Cases reported "Bone Neoplasms"

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1/97. US and CT findings of multicentric leiomyosarcomatosis.

    This article presents a case of leiomyosarcomatosis with widespread lesions involving the soft tissues and the most unlikely organs such as thyroid and salivary glands, pancreas, ligamentum teres, bladder wall, and bones without lymph node or distant metastasis. The CT and US findings of this rare phenomenon are discussed with regard to the literature.
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2/97. Pathologic fracture of the humerus due to metastatic cholangiocarcinoma.

    cholangiocarcinoma is a rare tumor of the bile duct system known to frequently metastasize to the axial skeleton, lungs, adrenal glands, brain, and lymphatic system. Spread to the long bones has not previously been reported in the literature partly because of the short life expectancies of patients with this disease. We discuss a case of a pathologic humerus fracture due to metastatic cholangiocarcinoma.
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3/97. Parotid lymph node metastasis from adenocarcinoma of the urachus.

    The parotid gland and its lymph nodes are frequent sites of metastases from head and neck cancers. However, metastasis from a distant primary below the clavicle is unusual. These originate from a variety of sites, most commonly the lung, kidney and breast. A case of a 59-year-old woman with parotid lymph node metastasis from an adenocarcinoma of the urachus, diagnosed on the basis of two discrete periparotid masses on CT and the patient's history, is presented.
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4/97. The beginnings of radioiodine therapy of metastatic thyroid carcinoma: a memoir of Samuel M. Seidlin, M. D. (1895-1955) and his celebrated patient.

    Emerging from a stimulating encounter over fifty years ago between Dr. S. M. Seidlin and a celebrated patient at Montefiore Hospital in new york city are a number of findings that bear significantly on the contemporary practice of medicine relating to targeted radioisotope therapy. In 1943, Seidlin administered radioiodine to this patient, who was hyperthyroid although previously thyroidectomized, but who had several metastases from adenocarcinoma of the thyroid which localized the radioisotope. Seidlin recognized early that some thyroid metastases would take up radioiodine (i.e., function), but only after the normal thyroid gland was ablated, an essential preliminary procedure before radioiodine therapy should be administered, the clinical practice followed to this day. He held that removing the normal thyroid increased TSH production and eliminated the gland's competition for radioiodine, inducing the metastases to function. From 1942 until his death in 1955, Seidlin and his group followed many patients having metastatic thyroid carcinoma, conducting fruitful investigations concerned with the induction of function, dosimetry, and the occurrence of leukemia in some massively treated patients.
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5/97. Malignant pheochromocytoma lacking clinical features of catecholamine excess until the late stage.

    A malignant pheochromocytoma is described in a 71-year-old man. Osseous metastases became manifest 12 years after successful removal of the primary tumor which originated in paraganglionic tissue near the right adrenal gland. Although the patient had no symptoms of catecholamine excess initially, hypertension, tachycardia and excessive sweating appeared several months before his death, concomitantly with a sharp increase in noradrenaline secretion due to an accelerated growth of metastatic tumors. Since there is no histologic criterion of malignancy in this neoplasm, it would be prudent to consider every case of pheochromocytoma as potentially malignant and to follow-up carefully for a long time after removal of the primary tumor.
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6/97. Solitary brain metastasis from papillary thyroid carcinoma in a patient with depression: report of a case.

    Papillary carcinoma of the thyroid is a common thyroid malignancy with a relatively good prognosis. However, distant metastases may develop and become threatening, particularly to older patients, in a more aggressive manner. We report herein the clinical, radiological, and pathological findings of a patient with papillary thyroid carcinoma who had a solitary cerebral metastasis. The patient had been suffering from depression and had already undergone a hemithyroidectomy for primary thyroid carcinoma, and was known to have metastatic thyroid carcinoma of the lungs and bone. After the removal of the remnant thyroid gland prior to radioiodine (131I) therapy, he developed additional problems related to depression. electroencephalography played an important role in identifying suspected brain metastasis and computed tomography demonstrated a space-occupying lesion in the left cerebral hemisphere. Consequently, an early removal of intracranial mass could be performed without any further life-threatening complications. Moreover, after removal of the brain mass the patient's depression improved immediately without the use of any antidepressants. This case report indicates the possibility that a patient's depression might be associated with brain metastasis from papillary thyroid carcinoma, and also suggests that an early diagnosis with the appropriate surgical management of a brain metastasis followed by radioiodine therapy could be valuable for achieving a prolonged disease-free period.
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7/97. Metastatic thyroid cancer occurring as an unknown primary lesion: the role of F-18 FDG positron emission tomography.

    Thyroid cancer can appear as metastatic disease of an unknown primary origin, and fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomographic (PET) studies are helpful in the workup evaluation of these patients. The authors describe two patients who had metastatic disease from an unknown primary lesion. F-18 FDG PET studies played an important role in localizing the primary malignant site in the thyroid gland. The utility of F-18 FDG imaging in decreasing the number of procedures, cost, and inconvenience to patients is shown clearly in both cases.
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8/97. Malignant mixed tumor of salivary gland with a solitary metastasis to the tibia.

    A 23-year-old, male patient previously operated on four times for a recurring, benign, paranasal mass was admitted to our clinic with pain and swelling under the knee. Physical and radiological examination revealed a malignant process. The histopathological examination of the fine-needle biopsy specimen of the tibia was a malignant mixed tumor. Then. en-bloc resection, free fibular grafting, and fixation with blade plate was performed for one-third of the tibia, conserving the knee joint. Recurrences and metastasis were not observed after surgery and radiotherapy.
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9/97. Ewing's sarcoma family of tumor arising in the adrenal gland--possible diagnostic pitfall in pediatric pathology: histologic, immunohistochemical, ultrastructural, and molecular study.

    We present an adrenal Ewing's sarcoma family of tumor (ESFT) arising in an 11-year-old Japanese boy. Although intensive chemoradiotherapy and radical surgery were performed, the patient died of obstinate disease 1 year and 3 months after the initial presentation. The primary site (adrenal gland) with radiologic findings (with foci of calcification), high titer of serum neuron specific enolase, and sheets of monotonous primitive rounded cells on histology mostly favored neuroblastoma. However, a diagnosis of ESFT was confirmed by immunohistochemical profile, including MIC2-positivity and molecular study disclosing EWS-FLI1 chimera gene verified by direct sequencing. Recognition of adrenal ESFT and use of newly developed diagnostic techniques are required for differential diagnosis of undifferentiated small round cell tumor of the adrenal gland.
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10/97. Primary mixed tumor of bone.

    Mixed tumors occur most commonly in major salivary glands. They may rarely appear in other sites, such as skin, breast, and lung. There have been rare reports of similar tumors occurring in bone. We report on a patient with a primary mixed tumor of bone. No other primary site has become apparent on follow-up of 5 years. Although mixed tumors detected by bone biopsy are likely to be metastatic, they may rarely represent primary bone neoplasms.
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