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PubMedDate not supplied

[The etiology of hypercalcemia: a study of 47 cases in a hospital internal medicine service].

In this study, we are presented the clinical and the aetiologic features of 47 patients having hypercalcemia (total serum calcium > or = 2.7 mmol/l). Our results show a positive significantly correlation between the degree of the hypercalcemia and the severity of the clinical symptomatology. As for to the aetiology, the multiple myeloma, the hyperparathyroid and the neoplastic process constituted 78% of the total aetiology.

Aged↗
PubMed2001

Patterns of immunohistochemical staining for p53 expression in hyperplastic endometrium and adenocarcinoma.

The p53, a tumour suppressor gene, is the most commonly mutated gene human cancer. In this study, we performed immunohistochemical investigations of the expression of p53 protein in hyperplastic endometrium and adenocarcinoma. Positive immunostaining was detected in 7 (30%) cases of invasive adenocarcinoma, 2 (12%) cases of simple hyperplasia with atypia and 2 (14%) cases of complex hyperplasia with atypia. In simple and complex hyperplasia without atypia staining was seen in occasional cells. The results suggested that endometrial hyperplasia is not always accompanied by p53 protein accumulation, hence its expression is not an early exponent of the neoplastic process.

Adenocarcinoma↗
PubMed1997

Molecular basis of cancer.

Cancer, for the most part, is caused by multiple somatic mutations in a single cell and its progeny. However, in some individuals, constitutional genetic alterations may also play a role. Depending on the specific cell type, the affected cell and its progeny accumulate sequential mutations and sustain multiple genetic alterations over decades. The defective genetic anomalies lead to disabled critical cellular pathways, which with DNA replications in between, evolve clonally and expand into a malignant phenotype. Additional mutations in some genes confer a further selective growth advantages and the neoplastic process progresses to invade surrounding tissues and metastasise to other organs.

Journal Article↗
PubMed1965

Sézary syndrome. A malignant leukemic reticuloendotheliosis.

Review of the literature and the study of a case associated with a malignant lymphoma strongly suggests that the Sézary syndrome is merely a clinical variant of mycosis fungoides. Additional evidence is presented that the lymphadenopathy of the Sézary syndrome is not always of a benign nature, as originally indicated in the literature. Both the Sézary syndrome and mycosis fungoides share the unpredictability of the neoplastic processes of the reticular system which are likely to involve simultaneously or successively, the skin and the lymph-hematopoietic system, as well as the ability of the cell involved in the process to invade the blood stream, giving rise to the leukemic variety of the malignant reticulosis.

Adult↗
PubMed2001

Hemangioblastoma causing cervical neural foraminal widening.

We present the MRI findings in a case of a 24-year-old woman with spinal hemangioblastoma, causing neural foraminal widening by producing a dumbbell mass in the lower cervical region. Hemangioblastomas can very rarely present as an intradural extramedullary lesions and this case is another exceptional pathology which should be considered among the differential diagnosis of enlarged intervertebral foramen due to neoplastic processes.

Adult↗
PubMed2002

[Maffucci's syndrome--case report of a 5-year-old female patient].

Maffucci's syndrome is a congenital non-hereditary syndrome characterized by a combination of dyschondroplasia (enchondromatosis) and haemangiomatosis. It is a rare disease. During the last 140 years only 200 cases were described [5]. 109 cases are described in the literature by other authors [21]. This disease is associated with a high risk of development of neoplastic processes, in particular sarcomatous transformation of enchondromatoses as well as other mesodermal and non-mesodermal malignities [13]. Based on the incidence of spinocellular haemangioendothelioma with other congenital syndromes, the presence at a young age of patients and the multicentric incidence support the assumption that spinocellular haemangioendothelioma may be the manifestation of genetically based mesodermal disease which may be associated with the picture of Maffucci's syndrome [6]. In their case-history the authors present a 5-year-old patient. They describe the clinical course and findings taking into account possible manifestations and risks associated with the disease. With regard to the low incidence of the disease and its interdisciplinary character the authors pen the question of possible causal, symptomatic or palliative treatment.

Child, Preschool↗
PubMed2002

Ileal intussusception due to intestinal metastases from primary malignant melanoma of the lung.

Primary malignant melanoma of the lung (PMML) is an uncommon tumor with very few cases reported in the literature that satisfy the required criteria to establish a primary bronchial origin. We report a case of a 44-year-old man with acute abdominal distress and a right pulmonary roentgenographic opacity. A cranial-thoracic-abdominal CT scan confirmed the presence of a pulmonary nodule with bilateral cerebral metastases and marked dilatation of intestinal loops. At laparotomy an ileal intussusception was noted and an ileal resection was done. The resected intestinal segment contained three endoluminal polypoidal formations. Histological and immunohistochemical analyses showed the presence of multiple sites of melanoma. These lesions as well as the brain lesions clearly appeared metastatic. The patient underwent further evaluation to identify a primary site of melanoma; bronchoscopy was performed with biopsy of the pulmonary nodule. Pathology revealed a neoplastic process of fusiform cells, with focal presence of melanic inter- and extracellular pigment. The immunohistochemical analysis confirmed the diagnosis of PMML. We discuss the criteria for diagnosis and histogenesis of PMML along with this unusual presentation.

Adult↗
PubMed2002

Infectious and neoplastic diseases of the sphenoid sinus--a report of 10 cases.

Sphenoid opacifications may be discovered during the radiological work up of patients presenting with fever, headache, or neurological changes. While most of these patients do not require surgical intervention, prompt assessment and management is nevertheless required. Ten patients who underwent sphenoidotomy for drainage or biopsy at Montefiore Hospital during a 4-year period from September 1995 through January 2000 are presented. Nine out of 10 patients had predisposing factors such as AIDS, diabetes, leukemia, and end-stage renal disease. The most common presentation was altered mental status. One patient rapidly developed cavernous sinus thrombosis. Microbiology of sphenoid cultures included various fungi, Mycobacterium avium intracellulare, coagulase negative Staphylococci, and Corynebacterium. Neoplastic processes included non-Hodgkin's lymphoma and sinonasal undifferentiated carcinoma. When evaluating hospitalized patients with sphenoid sinus disease, a thorough history and a bedside nasal endoscopy should be performed. Conservative management in the form of intravenous antibiotics and topical decongestion should always be the first line of treatment. Those patients with clinical or radiological evidence of disease extending beyond the confines of the sphenoid sinus require immediate surgical intervention.

AIDS-Related Opportunistic Infections↗
PubMed1975

[Histologic structure and spread of malignant neoplasms within the urinary bladder (author's transl)].

In 96 out of 250 cases of bladder cancer, neoplastic tissue was found by biopsy in areas within the bladder but remote of the primary and unsuspiciously looking mucosa. Neither the histologic type of the tumour nor the degree of infiltration of the primary allow predictions regarding remote cancerous lesions within the bladder. It must be concluded: In bladder cancer, indication and choice of treatment must take into consideration that the neoplastic process involves the urinary bladder as a whole.

Adenocarcinoma↗
PubMedDate not supplied

[Lipohyperplasia of the ileocecal valve: unusual cause of severe digestive surgery].

The lipohyperplasia of the ileocaecal valve is a condition of rare clinical observation mainly characterized by an abnormal accumulation of adipose tissue along the submucosal layer of the ileocaecal valve. This pathology presents an unspecific symptomatology that can make difficult the differential diagnosis with a local neoplastic process. Sometimes this pathology can be the cause of gastrointestinal bleeding of unknown origin. The Authors report a case of their observation that requested an emergency surgical operation for the massive digestive haemorrage at presentation. The definitive diagnosis could have been precised only after histological exam.

Adipose Tissue↗
PubMed2002

Managing disorders of the cervicothoracic junction.

A wide range of pathologic conditions occur at the cervicothoracic junction. These conditions are usually the result of trauma, neoplastic processes, infection, prior surgery, or degenerative changes. Instability in this region of the spine is difficult to manage, particularly because of the complex biomechanics involved and the challenging surgical approaches required for treatment. Traditional radiologic evaluation of the cervicothoracic junction is often inadequate; as a result, the standard 3-view cervical spine series should be augmented with swimmer's or oblique views. Surgical treatment, designed to increase stability and allow early mobilization and rehabilitation, often requires internal fixation devices; lateral-mass or pedicle screws are increasingly being used to avoid complications associated with devices occupying the spinal canal. Although posterior surgical approaches to the cervicothoracic junction are relatively straightforward, anterior approaches require mastery in traversing the various bony and soft-tissue structures.

Cervical Vertebrae↗
PubMed2002

[Anticancer chemotherapy containing cisplatin in patients with lung cancer and kidney function].

To carry out safe anticancer chemotherapy one should consider the kidney function. Insufficiency of that main organ responsible for drugs excretion, caused either by neoplastic disease or by chemotherapy, can diminish the possibility or even make impossible of carrying out a complete treatment cycle. The aim of our work was to evaluate the kidney function in patients with lung cancer during anticancer chemotherapy containing cisplatin. The tubular function was studied by estimation the activity of N-acetyl-beta-D-glucosaminidase in urine and glomerular function was studied by estimation the concentration of creatinine in urine, urea, uric acid and electrolytes in plasma. The observations have recorded that neoplastic process, as well as chemotherapy impaired the tubular function. It has showed that it does exist a necessity of detailed estimation of kidney excretory function before, during and after the end of anticancer therapy. Determination of NAG activity in urine may be helpful for the recognition of the patients at high nephrotoxicity risk, who need special care.

Acetylglucosaminidase↗
PubMed2001

[Biological risk factors for differentiated thyroid cancer].

UNLABELLED: Apart from the two relatively well documented risk factors for thyroid cancer i.e. iodine deficiency and ionising radiation, the mechanism of carcinogenesis involves a number of biological and environmental factors. The aim of the study was to analyse the selected biological and environmental risk factors in patients with differentiated thyroid cancer in comparison with a reference group in a case-control study. METHODS: Both the group of 188 women and 30 men with thyroid cancer including 92 with follicular carcinoma and 126 with papillary carcinoma and the control group of 287 women and 58 men were subjected to the examination. All the study participants were given a standard questionnaire and underwent physical examination including thyroid USG, blood hormone levels and urine iodine concentration. The following risk factors were included in the analysis: family history, sex, age, thyroid morbidity, employment, body weight, hormone replacement therapy in women, cigarette smoking. In both groups with thyroid cancer women predominant with the female to male ratio 6.7 in follicular carcinoma and 6.0 in the papillary variant. In both groups of diagnoses the mean age was high--above 50, higher in men than in women. Over 70% of the patients with thyroid cancer had nodular goitre before the detection of cancer. In the control group the proportion of diagnosed goitre was slightly above 10%. A significantly more frequent hormone replacement therapy and contraception and more frequent miscarriages in women with thyroid cancer were noteworthy. One may assume that initiation, promotion and progression of the neoplastic process in the thyroid is triggered by a number of factors, both biological and environmental, and only multifactorial analysis may provide an insight into the mechanisms of carcinogenesis followed by initiation of preventives measures in appropriate cases.

Abortion, Spontaneous↗
PubMed2001

[Significance of intraoperative isotope detection in primary and secondary radical surgical treatment of thyroid cancer].

When diagnosis of the thyroid carcinoma is made preoperatively, total thyroidectomy with excision of lymph nodes involved in neoplastic process is indicated. The cases of carcinoma diagnosed upon tissue examination after strumectomy performed for other indications should be referred for radical rethyroidectomy. Even after macroscopically total thyroidectomy, postoperative scintigraphy may reveal remnants of thyroid tissue, the most often in the place of pyramidal lobe, in proximity of the laryngeal recurrent nerves or small metastatic lymph nodes overlooked during the first operation. In order to improve the rate of surgical cure, intraoperative scintigraphy was performed. Intraoperative evaluation of totality of the operation was performed in 114 patients. In all cases postoperative scintigraphy revealed iodine uptake above 1% (ranging from 1.9% to 23%). The other group of 186 patients had the radicalness of total thyroidectomy and total rethyroidectomy checked intraoperatively with gamma-beams detector. Radioiodine uptake ranged postoperatively in these patients from 0% to 3.74%. Only 73 (39%) of them required radioiodine treatment due to iodine uptake above the neck. The intraoperative use of gamma-beams detector allows improving totality of thyroidectomy and for significant reduction in number of patients who require ablation with radioiodine.

Adolescent↗
PubMedDate not supplied

Empiric treatment of minimally abnormal papanicolaou smears with 0.75% metronidazole vaginal gel.

BACKGROUND: The purpose of this study was to compare the efficacy of 0.75% metronidazole vaginal gel with no treatment in patients who have had a minimally abnormal Papanicolaou smear. METHODS: One hundred forty-five patients whose initial Papanicolaou smears were limited by inflammation or benign cellular changes, reactive cellular changes, or atypical squamous cells of undetermined significance that did not favor a neoplastic process were randomized to 5 days of treatment with 0.75% metronidazole vaginal gel or to a control group receiving no treatment. Papanicolaou smears were repeated after 3 to 4 months. RESULTS: Cytologic findings of the follow-up Papanicolaou smears were normal in 61 of 114 (54%) of patients. Sixty-two percent (n = 37) of the Papanicolaou smears in the control group converted to normal on follow-up, whereas 44% (n = 24) of the Papanicolaou smears in the treatment group converted to normal (P = .07). Only one follow-up Papanicolaou smear worsened to low-grade squamous intraepithelial lesion. In no subgroup was treatment effective. CONCLUSIONS: Empiric treatment for an asymptomatic, minimally abnormal Papanicolaou smear with 0.75% metronidazole vaginal gel before a repeated cytologic examination did not improve the rate of reversion to normal cytologic findings.

Adult↗
PubMed2002

Elastofibroma dorsi. Report of five cases and review of the literature.

Five cases of elastofibroma dorsi are described. The location of the lesions (bilateral in one case) was typical, in the thoracoscapular region. In the first case the diagnosis was established by biopsy; in the remaining cases the diagnosis was suspected based on clinical and magnetic resonance imaging findings and was confirmed by histopathological study after surgical excision. Although these lesions are benign, histological study is advisable to establish a differential diagnosis with malignant neoplastic processes.

Biopsy↗
PubMed2002

A case report of inflammatory pseudotumor of the lung: rapid recurrence appearing as multiple lung nodules.

An inflammatory pseudotumor (IPT), known as a plasma cell granuloma, is a relatively uncommon neoplasm with an unidentified etiology. To our knowledge, an early relapse with multiple lung nodules following lung resection and occurrences in multiple organs is extremely rare. The patient was a 49-year-old man who presented with left chest pain and fever. A chest film demonstrated an 8x8 cm mass in the left lower lobe. During thoracotomy in April 2001, a mass was seen to have invaded the diaphragm with remarkable pleural adhesion. The intraoperative pathological diagnosis was infiltration of inflammatory cells with no malignancy. Therefore, a partial resection of the left lower lobe was performed. Three months after the thoracotomy, a chest CT scan disclosed multiple nodular opacities bilaterally, and an open lung-biopsy of the right lung was performed in January 2002. His past history included an excision of a mass on the penis in another hospital in 1994 and a subcutaneous mass that appeared on the right thigh and disappeared spontaneously following a needle biopsy in 1999. Pathologically there was no fundamental difference among his present lesion and the former two. The pathological diagnosis at each occurrence was inflammatory pseudotumor (IPT). In immunohistochemical study, the staining with smooth muscle actin cells was positive, but was negative for the staining with anaplastic lymphoma kinase (ALK). With no evidence of a neoplastic process, these histopathological and immunohistochemical findings could imply that this case may be a postinflammatory reparative reaction, although his condition exhibited the clinically aggressive behavior of suspected lung metastasis.

Humans↗
PubMed2002

Genetic alterations in Barrett's esophagus and esophageal adenocarcinoma.

Barrett's esophagus and esophageal adenocarcinoma are increasing health problems in the Western world. The rise in incidence of esophageal adenocarcinoma is greater than that for any other malignancy in Caucasian populations. The social impact of the disease is stressed in addition by the very aggressive nature of esophageal adenocarcinomas with 5-year survival rates of less than 25%. Far more people develop the premalignant condition Barrett's metaplasia than high grade dysplasia and invasive carcinoma. This means that fortunately not all patients with Barrett's metaplasia will make the progression to high grade disease. It is hoped that by unravelling the molecular mechanisms involved in the neoplastic transformation in Barrett's esophagus it will become possible to predict disease progression in the individual patient. This would be a major step forward in the curative treatment of this disease. In addition, identification of the crucial molecular pathways involved in esophageal adenocarcinogenesis would facilitate the development of new treatment strategies. The molecular mechanisms underlying the initiation and progression of this disease are largely unknown. In this review the histological sequence of Barrett's metaplasia via dysplasia to adenocarcinoma is introduced; then the general molecular concepts of carcinogenesis are explained. Furthermore, the most important esophageal neoplasia related genes are described including their possible role in the neoplastic process. The frequent genomic aberrations are put in relation to the different histological entities. Finally, as future prospect, a molecular grading of esophageal adenocarcinogenesis is anticipated.

Adenocarcinoma↗