1/21. Sentinel-node guided lymph-node dissection for merkel cell carcinoma.Merkel cell carcinoma is an aggressive neuroendocrine skin tumour. Treatment is still debatable. Merkel cell carcinoma resembles malignant melanoma in its cutaneous presentation and its embryonic origin; both have unpredictable biological behaviour, early regional lymph node involvement, early distant metastases and a high recurrence rate. In light of these common features, we used pre-operative lymphoscintigraphy, intraoperative lymph-node mapping and sentinel-node biopsy-a well-described technique for the treatment of melanoma-in a 60-year-old man with Merkel cell carcinoma in the right buttock. Following frozen section identification of a metastatic first-order sentinel node, radical right groin dissection was performed. All the other lymph nodes in this basin proved to be disease-free, including the second-order sentinel node and Cloquet node. The patient is now being treated with adjuvant chemotherapy and radiotherapy. This case shows that sentinel-node guided dissection is applicable to Merkel cell carcinoma.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/21. Mixed columnar cell and tall cell variant of papillary carcinoma of thyroid: a case report and review of the literature.Columnar cell and tall cell carcinomas are newly described variants of papillary thyroid carcinoma associated with aggressive clinical behaviour. Although several cases of tall cell and columnar cell variants have been reported, only a single detailed case report of a mixed tall cell and columnar cell variant has been described in the English-language literature. We report another such composite tumour with predominant columna cell features in an elderly female. The tumour showed extrathyroidal extension with intraluminal superior thyroid vein invasion and lymph node metastasis. dna ploidy analysis showed a diploid dna content with no increase of S-phase fraction. immunohistochemistry showed focal positivity for p53 and Ki-67 at the infiltrating margins of the tumour and diffuse positivity for proliferating cell nuclear antigen. The adverse clinical course warrants aggressive treatment and careful follow-up.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/21. Intracapsular carcinoma ex pleomorphic adenoma. Report of a case with unusual metastatic behaviour.Intracapsular carcinomas ex pleomorphic adenoma are exceedingly rare salivary glands tumours, known to have a benign clinical behaviour with metastatic unrecognised potential. We report a case of a 57-year-old female patient presenting with a typical example of intracapsular carcinoma ex pleomorphic adenoma of the parotid gland and evidence of ipsilateral cervical lymph node metastases two years before. The behaviour of this unique case illustrates the disputed malignancy of carcinomas arising within encapsulated pleomorphic adenomas.- - - - - - - - - - ranking = 6keywords = behaviour (Clic here for more details about this article) |
4/21. carcinosarcoma of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcoma components.We report a case of true malignant mixed tumour (carcinosarcoma) of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcomatous components in a 68-year-old woman. The pleomorphic sarcomatous component behaved aggressively with lymph node and distant metastases. The biological behaviour of the individual components in a malignant mixed tumour makes it difficult to diagnose. We could find no previous report of epithelial-myoepithelial carcinoma as a component of a carcinosarcoma of the parotid.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/21. Metastasising congenital subcutaneous sacrococcygeal ependymoma.A case of myxopapillary ependymoma located subcutaneously in sacrococcygeal area of a 18 months male child with metastasis to right inguinal lymph nodes is described; the tumour was present since birth. Histological examination of the tumour besides myxopapillary structures, also revealed an ependyma lined cystic space, resembling ventricular cavity. So far only two cases of congenital metastasising subcutaneous sacrococcygeal ependymoma have been described. However, the present case had a very aggressive post-operative biological behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/21. Treatment policy of neuroendocrine small cell cancer of the cervix.Small cell cancers of the cervix are very rare and aggressive tumours. It is difficult to manage these tumours. They are often diagnosed in an advanced stage and their prognosis is generally poor. There are no clinical trials, due to their rarity, that would suggest optimal treatment. The present report describes a patient with a neuroendocrine small cell cancer of the cervix Stage IB2 with a positive lymph node. The treatment consisted of radical hysterectomy and node dissection, adjuvant chemotherapy, chemoradiation and brachytherapy. Currently, after 52 months, the patient is well and free of disease. Since 1996, there has been a classification for neuroendocrine tumours (NETs) of the cervix in four categories (large cell, small cell, typical carcinoid and atypical carcinoid). The aggressive behaviour of neuroendocrine small cell cancer is demonstrated by the high percentage of early lymphatic node and vessel invasion (68 and 90%). Almost half of the patients with Stage I and II will recur with an estimated 5-year survival from 14% to a maximum of 55%. Multimodal therapy for these tumours appears to give good response but often implies severe side-effects.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/21. Malignant paraganglioma of the glomus jugulare: a case report.Jugular paragangliomas are noted for their tendency to recur, but frank malignant behaviour is rare. We report a case in which a patient harbouring a recurrent tumour of the glomus jugulare re-presented with metastatic spread to mediastinal lymph nodes. review of the 16 reported cases provides information which can be a basis for management of the malignant form of this tumour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
8/21. Acinic cell carcinoma of minor salivary gland origin.The occurrence of acinic cell carcinoma in the minor salivary glands appears to be exceptional. A review of the English language literature revealed about 80 previously reported cases. In this paper, the clinical behaviour and pathological findings in three cases are reported. The tumours took their origin from the hard palate, soft palate and lower lip. The three cases presented with malignant clinical behaviour; all three recurred. In one case the local recurrence was multinodular with capsular infiltration. Two cases developed regional lymph node metastasis, and one metastasized to the lung and liver. In one the tumour infiltrated bony structures, and nerve in another. These cases tend to support the belief of some authors that acinic cell 'tumours' are clinically malignant and should be included in the carcinoma group.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
9/21. Recurrent oral carcinoma in Ferguson-Smith disease.A patient with multiple self-healing squamous cell carcinomas of the skin is presented. mucous membrane involvement in this condition is very uncommon and the lesions may show aggressive behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
10/21. Clear cell sarcoma with melanin: report of two cases.Two cases of clear cell sarcoma, one with many melanin pigmented cells and the other scanty, are described. Both are associated with tendons of the lower extremities of young Chinese adults. Their clinical behaviour differed vastly; one patient was dead seven months after local excision and block dissection of regional lymph nodes, while the other had a history of the growth of eight years prior to local excision and is well four years later.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
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