Abdominal wall metastasis of carcinoma breast : a case report

Abdominal wall metastasis from breast carcinoma is an uncommon occurrence compared to local invasion into muscle from direct tumor spread. A 30 years old lady was referred to our hospital from a medical college hospital for adjuvant treatment after being done the left sided modified radical mastectomy. Pathological examination revealed poorly differentiated infiltrative duct cell carcinoma, metastatic deposits in axillary lymph node with histological grade 3. She underwent adjuvant chemotherapy and radiotherapy with regular schedule and follow up. Her adjuvant treatment and follow up period were uneventful upto 13 months. Thereafter she reported a painless lump in the right upper abdomen which was rapidly growing in size. Cytopathology report confirmed that the cells of the parietal lump were compatible with metastatic duct cell carcinoma. So, though the primary pathology was in the left side but the parietal lump was found in the right side. Skeletal muscle metastasis is uncommon and pain is the commonest symptom. But here the lump is painless and this is another rare presentation. Treatment principle is only palliation.Bangladesh Med J. 2015 Sep; 44 (3): 172-174

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Laparoscopic Resection of Renal Capsular Endometriosis in a Woman with Menstrual-Related Flank Pain: Case Report

African Journal of Urology ◽

10.1186/s12301-021-00186-2 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Abbas Basiri ◽

Iman Ghanaat ◽

Hamidreza Akbari Gilani

Keyword(s):

Flank Pain ◽

Pathological Examination ◽

Histologic Evaluation ◽

Normal Renal Parenchyma ◽

Perinephric Space ◽

Superior Portion ◽

The Right ◽

First Time ◽

Laparoscopic Removal

Abstract Background Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety. Case presentation A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence. Conclusion Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.

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RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa222.795 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii460-iii460

Author(s):

Mayuko Miyata ◽

Masahiro Nonaka ◽

Akio Asai

Keyword(s):

Radiation Necrosis ◽

Tumor Resection ◽

Pathological Examination ◽

Secondary Cancer ◽

Brain Necrosis ◽

Cerebellar Medulloblastoma ◽

Cerebellar Peduncle ◽

The Right ◽

The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

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Benign phyllodes tumour of the prostate: An extremely rare entity

Canadian Urological Association Journal ◽

10.5489/cuaj.2030 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 548 ◽

Cited By ~ 2

Author(s):

Ozgu Aydogdu ◽

Yusuf Ziya Atesci ◽

Ayhan Karakose ◽

Eren Demirtas

Keyword(s):

Lateral Lobe ◽

Prostatic Hyperplasia ◽

Pathological Examination ◽

Resonance Imaging ◽

Flexible Cystoscopy ◽

Urinary Tract Symptoms ◽

Phyllodes Tumour ◽

The Right ◽

Lower Urinary

Benign phyllodes tumour (BPT) of the prostate is a very rare neoplasm. It is composed of hyperplastic and neoplastic glandular stromal proliferation. Patients with BPT of the prostate generally present with lower urinary tract symptoms and hematuria. BPT of the prostate can potentially cause recurrent obstructive symptoms. Complete transurethral resection (TUR) and close postoperative follow-up is recommended. A 59-year-old man presented with dysuria and obstructive urinary symptoms. Flexible cystoscopy revealed prostatic hyperplasia and a polypoidal lesion originating from the right lateral lobe of the prostate. Magnetic resonance imaging revealed a 3 × 2.5-cm mass lesion in the right lateral lobe of the prostate. TUR of the prostate was performed and the pathological examination revealed benign prostatic hyperplasia and benign phyllodes tumour of the prostate.

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Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up

Modern Oncology ◽

10.26442/18151434.2020.3.200301 ◽

2020 ◽

Vol 22 (3) ◽

pp. 149-153

Author(s):

N. A. Ognerubov ◽

T. S. Antipova ◽

G. E. Gumareva

Keyword(s):

Computed Tomography ◽

Renal Cell Carcinoma ◽

Adrenal Gland ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Cell Cancer ◽

Primary Site ◽

The Right

Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Results.A 52-year-old patient U. with a history of increased blood pressure, up to 170/100 mmHg for the last 5 years, who had undergone many instrumental examinations, including ultrasound examination, because of this disease. The computed tomography of the abdomen showed a 4975 mm heterogeneous tumor in the right adrenal gland in October 2017. The combined positron emission and X-ray computed tomography showed a 795441 mm mass in the right adrenal gland, associated with elevated fluorodeoxyglucose metabolic activity SUVmax 7.25. Focal accumulation of the radiopharmaceutical SUVmax 4.31 in a 171124 mm mass was detected in the space of bifurcation in the mediastinum. The lytic lesion (1015 mm) was found in right superior L3 articular process. The patient underwent retroperitoneoscopic adrenalectomy and thoracoscopic removal of mediastinal tumor in November 2017 because of the oligometastatic nature of the process. The histological study identified clear-cell carcinoma with areas of papillary structure in the right adrenal gland. The immunohistochemical study showed carcinoma cells intensively expressing CD10, and some other cells RCC. The immune phenotype of the tumor was identified as clear-cell renal cell carcinoma. The immunohistological and immunohistochemical analysis reviled the metastases of the same variant of renal cell carcinoma in one of 9 lymph nodes. The patient was treated with pazopanib. The primary renal tumor was not detected during the dynamic observation, including the application of annual combined positron emission and X-ray computed tomography. The patient is alive without disease progression with a follow-up of 32 months. Conclusion.Metastases of clear-cell renal cell carcinoma, including adrenal gland, without evidence of a primary site are extremely rare. The main method of treatment is a combination of surgery and targeted therapy, providing long-term local control of the course of the disease.

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The largest reported intrathoracic lipoma: a case report and current perspectives review

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1030-8 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Mohammed Aldahmashi ◽

Abdalmotaleb Elmadawy ◽

Mahmoud Mahdy ◽

Mohamed Alaa

Keyword(s):

Single Case ◽

Tumor Resection ◽

Pathological Examination ◽

Complete Excision ◽

Case Presentation ◽

Medical Checkup ◽

Excellent Outcome ◽

The Right ◽

Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

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Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting

Journal of Primary Care & Community Health ◽

10.1177/2150132720916279 ◽

2020 ◽

Vol 11 ◽

pp. 215013272091627

Author(s):

Gayatri Setia ◽

Ilan Kedan

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Point Of Care ◽

Case Series ◽

Smoking History ◽

Point Of Care Ultrasound ◽

Gross Hematuria ◽

The Right

Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. Few present with the triad of gross hematuria, flank pain, and abdominal mass. In RCC patients, 36% had 2 symptoms of the triad, and 60% had gross hematuria as 1 symptom. Point-of-care ultrasound (POCUS) offers a way to identify clinically meaningful anatomic abnormalities. This case series presents 3 patients in whom routine POCUS examination performed in an outpatient cardiology clinic found asymptomatic renal masses, resulting in surgical resection and cure of early-stage RCCs. Case Presentation: Patient 1: 54-year-old female with hypertension (HTN). Two solid masses were identified with POCUS in the right kidney. Patient 2: 63-year-old male with coronary artery disease (CAD) and HTN was seen at an 8-month follow-up visit. A 6-cm mass was identified in the left kidney. Patient 3: 69-year-old male with CAD, HTN, and smoking history seen at 5-month follow-up visit. A 3-cm mass in the right kidney was identified. Conclusions: Incorporating POCUS into the routine physical examination in the ambulatory care setting may improve rates of detection and increase the pretest probability of identifying renal pathology with formal imaging studies. With minimal clinician training, earlier and increased detection of asymptomatic RCC may result in improved patient survival.

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Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study

Diagnostics ◽

10.3390/diagnostics10020085 ◽

2020 ◽

Vol 10 (2) ◽

pp. 85

Author(s):

Maciej Stukan ◽

Antonio Bugalho ◽

Amanika Kumar ◽

Julita Kowalewska ◽

Dariusz Świetlik ◽

...

Keyword(s):

Ovarian Cancer ◽

Ultrasound Examination ◽

Test Method ◽

Pathological Examination ◽

Lung Ultrasonography ◽

Reference Standard ◽

Method Performance ◽

Tumor Spread ◽

The Right ◽

Upper Abdomen

A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.

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Ultrasound as a Useful Diagnostic Tool in the Follow-up of Laryngeal Carcinoma

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/aijoc-6-1-13 ◽

2014 ◽

Vol 6 (1) ◽

pp. 13-15

Author(s):

Kathleen Klinge ◽

Andreas Mueller

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Total Laryngectomy ◽

Mri Scan ◽

Laryngeal Tumor ◽

The Status ◽

The Right ◽

To Receive

ABSTRACT Background Using neck ultrasound to evaluate the status of the lymph nodes of a patient with a head and neck cancer is common practice but laryngeal ultrasound could help to receive more information of the tumor. Methods and results We report a case of an initially T1a N0 M0 G2 R0 squamous-cell carcinoma of the right vocal cord. Despite regular follow-up, the relapse of the tumor remained undetected. The hypopharyngoscopy and laryngoscopy were performed. The tumor was evaluated with laryngeal ultrasound and to confirm the relapse of the tumor a MRI scan was performed. Endoscopically there was no obvious presence of the tumor. Laryngeal ultrasound facilitated the visualization of the tumor in good quality. Unfortunately, a total laryngectomy was necessary to treat the relapse of the squamous-cell carcinoma (T4a N0 (0/16) M0 G2 R0). Conclusion Despite careful follow-up via laryngoscopy a relapse of the laryngeal tumor was not visible. Using laryngeal ultrasound, the relapse might have been detected sooner.

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Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

Endocrine Connections ◽

10.1530/ec-21-0062 ◽

2021 ◽

Author(s):

Henghai Huang ◽

Qijian Ding ◽

XiaoCao Lin ◽

DeLin Li ◽

Jingjing Zeng ◽

...

Keyword(s):

Operative Management ◽

Pathological Examination ◽

Computed Tomography Imaging ◽

Tertiary Referral Hospital ◽

Female Ratio ◽

Tomography Imaging ◽

Male Female Ratio ◽

The Mean ◽

The Right

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

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Adaptive radiosurgery based on two simultaneous dose prescriptions in the management of large renal cell carcinoma brain metastases in critical areas: Towards customization

Surgical Neurology International ◽

10.25259/sni_275_2019 ◽

2020 ◽

Vol 11 ◽

pp. 21

Author(s):

Georges Sinclair ◽

M. Stenman ◽

H. Benmakhlouf ◽

P. Johnstone ◽

P. Wersäll ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Brain Metastases ◽

Cell Carcinoma ◽

Renal Cell ◽

Gamma Knife Radiosurgery ◽

Local Therapy ◽

Neurological Impairment ◽

Tumor Ablation ◽

The Right

Background: The long-term benefits of local therapy in metastatic renal cell carcinoma (mRCC) have been widely documented. In this context, single fraction gamma knife radiosurgery (SF-GKRS) is routinely used in the management of brain metastases. However, SF-GKRS is not always feasible due to volumetric and regional constraints. We intend to illustrate how a dose-volume adaptive hypofractionated GKRS technique based on two concurrent dose prescriptions termed rapid rescue radiosurgery (RRR) can be utilized in this particular scenario. Case Description: A 56-year-old man presented with left-sided hemiparesis; the imaging showed a 13.1 cc brain metastasis in the right central sulcus (Met 1). Further investigation confirmed the histology to be a metastatic clear cell RCC. Met 1 was treated with upfront RRR. Follow-up magnetic resonance imaging (MRI) at 10 months showed further volume regression of Met 1; however, concurrently, a new 17.3 cc lesion was reported in the boundaries of the left frontotemporal region (Met 2) as well as a small metastasis (<1 cc) in the left temporal lobe (Met 3). Met 2 and Met 3 underwent RRR and SF-GKRS, respectively. Results: Gradual and sustained tumor ablation of Met 1 and Met 2 was demonstrated on a 20 months long follow- up. The patient succumbed to extracranial disease 21 months after the treatment of Met 1 without evidence of neurological impairment post-RRR. Conclusion: Despite poor prognosis and precluding clinical factors (failing systemic treatment, eloquent location, and radioresistant histology), RRR provided optimal tumor ablation and salvage of neurofunction with limited toxicity throughout follow-up.

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