Pathologically confirmed brain metastases from primary uterine cervical tumors: two cases and a literature review

Abstract Background Pathologically confirmed brain metastasis from primary cervical cancer is extremely rare. Herein, we report two cases of intracranial metastasis from cervical cancer that were histopathologically confirmed after surgical excision. In addition, we conducted a literature review to characterize the clinical manifestation, pathogenesis, and treatment of these patients. Case summary Among the 1800 patients with primary cervical cancer who received therapy at our center from 2010 to 2018, two patients (0.1%) had definite histopathological evidence of brain metastasis. A 46-year-old female who had a history of poorly differentiated stage IIB cervical cancer with neuroendocrine differentiation presented with a solitary mass in the right occipital lobe 26 months after the initial diagnosis. She underwent surgery and chemotherapy but died of disease progression 9 months later. Another 55-year-old female diagnosed with poorly differentiated stage IVB cervical squamous cancer presented with a solitary mass in the right frontal lobe 16 months after simple hysterectomy. Twelve months later, multiple lesions were observed in the bilateral frontal-parietal lobe. The lesions were treated by surgery and stereotactic radiosurgery. The patient died of multiple organ failure 14 months later. Conclusion The pathogenesis and best management of brain metastasis from cervical cancer are not clear. Highly invasive subtypes or advanced cancer stages may be the key clinicopathological factors of brain metastasis. Surgical treatment is warranted in patients with a good health status and without metastasis to other sites.

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Metastatic intracranial carcinoid with immunohistochemical observation

Journal of Neurosurgery ◽

10.3171/jns.1990.73.1.0130 ◽

1990 ◽

Vol 73 (1) ◽

pp. 130-136 ◽

Cited By ~ 7

Author(s):

Tsunenori Ozawa ◽

Tadasu Terabayashi ◽

Hitoshi Takahashi ◽

Norio Takeda ◽

Yasushi Ito ◽

...

Keyword(s):

Occipital Lobe ◽

Neurological Complications ◽

Serotonin Release ◽

Blood Levels ◽

Metastatic Carcinoid ◽

Intracranial Metastasis ◽

Content Type ◽

Hydroxyindoleacetic Acid ◽

The Right ◽

Immunohistochemical Studies

✓ A case of metastatic carcinoid tumor in the right occipital lobe originating from a primary tumor in the right colon is reported in a 68-year-old man. The tumor had a high bromodeoxyuridine labeling index. Although immunohistochemical studies of the tumor specimen showed positive reactivity for serotonin and somatostatin, blood levels of serotonin and urinary 5-hydroxyindoleacetic acid content were normal. This suggests that coexistence of somatostatin with serotonin in the tumor tissue might lead to inhibition of serotonin release by “autocrine regulation.” The neurological complications of carcinoid tumors, including intracranial metastasis, are discussed briefly.

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Internal hernia beneath superior vesical artery after pelvic lymphadenectomy for cervical cancer: a case report and literature review

BMC Surgery ◽

10.1186/s12893-020-00985-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Wen Ai ◽

Zhihua Liang ◽

Feng Li ◽

Haihua Yu

Keyword(s):

Cervical Cancer ◽

Case Report ◽

Literature Review ◽

Internal Hernia ◽

Radical Hysterectomy ◽

Pelvic Lymphadenectomy ◽

Case Presentation ◽

The Common ◽

Laparoscopic Pelvic Lymphadenectomy ◽

The Right

Abstract Background The common complications of radical hysterectomy and pelvic lymphadenectomy usually include wound infection, hemorrhage or hematomas, lymphocele, uretheral injury, ileus and incisional hernias. However, internal hernia secondary to the orifice associated with the uncovered vessels after pelvic lymphadenectomy is very rare. Case presentation We report a case of internal hernia with intestinal perforation beneath the superior vesical artery that occurred one month after laparoscopic pelvic lymphadenectomy for cervical cancer. A partial ileum resection was performed and the right superior vesical artery was transected to prevent recurrence of the internal hernia. Conclusions Retroperitonealization after the pelvic lymphadenectomy should be considered in patients with tortuous, elongated arteries which could be causal lesions of an internal hernia.

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Post-Stimulation Effect of Electroacupuncture at Yintang (EX-HN3) and GV20 on cerebral functional regions in healthy volunteers: A resting functional MRI study

Acupuncture in Medicine ◽

10.1136/acupmed-2011-010123 ◽

2012 ◽

Vol 30 (4) ◽

pp. 307-315 ◽

Cited By ~ 8

Author(s):

Yu Zheng ◽

Shanshan Qu ◽

Na Wang ◽

Limin Liu ◽

Guanzhong Zhang ◽

...

Keyword(s):

Frontal Lobe ◽

Temporal Lobe ◽

Parietal Lobe ◽

Occipital Lobe ◽

Cingulate Gyrus ◽

Left Frontal Lobe ◽

Posterior Cingulate Gyrus ◽

Functional Regions ◽

Limbic Lobe ◽

The Right

Objective The aim of the present work was to observe the activation/deactivation of cerebral functional regions after electroacupuncture (EA) at Yintang (EX-HN3) and GV20 by functional MRI (fMRI). Design A total of 12 healthy volunteers were stimulated by EA at Yintang and GV20 for 30 min. Resting-state fMRI scans were performed before EA, and at 5 and 15 min after needle removal. Statistical parametric mapping was used to preprocess initial data, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) were analysed. Results ReHo at 5 min post stimulation showed increases in the left temporal lobe and cerebellum and decreases in the left parietal lobe, occipital lobe and right precuneus. At 15 min post stimulation, ReHo showed increases in the left fusiform gyrus; lingual gyrus; middle temporal gyrus; postcentral gyrus; limbic lobe; cingulate gyrus; paracentral lobule; cerebellum, posterior lobe, declive; right cuneus and cerebellum, anterior lobe, culmen. It also showed decreases in the left frontal lobe, parietal lobe, right temporal lobe, frontal lobe, parietal lobe and right cingulate gyrus. ALFF at 5 min post stimulation showed increases in the right temporal lobe, but decreases in the right limbic lobe and posterior cingulate gyrus. At 15 min post stimulation ALFF showed increases in the left frontal lobe, parietal lobe, occipital lobe, right temporal lobe, parietal lobe, occipital lobe and cerebellum, but decreases in the left frontal lobe, anterior cingulate gyrus, right frontal lobe and posterior cingulate gyrus. Conclusions After EA stimulation at Yintang and GV20, which are associated with psychiatric disorder treatments, changes were localised in the frontal lobe, cingulate gyrus and cerebellum. Changes were higher in number and intensity at 15 min than at 5 min after needle removal, demonstrating lasting and strong after-effects of EA on cerebral functional regions.

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Mucinous Ovarian Tumors With Anaplastic Mural Nodules: Case Report

Frontiers in Medicine ◽

10.3389/fmed.2021.753904 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xinxin Zou ◽

Hao Huang ◽

Qingyu Zhang ◽

Zhen Ma ◽

Yumei Chen ◽

...

Keyword(s):

Surgical Excision ◽

Exploratory Laparotomy ◽

Cystic Mass ◽

Anaplastic Carcinoma ◽

Diagnostic Methods ◽

Cystic Tumors ◽

Partition Walls ◽

Poorly Differentiated ◽

The Right ◽

Mural Nodules

Ovarian mucinous cystic tumors may be associated with various types of mural nodules, which can be classified as benign or malignant (anaplastic carcinoma, sarcoma, carcinosarcoma). However, anaplastic malignant nodules have rarely been reported. Here, we present a case of a 35-year-old woman who presented with abdominal discomfort. Ultrasonography showed a large cystic mass in the pelvic and abdominal cavities measuring 337 × 242 mm. Abdominal computed tomography revealed upper anterior and posterior uterine pelvic cystic lesions based on multiple nodule partition walls and classes. During hospitalization, the patient underwent exploratory laparotomy, which revealed a poorly differentiated ovarian malignant tumor, and subsequent surgical excision was performed. The pathological analysis of the surgical samples of the right ovary revealed a mucinous ovarian tumor, while the mural nodules were classified as anaplastic carcinoma. After surgery, the patient started receiving chemotherapy. Unfortunately, the patient died 6 months later. Mucinous tumor occurring with an anaplastic carcinoma is rare, and the current diagnostic methods are not sufficient in providing an early and accurate diagnosis. Most patients are already in the advanced stage upon diagnosis and combined with poorly differentiated pathological features, the prognosis is extremely poor. Clinicians need to improve the clinical evaluation before surgery and conduct preoperative preparation and communication to improve the prognosis of patients as much as possible.

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Calcified brain metastatic adenocarcinoma: A case report and review of the literature

The Neuroradiology Journal ◽

10.1177/1971400918805184 ◽

2018 ◽

Vol 32 (1) ◽

pp. 57-61

Author(s):

Eshagh Bahrami ◽

Morteza Taheri ◽

Mohsen Benam

Keyword(s):

Brain Metastasis ◽

Histopathological Examination ◽

Occipital Lobe ◽

Clonic Seizure ◽

Brain Parenchyma ◽

Metastatic Adenocarcinoma ◽

Case Presentation ◽

Rim Enhancement ◽

Autopsy Specimens ◽

The Right

Introduction Calcification in brain metastasis occurs rarely so it is reported in approximately 1% of surgical and 6.6% of autopsy specimens. Here we report a new case of brain metastasis with calcification. Case presentation A 44-year-old woman presented with a generalized tonic–clonic seizure with no neurological deficit on physical examination. Brain imaging demonstrated a hyperdense lesion on computed tomography scan and hyposignal and rim enhancement on T1, T2 and T1 with gadolinium injection sequence images in the right parieto-occipital lobe. Intraoperatively, there was a well-defined solid homogenous calcified mass within brain parenchyma. The lesion that resembled a meningioma was totally resected. The histopathological examination revealed metastatic adenocarcinoma. Conclusion Metastatic brain lesions should be in the differential diagnosis of a solitary calcified brain mass, although it occurs rarely. It is important to differentiate it radiologically from intralesional haemorrhage.

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Dilated odontoma: an unusual case report and literature review

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2020067 ◽

2021 ◽

Vol 27 (2) ◽

pp. 24

Author(s):

P. Galvez ◽

E. Garot ◽

A. Bres ◽

A. Crelier ◽

C. Castain ◽

...

Keyword(s):

Literature Review ◽

Oral Surgery ◽

Surgical Excision ◽

Severe Form ◽

Lateral Incisor ◽

Enamel Organ ◽

Incisor Tooth ◽

Complex Anatomy ◽

The Right ◽

Dens Invaginatus

Introduction: Dilated odontoma is the most severe form of a dens invaginatus, which is a rare dental malformation resulting from an invagination of the enamel organ into the dental papilla before calcification occurs. Observation: A healthy 7-years-old girl was referred to the oral surgery department to remove an impacted odontoma causing a delayed dental eruption of the right mandibular lateral incisor (tooth 42). The patient was painless and a lingual osseous swelling was observed. A computed tomography and a 3D segmentation revealed a shell-shaped mass in the position of the right mandibular lateral incisor, showing a complex anatomy. Surgical excision was carried out under general anesthesia. Histological analysis confirmed the diagnosis of DO. Discussion and conclusion: We performed a literature review investigating 16 cases of severe forms of dens invaginatus which required extraction. It highlighted the atypical aspect of our case and the importance of 3D imaging and segmentation in contributing to the accurate diagnosis and treatment of this dental malformation.

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Cerebral Blood Flow and Volume in Symptom-Free Migraineurs: a SPECT Study

Nuklearmedizin ◽

10.1055/s-0038-1629533 ◽

1990 ◽

Vol 29 (05) ◽

pp. 210-214 ◽

Cited By ~ 4

Author(s):

G. L. Turco ◽

G. Castellano ◽

W. Liboni ◽

V. Podio ◽

G. Chianale ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Gamma Camera ◽

Parietal Lobe ◽

Diagnostic Yield ◽

Occipital Lobe ◽

Occipital Cortex ◽

Nuclear Data ◽

The Right ◽

Ct And Mri

Both CBF and CBV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT.

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Massive intracerebral hemorrhages due to peripheral middle cerebral artery aneurysm rupture: A case report with a surgical video

Surgical Neurology International ◽

10.25259/sni_479_2021 ◽

2021 ◽

Vol 12 ◽

pp. 412

Author(s):

Takuma Aoki ◽

Yukihiro Goto ◽

Yujiro Komaru ◽

Shigeomi Yokoya ◽

Hideki Oka

Keyword(s):

Subarachnoid Hemorrhage ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Parietal Lobe ◽

Artery Aneurysm ◽

Surgical Excision ◽

Sudden Onset ◽

Aneurysm Rupture ◽

Saccular Aneurysm ◽

The Right

Background: Saccular aneurysm in the distal segment of the middle cerebral artery (DMCA) occurs very rarely and often represents with a rupture. We report a successful surgical case of a DMCA aneurysm rupture with large cerebral and subarachnoid hemorrhage. Case Description: A 44-year-old female presented a sudden onset headache and coma (the Glasgow Coma Scale was 3). Head computed tomography (CT) revealed a subarachnoid hemorrhage around the right Sylvian fissure and large intracranial hematoma in the right parietal lobe. The CT angiography showed a saccular aneurysm in the peripheral cortical segment of the right angular branch of the right DMCA. We decided to perform a right craniotomy to evacuate hematoma and interrupt the aneurysm. Just after the dural incision, the aneurysm ruptured again. We applied a temporary clip on the artery proximal to the aneurysm before excising it. Conclusion: Aneurysm in DMCA can be treated safely with surgical excision and risk of sudden recurrent hemorrhage needs to be anticipated.

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Micropapillary Adenocarcinoma of the Lung that Metastasized to the Same Site in the Brain Twice: A Rare Case Report and Review of Literature

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4677 ◽

2020 ◽

Vol 8 (C) ◽

pp. 184-187

Author(s):

Ahmad Faried ◽

Rhonaz P. Agung ◽

Hasrayati Agustina ◽

Bethy S. Hernowo ◽

Muhammad Z. Arifin

Keyword(s):

Case Report ◽

Brain Metastasis ◽

Histopathological Examination ◽

Good Communication ◽

Thyroid Transcription Factor ◽

Rare Case Report ◽

Poorly Differentiated ◽

The Right ◽

Total Tumor Removal ◽

The Brain

BACKGROUND: Adenocarcinoma (ADC) of the lung is the most common subtype of non-small cell lung cancer (NSCLC), occurring in ~40% of all patients with significantly higher incidence of brain metastasis compared with other subtypes of NSCLC. Among the five subtypes ADC of the lung, micropapillary predominant ADC may be more likely to metastasize. There are almost no reports of micropapillary ADC of the lung initially discovered to metastasis into the same site in the brain that has been previously operated. CASE REPORT: We reported a 54-year-old woman who was referred to ICU of Dr. Hasan Sadikin Hospital, Bandung, due to a decreased of consciousness. Head computed tomography scan revealed multiple isohypodense lesions in the right frontal with brain edema. She had craniotomy total tumor removal 8 months earlier and diagnosed as brain metastasis due to micropapillary ADC of the lung. She refused to receive chemoradiotherapy. At the operation site, multilobulated lesions were found, and hence, she was operated for the 2nd time at the same site with the first one, exhibited the same histology. Immunohistological shown positive results for thyroid transcription factor (TTF)-1 and cytokeratin (CK)-7; negative for CK-20, led to a diagnosis of micropapillary ADC of the lung. CONCLUSION: Herein, we reported our experience regarding a case of micropapillary ADC of the lung, considered as poorly differentiated ADC and associated with a high-grade lesion that metastasized to the same site that had been previously operated, twice. A definitive diagnosis was possible only through a histopathological examination along with a good communication between the surgeon and the pathologist.

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Cutaneous Rosai – Dorfman disease in a patient with late syphilis and cervical cancer – case report and a review of literature

BMC Dermatology ◽

10.1186/s12895-020-00115-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Angelika Bielach – Bazyluk ◽

Agnieszka B. Serwin ◽

Agata Pilaszewicz – Puza ◽

Iwona Flisiak

Keyword(s):

Cervical Cancer ◽

Immunohistochemical Staining ◽

Surgical Excision ◽

Cancer Case ◽

Serological Tests ◽

Serological Screening ◽

Benign Condition ◽

Complete Surgical Excision ◽

Rosai Dorfman Disease ◽

The Right

Abstract Background Cutaneous Rosai – Dorfman disease (CRDD) is extremely rare variant of idiopathic histiocytic proliferative disorder, which may manifest as a non-specific macules, papules, plaques or nodules ranging in size and colour from yellow – red to red -brown. Case presentation A 52-year-old female presented with three gradually enlarging, reddish - brown nodules on the right upper extremity lasting six months. The patients denied fever, weight loss, malaise. Clinical examination and imaging tests showed no sign of lymphadenopathy. A biopsy specimen of a nodule showed a dense dermal polymorphic infiltrate with numerous histiocytes exhibiting emperipolesis phenomenon. Immunohistochemical staining of the histiocytes showed S-100 protein (+), CD68(+), but CD1a (-). Aforementioned findings were consistent with CRDD characteristics. Additionally, a routine serological screening and confirmatory serological tests for syphilis were positive. Syphilis of unknown duration was diagnosed. The IgG antibodies titre against Chlamydia trachomatis was elevated. An isolated sensory impairment over the right trigeminal nerve was found on neurological consultation. Comprehensive gynaecological assessment was carried out because of patient’s complaints of bleeding after sexual intercourse and led to diagnosis of cervical cancer. The initial therapy with methotrexate was discontinued after three months due to neutropenia. Further therapy with dapson was ineffective, therefore complete surgical excision was recommended. Conclusions CRDD is a rare, benign condition especially difficult to diagnose due to lack of general symptoms and lymphadenopathy. Histopathologic examination with immunohistochemical staining, exhibiting characteristic and reproducible findings play a key role in establishing an accurate diagnosis. In the presented case activated histiocytes demonstrated in a lesional skin might be a response to immune dysregulation related to chronic, untreated sexually transmitted infections and cancer.

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