761/1569. Argyrophil carcinoma of the breast: a cytologic, histochemical, and ultrastructural study of a case. Aspirate from an argyrophil carcinoma ("carcinoid") of the breast showed malignant dispersed epithelial cells. With Diff-Quik, the cytoplasm was seen to be abundant, with prominent eosinophilic granularity. The nuclei were fairly uniform, round or oval, and eccentric and had a finely stippled chromatin pattern. On histology, the tumor appeared typical for argyrophil carcinoma, and staining with Grimelius for argyrophilic granules was positive. Membrane-bound neurosecretory granules were seen on electron microscopy. ( info) |
762/1569. Splenic metastasis in an ileal carcinoid tumor. The case of an ileal carcinoid tumor metastatic to the spleen causing splenomegaly and symptoms that necessitated splenectomy is described. Morphological analysis reveals that viable tumor cells are present along the whole pathway of splenic circulation and, accordingly, may lead to metastatic deposits at different sites within the spleen. ( info) |
| A case of laryngeal carcinoid in a 54-year-old Korean female is reported and discussed. This tumor is extremely rare in the larynx and there have been just over twenty cases reported in the literature to date. The case showed an initial histologic finding of epithelial dysplasia and was finally confirmed to be a carcinoid tumor. Laryngeal carcinoids are often atypical histologically and may be misdiagnosed as undifferentiated carcinoma. An electron microscopic study revealed neurosecretory-type granules. Although the patient underwent a total laryngectomy and radical neck dissection, multiple hepatic metastasis was noted postoperatively. ( info) |
764/1569. Long term treatment with tamoxifen for metastatic carcinoid tumor. carcinoid tumor associated with carcinoid syndrome is a very difficult condition to treat. Many different drugs have been used in order to control symptoms and different antineoplastic agents were experimentated to reduce the often large neoplastic lesions. Recently the description of the existence of estrogen receptors in carcinoid tumor tissue arose great enthusiasm on the possibility of using the antiestrogen tamoxifen as a direct antitumor agent. Few experiences appeared in the international literature and contrastant results were reported. In this paper we describe one case of long term treatment with tamoxifen for a metastatic carcinoid tumor. The patient experienced the regression of carcinoid syndrome symptoms with tamoxifen therapy. Unfortunately after one year symptoms reappeared in spite of tamoxifen therapy. We conclude that tamoxifen is at the moment the best therapy in patient affected by carcinoid tumor associated with carcinoid syndrome. Data on other drugs as the oral analogues of somatostatin or Calcitonin need to be confirmed by additional studies. ( info) |
| A 53-year-old male Caucasian presented with a massive liver tumor composed entirely of spindle-shaped cells showing light-microscopic and ultrastructural evidence of rhabdomyoblastic differentiation. No epithelial or other sarcomatous elements were included. Detailed postmortem examination failed to reveal evidence of metastatic tumor or an alternative primary site. There have been only four previous cases of primary rhabdomyosarcoma of the adult liver, all occurring in Japanese men. ( info) |
766/1569. An unusual second primary tumor. Report of a case of atypical carcinoid of the lung. This case report presents a rare occurrence of two primary tumors in the same patient: a transitional cell carcinoma of the bladder and an atypical carcinoid of the lung. The time interval between a linear density and tumor growth to 3 cm, determined by chest radiographs, was 9 months. The rapidly growing pulmonary nodule was suspected to be a metastasis from the primary transitional cell carcinoma. Fine-needle aspiration revealed malignant cells. Lobectomy and light and electron microscopy revealed an atypical carcinoid. The definition of "atypical" requires revision to indicate this tumor's true potential. ( info) |
767/1569. Inadvertent pancreatic embolization as a complication of hepatic carcinoid treatment--computed tomography appearance. A patient with hepatic metastases from a carcinoid tumor was treated by hepatic artery embolization and developed pancreatitis. A subsequent computed tomography scan (CT) demonstrated evidence of pancreatic embolization. The CT findings are reviewed as well as the probable mechanism of the development of pancreatitis. ( info) |
768/1569. Atypical carcinoid of the larynx: case report. The authors describe a rare case of laryngeal atypical carcinoid. They discuss the histologic pattern of the neoplasm and the differential diagnosis of laryngeal tumors, particularly with oat-cell carcinoma. These tumors represent a spectrum of neoplasms with endocrine differentiation. ( info) |
| A carcinoid tumour presenting as Cushing's syndrome is reported. Although no tumour mass could be initially identified the patient returned with first a liver and subsequently a cerebellar mass both of which were resected. Only at post-mortem was the lung primary discovered. ACTH, gastrin-releasing peptide (GRP) and calcitonin gene-related peptide were elevated in plasma before resection of the hepatic tumour. These peptides were demonstrated in both the hepatic and cerebellar tumours by immunocytochemistry and radioimmunoassay. This case illustrates the occasional tendency of primary lung carcinoids to remain small and clinically undetectable while generating secondary tumours which are symptomatic. It is suggested that immunological demonstration of GRP may be diagnostically helpful in directing attention to the lung as a primary site in neuroendocrine tumours which present in this fashion. ( info) |
770/1569. Adenocarcinoid tumor of appendix presenting as unilateral krukenberg tumor. We report a case of adenocarcinoid tumor of the appendix that presented initially as a unilateral krukenberg tumor (a signet ring cell mucinous adenocarcinoma with prominent cellular stroma). The primary tumor in the appendix was discovered 10 months later at the time of a "second look" laparotomy. The ovarian metastasis showed both goblet cell elements and tubular formations with numerous argyrophilic cells, indicating that both components of these tumors may metastasize, a finding at variance with the conclusions of some authors who suggest that only the mucinous component may metastasize. Theories of histogenesis of these tumors are discussed, and 12 previously reported cases presenting as Krukenberg tumors (all bilateral) are reviewed. Because the primary tumor in the appendix may be small and easily missed, appendectomy is recommended in all patients with Krukenberg tumors when another primary site cannot be identified at the time of surgery. ( info) |