Linitis plastica as the first indication of metastatic lobular carcinoma of the breast: case report and literature review.
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This report illustrates many of the long term complicatio of syphilis involving the stomach. A 49-year-old woman with diffuse squamous metaplasia of the gastric mucosa developed invasive pure squamous cell carcinoma. The literature is reviewed and the probable pathophysiology is discussed.
Signet ring cell adenocarcinomas of the bladder are regarded as rare tumours. The authors actually think that their frequency is underrated since they report three new cases out of a range of 700 bladder tumours. Revealing signs consist in urgency pain, frequency and/or hematuria. This set of cancer is usually tardily diagnosed and therefore of very poor prognosis whatever the therapies.
In this paper we describe the 16th case in the English medical literature of signet-ring cell carcinoma of the bladder, which occurred in a 65-year-old man who developed widespread abdominal metastases. This case illustrates the characteristic diffuse infiltrative pattern of this neoplasm. In addition to light microscopy, ultrastructural studies were performed.
Metastasis of the stomach wall in mammary cancer as first sign of disease spread 9 years after removal of the primary carcinoma is reported. The diagnosis was proven by surgical biopsy with demonstration of positive hormone receptors. The radiological and CT signs of infiltration of the stomach wall without mucosal destruction is a rare but typical finding in tubular invasive breast cancer.
Both inflammatory pseudotumors and sclerosing (retractile) mesenteritis are uncommon conditions of unknown origin. A number of authors have reported patients presenting with complaints that were attributed to one or the other of these entities. In our review of the literature, we were unable to find a single case report of mixed abdominal findings that could be explained by the presence of both conditions. We report a case of the patient presenting with abdominal mass that was identified as having features of both sclerosing mesenteritis and inflammatory pseudotumor on pathologic diagnosis.
Over a 12-month period, we diagnosed poorly differentiated infiltrative independent-cell gastric adenocarcinoma in two brothers and one sister aged 41 to 47 years. Their father had died from antral cancer at the age of 34 years. These cancers had two characteristic clinical features: rapid course and distant malignant dissemination. In all three patients, polymerase chain reaction-sequencing of the E-cadherin (CDH1) gene of white blood cells identified a heterozygous nonsense mutation of exon 3, producing a stop codon at position 95 (Q95X), resulting in a truncated protein. The alteration of this protein, which plays a crucial role in epithelial cell adhesion, probably explains the clinical expression in this type of familial diffuse gastric cancer.
A 53-year-old woman, 13 years after vertical banded gastroplasty (VBG), presented with recently increased vomiting and high-grade pouch outlet stenosis, and was confirmed at laparotomy to have linitis plastics, for which she underwent total gastrectomy. Her pathology is unfavorable. Question is raised as to the incidence of gastric carcinoma subsequent to VBG and other gastric reductive and/or bypass procedures. Comparison is made of the increased incidence of gastric carcinoma over time, after gastric resective procedures for benign disease, versus the 'normal' incidence of gastric carcinoma, and the worse prognosis of gastric stump carcinoma. Noted is the recent observation, in a small series, of worrisome mucosal changes by endoscopic biopsies in patients after VBG, in the area of the pouch outlet. Long-term follow-up, with interval endoscopic biopsies and careful case reporting, will be important if we are to know the risk of eventual gastric carcinoma in these patients.
The decreased incidence of gastric syphilis has made its clinical presentation less widely appreciated. A 61-year-old man suffering from epigastric pain, nausea, and vomiting had an initial diagnosis of gastric carcinoma; the pathologic diagnosis was equivocal. Eventually, gastric syphilis was diagnosed. In the context of the case described below, positive serologic findings in a relatively young adult should raise the suspicion of gastric syphilis. Carcinoma must be ruled out, lest the patient lose valuable time while being treated for syphilis.
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