1/16. Primary pulmonary osteogenic sarcoma.A 56-year-old man initially presented to his family physician with tingling in the fingertips of his left hand. A chest radiograph revealed a left upper lobe mass. Local resection found a soft tissue osteogenic sarcoma. This is a report of a rare case of primary pulmonary osteogenic sarcoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/16. Infusion port dislodgement of bilateral breast tissue expanders after MRI.Tissue expanders are placed routinely for breast reconstruction, and magnetic resonance imaging (MRI) is a common diagnostic procedure. Many studies have reported on the safety of MRI in patients with nonferromagnetic implants; however, many tissue expanders contain ferromagnetic components. The authors present a case of bilateral tissue expander infusion port dislodgment after MRI. A 56-year-old woman underwent bilateral mastectomy and immediate reconstruction with McGhan BIOSPAN tissue expanders. These implants contain integral nonferromagnetic infusion ports, as well as small, powerful Magna-Site magnets. Several weeks postoperatively the patient underwent MRI of her spine, which was ordered by her primary physician for back pain. Subsequently, the infusion ports could not be located with the finder magnet. A chest radiograph was obtained, which demonstrated bilateral dislodgment of the infusion ports. Surgical removal and replacement of the tissue expanders were required. safety considerations of MRI have been discussed extensively in the literature, and data on MRI with various implanted devices have been obtained. The potential risks of performing MRI on patients with metallic implants include conduction of electrical currents, heating of the implant, misinterpretation resulting from artifact, and the possibility of movement or dislodgment of the implant. The small magnet integral to many tissue expanders may be overlooked by patients and physicians during pre-MRI screening. All patients undergoing tissue expansion with implants that contain integral ports should be thoroughly warned about the potential hazards of MRI.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
3/16. A case of triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas.We report a 74-year-old man with triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas. The patient had consulted a nearby physician because of epigastralgia and icterus. On September 30, 1997, the patient was admitted to our department for further evaluation and treatment. Abdominal computed tomography (CT) showed dilatation of the common bile duct, cystic duct, and intrahepatic bile duct, and swelling of the gallbladder. On CT, the wall of the distal common bile duct was thick and a low-density mass was detected on the left side. cholangiography, performed via percutaneous transhepatic cholangiodrainage (PTCD), revealed stenosis of the distal common bile duct. Endoscopic retrograde pancreatography (ERP) showed marked dilatation of the main pancreatic duct. On October 17, 1997, pancreatoduodenectomy was performed under the diagnosis of carcinoma of common bile duct and pancreas. Histopathological examination revealed poorly differentiated tubular adenocarcinoma of the common bile duct, well-differentiated tubular adenocarcinoma of the gallbladder, and mucinous cystadenocarcinoma of the pancreas. These three tumors were histopathologically different. Moreover, p53-positive nuclei were recognized only in the pancreas tumor. These findings suggested that the oncogenic mechanisms of multiple synchronous cancers were not the result of only abnormal dna reparative mechanisms.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/16. Rare case of carcinoid tumor arising within teratoma in kidney.Not all enhancing lesions in the kidney are renal cell carcinoma. We report a rare case of a carcinoid tumor arising within a teratoma of the kidney in an asymptomatic female patient. Carcinoid tumors and teratomas involving the kidneys are rare. The two entities existing simultaneously in the same kidney are exceptionally unique. Still, the radiographic characteristics of these lesions have been previously described and should be familiar to practicing physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/16. Adenocarcinoma arising in an ileostomy. Report of two cases and review of the literature.Adenocarcinoma arising in an ileostomy is rare. Two cases are reported, one of a 58-year-old woman and the other of a 54-year-old man who had each undergone a colectomy for chronic ulcerative colitis. Seven other cases previously reported in the literature are reviewed. Though the exact pathogenesis is uncertain, several possibilities, particularly with regard to antecedent dysplasia and backwash ileitis, are discussed. Routine yearly follow-up and examination of the stoma by a physician or enterostomal therapist may lead to earlier detection of this rare complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/16. Other cancers in uveal melanoma patients and their families.To determine associations with other cancers, 400 consecutive uveal melanoma patients examined at wills eye Hospital between 1984 and 1985 were surveyed regarding personal and family history of cancer. Responses were received from 333 (83%). Sixty patients reported 43 nonbasal cell second primary cancers, which were confirmed pathologically or by physician records. The overall prevalence of nonbasal cell cancers diagnosed in uveal melanoma patients by December 1985 was over two times greater than the expected prevalence, based on the connecticut Tumor Registry data for an age- and sex-matched population. Gynecologic cancers tended to be more common in uveal melanoma female patients than in the comparison population. Although the observed prevalence of cutaneous melanoma was not significantly greater than expected, three cases with both primary cutaneous and uveal melanoma were reported. family histories of cutaneous melanoma were confirmed in 14 patients, and uveal melanoma in two patients. Data suggested that the overall cancer prevalence in uveal melanoma patients may be increased, that hormonal factors may play a role in the genesis of this malignancy, and that there may be a link between cutaneous and uveal melanoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/16. Quadruple cancer in a columnar-lined (Barrett) esophagus.In a 28-year-old man with a long history of esophageal reflux, two polypoid lesions in a columnar-lined (Barrett) esophagus proved to be adenopapillary cancer. Despite extensive preoperative endoscopic evaluation, no other malignant foci were found until after complete postoperative dissection of the esophageal specimen, when two more small flat lesions were diagnosed as adenocarcinoma. Dysplastic changes of specialized columnar epithelium and junctional epithelium were mild, except around the tumors. In the preoperative assessment of patients with a columnar-lined esophagus, physicians should be aware of the possibility of multifocal development of tumors either exophytic or superficial spreading, and multiple biopsies should be taken from normal-looking areas.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/16. Gardner's syndrome with an unusual fibro-osseous lesion of the mandible.A girl with a family history of Gardner's syndrome presented with an actively growing central lesion of the mandible and localized subcutaneous fibrous hyperplasia which required surgical intervention and bone grafting. The importance of this syndrome is the development of intestinal polyposis which become malignant. The presence of dentofacial stigmata and surface tumors should alert the dentist and physician to the possibility of Gardner's syndrome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/16. Nodular superficial pigmented basal cell epitheliomas.Eradication of multiple nodules, papules, and plaques of pigmented basal cell epitheliomas of the back of one patient was achieved by nine months of daily treatment with 5% fluorouracil cream. Such topical chemotherapy offers the physician an alternative to surgery and radiation in treating patients who have widespread nodular superficial epitheliomas. The need for a prolonged period of treatment and follow-up is emphasized.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/16. Blue rubber bleb nevus syndrome with CNS involvement and thrombosis of a vein of galen malformation.A patient is described with the dermatological features of blue rubber bleb nevus syndrome (BRBNS), focal seizures, and lateralized neurological signs. CAT scan demonstrated a nonenhanced density in the region of the vein of Galen. Neuropathological examination showed that this density was a clot within a vein of Galen malformation. Hemangiomas that grossly resembled the skin lesions of BRBNS were seen on the cerebral surface. Many of these hemangiomas were thrombosed and overlay patchy zones of infarction. Numerous vascular malformations of varying histological types were also found within the brain and systemic organs. Bluish, compressible, often raised hemangiomas of the skin should alert physicians to the BRBNS and the potential for vascular malformations ot occur within the brain as well as systemic organs. diagnosis of BRBNS involving the brain may assist in interpretation of radiographic findings. The tendency of these malformations to thrombose may account for focal neurological deficits.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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