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A rare case of retroperitoneal teratoma with evidence of papillary thyroid carcinoma: a case report.BMC Endocrine Disorders Jun 2024Teratomas are germ cell tumors composed of somatic tissues from up to three germ layers. Primary retroperitoneal teratomas usually develop during childhood and are...
BACKGROUND
Teratomas are germ cell tumors composed of somatic tissues from up to three germ layers. Primary retroperitoneal teratomas usually develop during childhood and are uncommon in adults and in the retroperitoneal space. While there are only a few cases of retroperitoneal thyroid tissue, we report a unique case of a retroperitoneal papillary thyroid carcinoma.
CASE PRESENTATION
A 41-year-old woman presented in our institution due to intermitted unspecific abdominal pain. Magnetic resonance imaging detected a multi-cystic solid retroperitoneal mass ventral to the psoas muscle and the left iliac artery. After surgical removal of the retroperitoneal mass, histology sections of the specimen indicated evidence of papillary thyroid carcinoma cells. A staging computed tomography scan of the body showed no further manifestations. To reduce the risk of recurrence, total thyroidectomy was performed followed by radioiodine therapy with lifelong hormone substitution.
CONCLUSIONS
Primary retroperitoneal teratoma with evidence of papillary thyroid carcinoma is a rare condition. Preoperative diagnosis is difficult due to its non-specific clinical manifestation and lack of specific radiologic findings. Histopathology analysis is necessary for diagnosis. Although surgery is considered the first line treatment, there is still discussion about the extent of resection and the need for total thyroidectomy with adjuvant radioiodine therapy.
Topics: Humans; Female; Adult; Teratoma; Retroperitoneal Neoplasms; Thyroid Neoplasms; Thyroid Cancer, Papillary; Thyroidectomy; Prognosis
PubMed: 38858658
DOI: 10.1186/s12902-024-01606-4 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024To investigate the treatment of internal carotid artery rupture after radiotherapy for nasopharyngeal carcinoma. The clinical data of 7 patients with internal carotid...
To investigate the treatment of internal carotid artery rupture after radiotherapy for nasopharyngeal carcinoma. The clinical data of 7 patients with internal carotid artery rupture after radiotherapy for nasopharyngeal carcinoma from March 2020 to March 2023 were retrospectively analyzed. Skull base osteonecrosis with infection occurred in 4 cases, and tumor recurrence with infection in 3 cases. DSA showed that internal carotid artery rupture was located in the internal carotid artery petrosal segment in 6 cases, and in the paravicular segment in 1 case. Balloon occlusion test(BOT) was performed in 6 patients, of which 3 passed and 3 failed. Vascular treatment included internal carotid artery embolization(4 cases), false aneurysm embolization 1 case(rebleeding), coated stent 1 case(rebleeding), muscle compression during operation(1 case). Patients with rebleeding received high-flow bypass. Three cases developed cerebral infarction after embolization without severe sequelae after treatment, and no death occurred within 90 days. After bleeding control, all 3 patients with cranial base necrosis received surgical treatment to remove the necrotic bone and tissue flap repair, and 1 patient with recurrence received gamma knife and targeted therapy, 1 patient received immune and surgical therapy, and 1 patient received immune and targeted therapy. Rupture and hemorrhage of internal carotid artery after radiotherapy is related to tumor invasion, tissue injury and local infection after radiotherapy. For those caused by tumor invasion, it is recommended to sacrifice the responsible vessels. For those caused by infection, emergency surgery is recommended and blood vessels preserved. Emergency vascular occlusion remains a life-saving option.
Topics: Humans; Nasopharyngeal Carcinoma; Retrospective Studies; Nasopharyngeal Neoplasms; Male; Middle Aged; Carotid Artery, Internal; Embolization, Therapeutic; Female; Adult; Carotid Artery Injuries
PubMed: 38858109
DOI: 10.13201/j.issn.2096-7993.2024.06.003 -
European Review For Medical and... May 2024Recently, the infiltration of a subpopulation of cells represented by mononucleated cells extracted from peripheral blood [Peripheral Blood-Mononuclear Cells (PB-MNCs)]...
BACKGROUND
Recently, the infiltration of a subpopulation of cells represented by mononucleated cells extracted from peripheral blood [Peripheral Blood-Mononuclear Cells (PB-MNCs)] is becoming a useful technique for medical and surgical regenerative procedures. Due to the angiogenetic and regenerative properties of PB-MNCs, the infiltration of these cells is, in our opinion, a new option indicated in the treatment of pathologies characterized by tissue dystrophy, loss of vascularization, and non-healing wounds.
CASE PRESENTATION
A 25-year-old active smoker patient was diagnosed with Rhabdomyosarcoma of the anterior tibial muscle of his left leg and treated with neoadjuvant chemo- and radiotherapy (RT). After the tumor excision, the patient developed wound dehiscence with bone exposure and a perilesional radiation-induced chronic dermatitis characterized by skin dyschromia and hair thinning along the treated area. The patient underwent surgical debridement and reconstruction with autologous skin grafts and dermal substitutes, with poor outcomes due to graft failure. The patient was subsequently treated with surgical debridement and coverage with a reverse sural fascia-cutaneous flap. After 13 days, wound dehiscence was observed, and reconstruction of the dehiscent areas was performed with a split-thickness autologous skin graft with no success. After wound debridement, a new split-thickness skin graft was performed, and a concentrate of autologous PB-MNCs was injected in the flap and perilesional skin. After 14 days, graft take was reached, and improvements in perilesional tissue tropism were noted. At 2 months follow-up, the patient appeared completely healed.
CONCLUSIONS
In our opinion, the use of PB-MNCs to treat conditions characterized by tissue dystrophy, which require neoangiogenesis and cell regeneration, can be a useful and unconsidered technique that could be utilized to improve tissue tropism. Furthermore, prospective trials are necessary to validate our observations.
Topics: Humans; Male; Adult; Leukocytes, Mononuclear; Plastic Surgery Procedures; Lower Extremity; Rhabdomyosarcoma; Wound Healing
PubMed: 38856134
DOI: 10.26355/eurrev_202405_36295 -
Acta Neurochirurgica Jun 2024During pituitary surgery, CSF leaks are often treated by intrasellar packing, using muscle or fat grafts. However, this strategy may interfere with the interpretation of...
BACKGROUND
During pituitary surgery, CSF leaks are often treated by intrasellar packing, using muscle or fat grafts. However, this strategy may interfere with the interpretation of postoperative MRI and may impact the quality of resection in cases of second surgery, due to the existence of additional fibrous tissue. We present an alternative technique, using a diaphragm reconstruction with a heterologous sponge combining fibrinogen and thrombin (TachoSil), applied in selected patients with low-flow CSF leaks. This study investigates the surgical outcome of patients treated with this strategy.
METHODS
From a cohort of 2231 patients treated from June 2011 to June 2023 by endoscopic endonasal approach for pituitary surgery, the surgical technique of diaphragm repair with TachoSil patch performed in 55 patients (2.6%) was detailed, and the rate of closure failure was analyzed at 6 months postoperatively. No intrasellar packing was used and sellar floor reconstruction was performed whenever possible. The rate of postoperative CSF leak was compared with that reported in three previous publications that also used the TachoSil patch technique.
RESULTS
Patients were mostly women (F/M ratio: 1.2) with a median age of 53.6 years. Surgery was indicated for non-functioning adenomas, Cushing's disease, acromegaly, and Rathke's cleft cysts in 38/55 (69.1%), 6/55 (10.9%), 5/55 (9.1%) and 6/55 (10.9%) patients respectively. The rate of postoperative CSF leak was 1.8% (n = 1/55), which was not significantly different from that reported in the three cohorts from the literature (2.8%, p > 0.05). No postoperative meningitis was recorded.
CONCLUSIONS
In highly selected patients with low-flow CSF leaks related to small focal diaphragm defects, diaphragm reconstruction using a TachoSil patch can be a safe and valuable alternative to intrasellar packing.
Topics: Humans; Female; Middle Aged; Thrombin; Male; Fibrinogen; Adult; Cerebrospinal Fluid Leak; Drug Combinations; Aged; Plastic Surgery Procedures; Cohort Studies; Diaphragm; Postoperative Complications; Pituitary Neoplasms; Treatment Outcome; Cerebrospinal Fluid Rhinorrhea; Pituitary Gland; Surgical Sponges
PubMed: 38853198
DOI: 10.1007/s00701-024-06152-5 -
International Journal of Surgery Case... Jul 2024Cutaneous leiomyomas, benign tumors from smooth muscle fibers, constitute about 5 % of all leiomyomas. They exhibit diverse inheritance patterns and can be linked to...
INTRODUCTION AND IMPORTANCE
Cutaneous leiomyomas, benign tumors from smooth muscle fibers, constitute about 5 % of all leiomyomas. They exhibit diverse inheritance patterns and can be linked to systemic malignancies. Gastrointestinal stromal tumors (GISTs), arising from the interstitial cells of Cajal, are the most common mesenchymal tumors in the gastrointestinal tract. Despite their prevalence, simultaneous occurrences of cutaneous leiomyomas and GISTs are rare, necessitating exploration of their potential relationship.
CASE PRESENTATION
A 25-year-old male with no significant medical history presented with multiple painful erythematous nodules on his chest, upper back, and arms. Histopathological analysis diagnosed these as multiple cutaneous piloleiomyomatosis. Despite recommendations for surgical intervention, the patient chose medical management and experienced significant pain relief with nifedipine. Later, the development of abdominal symptoms led to the discovery of multiple gastric lesions, diagnosed as benign spindle cell neoplasms, necessitating partial gastrectomy.
CLINICAL DISCUSSION
The differential diagnosis of cutaneous leiomyomas includes various soft tissue tumors, requiring histopathological confirmation. Genetic mutations affecting proteins critical to cellular energy production and tumor suppression underlie these conditions. Treatment options include pharmacological management and surgical excision. The discovery of GISTs in this patient aligns with rare literature reports, emphasizing the need for vigilant evaluation of systemic malignancies in patients with leiomyomatosis.
CONCLUSION
This case highlights the potential of cutaneous leiomyomas to indicate deeper malignancies like GISTs, stressing the importance of interdisciplinary collaboration in diagnosis and treatment. It underscores the interconnectedness of benign dermatological conditions and internal malignancies, advocating for comprehensive evaluation in patients with leiomyomatosis.
METHODS
This case report meticulously follows the SCARE 2023 guidelines: updating consensus Surgical Case Report guidelines (Sohrabi et al., 2023 [1]). These guidelines ensure high-quality reporting in surgical case reports. The report details the evaluation, diagnosis, and a comprehensive review of the literature pertaining to a patient with multiple leiomyoma cutis associated with gastrointestinal stromal tumors. By employing a multidisciplinary approach, this report achieves a thorough and standardized presentation of the case, serving as an additional tool for raising awareness regarding such rare conditions.
PubMed: 38851074
DOI: 10.1016/j.ijscr.2024.109870 -
Ugeskrift For Laeger May 2024This is a case report of a 44-year-old premenopausal woman who was admitted to hospital due to uncontrollable and life-threatening vaginal bleeding after starting...
This is a case report of a 44-year-old premenopausal woman who was admitted to hospital due to uncontrollable and life-threatening vaginal bleeding after starting rivaroxaban treatment for atrial fibrillation. She had a medical history with menorrhagia due to an intrauterine fibroma. She did not respond sufficiently to factor X supplement or other non-surgical medical interventions. The bleeding subsided after bilateral embolization of aa. uterinae.
Topics: Humans; Rivaroxaban; Female; Adult; Factor Xa Inhibitors; Uterine Hemorrhage; Atrial Fibrillation; Leiomyoma; Menorrhagia; Uterine Neoplasms
PubMed: 38847299
DOI: 10.61409/V01240012 -
BJR Case Reports May 2024Granular cell tumour is a rare, mostly benign, soft tissue, neuroectodermal tumour, most commonly seen in the skin and peripheral soft tissue. There are no publications...
Granular cell tumour is a rare, mostly benign, soft tissue, neuroectodermal tumour, most commonly seen in the skin and peripheral soft tissue. There are no publications to date of PSMA-PET avidity in a granular cell tumour. In this 60 year old male, staging PSMA-PET for a localized intermediate risk prostate cancer incidentally identified a PSMA-avid left supraspinatus lesion, which was subsequently biopsy-proven as a granular cell tumour. We present the first case of PSMA-avid granular cell tumour and add to the growing literature documenting PSMA-PET avidity in benign and malignant lesions apart from prostate cancer.
PubMed: 38846270
DOI: 10.1093/bjrcr/uaae015 -
Scientific Reports Jun 2024The role of skeletal muscle and adipose tissue in the progression of cancer has been gradually discussed, but it needs further exploration. The objective of this study...
The role of skeletal muscle and adipose tissue in the progression of cancer has been gradually discussed, but it needs further exploration. The objective of this study was to provide an in-depth analysis of skeletal muscle and fat in digestive malignancies and to construct novel predictors for clinical management. This is a retrospective study that includes data from Cancer Center, the First Hospital of Jilin University. Basic characteristic information was analyzed by T tests. Correlation matrices were drawn to explore the relationship between CT-related indicators and other indicators. Cox risk regression analyses were performed to analyze the association between the overall survivals (OS) and various types of indicators. A new indicator body composition score (BCS) was then created and a time-dependent receiver operating characteristic curve was plotted to analyze the efficacy of the BCS. Finally, a nomogram was produced to develop a scored-CT system based on BCS and other indicators. C-index and calibration curve analyses were performed to validate the predictive accuracy of the scored-CT system. A total of 575 participants were enrolled in the study. Cox risk regression model revealed that VFD, L3 SMI and VFA/SFA were associated with prognosis of cancer patients. After adjustment, BCS index based on CT was significantly associated with prognosis, both in all study population and in subgroup analysis according to tumor types (all study population: HR 2.036, P < 0.001; colorectal cancer: HR 2.693, P < 0.001; hepatocellular carcinoma: HR 4.863, P < 0.001; esophageal cancer: HR 4.431, P = 0.008; pancreatic cancer: HR 1.905, P = 0.016; biliary system malignancies: HR 23.829, P = 0.035). The scored-CT system was constructed according to tumor type, stage, KPS, PG-SGA and BCS index, and it was of great predictive validity. This study identified VFD, L3 SMI and VFA/SFA associated with digestive malignancies outcomes. BCS was created and the scored-CT system was established to predict the OS of cancer patients.
Topics: Humans; Male; Female; Middle Aged; Prognosis; Adipose Tissue; Tomography, X-Ray Computed; Digestive System Neoplasms; Retrospective Studies; Muscle, Skeletal; Body Composition; Aged; Adult; ROC Curve; Proportional Hazards Models; Nomograms
PubMed: 38844600
DOI: 10.1038/s41598-024-63806-1 -
Technology in Cancer Research &... 2024The purpose of this research was to compare two treatment techniques for oropharyngeal cancers: conventional linac-based static intensity-modulated radiotherapy (sIMRT)... (Comparative Study)
Comparative Study
OBJECTIVE
The purpose of this research was to compare two treatment techniques for oropharyngeal cancers: conventional linac-based static intensity-modulated radiotherapy (sIMRT) and helical tomotherapy (HT). The study examined several parameters, including target coverage, organs at risk, integral dose, and beam on time. Additionally, the study evaluated the doses to the parotid, temporomandibular joint, and pharyngeal constrictor muscles, which are important for swallowing.
METHOD
The present study retrospectively analyzed the data of 13 patients with oropharyngeal cancer who underwent radiotherapy between 2019 and 2021. The treatment plans for each patient were regenerated using both sIMRT and HT treatment planning systems with the sequential boost method. The techniques were evaluated and compared based on dose-volume histogram, homogeneity index, and conformity index parameters. The target coverage and organs at risk were statistically compared for two techniques. Additionally, the doses received by the healthy tissue volume were obtained for integral dose evaluation. The beam on time for each technique was assessed.
RESULTS
When considering planning target volume evaluation, there was no difference in D between the two techniques and sIMRT demonstrated higher D values compared to the HT. The HT technique had better results for all organs at risk, such as the parotid, temporomandibular joint, and pharyngeal constrictor muscle. As for integral dose, it has been shown that the sIMRT technique provides better protection compared to HT. In addition, the beam on time was also longer with the HT technique.
CONCLUSION
Both techniques may provide optimal target coverage for patients with oropharyngeal cancer. HT conferred notable advantages, especially with regard to critical structures implicated in swallowing, such as the parotid, temporomandibular joint, and pharyngeal constrictor muscle, in comparison to sIMRT.
Topics: Humans; Oropharyngeal Neoplasms; Parotid Gland; Radiotherapy Dosage; Organs at Risk; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated; Temporomandibular Joint; Male; Retrospective Studies; Pharyngeal Muscles; Female; Aged; Middle Aged
PubMed: 38841792
DOI: 10.1177/15330338241260646 -
Archivos Espanoles de Urologia May 2024This study aims to determine the effect of pelvic floor function exercise on the improvement of lower urinary tract symptoms in patients with uterine fibroid surgery.
BACKGROUND
This study aims to determine the effect of pelvic floor function exercise on the improvement of lower urinary tract symptoms in patients with uterine fibroid surgery.
METHODS
The clinical data of 188 patients who underwent uterine fibroid surgery in our hospital from February 2020 to December 2022 were retrospectively analysed. The patients were divided into a control group and an observation group according to the nursing methods recorded in the data. The observation group received targeted nursing combined with pelvic floor function exercise based on routine intervention. General demographic data, disease and surgery-related characteristics of the patients were collected. Propensity score matching was used to balance the baseline data of the two groups. Lower urinary tract symptoms, pelvic floor function, pelvic floor muscle strength and quality of life were compared between the two groups after matching.
RESULTS
A total of 130 patients were included in the two groups, and their baseline data were not statistically significant. At 3 months after the operation, the total incidence of lower urinary tract symptoms in the observation group (10.77%) was lower than that in the control group (30.77%, < 0.05). Before the intervention, the pelvic floor function, pelvic floor muscle strength and quality of life scores of the two groups were basically the same ( > 0.05). At 3 months after the operation, the pelvic floor function score of the observation group was lower than that of the control group, but the pelvic floor muscle strength index and quality of life score of the observation group were higher than those of the control group ( < 0.05).
CONCLUSIONS
Targeted nursing combined with pelvic floor function exercise for patients with uterine fibroids surgery can prevent the occurrence of lower urinary tract symptoms and improve the pelvic floor function, pelvic floor muscle strength and quality of life of patients and is thus worthy of promotion.
Topics: Humans; Female; Pelvic Floor; Leiomyoma; Retrospective Studies; Lower Urinary Tract Symptoms; Adult; Middle Aged; Uterine Neoplasms; Exercise Therapy; Postoperative Complications; Quality of Life
PubMed: 38840276
DOI: 10.56434/j.arch.esp.urol.20247704.47