Bone Marrow Recurrence with Microscopic Pulmonary Tumor Embolism after Excision of Extramammary Paget s Disease in Scrotum Three Years Ago
|
|
- Paulina Hodges
- 5 years ago
- Views:
Transcription
1 Soonchunhyang Medical Science 21(2): , December 2015 pissn: I eissn: CSE REPORT one Marrow Recurrence with Microscopic Pulmonary Tumor Embolism after Excision of Extramammary Paget s Disease in Scrotum Three Years go Seongcheol Cho¹, Jin Won Kim¹, Jeonghwan Youk¹, Sang Mee Hwang 2, Hyo Jin Park 3, Choon-Taek Lee¹ Departments of 1 Internal Medicine, 2 Laboratory Medicine, and 3 Pathology, Seoul National University undang Hospital, Seoul National University College of Medicine, Seongnam, Korea Here we report a case of a 72-year-old male patient recurred in bone marrow alone with pulmonary tumor embolism after an excision of extramammary Paget s disease of scrotum 3 years ago. The patient received paclitaxel/carboplatin chemotherapy with respiratory support in intensive care unit. Four days after chemotherapy, the oxygen demand decreased and the patient was transferred to general ward. The platelet count recovered after 2 weeks. Finally, he died of hepatic failure from Paget s disease hepatic involvement confirmed by liver biopsy at 10 months after recurrence. This is a rare case of recurred extramammary Paget s disease in bone marrow alone with pulmonary tumor embolism, which was properly diagnosed with high suspicion and was successfully treated with immediate chemotherapy. Keywords: Extramammary Paget s disease; Pulmonary hypertension; Pulmonary embolism; Neoplastic cells, circulating; Scrotum INTRODUCTION Extramammary Paget s disease (EMPD) is a rare cutaneous adenocarcinoma [1]. Most of patients with EMPD have a good prognosis, but invasive EMPD with regional metastasis has a poor prognosis [2]. few cases show aggressive manifestations of EMPD with systemic metastasis [2]. Pulmonary tumor embolism (PTE) is a rare complication of malignant disease and difficult to diagnose ante mortem. On the other hand, in solid tumor, bone marrow metastasis is also a rare presentation. We present a successfully diagnosed with high suspicion and treated case of recurred EMPD in bone marrow alone with PTE, which presented with progressive dyspnea. CSE REPORT 72-year-old male patient presented with anorexia, weight loss and progressive dyspnea of exertion over one month. Eight years earlier, he had been diagnosed of prostate cancer and he was treated with radical prostatectomy. Three years earlier, he was diagnosed for Paget s disease in scrotum and received two steps operation because residual tumor was detected in resection margin. He was finally treated with wide excision and local flap. He was without evidence of disease on routine surveillance exam. He had a 20 pack-year history of smoking but never had any breathing difficulty before. The physical examination including chest auscultation was unremarkable. He was afebrile with tachycardia of 108 beats/min, respiratory rate of 33/min, and blood pressure of 146/90 mm Hg. rterial blood gas analysis showed p ao 2 = 59.4 mm Hg and p aco 2 = 27.7 mm Hg while D-dimer levels were slightly elevated (5.87 µg/ml, reference range = less than 0.4 µg/ml). White blood cell, hemoglobin, and platelet count were 4,750/mm 3, 13.5 g/dl, and 97,000/mm 3, respectively. Prothrombin time was slightly prolonged to 15.4 seconds but partial thromboplastin time and fibrinogen were in normal range. Pulmonary function test showed normal ventilator pattern, but decreased diffusing capacity of the lungs for carbon monoxide (DLCO = 68%). Contrast enhancement computed tomography Correspondence to: Jin Won Kim Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University undang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, undang-gu, Seongnam 13620, Korea Tel: , Fax: , jwkim@snubh.org Received: Oct. 6, 2015 / ccepted after revision: Oct. 19, Soonchunhyang Medical Research Institute This is an Open ccess article distributed under the terms of the Creative Commons ttribution Non-Commercial License (
2 EMPD in one Marrow and Pulmonary Tumor Embolism Cho S, et al. Fig. 1. () bsence of filling defect on computed tomography pulmonary angiography. () No evidence of parenchymal disease on computed tomography scan, pulmonary window setting. NT NT Fig. 2. () Lung ventilation and () perfusion scan: multiple perfusion defects (arrows). NT, anterior images. (CT) scan did not show any intraluminal filling defects of pulmonary arteries and deep veins of low extremities (Fig. 1). Severe pulmonary hypertension with relatively preserved right ventricular function was documented with echocardiography; estimated pulmonary artery systolic pressure (epsp) was 80 mm Hg. Despite the negative CT scan result, pulmonary thromboembolism was suspected. Ventilation-perfusion lung scans demonstrated multiple perfusion defects with normal ventilation (Forte; DC-Philips, Holt, MO, US) (Fig. 2). These findings were consistent with microscopic pulmonary thromboembolism. nticoagulation therapy was suggested, but was postponed because progressive thrombocytopenia was detected. Multiple aggregations of large sized abnormal cells were observed in bone marrow specimen, suspecting malignancy. These tumor cells were same histology and immunohistochemical staining pattern (caudal-related homeobox 2 [CDX2, -], carcinoembryonic antigen [CE, +], cytokeratin [CK] 7 [+], CK19 [+], CK20 [-], epithelial membrane antigen [EM, +], prostate-specific antigen [PS, -], thyroid transcription factor-1 [TTF-1, -]) with previous EMPD of scrotum (Figs. 3, 4). There was no lesion that suggests distant me- Soonchunhyang Medical Science 21(2):
3 Cho S, et al. EMPD in one Marrow and Pulmonary Tumor Embolism C D E F G H Fig. 3. Initial pathologic finding of scrotum. Immunohistochemical staining of surgical specimen (reduced from 200) with () caudal-related homeobox 2 (CDX2, -), () carcinoembryonic antigen (CE, +), (C) cytokeratin (CK) 7 (+), (D) CK19 (+), (E) CK20 (-), (F) epithelial membrane antigen (EM, +), (G) prostate-specific antigen (PS, -), and (H) thyroid transcription factor-1 (TTF-1, -). C D E F G H I Fig. 4. Pathologic finding of bone marrow involvement. Immunohistochemical staining with () caudal-related homeobox 2 (CDX2, -), () carcinoembryonic antigen (CE, +), (C) cytokeratin (CK) 7 (+), (D) CK19 (+), (E) CK20 (-), (F) epithelial membrane antigen (EM, +), (G) prostate-specific antigen (PS, -), and (H) thyroid transcription factor-1 (TTF-1, -). (I) Hematoxylin and eosin (H&E) stained image of bone marrow biopsy specimen (reduced from 200). tastasis in additional whole body positron emission tomography- therapy, the oxygen demand decreased and the patient was trans- computed tomography-ct scan. Serum CE was elevated to 243 ferred to general ward. The platelet count recovered after 2 weeks ng/ml (reference range, 0 to 5 ng/ml) and serum prostate-specific (Fig. 5). fter 6 cycles of chemotherapy, epsp decreased to 34 mm antigen level was normal. Therefore, a diagnosis of recurred Hg and sequential bone marrow biopsy showed decreased tumor EMPD in bone marrow alone with microscopic PTE was made. cell infiltration. Unfortunately, the patient refused more paclitaxel/ The patient received paclitaxel/carboplatin chemotherapy with carboplatin chemotherapy cycle due to financial difficulties. One respiratory support in intensive care unit. Four days after chemo- month after he decided to receive alternative 5-fluorouracil/cisplat Soonchunhyang Medical Science 21(2):
4 EMPD in one Marrow and Pulmonary Tumor Embolism Cho S, et al Initial visit 64 dmission Platelet (1,000 cells/mm 3 ) in chemotherapy. fter 3 cycles of 5-fluorouracil/cisplatin chemotherapy, new hepatic metastasis was detected and confirmed by liver biopsy. We tried docetaxel chemotherapy to treat his progressive disease but it did not respond. Finally, he died of hepatic failure from Paget s disease hepatic involvement 10 months after recurrence. 61 Fig. 5. Platelet count (green) and CE level (blue) change after chemotherapy. CE, carcinoembryonic antigen. DISCUSSION EMPD is a rare cutaneous malignancy from intraepidermal region around apocrine gland. Distal metastasis beyond regional lymph nodes is rare and only few cases were reported [2,3]. EMPD within the epidermis may progress to dermally invasive adenocarcinoma. Then this might metastasize to locoregional lymph nodes and distant sites [4]. The depth of invasion was most significant prognostic factor [2]. Few cases were reported as bone marrow involvements. Most of them presented with locoregional lymph node involvement. One case of minimally invasive Paget s disease of the vulva, which presented by local recurrences and bone marrow metastases 6 years after excision, was reported [5]. Recurrence of EMPD of scrotum in liver and bone marrow 3 years after initial treatment was reported [6]. In our patient s case, minimal dermal invasion was detected but lymph node dissection was not done. t the time of recurrence, no evidence of local or nodal recurrence was detected. It is possible that some tumor cells could be introduced into lymphatics during surgery and some of them were able to survive in the vascular system [5]. fter long incubation period, sequential hematogenous spread of tumor cells from bone marrow one marrow Taxol/carbo C1D1 Taxol/carbo C1D12 Taxol/carbo C Taxol/carbo C3 Taxol/carbo C4 CE (ng/ml) Taxol/carbo C5 212 Taxol/carbo C6 to pulmonary vasculatures might have caused respiratory distress. Kane et al. [7] described four types of tumor involvement of the pulmonary vessels: (1) tumor emboli of the large pulmonary arteries and branches, (2) lymphatic dissemination, (3) microscopic tumor emboli in the small arteries or arterioles (microscopic PTE), and (4) combinations of above. Diagnosis of PTE requires a high index of suspicion. Rapid deterioration of patient makes confirmative diagnosis difficult. There are few cases reports in the literature where the diagnosis of PTE was made ante mortem [8]. If clinical diagnosis of microscopic PTE is made and severity of respiratory distress is rapidly progressing, immediate treatment is more important than confirmative diagnosis. In our case, suspicious PTE was diagnosed using all available image modalities including echocardiography, chest CT scan, and ventilation-perfusion lung scans, although there was not biopsy-confirmed. Improving dyspnea and O 2 demand after appropriate chemotherapy could confirm the proper diagnosis of PTE. Standard chemotherapy regimens for locally advanced or metastatic EMPD have not been established [6]. There is no clinical trial for the efficacy of chemotherapy in locally advanced or metastatic EMPD due to scarce incidence. Only case reports with several agents were reported including 5-fluorouracil, platinum-base agents, mitomycin-c, docetaxel, and vincristine [6,9-12]. Clinical responses from these case reports were various. In our case, paclitaxel and carboplatin was applied in first line chemotherapy. Response to the chemotherapy was very dramatic. fter progression on first-line chemotherapy, 5-fluorouracil/cisplatin and docetaxel was applied. Finally, he died of progressive liver involvement of disease in 10 months after recurrence, which is a little long survival period. This case is a rare presentation of bone marrow metastasis with PTE secondary to EMPD of scrotum, which was properly diagnosed with high suspicion and was successfully treated with immediate chemotherapy. CKNOWLEDGMENTS This case was present in 41th annual meeting of Korean Cancer ssociation in REFERNCES 1. Chanda JJ. Extramammary Paget s disease: prognosis and relationship to Soonchunhyang Medical Science 21(2):
5 Cho S, et al. EMPD in one Marrow and Pulmonary Tumor Embolism internal malignancy. J m cad Dermatol 1985;13: Hatta N, Yamada M, Hirano T, Fujimoto, Morita R. Extramammary Paget s disease: treatment, prognostic factors and outcome in 76 patients. r J Dermatol 2008;158: Hegarty PK, Suh J, Fisher M, Taylor J, Nguyen TH, Ivan D, et al. Penoscrotal extramammary Paget s disease: the University of Texas M. D. nderson Cancer Center contemporary experience. J Urol 2011;186: Lloyd J, Flanagan M. Mammary and extramammary Paget s disease. J Clin Pathol 2000;53: Cappuccini F, Tewari K, Rogers LW, DiSaia PJ. Extramammary Paget s disease of the vulva: metastases to the bone marrow in the absence of an underlying adenocarcinoma: case report and literature review. Gynecol Oncol 1997;66: eleznay KM, Levesque M, Gill S. Response to 5-fluorouracil in metastatic extramammary Paget disease of the scrotum presenting as pancytopenia and back pain. Curr Oncol 2009;16: Kane RD, Hawkins HK, Miller J, Noce PS. Microscopic pulmonary tumor emboli associated with dyspnea. Cancer 1975;36: Ho L, Szulakowski P, Mohamid WH. The diagnostic challenge of pulmonary tumour thrombotic microangiopathy as a presentation for metastatic gastric cancer: a case report and review of the literature. MC Cancer 2015;15: Voigt H, assermann R, Nathrath W. Cytoreductive combination chemotherapy for regionally advanced unresectable extramammary Paget carcinoma. Cancer 1992;70: Oguchi S, Kaneko M, Uhara H, Saida T. Docetaxel induced durable response in advanced extramammary Paget s disease: a case report. J Dermatol 2002;29: Kariya K, Tsuji T, Schwartz R. Trial of low-dose 5-fluorouracil/cisplatin therapy for advanced extramammary Paget s disease. Dermatol Surg 2004; 30(2 Pt 2): Mochitomi Y, Sakamoto R, Gushi, Hashiguchi T, Mera K, Matsushita S, et al. Extramammary Paget s disease/carcinoma successfully treated with a combination chemotherapy: report of two cases. J Dermatol 2005;32: Soonchunhyang Medical Science 21(2):
Extramammary Paget Disease of External Genitalia: Surgical Excision and Follow-up Experiences With 19 Patients
www.kjurology.org http://dx.doi.org/10.4111/kju.013.54.1.834 Urological Oncology Extramammary Paget Disease of External Genitalia: Surgical Excision and Follow-up Experiences With 19 Patients Jae Hyun
More informationMetachronous anterior urethral metastasis of prostatic ductal adenocarcinoma
http://dx.doi.org/10.7180/kmj.2016.31.1.66 KMJ Case Report Metachronous anterior urethral metastasis of prostatic ductal adenocarcinoma Jeong Hyun Oh 1, Taek Sang Kim 1, Hyun Yul Rhew 1, Bong Kwon Chun
More informationCancers of unknown primary : Knowing the unknown. Prof. Ahmed Hossain Professor of Medicine SSMC
Cancers of unknown primary : Knowing the unknown Prof. Ahmed Hossain Professor of Medicine SSMC Definition Cancers of unknown primary site (CUPs) Represent a heterogeneous group of metastatic tumours,
More informationThe Effectiveness of Mapping Biopsy in Patients with Extramammary Paget s Disease
The Effectiveness of Mapping Biopsy in Patients with Extramammary Paget s Disease Byung Jun Kim, Shin Ki Park, Hak Chang Department of Plastic and Reconstructive Surgery, Seoul National University Hospital,
More information췌장의단일종괴형태로재발해원발성췌장암으로오인된재발성폐암
Case Report The Korean Journal of Pancreas and Biliary Tract 2018;23:172-176 https://doi.org/10.15279/kpba.2018.23.4.172 pissn 1976-3573 eissn 2288-0941 췌장의단일종괴형태로재발해원발성췌장암으로오인된재발성폐암 대구가톨릭대학교의과대학내과학교실
More informationRegression of Advanced Gastric MALT Lymphoma after the Eradication of Helicobacter pylori
Gut and Liver, Vol. 6, No. 2, April 2012, pp. 270-274 CASE REPORT Regression of Advanced Gastric MALT Lymphoma after the Eradication of Helicobacter pylori Soo-Kyung Park, Hwoon-Yong Jung, Do Hoon Kim,
More informationPrimary invasive carcinoma associated with penoscrotal extramammary Paget's disease: a clinicopathological analysis of 56 cases
Sexual Medicine Primary invasive carcinoma associated with penoscrotal extramammary Paget's disease: a clinicopathological analysis of 56 cases Bo Dai*, Yun-Yi Kong, Kun Chang*, Yuan-Yuan Qu*, Ding-Wei
More informationAcantholytic Anaplastic Extramammary Paget s Disease: A Case Report and Review of the Literature
Ann Dermatol Vol. 23, Suppl. 2, 2011 http://dx.doi.org/10.5021/ad.2011.23.s2.s226 CASE REPORT Acantholytic Anaplastic Extramammary Paget s Disease: A Case Report and Review of the Literature Yu-Jin Oh,
More informationDa Costa was the first to coin the term. Marjolin s Ulcer: A Case Report and Literature Review. Case Report. Introduction
E-Da Medical Journal 2016;3(2):24-28 Case Report Marjolin s Ulcer: A Case Report and Literature Review Yue-Chiu Su 1, Li-Ren Chang 2 Marjolin s ulcer is an aggressive cutaneous malignancy, which is common
More informationSakamoto et al. Journal of Medical Case Reports (2018) 12:136
Sakamoto et al. Journal of Medical Case Reports (2018) 12:136 https://doi.org/10.1186/s13256-018-1671-6 CASE REPORT Open Access Successful resection of a slow-growing synchronous pulmonary metastasis from
More informationPrimary Pulmonary Colloid Adenocarcinoma: How Can We Obtain a Precise Diagnosis?
doi: 10.2169/internalmedicine.1153-18 Intern Med 57: 3637-3641, 2018 http://internmed.jp CASE REPORT Primary Pulmonary Colloid Adenocarcinoma: How Can We Obtain a Precise Diagnosis? Shinsuke Ogusu 1, Koichiro
More informationProstate Case Scenario 1
Prostate Case Scenario 1 H&P 5/12/16: A 57-year-old Hispanic male presents with frequency of micturition, urinary urgency, and hesitancy associated with a weak stream. Over the past several weeks, he has
More informationCase Report Scrotal Apocrine Adenocarcinoma with Pagetoid Phenomenon and Inguinal Lymph Node Metastases
Volume 2016, Article ID 8353745, 4 pages http://dx.doi.org/10.1155/2016/8353745 Case Report Scrotal Apocrine Adenocarcinoma with Pagetoid Phenomenon and Inguinal Lymph Node Metastases Aristeidis Hristos
More informationDiagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD. November 18, 2017
Diagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD November 18, 2017 Disclosures I do not have a financial interest/arrangement or affiliation with one or more organizations
More informationCase Scenario 1 Worksheet. Primary Site C44.4 Morphology 8743/3 Laterality 0 Stage/ Prognostic Factors
CASE SCENARIO 1 9/10/13 HISTORY: Patient is a 67-year-old white male and presents with lesion located 4-5cm above his right ear. The lesion has been present for years. No lymphadenopathy. 9/10/13 anterior
More informationManagement of Neck Metastasis from Unknown Primary
Management of Neck Metastasis from Unknown Primary.. Definition Histologic evidence of malignancy in the cervical lymph node (s) with no apparent primary site of original tumour Diagnosis after a thorough
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More informationRadiology Pathology Conference
Radiology Pathology Conference Sharlin Johnykutty,, MD, Cytopathology Fellow Sara Majewski, MD, Radiology Resident Friday, August 28, 2009 Presentation material is for education purposes only. All rights
More informationNeuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma
J Gastric Cancer 2011;11(4):234-238 http://dx.doi.org/10.5230/jgc.2011.11.4.234 Case Report Neuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma Ho-Yeun Kim, Sung-Il Choi 1,
More informationTreatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy
Korean J Hepatobiliary Pancreat Surg 2011;15:152-156 Original Article Treatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy Suzy Kim 1,#, Kyubo
More informationTumor Board Discussions: Case 1
Tumor Board Discussions: Case 1 David S. Ettinger, MD The Alex Grass Professor of Oncology Johns Hopkins University School of Medicine Baltimore, Maryland Case #1 50-year-old Asian female, never smoker
More informationAdenocarcinoma Arising in Type 1 Congenital Cystic Adenomatoid Malformation: A Case Report and Review of the Literature
The Korean Journal of Pathology 2008; 42: 396-400 denocarcinoma rising in Type 1 Congenital Cystic denomatoid Malformation: Case Report and Review of the Literature Jinyoung Yoo Sun Mi Lee Ji Han Jung
More informationImaging in gastric cancer
Imaging in gastric cancer Gastric cancer remains a deadly disease because of late diagnosis. Adenocarcinoma represents 90% of malignant tumors. Diagnosis is based on endoscopic examination with biopsies.
More informationDiffuse Follicular Variant of Papillary Thyroid Carcinoma in a 69-Year-old Man with Extensive Extrathyroidal Extension: A Case Report
SE REPORT Oncology & Hematology http://dx.doi.org/10.3346/jkms.2013.28.3.480 J Korean Med Sci 2013; 28: 480-484 Diffuse Follicular Variant of Papillary Thyroid arcinoma in a 69-Year-old Man with Extensive
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER VULVAR
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER VULVAR Last Revision Date July 2015 1 Site Group: Gynecologic Cancer Vulvar Author: Dr. Stephane Laframboise 1. INTRODUCTION
More informationCitation Auris, nasus, larynx (2011), 38(3):
TitleManagement of metastasis to the thy Author(s) Ishikawa, Masaaki; Hirano, Shigeru; Citation Auris, nasus, larynx (2011), 38(3): Issue Date 2011-06 URL http://hdl.handle.net/2433/139807 Right 2010 Elsevier
More informationMUSCLE-INVASIVE AND METASTATIC BLADDER CANCER
MUSCLE-INVASIVE AND METASTATIC BLADDER CANCER (Text update March 2008) A. Stenzl (chairman), N.C. Cowan, M. De Santis, G. Jakse, M. Kuczyk, A.S. Merseburger, M.J. Ribal, A. Sherif, J.A. Witjes Introduction
More informationIntroduction. Results. Discussion. Histopathologic and immunohistochemical findings. Results. conclusions,
1/5 2/5 Carcinoma distinctive carcinoma. form erysipeloides (CE), metastasis. which clinically Itfrom has resembles been termed erysipelas, is an uncommon, but may extend It164 toclassically back, presents
More informationJournal of Breast Cancer
CSE REPORT Journal of reast Cancer J reast Cancer 2012 September; 15(3): 359-363 Occult reast Cancers Manifesting as xillary Lymph Node Metastasis in Men: Two-Case Report Sung Mo Hur, Dong Hui Cho 1, Se
More informationCase Scenario 1: Thyroid
Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.
More informationSTAGE CATEGORY DEFINITIONS
CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery TX Tis Tis (DCIS) Tis (LCIS) Tis (Paget s) T1 T1mi T1a T1b T1c a b c
More informationPET in Rectal Carcinoma
Case Report PET in Rectal Carcinoma Josefina Jofré M 1, Paulina Sierralta C 1, José Canessa G 1,2, Pamela Humeres A 3, Gabriel Castro M 4, Teresa Massardo V 1,4 1 Centro PET de Imágenes Moleculares, Hospital
More informationCase Report Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor
Case Reports in Otolaryngology Volume 2016, Article ID 5393404, 4 pages http://dx.doi.org/10.1155/2016/5393404 Case Report Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor
More informationSURGERY OF THE HAND. Nodular Melanoma on the Tip of the Thumb INTRODUCTION CASE REPORT. Su Hyun Choi, Hong Bae Jeon, Ja Hea Gu
CSE REPORT pissn 1598-3889 eissn 2234-0998 J Korean Soc Surg Hand 2016;21(4):238-242. http://doi.org/10.12790/jkssh.2016.21.4.238 JOURNL OF THE KOREN SOCIETY FOR SURGERY OF THE HND Nodular Melanoma on
More informationCase Scenario 1. Pathology report Specimen from mediastinoscopy Final Diagnosis : Metastatic small cell carcinoma with residual lymphatic tissue
Case Scenario 1 Oncology Consult: Patient is a 51-year-old male with history of T4N3 squamous cell carcinoma of tonsil status post concurrent chemoradiation finished in October two years ago. He was hospitalized
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More informationPrimary cutaneous malignant melanoma of the breast
J Korean Surg Soc 2012;83:388-392 http://dx.doi.org/10.4174/jkss.2012.83.6.388 CASE REPORT JKSS Journal of the Korean Surgical Society pissn 2233-7903 ㆍ eissn 2093-0488 Primary cutaneous malignant melanoma
More informationEsophageal Cancer Initially Thought to be Accompanied by a Solitary Metastasis to an Intrathoracic Paraaortic Lymph Node
2012 66 5 417 421 Esophageal Cancer Initially Thought to be Accompanied by a Solitary Metastasis to an Intrathoracic Paraaortic Lymph Node a b* a a a a a a a b ʼ 418 Horio et al. Acta Med. Okayama Vol.
More informationCase Report Five-Year Survival after Surgery for Invasive Micropapillary Carcinoma of the Stomach
Case Reports in Surgery Volume 2013, Article ID 560712, 4 pages http://dx.doi.org/10.1155/2013/560712 Case Report Five-Year Survival after Surgery for Invasive Micropapillary Carcinoma of the Stomach Shigeo
More informationDefinition Prostate cancer
Prostate cancer 61 Definition Prostate cancer is a malignant neoplasm that arises from the prostate gland and the most common form of cancer in men. localized prostate cancer is curable by surgery or radiation
More informationPET IMAGING (POSITRON EMISSION TOMOGRAPY) FACT SHEET
Positron Emission Tomography (PET) When calling Anthem (1-800-533-1120) or using the Point of Care authorization system for a Health Service Review, the following clinical information may be needed to
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More informationPre-operative assessment of patients for cytoreduction and HIPEC
Pre-operative assessment of patients for cytoreduction and HIPEC Washington Hospital Center Washington, DC, USA Ovarian Cancer Surgery New Strategies Bergamo, Italy May 5, 2011 Background Cytoreductive
More informationBAP-oma & BEYOND MICHAEL A NOWAK, MD
BAP-oma & BEYOND MICHAEL A NOWAK, MD CONFLICTS No conflicts with the content of this lecture BAP-oma Wiesner 2011: Families with multiple tan dome-shaped papules of head, neck, trunk, and extremities.
More informationThymic Tumors. Feiran Lou MD. MS. Kings County Hospital Department of Surgery
Thymic Tumors Feiran Lou MD. MS. Kings County Hospital Department of Surgery Case HPI 53 yo man referred from OSH for anterior mediastinal mass. Initially presented with leg weakness and back pain for
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationCOLONIC METASTASIS FROM A PRIMARY ADENOCARCINOMA OF THE LUNG PRESENTING WITH ACUTE ABDOMINAL PAIN: A CASE REPORT
COLONIC METASTASIS FROM A PRIMARY ADENOCARCINOMA OF THE LUNG PRESENTING WITH ACUTE ABDOMINAL PAIN: A CASE REPORT Ming-Wei Weng, 1 Hong-Chung Wang, 2,4 Jen-Chih Chiou, 2,4 Shong-Ling Lin, 3,4 and Ruay-Sheng
More informationCase Scenario 1. Pathology: Specimen type: Incisional biopsy of the glottis Histology: Moderately differentiated squamous cell carcinoma
Case Scenario 1 History A 52 year old male with a 20 pack year smoking history presented with about a 6 month history of persistent hoarseness. The patient had a squamous cell carcinoma of the lip removed
More informationR. F. Falkenstern-Ge, 1 S. Bode-Erdmann, 2 G. Ott, 2 M. Wohlleber, 1 and M. Kohlhäufl Introduction. 2. Histology
Case Reports in Oncological Medicine Volume 2013, Article ID 167585, 4 pages http://dx.doi.org/10.1155/2013/167585 Case Report Late Lung Metastasis of a Primary Eccrine Sweat Gland Carcinoma 10 Years after
More informationPregnancy in the middle of adjuvant treatment of Her2 positive breast cancer
ESMO Preceptorship Programme ESMO Preceptorship ADOLESCENTS & YOUNG ADULTS MALIGNANCIES Lugano, Switzerland 11-12 May 2018 Petra Vuković, University Hospital for Tumors, University Hospital Center Sestre
More informationAcute cor pulmonale due to pulmonary tumor thrombotic microangiopathy in two patients with breast cancer
LETTER TO THE EDITOR Korean J Intern Med 2017;32:190-194 Acute cor pulmonale due to pulmonary tumor thrombotic microangiopathy in two patients with breast cancer Sung Young Moon, Kang Hoon Lee, Jong Sik
More informationA nonresponding small cell lung cancer combined with adenocarcinoma
Case Report A nonresponding small cell lung cancer combined with adenocarcinoma Hongyang Lu 1,2, Shifeng Yang 3 1 Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung
More informationCase Scenario 1. The patient agreed to a CT guided biopsy of the left upper lobe mass. This was performed and confirmed non-small cell carcinoma.
Case Scenario 1 An 89 year old male patient presented with a progressive cough for approximately six weeks for which he received approximately three rounds of antibiotic therapy without response. A chest
More informationEndobronchial ALK-Positive Anaplastic Large Cell Lymphoma Presenting Massive Hemoptysis
CSE REPORT http://dx.doi.org/10.4046/trd.2015.78.4.390 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2015;78:390-395 Endobronchial LK-Positive naplastic Large Cell Lymphoma Presenting Massive
More informationCase Scenario 1. The patient has now completed his neoadjuvant chemoradiation and has been cleared for surgery.
Case Scenario 1 July 10, 2010 A 67-year-old male with squamous cell carcinoma of the mid thoracic esophagus presents for surgical resection. The patient has completed preoperative chemoradiation. This
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationperformed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.
Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician
More informationMetastatic mechanism of spermatic cord tumor from stomach cancer
Int Canc Conf J (2013) 2:191 195 DOI 10.1007/s13691-013-0-9 CANCER BOARD CONFERENCE Metastatic mechanism of spermatic cord tumor from stomach cancer Masahiro Seike Yoshikazu Kanazawa Ryuji Ohashi Tadashi
More informationSubject Index. Androgen antiandrogen therapy, see Hormone ablation therapy, prostate cancer synthesis and metabolism 49
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index Androgen antiandrogen therapy, see Hormone ablation therapy, synthesis and metabolism 49 Bacillus Calmette-Guérin adjunct therapy with transurethral resection
More informationIntended for use by Clinicians and Health Care Providers involved in the Management or Referral of adult patients with pancreatic
Intended for use by Clinicians and Health Care Providers involved in the Management or Referral of adult patients with pancreatic cancer Section AA Cancer Centre Referrals In the absence of metastatic
More informationIndex. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type.
Surg Oncol Clin N Am 16 (2007) 465 469 Index Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, preoperative for gastric cancer, staging and, 339 B Breast cancer, metabolic
More informationCase Report Intramucosal Signet Ring Cell Gastric Cancer Diagnosed 15 Months after the Initial Endoscopic Examination
Hindawi Publishing Corporation Case Reports in Medicine Volume 2015, Article ID 479625, 5 pages http://dx.doi.org/10.1155/2015/479625 Case Report Intramucosal Signet Ring Cell Gastric Cancer Diagnosed
More informationAmerican Journals of Cancer Case Reports. A Rare Case of Rectal Metastasis from Sarcomatoid Variant of Urothelial Carcinoma: A Case Report
American Journals of Cancer Case Reports Lin JYJ et al. American Journals of Cancer Case Reports 2014, 3:1-5 http://ivyunion.org/index.php/ajccr Page 1 of 5 Vol 3 Article ID 20140539, 5 pages Case Report
More informationPSA. HMCK, p63, Racemase. HMCK, p63, Racemase
Case 1 67 year old male presented with gross hematuria H/o acute prostatitis & BPH Urethroscopy: small, polypoid growth with a broad base emanating from the left side of the verumontanum Serum PSA :7 ng/ml
More information5/8/2014. AJCC Stage Introduction and General Rules. Acknowledgements* Introduction. Melissa Pearson, CTR North Carolina Central Cancer Registry
AJCC Stage Introduction and General Rules Linda Mulvihill Public Health Advisor NCRA Annual Meeting May 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention
More informationChapter 1. Introduction
Chapter 1 Introduction Introduction 9 Even though the first reports on venous thromboembolism date back to the 13 th century and the mechanism of acute pulmonary embolism (PE) was unraveled almost 150
More informationLYMPHATIC DRAINAGE IN THE HEAD & NECK
LYMPHATIC DRAINAGE IN THE HEAD & NECK Like other parts of the body, the head and neck contains lymph nodes (commonly called glands). Which form part of the overall Lymphatic Drainage system of the body.
More informationPET imaging of cancer metabolism is commonly performed with F18
PCRI Insights, August 2012, Vol. 15: No. 3 Carbon-11-Acetate PET/CT Imaging in Prostate Cancer Fabio Almeida, M.D. Medical Director, Arizona Molecular Imaging Center - Phoenix PET imaging of cancer metabolism
More informationManagement of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms
Management of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms Dr. Claudia LY WONG, Department of Surgery, Kwong Wah Hospital Joint Hospital Surgical Grand Round Presentation,
More informationClinical Pathological Conference. Malignant Melanoma of the Vulva
Clinical Pathological Conference Malignant Melanoma of the Vulva History F/48 Chinese Married Para 1 Presented in September 2004 Vulval mass for 2 months Associated with watery and blood stained discharge
More informationA variation in recurrence patterns of papillary thyroid cancer with disease progression: A long-term follow-up study
ORIGINAL ARTICLE A variation in recurrence patterns of papillary thyroid cancer with disease progression: A long-term follow-up study Joon-Hyop Lee, MD, Yoo Seung Chung, MD, PhD,* Young Don Lee, MD, PhD
More informationKidney Case 1 SURGICAL PATHOLOGY REPORT
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
More informationNumber of Metastatic Lymph Nodes in Resected Non Small Cell Lung Cancer Predicts Patient Survival
Number of Metastatic Lymph Nodes in Resected Non Small Cell Lung Cancer Predicts Patient Survival Jin Gu Lee, MD, Chang Young Lee, MD, In Kyu Park, MD, Dae Joon Kim, MD, Seong Yong Park, MD, Kil Dong Kim,
More informationCase Report Primary Diaphragmatic Dedifferentiated Liposarcoma in a Young Female Patient after Delivery
Case Reports in Oncological Medicine Volume 2016, Article ID 4042719, 4 pages http://dx.doi.org/10.1155/2016/4042719 Case Report Primary Diaphragmatic Dedifferentiated Liposarcoma in a Young Female Patient
More informationSURGERY OF THE HAND. Basosquamous Carcinoma of the Hand in a Radiologist with Prolonged Radiation Exposure INTRODUCTION CASE REPORT CASE REPORT
CASE REPORT pissn 1598-3889 eissn 2234-0998 J Korean Soc Surg Hand 2016;21(3):162-166. http://dx.doi.org/10.12790/jkssh.2016.21.3.162 JOURNAL OF THE KOREAN SOCIETY FOR SURGERY OF THE HAND Basosquamous
More informationContiguous Spinal Metastasis Mimicking Infectious Spondylodiscitis 감염성척추염과유사하게보였던연속적척추전이의증례
Case Report pissn 1738-2637 / eissn 2288-2928 http://dx.doi.org/10.3348/jksr.2015.73.6.408 감염성척추염과유사하게보였던연속적척추전이의증례 Chul-Min Lee, MD 1, Seunghun Lee, MD 1 *, Jiyoon Bae, MD 2 1 Department of Radiology,
More informationA 64 y.o. man presents to the hospital with persistent cough and hemoptysis. Fernando Mut Montevideo - Uruguay
A 64 y.o. man presents to the hospital with persistent cough and hemoptysis Fernando Mut Montevideo - Uruguay Teaching case Bone # 1 A 64 y.o. man presents to the hospital with persistent cough and hemoptysis.
More informationLos Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010
Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Self Assessment Module on Nuclear Medicine and PET/CT Case Review FDG PET/CT IN LYMPHOMA AND MELANOMA Submitted
More informationMultiple Primary Quiz
Multiple Primary Quiz Case 1 A 72 year old man was found to have a 12 mm solid lesion in the pancreatic tail by computed tomography carried out during a routine follow up study of this patient with adult
More informationRECTAL CANCER CLINICAL CASE PRESENTATION
RECTAL CANCER CLINICAL CASE PRESENTATION Francesco Sclafani Medical Oncologist, Clinical Research Fellow The Royal Marsden NHS Foundation Trust, London, UK esmo.org Disclosure I have nothing to declare
More informationCase history: Figure 1. H&E, 5x. Figure 2. H&E, 20x.
1 Case history: A 49 year-old female presented with a 5 year history of chronic anal fissure. The patient s past medical history is otherwise unremarkable. On digital rectal examination there was a very
More informationSpinal Metastases of Extramammary Paget Disease with Radiologic-Pathologic Correlation
Spinal Metastases of Extramammary Paget Disease with Radiologic-Pathologic Correlation Jason T Little 1*, Vance T Lehman 1, Jonathan M Morris 1, Julia S Lehman 2, Felix E Diehn 1 1. Department of Radiology,
More informationCase Report Apocrine Adenocarcinoma of the Vulva: A Case Report and Review of the Literature
Case Reports in Obstetrics and Gynecology Volume 2016, Article ID 1712404, 4 pages http://dx.doi.org/10.1155/2016/1712404 Case Report Apocrine Adenocarcinoma of the Vulva: A Case Report and Review of the
More informationUnusual Osteoblastic Secondary Lesion as Predominant Metastatic Disease Spread in Two Cases of Uterine Leiomyosarcoma
49 Unusual Osteoblastic Secondary Lesion as Predominant Metastatic Disease Spread in Two Cases of Uterine Leiomyosarcoma Loredana Miglietta a Maria Angela Parodi b Luciano Canobbio b Luca Anselmi c a Medical
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Ablative therapy, nonsurgical, for pulmonary metastases of soft tissue sarcoma, 279 280 Adipocytic tumors, atypical lipomatous tumor vs. well-differentiated
More informationCoexistence of parathyroid adenoma and papillary thyroid carcinoma. Yong Sang Lee, Kee-Hyun Nam, Woong Youn Chung, Hang-Seok Chang, Cheong Soo Park
J Korean Surg Soc 2011;81:316-320 http://dx.doi.org/10.4174/jkss.2011.81.5.316 ORIGINAL ARTICLE JKSS Journal of the Korean Surgical Society pissn 2233-7903 ㆍ eissn 2093-0488 Coexistence of parathyroid
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer
THIS DOCUMENT IS North of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer [Based on WOSCAN NSCLC CMG with further extensive consultation within NOSCAN] UNCONTROLLED
More informationClinical indications for positron emission tomography
Clinical indications for positron emission tomography Oncology applications Brain and spinal cord Parotid Suspected tumour recurrence when anatomical imaging is difficult or equivocal and management will
More informationDisclosures. Outline. What IS tumor budding?? Tumor Budding in Colorectal Carcinoma: What, Why, and How. I have nothing to disclose
Tumor Budding in Colorectal Carcinoma: What, Why, and How Disclosures I have nothing to disclose Soo-Jin Cho, MD, PhD Assistant Professor UCSF Dept of Pathology Current Issues in Anatomic Pathology 2017
More informationQuality of life (QoL) in metastatic breast cancer patients with. maintenance paclitaxel plus gemcitabine (PG) chemotherapy:
Quality of life (QoL) in metastatic breast cancer patients with maintenance paclitaxel plus gemcitabine (PG) chemotherapy: results from phase III, multicenter, randomized trial of maintenance chemotherapy
More informationESD for EGC with undifferentiated histology
ESD for EGC with undifferentiated histology Jun Haeng Lee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Biopsy: M/D adenocarcinoma ESD: SRC >>
More informationBRAJACTT. Protocol Code. Breast. Tumour Group. Dr. Karen Gelmon. Contact Physician
BC Cancer Protocol Summary for Adjuvant Therapy for Breast Cancer using DOXOrubicin and Cyclophosphamide followed by PACLitaxel and Trastuzumab (HERCEPTIN) Protocol Code Tumour Group Contact Physician
More informationThe Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism
ORIGINAL ARTICLE DOI: 10.3904/kjim.2009.24.2.123 The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism Won-Ho Choi 1, Sung Uk Kwon 1,2, Yoon Jung Jwa 1,
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationCase 18. M75. Excision of mass on scalp. Clinically SCC. The best diagnosis is:
Case 18 M75. Excision of mass on scalp. Clinically SCC. The best diagnosis is: A. Pilomatrical carcinoma B. Adnexal carcinoma NOS C. Metastatic squamous cell carcinoma D.Primary squamous cell carcinoma
More informationCase Report pissn J Korean Soc Radiol 2012;67(4): INTRODUCTION CASE REPORT
Case Report pissn 1738-2637 Focal Fat Deposition Developed in the Segment IV of the Liver Following Gastrectomy Mimicking a Hepatic Metastasis: Two Case Reports 1 위절제술후에간의제 4 분절에서발생한간전이를닮은국소지방침윤 : 두증례보고
More informationFDG-PET/CT in Gynaecologic Cancers
Friday, August 31, 2012 Session 6, 9:00-9:30 FDG-PET/CT in Gynaecologic Cancers (Uterine) cervical cancer Endometrial cancer & Uterine sarcomas Ovarian cancer Little mermaid (Edvard Eriksen 1913) honoring
More informationJournal of Breast Cancer
CSE REPORT Journal of reast Cancer J reast Cancer 2016 December; 19(4): 459-464 Increased Malignant Microcalcifications after Neoadjuvant Chemotherapy in dvanced reast Cancer Gi Won Shin, Young Mi Park,
More informationIt is a malignancy originating from breast tissue
59 Breast cancer 1 It is a malignancy originating from breast tissue including both early stages which are potentially curable, and metastatic breast cancer (MBC) which is usually incurable. Most breast
More informationEpidermiology Early pulmonary embolism
Epidermiology Early pulmonary embolism Sitang Nirattisaikul Faculty of Medicine, Prince of Songkla University 3 rd most common cause of cardiovascular death in the United States, following ischemic heart
More information