Are Ovaries a Sanctuary for Lymphoma? Report of a Cure of Recurrent Lymphoma in Both Ovaries after Bilateral Oophorectomy.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4653-4653
Author(s):  
A. Majid Shojania ◽  
J. Kelly MacDonald
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Disease Free Survival ◽  
Pathology Report ◽  
Fallopian Tubes ◽  
Bilateral Oophorectomy ◽  
Lymphoma Cells ◽  
Free Survival ◽  
Poorly Differentiated ◽  
Disease Free

Abstract Isolated bilateral ovarian lymphoma is extremely rare. Those reported are generally due to aggressive lymphoma and are associated with a poor outcome. We present a case of low grade abdominal lymphoma which had been treated with bowel resection and chemotherapy. The patient subsequently developed recurrence of lymphoma in both ovaries and underwent bilateral oophorectomy. She has remained free of lymphoma for 10 years without any therapy for lymphoma. Case report: A Caucasian female was born in 1940. In July 1985, she underwent a surgical removal of a large mesenteric mass and a 72 cm length of small bowel. The pathology report indicated the involvement of small bowel, mesenteric nodes and mesenteric fat with: Diffuse poorly differentiated lymphocytic lymphoma (Rappoport), malignant lymphoma, follicular and diffuse, predominantly small cleave cells with focal sclerosis (working formulation). She was treated with chlorambucil until July 1992 when because of leucopenia, chemotherapy was discontinued. CT scan of the abdomen in August 1992 was normal. In August 1995, she presented with acute abdominal pain. She underwent a resection of both ovaries, of the Fallopian tubes and of the uterus. The pathology report indicated that both ovaries were involved with: Malignant lymphoma, lymphocytic, poorly differentiated, partly nodular. The Fallopian tubes and the uterus did not show any lymphoma. A post-operative bone marrow biopsy and a CT of the chest and abdomen did not show any abnormality. Because there was no evidence of residual lymphoma, no therapy was offered after the operation. She has remained disease free 10 years after resection of the ovaries. The CT scan of the chest and abdomen in May 2004 were normal. Because of the unusual course of the disease and long-term disease free survival post recurrence, all of the pathological specimens were reexamined and were found to be similar microscopically and immunohistochemically. The tumors of small bowel, mesentery, omentum as well as both ovaries were reclassified in modern terminology as: Follicular lymphoma, Grade 1. The tumors have a similar appearance in that they are composed predominantly of poorly formed nodules of lymphoma with diffuse area. They have similar immunohistochemical profiles. They are faintly positive for CD20, CD22, CD10 and strongly positive for Bcl-2. Both tumors are negative for CD43 and CD45RO. Conclusion: There are two possibilities for why isolated bilateral lymphoma may have developed in this case. One is that the lymphoma of the ovaries in this case was a second lymphoma unrelated to the initial lymphoma of the bowel and mesentery. If this is the case, the identical features of the two tumors and the simultaneous appearance in both ovaries, sparing other tissues is extremely unusual. The second possibility is that the ovaries provided a sanctuary for the original lymphoma cells. The resection of the original tumor followed by chemotherapy, had destroyed all of the lymphoma cells in the other organs. But the ovaries had provided a sanctuary for the lymphoma cells, allowing them to grow locally. Removal of the ovaries provided a 10 year disease free survival.

Gastrointestinal Stromal Tumors: Actin Expression, a New Prognostic Factor?

2010 ◽  
Vol 76 (11) ◽  
pp. 1244-1250 ◽  
Author(s):  
Jaime Ruiz-Tovar ◽  
María Diez-Tabernilla ◽  
Gada Housari ◽  
Enrique Martinez-Molina ◽  
Alfonso Sanjuanbenito
Keyword(s):  
Prognostic Factors ◽  
Small Bowel ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Mass ◽  
Disease Free Survival ◽  
Gastric Gist ◽  
Free Survival ◽  
Stromal Tumors ◽  
Actin Expression ◽  
Disease Free

The aim of this study is to analyze the clinical outcome of gastrointestinal stromal tumors (GISTs) and to determine new prognostic factors. We perform a retrospective study of all the patients diagnosed with GIST in any location and operated on between 2000 and 2008 at our institution. We analyzed 35 patients, 16 males (45.7%) and 19 females (54.3%), with a mean age of 64 ± 13.8 years. The tumors were located in the stomach in 22 patients (62.9%), in the small bowel in 10 (28.6%), and the retroperitoneum in three (8.6%). Referring to gastric GIST, endoscopy revealed an ulceration in the mucosa in five cases, suggesting an epithelial neoplasm. In all these cases, pathology of the biopsy specimen was nonconclusive. Survival rate at 1 and 5 years was 94.3 and 88.6 per cent, respectively. Disease-free survival at 1 and 2 years was 91.4 and 88.6 per cent, respectively. Analyzing prognostic factors, a lower disease-free survival was observed among patients with constitutional syndrome at diagnosis ( P = 0.000), small bowel GIST ( P = 0.037), and tumors not expressing actin ( P = 0.015). A lower global survival was observed among men ( P = 0,036), patients with an abdominal mass ( P = 0.033) or with constitutional syndrome ( P = 0.007) at diagnosis and tumors at a retroperitoneal location ( P = 0.0002). Gastric GIST may be confused with epithelial neoplasms, modifying the surgery. In our patients, masculine gender, constitutional syndrome and abdominal mass at diagnosis, small bowel and retroperitoneal location, and actin negative tumors are bad prognostic factors.

Clinicopathological Profiling of Lung Carcinoids with a Ki67 Index > 20%

2018 ◽  
Vol 108 (2) ◽  
pp. 109-120 ◽  
Author(s):  
Atsuko Kasajima ◽  
Björn Konukiewitz ◽  
Naomi Oka ◽  
Hiroyoshi Suzuki ◽  
Akira Sakurada ◽  
...  
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Japanese Patients ◽  
Clinicopathological Parameters ◽  
Neuroendocrine Neoplasms ◽  
Free Survival ◽  
Tumor Group ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Disease Free

The clinicopathological features of lung neuroendocrine neoplasms (NEN) with a high proliferative index at the border area between atypical carcinoid and neuroendocrine carcinoma have not been investigated so far. The aim of this study was, therefore, to search for lung NENs which are well differentiated but show Ki67 values that overlap with those of poorly differentiated (PD)-NENs. Resected lung NENs from 244 Japanese patients were reviewed, and Ki67 indices were assessed in all tumors. The data were then correlated to clinicopathological parameters and patient outcome. Among 59 (24%) well-differentiated (WD)-NENs and 185 (76%) lung PD-NENs, 7 were defined as WD-NENs with Ki67 indices > 20%. The Ki67 indices of these tumors (mean 29%, range 24–36) were significantly lower than those of PD-NENs (mean 74%, range 34–99). All WD-NENs with Ki67 > 20% lacked abnormal p53 and loss of retinoblastoma 1 (Rb1) expression. In contrast, many PD-NENs expressed p53 (48%) and showed loss of Rb1 (86%). The 2- and 5-year disease-free survival rates in WD-NEN patients with Ki67 > 20% were lower than those of WD-NEN patients with Ki67 ≤20% (p < 0.01 for disease-free and overall survival). No statistical differences were detected between outcome of WD-NEN patients with Ki67 > 20% and those of PD-NEN. It is concluded that WD-NEN patients with Ki67 > 20% share the morphological and immunohistochemical features of WD-NEN patients with Ki67 ≤20%, but they have a worse prognosis, suggesting that this tumor group requires particular attention in future classifications and probably new therapeutic regimes.

Impact of high-risk features on disease-free survival (DFS) in patients (pts) with high-risk stage II colon cancer (CC) in ACHIEVE-2 trial as part of the IDEA collaboration.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4011-4011
Author(s):  
Dai Manaka ◽  
Manabu Shiozawa ◽  
Masahito Kotaka ◽  
Makio Gamoh ◽  
Akio Shiomi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Vascular Invasion ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Free Survival ◽  
Nodal Harvest ◽  
Poorly Differentiated ◽  
Stage Ii Colon Cancer ◽  
Disease Free

4011 Background: The IDEA collaboration for high-risk stage 2 colorectal cancer patients (pts) demonstrated that for CAPOX, 3 months was non-inferior to 6 months treatment, while for FOLFOX, 6 months was superior to 3 months treatment. We investigated the impact of high risk features on disease-free survival (DFS). Methods: ACHIEVE-2, one of the 4 IDEA studies (SCOT, TOSCA, ACHIEVE-2, HORG), was an open-label, multicenter randomized trial for high-risk stage II colon cancer. High risk features are defined as one or more: T4, inadequate nodal harvest < 12, poorly differentiated, clinical sign of obstruction and perforation or vascular invasion. The association of high risk features with DFS were measured by Cox regression analyses. Results: Between 2014 and 2017, ACHIEVE-2 enrolled 525 pts, out of whom 514 pts were the modified ITT (mITT) population; 432 received CAPOX (84.0%) and 82 did mFOLFOX6 (16.0%). High-risk features included 35.8% of T4, 12.8% of inadequate nodal harvest, 11.5% of poorly differentiated, 19.3% of obstruction, 6.4% of perforation and 87.5% of vascular invasion; 47.3% had one features, 35.2% had two, 14.6% had three, and 2.9% had four or more. With a median follow-up of 36.1 months, 3-year DFS rates were 88% in both arms, with a hazard ratio (HR) of 1.12 (95% CI, 0.67-1.87, p=0.67). In multivariate analysis, T4 (HR 3.77 [2.18-6.53], p< 0.0001) and inadequate nodal harvest (HR 2.98 [1.59-5.59], p= 0.0006) remained independent significant negative prognostic factors. The 3-year DFS rates in T4 and Non-T4 diseases were 78% and 94% (p<0.0001), while 3-year DFS rate in pts with inadequate and adequate nodal harvest were 77% and 90% (p=0.0059). No interaction was observed between treatment duration and T4 or inadequate nodal harvest. Conclusions: Our findings indicated the relative impact of high risk features on DFS varies across factors; T4 and inadequate nodal harvest < 12 were more significant than the others. Our results must be interpreted within the combined analysis as well as within the reproducibility of results across the 4 trials. Clinical trial information: 000013036 .

scholarly journals Correlation of Computed Tomography Parameters with Histology, Stage and Prognosis in Surgically Treated Thymomas

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 10
Author(s):  
Angelo Carretta ◽  
Stefano Viscardi ◽  
Piergiorgio Muriana ◽  
Paola Ciriaco ◽  
Alessandro Bandiera ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Disease Free Survival ◽  
Tumor Stage ◽  
Tnm Staging ◽  
Prognostic Role ◽  
Free Survival ◽  
Staging Systems ◽  
Disease Free

Background and objectives: The histological classification and staging of thymic tumors remains a matter of debate. The correlation of computed tomography (CT) parameters with tumor histology and stage also still has to be completely assessed. The aim of this study was therefore to analyze the correlation of radiological parameters with histological and staging classifications of thymomas evaluating their prognostic role. Methods: Data of 50 patients with thymoma submitted to a complete surgical treatment between 2005 and 2015 were retrospectively analyzed. Tumors were classified according to the WHO and Suster and Moran (S&M) histological classifications and to the Masaoka–Koga and tumor, node and metastases (TNM) staging systems. The correlation of CT features with histology and stage and the prognostic role of histopathological and radiological features were assessed. Results: Five-year overall (OS) and disease-free survival (DFS) were 90.3% and 81.1%, respectively. A significant correlation of DFS with the Masaoka–Koga (p = 0.001) and TNM staging systems (p = 0.002) and with the S&M (p = 0.02) and WHO histological classifications (p = 0.04) was observed. CT scan features correlated with tumor stage, histology and prognosis. Moderately differentiated tumors (WHO B3) had a significantly higher incidence of irregular shape and contours (p = 0.002 and p = 0.001, respectively) and pericardial contact (p = 0.036). A larger tumor volume (p = 0.03) and a greater length of pleural contact (p = 0.04) adversely influenced DFS. The presence of pleural (p < 0.001) or lung invasion (p = 0.02) and of pleural effusion (p = 0.004) was associated with a significantly worse OS. Conclusions: Pre-operative CT scan parameters correlate with stage and histology, and have a prognostic role in surgically treated thymomas.

Outcome of locally advanced carcinoma of oesophagus: A single institution experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16507-e16507
Author(s):  
Thianeshwaran S ◽  
Sriniivas Bj ◽  
Niyati Prakash Sanghavi ◽  
Vinu Sarathy ◽  
Bhanu Prakash Lalkota ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Pathological Response ◽  
Complete Pathological Response ◽  
Free Survival ◽  
Poorly Differentiated ◽  
Disease Free

e16507 Background: Oesophageal cancer is the twelfth most common cancer worldwide and seventh leading cause of cancer related death. Neoadjuvant treatment in addition to surgery has shown improved overall survival compared to surgery alone in resectable oesophageal cancer. We aimed to analyse the survival outcome among locally advanced oesophageal carcinoma patients in neoadjuvant setting. Methods: We analysed 37 patients with locally advanced carcinoma of oesophagus from 2015 to 2019 who underwent neoadjuvant chemoradiotherapy followed by surgical excision of tumour. Descriptive analysis was used for demographic data. overall survival and disease free survival was analysed using Kaplan-Meier survival analysis. Results: Our study includes 20 males (54%) and 17 females (45%). Over all consumption of Tobacco and alcohol consumption was found to be 64% and 18% respectively. The most common tumour site in this study was middle oesophagus (56%) followed by lower (37%) and upper (5%). Histopathologically, moderately differentiated squamous cell carcinoma constituted the highest (62%), followed by well differentiated squamous cell carcinoma (21%) and poorly differentiated carcinoma (16%). The pathological stage post chemoradiotherapy was 80%, 50% and 57% for stage I, II and III respectively. Median over all survival is 60 months and no statistical difference in stage I and stage II. Median over all survival for poorly differentiated squamous cell carcinoma is 16 months and lower one third of squamous cell carcinoma is 37 months. Complete pathological response is 42 %. Conclusions: Our study concluded that patients with tobacco and alcohol consumption have poorer survival. Prognosis was worst for patients with lower end oesophagus and poorly differentiated type. Disease free survival was better for patients who achieved complete pathological response when compared to partial responders.

Long-term disease-free survival after breast cancer metastatic to the ovary

2002 ◽  
Vol 12 (3) ◽  
pp. 317-318 ◽  
Author(s):  
G Zehetleitner ◽  
I Thiel ◽  
E Petru
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Disease Free Survival ◽  
Radical Mastectomy ◽  
Adjuvant Radiation ◽  
Bilateral Oophorectomy ◽  
Term Survival ◽  
Free Survival ◽  
Disease Free

Abstract.Zehetleitner G, Thiel I, Petru E. Long-term disease-free survival after breast cancer metastatic to the ovary.The prognosis of patients with breast cancer symptomatically metastatic to the ovary is almost uniformly poor. In this case report, we present a 33-year-old para-4 with a symptomatic metastasis to the ovary. Previously, a modified radical mastectomy with adjuvant radiotherapy had been performed for invasive ductal carcinoma of the left breast. Laparotomy showed a 13-cm tumor of the left ovary; frozen section histology showed malignancy consistent with the previous breast cancer. The patient received adjuvant combination chemotherapy. About 5 years later, a carcinoma of the right breast was treated with conservative surgery and adjuvant radiation and chemotherapy. After a further 4 years, a recurrence at the left chest wall was treated with radiation. At the last follow-up, more than 13 years after the first breast cancer and 12 years after the ovarian metastasis, the patient was alive and well without evidence of disease. Bilateral oophorectomy is a therapeutic option in premenopausal patients with localized or advanced breast cancer. Our patient experienced long-term disease-free survival following an isolated metastasis to one ovary. This represents the first report of long-term survival of such a patient in the literature.

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