1/8. Malignant mesothelioma of the tunica vaginalis: a case with an unusually indolent course following radical orchidectomy and radiotherapy.Malignant mesothelioma (malignant adenomatoid tumour) of the tunica vaginalis testis is a very rare neoplasm with highly aggressive biological behaviour. Treatment is difficult, and widespread local invasion and/or metastatic disease at presentation are associated with a poor prognosis. In this case report we describe for the first time a patient who, despite presenting with locally advanced disease, remains well 10 years after diagnosis and treatment with radical orchidectomy and high dose radiotherapy.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/8. Severe hypoglycaemia associated with a giant solitary fibrous tumor of the pleura.solitary fibrous tumors (SFT) of the pleura are a rare neoplasm, with benign biological behaviour. Recurrences are rare, and no distant metastases are described in the literature. SFT can secrete hormone-like substances, responsible for paraneoplastic syndromes. The authors describe a case of severe hypoglycaemia due to insulin-like growth factor ii (IGF-2)'s secretion by a giant SFT of the pleura. Hypoglycaemia was controlled by the resection of the tumor. Diagnosis and surgical management of these neoplasms are also discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/8. A rare case of solitary fibrous tumour of the pre-sacral space: morphological and immunohistochemical features.A 28-year-old woman presented with abdominal pain. Ultrasonograhic examination showed a pre-sacral mass, with complex structure and well delimitated cystss with thick walls. The resected specimen was 7.5 x 6 x 4 cm in size, well circumscribed and yellow in colour, with cysstic change containing mucoid-like material. Histologically, the lesion was composed of spindle cells with high cellularity and rich vascularization with a haemangiopericytoma-like pattern. The diagnosis of solitary fibrous tumour (SFT) was made. The differential diagnosis for SFT of the pre-sacral spaace involves haemangiopericytoma, GIST, malignant mesothelioma, synovial sarcoma, leiomyomatous tumours and granulosa cell tumour. Immunohistochemical studies revealed reactivity for CD34, CD99 and Bcl-2, but no staining for desmin, inhibin, c-kit, EMA, CK, SMA, S-100 and CD31, confirming a diagnosis of SFT. Although SFT is usually associated with a favourable prognosis, close follow-up is recommended because of the limited information on its long-term behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/8. Metastasizing ectopic thymoma arising in the right thoracic cavity and mimicking diffuse pleural mesothelioma--an autopsy study of a case with review of literature.A case of metastasizing ectopic thymoma arising in the right thoracic cavity and infiltrating the right lung and pleura in a fashion reminiscent of diffuse pleural mesothelioma is presented. An involuted, non-neoplastic thymus was demonstrated microscopically in the anterior mediastinum. No case of thymoma showing the combination of ectopic location and biological malignancy has yet been reported in the literature. The pathogenesis of ectopic thymuses and thymomas is discussed from an embryological standpoint. The discrepancy between morphology and biological behaviour of thymomas is also mentioned with a review of the literature.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/8. Scope of scanning electron microscopy, transmission electron microscopy and freeze fracture technique in diagnostic cytology of effusions.A review of the literature on the application of scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to cytodiagnosis of neoplastic cells in effusion fluid reveals a lack of consensus as to which of the techniques is most beneficial to a cytologist for a satisfactory diagnosis. The purpose of this study is therefore to critically evaluate the relative merits of SEM, TEM and freeze-fracture (FF) techniques in enhancing the diagnostic "sensitivity" of ultrastructural cytology. Two cases of adenocarcinoma, one case of mesothelioma and one case of small cell undifferentiated carcinoma of the lung were studied in detail by SEM, TEM and FF techniques. A comparative analysis of the results demonstrates that SEM is a rapid and useful technique where the microvilli on the tumour cell surface is the most prominent feature especially in adenocarcinomas. The major handicap of SEM becomes evident in cases where the extreme variability of the surface morphology amongst tumour cells makes it difficult to establish a diagnosis with confidence. TEM along with light microscopy (LM) of toluidine blue sections gives us the most comprehensive method for cyto-diagnosis and is particularly useful in cases where LM cytology alone is inconclusive. It has the added advantage of revealing diagnostically significant nuclear and cytoplasmic features which are helpful in differentiating a benign from a malignant cell and in some instances the probable site of the primary neoplasm. FF technique, though not conducive to a routine diagnostic situation, is of benefit in demonstrating the organization of junctional complexes. From preliminary studies it appears that the tight junctions in adenocarcinoma are different from those seen in small cell carcinoma. In mesothelioma, gap junctions are invariably present, but they are not seen prominently in adenocarcinoma or small cell carcinoma. Thus in poorly differentiated tumours where LM and TEM are inconclusive, FF may prove useful. It is concluded that such coordinated studies in the future have the potential to better our understanding of the nature and behaviour of tumour cells in effusion fluid.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/8. Two cases of "multicystic peritoneal mesothelioma": description and critical review of the literature.Two cases of multicystic peritoneal mesothelioma (MPM) are reported. Ultrastructural and immunohistochemical techniques confirmed the mesothelial nature of the lesion. The biologic and clinical behaviour, pathogenesis and differential diagnoses of this rare pathology are discussed. Although regarded as a neoplasm, many analogies seem to link MPM to fibromatoses and other non-neoplastic lesions, suggesting a reactive hyperplastic process. The relationships between mesothelium and the secondary Mullerian system, to date not fully investigated, are stressed and a classification of the coelomatic reactive and neoplastic processes, both metaplastic (mullerian metaplasia) and non-metaplastic, is suggested.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/8. Prognostic value of high serum levels of CA-125 in malignant secretory peritoneal mesotheliomas affecting young women. A case report with differential diagnosis and review of the literature.AIMS: Very few cases of diffuse, malignant, peritoneal mesothelioma have been reported in young women. Distinction between peritoneal mesothelioma and serous epithelial tumours, including papillary serous carcinomas and borderline serous tumours, can be difficult. Differential diagnosis based on clinical appearance and imaging techniques is broad and inconclusive, thus the diagnosis must be confirmed by histological examination. Because the vast majority of tumours involving the peritoneal and serosal surfaces are due to primary or metastatic serous epithelial tumours, there is a tendency on part of pathologists to disregard the possibility of mesothelioma when examining a biopsy or excision specimen. This is especially likely to occur when mesothelioma is associated with highly elevated serum levels of CA-125, which is the typical tumoral marker of epithelial serous tumours from the ovary. The association between peritoneal mesothelioma and high serum levels of CA-125 has been reported in the literature only in two cases. CASE DETAILS: In order to avoid a misdiagnosis of this neoplasm we describe a new case of peritoneal mesothelioma in an 18-year-old woman with high serum levels of CA-125. CONCLUSIONS: Besides its clinicopathological characteristics and its histological, immunohistochemical and ultrastructural features, we describe its biological behaviour, which seems to be worst when CA-125 levels are high.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
8/8. Solitary fibrous tumour of the diaphragm.Solitary fibrous tumours are uncommon neoplasms that have been described as occurring in the pleura, peritoneum, lung, mediastinum, pericardium, nose and paranasal sinuses. This report describes the first known case of a solitary fibrous tumour of the diaphragm, occurring in a 60 year old woman with a two year history of respiratory symptoms. The lesion was initially misdiagnosed as an elevated left hemidiaphragm. The operative findings and histological appearance of the tumour are described. A review of the literature examines the various types and presenting features of solitary fibrous tumours as well as their clinical behaviour and postulated origin.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |