scholarly journals Mixed neuroendocrine–non-neuroendocrine neoplasms of the gallbladder: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tatsuki Ishikawa ◽  
Katsunori Nakano ◽  
Masafumi Osaka ◽  
Kenichi Aratani ◽  
Kadotani Yayoi ◽  
...  
Keyword(s):  
System Analysis ◽  
Cancer Control ◽  
Staging System ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Regional Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Case Presentation ◽  
History Of ◽  
Lymph Nodes Dissection

Abstract Background  Primary neuroendocrine tumors of the gallbladder (GB-NETs) are rare, accounting for 0.5% of all NETs and 2.1% of all gallbladder cancers. Among GB-NETs, mixed neuroendocrine–non-neuroendocrine neoplasms of the gallbladder (GB-MiNENs) are extremely rare. Case presentation We present the case of a 66-year-old woman who was referred to us for the management of a gallbladder tumor (incidentally found during abdominal ultrasonography indicated for gallbladder stones). The patient had no history of abdominal pain or fever, and the findings on a physical examination were unremarkable. Blood tests showed normal levels of tumor markers. Imaging studies revealed a mass of approximately 10 mm in diameter (with no invasion of the gallbladder bed) located at the fundus of the gallbladder. A gallbladder cancer was suspected. Therefore, an open whole-layer cholecystectomy with regional lymph nodes dissection was performed. The postoperative course was uneventful, and she was discharged on postoperative day 6. Pathological findings showed GB-MiNENs with invasion of the subserosal layer and no lymph node invasion (classified T2aN0M0 pStage IIA according to the Union for International Cancer Control, 8th edition staging system). Analysis of the neuroendocrine markers revealed positive chromogranin A and synaptophysin, and a Ki-67 index above 95%. Fourteen months after the operation, a local recurrence was detected, and she was referred to another hospital for chemotherapy. Conclusions  GB-MiNENs are extremely aggressive tumors despite their tumor size. Optimal therapy should be chosen for each patient.

scholarly journals Scrotal and Orbital Involvement in Extramedullary De-differentiated Multiple Myeloma

1970 ◽  
Vol 9 (3) ◽  
Author(s):  
Gavin Docherty ◽  
Barret Rush ◽  
Gary Victor ◽  
Greg Dueck
Keyword(s):  
Multiple Myeloma ◽  
Immunoglobulin A ◽  
Staging System ◽  
Ki 67 ◽  
Management Plans ◽  
History Of ◽  
International Staging System ◽  
Abdominal Paracentesis ◽  
Fluid Cell ◽  
Indian Male

A 71-year-old Indian male presented with a five-month history of progressive bilateral testicular swelling and swelling of the left orbit or one month duration. Nine months ago, he had undergone four cycles of chemotherapy (bortezomib, cyclophosphamide, and dexamethasone) for an immunoglobulin A (IgA) lambda multiple myeloma (3.8 grams per decilitre [g/dL]). This was stage 3 according to the International Staging System (ISS) and had no adverse cytogenetics. The patient had undergone six more cycles of treatment prior to presentation. Physical examination revealed gross distension of the left orbital tissues with violaceous colouring (Figure 1A). The abdomen was distended with ascites. Genitourinary examination revealed testicular enlargement (Figure 1B). There was no erythema or warmth associated with either area. Laboratory tests failed to demonstrate monoclonal paraproteinemia, but his lactate dehydrogenase (LDH) level was elevated at 2068 units per litre (units/L). Abdominal paracentesis revealed a fluid cell count of 16,180 106/L and a fluid LDH of 10,591 units/L. Cytology showed CD138 positivity, 80% for Ki-67, and lambda light chain restriction. These findings supported a diagnosis of dedifferentiated extramedullary multiple myeloma. The prognosis and available management plans were discussed with the patient, and he was discharged to the community to be placed in the care of the palliative care team per his wishes.

Discrepancies between two staging systems (European-ENETS versus. American-AJCC) of neuroendocrine neoplasms of the pancreas: A study of 77 cases.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 318-318 ◽  
Author(s):  
Javier A. Cienfuegos ◽  
Joseba Salguero ◽  
Jorge Nuñez ◽  
Fernando Rotellar ◽  
Pablo Marti-Cruchaga ◽  
...  
Keyword(s):  
Tnm Classification ◽  
Cancer Control ◽  
Staging System ◽  
Tnm Staging ◽  
Neuroendocrine Neoplasms ◽  
Biological Behaviour ◽  
Term Survival ◽  
Female Ratio ◽  
Staging Systems ◽  
Male To Female

318 Background: Pancreatic neuroendocrine tumors (pNETs) comprise a spectrum of neoplasm with variable biological behaviour and heterogeneous prognosis. The European Neuroendocrine Tumor Society (ENETS) and the American Joint Cancer Committee/Union for International Cancer Control (AJCC/UICC) TNM staging systems have been recently published. The aim of this study was to evaluate the consistency of both staging systems on outcomes for patients with pNETs. Methods: A retrospective clinico-pathological study of 77 consecutive patients with pNETs who were surgically treated from 1993 to 2014 was carried out. Results: The male to female ratio was 1.0 (38 men, 39 women); 56 tumors were non-functionating and 21 functionating. Most of the tumors were G1 (57) and 20 were classified as G2-G3. The AJCC/UICC stage was IA in 29 patients, IB in 14, IIA in 10, IIB in 7 and IV in 17. Meanwhile, according with the ENETS staging system was: stage I in 30, IIa in 14, IIb in 3, IIIa in 6, IIIb in 7 and IV in 17. We found 18 (23.3%) cases of ENETS - AJCC/UICC discrepancies regarding the primary tumor. They included 6 cases (33%) disagreement between IIA (T3 N0 M0) and IIIa (T4 N0 M0); and 7 cases (38.8%) between IIB (T1-T3 N1 M0) and IIIb (anyT N1 M0). Conclusions: The AJCC and ENETS TNM classification staging for pNETs provide meaninful prognostic value of long-term survival por patients with pNETs. The T staging discrepancies between AJCC/UICC and ENETS are relative frequent and should be strictly recognized.

scholarly journals Case Report: Adenocarcinoma Of The Appendix Presenting As A Cervical Polyp.

2021 ◽  
Author(s):  
Emilie De Smedt ◽  
Bram Pouseele ◽  
Koen Vindevoghel ◽  
Nathalie Storme
Keyword(s):  
Case Reports ◽  
Residual Tumor ◽  
Right Hemicolectomy ◽  
Regional Lymph Nodes ◽  
Case Presentation ◽  
Vaginal Mass ◽  
History Of ◽  
Diagnostic Work ◽  
Work Up ◽  
Cervical Polyp

Abstract Background: The differential diagnosis of a vaginal mass after hysterectomy is broad. Malignancies of the genital tract or metastasis from another primary tumor should be excluded. Appendiceal carcinoma is a rare cause, case reports are limited.Case presentation: A 77-year-old woman with a history of vaginal hysterectomy presented with a 12-month history of vaginal pressure. The vaginal mass, penetrating trough the cervix, is resected (vaginal approach). A Microscopic examination of the removed tissue revealed an adenocarcinoma of the appendix. Right hemicolectomy, resection of the vaginal vault and resection of the regional lymph nodes showed no residual tumor.Conclusions: Full diagnostic work-up of a vaginal mass should be performed to avoid unexpected malignancy. Transvaginal resection was in this case feasible and safe.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

Pulmonary Rehabilitation After Lobectomy On Pulmonary Aspergilloma: Case Report

2019 ◽  
pp. 35-41
Author(s):  
Andwi Setiawan Kokok ◽  
Selly Christina Anggoro ◽  
Siti Chandra Widjanantie
Keyword(s):  
Pulmonary Rehabilitation ◽  
Peak Flow ◽  
Case Presentation ◽  
Rehabilitation Programs ◽  
Abnormal Chest ◽  
History Of ◽  
Postural Correction ◽  
Chronic Pulmonary Aspergillosis ◽  
Pulmonary Aspergilloma ◽  
Breathing Retraining

Introduction: Complete resection of aspergilloma in chronic pulmonary aspergillosis (CPA), may has several health problem after surgery berupa sesak napas, batuk yang tidak efektif. Methods: A case presentation of 45 years old woman, after lobectomy on right upper of lung due to aspergilloma, with history of cough and haemoptysis for 3 months. Pulmonary Rehabilitation were breathing retraining exercise (BE), mobilization technique (MT), chest mobility exercise (CM), active cycle breathing technique (ACBT), postural correction exercise (PC) for three weeks. Results: There were dyspnea, peak flow rate (PFR:60-70-60), peak cough flow (PCF: 70-90-60 L/m), and abnormal chest expansion (CE: 2.5 – 3 – 2) cm. After three weeks of Pulmonary Rehabilitation, there were no dyspnea, increased the PCF: 193L/m, and CE: 2.5-4 -3. Conclusion: Pulmonary Rehabilitation programs for three weeks were relieved dyspnea, increased cough capacity and CE.

Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Asma H. Almaghrebi
Keyword(s):  
Treatment Options ◽  
Young Female ◽  
Similar Reaction ◽  
Careful Monitoring ◽  
Treatment Resistant ◽  
Blood Cell Count ◽  
Antipsychotic Medications ◽  
Case Presentation ◽  
Clozapine Treatment ◽  
History Of

Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia. Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue. Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 &#215; 10<sup>9</sup> L, and her neutrophils decreased to 0.1 &#215; 10<sup>9</sup> L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol). Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.

scholarly journals National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer

2017 ◽  
Vol 35 (34) ◽  
pp. 3800-3806 ◽  
Author(s):  
Christopher P. Childers ◽  
Kimberly K. Childers ◽  
Melinda Maggard-Gibbons ◽  
James Macinko
Keyword(s):  
Ovarian Cancer ◽  
Genetic Testing ◽  
Unmet Need ◽  
Cancer Control ◽  
The United States ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Age Of Diagnosis ◽  
History Of ◽  
Interview Survey

Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

scholarly journals A case of sigmoid volvulus in an unexpected demographic

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika
Keyword(s):  
Abdominal Pain ◽  
Severe Pain ◽  
Rare Case ◽  
Young Female ◽  
Sigmoid Volvulus ◽  
Case Presentation ◽  
Operative Complications ◽  
History Of ◽  
Male Sex ◽  
Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

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