1/74. melanosis in association with metastatic malignant melanoma: report of a case and a unifying concept of pathogenesis.An unusual case of melanosis associated with metastatic malignant melanoma is reported. This was characterized by progressive blue/gray discoloration of the skin of the chest and abdomen in an elderly patient, 1 year after removal of a polypoid malignant melanoma from the right arm. A biopsy of involved skin revealed perivascular aggregates of melanin-laden histiocytes throughout the dermis, the histopathologic hallmark of melanosis. An unusual aspect of the case was the coincidental finding of a tumor embolus within a small dermal vessel, probably a lymphatic. To date, neoplastic melanocytes have been detected in only a small minority of skin biopsies with features of melanosis. This case and a distillation of related information in the literature lead to the conclusion that the essence of melanosis, and the feature that distinguishes this from conventional metastatic melanoma, is the persistent and cumulative dissemination of melanin, via the bloodstream, throughout the body. This in turn leads to progressive pigmentation of all internal organs and the skin. Only continuous access to the circulation by neoplastic melanocytes could explain such a phenomenon. Potential mechanisms by which this could arise are discussed in the context of existing knowledge.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/74. Inflammatory metastatic melanoma.An 87-year-old woman developed erythema, induration and tenderness of the skin overlying each breast. One year before, she had undergone an axillary lymph node dissection because of metastases from melanoma. The primary site was unknown. A skin biopsy showed pigmented tumor nests within the dermal lymphatic vessels, and immunohistochemistry confirmed the melanocytic origin. The diagnosis of inflammatory metastatic melanoma was made.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/74. Extended resection of the pulmonary artery and the aorta for primary lung cancer. Report of a case.We report a case of squamous cell carcinoma of the lung in which a left pneumonectomy combined resection of the pulmonary artery and aorta was performed using a cardiopulmonary bypass. The bifurcation of the pulmonary artery was repaired with a pericardial patch and the descending aorta was replaced with an artificial vessel Eleven months later, the patient underwent dissection of the contralateral mediastinal lymph nodes because of a recurrence of the disease. Even though pulmonary metastases have again recently appeared, he is alive and doing well two years after operation. To obtain a better prognosis in cases demonstrating an involvement of the bifurcation of pulmonary artery, more effective combined treatment still needs to be developed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/74. Pulmonary lymphangitic carcinomatosis from an oropharyngeal squamous cell carcinoma: a case report.Pulmonary lymphangitic carcinomatosis (PLC), a form of lymphatic spread of cancer cells, from head and neck cancers is extremely rare. We report here a case of PLC from an oropharyngeal squamous cell carcinoma in a 68-year-old man. The patient underwent inductive chemoradioimmunotherapy which resulted in complete tumor remission. The tumor, however, recurred 6 months later and was resected. Late metastasis occurred in the ipsilateral cervical lymph nodes 13 months post surgery and these lymph nodes were dissected. Three months later, the patient suffered from a fever, cough and dyspnea and a chest radiograph revealed an interstitial linear pattern from the right hilum to the right upper lung field. Without diagnosis of the pulmonary lesion, swelling of the bilateral lymph nodes followed after a few months and dyspnea worsened with spread of the reticular shadow and appearance of Kerley's B line on the roentgenogram, suggesting PLC. The patient gradually became more distressed and finally died 6 months after the onset of dyspnea. The microscopy of the autopsied pulmonary tissue revealed tumor cell nests in the lymph vessels in the septa and the pulmonary lesion was histopathologically diagnosed as PLC. The present case indicates that we should consider PLC when cough and dyspnea with reticular shadows and Kerley's B line are observed in patients with head and neck carcinoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/74. A unique case of eccrine porocarcinoma with pulmonary lymphangitis and pericardial involvement: biological characterization and clinical aggressiveness.A unique case of eccrine porocarcinoma with pulmonary lymphangitis and pericardial involvement is reported. The clinical course was aggressive, leading to the death of the patient a few months after diagnosis. Certain pathologial markers of clinical aggressiveness were retrospectively investigated: p53 and Ki-67 expression were determined by means of immunohistochemistry. Angiogenesis was assessed by determination of intratumor microvessel density at the vascular 'hot spot' with the anti-CD34 monoclonal antibody and quantitative analysis using computerized image analyzer. Both primary tumor and metastatic lymph node presented immunostaining for p53 and Ki-67, with a higher degree of vascularization in the secondary lesions compared to the primary tumor. Our findings suggest a correlation between tumor vascularization and clinicopathological parameters of aggressiveness in malignant eccrine porocarcinoma. Taking into account the disappointing results of current treatments for metastatic eccrine porocarcinoma, the assay of microvessel density may be helpful in selecting the patients of high risk for recurrence or death who may benefit of anti-angiogenic therapies.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/74. A 7 mm lung adenocarcinoma with mediastinal involvement and lymphangiosis carcinomatosa: a case report.We report a case of a 46-year-old man with a 7 mm lung adenocarcinoma with mediastinal nodal involvement and lymphangiosis carcinomatosa. The resected right middle lobe contained a 7 mm well-differentiated papillary adenocarcinoma and lymphatic vessels towards the hilum were severely involved. The disease was pathologically diagnosed as T1N2M0. Six months after the operation, malignant pleural effusion and multiple bone metastases developed and he died 21 months after the operation. This case indicates that even a very small-sized lung cancer, 1 cm or smaller, could be biologically highly malignant.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/74. Inflammatory cutaneous metastasis from laryngeal carcinoma.The authors report the case of a 64-year-old man who presented with erythematous infiltrating plaques sited on his right supraclavicular and infraclavicular regions. Five years before a laryngeal epidermoid carcinoma had been surgically removed. After two years the patient underwent lymphadenectomy and radiotherapy for the presence of metastasis in his right cervical lymph nodes. He was disease free until two months before our examination when small red spots appeared on his right supraclavicular region, slightly enlarging. A skin biopsy was performed and histological examination showed the presence of metastatic cells inside dilated lymphatic vessels. Immunohistochemical markers showed only positive staining of atypical cells with monoclonal anti-cytokeratin antibodies (cytokeratin B-ORTHO=34betaE12) confirming the epithelial origin of metastastic cells. A diagnosis of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma was given. This type of metastasis has been frequently observed in patients with breast carcinoma and it has also been described during the course of other malignant tumours. Malignant tumour of the larynx generally spreads to regional lymph nodes or, through blood, to the lungs. skin metastasis have rarely been described, and always as multiple or solitary nodules. According to our knowledge this is the first case of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma reported in the literature.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/74. Recurrent malignant variant of phosphaturic mesenchymal tumor with oncogenic osteomalacia.Phosphaturic mesenchymal tumor is a rare neoplasm which causes osteomalacia or rickets. The tumor typically follows a benign clinical course. Even in the rare malignant cases, local recurrence and distant metastasis are uncommon. We report on an example of a malignant phosphaturic mesenchymal tumor which recurred several times over 16 years concurrently causing hypophosphatemia, bone pain, and osteomalacia. Following each surgery, symptoms and hypophosphatemia improved. The patient died of disease 17 years after the first surgery. Histologically, the initial tumor was composed of small spindle cells with clusters of giant cells, prominent blood vessels, poorly formed cartilaginous areas, and crystalline material. Cytological atypia was minimal. Following multiple recurrences, the tumor demonstrated areas of high-grade sarcoma exhibiting marked pleomorphism, numerous mitotic figures, and p53 overexpression. This case illustrates the potential lethality of incompletely removed phosphaturic mesenchymal tumors.- - - - - - - - - - ranking = 4.2916996547827keywords = blood vessel, vessel (Clic here for more details about this article) |
9/74. Extended surgery with en bloc resection of the right common iliac vessels for lymph node metastasis of mucinous colon carcinoma: report of a case.We report herein the case of a 63-year-old woman who underwent surgery for recurrent mucinous carcinoma of the cecum. Recurrent metastatic lymph nodes had invaded the right common iliac vessels and right ureter, but she had no distant metastases and no peritoneal dissemination. Extended surgery with en bloc resection of the right iliac vessels and right ureter, and femorofemoral bypass were performed. Postoperatively, several complications developed which were successfully treated by further operations. By 1 year after surgery, she had no recurrent tumors on radiological examination, suggesting that our aggressive surgery with resection of the invaded regional vessels had effectively removed the recurrent tumors. This procedure may therefore significantly prolong the survival time and improve the quality of life of such patients.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
10/74. Zosteriform and epidermotropic metastatic primary cutaneous squamous cell carcinoma.The first case of primary cutaneous squamous cell carcinoma (SCC) to cause zosteriform and epidermotropic metastasis to skin is reported. The patient is a 72-year-old Japanese woman. A cutaneous SCC appeared on the lateral side of her right knee and was removed. After dissection of the right inguinal lymph nodes, which revealed metastases, and irradiation of the right inguinal region, the patient presented with slightly pruritic and painful erythematous papules on the right hip and small brownish papules and vesicles with crusts on the anterior side of the right thigh. The eruptions were in a zosteriform distribution along the right L1 to L3 dermatomes. Histologically neoplastic squamous cell nests were observed in the epidermis, below the epidermal-dermal junction, and within lymphatic vessels in the deeper reticular dermis. We postulate that neoplastic cells with the ability to fuse with adjacent squamous epithelium may have been carried beneath the basal lamina or to the epidermis via dermal lymphatic backflow, resulting in epidermotropic metastasis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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