scholarly journals Epidural tumor pseudoprogression after spine SBRT: A case report and a mini review of the literature

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Emanuel Stutz ◽  
Martin Wartenberg ◽  
Hossein Hemmatazad
Keyword(s):  
Tumor Progression ◽  
Epidural Space ◽  
Response Assessment ◽  
Anaplastic Thyroid Carcinoma ◽  
Carcinoma Cells ◽  
Review Of The Literature ◽  
First Case ◽  
Mri Sequences ◽  
Treatment Response Assessment ◽  
Tissue Specimens

Introduction: Stereotactic body radiotherapy (SBRT) to the spine is becoming a more common form of treatment. Response assessment is challenging because pseudoprogression (PP) is difficult to distinguish from true tumor progression (TTP). Methods: We report the case of a patient with anaplastic thyroid carcinoma and a bony metastasis to T-7. The MRI 22 months after the first SBRT to this location showed radiological tumor progression to the epidural space resulting in a re-SBRT. The three and six months MRI after re-SBRT showed again progressive epidural growth. After T-7 vertebrectomy, obtained tissue specimens were histopathologically evaluated. Results: Although the MRI sequences after second SBRT were highly suspicious of tumor progression into epidural space, only a small cluster of carcinoma cells of 1mm diameter was found within the bony structure near the disc, not belonging to the radiologically highly suspicious epidural mass. Conclusion: To our knowledge, we report the first case of a radiographic tumor progression to the epidural space following primary SBRT and re-SBRT, which histopathologically revealed a PP after spine surgery. Based on the “epidural progression criterion” from the SPINO-consensus, the first and the second progression after SBRT should have been classified as TTP. Due to the challenge in distinguishing TTP from PP, reporting of such cases are essential to share experiences and thereby improve the understanding of PP after spine SBRT.

Evaluation of E-Cadherin and β-Catenin Immunoreactivity for Determining Undifferentiated Cells in Anaplastic Thyroid Carcinoma

Pathobiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Risa Kanematsu ◽  
Mitsuyoshi Hirokawa ◽  
Aki Tanaka ◽  
Ayana Suzuki ◽  
Miyoko Higuchi ◽  
...  
Keyword(s):  
Cell Membrane ◽  
Thyroid Carcinoma ◽  
Undifferentiated Carcinoma ◽  
Anaplastic Thyroid Carcinoma ◽  
Carcinoma Cells ◽  
Membrane Expression ◽  
Thyroid Carcinomas ◽  
Nuclear Expression ◽  
Thyroid Transcription Factor 1 ◽  
E Cadherin

<b><i>Introduction:</i></b> An immunohistochemical study has occasionally been performed to diagnose anaplastic thyroid carcinoma (ATC). However, antibodies to confirm the undifferentiated nature of ATC have not yet been evaluated. The aim of this study was to evaluate E-cadherin and β-catenin expressions in immunoreactivity to determine undifferentiated carcinoma cells in the diagnosis of ATC. <b><i>Methods:</i></b> We immunohistochemically examined 29 ATCs, 30 poorly differentiated thyroid carcinomas (PDTCs), 22 well-differentiated thyroid carcinomas (WDTCs), and 3 squamous cell carcinomas. Antibodies for thyroid transcription factor-1 (TTF-1), paired-box gene 8 (PAX8), β-catenin, and E-cadherin were used. <b><i>Results:</i></b> All WDTCs tested positive for TTF-1, PAX8, and E-cadherin. The positive rates of TTF-1, PAX8, and E-cadherin were 93.3, 93.3, and 100%, respectively, in PDTCs and 17.2, 51.7, and 10.3%, respectively, in ATCs. WDTC expressed the lateral cell membrane staining for β-catenin and E-cadherin, whereas PDTC showed circumferential cell membranous expression (fishnet pattern). β-catenin cell membrane expression in ATCs is lost or discontinuous. Carcinoma cells with β-catenin nuclear expression without cell membranous expression were scattered in 72.4% of ATCs but were not observed in the other carcinomas. <b><i>Conclusion:</i></b> We propose 3 immunohistochemical findings to determine undifferentiated carcinoma cells in the diagnosis of ATC: (1) β-catenin nuclear expression with no or reduced cell membranous expression, (2) the loss or discontinuous pattern of E-cadherin expression, and (3) the loss of PAX8 nuclear expression.

Multi‐parametric MRI (mpMRI) for treatment response assessment of radiation therapy

2021 ◽  
Author(s):  
Chunhao Wang ◽  
Kyle R. Padgett ◽  
Min‐Ying Su ◽  
Eric A. Mellon ◽  
Danilo Maziero ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Treatment Response ◽  
Response Assessment ◽  
Treatment Response Assessment

scholarly journals Flare phenomenon in prostate cancer: recent evidence on new drugs and next generation imaging

2021 ◽  
Vol 13 ◽  
pp. 175883592098765
Author(s):  
Vincenza Conteduca ◽  
Giulia Poti ◽  
Paola Caroli ◽  
Sabino Russi ◽  
Nicole Brighi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Response Assessment ◽  
New Drugs ◽  
Biological Mechanisms ◽  
Early Discontinuation ◽  
Flare Phenomenon ◽  
Discontinuation Of Treatment ◽  
Different Types ◽  
Treatment Response Assessment ◽  
New Evidence

Over the years, an increasing proportion of metastatic prostate cancer patients has been found to experience an initial bone flare phenomenon under both standard therapies (androgen deprivation therapy, chemotherapy, radiotherapy, abiraterone, enzalutamide) and novel agents (immunotherapy, bone-targeting radioisotopes). The underlying biological mechanisms of the flare phenomenon are still elusive and need further clarification, particularly in relation to different types of treatment and their treatment response assessment. Flare phenomenon is often underestimated and, in some cases, can negatively affect clinical outcome. In cases with suspected bone flare, the treatment should be continued for a minimum of 12 more weeks before further decisions about efficacy can be taken. Physicians and patients should be aware of this effect to avoid unwarranted anxiety and inadequate early discontinuation of treatment. This review aims at highlighting new evidence on flare phenomenon arising after the introduction of new drugs extending across the biochemical, radiographic and clinical spectrum of the disease.

scholarly journals Osteoid Osteoma of the Atlas in a Boy: Clinical and Imaging Features–A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Adelaide Valluzzi ◽  
Salvatore Donatiello ◽  
Graziana Gallo ◽  
Monica Cellini ◽  
Antonino Maiorana ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Osteoid Osteoma ◽  
Soft Tissues ◽  
Tissue Reaction ◽  
Imaging Features ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
First Case ◽  
Upper Cervical

AbstractOsteoid osteoma is a benign osteoblastic tumor, quite uncommon in the spine. We report a case of an osteoid osteoma involving the atlas in a 6-year-old boy, who presented with suboccipital pain and torticollis. Initial radiological findings were ambiguous as magnetic resonance imaging showed mainly edema of upper cervical soft tissues. The subsequent computed tomography depicted a lesion of left lamina of C1. As conservative treatment failed, the lesion was surgically resected and the patient became pain free. To our knowledge, this is the first case of osteoid osteoma involving the atlas associated with abnormal soft tissue reaction reported in literature.

Osteoblastoma of the clavicle at the site of a previous fracture—first case report and review of the literature

2019 ◽  
Vol 48 (10) ◽  
pp. 1623-1628
Author(s):  
Adriana C. Moreira ◽  
David I. Suster ◽  
Sterling Ellis Eide ◽  
Daniel I. Rosenthal ◽  
Connie Y. Chang
Keyword(s):  
Case Report ◽  
Review Of The Literature ◽  
Previous Fracture ◽  
First Case

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

scholarly journals Hemophagocytic Lymphohistiocytosis Complicating Erythroleukemia in a Child with Monosomy 7: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Samin Alavi ◽  
Maryam Ebadi ◽  
Alireza Jenabzadeh ◽  
M. T. Arzanian ◽  
Sh. Shamsian
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Chromosomal Abnormalities ◽  
Bone Marrow Aspiration ◽  
Review Of The Literature ◽  
Monosomy 7 ◽  
Persistent Fever ◽  
First Case ◽  
Erythroid Precursors

Herein, the first case of childhood erythrophagocytosis following chemotherapy for erythroleukemia in a child with monosomy 7 is reported. A 5-year-old boy presented with anemia, thrombocytopenia, and hepatosplenomegaly in whom erythroleukemia was diagnosed. Prolonged pancytopenia accompanied by persistent fever and huge splenomegaly and hepatomegaly became evident after 2 courses of chemotherapy. On bone marrow aspiration, macrophages phagocytosing erythroid precursors were observed and the diagnosis of HLH was established; additionally, monosomy 7 was detected on bone marrow cytogenetic examination. In conclusion, monosomy 7 can lead to erythrophagocytosis associated with erythroid leukemia and should be considered among the chromosomal abnormalities contributing to the association.

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