1/19. Cervical metastasis of occult papillary thyroid carcinoma associated with epidermoid carcinoma of the larynx.An occult, laterocervical papillary thyroid carcinoma tissue was found in a functional neck dissection for larynx cancer. The patient was a 76-year-old man with a history of smoking and alcohol ingestion who presented with a supraglottic carcinoma of the larynx located at the laryngeal surface of the epiglottis, left aryepiglottic fold, band and left ventricle with extension to the left vocal cord. light microscopy showed a lymph node with a fibrous stroma with lymphoid follicles that presented a total substitution of the parenchyma by a papillary thyroid carcinoma. Although examination of the thyroid gland by seriated sections did not reveal any neoplasm, we argue that the papillary thyroid tissue is metastatic.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/19. Lymphepithelioma-like carcinoma of the lacrimal gland.In this report a patient with a lymphoepithelioma (LE)-like carcinoma of the lacrimal gland is described for the first time in the literature. LE-like carcinomas outside the nasopharynx rarely occur in the major and minor lacrimal glands of natives of greenland, Inuit or natives of southern china. The patient's tumor was extirpated using a Kronlein approach followed by total parotidectomy and modified radical neck dissection on the ipsilateral side after the detection of suspicious lymph nodes by ultrasound transmission. Adjuvant radiochemotherapy with cisplatin and 5-fluorouracil was then carried out. Three years later there is no sign of recurrence. As a result of this case we recommend careful examination of the orbit and lacrimal gland in cases of LE-like cancer with an unidentified primary tumor.- - - - - - - - - - ranking = 7keywords = gland (Clic here for more details about this article) |
3/19. Metastatic thyroid cancer occurring as an unknown primary lesion: the role of F-18 FDG positron emission tomography.Thyroid cancer can appear as metastatic disease of an unknown primary origin, and fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomographic (PET) studies are helpful in the workup evaluation of these patients. The authors describe two patients who had metastatic disease from an unknown primary lesion. F-18 FDG PET studies played an important role in localizing the primary malignant site in the thyroid gland. The utility of F-18 FDG imaging in decreasing the number of procedures, cost, and inconvenience to patients is shown clearly in both cases.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/19. Metastatic cancer to the floor of mouth: the lingual lymph nodes.BACKGROUND: The upper level of a cervical lymphadenectomy is anatomically defined at its anterior extent by the lower border of the mandible and, in surgical practice, by the lingual nerve. A neck dissection completed below this level is generally considered adequate for removal of lymph nodes at risk for metastases from oral cavity cancer. Traditional discontinuous neck dissections do not provide for removal of floor of mouth tissue along with the primary and neck specimens. methods: A case report presenting biopsies from a T2N2bM0 squamous cell carcinoma of the mobile tongue and adjacent floor of the mouth in a 73-year-old man. RESULTS: Deep biopsy of a ventral tongue and floor of mouth squamous cell carcinoma revealed occult metastatic cancer to lymph nodes located in the superficial floor of mouth associated with the sublingual gland above the lingual nerve. This report identifies floor of mouth lymph nodes that can be involved with cancer and missed through the standard practice of discontinuous neck dissection.Conclusions. This finding offers evidence that, in certain cases, a traditional discontinuous neck dissection may not address all lymph nodes at risk in the treatment of oral cavity cancer. Further investigation into lymph node distribution within the oral cavity is warranted to reappraise the upper limits of cervical lymphadenectomy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/19. A long-standing cystic lymph node metastasis from occult thyroid carcinoma--report of a case.The authors describe a patient with a cervical cystic mass present for 14 years which proved to be a cystic metastasis from a papillary carcinoma of the thyroid gland. This is probably the first case report of a long-term lateral cervical cyst caused by an occult thyroid carcinoma.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/19. The role of positron emission tomography (PET) in the management of cervical lymph nodes metastases from an unknown primary tumour.Cervical lymph node metastases may be the initial manifestation of occult cancer. Despite a very exhaustive search, the primary site of approximately 2-10% of these tumours remain undetected. Evaluation of the patient includes: detailed physical examination of skin, upper airways (fiberoptic endoscopy), salivary glands and thyroid; fine-needle biopsy, multiple endoscopic biopsies, and imaging studies (ultrasonography, computed tomography scan or magnetic resonance imaging). Recently, positron emission tomography scan has been demonstrated to be a useful diagnostic imaging study in these patients. The records of 11 patients were reviewed. End-points were the usefulness of positron emission tomography in the detection of an unknown primary tumour and/or distant metastatic disease. In 5 patients, positron emission tomography detected a primary lesion, confirmed pathologically and revealed distant metastases in 2 patients. Two cases were false-positive and 1 false-negative. In 3 patients no primary tumour was found after 3 years follow-up. In conclusion, positron emission tomography was not of any significant advantage in detecting occult primary tumour vs. computed tomography scan or magnetic resonance imaging. Positron emission tomography, as "ab initio" total body examination, is important in detection of unsuspected distant diseases.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/19. Poorly differentiated small cell neuroendocrine carcinoma localized in three different endocrine glands: response to chemotherapy and octreotide LAR.neuroendocrine tumors represent a heterogeneous category of neoplasm, with conflicting diagnostic and therapeutic demands. We here describe the case of a 72-yr-old woman with evidence of a poorly differentiated small-cell neuroendocrine carcinoma (NEC) localized in different endocrine glands and other non-endocrine organs. In particular, a large ovarian mass, multinodular thyroid goiter, right adrenal mass, cystic liver metastases and anterior mediastinum lymph node metastasis were present. The largest thyroid nodule caused tracheal restriction and dyspnea. diagnosis of poorly differentiated metastasized NEC of unknown origin was made on the basis of histological and immunohistochemical findings, and treatment with etoposide (100 mg/m2 in days 1, 2 and 3) and cisplatinum (45 mg/m2 in days 2 and 3) was initiated. Simultaneously, im administration of octreotide LAR 20 mg every 28 days was started, according to the presence of SS receptors at 111In-octreotide scan. Rapid improvement of dyspnea and a reduction of the largest thyroid nodule, liver metastases and adrenal mass by 50% were observed after 3 months of treatment; the dimensions remained stable thereafter, while the pericardial lymph node disappeared. In conclusion, poorly differentiated NEC of unknown primary site is a well-recognized category, usually with an aggressive behavior, rapid growth rate and wide dissemination. Median survival of these patients is 6 months if left untreated. Our patient is alive 18 months after beginning the treatment, reporting good general condition and quality of life over the whole follow-up period.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
8/19. Carcinoma erysipelatoides from squamous cell carcinoma of unknown origin.Carcinoma erysipelatoides, also known as inflammatory metastatic carcinoma, is a rare form of cutaneous metastasis from a malignancy. The characteristic histopathological finding is metastatic tumour cells inside the dermal lymphatic ducts. It is frequently observed in patients with breast carcinoma as well as adenocarcinoma of pancreas, rectum, lung, ovary and parotid gland. We present a 66-year-old man diagnosed to have metastatic squamous cell carcinoma by aspiration cytology from an enlarged neck lymph node and a core biopsy of a left axillary mass. He subsequently received radiotherapy; however, due to intolerance to erythema and swelling on local irradiated skin, radiotherapy was deferred. skin lesions on upper chest and neck area, consisting of erythematous induration with telangiectasia and tenderness, progressed slowly and were treated as cellulitis. The erythema remained stationary with antibiotic treatment. skin biopsy shows poorly differentiated squamous carcinoma cells within dermis and dilated dermal vessels.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/19. Extra-salivary gland presentations of adenoid cystic carcinoma: a report of three cases.Adenoid cystic carcinoma (ACC) is a malignant neoplasm most commonly originating in salivary glands of the head and neck area. When ACC presents outside of these locations, the diagnosis may become more challenging. We describe three cases of ACC presenting in extra-salivary gland sites. Two cases were metastatic; in case 1 the initial presentation was widespread bony metastasis of unknown primary origin. The other metastatic case (case 2) was from a patient presenting with a pleural effusion and a history of previously treated metastatic pulmonary ACC. The pleural effusion cytology was unusual in that exfoliated ACC cells were present in the effusion itself, a rare occurrence. Case 3 was a primary bronchial ACC. In conclusion, ACC can present in various body sites and cytologists must consider this neoplasm when presented with a basaloid carcinoma of uncertain origin.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
10/19. Primary malignant melanoma of the adrenal gland. A report of two cases and review of the literature.Primary malignant melanoma of the adrenal gland is an established entity despite early doubts. It originates in the adrenal medulla from cells derivative of the neural crest. Because of the high frequency of metastatic involvement of the adrenal by cutaneous and ocular melanomas, rigid diagnostic criteria should be followed. Only four cases of this lesion have been reported since 1946. review of these four together with the two described in this article shows that primary adrenal melanoma is a highly malignant tumor of middle age that often manifests as a painful flank mass. Distant lymph node metastases can be seen as a presenting sign. Treatment is not effective with a mortality rate approaching 100 per cent within two years. Since the true melanocytic origin of primary adrenal melanoma has not been established and because of the similarity of its pathologic findings with the pheochromocytomas, we believe that adrenal melanoma arises from the pheochromocytes and should be called "melanotic malignant pheochromocytoma."- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
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