1/63. Refractory arthropathy after intravesical bacillus Calmette-Guerin therapy. Usefulness of isoniazide.BACKGROUND: arthritis associated with bacillus Calmette-Guerin immunotherapy usually responds dramatically to nonsteroidal antiinflammatory drug therapy. isoniazid is generally reserved for other complications such as granulomatous hepatitis. CASE-REPORT: A 73-year-old man was admitted for fever, arthritis of the knees and right temporomandibular joint, an inflammatory swelling over the left achilles tendon and bilateral conjunctivitis. The symptoms started in the wake of a course of intravesical bacillus Calmette-Guerin immunotherapy. Laboratory tests showed evidence of severe inflammation. Cultures of blood, urine and joint fluid specimens were negative, as were tests for autoantibodies and serologic tests for organisms known to cause reactive arthritis. Nonsteroidal antiinflammatory therapy was ineffective and glucocorticoid therapy produced only a partial response. All the symptoms resolved under isoniazid therapy in a dosage of 300 mg/day for three months. CONCLUSION: Use of antituberculous agents may be required in some cases of arthritis associated with bacillus Calmette-Guerin immunotherapy, most notably those with severe pyrexia.- - - - - - - - - - ranking = 1keywords = tube (Clic here for more details about this article) |
2/63. Primary tuberculosis of the penis.We present a case of primary tuberculosis of the inner lining of the prepuce in a 63-year-old man. The condition resembled carcinoma. The diagnosis was based on histopathology and on M. tuberculosis culture. Successful treatment was by a combined medical and surgical approach. The rarity of the case is emphasized.- - - - - - - - - - ranking = 6keywords = tube (Clic here for more details about this article) |
3/63. Germline BRCA2 mutation in a patient with fallopian tube carcinoma: a case report.OBJECTIVES: Fallopian tube carcinoma is similar to ovarian and peritoneal carcinoma with respect to histology, response to chemotherapy, and prognosis. BRCA germline mutations have been commonly reported in ovarian and peritoneal carcinoma but rarely in other gynecologic cancers. methods: A patient with fallopian tube carcinoma and a family history of ovarian carcinoma underwent genetic counseling and BRCA testing as did her daughter. RESULTS: The patient and her daughter were found to have a germline BRCA2 mutation. CONCLUSION: Like a family history of ovarian or peritoneal carcinoma, the occurrence of fallopian tube cancer should alert the clinician to the possibility of an abnormality in the breast cancer susceptibility 1 or 2 genes.- - - - - - - - - - ranking = 829.66053035284keywords = fallopian tube, tube (Clic here for more details about this article) |
4/63. Endometrial intraepithelial carcinoma with associated peritoneal carcinomatosis.Endometrial intraepithelial carcinoma (EIC) is a recently described entity, defined as a noninvasive, cytologically malignant lesion that replaces the endometrial surface epithelium. EIC frequently coexists with uterine serous carcinoma (USC) and is hypothesized to be its precursor lesion. However, the clinical significance and biologic potential of finding EIC without USC is not known. We report three postmenopausal women with EIC alone who were found to have multiple, synchronous foci of extrauterine serous carcinoma at presentation. Because the clinical findings in these patients simulated primary peritoneal serous carcinoma (PSC), we compared the clinicopathologic features of these cases with a group of nine bona fide PSCs for which exhaustively sectioned endometria, fallopian tubes, and ovaries were available for review. The average age of the EIC patients was 73 years. Two patients presented with abdominal distention and one with vaginal bleeding. hysterectomy in each case showed endometrial polyps with EIC, but without invasive USC, in a background of atrophic endometrium. Bilateral salpingo-oophorectomy and staging showed serous carcinoma involving the ovarian hilum, the surfaces of the fallopian tubes and ovaries, in addition to peritoneal carcinomatosis. p53 overexpression was observed in both EIC and the extrauterine deposits of serous carcinoma in each case. The average age of the PSC patients was 66 years. All nine patients presented with abdominal distention. EIC was not identified in any of the hysterectomy specimens. Bilateral salpingo-oophorectomies, omentectomies, and peritoneal biopsies showed peritoneal carcinomatosis, including bulky peritoneal tumor deposits, but only minimal ovarian surface involvement. p53 overexpression was observed in seven cases. These findings indicate that EIC without coincident USC can be associated with invasive, extrauterine serous carcinomatosis. We did not, however, find any significant differences between the clinicopathologic features of primary extrauterine serous carcinomas (PSCs) and those associated with EIC. We conclude that the finding of EIC in an endometrial curettage specimen should prompt a thorough search for an invasive uterine and/or extrauterine serous carcinoma. Conversely, an endometrial origin should be excluded in patients with peritoneal carcinomatosis.- - - - - - - - - - ranking = 276.22017678428keywords = fallopian tube, tube (Clic here for more details about this article) |
5/63. Long-standing painless intussusception in adults.Long-standing painless intussusception in adults is considered to be rare. We report three such cases with an emphasis on color Doppler results. In our three cases the indication for abdominal US was a palpable mass in all these cases, and intussusception was detected by US at a time when the patients had only very mild abdominal discomfort. Persistence of sufficient blood flow, as was suggested by the color Doppler results, was thought to be the most likely pathomechanism of long-standing painless intussusception. The underlying disease was tuberculosis in two of the three cases. Thus, when encountering patients with painless intussusception, tuberculosis must be kept in mind.- - - - - - - - - - ranking = 2keywords = tube (Clic here for more details about this article) |
6/63. The great imitator: miliary peritoneal tuberculosis mimicking stage III ovarian carcinoma.PURPOSE: To report a case of peritoneal tuberculosis initially mistaken at the time of surgery for metastatic ovarian carcinoma. CASE REPORT: A 31-year-old Filipino female was found to have increasing abdominal pain, ascites, early satiety, increasing abdominal girth and bilateral complex masses. Diagnostic laparoscopy revealed the presence of > 4 liters of ascites, a frozen pelvis secondary to what appeared to be bilateral ovarian carcinomas, along with miliary seeding of the entire anterior abdominal wall, omentum, small bowel and small bowel mesentery, right and left diaphragmatic surfaces, and hepatic surface. Frozen section, at the time of laparotomy, revealed necrotizing granulomas most consistent with disseminated tuberculosis that was confirmed at the time of final pathologic review and culture. CONCLUSION: Peritoneal tuberculosis can be mistaken for widely metastatic ovarian carcinoma at time of surgery.- - - - - - - - - - ranking = 7keywords = tube (Clic here for more details about this article) |
7/63. Superficial depressed early carcinoma that developed into protuberant advanced carcinoma in the transverse colon.A screening colonoscopic examination in a 70-year-old man revealed a nonpolypoid type superficial depressed early carcinoma, about 2cm in diameter, in the transverse colon. The lesion was not resected and was observed because of coexisting nonresectable hepatocellular carcinoma (HCC). Fifteen months later, follow-up examinations revealed a polypoid type protuberant advanced carcinoma, about 6 cm in diameter, at the same site. Because complete response of the HCC had been induced by transarterial embolization, the colon carcinoma was operatively resected. There is an indefinite concept that colorectal carcinomas develop without substantial morphological changes, and no superficial depressed carcinoma that developed into a protuberant type advanced carcinoma has been reported. The case reported here provides evidence that some polypoid carcinomas arise from superficial depressed precursors. There is some intermingling between the two postulated colorectal carcinogenic pathways, the conventional polypoid pathway named the "adenoma-carcinoma sequence", and the nonpolypoid pathway, including so-called "de-novo" carcinogenesis.- - - - - - - - - - ranking = 6keywords = tube (Clic here for more details about this article) |
8/63. A case of spindle cell carcinoma of the breast--long survival achieved by multiple surgical treatment.Spindle cell carcinoma of the breast was formerly called carcinosarcoma, and is relatively rare. We report a case of spindle cell carcinoma of the breast. The patient was treated with multiple surgeries and achieved long-term survival. The patient was a 52-year-old woman, in whom small induration developed at the areola of the nipple of the right breast. The lesion was resected, and benign tumor was diagnosed pathologically. Four years later, she had recurrence at the scar, and a typical mastectomy was performed. A tumor developed again 5 years later; the lesional focus was at the scar of the right chest wall and invasion of the ribs and the sternum was noted. The sternum and the right costal cartilage of ribs 3-9 were dissected together. The right chest wall was reconstructed and adjuvant radiation therapy performed. Four years after this operation, tumor recurred near the scar and chest wall resection including part of the pericardial cavity and the left lung was performed. However, 6 months later, invasion of the mediastinum, heart and lung were noted. The patient died 16 years after the first surgery. dermatofibrosarcoma protuberance of the breast was diagnosed at the second operation. However, the diagnosis was changed to spindle cell carcinoma of the breast following immunohistochemical studies. Spindle cell carcinoma of the breast is rare, and definitive histopathological diagnosis is often difficult. When spindle cell carcinoma is suspected, comprehensive diagnostic studies including immunohistochemical examinations should be performed. Even in case with multiple recurrences correctly performed operations may contribute to prolongation of survival.- - - - - - - - - - ranking = 1keywords = tube (Clic here for more details about this article) |
9/63. Primary tuberculous stricture of the oesophagus mimicking carcinoma.A middle-aged woman presented with progressive dysphagia and weight loss was investigated. A stricture involving the lower third of oesophagus was identified but precise histology of the lesion could not be obtained even after multiple biopsies. The resected specimen showed histology consistent with oesophageal tuberculosis.- - - - - - - - - - ranking = 5keywords = tube (Clic here for more details about this article) |
10/63. Relapsed, poor-prognosis ovarian cancer, individualized, interdisciplinary treatment approach, and quality of life: a case report.Metastatic ovarian cancer after cisplatin-containing first-line therapy is a disease with poor prognosis. The second-line treatment options currently available can induce objective remissions, but only rarely lead to prolonged periods of response. Thus, the best possible quality of life is the main goal for these patients. We report on the course of disease in a 51-year-old woman who presented with metastatic ovarian cancer that had relapsed to the liver, cisplatin-induced renal impairment, and bone marrow tuberculosis. Because of the severe co-morbidities and the poor prognosis with a life expectancy of less than 6 months, the patient had been rejected by two other hospitals. In presenting this case, we want to demonstrate that despite poor prognostic factors, co-existing morbidity, and serious therapy-related side-effects, it is possible to induce long-lasting remissions leading to sustained quality of life and ultimately to prolong the remaining life-span in selected patients. To reach such a positive outcome, it is necessary to tailor an interdisciplinary treatment approach to each patient's needs. Such treatment approaches are available in dedicated tumor centers.- - - - - - - - - - ranking = 1keywords = tube (Clic here for more details about this article) |
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