The role of puncture biopsy in the treatment of pathological fractures of the cervical vertebrae

The aim is to analyze the data obtained during biopsy of primary and secondary lesions and pathological fractures of the cervical vertebrae and their influence on the tactics of treatment of patients. Evaluation of the effectiveness of biopsy of pathological processes in the cervical vertebrae. Materials. The results of biopsies of 20 patients with lesions of the cervical vertebrae of unknown etiology or with the presence of pathological fractures with compression of the spinal cord and roots by a vertebra or a soft tissue component were analyzed. The following results were obtained: the presence of a secondary lesion of the cervical vertebrae was revealed: metastatic nature – 10, primary tumors – 1, lymphoproliferative tumors – 3, no tumor lesion was detected – 3, not enough material for the study – 3. Conclusion. The results obtained indicate the high efficiency and sufficient safety of puncture biopsy in diagnosing lesions of the cervical vertebrae, even in complex localizations (C2). Revealing the nature of vertebral lesions in the absence of absolute indications for decompression and stabilization interventions significantly affects the tactics and order of treatment of the patient.

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

We present the case of a 35-year-old man with intractable nausea, vomiting, and severe anemia. A computed tomography (CT) scan of the chest, abdomen, and pelvis showed a circumferential lesion thickening of up to 3.5 cm at the level of the third portion of the duodenum. No aortocaval, retroperitoneal lymphadenopathy, nor secondary lesion was observed. Esophagogastroduodenoscopy (EGD) revealed a circumferential mass within the third portion of the duodenum. Histopathology of biopsy materials from the duodenal mass showed it most likely to be a poorly differentiated adenocarcinoma. The patient underwent a subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection. Histologically, tumor cells with basophilic cytoplasm and pleomorphic nuclei showed a solid pattern, and expressed CD30 and SALL4 immunohistochemically, leading to a diagnosis of embryonal carcinoma-like tumor. No other primary tumor could be identified, and the location of the tumor, mainly on the mucosal surface, suggested a duodenal origin. The UICC TNM staging was T3N2M0, stage IIB. This is a rare case of primary duodenal carcinoma with features of embryonal carcinoma.

Secondary Tumor Arising in a Nevus Sebaceous

Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous glands, sweat glands and hair follicles. It is possible to develop secondary tumors in the area of nevus sebaceous during the lifetime, most often after puberty. Secondary lesions are most often benign, while malignant lesions may occur but significantly less frequently. Case report. We present the case of a 21-year-old patient who came for an examination due to the appearance of a nodule in the area of a yellowish lesion on the head. The yellowish lesion was present since birth, and the nodule appeared about a year before. The dermoscopic examination of the lesion was nonspecific. The final diagnosis of eccrine poroma as a secondary lesion in nevus sebaceous was made by pathohisto-logical analysis. Conclusion. Every secondary tumor in nevus sebaceous deserves full attention, with either close follow up, or excision with pathohistological analysis.

A case report of an unusual caecal metastatic location of a primary cervical squamous cell carcinoma

Squamous cell carcinoma (SCC) of the colon is a rare malignant tumor occurring as either a primary or secondary lesion. Few cases of metastatic or secondary colonic SCC have been published. We report an unusual case of a 59-year-old female patient who was treated by Wertheim hysterectomy and adjuvant chemoradiation for stage IIB SCC of the uterine cervix. Two years later, she developed a metastatic location in the caecum causing an acute intestinal obstruction. She underwent an emergency open right hemicolectomy with ileocolic anastomosis and resection of two nodules of the umbilicus and the right parietal peritoneum. Histopathological examination confirmed a triple metastatic location of SCC. She is disease-free 11 months after surgery. We discuss the clinicopathological features, management strategies, and the prognosis of this rare entity.

BILATERAL BREAST CANCER - CASE SERIES

This is a presentation of four rare and interesting cases of bilateral breast cancer. The cases vary from Synchronous double primary carcinoma breast, bilateral infiltrating ductal carcinoma, bilateral synchronous metastatic carcinoma and metachronous breast carcinoma. The incidence of developing either primary or metastatic carcinoma in the other breast is increased in patients who already have carcinoma in one side and mammography contributes greatly to the detection of these lesions. (1) It is of significant prognostic value and important in deciding the clinical management based on the classification whether it is a primary or a secondary lesion.

Malignant seeding of the biopsy needle tract outside of the radiation therapy field in a patient with Glioblastoma

A 44-year-old male initially presented with a right thalamic brain tumor that was confirmed with stereotactic biopsy to be glioblastoma (GBM). The patient was treated with radiotherapy and temozolomide for 6 weeks. At 1 month after completing chemoradiation therapy, the patient underwent follow-up imaging that revealed the primary lesion had mildly responded to chemoradiation, but a secondary lesion had developed along the biopsy needle tract. This secondary lesion was outside of the field of radiation therapy for the primary tumor and concluded to be intracranial spread of GBM along the biopsy tract. The patient’s final imaging 4 months after initial diagnosis revealed the primary and secondary lesions had enlarged. Subsequently, the patient clinically deteriorated and died 7 months after initial diagnosis.

The 2019 novel coronavirus disease with secondary ischemic stroke: two cases report

Background: The 2019 novel coronavirus disease is an outbreak of respiratory illness first detected in Wuhan, China in the end of Dec, 2019. The older patients complicated with underlying diseases are reported more likely to have clinical symptoms. But its secondary lesion is rarely reported. Case presentation: We reported two cases of coronavirus infected pneumonia with acute ischemic stroke in patients at their middle-age. In both 2019 coronavirus diseases cases, neurological physical examination are normal before infection. Lymphocytopenia and high expression of cytokines and D-dimer were found from serum clinical laboratory test at admission. The dysarthria and limb muscle weakness are initial manifestations in one week after 2019 novel coronavirus infection. The head CT and head/neck arterial CTA showed small-vessel occlusion. The patients were diagnosed with coronavirus diseases with secondary acute ischemic stroke. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. Conclusion: The present cases suggested that secondary ischemic stroke, which mainly manifested as small-vessel occlusion, should be considered for coronavirus disease patients with prompt diagnosis and treatment.

The 2019 novel coronavirus disease with secondary ischemic stroke: two cases report

Background : The 2019 novel coronavirus disease is an outbreak of respiratory illness first detected in Wuhan, China in the end of Dec, 2019. The older patients complicated with underlying diseases are reported more likely to have clinical symptoms. But its secondary lesion is rarely reported. Case presentation : We reported two cases of coronavirus infected pneumonia with acute ischemic stroke in patients at their middle-age. In both 2019 coronavirus diseases cases, neurological physical examination are normal before infection. Lymphocytopenia and high expression of cytokines and D-dimer were found from serum clinical laboratory test at admission. The tongue palsy, dysarthria and limb muscle weakness are initial manifestations in one week after 2019 novel coronavirus infection. The head CT and head/neck arterial CTA showed small-vessel occlusion. The patients were diagnosed with coronavirus diseases with secondary acute ischemic stroke. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. Conclusion : The present cases suggest that secondary ischemic stroke, which mainly manifested as small-vessel occlusion, should be considered for coronavirus disease patients with prompt diagnosis and treatment.

An Atypical Presentation of Cystic Echinococcosis

Cystic echinococcosis (CE) is an infection caused by the Echinococcus granulosus tapeworm. CE generally manifests in the liver, but it may present in any organ. These patients often first present to the emergency department. Mortality over 10 years is significant for those who go undiagnosed. We report the case of a 34-year-old patient who immigrated from Yemen six years earlier. She presented with acute onset dysuria, suprapubic pain, and fever. Imaging revealed a primary multicystic mass on the right renal pole with a secondary lesion in the right hepatic lobe. On further investigation, the patient’s serum was positive for echinococcus antibodies.