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Multiple cutaneous granular cell tumors are rare in childhood. We cared for two children with 15 and 6 tumors respectively. The tumors were asymptomatic nodules in the skin. Histologically, they consisted of large cells containing granules that were positive on periodic acid-Schiff stain and diastase resistant.
This report presents a rare malignant endothelial neoplasm which arose at the site of a pre-existing lymphangioma. The lymphangioma was located on the right buccal mucosa, and the malignant neoplasm arose 17 years after irradiation of the initial tumor. Clinical, light microscopic and immunohistochemical (Factor VIII-related antigen and Ulex europaeus Agglutinin-I) studies were made, together with observations by transmission and scanning electron microscopy. These studies provide evidence that this malignant neoplasm was well-differentiated and had not yet lost the characteristics of normal lymphatic cells.
BACKGROUND: Nevus sebaceus (NS) is a congenital hamartomatous lesion, usually involving the scalp or the face. Various benign and malignant neoplasms can develop in association with NS, the most common being trichoblastoma, syringocystadenoma papilliferum, viral warts and basal cell carcinoma (BCC). PATIENTS AND METHODS: We retrospectively examined the clinical and histopathological records of 15 NS cases with an associated tumor which were diagnosed between 1996 and 2004. RESULTS: All cases were adults and 3 of them had more than one tumor. Six cases had BCC, which is a higher incidence of malignant tumor association with NS, than that reported in last years. Trichoblastoma was observed in 3 cases and was the most common benign tumor in our series. Filiform, hyperkeratotic, pigmented, pedunculated and/or eroded papulonodular changes were major clinical signs of secondary tumors on NS in our series. CONCLUSION: Clinical features are not sufficient enough to make an exact diagnosis of benign or malignant secondary tumors. Though prophylactic excision for NS is done less in last years, especially adult patients should closely be followed for any new changes evoking tumor development on this congenital lesion.
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BACKGROUND: Hepatocellular carcinoma (HCC) arising in cirrhosis is frequently multifocal. Whether HCC develops monoclonally or multiclonally is an unresolved question. Of the multiple tumour nodules present in many patients, it has not been established whether the smaller lesions represent intrahepatic metastases or de novo cancers. AIMS: To assess the degree of genomic heterogeneity in synchronous HCCs in cirrhosis. METHODS: The arbitrarily primed polymerase chain reaction technique was utilised to compare the DNA fingerprint of HCCs and regenerative nodules (RNs) removed from cirrhotic explant livers. RESULTS: Polymorphic genomic heterogeneity was noted in 54 HCCs and 31 RNs microdissected. Even satellite nodules in close proximity within the same segment of the liver were found to have distinct genomic patterns. CONCLUSION: Such genomic heterogeneity in synchronous HCCs may explain poor patient survival after surgical resection. If the smaller tumours are de novo lesions rather than metastases (as these data suggest), then current concepts regarding liver resection as a curative treatment modality for HCC may require reassessment.
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Two patients with multiple intrathorcic granular cell myoblastomas are described. In one case multiple tumours were present in the major airways and oesophagus. The patient presented with recurrent pulmonary infections and stridor due to airway obstruction. In the other case dysphagia caused by multiple oesophageal granular cell myoblastomas was the major symptom. Granular cell myoblastoma is a rare tumour of neurogenic origin with a characteristic histological appearance. The pattern of multiple tracheobranchial and oesophageal tumours is uncommon and forms the basis of this report.
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PURPOSE: To assess the contribution of mammography in the detection of cancer in the contralateral breast in women with bilateral breast cancer. MATERIALS AND METHODS: Mammograms and clinical records of 77 patients with bilateral breast cancer were reviewed in a retrospective study. RESULTS: The contralateral cancer was detected at mammography in 68 of 77 patients (88%) and identified at mammography alone in 50 patients (65%). No statistically significant differences in either mammographic detection rates or stage of the contralateral cancer were noted in patients younger than 50 years (n = 25) compared with those 50 years of age or older (n = 52). Cancers detected at annual screening mammography were of lower stage than cancers in unscreened patients. In the screened group, 41% of tumors were ductal carcinoma in situ alone and 23% were stage II or III, compared with 22% and 50%, respectively, in the unscreened group. CONCLUSION: Mammographic examination and follow-up in patients with unilateral breast cancer allow detection of the majority of contralateral breast cancers and earlier stage cancers.
Tamoxifen administration to postmenopausal women has been described as being associated with various endometrial and other gynecological pathologies. However, different coexisting gynecological pathologies in such patients have not yet been described. In the present study, we assessed the histopathological conditions diagnosed in endometrium, myometrium, and ovaries of 28 postmenopausal breast cancer patients who were treated with tamoxifen (study group) and compared the findings to those obtained from 14 similar patients without tamoxifen treatment (control group I) and from 28 age-matched healthy postmenopausal controls (control group II). All specimens were removed by total abdominal hysterectomy and bilateral salpingo-oophorectomy for various indications. The overall incidence of two or more different coexisting gynecological pathologies was significantly higher among the study group (92.9%) than in control group I or in control group II (42.9 and 50%, respectively; p = 0. 0001). There was no significant statistical difference between the control groups. Overall endometrial (and endometrial-like) origin of pathological conditions was significantly more common in the study group (92.6%) than in control group I (50%; p = 0.00072) and control group II (32.1%; p = 0.0000), while there was no significant difference between the latter two groups. These findings suggest that there might be an association between postmenopausal tamoxifen exposure and the development of such different coexisting or specific single gynecological pathologies originating from the endometrium.
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The multiple malignancies (MM) autoptically verified at our department within a period of 15 years were reviewed for evidence of a potential iatrogenic induction. Special emphasis was placed on the problems encountered in causally relating metachronic MM's with the treatment of the preceding malignancy and suitable criteria were developed. In 22 (5.6%) of the 392 MM's available for evaluation induction by previous radiotherapy and/or chemotherapy was thought to be likely; that is 40% of all radiological or chemical treated MM. In light of this relatively low number major objections to vitally indicated anticancer treatment appear to be unfounded. The high share of triple malignancies (34.5%) among the MM's presumably induced by treatment constituted a finding of particular interest.
A patient with a sarcoma of the left groin at a site where a prior seminoma had been irradiated is presented. Very few postirradiation sarcomas are described in patients treated with radiation therapy for testicular cancers, even if an increased risk of second malignancies has been reported. In contrast with the highly aggressive clinical course of postirradiation sarcomas, an early discovery of the lesion allowed a radical surgical approach with a presumable cure of the patient. A continuous and precise follow-up of patients irradiated for seminoma is suggested.