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Lymphangiomyoma.

A case report is presented of the incidental finding of a lymphangiomyoma in a 50-year-old woman who underwent total hysterectomy for squamous cell carcinoma of the cervix. The condition seems to occur only in women after puberty and so far, has been mainly reported in association with chylothorax or chylous ascites. There is no evidence of any clinical complication more than 2 years after removal of the lesion. The lesion is most likely a hamartoma although the term lymphangiomyoma is acceptable. The term lymphangiomyomatosis is best reserved for the fully developed clinico-pathological syndrome.

Carcinoma, Squamous Cell↗

Immunohistochemical study of granular cell tumour.

Immunoperoxidase studies were performed on 8 granular cell tumours using various intermediate filament proteins, as well as lysozyme, S-100 protein, and lectins. All the lesions gave negative results to cytokeratin, vimentin, desmin, myoglobin, neurofilament protein, glial fibrillary acidic protein and lysozyme. One was positive for alpha-1-antitrypsin and alpha-1-antichymotrypsin. S-100 protein and lectins (Concanavalin ensiformis and Triticum vulgaris) were uniformly positive in all the lesions. S-100 protein positivity would indicate that granular cell tumours are of neural or neuroectodermal origin, although the cell type involved is not clear. There is no obvious explanation for the lectin-binding properties of granular tumour cells. It is hoped that further studies will evaluate the usefulness of lectin histochemistry in defining the nature of granular cell tumours.

Adult↗

Effects of all-trans retinoic acid on tumor recurrence and metastasis.

OBJECTIVE: All-trans-retinoic acid (ATRA) promotes cell differentiation. We have studied its effect on the local recurrence and metastatic spreading of an experimental rhabdomyosarcoma in rats. DESIGN: syngenic rhabdomyosarcoma cells (S4MH) were inoculated s.c. in male WAG/RijCrl rats. After 25 days tumors were excised and a 40% hepatectomy was performed for all animals. Ten days later the rats were sacrificed and a thorough necropsy was performed. The animals were randomly allocated to receive daily doses of ATRA (5 mg/kg, i.p.) or its solvent (Clinoleic/ethanol 90/10), starting three days before surgery until the end of the experiment. RESULTS: ATRA reduced the incidence of local recurrence from 70 to 33% (p < 0.05), but the tumor size was not altered (1.8 vs. 2.0 cc). Regarding inguinal metastasis, there was a six-fold decrease (0.2 vs. 1.2 cc; p < 0.05) in mean tumor volume, although the rate of this proliferation increased sharply (86 vs. 29%; p < 0.05) for treated animals. The volume of the retroperitoneal tumor masses also decreased with ATRA (0.7 vs. 5.1 cc; p < 0.05), but the difference in rate was not significant (71 vs. 67%). Lung metastases, which were present in 100% of control animals, were found in only 33% of treated rats, while the mean number of metastatic foci dropped from 26.7 to 5.7 (p < 0.05). CONCLUSION: Protocols including retinoid administration prior to and following primary tumor excision could help in controlling both recurrence and metastatic progression in surgically treated rhabdomyosarcoma.

Animals↗

[Nonspecific symptoms due to gastrointestinal stromal tumors].

Three patients, two women aged 64 and 52 years and one man aged 78 years, had non-specific symptoms and they had signs of a tumour at imaging examination. Immunohistochemical study of operation preparations led to the diagnosis of 'gastrointestinal stromal tumour' (GIST). It is important to consider the possibility of a GIST at surgery, because the potential malignancy requires a resection with free margins.

Aged↗

Inflammatory myofibroblastic tumor involving the pterygopalatine fossa.

SUMMARY: Inflammatory myofibroblastic tumors (IMT) comprise a rare group of lesions characterized histologically by acute and chronic inflammatory cells with a variable degree of fibrous stroma. Occurrence in the extracranial head and neck in children is unusual, and involvement in the pterygopalatine fossa has not, to our knowledge, been reported as occurring in this age group. We present the CT findings of an IMT of the pterygopalatine fossa in a 6-year-old female patient with a 2-week history of fever and a painless swelling of the left cheek. The diagnosis of IMT should be included in the differential diagnosis of a child presenting with an aggressive mass associated with systemic features such as fever, elevated sedimentation rate, and leukocytosis.

Child↗

[Myogenic stromal tumors of the stomach: personal experience].

Myogenic gastric tumours are a rare pathology and present difficulties in terms of nosographic classification, which in most cases can be overcome thanks to improvements in imaging and immunohistochemical techniques. Over the period 1995-1999 we observed 5 patients with aspecific dyspeptic symptoms and occasional epigastric pain, suffering from non-epithelial gastric tumours, associated, in one case, with a carcinoma of the stomach. Histological examination of endoscopic biopsies was inconclusive for a definite histopathological diagnosis, while intraoperative biopsies showed the myogenic origin and the absence of morphostructural abnormalities. In the light of these data, we performed three wedge resections, one distal gastric resection and, in the patient with advanced gastric cancer, a D3 total gastrectomy. Histological examination, immunohistochemistry and cytofluorometry enabled us to diagnose stromal tumours with a low risk of malignancy in all cases. At follow-up after 9-54 months all patients are still alive and free of disease. Though the preoperative diagnosis of stromal tumours is possible with endosonography and CT, only histology, immunohistochemistry and cytofluorometry enable us to define the condition nosographically and establish a prognosis with sufficient accuracy to allow correct surgical treatment. A prolonged follow-up is always necessary to identify eventual relapses and/or metastases, which are particularly frequent in the borderline group or in cases with a high risk of malignancy.

Adult↗

Reliability of measuring volume by different methods for tumors of the musculoskeletal system.

In the present study different methods for determining the volume of a tumor were evaluated. For 12 models, the real volume, the volume according to measurement of the surface area on MRI, an ellipsoid and a cylindrical approximation of the volume, as well as the maximum diameter, were determined. There appeared to be a good correlation between all calculated volumes and the real volume. The error (mean: 17%) and the standard deviation (SD: 14%) on this error were smallest if the volume was determined by means of determination of the surface area. The ellipsoid approximation resulted in a smaller error (mean: 0%) but a higher standard deviation (SD: 27%). The cylindrical approximation resulted in unacceptable deviations (mean: 51%; SD: 40%). Volume was significantly related to the maximal diameter to the power of 2.3. Volume calculated according to this power resulted in an error of 18%. Standard deviation in this case however was unacceptable (SD: 89%). Volume calculation based upon the determination of the surface area has given the best and most reliable results. Ellipsoid approximation was less reliable, but faster and cheaper. Cylindrical approximation was unacceptable. Size, expressed as maximal diameter of the tumor, was also unacceptable as a parameter for volume.

Bone Neoplasms↗

[Contribution of the semi-free radial forearm flap for head and neck reconstruction].

Flap failure is mostly caused by venous thrombosis of the anastomosis. The failure rate is higher in post-irradiated neck. To reduce the risk of venous thrombosis, the authors propose to harvest the radial forearm flap using the cephalic vein as the drainage vein and as a pedicle. Only a single arterial anastomosis is carried out. This technique has been described already in patients who underwent head and neck ablative surgery with radical neck dissection. The authors report 2 cases in patients with post-irradiated neck. The flap transfers were successful in the 2 cases. The operative time of harvesting this hybrid version is the same with the conventional free flap technique. This version of the radial forearm flap can be a method of choice for some complex microvascular reconstruction in the head and neck region.

Aged↗

[Parietal implantation after thoracoscopic surgery: a case report].

The Authors report the case of a patient who underwent video-thoracoscopic resection of a solitary pulmonary metastasis. She presented, after about two years, a local relapse (implantation) in the trocar site. Pathogenesis and surgical therapeutic problems are discussed as well.

Carcinoma, Renal Cell↗