scholarly journals Inflammatory myofibroblastic tumours of the respiratory system and the impact of the varying patterns

2016 ◽  
Vol 98 (1) ◽  
pp. e8-e10 ◽  
Author(s):  
JV Lodhia ◽  
TD Christensen ◽  
SE Trotter ◽  
ES Bishay
Keyword(s):  
Local Recurrence ◽  
Malignant Transformation ◽  
Respiratory System ◽  
Surgical Procedure ◽  
Complete Resection ◽  
Anatomical Location ◽  
The Impact

Inflammatory fibroblastic tumours are very rare. They are mostly located in the respiratory system. We present three cases of patients with fibroblastic tumours. The diversity of inflammatory fibroblastic tumours in the respiratory system and the surgical considerations are discussed. Our recommendation is that treatment should include a complete resection to prevent local recurrence and malignant transformation, and follow-up review should reflect the procedure carried out, especially in terms of the anatomical location and the extent of the surgical procedure performed.

scholarly journals RARE-31. TREATMENT OUTCOME OF CHILDREN WITH PLEOMORPHIC XANTHOASTROCYTOMA: RETROSPECTIVE ANALYSIS – A SINGLE INSTITUTION EXPERIENCE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi228-vi228
Author(s):  
Ossama Maher ◽  
Toba Niazi ◽  
Ziad Khatib ◽  
John Ragheb
Keyword(s):  
Local Recurrence ◽  
Retrospective Analysis ◽  
Malignant Transformation ◽  
Cranial Nerve ◽  
Pleomorphic Xanthoastrocytoma ◽  
Braf V600e ◽  
Biological Behavior ◽  
High Local Recurrence Rate ◽  
Cranial Nerve Palsies

Abstract BACKGROUND Pleomorphic xanthoastrocytoma (PXA) and anaplastic pleomorphic xanthoastrocytoma (APXA) are two types of rare astrocytomas in pediatrics. There is limited literature reporting their outcomes. METHODS A retrospective analysis of pediatric patients with diagnosis of PXA and APXA treated at Nicklaus Children’s Hospital was conducted using descriptive measures. RESULTS A chart review of patients with brain tumors from 2001 to 2019 revealed that 13 patients (median age 6 years, range 2–17 years) were diagnosed with non-metastatic PXA (n=12) and APXA (n=1). Six patients (46%) were male. Clinical presentation included seizures (n=8), headaches (n=2) cranial nerve palsies (n=2). Diagnostic imaging showed tumor in the temporal lobe (n=5), parietal lobe (n=2), temporoparietal lobe (n=2), frontal lobe (n=1), occipital lobe (n=1), others (n=2). BRAF V600E mutation were identified in three of five analyzed tumors including PXA (n=4) and APXA (n=1). Surgical intervention consisted of gross total resection (n=8) and near/subtotal resection (n=5). Ten patients (76%) required a second surgery (median 2; range 1–4) due to local recurrence. The median time to recurrence was 3 years (range 6 months - 7 years). Three patients (23%) had malignant transformation of PXA, which occurred three to eight years from the initial surgery; one of them also had extensive spinal metastasis. Focal radiation was given to six patients (46%) due to multiple recurrence (n=2), malignant transformation (n=3), APXA (n=1). At a median follow up of 8 years (range 3 to 20 years), eight patients remain alive, three patients had lost to follow up, two patients died from progressive disease. Long-term sequelae varied as follows; seizures (n=5), motor weakness (n=4), cranial nerve palsies (n=2), and learning disability (n=1). CONCLUSION PXA is associated with high local recurrence rate and uncommonly malignant transformation to APXA in pediatrics, which requires close follow-up due to unpredictable biological behavior of these tumors.

scholarly journals Malignant Transformation of Nodular Hidradenoma in the Lower Leg

2018 ◽  
Vol 11 (2) ◽  
pp. 298-304
Author(s):  
Nhuan Ngo ◽  
Michiro Susa ◽  
Takahiro Nakagawa ◽  
Yo Kawahara ◽  
Chiaki Sato ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Malignant Transformation ◽  
Rare Case ◽  
Lower Leg ◽  
Sweat Glands ◽  
Anterior Surface ◽  
Adnexal Tumor ◽  
Nodular Hidradenoma

Nodular hidradenoma (NH) is a benign adnexal tumor that arises from either eccrine or apocrine sweat glands. NH can originate from any cutaneous site, but the most common sites are the head and anterior surface of the trunk, with very rare cases in the extremities. Long-standing NH has been reported to undergo malignant transformation to malignant NH (MNH); however, its occurrence in the lower leg is extremely rare with only one other case reported to date. In this report, we present a rare case of MNH occurring in the lower leg which was resected with the intent to make a diagnosis. At the final follow-up after 11 months, no local recurrence or metastasis has been observed.

Effect of downstaging without complete pathologic response after neoadjuvant treatment on cancer outcomes for cIII and cII rectal cancers

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4108-4108
Author(s):  
L. F. Lobato ◽  
L. Stocchi ◽  
A. da Luz Moreira ◽  
M. Kalady ◽  
D. Dietz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anal Verge ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Treatment ◽  
Significant Prognostic Factor ◽  
Cancer Outcomes ◽  
The Impact

4108 Background: Neoadjuvant chemoradiation followed by surgery is standard of care for locally advanced rectal cancer. The impact of downstaging on prognosis when pathologic complete response (pCR) cannot be achieved remains unclear. The aim of this study was to evaluate whether downstaging impacts prognosis in patients with cII vs. cIII rectal cancer. Methods: We identified from our colorectal cancer database 233 patients with primary cII and cIII rectal cancer staged by CT and ERUS/MRI who received 5FU-based chemoradiation followed by R0 surgery after a median interval of 7 weeks during 1997–2007. Median radiotherapy dose was 5040 cGy. We excluded 58 patients with pCR and. Compared among the remaining 175 patients pathologic downstaging (cII to ypI, cIII to ypII or ypI) vs. No pathologic downstaging (c stage ≤ yp stage). Outcomes evaluated were 5-year overall survival, 3-year recurrence-free survival, overall recurrence, local recurrence and distant recurrence. Results: Median age was 58 years and median follow-up was 48 months. Patients with cII vs. cIII stage were statistically comparable regarding demographics, chemoradiation regimen, interval to surgery after neoadjuvant treatment, tumor distance from anal verge, operations performed and follow-up. The incidence of downstaging was increased in stage cIII vs. cII patients (68% vs. 21%, p <0.001). With the exception of local recurrence rates, downstaging resulted in significantly improved cancer outcomes for cIII but not cII ( Table ). Conclusions: Downstaging without pCR is a significant prognostic factor for patients with stage cIII rectal cancer. A larger sample size is required to confirm lack of downstaging benefits in stage cII. [Table: see text] No significant financial relationships to disclose.

scholarly journals ESD versus EMR in non-ampullary superficial duodenal tumors: a systematic review and meta-analysis

2018 ◽  
Vol 06 (08) ◽  
pp. E998-E1007 ◽  
Author(s):  
Enrique Pérez-Cuadrado-Robles ◽  
Lucille Quénéhervé ◽  
Walter Margos ◽  
Tom G. Moreels ◽  
Ralph Yeung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Local Recurrence ◽  
Meta Analysis ◽  
Random Effect ◽  
Complete Resection ◽  
Cochrane Library ◽  
Resection Rate ◽  
En Bloc ◽  
Delayed Bleeding ◽  
The Impact

Abstract Background and study aims Endoscopic submucosal dissection (ESD) has been developed as an option for treatment of esophageal, gastric and colorectal lesions. However, there is no consensus on the role of ESD in duodenal tumors. Methods This systematic review and meta-analysis compared ESD and endoscopic mucosal resection (EMR) in sporadic non-ampullary superficial duodenal tumors (NASDTs), including local experience. We conducted a search in PubMed, Scopus and the Cochrane library up to August 2017 to identify studies that compared both techniques reporting at least one main outcome (en-bloc/complete resection, local recurrence). Pooled outcomes were calculated under fixed and random-effect models. Subgroup analyses were conducted. Results A total of 753 patients presenting with 784 NASDTs (242 ESD, 542 EMR) in 14 studies were included. Tumor size (MD: 5.88, [CI95 %: 2.15, 9.62], P = 0.002, I2 = 79 %) and procedure time (MD: 65.65, [CI95 %: 40.39, 90.92], P < 0.00001, I2 = 88 %) were greater in the ESD group. En-bloc resection rate was significantly higher in Asian studies (OR: 2.16 [CI95 %: 1.15, 4.08], P = 0.02, I2: 46 %). ESD provided a higher complete resection rate (OR: 1.63 [I95 %: 1.06, 2.50], P = 0.03, I2: 59 %), but there was no risk difference in the risk of local recurrence (RD: – 0.03 [CI95 %: – 0.07, 0.01], P = 0.15, I2: 0 %) or delayed bleeding. ESD was associated with an increased number of intraoperative perforations [RD: 0.12 (CI95 %: 0.04, 0.20), P = 0.002, I2: 56 %] and emergency surgery for delayed perforations. The inclusion of eligible studies was limited to retrospective series with inequalities in comparative groups. Conclusions Duodenal ESD for NASDTs may achieve higher en-bloc and complete resections at the expense of a greater perforation rate compared to EMR. The impact on local recurrence remains uncertain.

The impact of pattern of tumor response and other post-treatment histologic features on local recurrence in patients treated with neoadjuvant chemotherapy and breast conservation.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 581-581
Author(s):  
Alison Laws ◽  
Ricardo G. Pastorello ◽  
Jungeon Choi ◽  
Olga Kantor ◽  
Samantha Grossmith ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Treatment Effect ◽  
Tumor Response ◽  
Residual Disease ◽  
Breast Conserving Surgery ◽  
Invasive Disease ◽  
Post Treatment ◽  
The Impact

581 Background: Residual disease after neoadjuvant chemotherapy (NAC) is a poor prognostic factor. The relationship between the pattern of tumor response and other post-treatment histologic features on local recurrence (LR) is not well studied. Methods: We identified 380 patients (pts) treated with NAC, breast-conserving surgery and radiation from 2002-2014. Pts with available surgical slides underwent detailed pathology review. Pathologic complete response (pCR) was defined as no invasive or in situ disease in the breast or axilla. Pattern of tumor response was defined as: none, scattered, or concentric. The degree of treatment effect was categorized as: absent, mild or marked. Univariate (UVA) and multivariate analyses (MVA) were performed to identify factors associated with LR. Results: 243 (64%) cases had complete slides available and formed the study cohort. 76 (31%) were ER+/HER2-, 90 (38%) ER-/HER2- and 77 (31%) HER2+. 98% of HER2+ pts received neoadjuvant trastuzumab; 89% of ER+ pts received adjuvant endocrine therapy. At median follow-up of 75 months, 10/243 (4.1%) pts had LR and 5-yr LR-free survival was 95.7%. LR occurred in 1/76 (1.3%) pts with breast pCR, 1/19 (5.2%) with residual DCIS, and 8/148 (5.4%) with residual invasive disease; including 6/78 (7.7%) with scattered tumor response, 2/46 (4.3%) with concentric response and 0/24 with no response. On UVA, age (OR < 50 vs ≥50 5.9, p = 0.03) and residual DCIS with comedonecrosis (OR 8.2, p < 0.01) were significantly associated with LR. Presence of tumor bed at the margin (OR 4.6, p = 0.06) approached significance. The odds of LR were higher with scattered regression (OR 1.83 vs. concentric, p = 0.47) and lower with breast pCR (OR 0.23, p = 0.17), but these results were not statistically significant. Multicentric disease, receptor status, ypT, ypN, RCB score, degree of treatment effect, high-grade residual invasive disease, margin status of residual disease and lymphovascular invasion were not associated with LR (all p > 0.05). Age (OR < 50 vs ≥50 7.4, p = 0.04) and residual DCIS with comedonecrosis (OR 7.5, p = 0.02) remained significant on MVA. Conclusions: With modern systemic therapy, LR rates after NAC, breast-conserving surgery and radiation are low, with less than 5% of patients experiencing a LR after a median follow-up of over 6 years. Young age and residual DCIS with comedonecrosis were associated with LR, but not pattern of tumor response.

scholarly journals The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

2013 ◽  
Vol 5 (6) ◽  
pp. 125 ◽  
Author(s):  
Chee Kwan Ng ◽  
Naji J. Touma ◽  
Venu Chalasani ◽  
Madeleine Moussa ◽  
Donal B. Downey ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Prognostic Value ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Free Survival ◽  
Prostate Biopsies ◽  
Before And After ◽  
The Impact ◽  
Disease Free

Objective: We assessed the pattern of local recurrence after salvagecryoablation of the prostate, and the impact of local recurrence onintermediate-term outcome.Methods: One hundred twenty-two patients who underwentsalvage cryoablation were studied after a mean follow-up of 56months. Serial prostate biopsy was carried out after cryoablation.The histopathology of prostate biopsies before and after cryoablationwere compared. The prognostic value of post-cryoablationbiopsy was assessed with the Cox regression method.Results: 23.1% of patients had a positive biopsy for prostate cancerfollowing salvage cryoablation. Most cancer recurrences occurredin the apex (51.5%), base (21.2%) and seminal vesicles (18.2%).The presence of cancer at the base of the prostate was found tobe a prognostic factor for eventual biochemical failure. Overall5-year biochemical disease-free survival (bDFS) was 28%, howeverpatients with cancer at the base of the prostate had a 5-yearbDFS of 0%.Conclusion: Cancer recurrences occurred in areas where aggressivefreezing was avoided as it might result in serious problems (e.g.,urethro-rectal fistula and incontinence). Post-cryoablation biopsiesand the location of persistent disease are of prognostic value.

scholarly journals Giant cell tumor of bone: Unusual features of a rare tumor

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131987889 ◽  
Author(s):  
Ziyad M Mohaidat ◽  
Hisham Z Al-jamal ◽  
Audai M Bany-Khalaf ◽  
Ahmad M Radaideh ◽  
Ziad A Audat
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Malignant Transformation ◽  
Fatal Outcome ◽  
Cell Tumor ◽  
Anatomical Location ◽  
Histopathological Diagnosis ◽  
Intralesional Curettage ◽  
Primary Tumors

Giant cell tumor of bone is a benign tumor with an aggressive behavior. Its typical subarticular location and high recurrence risk can be associated with significant morbidity. Although benign, it can rarely metastasize especially to the lungs. Also, it can be multicentric in less than 1% of patients. Late malignant transformation, although rare, can occur with a very poor prognosis. This series reports on these unusual and challenging features and management considerations of giant cell tumor of bone. This retrospective study included review of the medical records of patients with a confirmed histopathological diagnosis of giant cell tumor of bone. A total of 25 patients (16 females and 9 males) with a mean age of 34.5 years were included; 22 had primary tumors, while 3 were referred with recurrent tumors. Pain was the most common presenting symptom. Most patients had grade III tumors. Tumors around the knee were the most common. Multicentric tumors were detected in three patients. Twenty-three patients (20 primary giant cell tumor of bone and 3 with recurrence) received treatment. Most patients (15/23) were treated with intralesional curettage with or without adjuvants. Seven patients had wide excision. Recurrence was seen in 45% (9/20) of primary giant cell tumor of bone especially with difficult anatomical locations. Most recurrences occurred more than 4 years after treatment. Pulmonary nodules were detected in four patients; two of them showed resolution during follow-up. One patient developed secondary sarcoma transformation with a fatal outcome. Giant cell tumor of bone was more common in females. Long bones were more affected, especially around the knee. Intralesional curettage was the most frequently used treatment. Recurrence was associated with inadequate tumor resection (especially in difficult anatomical location), younger age, male gender, and advanced local tumor grade. Denosumab can be used in the treatment of pulmonary metastasis, multicentric and recurrent giant cell tumor of bone. Due to late recurrence and malignant transformation, a prolonged follow-up is warranted.

scholarly journals Positron Emission Tomography /Computed Tomography Follow-Up in Patients with Gastrointestinal Tract Malignancies

2020 ◽  
pp. 77-87
Author(s):  
Abdellatief Mohammed Khairy Eltahan ◽  
Mohamad Abd El-Hamid Alm El- Din ◽  
Alsiagy Ali Abdel- Aziz ◽  
Emad Mohamad Mashaly
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Gastrointestinal Tract ◽  
Local Recurrence ◽  
Radiology Department ◽  
Therapy Assessment ◽  
Pet Ct ◽  
Treatment Plans ◽  
The Impact

Background: PET/CT has an increasing role in the oncology field, including GIT. The role of PET/CT is more significant in the follow-up than initial staging and diagnosis as it helps in therapy assessment and detects recurrence and metastasis. In esophageal cancer, it helps by detecting the distant metastasis and discover synchronous neoplasm. Also, it is acclaimed to help in early detection of the response of the patient to chemo and radiotherapy. In the follow-up, it may be useful to detect recurrence. PET/CT has a minimal role in gastric cancer, as it shows no superiority over C.T. alone. For Colorectal Cancer, PET/CT has a good value in cases of suspected liver or lung metastasis and local recurrence after surgery. This study aimed to evaluate the impact of PET/CT on treatment decision & follow-up of patients with gastrointestinal tract malignancies. Methods: This study is a cross-sectional study and was done retrospectively by collecting data and records of 47 GIT malignancy patients who underwent PET/CT during or after treatment. At PET/CT unit, Diagnostic Radiology Department in Educational hospitals - Tanta University between July 2015 and December 2017. Results: The patients were mainly colorectal in the site and primarily adenocarcinoma in type. We found that 27.7% of cases treatment plans were influenced by the PET/CT results, the percentage is highest with colon cancer (40%) then rectal cancer (25%), and our few esophageal, gastric, intestinal malignancies cases have shown no influence which is due to a small number of cases. PET/CT seems to have the best add value in patients with colorectal cancer with metastasis with a 66.7% change in treatment plans. Six patients had inconclusive results of PET/CT due to scan limitations. Conclusion: Relying on PET/CT in clinical decisions in esophageal or gastric cancer is not encouraged unless in case of clinical or imaging suspicion of recurrence. On the other hand, PET/CT is useful in detecting post-treatment metastasis and local recurrence in colorectal cancer.

Seeding of a parotid pleomorphic adenoma

1995 ◽  
Vol 109 (7) ◽  
pp. 671-673 ◽  
Author(s):  
D. J. Commins ◽  
D. Roberts ◽  
C. Fisher ◽  
N. M. Breach
Keyword(s):  
Local Recurrence ◽  
Pleomorphic Adenoma ◽  
Malignant Transformation ◽  
Radical Surgery ◽  
Distant Metastases ◽  
Younger Patients ◽  
Primary Procedure ◽  
Recurrent Pleomorphic Adenoma

AbstractRecurrent pleomorphic adenoma of the parotid usually occurs in the distribution of the primary procedure. There are numerous reports of widespread local recurrence and a few reported cases of distant metastases. Extensive seeding throughout the entire ipsilateral neck is rare. Treatment involves a combination of radical surgery and radiotherapy. The potential for malignant transformation demands close follow-up of younger patients particularly.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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