1/15. Microvascular anastomosis of a rectus abdominis free flap into a prosthetic vascular bypass graft.Distal bypass grafts are frequently employed to revascularize lower extremities and to replace major peripheral vessels following excision of large soft-tissue or bone tumors. Autogenous vein grafts are generally used for such bypasses, when available. Large wounds associated with peripheral vascular disease or excision of massive tumors frequently require concomitant free-tissue transfers. Anastomosis of a free-tissue transfer pedicle to a vein bypass graft has been reported. The first successful case of an anastomosis of a flap pedicle to a Gore-tex bypass graft is presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/15. chondrosarcoma, lupus anticoagulant and cerebral ischaemia.chondrosarcoma is a malignant disease of cartilage. Systemic embolisation usually arises from cancerous invasion of pulmonary vessels or the left atrium but cerebral embolisation or ischaemia is rarely recognised. We report a man with left leg amputation for tibial myxoid chondrosarcoma who suffered multiple cerebral embolisms one year later. cerebral angiography and aortogram did not reveal luminal stenosis and a cardiac survey was normal. Lupus anticoagulant (LAC) and a prolonged activated partial thromboplastin time were detected. A molecular mimicry between prothrombin and paracrine hormones may have accounted for his LAC. A procoagulant autoantibody reacting against metastatic cancer cells may contribute to cancerous thrombosis, such as in chondrosarcoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/15. Management of cranial base chondrosarcomas.OBJECTIVE: Chondrosarcomas are rare, infiltrative, progressive lesions that occur at the cranial base. Their intimate association with cranial nerves and major vessels of the head and neck often precludes complete surgical resection. methods: Between 1983 and 2003, 23 patients (14 females, 9 males) were treated at our institution with the diagnosis of chondrosarcoma of the cranial base (mean age at presentation, 43 yr). A retrospective chart review was performed to evaluate presentation, management, and adjunctive treatment. All living patients were contacted for a current examination and disease status. RESULTS: The 23 patients underwent 43 surgical resections. Follow-up ranged from 8 months to 25 years (mean, 97 mo). Ten patients underwent various adjuvant radiation therapies. Five patients have died. Four patients have no evidence of disease, and 13 have residual tumor. One was lost to follow-up. Of 14 patients with 5 years of follow-up, 13 are living. Therefore, the absolute 5 year survival rate is 93%. The 10 year survival rate is 71%. CONCLUSION: Because of the intricate nature of the cranial base, a team approach is preferable for managing these challenging lesions. Maximum cytoreductive surgery should be pursued as an initial strategy to minimize neurological injury. Adjuvant stereotactic radiosurgery can be used to treat residual disease or small recurrences. This cohort also illustrates that patients with chondrosarcomas have better long-term survival rates than patients with chordomas of the cranial base.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/15. Clinicopathologic features of two rare cases of mesenchymal metastatic tumors in the pancreas: review of the literature.OBJECTIVES: A clinicopathologic presentation of 2 unusual cases of metastatic mesenchymal neoplasms in the pancreas. methods: The first case concerns a 26-year-old man with a history of intracranial mesenchymal chondrosarcoma (since the age of 17), 2 left lung operations, and 3 right thigh operations. Distal pancreatectomy and splenectomy was performed because of suspicious mass in the pancreas. The second case concerns a 66-year-old woman with a history of uterus leiomyosarcoma (10 years ago) with left axillary and right femoral metastases. She underwent distal pancreatectomy and splenectomy because of suspicious mass measuring 4 x 4 cm, in the pancreatic body. RESULTS: In the first case, the pathological examination revealed a tumor measuring 3.8 x 3.5 cm and histologically compatible with mesenchymal chondrosarcoma, developing in a vessel lumen and invading into the pancreatic parenchyma. In the second case, the pathological examination showed metastatic leiomyosarcoma of high-grade malignancy. The incidence of metastatic pancreatic tumors has been reported to be only 1.6% to 3%. Most of these tumors were of epithelial origin, and the most common sites of the primary lesions were the lung, kidney, and gastrointestinal tract. CONCLUSIONS: The cases of metastatic uterus leiomyosarcoma and the metastatic intracranial chondrosarcoma are, to our knowledge, the first to be described.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/15. Application of the free vascularized bone graft in the treatment of malignant or aggressive bone tumors.Although recent advances in clinical microsurgery have made free tissue transfer a clinical reality, the value of free bone transfers in the reconstructive tumor surgery of long bones has not been reported to our knowledge. Two patients with malignant or aggressive bone tumors who underwent en bloc resection of their tumors and reconstruction with free vascularized bone grafts are presented. In the first case, a giant cell tumor of the distal radius was resected, and a 10 cm free vascularized fibular graft was performed as a reconstructive procedure; in the second case a chondrosarcoma of the femur was excised and replaced by a 20 cm segment of free vascularized fibula. Postoperatively, these patients were followed with arteriograms and sequential bone scans. The indications for the procedure and the operative technique are discussed. A comparison of the merits of free rib versus free fibular transfers is presented with emphasis on bony architecture, vessel characteristics, dissection required and the options available for reconstructive surgery. The advantages and disadvantages of free vascularized bone grafts with respect to conventional methods and the potential applicability of this technique are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/15. Maxillary chondrosarcoma.chondrosarcoma is a malignant tumor that arises from cartilage. In the maxillary area, the tumors spread locally but may also invade blood vessels and metastasize systemically. Initial surgical resection is the treatment of choice.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/15. Two malignant pleural mesotheliomas with unusual histological features.Morphologically, mesotheliomas may be composed of epithelial and/or sarcomatous elements with various patterns, such as tubular, papillary, tubulopapillary, and diffuse epithelial or mixtures of these. Two cases are descirbed in which, in addition to typical mesothelioma, there was cartilage with foci of calcification and ossificated with the mesothelioma, which suggested that they formed an integral part of the tumour. One of the cases also showed a cuff of cartilage and bone round blood vessels and bronchioles in the lung parenchyma. The patholgenesis could be explained if the mesothelial cell is considered to be totipotent and able to give rise to epithelial and connective tissue elements. Other theories that must be considered are: that there are two separate neoplasms; that there is a circulating substance, perhaps induced by the mesothelioma, which stimulated the cartilage and bone formation; and that the cartilage and bone were due to a previous or associated infection such as tuberculosis. Calcification is also common in asbestotic pleural plaques.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/15. Primary intracerebral tumor with mixed chondrosarcoma and glioblastoma--gliosarcoma or sarcoglioma?An unusual primary intracerebral tumor with combined features of chondrosarcoma and glioblastoma multiforme is presented. Glial elements showing a spectrum of hyperplastic and neoplastic changes were intermingled with sarcomatous areas, similar to that recently described by Lalitha and Rubinstein as "sarcoglioma." Many vessels in the gliomatous regions contained proliferating endothelial cells with marked cytologic abnormalities. Although no direct extension out of the vessel wall was conclusively identified, the possibility of sarcomatous change could not be completely excluded. We conclude that, in this case, we could not establish whether the sarcoma was primary and the glioma secondary ("sarcoglioma") or vice versa ("gliosarcoma"), nor could we rule out that the two components originated from the same ancestral pluripotential cells.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/15. Pulmonary hypertension due to tumor emboli: a report of three autopsy cases with morphological correlations to radiological findings.Three cases of pulmonary hypertension caused by tumor emboli to the lungs are described. Two of the three cases had a clinical diagnosis of pulmonary thromboembolism until surgical embolectomy, and the other had a diagnosis of primary pulmonary hypertension. autopsy disclosed chondrosarcoma, choriocarcinoma and gastric cancer as the primary tumors, respectively. Pulmonary vascular obstruction due to tumor embolism leading to pulmonary hypertension is a previously rare clinical entity, and obstructed pulmonary vessels are believed to tend to be small vessels. We compared the autopsy and radiological findings and concluded that pulmonary tumor embolism involved not only the small peripheral arteries but also the segmental and/or lobar arteries.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/15. Primary chondrosarcoma of the lung. A clinicopathologic study.BACKGROUND. Primary pulmonary chondrosarcoma is a rare neoplasm. A 73-year-old Japanese man had chondrosarcoma in the right lung. The tumor was considered to be of pulmonary origin because of the absence of extrapulmonary primary lesions for 2 years after lung resection. methods. The histologic sections were stained with hematoxylin and eosin, conventional special staining, and immunohistochemical staining. The authors discussed the differential diagnosis and growth pattern, in addition to the histopathologic findings in the tumor cells. In a review of the literature, the authors compared the characteristics between the major bronchus (MB) and lung types. RESULTS. Histopathologically, the tumor cells showed atypical cartilaginous differentiation without osteoid formation, benign or malignant-appearing epithelium, or sarcomatous components other than chondrosarcoma. The tumor showed expansive proliferation, invasion through the alveolar spaces, massive proliferation along the bronchial lumen, significant invasion into small vessels, and extrathoracic metastases. The review of the literature showed that the clinical period ending with surgical treatment was longer in the lung tumors than in the MB tumors. CONCLUSIONS. Although MB tumors were reported to be discovered early, the invasion to major arteries or trachea often led to inoperability; however, lung tumors were considered to be resectable until they grew very large, even though the clinical period from onset to surgical treatment was longer in this type. Recent advancements in diagnostic and surgical techniques are expected to promote early discovery and improve prognosis whether the tumor occurs in the MB or lung.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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