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At least 19 recordsLinked to original sources
PubMed2026

Tumor Mutational Concordance and Recurrence Timing in Hepatocellular Carcinoma.

INTRODUCTION: In hepatocellular carcinoma (HCC), intrahepatic recurrence includes true recurrence from clonal relapse and multicentric recurrence from de novo tumorigenesis. Recurrence timing is used to distinguish these types; however, its accuracy remains unclear. This study aimed to classify recurrent tumors based on somatic mutational concordance and assess the validity of recurrence timing. METHODS: Whole-exome sequencing was performed on paired primary and recurrent HCC tumors from 49 patients enrolled in a prospective institutional omics project. Tumors with &#x2265; 10 shared somatic mutations were classified as true recurrence. Clinicopathological features, recurrence timing, driver mutation patterns, and survival outcomes were compared between recurrence types. Mutational concordance was quantified using shared variant counts and the Jaccard similarity index. RESULTS: Of the 49 patients, 22 (44.9%) showed true recurrence and 27 (55.1%) had multicentric recurrence. Multicentric recurrence tumors harbored no shared variants or only a single shared variant with the primary tumor. True recurrence was associated with significantly higher concordance in histological differentiation and Edmondson-Steiner grading and greater retention of CTNNB1, TP53, ARID1A, and KEAP1 mutations. The number of shared variants (median: 115 vs. 0, and p&#xa0;<&#xa0;0.001) and the Jaccard index (median: 0.44 vs. 0.00 and p&#xa0;<&#xa0;0.001) were significantly higher in the true recurrence group. Recurrence timing was inconsistently correlated with mutational concordance, although a 3-year cutoff yielded significant separation. CONCLUSION: Recurrence timing alone insufficiently reflects clonal relationships. Genomic profiling offers a reliable framework for distinguishing between recurrence types and guiding HCC management.

clonal relapse↗
PubMed1979

[Recurrent carcinoma in situ of the uterine cervix (author's transl)].

Among 228 patients who had previous treatment for carcinoma in situ of the cervix, most by hysterectomy, 3 recurrences in vaginal stumps were detected in women age 36, 46, and 56. In another case a carcinoma in situ of the cervix was found in a 25 year old patient who had a diagnostic and therapeutic conization because of desire for childbearing. The histology of the cone showed no residual carcinoma. Concommitent to the recurrent carcinoma in situ of the cervix a carcinoma of the vulva was detected. Recurrences of carcinoma in situ could occur because of incomplete resection of primary lesion. Wrong classification in the laboratory is possible if the invasion is missed on the microscopic examination and the case therefore receives the wrong treatment. Recurrences which are not true recurrences could arise from multicentric atypical foci of the squamous epitheleum of the -ower female genital tract. These considerations lead to the following recommendations: 1. When the suspected diagnosis carcinoma in situ of the uterine cervix is made a large enough cone biopsy which is appropriately marked is obtained and a complete microscopic examination of the cone must be obtained. 2. A hysterectomy with a large vaginal cuff is the treatment of choice. 3. A careful workup of the operative specimen in the microscopic laboratory is expecially essential. 4. A patient with such previous treatment for carcinoma in situ of the uterine cervix must be urged to continue with regular preventive examinations for cancer. The vaginal stump must be regularly re-examined both by colposcopy and by cytology.

Adult↗
PubMed1979

Localization of pheochromocytoma by selective venous catheterization and assay of plasma catecholamines.

The diagnosis of pheochromocytoma rests primarily on determination of the 24-hour urinary excretion of catecholamines and their metabolites. In most cases nephrotomography and selective arteriography or venography, or both, are sufficient to localize the tumour. Selective venous catheterization and the assay of plasma catecholamines should be considered for pheochromocytoma localization in: (a) patients in whom standard techniques fail to localize the tumour; (b) patients who exhibit idiosyncratic reactions to the angiographic contrast materials; (c) young patients or patients with familial pheochromocytoma, including those with multiple neurofibromatosis or multiple endocrine adenomatosis, type 2; (d) patients with recurrent, malignant, or suspected multicentric or extra-adrenal tumours; and (e) patients excreting only norepinephrine in the urine. The validity of the results is particularly dependent on the skill with which venous catheterization is carried out.

Adrenal Gland Neoplasms↗
PubMed1976

Fibroadenoma of the female breast. Some epidemiologic surprises.

In a study of 70 cases of fibroadenoma of the female breast, two ages of peak incidence were recorded, one of them in the late 20s to early 30s and a second in the late 40s to early 50s. At the time of diagnosis, the lesions usually were less than 3.0 cm in diameter. Almost two thirds of the tumors were situated in the lateral quadrants of the breast. Incidence of fibroadenoma was significantly higher among parous females tham among nulliparas. Review of family histories showed a remarkably high incidence of breast disease of all types in the mothers and sisters of the patients studied. An inordinately high proportion of patients under 40 years of age were nonwhite. Recurrences and multiple lesions were much more frequent in patients over 40. "Recurrences" are undoubtedly serial presentations of multicentric lesions.

Adenofibroma↗
PubMed1978

Radiotherapy of Kaposi's sarcoma.

Between 1958 and 1976, 34 patients with Kaposi's sarcoma were seen. Two patients were kidney transplant recipients. Co-existing malignancies were seen in 22% of patients. From 1958 to 1965, cutaneous lesions were treated solely with local radiotherapy techniques, single doses of 800 rads being found adequate to produce a complete response. In 1965, because of the multicentric occurrence of the disease and frequent recurrences after local radiotherapy techniques, extended field radiotherapy was begun. Ten of twelve patients thus treated responded completely. It is concluded that extended field radiotherapy using a single dose of 800 rads offers complete relief of symptoms and better control of the disease when compared to local radiotherapy. There was very little morbidity, with the extended field technique.

Adult↗
PubMed2026

Craniotomy versus Endoscopic Membranectomy in the Treatment of Non-Homogeneous Chronic Subdural Hematoma: A Pilot Randomized Parallel-Group Active-Controlled Trial (EMiT CSDH 2).

BACKGROUND: Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition with persistent challenges related to recurrence. Endoscopic membranectomy (EM) has shown promising results in managing symptomatic non-homogenous (SNH)-CSDH, but comparative evidence against craniotomy with membranectomy (CM) is lacking. OBJECTIVES: To compare the safety and efficacy of EM versus CM in managing SNH-CSDH. MATERIALS AND METHODS: A pilot randomized parallel-group active-controlled open- labeled superiority trial from September 2023 to November 2024 at Government Kilpauk Medical College, Chennai, India. Sixty patients with SNH-CSDH were randomized into EM and CM groups. Recurrence was the primary outcome. Secondary outcomes included operative time, complications, radiological indices, pain, hospital stay, and functional recovery. All patients were followed for six months. RESULTS: No recurrence was observed in either group at six months. Two CM patients required reoperation on postoperative day one ( P = 0.15). EM was associated with shorter operative time ( P = 0.02), lower incidence of post-operative subdural residual fluid ( P = 0.015), better early hematoma reduction/subdural space reduction index ( P = 0.008), midline shift/symmetry improvement index ( P = 0.001), and lesser surgical site swelling ( P < 0.001). All patients were ambulant and had a Glasgow coma scale (GCS) 15 at discharge and at six months (including reoperated patients). Pain scores and functional recovery were comparable. EM patients had shorter hospital stays ( P = 0.004) and no significant complications. CONCLUSION: EM demonstrated favorable early radiological outcomes, fewer complications, and comparable functional recovery and recurrence versus CM in SNH-CSDH. Independent reproduction and larger multicentric trials are needed for validity and generalizability.

Humans↗
PubMedDate not supplied

Basal cell carcinoma of the vulva.

Basal cell carcinoma was found in eight of 61 cases of vulvar malignancy occurring over a 20-year period. This incidence of basal cell carcinoma was 13.1%, higher than the expected 2%-5% reported previously in the literature. Symptoms of a mass, usually discharge, pruritus or bleeding, were commonly ignored for long periods of time by the elderly patient. The specific location and size were difficult to ascertain from hospital records. Therapy is always surgical with wide local excision recommended. Local recurrence will be noted in 10%-20%, as vulvar basal cell carcinoma is a multicentric lesion and, therefore, long-term follow-up, as with any malignancy, is mandatory. Adequate identification and reporting may well show that this lesion is more common than has been previously thought.

Adult↗
PubMed1979

Granular cell myoblastoma of the head and neck: review of the literature and 10 year experience.

The literature on granular cell myoblastoma (Abrikossoff's tumor) is reviewed and 16 new cases are presented. The etiology of this tumor remains uncertain, although a neurogenic origin appears likely. Individual tumors are usually small, nodular, and nonulcerating. There appeared to be no predilection for either sex in our series, and most tumors occurred between the third and sixth decades of life. Pseudoepitheliomatous hyperplasia is frequently associated with granular cell myoblastoma, and this combination must be distinguished from squamous cell carcinoma. Wide local excision, the treatment of choice, should be curative, although the incidence of multicentricity may exceed 15%. Thus, despite the usually benign nature of granular cell myoblastoma, its propensity for local invasion, multicentricity, and associated pseudoepitheliomatous hyperplasia should alert surgeons to its potential hazards, to the probability of recurrence if it is only marginally excised, and to the possible later development of similar lesions.

Adolescent↗
PubMed1977

Biological factors involved in the clinical features and surgical management of cerebellar hemangioblastomas.

Sixty-five personal cases of cerebellar hemangioblastomas plus others from the literature making a total of 539 cases are reviewed regarding their clinical, biological and surgical aspects. A variable genetic blastomatous growth potential seems to determine the individual biological behavior of these tumors. Retinal angiomatosis, family incidence, multicentric tumors in the central nervous system and in other organs, and some of the so-called recurrences, are considered within this concept.

Adult↗
PubMed2026

IVF patient subgroups benefit from preimplantation genetic testing for aneuploidy: a prospective multicentre cohort study.

RESEARCH QUESTION: Can preimplantation genetic testing for aneuploidy (PGT-A) improve the ongoing pregnancy rate per transfer and reduce miscarriage rate in patients with advanced maternal age (AMA), recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or both, without affecting cumulative pregnancy rate? DESIGN: Prospective cohort study of 260 patients undergoing PGT-A aged 36 years or over (AMA group), with a history of three or more blastocyst transfers without birth (RIF group), two or more early pregnancy losses (RPL group), or all. Trophectoderm biopsy was conducted day 5 or 6, and comprehensive chromosome screening was used for PGT-A before single frozen embryo transfer (PGT-A-FET). A total of 3060 patients undergoing single conventional frozen embryo transfer (FET) served as a historical reference group. RESULTS: Patients had increased odds of positive serum beta-HCG after PGT-A-FET compared with FET in the AMA (OR 1.53, 95% CI 1.06 to 2.21) and RIF (OR 2.11, 95% CI 1.41 to 3.14) groups. The PGT-A-FET group significantly improved the odds of ongoing pregnancy in the AMA (OR 2.20, 95% CI 1.52 to 3.18), RIF (OR 3.96, 95% CI 2.60 to 6.04) and RPL (OR 2.81, 95% CI 1.52 to 5.21) groups. The odds of pregnancy loss were significantly reduced with PGT-A-FET in the AMA (OR 0.36, 95% CI 0.21 to 0.64), RIF (OR 0.10, 95% CI 0.04 to 0.26) and RPL (OR 0.14, 95% CI 0.04 to 0.53) groups. Cumulative pregnancy rate did not differ between PGT-A and conventional cycles (RR 0.94, 95% CI 0.80 to 1.10). CONCLUSIONS: PGT-A improved the odds of ongoing pregnancy and reduced the odds of pregnancy loss in all groups. The cumulative pregnancy rate did not differ between PGT-A and conventional cycles. Findings should be interpreted in the context of the observational design.

Adult↗
PubMed1979

The presentation of gastrointestinal lymphoma: study of a population.

The clinical presentation and findings in 45 patients with lymphoma of the gastrointestinal tract occurring in an unselected population are described. Nineteen patients presented as emergencies with haemorrhage, perforation, pyloric stenosis or intestinal obstruction. Systemic symptoms, peripheral lymph node enlargement and hepatosplenomegaly were rare, and a preoperative diagnosis of lymphoma was seldom made. Endoscopy was superior to radiology in defining lesions in the stomach and duodenum. Lesions which were multicentric, or of unusual macroscopic appearance, were common in the small bowel, and these should raise the suspicion of lymphoma. Local and systemic recurrence was common, but was not always fatal. Patients with gastric lymphomas survived longer than those with intestinal disease.

Adult↗
PubMed1979

Selective management of subphrenic abscesses.

Although extraserous drainage of subphrenic abscesses has gained wide acceptance, there is some renewed enthusiasm for the more frequent use of a transperitoneal operation because it affords the opportunity to discover unsuspected pathologic conditions, particularly heterotopic abscess. In 44 patients with postoperative subphrenic abscesses, the approach to drainage was selected on the basis of the clinical circumstances. Among 28 patients whose abscesses were drained extraserously, the incidence of heteroptic and recurrent abscesses was low. No serious complications of peritoneal or wound soilage occurred after transperitoneal drainage in 16 patients, yet the problems of inadequate drainage and heteroptic abscess were not eliminated. Celiotomy prior to definitive abscess localization was required for 13 patients. Five patients died. The operative approach should be based on the clinical assessment of the patient and particularly on the probability that multicentric intra-abdominal pathologic conditions exist.

Adolescent↗
PubMed1978

Multicentric tracheobronchial and oesophageal granular cell myoblastoma.

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.

Adult↗
PubMed1975

Liver tumors in children in the particular reference to hepatoblastoma and hepatocellular carcinoma: American Academy of Pediatrics Surgical Section Survey--1974.

A review of 227 cases of hepatoblastoma, hepatic cell carcinoma in children seen in the United States over a 10-yr period is presented. Both tumors were seen most commonly in infancy, but the hepatocellular carcinoma shows a second peak of incidence around puberty. Males predominated in both diseases more so in hepatoblastoma. Presenting symptoms in both diseases were very similar, most commonly an upper abdominal mass or abdominal enlargement associated with anorexia and weight loss. In the preoperative evaluation the presence of alpha-feto protein was one of the most helpful diagnostic tests. Disturbances of liver function were usually mild but were more marked in those children with hepatocellular carcinoma. Preoperative x-rays were abnormal in a large percentage of cases with the hepatic arteriogram and vena cavagram being the most useful diagnostic x-rays for liver tumors. Liver scans were positive for liver tumor in 95% of the children when this test was carried out. The follow-up for these patients ranged from 2 to 10 yr. The size of the primary tumor did not appear to correlate with survival but bilateral location of the tumor, 33% in hepatoblastoma and 45% in hepatocellular carcinoma, made many of these tumors inoperable. Multicentric tumors were also found in a large number of patients, being more common in hepatocellular carcinoma. There was a high rate of local recurrence or local extension after operation in both diseases, and metastatic spread was similar being most common to the lungs and abdomen. A wide variety of surgical procedures were carried out in these patients from biopsy only to extended hepatic lobectomy. When incomplete excision or biopsy only was carried out no patient survived in either group. Among the hepatoblastoma patients, 45 of 78 patients who had complete excision are surviving. In the hepatocellular carcinoma patients where the operability rate was much lower 12 of 33 patients are surviving when tumor was completely excised. Complications were frequent, the most common being excessive blood loss at operation. There were eight operative deaths and 17 postoperative deaths in the combined group. There was no evidence that radiation therapy or chemotherapy controlled disease which could not be completely excised surgically. The only direct evidence of a favorable effect of radiation and chemotherapy were three cases of hepatoblastoma in which the tumor changed from inoperable to operable by a combination of radiation therapy and multiple drug chemotherapy. Both tumors are highly malignant, and 90% of the children who died of hepatoblastoma died within 12 mo of diagnosis. In the hepatocellular carcinoma 80% of the deaths occurred within 1 yr of diagnosis. At this time it seems that operative excision offers the only chance of cure in children with these tumors and cure rates of 60% can be expected with hepatoblastoma and 33% in hepatocellular carcinoma if the tumor can be completely excised.

Adolescent↗
PubMed1978

Levamisole in chronic inflammatory diseases.

The use of levamisole in a variety of non-rheumatoid chronic inflammatory diseases has been reviewed. Both the clinical responses and the in vivo and in vitro tests of immunological function during levamisole therapy are discussed in an attempt to correlate the immuno-stimulatory properties of the drug with any therapeutic effect. It was concluded that in many diseases there are conflicting reports on the usefulness of levamisole and that there were few correlates of the therapeutic and immunological effects of the drug. There was, however, evidence that the drug may prove clinically useful and more double-blind, multicentre controlled studies with adequate laboratory testing are needed. At present levamisole would appear to be useful in the treatment of Crohn's disease, recurrent oral ulceration, and herpes simplex infections.

Adult↗
PubMed1978

Sixth interim progress report of the British Institute of Radiology fractionation study of 3F/week versus 5F/week in radiotherapy of the laryngo-pharynx.

The results are reported of the multicentre BIR fractionation trial of 3F/week versus 5F/week in radiotherapy of the laryngo-pharynx. 687 patient records have been analysed with respect to survival rates, recurrence-free rates and laryngectomy-free rates. For the group as a whole these analyses show no difference between the two fractionation regimes. Analysis of the sub-group which had early disease confined to the vocal cords does, however, show a better recurrence-free and laryngectomy-free rate for those patients treated with 5F/week, though the survival rate for the two groups remains similar. Acute and late normal tissue reactions are reported for up to six years after treatment. It appears that treatment with 3F/week can be given safely to patients with advanced disease. The differences between the two treatment groups who had early disease of the vocal cords are discussed, but until more data become available in the future the problems raised cannot be resolved.

Dose-Response Relationship, Radiation↗