scholarly journals Metastatic Adenocarcinoma to the Breast arising from a Mediastinal Mature Teratoma with Somatic Malignancy: A Case Report with a Review of the Literature

2020 ◽  
Author(s):  
Gwenaëlle ARHANT ◽  
Dahlia Mirdad ◽  
Anca Berghian ◽  
Nicolas PITON ◽  
Jean-Cristophe Sabourin
Keyword(s):  
Malignant Transformation ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Mature Teratoma ◽  
Subsequent Treatment ◽  
Exceptional Case ◽  
Pathological Examination ◽  
Unknown Primary ◽  
Anterior Mediastinal Mass ◽  
Metastatic Adenocarcinoma

Abstract Background Malignant transformation in mature teratomas, especially somatic-type malignancies, are extremely rare phenomena with few cases described in the literature. In the mediastinum, these lesions are often accompanied by metastases, ultimately unmasking them. Case presentation We report an exceptional case of metastatic adenocarcinoma to the breast arising from a mediastinal mature teratoma with malignant transformation in a 31-year-old female. The patient initially presented with a breast lesion that was later diagnosed as either a triple negative ductal carcinoma or a metastatic adenocarcinoma of unknown origin. Extensive clinical workup and radiological imagining revealed an anterior mediastinal mass. Subsequent pathological examination of the mass showed a mature teratoma with malignant transformation equivalent to that found in the breast biopsy. Conclusion Mediastinal teratomas with malignant transformation (TMTs) are rare entities; however these tumors should be suspected in cases of suspicious mediastinal masses presenting with unusual clinical and radiological signs, such as metastasis of unknown primary origin. Pathological corroboration of extensive sampling and meticulous microscopic examination is crucial for the diagnosis in order to tailor subsequent treatment.

Therapy alteration of solid tumors based on FoundationOne comprehensive genome profiling assay.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14742-e14742
Author(s):  
Kirill Karlin ◽  
Abdullah Kahraman ◽  
Alessandra Curioni Fontecedro ◽  
Holger Moch ◽  
Martin Zoche ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Clinical Utility ◽  
Ductal Carcinoma ◽  
Treatment Plan ◽  
Subsequent Treatment ◽  
Unknown Primary ◽  
Tumor Type ◽  
Genome Profiling ◽  
New Therapy ◽  
Therapy Option

e14742 Background: Molecular profiling assays are becoming widely available and provide valuable information on tumor characteristics, which can identify targeted therapies or immunotherapies for cancer patients. However, the clinical utility of such tests remains unclear. Within our institution, we analyzed the clinical utility and subsequent treatment alterations of the FoundationOne Comprehensive Genome Profiling Test (FOne). Methods: We conducted a retrospective cohort review (2017 - 2018) of patients with solid tumors under standard diagnostic care who received FOne testing. We reviewed the therapies that were proposed by FOne and studied whether they led to a therapeutic alteration. Results: 71 patients were identified, of which the majority presented a progressive disease state (80%). Among the cancer types most frequently tested were adenocarcinoma of the colon (14%), prostate (8%), lung (4%), intrahepatic cholangiocarcinoma (8%) and breast invasive ductal carcinoma (4%). In 16 cases (22%), therapies suggested by FOne were approved in patient’s tumor type while in 30 cases (42%) therapies were approved in another tumor type. For an additional 13 cases (18%) only therapies tested in clinical trials were reported. 4 patients (6%) received a new therapy based on the FOne result: cancer of unknown primary (Everolimus due to a TSC1 mutation), cutaneous angiosarcoma (Pembrolizumab due to a high tumor mutational burden (TMB)), gastrointestinal neuroendocrine carcinoma (Ipilimumab and Nivolumab due to an intermediate TMB) and mucinous adenocarcinoma of the appendix (Talazoparib due to an ATM mutation). For 11 cases (15%), a new therapy option was identified by FOne, which due to the current treatment plan might be considered for later use. 3 cases (4%) were evaluated for potential clinical trial enrollment. Note that for an additional 6 patients (8%), the therapies proposed by FOne were already established on the basis of previous testing (e.g. smaller genomic panels, IHC, FISH). Conclusions: Overall, 18 (25%) patients received a new therapy option by FOne after standard of care diagnostics. Therapeutic alterations were observed particularly in patients with a rare or unknown tumor type.

Ultrasound-guided mammotome for diagnosis and minimally invasive excision of mammary clustered calcifications.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13034-e13034
Author(s):  
Wei Hu
Keyword(s):  
Minimally Invasive ◽  
Carcinoma In Situ ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Pathological Examination ◽  
Ultrasound Guided ◽  
Breast Calcification ◽  
Cosmetic Outcomes ◽  
Clinically Significant

e13034 Background: To validate the ultrasound-guided vacuum-assisted breast biopsy system (Mammotome) for diagnosis and minimally invasive excision of calcification in breast. Methods: In 20 patients, breast calcification lesions diagnosed by mammography were excised by ultrasound-guided Mammotome system with 8-gauge probe. The samples were taken mammography and followed by pathological examination. Results: All lesions were removed accurately and thoroughly with satisfactory cosmetic outcomes. No clinically significant hematoma developed. Each mass was resected through 9.15±2.70 cores on average over a mean of 11.65±3.88 minutes. Two cases of them were histologically diagnosed as ductal carcinoma in situ and 8 cases were fibroadenoma and 10 cases were adenosis. Conclusions: Ultrasound-guided Mammotome system can profit to diagnose and treat breast calcification lesions which is ultrasound positive. Ultrasound detection rate of microcalcifications is up to the instrument resolution and the operator's experience and patience.

Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

2019 ◽  
Vol 15 (2) ◽  
pp. 209-213
Author(s):  
Yu Wang ◽  
Jiantao Wang ◽  
Haiping Wang ◽  
Xinyu Yang ◽  
Liming Chang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Pearson Correlation ◽  
Dense Breast ◽  
Pathological Examination ◽  
Negative Group ◽  
The Difference

Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.

scholarly journals A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ikuma Nozaki ◽  
Yumi Tone ◽  
Junko Yamanaka ◽  
Hideko Uryu ◽  
Yuko Shimizu-Motohashi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Malignant Transformation ◽  
Poor Prognosis ◽  
Mediastinal Mass ◽  
Bone Biopsy ◽  
Systematic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Malignant Teratoma ◽  
Experienced Pain

We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

scholarly journals Risk factors and predictors for tumor site origin in metastatic adenocarcinoma of unknown primary site

2021 ◽  
Author(s):  
Xinrong Li ◽  
Yan Shao ◽  
Liqiang Sheng ◽  
Junquan Zhu ◽  
Zeming Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Site ◽  
Unknown Primary ◽  
Tumor Site ◽  
Metastatic Adenocarcinoma ◽  
Unknown Primary Site

scholarly journals Clinical analysis of 12 cases of ovarian cystic mature teratoma with malignant transformation into squamous cell carcinoma

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098154
Author(s):  
Xiangyu Wang ◽  
Wenjing Li ◽  
Yan Kong ◽  
Xiangyu Liu ◽  
Zhumei Cui
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Malignant Transformation ◽  
Squamous Cell ◽  
Tumor Size ◽  
Treatment Guidelines ◽  
Mature Teratoma ◽  
Cystic Teratoma ◽  
Clinical Analysis ◽  
Palpable Mass

Objective This study aimed to examine the clinicopathological characteristics, treatment, and prognostic factors in 12 cases of malignant transformation of mature cystic teratoma of the ovary (MCTO). Methods We performed a retrospective study of 12 patients with malignant transformation of MCTO who were admitted to the Affiliated Hospital of Qingdao University from 2003 to 2019. We examined case records, clinical parameters, and biological assessments. Results The median age of the patients was 56.5 years and seven of them were postmenopausal. The average tumor size was 18.5 cm. All patients had pelvic masses at their first hospital visit. Nine of the patients had discomfort in the lower abdomen, two presented with a lower abdominal palpable mass, and three were complicated by fever. The median follow-up time was 73 months (12‒193 months). Ten patients survived with a disease-free status and two died. Conclusions There is a low incidence of malignant transformation of MCTO, and its most common histological type is squamous cell carcinoma. Age and tumor size are important factors in malignant transformation of teratomas. While there is a lack of treatment guidelines for malignant transformation of MCTO, early diagnosis and treatment may be beneficial for these patients.

scholarly journals Intraductal Papilloma Without Atypia on Image- Guided Breast Biopsy: Upgrade Rates to Carcinoma at Surgical Excision

Breast Care ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. 364-368 ◽  
Author(s):  
Doris Leithner ◽  
Benjamin Kaltenbach ◽  
Petra Hödl ◽  
Volker Möbus ◽  
Volker Brandenbusch ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Statistical Tests ◽  
Menopausal Status ◽  
Surgical Excision ◽  
Lesion Size ◽  
Intraductal Papilloma ◽  
Image Guided ◽  
Institutional Review

Background: The management of intraductal papilloma without atypia (IDP) in breast needle biopsy remains controversial. This study investigates the upgrade rate of IDP to carcinoma and clinical and radiologic features predictive of an upgrade. Methods: Patients with a diagnosis of IDP on image-guided (mammography, ultrasound, magnetic resonance imaging) core needle or vacuum-assisted biopsy and surgical excision of this lesion at a certified breast center between 2007 and 2017 were included in this institutional review board-approved retrospective study. Appropriate statistical tests were performed to assess clinical and radiologic characteristics associated with an upgrade to malignancy at excision. Results: For 60 women with 62 surgically removed IDPs, the upgrade rate to malignancy was 16.1% (10 upgrades, 4 invasive ductal carcinoma, 6 ductal carcinoma in situ). IDPs with upgrade to carcinoma showed a significantly greater distance to the nipple (63.5 vs. 36.8 mm; p = 0.012). No significant associations were found between upgrade to carcinoma and age, menopausal status, lesion size, microcalcifications, BI-RADS descriptors, initial BI-RADS category, and biopsy modality. Conclusion: The upgrade rate at excision for IDPs diagnosed with needle biopsy was higher than expected according to some guideline recommendations. Observation only might not be appropriate for all patients with IDP, particularly for those with peripheral IDP.

Sign in / Sign up

Export Citation Format

Share Document