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occult malignancy

Ashwin Singh Parihar, Bhagwant Rai Mittal, Shelvin Kumar Vadi, Rajender Kumar, Kaniyappan Nambiyar, Bishan Radotra, Lileswar Kaman
We present the case of a 36-year-old woman who underwent 18 F-FDG PET/CT with suspicion of a primary breast malignancy. However, PET/CT detected an occult renal cell carcinoma with metastases to the thyroid, breast, lungs and lymph nodes. Thyroid and breast metastases are atypical metastatic sites of renal cell carcinoma. Breast metastases from extra mammary tissue are extremely rare, more so from renal cell carcinoma. Histopathologic confirmation of the breast lesions is imperative to avoid unnecessary mastectomy and imaging can help in raising the suspicion of metastatic involvement versus primary breast malignancy...
December 2018: Nuclear Medicine and Molecular Imaging
Pushpendra Nath Renjen, Dinesh Mohan Chaudhari, U S Shilpi, Dhruv Zutshi, Kamal Ahmad
Paraneoplastic syndromes are a rare heterogeneous group of disorders that are indicators of the underlying occult malignancy. Subacute cerebellar ataxia in a patient with a known cancer is often due to metastatic invasion or other complications of the cancer, such as infection, coagulopathy, metabolic and nutritional deficits, or side effects of treatment. When tumor- and treatment-related causes have been excluded, the patient is considered to suffer from paraneoplastic cerebellar degeneration (PCD). We report a case of PCD that presented before any evidence of tumor, but early diagnostic workup and clinical vigilance helped us to find the underlying high-grade ovarian adenocarcinoma which was surgically removed later...
October 2018: Annals of Indian Academy of Neurology
Claudia Ciaccio, Veronica Saletti, Stefano D'Arrigo, Silvia Esposito, Enrico Alfei, Isabella Moroni, Davide Tonduti, Luisa Chiapparini, Chiara Pantaleoni, Donatella Milani
OBJECTIVE OF THE STUDY: To give a full overview of the clinical presentation of PTEN mutations in pediatric patients and to propose a pediatric follow-up protocol. METHODS: Recruitment of 16 PTEN mutated children (age 6 months-11 years) from two pediatric centers in Milan (Italy) between 2006 and 2017. All the patients underwent clinical and neurologic evaluations, cognitive and behavioral tests, and brain MRI; they are currently following an oncologic follow-up...
December 4, 2018: European Journal of Medical Genetics
David I Shalowitz, Alexandra Goodwin, Nicholas Schoenbachler
Patients with atypical endometrial hyperplasia (AEH) in the United States are commonly referred to a gynecologic oncologist given a moderate risk of concurrent carcinoma. However, selective referral of patients to non-oncologic gynecologic surgeons for surgical treatment of AEH may offer increased access to care without compromising clinical outcomes. Non-oncologic surgeons who consider providing surgical treatment for AEH must be able to offer minimally invasive surgery when appropriate and have sufficient surgical volume to deliver optimal clinical outcomes...
December 7, 2018: American Journal of Obstetrics and Gynecology
C Y Shui, C Li, R H Sun, Y Q Zhou
Sinonasal neoplasms are common tumors in the head and neck.The types of tumor pathological tissues are complex and diverse, and the incidence of malignant tumors is relatively low.The malignant tumor of paranasal sinuses is occult, and most of them are locally advanced.Although surgery is the main treatment for such diseases, the specific treatment plan is still controversial.This article reviews the treatment of sinonasal malignancy.
November 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Enyinnaya Ofo, Harry Spiers, Dae Kim, Umamaheswar Duvvuri
Carcinoma of unknown primary (CUP) comprises approximately 1%-5% of all head and neck malignancies. Primary site detection rates for metastatic cervical squamous cell carcinoma (SCC) remain variable, with current diagnostic imaging unable to identify all tumours. Prevailing evidence suggests that most head and neck CUP are located in the oropharynx. Diagnostic surgical efforts have been directed at sampling the entire oropharynx. Present techniques that make this possible include transoral robotic surgery (TORS)...
2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Joost M Blok, J Martijn Kerst, Erik Vegt, Oscar R Brouwer, Richard P Meijer, J L H Ruud Bosch, Axel Bex, Henk G van der Poel, Simon Horenblas
OBJECTIVES: To report the long-term results of the sentinel node approach in clinical stage I testicular tumour patients in our facility. PATIENTS AND METHODS: Analysis of 27 consecutive patients suspected of clinical stage I testicular germ cell tumour and treated with a sentinel node procedure at our tertiary referral centre. Sentinel nodes were identified using lymphoscintigraphy with or without single photo emission computed tomography with computed tomography...
November 11, 2018: BJU International
Sarah Dotson, Alejandro Landa, Jessie Ehrisman, Angeles Alvarez Secord
Background: Widespread concerns have been raised regarding the safety of power morcellation of uterine specimens because of the potential to disseminate occult malignancy. We sought to assess the safety and feasibility of contained manual uterine morcellation within a plastic specimen bag among women with uterine neoplasms. Methods: A retrospective single-institution descriptive cohort study was conducted from 2003 to 2014. Patients with leiomyoma and/or uterine malignancy who underwent minimally invasive surgery with contained uterine manual morcellation were identified from surgical logs...
2018: Gynecologic Oncology Research and Practice
Marina N Boushra, Susan N Miller, Alex Koyfman, Brit Long
BACKGROUND: Evaluation and treatment of the acutely ill patient is typically complicated by multiple comorbidities and incomplete medical histories. This is exemplified by patients with sepsis, whose care is complicated by variable presentations, shifting definitions, and a variety of potential sources. Many practitioners fail to consider and recognize less-common sources of infection in a timely manner. Additionally, multiple noninfectious conditions can present with the fever and tachycardia typical of the septic patient...
November 2, 2018: Journal of Emergency Medicine
Hiroyuki Yamashita
Patients with malignant tumors may present with joint pain or arthritis(paraneoplastic arthritis). It needs to be carefully determined whether these symptoms are related to the malignant tumor, due to a concomitant rheumatoid disease, due to an adverse reaction to treatment, or due to a relapse. It can be relatively easy to diagnose paraneoplastic syndrome when there is clearly a malignant tumor present or typical symptoms are exhibited. However, clinicians should be aware that these paraneoplastic syndrome phenomena can occur before the malignant tumor is diagnosed...
2018: Clinical Calcium
Cenk Demirdover, Alper Geyik, Haluk Vayvada, Adnan Menderes
Background: Reduction mammaplasty (RM) is one of the most common plastic surgery procedures. Despite its cost, the total number of RM procedures continues to increase every year. Objectives: The purpose of this study is to review the prevalence of benign and malignant breast lesions among women who live in Aegean region of Turkey, based on our university hospital's records and to compare our results with those in the literature. Methods: Seven hundred and thirty-three consecutive female patients who underwent RM between January 2003 and January 2017 in the Department of Plastic, Reconstructive, and Aesthetic Surgery were included in this study...
October 29, 2018: Aesthetic Surgery Journal
Michael C Burke, Ankur Garg, Jonathan M Youngner, Swati D Deshmukh, Imran M Omar
OBJECTIVE: Our purpose was to determine whether dual-energy CT (DECT), specifically the bone marrow setting of the virtual noncalcium (VNCa) algorithm, could be used to identify and accurately biopsy suspected bone malignancies that were visible on magnetic resonance imaging (MRI), nuclear bone scintigraphy, or positron-emission tomography/computed tomography (PET/CT), but occult on monoenergetic computed tomography (CT) by virtue of being either isodense or nearly isodense to surrounding normal bone...
October 20, 2018: Skeletal Radiology
Aris Giannos, Sofoklis Stavrou, Athanasios Douskos, Peter Drakakis, Dimitrios Loutradis
INTRODUCTION: BRCA1 inherited mutation carriers face a lifetime risk of 72% to develop breast cancer and a percentage of 44% risk for ovarian cancer. PRESENTATION OF CASE: We present a case of a 35-year old Caucasian woman who, after the excision of a possible malignant finding on the right breast, was diagnosed with ductal breast carcinoma. The patient treatment included first chemotherapy and radiotherapy and then prophylactic bilateral mastectomy with plastic reconstructive surgery...
2018: International Journal of Surgery Case Reports
Alfonso Fausto, Marco Bernini, Daniele La Forgia, Annarita Fanizzi, Marco Marcasciano, Luca Volterrani, Donato Casella, Maria Antonietta Mazzei
OBJECTIVE: The aim of this study is to present a 6-year prospective evaluation of second-look ultrasound (US) using volume navigation (V Nav) for MRI-detected additional breast lesions. METHODS: After IRB approvals in both institutions, 1930 consecutive prone MRI breast examinations in 1437 patients were prospectively evaluated. All patients with an MRI-detected additional lesion underwent second-look US, and if occult, contrast-enhanced MRI in supine position was performed for US and MRI co-registration...
October 15, 2018: European Radiology
Iwona Gawron, Krzysztof Skotniczny, Artur Ludwin
OBJECTIVES: To estimate the incidence of occult uterine malignancies during laparoscopic supracervical hysterectomy (LSH). MATERIAL AND METHODS: Retrospective cohort study based on archival data (2010-2016) of the Department of Gynecology and Oncology, Jagiellonian University. RESULTS: Medical records of 696 women, who underwent LSH were analyzed. Two occult sarcomas (2/696; 0.29%, 0.003, 95% CI: 0.001 to 0.01), including one case of low-grade endometrial stromal sarcoma (ESS) with co-occurring atypical endometrial hyperplasia (AH) and one case of high-grade ESS were found postoperatively...
2018: Ginekologia Polska
Henry To, Bee Shan Ong, Tom Dodd, Subhita Prasannan
Synchronous phyllodes tumour and invasive lobular carcinoma is an extremely rare event. We report these concurrent diagnoses in a patient observed in an ipsilateral breast, suspected due to breast risk factors (family history and lobular carcinoma in situ ) and the presence of malignant phyllodes. Screening breast magnetic resonance imaging was able to identify the carcinoma which was occult in other imaging. An understanding of the possibility of dual diagnoses may lead to additional investigations for its identification...
October 2018: Journal of Surgical Case Reports
Lindsey West, Matthew Carlson, Luke Wallis, Heather W Goff
BACKGROUND: The sign of Leser-Trelát is controversial and rarely reported in gynecologic malignancies. It is characterized by rapid development of new or enlarging seborrheic keratoses. CASE: A 78-year-old woman presented with unintentional weight loss and new-onset erythematous patches and plaques with thickened, rugated skin and stuck-on brown waxy papules on the chest and back. Her symptoms were concerning for a paraneoplastic eruption; workup revealed an elevated CA 125 level and an ovarian mass on abdominal computed tomography scan...
October 5, 2018: Obstetrics and Gynecology
Evelyn Hall, Katina Robison, Kyle Wohlrab
PURPOSE OF REVIEW: This article serves as an update on issues relating to the intersection of pelvic floor disorders and gynecology oncology. RECENT FINDINGS: Gynecologic cancer survivors experience pelvic floor disorders (PFDs) at a higher rate than their age-matched peers, often because of shared risk factors and as sequelae of cancer treatment. Concomitant pelvic floor and oncologic surgery can serve as a method to promote quality of life. Studies have demonstrated concomitant surgery to be well tolerated in appropriately selected patients, but only about 2% of oncologic surgeries are coordinated to include the treatment of PFDs...
December 2018: Current Opinion in Obstetrics & Gynecology
Hiroto Sasamori, Kimiichi Uno, Jin Wu
OBJECTIVE: Positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose (F18-FDG) is useful for the detection of malignant lesions, including metastatic lesions, and this technique is widely used in cancer screening. However, this approach may occasionally yield false-positive and false-negative findings. At our PET center, to increase the accuracy of PET/CT, we use PET/CT and whole-body diffusion-weighted imaging (WB-DWI) together. This study aimed to assess the usefulness of this combination...
October 8, 2018: Annals of Nuclear Medicine
Daniel P Noij, Roland M Martens, Ben Zwezerijnen, Thomas Koopman, Remco de Bree, Otto S Hoekstra, Pim de Graaf, Jonas A Castelijns
BACKGROUND AND PURPOSE: Head and neck squamous cell carcinoma (HNSCC) may present with cervical metastases without an apparent primary tumor. Detecting the primary tumor results in more targeted treatment. Acquisition of DWI is improving with less artifacts and image distortion. We assessed the diagnostic value of DWI and 18 F-FDG-PET/CT for detecting primary tumors in patients presenting with nodal metastasis of an unknown primary HNSCC. MATERIALS AND METHODS: For this retrospective study we included 31 patients (male/female ratio = 23/8, median age = 66 years, age range = 40-80 years) who presented with a pathologically proven cervical nodal metastasis from HNSCC without overt primary tumor location between January 2013 and November 2016 and underwent both DWI and 18 F-FDG-PET/CT...
October 2018: European Journal of Radiology
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