Search PubMed⌕ Search

Biomedical subjects

W A A Tjalma

Publications and source records attributed to W A A Tjalma.

At least 19 recordsLinked to original sources
PubMed2006

The management of ectopic breast cancer--case report.

Ectopic breast tissue occurs when the mammary ridge fails to resolve during embryonic development. Ectopic breasts, either supernumerary or aberrant, have an incidence of 6%. Ectopic breast tissue is however hardly mentioned in the literature. Also benign and malignant alterations in these "breasts" are under-reported. The lifetime risk of women being diagnosed with breast cancer is 13%. It should be recommended that these "breasts" be included in the screening. Due to the unawareness this is generally not happening. The present article describes a case of ectopic breast cancer and discusses therapeutic management. A subcutaneous mass along the 'milk line' should be examined carefully and any suspicious lesions should be approached according to the guidelines for the management of symptomatic breast disease. Ipsilateral prophylactic mastectomy has no role in the management of a single ectopic breast cancer tissue.

Axilla↗
PubMed2006

Abdominal apoplexy associated with the levonorgestrel intrauterine system--case report.

Abdominal apoplexy is defined as intraabdominal haemorrhage without an identifiable pathology. This life-threatening situation is hardly mentioned in the literature. The clinical tableau is non-specific. The onset can be with nausea, mild to severe abdominal pain, a palpable mass in the abdomen or flank and sings of hypovolemic shock. The approach should be resuscitation, look for a likely underlying cause and control the bleeding. The present report will describe a case of abdominal apoplexy in a patient using a levonorgestrel intrauterine system. The management and possible origins of abdominal apoplexy will be discussed.

Adult↗
PubMed2005

Suction drain-induced haemorrhage after nerve- and vessel-sparing axillary lymph node dissection for breast cancer.

Suction drainage following axillary lymph node dissection for breast cancer is generally accepted as a routine measure for reducing seroma formation. When performing more nerve- and vessel-sparing axillary lymph node dissection, nerves and vessels can be ruptured by the suction of the drainage system. In the literature no reports could be found describing this type of complication. When using a suction system, we recommend a low-pressure system and that the fully perforated drain should not reach or touch neighbouring vessels or nerves in the axilla when installed.

Breast Neoplasms↗
PubMed2005

Role of human papillomavirus in the carcinogenesis of squamous cell carcinoma and adenocarcinoma of the cervix.

Human papillomavirus (HPV) infection is the most common sexually transmitted disease, with more than 80% of the population infected at some time in their life. In rare cases, this infection may lead to cervical cancer. Virtually all squamous cell carcinomas and the overwhelming majority of adenocarcinomas of the cervix are HPV positive. HPV integration in the genome will lead to inactivation of the p53 pathway and the Rb pathway. Integration is essential for the onset of cervical carcinogenesis, but is probably not sufficient for progression to invasive cervical cancers. It is likely that several cofactors, such as environmental, viral and host-related factors, are necessary for the development of cervical cancer. There are several similarities and differences between the two major histological types. This article will address the role of HPV in cervical carcinogenesis as well as the molecular biology involved in the process.

Adenocarcinoma↗
PubMed2005

Myxoid leiomyosarcoma of the vulva.

BACKGROUND: Myxoid leiomyosarcoma (MLMS) of the vulva is a mesenchymal tumor with only five reported cases in the literature. CASE: We report an 85-year-old woman with a unilateral nonulcerating, painless vulvar mass. According to the patient, the mass slowly enlarged. Initial biopsies were benign. However, clinically, this lesion was suspicious for a soft tissue tumor. Therefore, the mass was removed by a wide local excision. Definitive histology revealed a myxoid leiomyosarcoma of the vulva. At present, 25 months after the operation, the patient is well with no sign of recurrence. CONCLUSIONS: Vulvar myxoid leiomyosarcomas are rare and can be confused with other benign or malignant tumors. It is important to be aware of this rare tumor variant, in order to plan appropriate treatment.

Aged↗
PubMed2005

Biphasic sarcomatoid carcinoma or carcinosarcoma of the breast: prognosis and therapy.

Biphasic sarcomatoid carcinoma of the breast represents only 0.2% of all breast cancer. Due to its rarity and repetitive reclassifications little is known about optimal treatment modalities. These tumours form a diagnostic and therapeutic challenge. The present report describes our experience with a case of biphasic sarcomatoid carcinoma of the breast and a review of the relevant literature is discussed.

Breast Neoplasms↗
PubMed2004

Determination of tumour prognosis based on angiogenesis-related vascular patterns measured by fractal and syntactic structure analysis.

AIMS: Intratumoural micro-vessel density (IMD) has recently been shown to be a valuable prognostic tool in many tumours. Yet, IMD does not take into account the spatial arrangement of the vessels, therefore only partly reflecting the angiogenic situation. In order to describe contextual vascular relationships more accurately, we have used fractal and syntactic structure analysis (SSA) based on computerised image processing to quantify micro-vascular hot spots. MATERIALS AND METHODS: The parametric performance in prediction of patients' outcome was evaluated by univariate analysis and compared with manually obtained IMDs, whereas an automated K-nearest-neighbour (KNN) classifier searched most discriminative parametric combinations. The method is based on analysis of vascular 'hot-spots' of paraffin-embedded tissue sections of invasive cervical carcinoma, colorectal carcinoma and malignant mesothelioma. RESULTS: For all three cancers, prediction of prognosis based on SSA yielded in general much higher recognition scores compared with IMD or fractal dimension. Survival of cervical carcinoma was mostly correlated with clinical data, with the vascular permeation being the only parameter with independent value. Prognosis of colorectal carcinoma is best described by SSA, completed with IMD, indicating an inverse correlation of survival time with a more irregular pattern and a slight increase in vessel number. For mesothelioma, we found a strong correlation with SSA and patients' outcome, with two SSA-parameters having independent prognostic value. CONCLUSIONS: The more accurate angiogenic description obtained with SSA may be useful for further exploitation as a prognosticator in a general diagnostic pathology service.

Belgium↗
PubMed2004

Primary ovarian small cell carcinoma of the pulmonary type: a case report and review of the literature.

Small cell carcinoma of the ovary is a rare type of ovarian carcinoma with a poor prognosis. Two types should be distinguished: the hypercalcemic type and the pulmonary type. We report the case history of a 54-year-old woman with both a Stage IIIC small cell carcinoma, pulmonary type and a well-differentiated endometrioid adenocarcinoma of the left ovary in combination with a Brenner tumor in the right ovary. A review of the literature on small cell carcinoma of the ovary is given and the findings of our patient are brought into perspective in terms of both histopathogenesis and treatment outcome.

Brenner Tumor↗
PubMed2004

Treatment policy of neuroendocrine small cell cancer of the cervix.

Small cell cancers of the cervix are very rare and aggressive tumours. It is difficult to manage these tumours. They are often diagnosed in an advanced stage and their prognosis is generally poor. There are no clinical trials, due to their rarity, that would suggest optimal treatment. The present report describes a patient with a neuroendocrine small cell cancer of the cervix Stage IB2 with a positive lymph node. The treatment consisted of radical hysterectomy and node dissection, adjuvant chemotherapy, chemoradiation and brachytherapy. Currently, after 52 months, the patient is well and free of disease. Since 1996, there has been a classification for neuroendocrine tumours (NETs) of the cervix in four categories (large cell, small cell, typical carcinoid and atypical carcinoid). The aggressive behaviour of neuroendocrine small cell cancer is demonstrated by the high percentage of early lymphatic node and vessel invasion (68 and 90%). Almost half of the patients with Stage I and II will recur with an estimated 5-year survival from 14% to a maximum of 55%. Multimodal therapy for these tumours appears to give good response but often implies severe side-effects.

Adult↗
PubMed2003

Malignant mixed müllerian tumor of the ovary and false negative punctures.

Malignant mixed müllerian tumour (MMMT) of the ovary is a rare and aggressive tumour with a poor prognosis. We present a case of a 57-year-old woman with a large pelvic mass, omental cake, ascites and pleural effusions, clinically highly suspect of an ovarian neoplasm. Paracentesis and ultrasound-guided biopsy of the ovary were negative for malignant disease. Therefore a CT-guided true cut biopsy was performed. The latter gave a histopathologic diagnosis of an endometrioid adenocarcinoma of the ovary. However after cytoreductive surgery anatomopathologic examination revealed a malignant mixed müllerian tumour of the ovary with heterologous differentiation. Apparently only one of the two components was found in the puncture. Adjuvant chemotherapy, active against the sarcomatous and the carcinomatous component, was given. At present the patient is well and disease free 35 months after the initial diagnosis. Cytological examination of ascites may be negative in the presence of malignant disease. If a tumour consists of two components, puncture can miss one, which may lead to undertreatment. Punctures should be discouraged as a diagnostic tool in patients in whom an ovarian malignancy is suspected.

Adenocarcinoma↗
PubMed2003

Ovarian tumour: ovarian pregnancy. Diagnosis and management.

An ovarian mass in a premenopausal patient has many differential diagnoses. In young patients the mass is most likely to be benign. Sometimes patients with an abdominal mass will present as acute abdomen. If the patients have an IUD and a positive test for serum HCG, an ectopic ovarian pregnancy has to be suspected. However one also has to take into consideration the possibility of an ovarian germ cell tumour. The latter occurs in young patients, presents as an ovarian mass and can produce HCG. The preoperative and even intraoperative diagnosis are difficult. In these cases where there is a suspected ovarian mass and no clear diagnosis a laparoscopic approach should be considered. Patients with an ovarian pregnancy have a good prognosis for future fertility and therefore conservative surgical management is advocated. The approach and treatment modalities of an ovarian pregnancy are discussed.

Adult↗