1/17. Advanced adenosquamous carcinoma of the gallbladder with bilio-biliary fistula: an uncommon case treated by hepatopancreatoduodenectomy.A 70 year-old female, who presented with jaundice and abdominal pain, was found to have an advanced gallbladder cancer involving the liver parenchyma, duodenum, and transverse colon. This was complicated by a bilio-biliary fistula between the gallbladder and both the right and left hepatic ducts. After obtaining an accurate pre-operative diagnosis, the patient underwent hepatopancreatoduodenectomy (HPD) with lymph node dissection around the hepatic pedicle, celiac trunk, aorta, and inferior vena cava. Histologic examination revealed adenosquamous carcinoma. This rare variant accounts for 3.5% of gallbladder cancers, and is associated with a worse prognosis than adenocarcinoma. The patient is in good condition without any signs of recurrence 42 months after the HPD. In this case report, we discuss the histological type and internal biliary fistula with regard to the literature, and the usefulness of an aggressive surgical procedure such as HPD with extended lymph node dissection which can improve survival and quality of life in selected patients.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/17. Multiple pulmonary infarctions associated with lung cancer.We present a case of right lung adenosquamous cell carcinoma that had obstructed the main pulmonary artery and superior pulmonary vein, causing multiple pulmonary infarctions in the right upper and middle lobes. Multiple peripheral pulmonary nodules showed clinical features that are characteristic of pulmonary infarction: rapid appearance and gradual reduction in size, pleural-based parenchymal density with a truncated apex and a round nodular shadow with a blurred margin and a centrally directed linear shadow. The nodules were more intense than the primary tumor in both T1- and T2-weighted magnetic resonance imaging (MRI). We conclude that pulmonary infarction can look like a nodule when lung cancer invades both the pulmonary artery and vein and that such cases can be distinguished from pulmonary metastasis by MRI, computed tomography and a series of radiological examinations.- - - - - - - - - - ranking = 0.099827005233336keywords = upper (Clic here for more details about this article) |
3/17. Primary adenosquamous and squamous cell carcinoma of the upper urinary tract. Report on three cases.Three cases of adenosquamous cell carcinoma and squamous cell carcinoma of the upper urinary tract are presented. The fact that the urothelium normally has no glandular or squamous structures renders the pathogenesis of these tumours interesting. The process is assumed to begin with an urothelial metaplasia resulting from a reaction to chronic irritation, leading to dedifferentiation, dysplasias and, in the end, to a squamous cell carcinoma or adenocarcinoma. The relevant medical histories include chronic episodes of pyelonephritis or nephrolithiasis. diagnosis, therapeutic approaches and prognosis of these rare tumours are discussed.- - - - - - - - - - ranking = 0.49913502616668keywords = upper (Clic here for more details about this article) |
4/17. Pancreatobiliary adenosquamous carcinoma (report of two cases).Adenosquamous carcinomas are rare malignant tumors of the pancreas and periampullary region. We present two cases of pancreatic and periampullary adenosquamous carcinoma with clinicopathologic, histo- and immunohistochemical findings. A 51-year-old and a 48-year-old man presented with right upper quadrant pain of three months duration and jaundice for two weeks. Both cases had an elevation of liver enzymes and CA 19-9. In the first case, computerized tomography showed a 3 cm-mass at the pancreatic head. In the second one, endoscopic retrograde choledocopancreatography (ERCP) revealed a mass at the ampulla Vateri localization. A pancreatoduodenectomy was performed for both cases. Gross pathologic examination displayed a solid, gray-white colored 4 cm-tumor at the pancreatic head and a solid, pink-white colored, 2 cm-tumor at the periampullary region bulging into the duodenal lumen. Microscopically, both tumors were composed of solid nests of squamous cells with pearl formation and mucin-containing glandular cells and diagnoses were adenosquamous carcinoma. Furthermore, histo- and immunohistochemical findings were consistent with microscopic diagnoses.- - - - - - - - - - ranking = 0.099827005233336keywords = upper (Clic here for more details about this article) |
5/17. Adenosquamous carcinoma of the jejunum.Primary adenosquamous carcinomas of the intestine are rare, particularly in the small intestine. One case, in the jejunum of an adult female, is described here. The patient was a 70-year-old Japanese woman presenting with upper abdominal pain. Computed tomography of the abdomen showed a mass in the small intestine, measuring 86 x 44 mm, and a double-contrast barium study revealed a filling defect in the upper jejunum. The patient was diagnosed as suffering from upper small-intestinal cancer, and surgical excision was performed. Histological examination, including immunohistochemistry and electron microscopy, revealed the tumor to have both malignant glandular and squamous components. A review of the literature regarding this type of lesion is presented.- - - - - - - - - - ranking = 1.2994810157keywords = abdominal pain, upper (Clic here for more details about this article) |
6/17. Mucoepidermoid carcinoma (adenosquamous carcinoma) treated with Mohs micrographic surgery.BACKGROUND: Mucoepidermoid carcinoma (MEC), sometimes referred to as adenosquamous carcinoma (ASC), is a common malignant tumor of the salivary glands that can also develop from the esophagus, lacrimal passages, lung, upper respiratory tract, pancreas, prostate and thyroid. Rarely, MEC will present primarily in the skin. CASE: We present a case of primary MEC of the lower eyelid treated successfully with Mohs micrographic surgery. RESULTS: Mohs micrographic surgery was performed because of the highly aggressive and unpredictable nature of this tumor. The tumor was completely excised using Mohs with negative margins achieved in three stages. The patient has been disease free for 3 years since the surgery. CONCLUSION: We offer Mohs as an option for treating MEC.- - - - - - - - - - ranking = 0.099827005233336keywords = upper (Clic here for more details about this article) |
7/17. Case report: adenosquamous carcinoma of the liver successfully treated with repeated transcatheter arterial infusion chemotherapy (TACE) with degradable starch microspheres.This report describes a 58-year-old female with adenosquamous carcinoma (ASC) of the liver presenting with right lower abdominal pain. In most ASC of the liver, surgery is the first choice of treatment. However, surgery often seems to be ineffective because of the aggressive behaviour of this disease. At surgical laparotomy in the present case, there was a large tumour occupying the entire right lobe of the liver and invading the diaphragm. Thus, partial hepatectomy was performed. For the residual tumour, we performed repeated transcatheter arterial infusion chemotherapy with degradable starch microspheres (DSM). After four sessions of transcatheter arterial infusion chemotherapy, tumour size decreased remarkably and tumour markers had also decreased. Despite the poor prognosis, the patient remains alive and well 12 months after laparotomy. It is suggested that minimally invasive transcatheter infusion chemotherapy with DSM can be an effective treatment preserving a high quality of life.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/17. Paraneoplastic hypercalcemia with adenosquamous carcinoma of the colon.hypercalcemia is a well-known manifestation of paraneoplastic syndromes associated with a variety of malignancies. However, colon cancer has only rarely been associated with hypercalcemia. Here we present the first case of adenosquamous carcinoma of the sigmoid colon in a patient who was found to have hypercalcemia associated with parathyroid hormone-related protein (PTHrP), with no radiological evidence of metastasis to other organs. A 78-year-old woman was admitted to our hospital complaining of lower abdominal pain. physical examination and computed tomography revealed a tumor, 13 cm in diameter, in the sigmoid colon. Laboratory data showed an elevated serum calcium level (11.2 mg/dl). Primary colostomy was performed. After the primary operation, the patient was found to have hypercalcemia and an elevated PTHrP level. We performed sigmoidectomy, total hysterectomy, and partial urinary bladder resection 1 month after the primary operation, and both PTHrP and calcium levels immediately returned to normal. The histopathologic diagnosis was poorly differentiated adenosquamous carcinoma. The patient died due to tumor recurrence 4 months after the second surgery.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/17. Adenosquamous carcinoma of the pancreas with an acantholytic pattern together with osteoclast-like and pleomorphic giant cells.A 45 year old man presented with abdominal pain, loss of appetite, and significant weight loss over a period of about four weeks. Imaging of the abdomen showed a mass in the region of the head of the pancreas. In view of the size of the mass and the clinical picture, a Whipple's procedure was performed. Histological evaluation of the pancreatic tumour showed an adenosquamous carcinoma (predominantly composed of squamous carcinoma), which was extensively infiltrative with perineural invasion and involvement of peripancreatic lymph nodes. Areas of pancreatic intraepithelial neoplasia grade III and merging of the squamous and adenocarcinoma components were evident. Unusual histological features that characterised this case included a pronounced acantholytic pattern within the squamous carcinoma component, and the presence of both osteoclastic and pleomorphic giant cells. giant cells have not been documented previously in association with an adenosquamous carcinoma. Although an acantholytic pattern has been noted in squamous carcinomas in other sites, this is the first report of such a pattern in an adenosquamous carcinoma of the pancreas.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/17. gallbladder adenosquamous cell carcinoma: report of two cases.adenocarcinoma is the usual histological presentation of the very rare gallbladder carcinoma. Adenosquamous cell carcinoma accounts for less than 3.5% of gallbladder carcinomas, and is characterised by invasive growth, a reduced tendency for lymph node metastasis, an increased tendency for hepatic infiltration or liver metastasis, and a poorer prognosis than adenocarcinoma. We present two cases. The first patient presented to our institution with increased bilirubin levels and dilated intra- and extrahepatic bile ducts. Adenosquamous carcinoma of the gallbladder was diagnosed on the post-operative pathological specimen. After surgery, bilirubin levels decreased, but hepatic metastases occurred that did not respond to conventional chemotherapy. The second patient was admitted to our hospital with jaundice and abdominal pain. Abdominal computed tomography (CT) imaging showed marked thickening of the gallbladder with direct extension of a mass into the left liver lobe. Cytology specimens obtained with an endoscopic retrograde cholangiopancreatography (ERCP) procedure revealed a malignant epithelial tumour. The patient underwent surgery but the tumour was incompletely resected. A regimen of oral UFT (tegafur uracil) chemotherapy was begun. serum bilirubin levels increased due to occlusion in the surgical area 15 weeks after the start of chemotherapy.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
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