scholarly journals Uterine Carcinosarcoma after Prolonged Antiestrogenic Therapy-Pathohistological Characteristics, Immunohistichemical Analysis, Prognosis and Complex Treatment: A case report with literature review

2021 ◽  
Vol 2 (2) ◽  
pp. 01-11
Author(s):  
Lena Marinova ◽  
Bistra Yordanova ◽  
Nikolay Evgeniev
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Histological Study ◽  
Immunohistochemical Analysis ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Tamoxifen Treatment ◽  
Peritoneal Cytology ◽  
Uterine Carcinosarcoma ◽  
Invasive Ductal Breast Carcinoma

Uterine carcinosarcoma (UCS) is a rare aggressive neoplasm.We present a clinical case with UCS, developed during along-term five years adjuvant tamoxifen treatment and ovarian suppression with LHRH agonist on the occasion of invasive ductal breast carcinoma. Crucial for obtaining diagnosis of this rare aggressive neoplasm is the strict pathohistological and immunohistochemical analysis, carried out by an experienced pathologist. Every patient with a history of breast carcinoma is a subject for periodic monitoring. Genital bleeding is required to perform a separated endometrial abrasion with a precise histological study. For UCS / III C2 FIGO stage without distant metastases is necessary to conduct a maximal surgical tumor reduction, involving ever total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy, followed by a combined simultaneous chemo-radiotherapy of tumor bed and pelvic lymph nodes, definitive radiotherapy of para-aortical lymph nodes, as well as adjuvant chemotherapy.

scholarly journals A Rare Case of Choriocarcinoma following a Normal Pregnancy and Delivery

2017 ◽  
Vol 03 (01) ◽  
pp. 064-066
Author(s):  
C Hariharan ◽  
Shubhada Jajoo ◽  
Anuradha Khemka
Keyword(s):  
Postpartum Hemorrhage ◽  
Histological Study ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Subsequent Treatment ◽  
Time Interval ◽  
Vaginal Deliveries ◽  
Secondary Postpartum Hemorrhage

Abstract Introduction: Choriocarcinoma is one of the rarest entities encountered in routine obstetric practice. It is usually diagnosed when patient is symptomatic, presenting with either abnormal bleeding per vaginum or symptoms of distant metastases. The presentation of choriocarcinoma as secondary postpartum hemorrhage is a least common scenario. Choriocarcinoma is mostly seen following an abnormal pregnancy, either a partial or complete mole. Case report: A 25-year-old para 3 live 3 patient presented with secondary postpartum hemorrhage on 4th week postpartum. She had two normal full-term vaginal deliveries that were uncomplicated with normal antenatal period. As she presented with secondary postpartum hemorrhage with the thought of retained products of conception, an emergency diagnostic dilatation and curettage was done. Histopathology was suggestive of gestational choriocarcinoma. Patient was given single regimen of methotrexate and subsequently decision of total abdominal hysterectomy was taken and patient was kept in close follow-up. Presently, beta-human chorionic gonadotropin (hCG) is below 2 mIU/mL. Conclusion: The concern is the time interval or delay between the onset of symptoms and diagnosis with subsequent treatment. Although there are a number of reasons of postpartum hemorrhage, simple curettage for histological study and titer serum beta-hCG may lead to early diagnosis and initiation of treatment. Obstetricians and pathologists should have increased awareness regarding the consequences of choriocarcinoma.

scholarly journals Thyroid metastases from breast carcinoma: case report and review of literature

2020 ◽  
Author(s):  
Yichao Wang ◽  
Shengliang Zhou ◽  
Boyang Yu ◽  
Ping Zhou ◽  
Zhihui Li ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Distant Metastases ◽  
Needle Aspiration ◽  
Thyroid Lesion ◽  
Cervical Lymph Nodes ◽  
Left Chest ◽  
History Of ◽  
Thyroid Metastases ◽  
The Right

Abstract Rationale: The thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2%.Patient concerns: We report a case of 54-year-old woman with a history of breast carcinoma presented with diffuse scattered microcalcifications in thyroid and enlarged bilateral cervical lymph nodes detected on ultrasound (US). Physical examination of the patient revealed stiff and enlarged thyroid lobes.Diagnoses: FNAB and immunohistochemistry （IHC）of the thyroid lesion confirmed the thyroid metastases from breast cancer.Interventions and outcomes: Due to the comorbidities of breast carcinoma metastases to the right axillary, cervical lymph nodes and left chest wall, the patient received chemotherapy. After a follow-up of 10 months, the patient was alive without any new distant metastases.Lessons: Our case highlights that thyroid metastases should be considered in a patient combined with thyroid lesions and a history of breast carcinoma. IHC played an important role in differentiating thyroid metastases from primary thyroid cancer.

Stage III Uterine Carcinosarcoma: 2009 International Federation of Gynecology and Obstetrics Staging System and Prognostic Determinants

2011 ◽  
Vol 21 (9) ◽  
pp. 1606-1612 ◽  
Author(s):  
Gunjal Garg ◽  
Michael Kruger ◽  
Carl Christensen ◽  
Gunter Deppe ◽  
Eugene P. Toy
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Involvement ◽  
Disease Spread ◽  
Peritoneal Cytology ◽  
Uterine Carcinosarcoma ◽  
Stage Iiic ◽  
Gynecology And Obstetrics ◽  
Node Involvement ◽  
Positive Peritoneal Cytology

Objectives(1) To determine the significance of positive peritoneal cytology and pelvic versus para-aortic lymph node involvement in uterine carcinosarcoma. (2) To evaluate the impact of isolated retroperitoneal lymph node involvement (IIIC-N) versus retroperitoneal lymph node involvement plus other evidence of extrauterine disease spread (IIIC-N+) on survival in patients with stage IIIC uterine carcinosarcoma.MethodsData were extracted from the Surveillance, Epidemiology, and End Results database between 1988 and 2005. Statistical analysis used χ2, Kaplan-Meier method, and Cox proportional hazards model.ResultsA total of 690 women were identified. When comparing overall survival between patients with disease spread to uterine serosa and/or adnexa and those with positive peritoneal cytology, there was no significant difference (25.4% vs 15.5%, P = 0.2). However, although the 5-year overall survival was comparable between patients with positive pelvic lymph nodes and those with positive para-aortic lymph nodes (22.1% vs 25.4%, P = 1.0), it was significantly worse in stage IIIC-N(+) compared to stage IIIC-N patients (15.0% vs 33.4%, P < 0.001). Only patient’s age (P < 0.001), race (P = 0.03), stage (P < 0.03), and lymphadenectomy (P < 0.001) were independent predictors of survival after adjusting for other contributing factors. In addition, the results of unadjusted analysis concerning the survival difference between different stage groups were confirmed on multivariate analysis.ConclusionsPositive peritoneal cytology is associated with poor prognosis in uterine carcinosarcoma, comparable to current International Federation of Gynecology and Obstetrics stage IIIA classification of disease. Although there does not seem to be a significant survival difference between patients with positive pelvic versus those with para-aortic lymph nodes, the prognosis seems to be much worse in patients with stage IIIC uterine carcinosarcoma with other evidence of extrauterine disease spread, suggesting the need for more aggressive therapy.

scholarly journals Case Report and Review of Literature: Thyroid Metastases From Breast Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Yichao Wang ◽  
Shengliang Zhou ◽  
Boyang Yu ◽  
Ping Zhou ◽  
Jingqiang Zhu ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Distant Metastases ◽  
Needle Aspiration ◽  
Thyroid Lesion ◽  
Cervical Lymph Nodes ◽  
Left Chest ◽  
History Of ◽  
Thyroid Metastases ◽  
The Right

RationaleThe thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2%.Patient concernsWe report a case of 54-year-old woman with a history of breast carcinoma presented with diffuse scattered microcalcifications in thyroid and enlarged bilateral cervical lymph nodes detected on ultrasound (US). Physical examination of the patient revealed firm and enlarged thyroid lobes.DiagnosesFNAB and immunohistochemistry (IHC) of the thyroid lesion confirmed the thyroid metastases from breast cancer.Interventions and OutcomesDue to the comorbidities of breast carcinoma metastases to the right axillary, cervical lymph nodes and left chest wall, the patient received chemotherapy. After a follow-up of 19 months, the patient was alive without any new distant metastases.LessonsOur case highlights that thyroid metastases should be considered in a patient combined with thyroid lesions and a history of breast carcinoma. IHC played an important role in differentiating thyroid metastases from primary thyroid cancer.

Clinical Outcomes of Uterine Carcinosarcoma: Results of 94 Patients

2015 ◽  
Vol 25 (2) ◽  
pp. 279-287 ◽  
Author(s):  
Zeynep Kestel Gokce ◽  
Taner Turan ◽  
Alper Karalok ◽  
Tolga Tasci ◽  
Isin Ureyen ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Adjuvant Therapy ◽  
Lymph Nodes ◽  
Independent Prognostic Factor ◽  
Peritoneal Cytology ◽  
Uterine Carcinosarcoma ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Staging Surgery ◽  
Positive Peritoneal Cytology

ObjectiveWe aimed to determine the clinicopathologic features and identify prognostic factors of patients with uterine carcinosarcoma.Materials and MethodsA total of 94 patients with uterine carcinosarcoma who were diagnosed between January 1993 and October 2013 were included. Staging surgery consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy. Staging is undertaken according to the 2009 International Federation of Gynecology and Obstetrics staging system. Kaplan-Meier survival analysis was used to determine the effects of variables on disease-free survival (DFS) and overall survival (OS).ResultsSeventy-nine patients underwent staging surgery and none of them had residual tumor after surgery. Three-year DFS and 3-year OS were 42.7% and 59.2%, respectively. In the univariate analysis, stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, and extrapelvic metastases were associated with 3-year DFS and stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, adnexal involvement, and extrapelvic metastases were associated with 3-year OS. Seventy-four patients received adjuvant therapy. Adjuvant therapy did not reduce recurrence or improve survival. Any of the chemotherapy regimens was not superior to the others. In the multivariate analysis, only age was an independent prognostic factor for 3-year DFS and no parameter was statistically significant for 3-year OS.ConclusionsAge was an independent prognostic factor for 3-year DFS. Older age was associated with poor survival. Extrauterine spread was associated with survival. The aims of surgery should be both staging and providing tumoral debulking. Prospective randomized trials are needed to better define the necessity and modality of the administered adjuvant therapy.

scholarly journals Synchronous presentation of invasive ductal breast carcinoma and follicular lymphoma: a diagnostic challenge

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Priscila Nunes Silva Morosini ◽  
Murilo do Vale Sabóia ◽  
Teresa Cristina Santos Cavalcanti ◽  
Ágata Rothert ◽  
Marcela Santos Cavalcanti
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Follicular Lymphoma ◽  
Breast Neoplasm ◽  
Axillary Lymph Node ◽  
Core Biopsy ◽  
Left Breast ◽  
Axillary Lymph ◽  
Invasive Ductal Breast Carcinoma

Introduction: The presentation of synchronous tumors is rare. At the same time, the increase in the incidence of non-Hodgkin lymphoma in patients treated for malignant breast neoplasm submitted to radiotherapy is a known fact. However, some authors have reported cases of breast neoplasm and lymphoma at initial diagnosis. It is unclear whether they originate from common underlying mechanisms, triggering others, or if one disease process is completely independent of the other. Clinical case: A 69-year-old asymptomatic female patient was referred to the mastology department due to abnormalities in the routine mammography. Upon presentation, she had no associated B symptoms, and the physical examination revealed a palpable nodule in the left breast and suspicious palpable left axillary lymphadenopathy. Mammography prior to the appointment showed a 15 mm nodule in the left breast with well-defined margins. A complementary ultrasound revealed multiple simple cysts in the left breast, the largest with 1.3 cm and retroareolar. The anatomopathological report of the core biopsy and fine-needle aspiration biopsy (FNAB) indicated an invasive ductal carcinoma in the left breast, with T2N2M0 as the initial clinical staging. Immunohistochemical evaluation revealed estrogen receptor-positive (ER+++ 95%), progesterone receptor-negative (PR-), HER2-, Ki67 8%. FNAB of axillary lymph node showed no malignancy in the sample. Staging tomography had no evidence of distant lesions. The patient underwent a radical mastectomy and axillary lymph node dissection with plans for adjuvant chemotherapy. The final anatomopathological report of the surgical specimen revealed a well-differentiated invasive ductal breast carcinoma associated with intraductal carcinoma, measuring 2.7x1.9x1.8 cm and with free margins. A total of 45 lymph nodes were dissected, with no evidence of involvement by carcinoma. However, an atypical proliferation strongly suggestive of follicular lymphoma was identified. Immunohistochemistry was positive for CD 10, Bcl-6, and Bcl-2, compatible with follicular lymphoma, grade 1-2 (predominantly follicular >75%). Discussion: Literature reviews show that 88.9% of case reports have failed in diagnosing the second synchronous neoplasm. Usually, FNAB and even core biopsy of these lymph nodes does not guarantee the diagnosis, given the high rates of false-negative in these cases, and their findings are often insufficient. Imaging diagnosis is frequently unclear in these situations, and the diagnosis is mainly reached after surgical treatment and final histological evaluation. Final considerations: The case brings to light the discussion about the treatment of a complex, hard to diagnose situation, which leads to delayed management. Multidisciplinary follow-up is crucial for this diagnosis so as to prevent unfavorable outcomes.

Challenges in the correct assessment of a case of aggressive thyroid carcinoma with synchronous breast cancer, case report and review of the literature: essential role of radiopharmaceuticals

2020 ◽  
Vol 13 ◽  
Author(s):  
Andra Piciu ◽  
Alexandru Mester ◽  
George Rusu ◽  
Doina Piciu
Keyword(s):  
Breast Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Breast Carcinoma ◽  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Essential Role ◽  
Papillary Thyroid ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma

Background: Thyroid carcinoma represents a complex pathology that can still be considered a medical challenge, despite having a better prognosis and life expectancy than most other neoplasms, also the scenario of multiple malignancies involving thyroid cancer is nowadays a common reality. Materials and methods: We reviewed the literature regarding the aggressive presentation of synchronous thyroid and breast cancer. In the current paper we are reporting the case of a 59 years-old woman, diagnosed with invasive ductal breast carcinoma and papillary thyroid carcinoma, presenting a natural history of both aggressive synchronous tumors. At the moment of hospitalization, the diagnostic was breast carcinoma with multiple secondary lesions, suggestive for lung and bone metastases, and nodular goiter. Results: Searching the literature PUBMED with the terms “thyroid carcinoma and synchronous breast carcinoma we found 86 studies; introducing the term “aggressive” the result included 4 studies, among them none being relevant for aggressive and synchronous. A similar search was done in SCOPUS finding 92 documents and after introducing the term aggressive, the number of papers was 8, none being for the synchronous aggressive metastatic thyroid and breast carcinoma. The majority of imaging diagnostic tools were used in this particular medical case, in order to ensure the best potential outcome. The final diagnostic was papillary thyroid carcinoma with lung and unusual multiple bone metastases and synchronous invasive ductal breast carcinoma with subcutaneous metastases. Conclusion: The case illustrates the challenges in correct assessment of oncologic patients, despite the advances in medical imaging and technologies and underlines the essential role of nuclear medicine procedures in the diagnostic and therapy protocols.

scholarly journals T stage-dependent lymph node and distant metastasis and the accuracy of lymph node assessment in rectal cancer

2021 ◽  
Author(s):  
Henry Ptok ◽  
Frank Meyer ◽  
Roland S. Croner ◽  
Ingo Gastinger ◽  
Benjamin Garlipp
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
Cumulative Risk ◽  
Distant Metastases ◽  
Number Of Patients ◽  
Tumor Stages ◽  
The Impact

Summary Objective To analyze data obtained in a representative number of patients with primary rectal cancer with respect to lymph node diagnostics and related tumor stages. Methods In pT2-, pT3-, and pT4 rectal cancer lesions, the impact of investigated lymph nodes on the frequency of pN+ status, the cumulative risk of metachronous distant metastases, and overall survival was studied by means of a prospective multicenter observational study over a defined period of time. Results From 2000 to 2011, the proportion of surgical specimens with ≥ 12 investigated lymph nodes increased significantly, from 73.6% to 93.2% (p < 0.001; the number of investigated lymph nodes from 16.2 to 20.8; p < 0.001). Despite this, the percentage of pN+ rectal cancer lesions varied only non-significantly (39.9% to 45.9%; p = 0.130; median, 44.1%). For pT2-, pT3-, and pT4 rectal cancer lesions, there was an increasing proportion of pN+ findings correlating significantly with the number of investigated lymph nodes up to n = 12 investigated lymph nodes. Only in pT3 rectal cancer was there a significant increase in pN+ findings in case of > 12 lymph nodes (p = 0.001), but not in pT2 (p = 0.655) and pT4 cancer lesions (p = 0.256). For pT3pN0cM0 rectal cancer, the risk of metachronous distant metastases and overall survival did not depend on the number of investigated lymph nodes. Conclusion In rectal cancer, at least n = 12 lymph nodes are to be minimally investigated. The investigation of fewer lymph nodes is associated with a higher risk of false-negative pN0 findings. In particular, in pT3 rectal cancer, the investigation of more than 12 lymph nodes lowers the risk of false-negative pN0 findings. An upstaging effect by the investigation of a possibly maximal number of lymph nodes could not be detected.

scholarly journals Acute appendicitis as an unusual cause of invasive ductal breast carcinoma metastasis

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Vincent De Pauw ◽  
Julie Navez ◽  
Stephane Holbrechts ◽  
Jean Lemaitre
Keyword(s):  
Abdominal Pain ◽  
Breast Carcinoma ◽  
Acute Appendicitis ◽  
Ductal Carcinoma ◽  
Hormonal Treatment ◽  
Locoregional Therapy ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
History Of ◽  
Anticancer Treatment

Abstract Acute appendicitis is one of the most common causes of abdominal pain at the emergency room. In rare cases, it can be caused by malignancy, even metastatic lesions from extra-abdominal neoplasia. Herein, we report a case of a 64-year-old female with a history of invasive ductal carcinoma of the breast treated by chemotherapy, surgery, radiotherapy and hormonotherapy, relapsing several years later as a bone and a pleura metastasis successfully cured by locoregional therapy and hormonal treatment. She presented with acute abdominal pain without signs of peritonitis. Abdominal computed tomodensitometry showed sign of appendicitis. Therefore, laparoscopic exploration and appendicectomy was performed. During surgery, multiple peritoneal nodules were found and harvested. Pathology showed metastatic nodules of invasive ductal breast carcinoma, including in the appendicular wall, concluding to peritoneal carcinomatosis. The postoperative course was uneventful, but the patient died 1 year later after refusing anticancer treatment.

Sign in / Sign up

Export Citation Format

Share Document