not the ultimate diagnosis. The incidence of ectopic pregnancy is about 27 per 1000 pregnancies [1]. On average, about 6–16% will present to an emergency department with first-trimester bleeding and abdominal pain [2]. On presenting with these symptoms with the simultaneous presence of an adnexal mass and an empty uterus, a UPT is of paramount importance to determine whether the symptoms are pregnancy related or not. When the UPT is positive, an ectopic pregnancy is not the only diagnosis as the rare entity of non-gestational ovarian choriocarcinoma (NGOC) should be considered. Here we present two case reports of NGOC, which were initially diagnosed as ectopic pregnancy. The first case is a 16-year-old girl, with vaginal bleeding and an adnexal mass due to an ovarian choriocarcinoma, She underwent unilateral oophorectomy and received multiple courses of chemotherapy. She is disease free without evidence of recurrence or metastasis after 12 months of follow-up. The second patient is also 16 years old and presented with an acute abdomen. She was diagnosed as a ruptured luteal cyst and underwent partial oophorectomy. When the pathologist diagnosed a choriocarcinoma she received multiple courses of chemotherapy, but thereafter an advanced disease was diagnosed with evidence of distant metastasis.

Robot-Assisted Radical Hysterectomy in Cervical Carcinoma: The Belgian Experience

2015 ◽  
Vol 25 (9) ◽  
pp. 1690-1696 ◽  
Author(s):  
An Segaert ◽  
Koen Traen ◽  
Philippe Van Trappen ◽  
Frederik Peeters ◽  
Karin Leunen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Oncological Outcome ◽  
International Federation ◽  
Adjuvant Radiation ◽  
Robot Assisted ◽  
Gynecology And Obstetrics ◽  
Stage Ia ◽  
Disease Free

ObjectiveThe purpose of this study was to report the experience and oncological outcome of robot-assisted radical hysterectomies (RRHs) for cervical cancer performed in Belgium.MethodsPatients undergoing RRH for cervical cancer (n = 109) were prospectively collected between July 2007 and April 2014 in the 5 Belgian centers performing RRH for cervical cancer.ResultsThe median age of the patients was 46 years (range, 31–80 years). Histological types included squamous cell carcinoma in 61 patients, adenocarcinoma in 22 patients, adenosquamous in 8 patients, endometrioid carcinoma in 2 patients, and other types (n = 16). The International Federation of Gynecology and Obstetrics stage distribution was IA (n = 9), stage IB1 (n = 71), stage IB2 (n = 4), stage II (n = 24), and unknown (n = 1). Twenty-four patients received adjuvant therapy, 17 patients underwent radiochemotherapy, and 7 underwent adjuvant radiation. Eighteen patients relapsed, and 5 died of disease. The median follow-up was 27.5 months (range, 3–82 months). The 2- and 5-year overall survivals were 96% and 89%, respectively. The 2- and 5-year disease-free survivals (DFSs) were 88% and 72%, respectively. The 2-year DFS per stage was 100% for IA, 88% for IB1, 100% for IB2, and 83% for II. The 5-year DFS per stage was 100% for stage IA and 75% for IB1. The complications were as expected for radical hysterectomy.ConclusionsThis series confirms the feasibility and safety of RRH not only in cervical cancer stage IA to IB1, but also after neoadjuvant chemotherapy in stage IB2 to IIB.

Mammary invasive micropapillary carcinoma in a male cat: Immunohistochemical description and clinical follow-up

2012 ◽  
Vol 60 (2) ◽  
pp. 257-261 ◽  
Author(s):  
Hugo Gregório ◽  
Isabel Pires ◽  
Fernanda Seixas ◽  
Felisbina Queiroga
Keyword(s):  
Regional Lymph Node ◽  
Distant Metastases ◽  
Invasive Micropapillary Carcinoma ◽  
Micropapillary Carcinoma ◽  
Ki 67 ◽  
Disease Free Interval ◽  
First Case ◽  
Histology And Immunohistochemistry ◽  
Disease Free

We describe the case of a 14-year-old Domestic Short Hair male cat that presented with a single mammary tumour one centimetre in diameter, classified as invasive micropapillary carcinoma. Histology and immunohistochemistry revealed a high mitotic index, a KI-67 index of 10%, a lack of reactivity to myoepithelial markers, and a dense infiltration with T and B lymphocytes at the periphery of the tumour. Micrometastases were detected in the regional lymph node at the time of surgery. Overall survival time was 10 months with a disease-free interval of 7.5 months. Distant metastases in the sublumbar lymph nodes confirmed the aggressiveness of this tumour, which has recently been subtyped in female cats. This is the first case reported in male cats with a complete follow-up, highlighting the importance of prompt and aggressive treatment in the presence of mammary tumours in male cats.

scholarly journals Spinal drop of atypical choroid plexus papilloma in an adult patient: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 409
Author(s):  
Diego Ochoa-Cacique ◽  
María Córdoba-Mosqueda ◽  
José Ramón Aguilar-Calderón ◽  
Martha Cristina Sánchez-Silva ◽  
Rosa María Vicuña-González ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Choroid Plexus Papilloma ◽  
Radicular Pain ◽  
Subtotal Resection ◽  
Resonance Imaging ◽  
Spinal Level ◽  
Total Resection ◽  
First Case ◽  
History Of

Background: Choroid plexus papillomas (CPPs) are benign extra-axial tumors that originate from the choroid plexus; these tumors rarely have metastases, being at the spinal level the location with few reported cases. Case Description: We report the case of a 48-year-old man with a history of atypical fourth ventricular CPP and gross total resection (GTR) in 2008. In 2015, he presented with radicular pain, decreased strength, and paresthesia in the left leg. Magnetic resonance imaging revealed a well-defined intradural ovoid lesion in the vertebral canal at the level of the L3-L4 intersomatic space. Subtotal resection of the tumor was performed. The patient recovered well, with relief of pain and no neurological deficit. A literature research few cases of CPP metastasis in adults. We describe here a fifth-decade male patient with a lumbar neoplasm, which according to the histopathologic characteristics and location is the first case of an atypical papilloma implant of the choroid plexus at this spinal level. Conclusion: GTR of primary lesions and associated implants remains the gold standard for surgical treatment of CPP. Radiotherapy, stereotactic radiosurgery, and chemotherapy are adjuvant therapies for CPP but there is no definitive protocol for the management of implants. Proper follow-up of these patients is essential since spinal drop can appear many years after the initial presentation of CPP.

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