scholarly journals Cutaneous Angiosarcoma - A Clinicopathological Study of 16 Cases over a Period of Nine Years

2020 ◽  
Vol 7 (45) ◽  
pp. 2631-2634
Author(s):  
Reema Miria Abraham ◽  
Shiny Padinjarayil Manakkad ◽  
Sathi Puthen Parampath ◽  
Bindu Valiaveetil
Keyword(s):  
Head And Neck ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Cell Types ◽  
Elderly Persons ◽  
Common Location ◽  
High Local Recurrence Rate ◽  
History Of ◽  
Chronic Lymphedema

BACKGROUND Cutaneous angiosarcoma is an aggressive malignant mesenchymal vasoformative neoplasm accounting for 1 % of all soft tissue sarcomas. It carries a poor prognosis with high local recurrence rate. Cutaneous angiosarcoma occurs in 3 clinical settings namely idiopathic angiosarcoma of head and neck, angiosarcoma associated with chronic lymphedema and post irradiation angiosarcoma. Idiopathic angiosarcoma of head and neck of elderly are distinct from other types of angiosarcoma. Clinicopathological correlation of cutaneous angiosarcomas diagnosed during a period of nine years from January 2010 to July 2019 was done. METHODS We retrospectively studied and analysed specific data such as age, sex, site, size, clinical setting as well as six histopathological parameters and follow up. RESULTS There were 30 patients diagnosed as angiosarcoma. 16 of these cases were cutaneous. Their mean age was 60 years (44 – 80 years). Mean size of cutaneous tumours was 4 cms (3 – 10 cm). 15 were primary; one had history of preceding lymphedema. Most common location was scalp (14) followed by leg (2). Predominant pattern was vasoformative (75 %) which included spindle (62.5 %) and epithelioid (37.5 %) cell types. Four (25 %) showed extensive necrosis; ten (66.6 %) had high mitotic index and 12 (75 %) showed tumour infiltrating lymphocytes. All cases (100 %) were positive for CD31 & CD34. All underwent wide local excision. Adjuvant chemotherapy was given in two cases and adjuvant radiotherapy in three cases. Of the seven cases with follow up, five cases died of their disease and two survived. CONCLUSIONS Larger tumour size & older age group were associated with worse outcome. All our 14 cases very well fit with the angiosarcoma of scalp & face in elderly persons as described in the literature. This disease has unique characteristics compared to angiosarcoma in other locations. KEYWORDS Cutaneous, Angiosarcoma, Scalp, Elderly

scholarly journals A rare case of paratesticular leiomyosarcoma

2012 ◽  
Vol 2 (1) ◽  
pp. 29 ◽  
Author(s):  
James Moloney ◽  
John Drumm ◽  
Deirdre M. Fanning
Keyword(s):  
Soft Tissue ◽  
Adjuvant Radiotherapy ◽  
Spermatic Cord ◽  
Soft Tissue Sarcomas ◽  
Solid Mass ◽  
Urological Malignancies ◽  
History Of ◽  
To Receive ◽  
Groin Swelling

Soft-tissue sarcomas of the genitourinary tract account for only 1-2% of urological malignancies and 2.1% of soft-tissue sarcomas in general. A 69-year-old male complained of a 4 month history of a painless right groin swelling during routine urological review for prostate cancer follow-up. Clinical examination revealed a non-tender, firm right inguinoscrotal mass. There was no discernible cough impulse. Computed tomography of abdomen and pelvis showed a non-obstructed right inguinal hernia. During elective hernia repair a solid mass involving the spermatic cord and extending into the proximal scrotum was seen. The mass was widely resected and a right orchidectomy was performed. Pathology revealed a paratesticular sarcoma. He proceeded to receive adjuvant radiotherapy. Only around 110 cases of leiomyosarcoma of the spermatic cord have been described in the literature. They commonly present as painless swellings in the groin. The majority of diagnoses are made on histology.

Locations, associations and temporal evolution of intracranial arterial infundibular dilatations in children

2019 ◽  
Vol 12 (5) ◽  
pp. 495-498
Author(s):  
Adam A Dmytriw ◽  
Daniel-Alexandre Bisson ◽  
Kevin Phan ◽  
Afsaneh Amirabadi ◽  
Helen Branson ◽  
...  
Keyword(s):  
Temporal Evolution ◽  
Posterior Cerebral Artery ◽  
Parent Artery ◽  
Short Term ◽  
Institutional Review ◽  
Common Location ◽  
History Of ◽  
Imaging Surveillance ◽  
Few Data

BackgroundThere are few data in the literature on the characteristics and natural history of intracranial arterial infundibular dilatations in children.MethodsAn institutional review board-approved retrospective review was performed of infundibula reported on MR angiography in patients <18 years of age at our tertiary pediatric institute from 1998 to 2016. Clinical data (age, sex, diagnosis, other vascular variants/pathologies) were recorded and images assessed for vessel of origin, infundibulum size and exact location. Ratios of infundibulum:parent artery were assessed at diagnosis and last follow-up. Temporal evolution to aneurysm was evaluated.ResultsWe found 60 intracranial infundibula in 60 children (male:female=27:33; mean age 9.7±5.2 years, range 2–18 years,). Family history of aneurysms was present in 2/60 (3.3%). Syndromic association was found in 14/60 (23.3%), most frequently sickle cell disease (4/14=28.6%). Mean infundibulum size was 2.2±0.5 mm, with mean ratio to parent artery of 0.54±0.17. The most common location was on the P1-posterior cerebral artery (34/63=56.7%), whereas posterior communicating infundibula were seen in only 4/60 (6.7%) cases. Other cerebrovascular variants were seen in 12/60 (20%) patients. On follow-up imaging (in 32/60 patients over 86 patient-years, mean 32.3±35.7 months), no significant change in infundibulum:parent artery ratio was noted. None of the infundibular dilatations showed interval evolution to aneurysm.ConclusionWe present the largest reported cohort of pediatric intracranial arterial infundibula, which we found to be distinct from their adult counterparts with regard to location, etiology and temporal evolution. Growth over time and/or aneurysmal formation are rare, not necessitating frequent short-term imaging surveillance during childhood.

Multiple primary malignancies (MPM) in Israeli patients with soft tissue sarcomas (STS)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9571-9571
Author(s):  
R. Geva ◽  
O. Merimsky
Keyword(s):  
Survival Data ◽  
Primary Tumor ◽  
Soft Tissue Sarcomas ◽  
Unknown Origin ◽  
Second Primary ◽  
Urogenital System ◽  
Second Primary Cancers ◽  
Multiple Primary Malignancies ◽  
History Of

9571 Background: An increased incidence of MPM has been reported in association with STS. In a previous series we reported 28 patients out of 375 patients with STS as having second or third additional primary malignancies not all accountable by previous chemotherapy or radiotherapy. In the present series we re-examined the phenomenon in a large Israeli database of adult STS patients. Methods: A retrospective search of the database of approx.1350 adult STS patients who were referred, diagnosed or treated at our center between 1995–2005. Results: A group of 132 patients (F=66, M=66, age 1–87y, median 59y) with STS and at least one additional malignancy was retrieved. Overall, a family history of malignancy was reported by 26%, exposure to carcinogens prior to 1st tumor by 10%. Exposure to carcinogens/RT/Chemo given for the 1st tumor prior to the 2nd tumor was recorded in 61%. Taken together (n=132), STS were associated with a second malignancy arising mainly from the various sites of the urogenital system (18%), breast (17%), GIT (11%), lung (8%), and thyroid (7%). When non-STS was the first malignancy (n=73 at a median age 59y), the main malignancies included breast (23% ), colorectal (11%), melanoma (10%), prostate (8%), thyroid (7%), and bladder (5%). STS as a second primary (n=66) after a median time of 8y, included MFH (28%), LMS (16%), and liposarcoma (15%). The STS originated in a limb in 42%, trunk- 12%, retroperitoneum or viscera-34%, and unknown origin-1%. In the other 6 patients (median age 76.5), STS was the 3rd or more primary tumor. When STS was the first malignancy (n=59 at a median age of 59y), the second primary cancers were diagnosed after a median of 5 years, and included lung (15%), STS of different type (12%), kidney (10%), skin (10%), breast (10%), colorectal (8.5%), prostate (8.5%), and thyroid (7%). Updated survival data will be presented. Conclusions: The incidence of malignancies among patient population of primary STS is higher than the incidence of the same malignancies in the general population. This implies for the need to search for an occult second primary tumor in patients with STS as an integral part of their follow-up. No significant financial relationships to disclose.

scholarly journals Advanced acromegaly: successful disease control for more than 16 years using octreotide LA

2020 ◽  
Vol 2020 ◽  
Author(s):  
Omayma Elshafie ◽  
Nicholas Woodhouse
Keyword(s):  
Clinical Symptoms ◽  
Tumour Size ◽  
Uncontrolled Hypertension ◽  
Therapeutic Trial ◽  
List Type ◽  
Residual Tumour ◽  
History Of ◽  
Successful Control ◽  
Long Acting

Summary A 79-year-old male presented with a 10-year history of intermittent headache, sweating, persistent hand numbness and uncontrolled hypertension. He was receiving Nifedipine and Hydrochorothizide. On examination (O/E), his BP was 180/100 he was acromegalic. His growth hormone (GH) was 10 mIU/L (0.0–0.1) and his insulin-like growth factor (IGF-1): 952 µg/L (76–160). An MRI of the pituitary revealed a 3 × 2 cm pituitary macroadenoma. Surgery was refused and the family agreed for a therapeutic trial of octreotide. His GH levels fell immediately. Two weeks later he was switched to long-acting monthly octreotide in September 2003. During his 16-year follow-up, he has remained well and asymptomatic off medications for hypertension. His BP and IGF-1 levels were also normal until octreotide Long acting (LA) octrotide was stopped for 3 months at age 96. During this period the IGF-1 level returned to pretreatment levels 500 ng/L (50–141), GH 24 mIU/L (0.0–0.1), and a small residual tumour 0.5–0.8 cm was seen on the MRI. Octreotide LA was restarted and the IGF-1 and GH levels returned to normal. He continues the same treatment to date age 97 without side effects. We conclude that the successful control of IGF-1, GH levels, hypertension, tumour size and clinical symptoms for more than 16 years occurred using octreotide LA in an elderly advanced acromegalic patient. To the best of our knowledge, this is the first report of the successful use of octreotide LA for more than 16 years. Learning points: The value of a therapeutic trial of octreotide to identify responders. Control of GH and IGF-1 secretion using octreotide LA. The report of the successful use of octreotide for more than 16 years irrespective of age.

scholarly journals Management of radiation-related supraglottic stenosis with serial in-office steroid injections

2018 ◽  
Vol 5 (1) ◽  
pp. 184
Author(s):  
Christine M. Kim ◽  
Pratik B. Patel ◽  
Aaron J. Feinstein ◽  
Dinesh K. Chhetri
Keyword(s):  
Head And Neck ◽  
Paradigm Shift ◽  
Surgical Intervention ◽  
Outpatient Management ◽  
Clinical Protocol ◽  
Steroid Injections ◽  
Clinical Challenge ◽  
History Of ◽  
Head And Neck Radiation

<p class="abstract">Management of supraglottic stenosis in patients with history of head and neck radiation presents a clinical challenge for otolaryngologists. The cornerstone of treatment has historically been surgical intervention, both endoscopic and open. However, recently described techniques related to outpatient management of subglottic and tracheal stenosis with routine in-office steroid injections may provide a translatable model for supraglottic stenosis management.<strong> </strong>We describe a clinical protocol for in-office steroid injections to the laryngopharynx for patients with supraglottic stenosis secondary to radiation fibrosis.<strong> </strong>Two patient cases are reported, including endoscopic examinations over a follow-up period of 12 to 16 months. Both patients experienced significant improvement in their supraglottic airways. In-office steroid injections may be beneficial to prevent or slow stenosis recurrence in patients treated with radiation for head and neck cancer. With continued refinement of this technique, a paradigm shift may occur in the management of supraglottic stenosis.</p>

scholarly journals Study of the Incidence, Clinicopathological Profile, and Management of Second Primary Tumors in Patients with Index Head and Neck Tumors

2020 ◽  
Vol 6 (02) ◽  
pp. 53-60
Author(s):  
Chirag Jain ◽  
Mansi Jain ◽  
Ajay Kumar Dewan ◽  
Pavani Medisetty ◽  
Ankush Jajodia ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck ◽  
Second Primary ◽  
Primary Tumors ◽  
Alive With Disease ◽  
Clinicopathological Profile ◽  
History Of ◽  
Second Primary Tumors ◽  
The Mean

Abstract Introduction This study was performed to study the incidence and clinicopathological profile of second primary tumors (SPTs) in patients with squamous cell carcinoma of head and neck at our institute. Materials and Methods In this study, we included the data of 120 patients who developed an SPT of the upper aerodigestive tract following treatment of their index tumor (IT). Since the online data of cancer patients in our cancer registry was available from January 2005, we started the study retrospectively from that time. At our institute, Rajiv Gandhi Cancer Institute and Research Centre, the incidence was found to be 8.4%. Warren and Gates criteria were followed for defining a second tumor. Results Our study results showed an incidence of 8.4% of SPTs among patients of head and neck squamous cell carcinoma (HNSCC). The mean age of the patients was 56.47 ± 10.42 years with a male predominance. The mean period of addiction in patients was 18.48 ± 4.63 years. It was found that patients with SPT had significant history of tobacco and alcohol use. The most common location for ITs and SPT was tongue and buccal mucosa. The main modality of treatment was surgery in all patient groups. Patients were followed up at three-month intervals for the first 2 years. The SPT was diagnosed with a confirmation biopsy. Majority of patients with SPT again underwent surgery with reconstruction with either free flaps or local flaps. Recurrence after SPT treatment was seen in 16.67% cases, and primarily, it was a locoregional recurrence. Only patients with at least 6 months follow-up posttreatment of SPT were included in this study. At the end of the study, 62.5% patients were disease free, 20.83% patients were alive with disease, and 16.67% patients were dead. Some of the patients who are alive with disease developed a third primary tumor which was managed as per guidelines. Conclusion The incidence of SPTs is 8.4% in our institute. This study adds to the theory of field cancerization proposed by Slaughter et al. We found a significant history of tobacco chewing in our patients who developed SPT. The clinical significance of this study is identifying the features of SPT in patients with HNSCC and allowing for a rational follow-up schedule. The most important part of treatment although still lies with the patient by quitting use of alcohol and tobacco.

Nasopharyngeal Radium Irradiation: The Washington County, Maryland, Study

1996 ◽  
Vol 115 (5) ◽  
pp. 409-414 ◽  
Author(s):  
Dale P. Sandler
Keyword(s):  
Head And Neck ◽  
Laboratory Data ◽  
Treated Group ◽  
Application Site ◽  
Washington County ◽  
Neck Irradiation ◽  
History Of ◽  
Head And Neck Irradiation

Although there have been many studies of cancer risk associated with a variety of x-ray treatments for benign conditions of the head and neck, little is known about the possible long-term health consequences of nasopharyngeal radium irradiation. This treatment results in minimal radiation exposure to the thyroid gland, which is the focus of much of the research regarding other head and neck irradiation. With nasopharyngeal radiation, on the other hand, exposure to the pituitary gland and the nasopharynx in the area immediately adjacent to the application site may have been substantial. In 1975 a follow-up study was undertaken in Washington County, Maryland, of 2925 persons who were treated at the Health Department's Clinic for the Prevention of Deafness in Children between 1943 and 1960. Of these, 904 persons had been treated with nasopharyngeal radium. After an average of 24 years of follow-up, an excess risk from brain cancer was suggested on the basis of three cases of cancer occurring in the treated group and none occurring in those who were not treated. This finding could have resulted by chance. Other results were consistent with a potential pituitary effect of radiation, but interpretation is limited by the absence of clinical and laboratory data. The history of the study is reported along with an overview of study methods and results.

scholarly journals Cricopharyngeal myotomy for delayed Cricopharyngeal dysfunction after head and neck surgery – case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
An Sung ◽  
Ka-Wo Lee
Keyword(s):  
Head And Neck ◽  
Neck Surgery ◽  
Cricopharyngeal Myotomy ◽  
Medialization Thyroplasty ◽  
History Of ◽  
Lymph Nodes Dissection ◽  
Cricopharyngeal Dysfunction ◽  
Contrast Swallow

Abstract Background Head and neck surgeries can perturb normal structures of neck muscles and nerve innervations, which are supposed to function in harmony to allow complicated process like swallowing. It is still likely that cricopharyngal dysfunction emerges years after the head and neck surgeries. Case presentation We report a case with history of left unilateral vocal cord immobility and development of dysphagia and aspiration 2 years after radical thyroidectomy with neck lymph nodes dissection and medialization thyroplasty. Cricopharyngeal dysfunction was impressed and was confirmed with visualization of cricopharyngeal narrowing segment in radiographic contrast swallow examination. The patient was treated successfully by cricopharyngeal myotomy, achieving long-term relief in our 4 years of follow up. Conclusions Our case of delayed cricopharyngal dysfunction after radical thyroidectomy and medialization thyroplasty shows that it is important to follow up swallowing functions after patients with UVCI undergo medialization thyroplasty. In the event of delayed manifestation of cricopharyngeal function, it can still be treated successfully by cricoharyngeal myotomy, achieving long term relief of dysphagia.

Mo1033 Natural History of Superficial Head and Neck Squamous Cell Carcinoma Under Follow-Up Endoscopic Observation With Narrow Band Imaging

2016 ◽  
Vol 83 (5) ◽  
pp. AB436
Author(s):  
Hiroshi Nakamura ◽  
Tomonori Yano ◽  
Satoshi Fujii ◽  
Tomohiro Kadota ◽  
Toshifumi Tomioka ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Natural History ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Endoscopic Observation ◽  
History Of

scholarly journals Nonreferral of Possible Soft Tissue Sarcomas in Adults: A Dangerous Omission in Policy

Sarcoma ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Juan F. Abellan ◽  
José M. Lamo de Espinosa ◽  
Julio Duart ◽  
Ana Patiño-García ◽  
Salvador Martin-Algarra ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Histologic Grade ◽  
Specialist Centre ◽  
Group A ◽  
Patient Groups ◽  
Group B

Introduction. The aim of this study is to compare outcomes in three groups of STS patients treated in our specialist centre: patients referred immediately after an inadequate initial treatment, patients referred after a local recurrence, and patients referred directly, prior to any treatment.Patients and methods. We reviewed all our nonmetastatic extremity-STS patients with a minimum follow-up of 2 years. We compared three patient groups: those referred directly to our centre (group A), those referred after an inadequate initial excision (group B), and patients with local recurrence (group C).Results. The study included 174 patients. Disease-free survival was 73%, 76%, and 28% in groups A, B, and C, respectively (P<.001). Depth, size, and histologic grade influenced the outcome in groups A and B, but not in C.Conclusion. Initial wide surgical treatment is the main factor that determines local control, being even more important than the known intrinsic prognostic factors of tumour size, depth, and histologic grade. The influence on outcome of initial wide local excision (WLE), which is made possible by referral to a specialist centre, is paramount.

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