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Biomedical subjects

L Resta

Publications and source records attributed to L Resta.

87 records · Page 5Linked to original sources
PubMedDate not supplied

Rapid growth of myxoid leiomyosarcoma of the vulva during pregnancy: a case report.

Smooth muscle tumors arising in the vulva are rare. Leiomyosarcoma is the most common variant of vulvar sarcoma, and very few cases have been reported during pregnancy. A 36-year-old woman presented with a progressively enlarging vulvar mass during pregnancy, diagnosed as a Bartholin's gland cyst. The lesion was resected at 38 weeks of gestation during cesarean section and diagnosis of myxoid leiomyosarcoma of the vulva was made. Six weeks later the patients were referred to our center and submitted to wide vulvar excision with groin lymph node dissection that revealed the presence of a small residual focus of leiomyosarcoma. At 30 months of follow-up the patient was well without any sign of recurrent disease. Leiomyosarcoma should be included in the differential diagnosis of vulvar masses; progressively enlarging vulvar lesion should be biopsied even during pregnancy. Leiomyosarcoma should be considered in the differential diagnosis of vulvar mass.

Adult↗
PubMedDate not supplied

Neoadjuvant chemotherapy in advanced ovarian cancer: a case-control study.

The aim of this study was to compare the outcome of patients with advanced ovarian carcinoma treated with neoadjuvant chemotherapy (NACT) with those treated conventionally with primary debulking surgery. From 1994 to 2003, all consecutive cases of advanced-stage epithelial ovarian carcinoma treated with NACT at the University of Bari were identified. A well-balanced group of women who underwent primary debulking surgery followed by platinum-based chemotherapy was selected as controls. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival. Thirty women with advanced-stage epithelial ovarian carcinoma were treated with NACT and compared to 30 patients who underwent primary debulking surgery. Patients in the NACT were significantly older and had a poorer performance status compared to the controls. However, no statistical difference was observed in overall disease-specific survival (P= 0.66) and disease-free survival (P= 0.25) between the two groups. Although patients in the NACT group are significantly older and have a poorer performance status, this treatment modality does not compromise survival. Prospective randomized trials comparing NACT to conventional treatment to determine the quality of life and cost/benefit outcomes are now appropriate for women presenting advanced epithelial ovarian cancer.

Aged↗
PubMedDate not supplied

A case of Sertoli-Leydig cell tumor in a postmenopausal woman.

Sertoli-Leydig cell tumor belongs to the group of sex cord-stromal tumors of the ovary. These neoplasms account for less than 0.5% of all ovarian tumors and are more often encountered in young women between the ages of 20 and 30 years who usually become virilized. We described an unusual case of Sertoli-Leydig cell tumor in a postmenopausal women who presented with a solid right pelvic mass, a large amount of ascites, and laboratory tests revealing an elevated CA125, all suggesting a pelvic malignancy. Although five similar cases of postmenopausal women with Sertoli-Leydig cell tumor of ovary have been reported in the literature, we believe that this is an useful addition to the literature.

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PubMedDate not supplied

A rare case of choroidal metastasis presented after conservative management of endometrial cancer.

Hematogenous dissemination from endometrial cancer is quite rare. We report a 31-year-old woman who developed choroidal metastasis following conservative management of early-stage endometrial carcinoma. She had received kidney transplantation and was taking steroids and cyclosporine. Three years after hysterectomy for persistent endometrial carcinoma, she developed multiple metastatic disease (to both lungs and right pelvis), and while on treatment with paclitaxel and carboplatin, she complained of a rapid visual deterioration. Ophthalmologic evaluation revealed a metastatic choroidal tumor associated with multiple central nervous system metastases. The patient refused further treatment and died 1 month after diagnosis of choroidal involvement. In conclusion, this is the first reported case of choroidal metastasis from endometrial cancer and highlights the need to consider immunosuppressive treatment as an absolute contraindication to conservative fertility-sparing treatment in gynecological malignancies.

Adult↗
PubMedDate not supplied

Cholesteatoma in children: histopathologic findings in middle ear ossicles.

Middle ear ossicles removed during ear surgery in 40 patients were examined in order to compare the histopathologic changes in children with those observed in adults. Bone resorption, mainly localized at the level of the periosteum and haversian canals in adults, was much more extensive in children. Replacement of bone by fibrous granulation tissue was observed in 60% of children's ossicles and in 27% of those belonging to adults. In children, extensive active resorptive osteitis of the ossicles was frequently associated with intensive round cell infiltration, which seems to play an important role in bone absorption and in the aggressiveness of cholesteatoma.

Adolescent↗
PubMedDate not supplied

[The reliability of biopsy-determined grading in laryngeal squamous cell carcinoma].

Grading evaluation is becoming increasingly more important in establishing a valid prognosis and in the choice of therapeutical strategies in dealing with squamous laryngeal cancer. It follows, therefore, that grading of bioptic tissue, made before therapy planning, must offer reliable data and correspond to data gathered through grading of the entire neoplasm. Thus the aim of our study carried out on 267 cases was to verify if grading of bioptic tissue corresponds to that of the operatory specimen. In 7% of the cases (19 in 267) bioptic grading overestimated the neoplasm in that post-operatory grading revealed a less differentiated form. On the contrary, in 16% of the cases (43 in 267) bioptic grading underestimated the form since as post-operatory grading showed a more highly differentiated form. It appears clear that these values depend on the clinical extension of the neoplasm in that the difference was inferior in the case of limited neoplasms and greater in that more largely extended ones. Generally speaking then, the less extended the neoplasm (the most frequently observed clinical form), the more coinciding the bioptic evaluation indicating good differentiation with the post-operatory evaluation. On the other hand, bioptic evaluation indicating moderate or poor differentiation is less reliable since it does not coincide with findings in approximately 16% of the neoplasms, above all those most limited (12%). This means that any reductive adoption of therapy planning made on the basis of the degree of differentiation revealed upon bioptic examination is possible only in the case of those forms more advanced with regard to extension.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMedDate not supplied

[The status of receptors in laryngeal carcinoma: a study of receptors for estrogen, progesterone, androgens and glucocorticoids].

In order to verify the hypothesized hormone sensibility of the laryngeal carcinoma, we evaluated the level of steroid receptors in this type of neoplasm and correlated this datum with common pathological and clinical prognostic indices. Estrogen and progesterone receptors were evaluated in 105 patients with a squamous cell carcinoma and 2 patients with a mucoepidermoid laryngeal carcinoma. Receptors for androgens and glucocorticoids were evaluated in 35 patients (all with a squamous cell carcinoma). Dosage was performed on fresh neoplastic tissue using the DCC (Dextran Coated Charcoal) method. Estrogen receptors were present in 26 cases (24.3%); progesterone receptors were present in 18 cases (16.8%); both receptors were revealed in 8 patients (7.5%). Androgen receptors were evident in 4 patients (4/35, 11.4%); glucocorticoid receptors were evident in 7 patients (7/35, 20%); both receptors were revealed in 4 (11.4%) cases. No statistical difference with regard to grading, site and extension of the cancer, extralaryngeal tissue involvement or node metastasis was noted in the groups of patients with or without steroid receptors.

Adult↗
PubMedDate not supplied

[What is the prognostic significance of histomorphology in small cell lung carcinoma?].

What is the prognostic significant of the histomorphology in the small cell carcinomas of the lung? After the WHO classification of the lung cancer (1981), several studies criticized the subdivision of the small cell carcinoma in three sub-types (oat-cell, intermediate cell and combined types). The role of histology in the prognostic predition has been devaluated. In order to verify the prognostic value of the morphology of the small cell types of lung cancer, we performed a multivariate analysis in 62 patients. The survival rate was analytically compared with the following parameters: nuclear maximum diameter, nuclear form, nuclear chromatism, chromatine distribution, presence of nucleolus, evidence of cytoplasm. The results showed that none of these parameters are able to express a prognostic value. According to the recent studies, we think that the small cell carcinoma of the lung is a neoplasia with a multiform histologic pattern. Differences observed in clinical management are not correlate with the morphology, but with other biological parameters still unknown.

Carcinoma, Small Cell↗
PubMedDate not supplied

[The prognostic significance of the extralaryngeal microscopic extension of a T3 glottic carcinoma].

Incidence of microscopic infiltration of the laryngeal framework, with or without extra-laryngeal extension, was studied retrospectively in a series of 63 patients treated surgically for glottic T3 carcinomas in order to establish prognostic values. The results of histopathological examination revealed neoplastic invasion of the fibro-cartilaginous skeleton in 46 of the patients examined and in half of these microscopic diffusion in peri-laryngeal tissue. As far as prognosis is concerned, there was a clear-cut correlation between a decrease in survival rates and a contemporaneous increase in the real extension of the neoplasia, even if microscopic. In fact the NED survival rate of confirmed T3 patients was 85% while in cases reclassified as pT4, it was 64% and 47% on the basis on the absence or presence of extra-laryngeal extension. With these observations it is possible to affirm that the major staging is also attributable to cases with initial infiltration of the "laryngeal framework" without an extensive extension toward peri-laryngeal tissue. As far as T recurrences are concerned, a high incidence of relapse of the neoplasia was observed principally in the cases with extra-cartilaginous diffusion. This observation may have a predictive role and therefore direct post-surgery follow-up as well as eventual complementary treatment.

Carcinoma↗
PubMedDate not supplied

Cathepsin D in laryngeal carcinoma. preliminary report.

The biological activity of tumor cells seems to be related to some peptides produced in the same neoplastic cytoplasms. Cathepsin D is considered one of these proteins, which is able to promote mitosis and tumor invasion. The effects of cathepsin D have been studied in tumors of the breast, ovary and endometrium, and in few cases of laryngeal cancer. Using an immunohistochemical method, we have attempted to evaluate cathepsin D expression in 17 cases of laryngeal squamous cell carcinoma in comparison with the presence of the same protein in the adjacent normal laryngeal mucosa and in inflammatory cells surrounding the tumor. In 11 cases, cathepsin D was present in more than 50% of neoplastic cells, in 4 cases positive cells were 30-50% of all neoplastic cells, in the last 2 cases less than 30% of neoplastic cells expressed the antigen. In normal respiratory epithelium the expression of cathepsin D was limited to the apex of cells. In flat metaplastic epithelium, we observed a positive reaction of basal and parabasal cells. Such positivity became diffuse to all cellular layers in dysplastic foci. A minimal positivity was also detected in salivary glands and ducts. A strong positivity was present in macrophages around and among tumor cells. Our findings suggest that cathepsin D plays a role in cancerogenesis and growth of laryngeal squamous cell carcinoma. The expression of cathepsin D also in normal and inflammatory cells may influence the quantitation of this antigen in studies in which cytosolic levels of cathepsin D are measured after protein extraction.

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