Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the c...Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.展开更多
AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA wer...AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.展开更多
BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchyma...BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.展开更多
BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of ...BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.展开更多
BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip...BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.展开更多
BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphi...BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.展开更多
Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the acces...Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.展开更多
Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual...Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.展开更多
Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invagina...Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.展开更多
Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and ot...Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and others very rarely, also may clinically mimic meningiomas. Case Description: We present the case of A 28-year-old male patient, with no notable medical history, who presented with worsening headaches for 3 months, imbalance, and visual deficits, An initial MRI revealed extra-axial lesion involving the right Parieto-occipital, The tumor was hypointense on T1-weighted MR images, hyperintense signals on T2-weightedMR images, and heterogeneously enhanced suggestive of a meningioma, total resection was achieved, and the histopathological analysis confirmed the diagnosis of an angioblastic meningioma. However, 15 months later, the patient presented with the same initial visual complaints. A subsequent MRI showed lesion recurrence, leading to a second surgical intervention. The histopathological analysis confirmed the diagnosis of an anaplastic xanthoastrocytoma. Conclusion: This represents an unusual location for an anaplastic pleomorphic xanthoastrocytoma, which should broaden the differential diagnosis of extra-axial lesions.展开更多
Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnos...Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnosis of exclusion requiring Immunohistochemical work-up to exclude other types of tumors. Case Report: We present a case involving an ulcerated solitary lesion on the scalp of an elderly man. Histological examination revealed that the dermal tumor was composed of large pleomorphic, epithelioid, and spindle cells with clear cytoplasm. These cells were negative for cytokeratins, melanocytes and smooth muscle markers, but positive for CD10. These findings are consistent with a diagnosis of clear cell (CC) PDS. Conclusion: PDS is a low-grade malignancy that can recur locally and metastasize, which is distinguished from AFX by its larger size and the presence of aggressive histopathologic features including deeper invasion into the subcutaneous tissue, tumor necrosis, and lymphovascular and/or perineural involvement. Among several histopathologic variants, the CC variant is extremely rare with only two cases of PDS reported in the literature to date.展开更多
Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squa...Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.展开更多
There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epi...There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epitopes of surface proteins, protection against the immune system through tick saliva, the ability to migrate to regions where it is not exposed to the immune system or antibiotics, invagination or invasion within various cells, pleomorphic forms, and the potential to produce biofilms. The window of conventional treatment for Lyme disease is short and has the potential to display different symptoms depending on the strain of Borrelia bugdorferi. These symptoms are dependent on the localization of Borrelia burgdorferi which correlates to the significance of diagnosing Lyme disease early to prevent such a spread throughout the body. Such complications of Borrelia burgdorferi may demand new clinical treatment discoveries for patient fighting the chronic form.展开更多
Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved i...Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved its efficiency by means of high resolution microscopes and in 1934, by controlled clinically tests. However, these results seemed to be unbelievable, since the underlying mechanism was not yet understood. Actually, we are faced with three problems: 1) the functioning of Rife’s supermicroscopes, 2) his observation that bacteria can undergo size reduction, and 3) the decisive resonance phenomenon. We explain the high magnification and resolving power of Rife’s microscopes and show that new discoveries confirm that the postulate of invariable forms of bacteria has to be abandoned. Then we prove that forced oscillations of virus spikes lead to a peculiar resonance, because of nonlinear effects. It causes total destruction of the virus by rupture of its coating. The same theory applies to bacteria and nanobacteria, because of their pili. The worldwide coronavirus pandemic, the constant threat of unpredictable mutations and the now available explanations should make it obvious that biophysical methods cannot be neglected anymore.展开更多
Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant incre...Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant increase in the percentage of 5 and 8 sided cells and a statistically significant decrease in the percentage of six sided cells. Central corneal thickness and the percentage of 4 and 7 and more than 8 sided did not change in a statistically significant way. Comparing the test group and control group, no statistically significant differences were detected in the examined parameters. The present study also shows that the cornea in the eyes with congenital cataract does not show statistically significant changes in the density and the morphology of the corneal endothelial cells and the thickness of the cornea and in terms of corneal thickness in comparison to the corneas of healthy eyes. Although in corneas undergoing cataract occurs statistically significant changes, the influence of the cornea does not affect the improvement in visual acuity which was also demonstrated in this study.展开更多
AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were col...AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.展开更多
Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial ...Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial histogenesis,with some authors favoring an epithelial origin and others favoring a mesenchymal origin.The true origin of these lesions remains unclear at this time.These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important.The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma.Recognition of these differences can significantly affect patient care.These lesions have a unique appearance when imaged with endoscopic ultrasound(EUS),and these lesions can be diagnosed via EUS guided Fine Needle Aspiration(FNA).This manuscript will review the endoscopic,clinical,and pathologic features of these tumors.展开更多
文摘Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.
基金Supported by National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)+1 种基金Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503)Natural Science Foundation of Beijing(No.7222025).
文摘AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.
文摘BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.
基金Supported by the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City,No.2021AD30091.
文摘BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.
文摘BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
文摘BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.
文摘Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.
文摘Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.
文摘Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.
文摘Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and others very rarely, also may clinically mimic meningiomas. Case Description: We present the case of A 28-year-old male patient, with no notable medical history, who presented with worsening headaches for 3 months, imbalance, and visual deficits, An initial MRI revealed extra-axial lesion involving the right Parieto-occipital, The tumor was hypointense on T1-weighted MR images, hyperintense signals on T2-weightedMR images, and heterogeneously enhanced suggestive of a meningioma, total resection was achieved, and the histopathological analysis confirmed the diagnosis of an angioblastic meningioma. However, 15 months later, the patient presented with the same initial visual complaints. A subsequent MRI showed lesion recurrence, leading to a second surgical intervention. The histopathological analysis confirmed the diagnosis of an anaplastic xanthoastrocytoma. Conclusion: This represents an unusual location for an anaplastic pleomorphic xanthoastrocytoma, which should broaden the differential diagnosis of extra-axial lesions.
文摘Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnosis of exclusion requiring Immunohistochemical work-up to exclude other types of tumors. Case Report: We present a case involving an ulcerated solitary lesion on the scalp of an elderly man. Histological examination revealed that the dermal tumor was composed of large pleomorphic, epithelioid, and spindle cells with clear cytoplasm. These cells were negative for cytokeratins, melanocytes and smooth muscle markers, but positive for CD10. These findings are consistent with a diagnosis of clear cell (CC) PDS. Conclusion: PDS is a low-grade malignancy that can recur locally and metastasize, which is distinguished from AFX by its larger size and the presence of aggressive histopathologic features including deeper invasion into the subcutaneous tissue, tumor necrosis, and lymphovascular and/or perineural involvement. Among several histopathologic variants, the CC variant is extremely rare with only two cases of PDS reported in the literature to date.
文摘Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.
文摘There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epitopes of surface proteins, protection against the immune system through tick saliva, the ability to migrate to regions where it is not exposed to the immune system or antibiotics, invagination or invasion within various cells, pleomorphic forms, and the potential to produce biofilms. The window of conventional treatment for Lyme disease is short and has the potential to display different symptoms depending on the strain of Borrelia bugdorferi. These symptoms are dependent on the localization of Borrelia burgdorferi which correlates to the significance of diagnosing Lyme disease early to prevent such a spread throughout the body. Such complications of Borrelia burgdorferi may demand new clinical treatment discoveries for patient fighting the chronic form.
文摘Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved its efficiency by means of high resolution microscopes and in 1934, by controlled clinically tests. However, these results seemed to be unbelievable, since the underlying mechanism was not yet understood. Actually, we are faced with three problems: 1) the functioning of Rife’s supermicroscopes, 2) his observation that bacteria can undergo size reduction, and 3) the decisive resonance phenomenon. We explain the high magnification and resolving power of Rife’s microscopes and show that new discoveries confirm that the postulate of invariable forms of bacteria has to be abandoned. Then we prove that forced oscillations of virus spikes lead to a peculiar resonance, because of nonlinear effects. It causes total destruction of the virus by rupture of its coating. The same theory applies to bacteria and nanobacteria, because of their pili. The worldwide coronavirus pandemic, the constant threat of unpredictable mutations and the now available explanations should make it obvious that biophysical methods cannot be neglected anymore.
文摘Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant increase in the percentage of 5 and 8 sided cells and a statistically significant decrease in the percentage of six sided cells. Central corneal thickness and the percentage of 4 and 7 and more than 8 sided did not change in a statistically significant way. Comparing the test group and control group, no statistically significant differences were detected in the examined parameters. The present study also shows that the cornea in the eyes with congenital cataract does not show statistically significant changes in the density and the morphology of the corneal endothelial cells and the thickness of the cornea and in terms of corneal thickness in comparison to the corneas of healthy eyes. Although in corneas undergoing cataract occurs statistically significant changes, the influence of the cornea does not affect the improvement in visual acuity which was also demonstrated in this study.
文摘AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.
文摘Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial histogenesis,with some authors favoring an epithelial origin and others favoring a mesenchymal origin.The true origin of these lesions remains unclear at this time.These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important.The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma.Recognition of these differences can significantly affect patient care.These lesions have a unique appearance when imaged with endoscopic ultrasound(EUS),and these lesions can be diagnosed via EUS guided Fine Needle Aspiration(FNA).This manuscript will review the endoscopic,clinical,and pathologic features of these tumors.
