A poor prognostic metastatic nongestational choriocarcinoma of the ovary: a case report and the literature review

Abstract Background Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. Case presentation A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma. Conclusion Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

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A Poor Prognostic Metastatic Nongestational Choriocarcinoma of the Ovary: A Case Report and the Literature Review.

10.21203/rs.3.rs-90334/v1 ◽

2020 ◽

Author(s):

Kimihiro Nishino ◽

Eiko Yamamoto ◽

Yoshiki Ikeda ◽

Kaoru Niimi ◽

Toshimichi Yamamoto ◽

...

Keyword(s):

Tumor Cells ◽

Tumor Resection ◽

Left Lung ◽

Str Analysis ◽

Case Presentation ◽

Gestational Choriocarcinoma ◽

Mucosal Cells ◽

Malignant Germ Cell Tumor ◽

Brain Tumor Resection ◽

Short Tandem

Abstract Background: Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. Case presentation: A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma.Conclusion: Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

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Restored Activation of Primary Motor Area from Motor Reorganization and Improved Motor Function after Brain Tumor Resection

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(08)79152-x ◽

2008 ◽

Vol 2008 ◽

pp. 204-205

Author(s):

S.R. Shepard

Keyword(s):

Brain Tumor ◽

Motor Function ◽

Tumor Resection ◽

Motor Area ◽

Primary Motor Area ◽

Motor Reorganization ◽

Brain Tumor Resection

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NCMP-13. LEPTOMENINGEAL DISEASE FOLLOWING RESECTION OF INTRAVENTRICULAR MELANOMA METASTASIS DIAGNOSED THROUGH CIRCULATING TUMOR CELLS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.524 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii125-ii125

Author(s):

Christopher Wang ◽

Melissa Limia ◽

Peter Forsyth ◽

James Liu

Keyword(s):

Early Intervention ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Surgical Resection ◽

Tumor Resection ◽

Leptomeningeal Disease ◽

Melanoma Metastasis ◽

Tumor Seeding ◽

Csf Analysis ◽

Dismal Prognosis

Abstract Leptomeningeal disease in the setting of malignant melanoma metastatic to the brain provides a dismal prognosis. The relationship between intraventricular metastatic tumor seeding following surgical resection and development of leptomeningeal disease (LMD) is not completely clear, although there appears to be correlation. While the mechanisms that drive the development of LMD is not well understood, monitoring of cerebrospinal fluid (CSF) for circulating tumor cells (CTCs) in high risk patients may allow for early intervention for LMD prior to radiographical diagnosis. This report describes a patient with metastatic melanoma who developed ventricular trapping from an intraventricular melanoma metastasis. The patient underwent endoscopic assisted resection of the tumor. Due to concern for leptomeningeal seeding given the location of the tumor and use of surgical resection, CSF analysis was performed. CTC count was increased shortly after surgical resection along with cytology that was suspicious for malignancy. Due to the increase in CTCs, the patient was treated for LMD with whole brain radiation therapy and intrathecal pembrolizumab. Subsequent CSF analysis revealed clearing of malignant cells in the CSF. The patient developed symptoms consistent with LMD approximately 9 months after the surgery and died 21 months after resection of his brain metastasis. This case illustrates a rare occurrence of an intraventricular melanoma metastasis, and the use of CTC presence within the CSF to diagnose LMD for early intervention. This emphasizes that the risk of developing LMD must be considered with intraventricular metastasis or ventricular exposure during tumor resection, and that CTCs may be an effective factor to monitor for early development of disease with possible prolonged survival benefit.

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Personality and behavioral changes after brain tumor resection: a lesion mapping study

Acta Neurochirurgica ◽

10.1007/s00701-021-04756-9 ◽

2021 ◽

Vol 163 (5) ◽

pp. 1257-1267 ◽

Cited By ~ 1

Author(s):

Anne-Laure Lemaitre ◽

Guillaume Herbet ◽

Hugues Duffau ◽

Gilles Lafargue

Keyword(s):

Brain Tumor ◽

Tumor Resection ◽

Behavioral Changes ◽

Mapping Study ◽

Lesion Mapping ◽

Brain Tumor Resection

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Retroperitoneal fibrous tumor recurring as lung metastases after 10 years: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01209-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kozue Matsuishi ◽

Kojiro Eto ◽

Atsushi Morito ◽

Hirokazu Hamasaki ◽

Keisuke Morita ◽

...

Keyword(s):

Case Report ◽

Solitary Fibrous Tumor ◽

Distant Metastasis ◽

Curative Resection ◽

Lung Metastases ◽

Lung Resection ◽

Left Lung ◽

Metastatic Lesion ◽

Case Presentation ◽

Fibrous Tumor

Abstract Background Solitary fibrous tumor (SFT) is a relatively rare mesenchymal tumor that mainly affects adults. Its prognosis is good after curative resection, but distant recurrences after 10 years or longer have been reported. Recurrent SFT usually arises as a local lesion; distant metastasis is rarely reported. Here, we report lung metastases that recurred a decade after excising a retroperitoneal primary SFT. Case presentation A 44-year-old woman had an SFT resected from her right retroperitoneum at our hospital. Ten years later, at age 54, she underwent a lung resection after CT showed three suspected metastases in her left lung. All three were histologically diagnosed as lung metastases from the retroperitoneal SFT. However, whereas the primary SFT had 1–2 mitotic cells/10 high power fields (HPF), the metastatic lesion increased malignancy, at 50/10 HPF. Conclusion Patients who have had resected SFTs should be carefully followed up, as malignancy may change in distant metastasis, as in this case.

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Therapy and regeneration-combined bone cements for minimally invasive treatment of neoplastic bone defects

Journal of Materials Chemistry B ◽

10.1039/d1tb00703c ◽

2021 ◽

Author(s):

Yu Qu ◽

Hui Zhuang ◽

Meng Zhang ◽

Yufeng Wang ◽

Dong Zhai ◽

...

Keyword(s):

Calcium Phosphate ◽

Minimally Invasive ◽

Tumor Cells ◽

Bone Tumor ◽

Tumor Resection ◽

Bone Defects ◽

Bone Cements ◽

Invasive Treatment ◽

Calcium Phosphate Cements ◽

Bone Tumor Resection

Although calcium phosphate cements (CPC) have been clinically used to repair bone defects caused by bone tumor resection, traditional CPC cannot kill the remaining tumor cells after surgery and prevent...

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Specific airway management for SVC replacement during giant anterior mediastinal tumor resection

JA Clinical Reports ◽

10.1186/s40981-020-00377-w ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Izumi Kawagoe ◽

Daizoh Satoh ◽

Chieko Mitaka ◽

Masataka Fukuda ◽

Tsukasa Kochiyama ◽

...

Keyword(s):

Mediastinal Tumor ◽

Main Bronchus ◽

Superior Vena ◽

Tumor Resection ◽

Left Lung ◽

Vena Cava ◽

Double Lumen Tube ◽

Lower Airway ◽

Tumor Spread ◽

Anterior Mediastinal Tumor

Abstract Background Giant anterior mediastinal tumor (GAMT) resection is a challenging procedure, for which anesthesiologist might take to need special precautions. Case presentation A 48-year-old male patient had been scheduled to undergo GAMT resection and superior vena cava (SVC) replacement. The tumor spread surrounding SVC and left main bronchus (LMB), resulting in small volume of his left lung. A soft left-sided double lumen tube (DLT) was selected to keep the patency of LMB during left one lung ventilation (OLV) against the tumor weight. Semi-awake intubation with spontaneous breathing was selected for DLT insertion to avoid lower airway occlusion. During left OLV after right open thoracotomy, his SPO2 decreased below to 90%. We performed selective right upper lobe bronchial blockade using the combination of DLT and bronchial blocker. The surgery was successfully completed with this strategy. Conclusions Although such cases are rare, they are informative for anesthesiologists, providing optional strategies.

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Isolation of Mycobacterium talmoniae from a patient with diffuse panbronchiolitis: a case report

BMC Infectious Diseases ◽

10.1186/s12879-021-05944-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomoko Suzuki ◽

Miwako Saitou ◽

Yuriko Igarashi ◽

Satoshi Mitarai ◽

Katsunao Niitsuma

Keyword(s):

Combination Therapy ◽

Bronchoalveolar Lavage Fluid ◽

Left Lung ◽

Lavage Fluid ◽

Drug Susceptibility ◽

Acid Fast Bacillus ◽

Case Presentation ◽

Diffuse Panbronchiolitis ◽

Potential Pathogen ◽

Culture Positive

Abstract Background Mycobacterium (M) talmoniae isolated from a patient with cystic fibrosis was first described in 2017, and cases of M. talmoniae remain exceedingly rare. Case presentation A 51-year-old woman had respiratory symptoms for 10 years. Diffuse panbronchiolitis (DPB) was detected at the first visit at our hospital. A cavity lesion in the apex of the left lung was found, and sputum and bronchoalveolar lavage fluid were acid-fast bacillus (AFB) smear- and culture-positive besides Pseudomonas aeruginosa. M. talmoniae was finally identified, and the standard combination therapy for non-tuberculous mycobacteria (NTM) was administered for 2 y referring to the drug-susceptibility test. Thereafter, the AFB culture was negative, the wall thickness of the lung cavity was ameliorated, and oxygen saturation improved. Conclusions We encountered a rare case of M. talmoniae with DPB, for which standard combination therapy was effective. M. talmoniae may be considered a potential pathogen of lung disease, especially in patients with bronchiectatic lesions.

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