CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  
Keyword(s):  
Good Condition ◽  
Lung Neoplasm ◽  
Rare Condition ◽  
Epithelioid Cell ◽  
X Ray ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Preoperative Ct ◽  
Lymph Duct ◽  
The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

Malignant perivascular epithelioid cell tumor (PEComa) arising in the broad ligament

2004 ◽  
Vol 14 (5) ◽  
pp. 1036-1039 ◽  
Author(s):  
D. Fink ◽  
D. E. Marsden ◽  
L. Edwards ◽  
C. Camaris ◽  
N. F. Hacker
Keyword(s):  
Broad Ligament ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Epithelioid Cell ◽  
Cell Tumor ◽  
Perivascular Epithelioid Cell Tumor ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Eosinophilic Cytoplasm

Malignant perivascular epithelioid cell tumor (PEComa) is an extremely rare mesenchymal neoplasm mostly composed of HMB-45-positive epithelioid cells with clear-to-eosinophilic cytoplasm, a propensity for perivascular distribution and a coexpression of smooth muscle markers. The uterus seems to be one of the most prevalent sites of involvement, although only 14 cases of uterine PEComa have been described. We report the case of a 51-year-old woman with a PEComa arising in the broad ligament. She was treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic radiation, and remains without evidence of disease 15 months after diagnosis. This is, to the best of our knowledge, the first report of a malignant PEComa arising in the broad ligament. To correctly diagnose PEComa, an extensive immunohistochemical panel is essential. As PEComas can behave in an aggressive manner, careful follow-up is warranted.

scholarly journals A Rare Cause of Acute Abdomen: Perforation of Double Meckel’s Diverticulum

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
İlhan Tas ◽  
Serdar Culcu ◽  
Yigit Duzkoylu ◽  
Sadik Eryilmaz ◽  
Mehmet Mehdi Deniz ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Rare Condition ◽  
Meckel's Diverticulum ◽  
Rare Entity ◽  
Lower Quadrant ◽  
X Ray ◽  
The Right ◽  
Right Lower Quadrant

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel’s diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel’s diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel’s diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel’s diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

scholarly journals Ureteral Dissection is a Transient Process Before Ureteral Rupture: A Case Report

2020 ◽  
Author(s):  
Kun Xia ◽  
Rongpin Wang ◽  
zhiyan Shen ◽  
Xianchun Zeng ◽  
Zhuxue Zhang
Keyword(s):  
Transient Process ◽  
Good Condition ◽  
Rare Condition ◽  
Warning Sign ◽  
Ureteral Calculus ◽  
Retrograde Pyelography ◽  
Contrast Extravasation ◽  
Enhanced Ct ◽  
The Right ◽  
Ureteral Rupture

Abstract Background: Ureteral dissection（UD）is a rare condition which occurs when injury through the intima and occasionally the media allows entry of urine and separation of the inner and medial ureteral layer just like the formation of aortic dissection. Ureteral rupture (UR) is generally caused by ureteral calculus, operation of ureteral endoscope, trauma, tumors, iatrogenic injury and easy to cause peritonitis, so patients usually show symptoms of peritonitis prior to signs of urinary tract. Ureteral rupture caused by ureteral dissection is rarely reported. Case presentation:21-year-old male and 43-year-old female were both admitted into hospital because of abdominal pain. Enhanced CT and retrograde pyelography showed “double lumen sign” in the right proximal ureter and contrast extravasation in the perinephric gap. The male is dead due to serious condition but the female is in good condition without complication after correct and timely therapy. Conclusions: UD is a transient process viewed by enhanced CT or retrograde pyelography offering a warning sign of UR in order to improve prognosis.

scholarly journals Asymmetric pulmonary edema after scorpion sting: a case report

2008 ◽  
Vol 50 (6) ◽  
pp. 347-350 ◽  
Author(s):  
Ebrahim Razi ◽  
Elaheh Malekanrad
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Pulmonary Edema ◽  
Good Condition ◽  
Clinical Manifestations ◽  
Scorpion Sting ◽  
Scorpion Envenomation ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

A 12-year-old boy was referred with acute asymmetric pulmonary edema (APE) four-hour after scorpion sting to Emergency department. On admission, the main clinical manifestations were: dyspnea, tachypnea, and tachycardia. Chest x-ray revealed APE predominantly on the right hemithorax. The patient was treated with oxygen, intravenous frusemide and digoxin and discharged on the sixth hospital day in a good condition. This case report emphasizes the occurrence of asymmetric pulmonary edema after severe scorpion envenomation within few hours immediately after the sting.

scholarly journals Malignant Mesenteric Perivascular Epithelioid Cell Neoplasm Presenting as an Intra-Abdominal Fistula in a 49-Year-Old Female

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Sakshi Kapur ◽  
Napoleon K. Patel ◽  
Miles B. Levin ◽  
Richard Huang
Keyword(s):  
Exploratory Laparotomy ◽  
Epithelioid Cell ◽  
Hepatic Flexure ◽  
The Body ◽  
Mesenchymal Tumors ◽  
Diffuse Abdominal Pain ◽  
Perivascular Epithelioid Cell ◽  
Mesenteric Mass ◽  
Poor Differentiation ◽  
The Right

Perivascular epithelioid cell tumors are rare mesenchymal tumors arising from histologically and immunohistochemically distinctive perivascular epithelioid cells that express both myogenic and melanocytic markers. These tumors are known to arise from different organs in the body and usually have an unpredictable clinical course. We report a case of a 49-year-old female who presented with diffuse abdominal pain, fever, chills, and nonbilious vomiting for a day. Work-up revealed a mesenteric mass measuring13.5×7.7×9.5 cm, arising in the mesentery of the hepatic flexure, with adjacent gas suggestive of fistularization into the right colon. An exploratory laparotomy with resection of the mesenteric mass was performed, and the initial histopathology results were compatible with either an adenocarcinoma or a sarcoma; however, because of poor differentiation it was difficult to make a definitive diagnosis. However, final histopathology results revealed a malignant perivascular epithelioid cell tumor (with reservation that a S100 negative metastatic melanoma must be excluded clinically). Following surgery the patient was started on everolimus, an m-TOR inhibitor, and has shown good response to this medication.

scholarly journals Laparoscopically resected perivascular epithelioid cell tumor of the ascending colon demonstrating submucosal tumor morphology: a case report

2020 ◽  
Author(s):  
Yuzo Nagai ◽  
Tomomichi Kiyomatsu ◽  
Ayako Kume ◽  
Atsuko Kataoka ◽  
Yoshimasa Gohda ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Submucosal Tumor ◽  
Epithelioid Cell ◽  
Malignant Potential ◽  
Cell Tumor ◽  
Ascending Colon ◽  
Perivascular Epithelioid Cell Tumor ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm

Abstract Background: The differential diagnosis for a colonic submucosal tumor (SMT) can include many types of cancer. We report a case of a perivascular epithelioid cell tumor (PEComa), a rare mesenchymal neoplasm that demonstrates SMT morphology, in the ascending colon.Case presentation: A mass was incidentally detected by computed tomography (CT) in a 53-year-old man. Colonoscopy revealed an SMT with central ulceration in the ascending colon, and 18F-fluoro-2-deoxy-D-glucose positron emission tomography CT demonstrated a high maximum standardized uptake value of 7.33. Preoperative diagnosis was inconclusive. Given the malignant potential of the tumor, we performed a laparoscopic right hemicolectomy with D3 lymph node dissection. The tumor was 5.5 cm × 4.1 cm and located in the submucosa and muscular propria. There was no lymph node metastasis (0/46). Based on the positive immunohistochemical stainings of both melanocytic (HMB45) and muscle (desmin) markers, we diagnosed the tumor as a PEComa. In the 17 months since surgical resection, the patient has not experienced recurrence, but careful observation should continue because of the malignant potential of the tumor.Conclusions: Although rare, a PEComa should be considered in the differential diagnosis of colonic SMT. Immunohistochemical staining of melanocytic and muscle markers is useful for the diagnosis.

scholarly journals New recognition of hepatic perivascular epithelioid cell tumours (PEComa): a retrospective analysis of 35 cases

2020 ◽  
Author(s):  
Xiao Yang ◽  
Qing Yuan Wang ◽  
Xiao Zhou ◽  
Haoming Zhou ◽  
Wen Bo Jia ◽  
...  
Keyword(s):  
Smooth Muscle Actin ◽  
Clinical Manifestations ◽  
Epithelioid Cell ◽  
Tumour Recurrence ◽  
Preoperative Imaging ◽  
Perivascular Epithelioid Cell ◽  
Imaging Examination ◽  
Right Lobe ◽  
The Right

Abstract Purpose Our primary objective was to investigate the clinical features, diagnosis, treatment and prognosis of hepatic perivascular epithelioid cell tumours (PEComa).Patients and Methods Thirty-five cases of pathologically proven hepatic PEComa that were treated in the Department of Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University from January 2008 to February 2019 were retrospectively analysed, and the literature was reviewed.Results Twenty-nine females and 6 males were included in this study. The mean age of these patients was 48.0 years (range, 21-75 years). Thirteen patients complained of upper abdominal pain and discomfort, but the tumours in the other patients were identified by performing an imaging examination. Hepatic PEComas tended to occur in the right lobe of the liver (20 cases in the right lobe, 13 in the left lobe and 2 in the caudate lobe). Two cases were characterized by multiple tumours, and the remaining cases were single lesions (range, 1.2-12 cm). Only 8 cases were correctly diagnosed by the preoperative imaging examination, and the correct diagnosis rate was only 22.9%. The postoperative immunohistochemistry analysis showed that hepatic PEComas are positive for human melanoma black 45 (HMB-45), Melan-A and smooth muscle actin (SMA), with the exception of 1 case that was negative for Melan-A. All patients undergoing an operation accepted regular follow-up, and the average time was 66.5 months (range, 3-132 months). Two patients who experienced tumour recurrence and 1 patient who died due to cardiovascular disease, but the remaining patients showed no evidence of tumour recurrence or metastasis during the follow-up period.Conclusions Hepatic PEComa is a rare type of tumour that mainly occurs in young and middle-aged women. The lack of clinical manifestations and imaging findings increases the difficulty of determining a preoperative diagnosis, which mainly depends on the pathological examinations. Surgery is currently the only effective treatment, and long-term clinical follow-up is necessary due to the aggressive behaviour and relapse of hepatic PEComa in some cases.

Malignant perivascular epithelioid cell tumour of the fibula: a report and a short review of bone perivascular epithelioid cell tumour

2008 ◽  
Vol 61 (10) ◽  
pp. 1127-1129 ◽  
Author(s):  
D W Q Lian ◽  
K L Chuah ◽  
M H W Cheng ◽  
W M Yap
Keyword(s):  
Short Review ◽  
Epithelioid Cell ◽  
Cell Tumour ◽  
Perivascular Epithelioid Cell ◽  
First Case ◽  
Cell Components ◽  
Primary Bone ◽  
The Right ◽  
Mesenchymal Tumours ◽  
Hmb 45

Perivascular epithelioid cell tumour (PEComa) is a term applied to a family of mesenchymal tumours composed of varying proportions of spindle and epithelioid cell components associated with HMB-45 expression. PEComa rarely arises in the soft tissue, visceral organs, skin and bone. This report details an instance when a purely epithelioid PEComa arose from the right fibula of a 52-year-old Chinese woman without features of tuberous sclerosis complex. The excision specimen disclosed an epithelioid tumour with a nested pattern associated with areas of nuclear pleomorphism, mitotic activity, necrosis and vascular invasion in addition to HMB-45 expression on immunohistochemistry. To the best of the authors’ knowledge, this represents the first case of a histologically malignant PEComa of the bone. A short review of primary bone PEComas and potential problems in diagnosis is presented.

Low temperature x-ray microanalysis of frozen-hydrated tobacco leaves

1984 ◽  
Vol 42 ◽  
pp. 284-285
Author(s):  
S. Edith Taylor ◽  
Patrick Echlin ◽  
May McKoon ◽  
Thomas L. Hayes
Keyword(s):  
Low Temperature ◽  
Lemna Minor ◽  
Root Tips ◽  
Tobacco Leaves ◽  
X Ray ◽  
Whole Cells ◽  
Carbon Coated ◽  
The Right ◽  
Beam Currents ◽  
The University

Low temperature x-ray microanalysis (LTXM) of solid biological materials has been documented for Lemna minor L. root tips. This discussion will be limited to a demonstration of LTXM for measuring relative elemental distributions of P,S,Cl and K species within whole cells of tobacco leaves.Mature Wisconsin-38 tobacco was grown in the greenhouse at the University of California, Berkeley and picked daily from the mid-stalk position (leaf #9). The tissue was excised from the right of the mid rib and rapidly frozen in liquid nitrogen slush. It was then placed into an Amray biochamber and maintained at 103K. Fracture faces of the tissue were prepared and carbon-coated in the biochamber. The prepared sample was transferred from the biochamber to the Amray 1000A SEM equipped with a cold stage to maintain low temperatures at 103K. Analyses were performed using a tungsten source with accelerating voltages of 17.5 to 20 KV and beam currents from 1-2nA.

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