scholarly journals Adult sacrococcygeal teratoma excised by endoscopic surgery with a transsacral approach: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ryosuke Machi ◽  
Chikashi Hiranuma ◽  
Hayato Suzuki ◽  
Masakazu Hattori ◽  
Kenji Doden ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Mature Teratoma ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Cystic Mass ◽  
Cystic Tumor ◽  
Sacrococcygeal Teratoma ◽  
Transsacral Approach ◽  
Surgical Field ◽  
Magnetic Resonance Imaging Mri

Abstract Background Although sacrococcygeal teratoma (SCT) is relatively common in children, it is rare in adults. The prognosis for malignant cases is poor, so prompt surgical resection is required. Transabdominal and transsacral approaches are common approaches for tumor resection. In recent years, there have been reports of tumor removal with laparoscopic assistance, but all have applied transabdominal approaches. Case presentation A 27-year-old woman visited our gynecology department because of abdominal pain and genital bleeding. Magnetic resonance imaging (MRI) revealed a 3-cm-sized cystic mass in the left retrorectal area, and she was referred to our department for detailed examinations and treatment. She was diagnosed with a presacral cystic tumor and decided to undergo surgery. We used a transsacral approach to perform tumor excision. Since it was difficult to confirm the deep part of the tumor through direct visualization, we used GelPOINT® Path (a transanal access platform) and AirSEAL® System (insufflation device) to remove the tumor endoscopically. The postoperative course was uneventful with no bladder or rectal dysfunction. Histopathological examination revealed a mature teratoma. Conclusions When the tumor is relatively small and located in the lower sacrum, the endoscopically assisted transsacral approach can establish a stable field of view by expanding the depth of the surgical field. This method is useful considering its ability to perform excision without leaving residual tumor tissue and satisfactory safety and cosmetic results.

Residual Tumor Resection After High-Dose Chemotherapy in Patients With Relapsed or Refractory Germ Cell Cancer

2004 ◽  
Vol 22 (18) ◽  
pp. 3713-3719 ◽  
Author(s):  
O. Rick ◽  
C. Bokemeyer ◽  
S. Weinknecht ◽  
J. Schirren ◽  
T. Pottek ◽  
...  
Keyword(s):  
Germ Cell ◽  
Mature Teratoma ◽  
Univariate Analysis ◽  
Cell Cancer ◽  
Tumor Resection ◽  
Residual Tumor ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Incomplete Resection ◽  
Residual Tumor Resection

Purpose To assess the role of residual tumor resection performed after high-dose chemotherapy (HDCT) in patients with relapsed or refractory germ cell tumors (GCT). Patients and Methods Between July 1987 and October 1999, postchemotherapy resections of residual tumors were performed in 57 patients who had been treated with HDCT for relapsed or refractory GCT and who had achieved a partial remission to this treatment. Results Complete resections of residual masses were achieved in 52 (91%) of 57 patients who were rendered disease free; in five (9%) of 57 patients, the resections were incomplete. Resection of a single site was performed in 39 (68%) of 57 patients, and the remaining 18 (32%) of 57 patients required interventions at two or more residual tumor sites. Necrosis was found in 22 (38%) of 57 patients, mature teratoma with or without necrosis was found in nine (16%) of 57 patients, and viable cancer with or without additional necrosis or mature teratoma was found in 26 (46%) of 57 patients. Viable cancer consisted either of residual germ cell or undifferentiated cancer in 22 (85%) of 26 patients, with additional non-GCT histologies in the remaining four patients. Patients with viable cancer had a significantly inferior outcome after surgery compared with patients with necrosis and/or mature teratoma even if all cancer was completely resected. Pulmonary lesions with a diameter of more than 2 cm were the only predictive variable for viable cancer in univariate analysis. Conclusion Resections of all residual tumors should be attempted in patients with relapsed or refractory GCT and partial remissions after HDCT.

Short-term preoperative treatment of macroprolactinomas by dopamine agonists

1987 ◽  
Vol 67 (6) ◽  
pp. 807-815 ◽  
Author(s):  
Rudolf Fahlbusch ◽  
Michael Buchfelder ◽  
Uwe Schrell
Keyword(s):  
Dopamine Agonists ◽  
Low Dose ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Cystic Tumor ◽  
Preoperative Treatment ◽  
Short Term ◽  
Content Type ◽  
Transsphenoidal Microsurgery ◽  
Injectable Form

✓ During a period of 3 years, 25 patients with intra- and extrasellar macroprolactinomas were pretreated with dopamine agonists for a period of 2 to 6½ weeks prior to transsphenoidal microsurgical tumor resection. Dopamine agonists were administered orally to 17 patients, intramuscularly to three patients, and both orally and intramuscularly to five patients. Repeated computerized tomography (CT) examinations revealed that all neoplasms except one cystic tumor were reduced in size during the course of dopamine-agonist administration. No complications attributable to medical pretreatment were observed. Tumor shrinkage increased the efficacy of surgery, especially in cases with considerable extrasellar extension of the adenomas. Within 3 months following adenomectomy, prolactin levels were adjusted to normal levels in 19 patients by additional low-dose treatment with dopamine agonists. Thin-collimation CT assessments performed at least 3 months after surgery showed no evidence of residual tumor tissue in 23 patients. It is concluded that administration of dopamine agonists for some weeks prior to surgery is a useful adjunct to transsphenoidal microsurgery for macroprolactinomas. The new injectable form of bromocriptine is particularly valuable for this purpose.

scholarly journals CS-03 LARGE CYSTIC INTRADURAL SCHWANNOMA IN CERVICAL REGION: A CASE REPORT

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii38-ii38
Author(s):  
Yuki Takeshima ◽  
Tatsuya Takezaki ◽  
Tadashi Hamasaki ◽  
Seiji Tajiri ◽  
Akitake Mukasa
Keyword(s):  
Histopathological Examination ◽  
Tumor Resection ◽  
Cyst Formation ◽  
Cystic Mass ◽  
Cervical Region ◽  
Spinal Tumors ◽  
Neurenteric Cyst ◽  
Cystic Changes ◽  
Intradural Extramedullary ◽  
One Year

Abstract Schwannomas are the most common intradural extramedullary spinal tumors. However, they are usually solid tumors, and totally cystic changes are rare. Herein, we report a case of a 46-year-old male presenting with numbness of right limbs, right hemiplegia, and posterior neck pain for one year. MRI revealed a well-defined cystic long-segment, from C1 to C6, intradural extramedullary mass. The lesion showed hypointense on T1WI, hyperintense on T2WI, hyperintense on DWI, and it was marginally enhanced on the contrast image with Gd-DTPA. C1 laminectomy and hemi-laminectomy from C2 to C6 was performed for tumor resection. The tumor was found to be totally cystic and tensed with a jelly-like content. It was completely resected with the attachment of the C3 dorsal root. Histopathological examination confirmed it to be a schwannoma. The mechanism of cyst formation in schwannoma is considered as results of ischemic necrosis associated with tumor growth, or cystosis due to degeneration of Antoni-type B region. The long-segment, totally cystic intradural cervical schwannoma is rare, bit it should be included in the differential diagnosis of a cystic mass in the spinal region. It can be difficult to distinguish cystic spinal schwannomas from other cystic lesions like arachnoid cyst, epidermoid cyst, and neurenteric cyst. Contrast enhanced MRI is useful by enhancing the margin of the tumor.

scholarly journals NI-11 Clinical significance of intracystic diffusion hyperintensity lesions remaining after treatment of intracranial germ cell tumor

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii14-ii14
Author(s):  
Motoki Takano ◽  
Takeshi Takayasu ◽  
Ushio Yonezawa ◽  
Akira Taguchi ◽  
Kazuhiko Sugiyama ◽  
...  
Keyword(s):  
Germ Cell ◽  
Clinical Significance ◽  
Cyst Wall ◽  
High Intensity ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Residual Tumor ◽  
Cystic Tumor ◽  
Intracranial Germ Cell Tumor ◽  
Intensity Lesion

Abstract Background and purpose: About 30% of intracranial germ cell tumors are mixed germ cell tumors and teratomas are often found as those components. Intense chemoradiotherapy is performed according to the malignancy of the histopathology, but high-intensity lesion inside the cystic tumor on diffusion weighted imaging (DWI) sometimes remains after completion of the chemoradiotherapy. In this study, we examined the clinical significance of the DWI high-intensity lesion remaining in the cyst. METHODS: Five patients after initial chemoradiotherapy were resected residual tumor by craniotomy at our hospital from 2009 to 2019. Preoperative gadolinium-enhanced MRI defined the non-contrast-enhanced part of the tumor as intracystic, and DWI intensity was classified by its look as low-intensity, equal-intensity, and high-intensity compared to the cortex of the same slice. DWI signals in the solid area, cyst wall, and cyst were evaluated. Results: All cases were mature teratoma in histopathology, and no other tumor components were observed. On DWI, the cyst wall and solid part were visualized with low signal. High-intensity lesions and equal-intensity lesions in the cyst cavity were found in 3 and 1 cases, respectively. In these cases, pathological findings revealed a keratin-like substance in the cyst. Discussion: The intracystic high and equal intensity lesions on DWI removed after completion of chemoradiotherapy are considered to reflect the keratin-like component of mature teratoma. If DWI- high intensity and equal intensity lesions remain in the cyst of the tumor after the completion of chemoradiotherapy, tumor shrinkage cannot be expected even if the chemotherapy is strengthened. In such cases, we should consider to removing them by surgery. Conclusion: When DWI high and equal intensity lesions are found in the cysts of tumors remaining after chemoradiotherapy for intracranial germ tumors, it is possible that mature teratoma remains.

scholarly journals Zinner’s Syndrome – The Value of Clinical Imaging and Morphopathological Findings for Diagnosis

2019 ◽  
Vol 4 (4) ◽  
pp. 196-200
Author(s):  
Bogdan Călin Chibelean ◽  
Octavian Sabin Tătaru ◽  
Angela Borda ◽  
Andrada Loghin ◽  
Alin Nechifor-Boilă ◽  
...  
Keyword(s):  
Seminal Vesicle ◽  
Renal Agenesis ◽  
Histopathological Examination ◽  
Left Kidney ◽  
Correct Diagnosis ◽  
Bladder Wall ◽  
Digital Rectal Examination ◽  
Cystic Tumor ◽  
Magnetic Resonance Imaging Mri ◽  
Zinner’S Syndrome

Abstract Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age. Case presentation: A 61-year-old male was referred to the Urology Clinic with intermittent pain and sensibility in his lower left abdomen in the last 12 months accompanied by intermittent bowel obstruction. The digital rectal examination could not assess the prostate due to a rectal stenosis. On computed tomography and magnetic resonance imaging (MRI) a cystic tumor with close relations with the bladder wall and prostate, associated with left kidney agenesis was identified. The cystic tumor was surgically removed. The histopathological examination of the tumor revealed a multilocular seminal vesicle cyst, with a muscular wall. Conclusions: Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Imaging allows a comprehensive investigation of renal and seminal vesicle anomalies. MRI seems to better visualize cysts and differentiate them from ureteroceles, while the histopathological examination contributes to a correct diagnosis. A multidisciplinary team (urologists, radiologists, and morphologists) is necessary for the proper diagnosis of Zinner’s syndrome.

scholarly journals Case Report: Identification of Multiple TERT and FGFR2 Gene Fusions in a Pineal Region Glioblastoma Case

2021 ◽  
Vol 11 ◽  
Author(s):  
Xing Guo ◽  
Teng Chen ◽  
Shiming Chen ◽  
Chao Song ◽  
Dezhi Shan ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Residual Tumor ◽  
Pineal Region ◽  
Proliferation Index ◽  
Gene Fusions ◽  
Who Grade ◽  
First Case ◽  
Fgfr2 Gene ◽  
Magnetic Resonance Imaging Mri ◽  
Next Generation Sequencing Ngs

As an oncogenic somatic variant, telomerase reverse transcriptase promoter (TERTp) mutations are frequently observed in adult glioblastoma (GBM). Alternatively, we report the first case of glioblastoma with TERT amplification accompanied by multiple TERT and FGFR2 gene fusions instead of TERTp mutation. A 55-year-old woman presented with dizziness, headache, and diplopia for three weeks. Magnetic resonance imaging (MRI) demonstrated a heterogeneously enhancing lobulated mass centered in the pineal region. Partial tumor resection and ventriculoperitoneal shunt were achieved, and the residual tumor was then treated with standard radiation. The tumor was diagnosed as GBM, IDH-wild type, WHO grade IV, and the Ki67 proliferation index was high (30–40%). Intriguingly, TERT amplification without TERTp mutation was identified via next generation sequencing (NGS). Further analysis revealed multiple TERT (TERT–NUBPL, MARCH6–TERT, and CJD4–TERT) and FGFR2 (CXCL17–FGFR2, SIPA1L3–FGFR2, FGFR2–SIPA1L3, and FGFR2–CEACAM1) gene fusions. After the surgery, the patient’s condition deteriorated rapidly due to the malignant nature of the tumor and she died with an overall survival of 3 months. Our report provides the molecular clue for a novel telomerase activation and maintenance mechanism in GBM.

scholarly journals Complete Resection of a Large Mediastinal Calcifying Fibrous Tumor

2020 ◽  
Vol 08 (01) ◽  
pp. e48-e51
Author(s):  
Géraldine L. P. Bono ◽  
Markus Lehner ◽  
Freimut H. Schilling ◽  
Nikolai Stahr ◽  
Miriam Nowack ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Residual Tumor ◽  
Anterior Mediastinum ◽  
Complete Resection ◽  
Venous Stasis ◽  
Surgical Removal ◽  
Large Tumor ◽  
Calcifying Fibrous Tumor ◽  
Magnetic Resonance Imaging Mri ◽  
Fibrous Tumor

AbstractCalcifying fibrous tumor (CFT) is a benign tumor entity which can present in a variety of different sites. Till date, eight cases with a mediastinal manifestation have been published in literature. Surgical removal is the treatment of choice for this often incidentally detected tumor. Surgery of thoracic CFT may be challenging due to its localization within the mediastinum. A 10-year old boy with a right-sided thoracic pectus carinatum-like deformity was referred for further evaluation, incidentally, revealing a mediastinal mass in computed tomography (CT). Laboratory results were all within normal range. Magnetic resonance imaging (MRI) showed a large tumor in the upper anterior mediastinum suggesting expansive but not infiltrative character. The tumor was displacing surrounding structures like the heart and the diaphragm. Lower venous stasis with dilation of the inferior cava vein could be demonstrated. The tumor was considered to be of benign dignity and surgical removal was indicated. Complete tumor resection could be achieved through a sternotomy approach, along with thymectomy. A partial resection of both the pericardium and diaphragm was required due to adhesion with soft tissue at those sites. The specimen's size was 320 mm × 145 mm × 100 mm, histologically confirmed as CFT. The patient showed no residual tumor at 3- and 9-month follow-up. This case is a report on a large mediastinal CFT which underwent successful complete surgical removal. Following tumor resection, prognosis is considered to be good; however, key issue is complete resection to avoid local tumor recurrence.

scholarly journals DIAGNOSIS OF PLEOMORPHIC XANTHOASTROCYTOMA

2021 ◽  
Vol 11 (9) ◽  
pp. 457-461
Author(s):  
Eryk Mikos ◽  
Joanna Dmochowska ◽  
Karol Kanon ◽  
Sara Moqbil ◽  
Wanesa Góralczyk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Final Diagnosis ◽  
Pleomorphic Xanthoastrocytoma ◽  
Braf V600e ◽  
Cell Nuclei ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Introduction. Pleomorphic xanthoastrocytoma (PXA) is a rare astrocytic cancer of the central nervous system that is classified as grade II according to the WHO score. It accounts for 1% of primary brain tumors. It is mainly located in the temporal lobe and belongs to a group of tumors called long-term epilepsy associated tumors. Surgical tumor resection is the treatment of choice. Brief description of the state of knowledge. The non-invasive method of PXA diagnostics is neuroimaging, which is based on computer tomography (CT) and magnetic resonance imaging (MRI). In the image, PXA presents as a solid tumor undergoing contrast enhancement, located supratentorial, with frequent peripheral cystic components. The characteristic histologic picture for PXA is the presence of highly pleomorphic, fusiform or round, large astrocytes with single or multiple cell nuclei. Lymphoplasmic infiltrates are visible within the tumor. The most common mutations associated with the occurrence of this cancer are mutations in the BRAF V600E gene. Conclusions. PXA is a very rare tumor of the central nervous system (CNS) that can recur and spread throughout the CNS. Imaging tests, i.e. CT and MRI, allow for precise imaging of the lesion, however, it is necessary to perform a histopathological examination to make a final diagnosis. The rarity of this cancer assimilates diagnostic problems. Therefore, further molecular research is needed to develop more efficient diagnostics.

scholarly journals Cystic lymphangioma of breast and axillary region in an adult: a rare presentation

2020 ◽  
Vol 8 (1) ◽  
pp. 391
Author(s):  
Samir Shukla ◽  
Rahul Shivhare ◽  
Vikas Lal ◽  
Deepak Rathore
Keyword(s):  
Histopathological Examination ◽  
Neck Region ◽  
Cystic Hygroma ◽  
Left Breast ◽  
Cystic Mass ◽  
Cystic Lymphangioma ◽  
Rare Presentation ◽  
Hypoechoic Mass ◽  
Axillary Region ◽  
Magnetic Resonance Imaging Mri

Cystic lymphangioma also known as cystic hygroma, is a congenital malformation of lymphatic system. Most lymphangioma are present at birth and are diagnosed by the age of 2 years. They are usually located in the head and neck region and are rare in other location. We are reporting a case of cystic lymphangioma in breast and axillary region in a 23 years old female. Physical examination revealed a non-tender cystic mass in axilla and upper outer quadrant of left breast. Ultrasonography (USG) revealed a hypoechoic mass lesion and magnetic resonance imaging (MRI) showed a multi-spectated cystic mass in left axilla closely involving the left breast parenchyma. Wide local excision was done and histopathological examination further confirmed the diagnosis of cystic lymphangioma. Although it is very rare, cystic lymphangioma should be considered in the differential diagnosis of mass in breast and axillary region.

scholarly journals A Rare Case of a Giant Retroperitoneal Gastrointestinal Stromal Tumor of Malignant Potential

2021 ◽  
Vol 6 (01) ◽  
pp. 67-72
Author(s):  
Abdullah M. Alshamrani ◽  
Meshare A Albattah ◽  
Rasha A Bssas ◽  
Fatemah Y Alhedaithy ◽  
Mshaeel H Almutairi ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Abdominal Mass ◽  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Cystic Mass ◽  
Cystic Tumor ◽  
Mesenchymal Tumors ◽  
Once Daily ◽  
Initial Imaging

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors that originate in the gastrointestinal tract. We present the case of a 30-year-old man who presented with progressive abdominal distension of one-years’ duration. A physical examination revealed a distended, tense, non-tender abdomen, and initial imaging investigations revealed a huge cystic, septate abdominal mass. A provisional diagnosis was made of a huge retroperitoneal, malignant, cystic mass. However, aspiration cytology showed signs suggestive of a benign cyst. Cystic tumor excision performed with control of drain site to prevent leakeage throughout the procedure. The tumor extending into the pelvis, measuring approximately 17 x 31 x 42 cm in diameter and weighing 3.78 kg. The tumor was resected, and a histopathological examination showed findings consistent with a GIST of mixed spindle and epithelioid type. Further evaluations revealed that the tumor was positive for CD 117 and CD 34, prompting the oncology team to start the patient on oral imatinib 400 mg once daily. No evidence of local recurrence or distant metastasis was noted on an abdominal computed tomography scan performed during the follow-up visit up to October 2020 last follow-up. The clinical presentation of GISTs is often complex, making its diagnosis challenging, especially in patients who present with non-specific gastrointestinal symptoms. The successful management of these tumors requires a multidisciplinary approach, and regular follow-ups.

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