2461/3084. Combined thoracoscopy and mediastinoscopy for the evaluation of mediastinal lymph node metastasis in left upper lobe lung cancer. Cervical mediastinoscopy has an important but limited role in the evaluation of mediastinal adenopathy of the aorticopulmonary window in patients with left lung cancer. thoracoscopy is another valuable diagnostic procedure in the assessment of mediastinal adenopathy. Combined thoracoscopic and mediastinoscopic evaluation may be more accurate for assessing mediastinal lymph node metastasis in left lung cancer than either procedure alone. ( info) |
2462/3084. glycogen-rich clear cell carcinoma in the tongue. The case of a minor salivary gland tumour, arising from the tongue, with nodal metastasis is presented. biopsy of the tumour and fine-needle aspiration cytology of the neck swelling showed the presence of a clear cell carcinoma with evidence of nodal metastases. A commando operation was performed and the defect was reconstructed using a local tongue flap. The literature review indicated that the neoplasm was rare and its site of occurrence rather unusual. ( info) |
2463/3084. Calcified lymph node metastases in adenocarcinoma of the colon. Radiologically demonstrable calcification has been described in a variety of primary tumours and metastatic deposits. Dystrophic calcification in retroperitoneal lymph nodes may occur in malignant lymphoma or metastatic carcinoma, most often after radiotherapy or chemotherapy. However, de novo calcification in retroperitoneal lymph node metastases from carcinoma are very rare. Such a case is presented here. ( info) |
2464/3084. Melanotic neuroectodermal tumor of infancy (MNTI) in the epididymis. A case report with immunohistological studies and special consideration of malignant features. Melanotic neuroectodermal tumors of infancy (MNTI) are uncommon, usually benign neoplasms, most frequently found in the maxilla. These tumors are extremely rare in the epididymis. Only 18 cases with this site of origin are documented. We report on the third epididymal MNTI with some morphological characteristics of malignancy but favorable clinical outcome. The 2 cm large tumor of a 6-month-old male infant showed large epitheloid cells in the center and small neuroblastoma-like cells at the periphery. Despite invasion of lymphatics there is no evidence of relapse or metastases during 4 years of follow-up. Immunohistochemically, the large tumor cells were distinctly positive for cytokeratin, vimentin, GFAP, the melanoma marker NKI-C3, NSE, and S100. The small tumor cells were only slightly positive for GFAP, NKI-C3, NSE, and S100 but they were negative for cytokeratin and vimentin. Neurofilament and chromogranin could not be proved in the tumor. ( info) |
2465/3084. Treatment of lymph node recurrence in patients with hepatocellular carcinoma. The clinicopathological features and results of lymph node dissection were investigated in four patients with hepatocellular carcinoma (HCC) who developed lymph node recurrence following hepatectomy. One patient was found to have metastasis in the periportal lymph nodes at the time of a second laparotomy, while the other three developed posterior pancreaticoduodenal lymph node metastasis. All four patients had concomitant cirrhosis of the liver and were negative for hepatitis b surface antigen. No relationship between the site of the primary lesion and the location of lymph node metastasis was found. Two of the four patients are alive and in good health 4 years and 3 months, and 7 years and 3 months after their first operation, respectively. Thus, we conclude that the posterior pancreaticoduodenal lymph nodes are the most common site of lymph node recurrence of HCC, and that dissection of the affected lymph nodes offers the best chance of long-term survival. ( info) |
2466/3084. Superficial spreading type extrahepatic bile duct cancer with lymphatic micrometastasis: report of a case. We report herein the case of a 69-year-old woman with extrahepatic bile duct cancer which had developed superficially along the ductal mucosa without penetrating the fibromuscularis. She underwent a pancreatoduodenectomy; however, micrometastases were found histologically in the regional lymph nodes and she died with involved para-aortic lymph nodes and bone metastases 14 months after the operation. ( info) |
2467/3084. Clear cell odontogenic carcinoma. Report of a case with lymph node and pulmonary metastases. The authors present a case of a rare type of odontogenic tumour, recently described as "clear cell odontogenic tumour". The patient died 5 years after the initial diagnosis with lymph node and diffuse pulmonary metastases. This fact can support the view that this tumour, histologically characterised by the presence of cells with a clear cytoplasm, can behave in an aggressive way and has true metastatic potential, despite the absence of malignant cellular features. ( info) |
2468/3084. Fine-needle aspiration biopsy of pituitary carcinoma with cervical lymph node metastases: a report of two cases and review of the literature. Metastases from pituitary carcinomas are rare lesions that can mimic other tumors on fine-needle aspiration biopsies. Two patients with primary pituitary neoplasms developed cervical lymph node metastases, which were sampled and diagnosed correctly using the fine-needle aspiration biopsy technique. These two cases demonstrate the varied cytologic patterns of pituitary neoplasms, ranging from uniform bland cells to cells with striking anaplastic features. The time period between the onset of symptoms and subsequent metastases is unpredictable as well, underscoring the need for an accurate clinical history before a meaningful cytologic interpretation is made. ( info) |
2469/3084. Retrograde lymphatic metastasis of an ileal carcinoid. BACKGROUND: Carcinoid tumors are uncommon tumors, derived from Kulchitsky cells, which generally follow a slow, orderly metastatic spread. They are often associated with second primary malignant neoplasms either synchronously or metachronously. CASE REPORT: A 62 year old white female with a history of severe dysplasia of the vulva and carcinoid of the distal ileum presented with a presumed vulvar malignancy by biopsy from a referring hospital. She did not have symptoms of the carcinoid syndrome. Wide vulvar excision revealed chronic inflammation without residual tumor. Bilateral superficial and deep inguinal lymphadenectomy revealed metastatic carcinoid. CONCLUSION: The inguinal lymph nodes should be considered a site of distant metastasis for carcinoid tumors of the distal ileum. ( info) |
2470/3084. The role of brachytherapy in the treatment of stage III vaginal cancer. A report of 3 cases. Advanced vaginal cancer has a grim prognosis: management is complicated. It may include surgery which needs to be exenterative if cure is intended, and/or radiation therapy (RT), the dose of which is limited by the radiosensitivity of adjacent structures. We report on 3 cases, in each of which the tumor was located in different anatomic sites, and we demonstrate how therapy was tailored to each situation. All 3 patients had Stage III, squamous cell carcinoma of the vagina. They received external beam irradiation (EBI) 4000-5000 cGy to the pelvis. This is the maximal tolerable dose by most pelvic organs, but is not curative. Therefore brachytherapy was combined with EBI. In one patient brachytherapy was given intraoperatively, following extensive removal of residual tumor in the pelvis. Two patients are alive and free of disease three and six and a half years later, and one patient died of disease five years following therapy. For eradication of advanced vaginal cancer, treatment includes the combination of EBI and brachytherapy with or without debulking surgery, the role of which was not previously described in this setting. Treatment strategy should be adapted to the anatomic location of the tumor, its intravaginal extension and the age of the patient. ( info) |