scholarly journals Axillary nodal metastasis of operated gallbladder carcinoma: remote site of aggression—a case report

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer. Case presentation A 63-year-old gentleman presented with the complaint of a non-healing ulcer at upper abdomen for the last 1 month. He had undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed isolated bilateral axillary metastasis and the patient underwent a bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later. Conclusion Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of isolated bilateral axillary lymph nodes as a distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

scholarly journals Axillary Nodal Metastasis of Operated Gallbladder Carcinoma – First Remote Site of Aggression.

2021 ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background: Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer.Case summary: A 63-year-old gentleman presented with the complaint of a non-healing ulcer at epigastrium for the last 1 month, after having undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed bilateral axillary metastasis. He then underwent bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later.Conclusion: Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of bilateral axillary lymph nodes as the first distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

Report on a Case of Breast Sarcoma Metastatic to the Axillary Lymph Nodes

2006 ◽  
Vol 92 (2) ◽  
pp. 188-190 ◽  
Author(s):  
Jack Antonio Diaz Brito ◽  
Giovanna Gatti ◽  
Anna Rita Vento ◽  
Viviana Galimberti ◽  
Mattia Intra ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Follicular Dendritic Cell ◽  
Lymph Node Involvement ◽  
Left Breast ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Breast Sarcoma ◽  
Direct Invasion ◽  
Axillary Lymphadenectomy

Breast sarcoma is a rare entity that accounts for less than 1% of all breast malignancies; it may spread by direct invasion and/or through the blood. Axillary lymph node involvement is extremely rare and usually associated with advanced-stage disease. In the surgical treatment of this neoplasm, complete axillary lymphadenectomy is important for the local clearance of the clinically involved lymph nodes. We report a case of a 65-year-old woman affected by follicular dendritic cell sarcoma of the left breast. Six months after breast surgery she developed an axillary metastasis from the same disease.

scholarly journals Giant Benign Mammary Phyllodes Tumor: Report of a Case and Review of the Literature

2021 ◽  
pp. 123-133
Author(s):  
Ricardo Fernández-Ferreira ◽  
Andrés Arroyave-Ramírez ◽  
Daniel Motola-Kuba ◽  
Gabriela Alvarado-Luna ◽  
Ileana Mackinney-Novelo ◽  
...  
Keyword(s):  
Case Reports ◽  
Standard Of Care ◽  
Phyllodes Tumor ◽  
Surgical Excision ◽  
Axillary Lymph Node Metastasis ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Phyllodes Tumors ◽  
Complete Surgical Excision ◽  
Mexican Woman

Phyllodes tumor of the breast is an infrequently encountered fibroepithelial neoplasm, which accounts for 0.3–1% of all tumors. Few case reports have described the occurrence of giant phyllodes tumor. To our knowledge, about 20% of phyllodes tumors would be considered giant benign. Complete surgical excision is the standard of care for giant benign phyllodes tumors; axillary lymph node metastasis is rare, and dissection should be limited to patients with pathologic evidence of tumor in the lymph nodes. We report the case of a 40-year-old Mexican woman with giant mammary tumor who underwent a right total mastectomy. The pathology results showed a benign phyllodes tumor 4,857 g in weight and 40.2 × 36.3 × 15 cm in size. We do not suggest adjuvant radiation therapy for patients with benign phyllodes tumors that are widely excised. A review of the pertinent literature was performed.

Topical Therapy for Ocular Surface Squamous Neoplasia

2013 ◽  
Vol 06 (02) ◽  
pp. 154
Author(s):  
Derek Bitner ◽  
Donald U Stone ◽  
◽  
Keyword(s):  
Ocular Surface ◽  
Topical Therapy ◽  
Genetic Defect ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Ocular Surface Squamous Neoplasia ◽  
Recurrence Rates ◽  
Interferon Alpha 2B ◽  
Complete Surgical Excision ◽  
Treatment Paradigm

Ocular surface squamous neoplasia, or OSSN, is a clinical spectrum often encountered in ophthalmic practice. The incidence varies depending on the population being studied, but is more common among less pigmented males with increased occupational ultraviolet (UV) exposure as well as among those living in closer proximity to the equator. The incidence increases with age; in younger patients, the presence of OSSN is often associated with another underlying disorder, such as the genetic defect in xeroderma pigmentosum, or immunosuppression as is seen in patients infected with HIV. The challenges of complete surgical excision in patients with extensive tumors, in addition to the high recurrence rates in some series, led to a search for nonsurgical treatment modalities. In addition to avoiding surgery, topical agents may offer the additional benefit of treating clinically unapparent disease. Due to the theoretic advantages of topical chemotherapy, multiple agents have been used in both the primary and adjuvant treatment of OSSN. Mitomycin, interferon alpha-2b, and 5-fluorouracil have all been utilized with success; mitomycin may invoke a greater risk for limbal stem cell failure, and interferon is well tolerated and effective but more expensive. Future developments in imaging and chemotherapeutics will likely continue to alter the treatment paradigm for ocular surface tumors.

scholarly journals Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Karaninder S. Mehta ◽  
Vikram K. Mahajan ◽  
Pushpinder S. Chauhan ◽  
Anju Lath Sharma ◽  
Vikas Sharma ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Neck Region ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Metastatic Basal Cell Carcinoma ◽  
Treat All

Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenouscisplatin (50 mg) and 5-florouracil (5-FU, 750 mg) on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

scholarly journals Pediatric Bartonella Infection (Cat Scratch Disease) Presenting as Inguinal Lymphadenopathy

2020 ◽  
Vol 5 ◽  
Author(s):  
Ganesh Maniam ◽  
Aisha Khan ◽  
Raphael Mattamal
Keyword(s):  
Bartonella Henselae ◽  
Surgical Excision ◽  
Empiric Antibiotic Therapy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Cat Scratch Disease ◽  
Positive Serology ◽  
Recent Infection ◽  
Left Groin ◽  
Inguinal Lymphadenopathy

Cat scratch disease is an infectious disease resulting from inoculation of Bartonella species through a cat scratch or bite, often presenting as an erythematous papule at the site of inoculation with nearby painful lymphadenopathy. The diagnosis of this disease is complicated by a wide variety of clinical presentations, as the primary lesion may not be initially noticed. Furthermore, cervical and axillary lymph nodes are the most commonly involved regions of tender lymphadenopathy, but there have been reported cases that do not fit the typical clinical picture – such the case discussed in this report of a pediatric Bartonella henselae infection that initially presented as left inguinal lymphadenopathy with underlying necrosis and abscess formation. In this case, a 9-year-old boy presented to the ED with a 4-day history of increasing mass in the left groin, as well as a subjective fever for the previous 2 days. An ultrasound revealed a necrotic abscess in the left inguinal lymph node which necessitated empiric antibiotic therapy and surgical excision; titers revealed a recent infection with Bartonella henselae. Atypical presentations of cat scratch disease, such as inguinal lymphadenopathy, have historically confounded the diagnosis. However, positive serology studies ultimately yielded the correct diagnoses in these children. Given that cat scratch disease can present in an atypical fashion in approximately 5 - 25% of cases, physicians should keep the disease on the differential even when presented with rare presentations such as inguinal lymphadenopathy; serological testing for B. henselae can be utilized once more likely etiologies have been ruled out.

scholarly journals Axillary Imaging Following a New Invasive Breast Cancer Diagnosis—A Radiologist’s Dilemma

2021 ◽  
Author(s):  
Vandana Dialani ◽  
Basak Dogan ◽  
Katerina Dodelzon ◽  
Brian N Dontchos ◽  
Neha Modi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Treatment Plan ◽  
Clinical Stage ◽  
Breast Cancer Diagnosis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Image Guided

Abstract Traditionally, patients with newly diagnosed invasive breast cancer underwent axillary US to assess for suspicious axillary lymph nodes (LNs), which were then targeted for image-guided needle biopsy to determine the presence of metastasis. Over the past decade, there has been a shift towards axillary preservation. For patients with palpable lymphadenopathy, the decision to perform axillary imaging with documentation of the number and location of abnormal LNs in preparation for image-guided LN sampling is straightforward. Since LN involvement correlates with cancer size, it is reasonable to image the axilla in patients with tumors larger than 5 cm; however, for tumors smaller than 5 cm, axillary imaging is often deferred until after the tumor molecular subtype and treatment plan are established. Over the last decade, neoadjuvant chemotherapy (NACT) is increasingly used for smaller cancers with more aggressive molecular subtypes. In most cases, detecting axillary metastasis is critical when deciding whether the patient would benefit from NACT. There is increasing evidence that abnormal axillary US findings correlates with LN metastases and reliably establishes a baseline to monitor response to NACT. Depending on hormone receptor status, practices may choose to image the axilla in the setting of clinical stage T1 and T2 cancers to evaluate nodal status and help determine further steps in care. Radiologists should understand the nuances of axillary management and the scope and challenges of LN marking techniques that significantly increase the precision of limited axillary surgery.

scholarly journals Breast sarcomas. A review of the possible treatment modalities

2017 ◽  
Vol 12 (2) ◽  
pp. 23-27
Author(s):  
Nicolae BACALBASA ◽  
◽  
Olivia IONESCU ◽  
Keyword(s):  
Surgical Treatment ◽  
Adjuvant Chemotherapy ◽  
Connective Tissue ◽  
Adjuvant Radiotherapy ◽  
De Novo ◽  
The Body ◽  
Treatment Modalities ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Tumor Type

Background. Breast sarcomas (BS) are rare tumors which origin within the connective tissue of the breast. A clear delimitation from breast carcinoma should be established because the management and evolution and prognosis are different. BS can develop “de novo” – primary BS or can be related to a previously treated malignant breast tumor – for example after breast conservative surgery and adjuvant radiotherapy. Aim. Owing to the rarity of this tumor type, there is limited evidence with regard to the optimal treatment possibilities. The information comes primary from small retrospective studies so that the treatment principles resemble that of primary mesenchymal malignancies arising in other parts of the body (e.g. leiomyosarcoma, angiosarcoma or liposarcoma). We aimed to make a review of the current treatment possibilities of the BS emphasizing on the type and extent of the surgical treatment, the utility of the axillary lymph node (LN) dissection and the feasibility and benefit of an adjuvant chemotherapy. Method. We performed an online research on Pubmed using the following key words: “sarcoma”, “radiotherapy”, “surgery”, “chemotherapy”. We tried to select the data referring to sarcoma developing with the connective tissue of the breast as well as the information of BS developing after irradiation of the breast in women previously diagnosed with breast cancer (BC) who received adjuvant radiotherapy. We further looked for reports about the role of an adjuvant treatment, namely chemotherapy. Conclusion. The only treatment proved to have a benefit on the prognosis is the surgical treatment with the achievement of a wide, radical, complete resection (R0-resection). For angiosarcomas, either primary or therapy-related, the margins of resection should be more than 1 cm for small tumors and more than 3 cm for larger tumors. Adjuvant chemotherapy has limited benefits and should be applied in selected cases.

scholarly journals Nasolabial cyst: case report and review of management options

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdulhakeem Almutairi ◽  
Abeer Alaglan ◽  
Mazyad Alenezi ◽  
Sultan Alanazy ◽  
Osama Al-Wutayd
Keyword(s):  
Soft Tissue ◽  
Nasal Obstruction ◽  
Surgical Excision ◽  
Mass Effect ◽  
Treatment Modalities ◽  
Open Approach ◽  
Management Options ◽  
Case Presentation ◽  
Complete Surgical Excision

Abstract Background Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature. Case presentation We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up. Conclusions The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

Sign in / Sign up

Export Citation Format

Share Document