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International Journal of Clinical and... 2014Hemangioblastoma of soft tissue is a very rare tumor of uncertain histological type. Herein, we reported a 51-year-old woman was found to have a solid and cystic mass... (Review)
Review
Hemangioblastoma of soft tissue is a very rare tumor of uncertain histological type. Herein, we reported a 51-year-old woman was found to have a solid and cystic mass measuring 31×30 mm in the right adnexa area on a computed tomography scan. The tumor showed the typical histology of hemangioblastoma. Tumor was composed of numerous capillaries and stromal cells with cytoplasmic vacuolization. Immunohistochemical study revealed that the tumor stromal cells were positive for CD56, S-100 protein, NSE, Syn, CgA, and inhibin-α. Focal EMA positivity was present. Ki-67 expression was found in approximately 1% of tumor cells. The tumor cells were negative for CK, HMB-45, Melan-A, SMA, and CD68. The differential diagnosis of Hemangioblastoma arising in pelvic cavity includes hemangioma, hemangioendothelioma, liposarcoma, renal cell carcinoma, fat-forming solitary fibrous tumor, paraganglioma, and perivascular epithelioid cell tumor (PEComa).
Topics: Biomarkers, Tumor; Biopsy; Diagnosis, Differential; Female; Hemangioblastoma; Humans; Immunohistochemistry; Middle Aged; Pelvic Neoplasms; Predictive Value of Tests; Tomography, X-Ray Computed
PubMed: 25400795
DOI: No ID Found -
The Journal of International Medical... Jun 2020Primitive neuroectodermal tumours (PNETs) are rare malignant small round cell tumours. Notably, despite widespread reports of PNET in multiple parts of the body, it is... (Review)
Review
Primitive neuroectodermal tumours (PNETs) are rare malignant small round cell tumours. Notably, despite widespread reports of PNET in multiple parts of the body, it is extremely rare in the pelvis. Here, a rare case of giant PNET of the pelvis, that was treated with surgical intervention comprising hemipelvectomy and amputation, is reported. A 42-year-old female patient presented with an enlarged mass on the left hip and severe pain in the left lower extremity for the previous 6 months. Preoperative imaging examinations indicated an irregular soft tissue-like signal shadow sized 19 × 15 × 12 cm at the left ilium and sacrum. After surgical intervention involving left hemipelvectomy and amputation, the tumour was diagnosed by pathology as PNET. During the courses of postoperative radiotherapy and chemotherapy, local recurrence and distant metastasis occurred, and the patient died 9 months following surgical treatment. To the best of the authors' knowledge, the current case is the largest pelvic PNET resection reported to date. Pelvic PNET is extremely malignant and has a high mortality rate regardless of surgical treatment, however, surgical resection of the lesion may relieve the symptoms, extend life, and improve quality of life to a certain extent.
Topics: Adult; Biopsy; Female; Humans; Neoplasm Recurrence, Local; Neuroectodermal Tumors, Primitive; Pelvic Neoplasms; Pelvis; Quality of Life
PubMed: 32500784
DOI: 10.1177/0300060520906747 -
International Journal of Urology :... Nov 2001We present two interesting cases of a 24-year-old man and a 14-year-old boy, uncle and nephew, with lower urinary tract symptoms, café au lait patches and subcutaneous... (Review)
Review
We present two interesting cases of a 24-year-old man and a 14-year-old boy, uncle and nephew, with lower urinary tract symptoms, café au lait patches and subcutaneous nodules. Ultrasonography and computed tomography scans showed a large, irregular lobulated soft tissue mass between the bladder and sacrum. Cystoscopy, laparotomy and biopsies revealed neurofibromatosis involving the urinary bladder. No enlargement of the tumor or upper urinary tract obstruction has occurred during the long-term follow up. We recommend meticulous follow up of patients with giant intrapelvic neurofibromatosis.
Topics: Adolescent; Adult; Follow-Up Studies; Humans; Male; Neoplasm Invasiveness; Neurofibromatoses; Pelvic Neoplasms; Radiography; Soft Tissue Neoplasms; Ultrasonography; Urinary Bladder
PubMed: 11903695
DOI: 10.1046/j.1442-2042.2001.00380.x -
Canadian Journal of Surgery. Journal... Feb 2009
Topics: Dysuria; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurilemmoma; Pelvic Neoplasms; Perineum
PubMed: 19234643
DOI: No ID Found -
Medicine Sep 2019Pelvic tumor had great impact on patients' quality of life. After tumor resection, how to accurately fill bone defect remained challenging for orthopedic surgeons. Due...
RATIONALE
Pelvic tumor had great impact on patients' quality of life. After tumor resection, how to accurately fill bone defect remained challenging for orthopedic surgeons. Due to lack of individual design, high incidence of prosthetic mismatching, and loosening were reported in pelvic reconstruction surgery with conventional modular prostheses. Nowadays, with rapid development of three-dimensional (3D) print technology, pelvic prostheses could be designed according to patients' own anatomy. The objective of this study was to describe the application of 3D printed customized hemi-pelvic prosthesis for patients with pelvic tumor.
PATIENT CONCERNS
A 62-year-old female had developed severe right joint pain without obvious inducement from 5 months before she sought medical advice. Pain, swelling, and limited range of motion of right joint were founded during physical examination.
DIAGNOSIS
The patients were diagnosed as "right acetabulum metastatic carcinoma" INTERVENTION:: 3D printed titanium alloy hemi-pelvic prosthesis was designed according the morphology of unaffected side hemi-pelvis and subsequently implanted in surgery to reconstruct the pelvis. 3D printed osteotomy guide and pelvic model were also manufactured and applied to improve accuracy of osteotomy and reduce operation time. X-Ray of pelvis, Harris score, musculoskeletal tumor society score (MSTS) and The MOS item short from health survey (SF-36) were recorded during the period of preoperation, 1, 3, 6, 12 months follow-up after operation.
OUTCOMES
3D printed hemi-pelvic prosthesis matched precisely with pelvis and implanted successfully. There was no sign of prosthetic loosening within 12 months' follow-up. No sign of peri-prosthetic infection from laboratory examination. Harris score, MSTS, and SF-36 were gradually increasing during follow-up period.
LESSONS
Satisfactory effect of pelvic reconstruction could be achieved by 3D printed hemi-pelvic prostheses. It also provided a promising way to the treatment of pelvic tumor in similar cases.
Topics: Female; Humans; Middle Aged; Neoplasm Metastasis; Pelvic Neoplasms; Printing, Three-Dimensional; Prosthesis Design; Prosthesis Implantation; Plastic Surgery Procedures
PubMed: 31490360
DOI: 10.1097/MD.0000000000016658 -
BMC Surgery Oct 2022Limb salvage reconstruction for pelvic tumors, especially periacetabular tumors, is challenging. We combined the use of dual mobility bearing and 3D-printed hemipelvic...
3D-printed hemipelvic prosthesis combined with a dual mobility bearing in patients with primary malignant neoplasm involving the acetabulum: clinical outcomes and finite element analysis.
BACKGROUND
Limb salvage reconstruction for pelvic tumors, especially periacetabular tumors, is challenging. We combined the use of dual mobility bearing and 3D-printed hemipelvic prosthesis to improve function and reduce the probability of complications after hemi-pelvic resection in patients with primary acetabular malignancy. The purpose of this study was to evaluate the efficacy and safety of this combination.
METHODS
Between October 2011 and May 2021, 11 patients with malignancies involving the acetabulum received hemipelvic replacement with a 3D-printed prosthesis and dual mobility bearing. Follow-up of postoperative survival, complications, and Musculoskeletal Tumor Society 93 (MSTS-93) lower limb functional scores were carried out. A finite element model of the postoperative pelvis was developed and input into the finite element analysis software. The Von Mises equivalent stress formula was used to analyze the stress distribution of each part of the pelvis under one gait cycle and the stress distribution at different angles of the hip joint.
RESULTS
By the last follow-up, 9 of the 11 patients (81.8%) were still alive, and 2 patients had local tumor recurrence. The complications including 1 deep infection and 1 dislocation of the artificial joint. Excluding 1 amputation patient, the average score of the remaining 8 patients at the last follow-up was 21.4/30 (71.3%) on the MSTS-93. In the reconstructed pelvis, stress distributions were concentrated on the junction between hemipelvic prosthesis and screw and iliac bone on the resected side, and between femoral prosthesis stem and femoral bulb, while the stress of polyethylene lining was small. Before impact, the polyethylene lining will rotate at a small angle, about 3°. The inner stress of polyethylene liner is greater than the outer stress in all conditions. The polyethylene liner has no tendency to slide out.
CONCLUSION
Pelvic tumor resection and reconstruction using 3D-printed hemipelvic prosthesis combined with dual mobility bearing was an effective treatment for pelvic tumors. Our patients achieved good early postoperative efficacy and functional recovery. The dual mobility bearing is beneficial to prevent dislocation, and the mechanical distribution and wear of the prosthesis are acceptable.
Topics: Acetabulum; Bone Neoplasms; Bone Screws; Finite Element Analysis; Humans; Pelvic Neoplasms; Polyethylenes; Printing, Three-Dimensional; Prosthesis Design; Retrospective Studies; Treatment Outcome
PubMed: 36203147
DOI: 10.1186/s12893-022-01804-8 -
Radiotherapy and Oncology : Journal of... Jun 2015Radiotherapy is used to palliate pelvic symptoms of castration resistant prostate cancer (CRPC). However, magnitude and time course of effects and toxicities are poorly...
BACKGROUND AND PURPOSE
Radiotherapy is used to palliate pelvic symptoms of castration resistant prostate cancer (CRPC). However, magnitude and time course of effects and toxicities are poorly documented. Study aims were to evaluate changes in patient-reported target symptoms (TS), health-related quality of life (HRQOL) and toxicity following palliative pelvic radiotherapy (PPRT) of CRPC.
MATERIAL AND METHODS
47 patients with CRPC and a symptomatic pelvic mass prescribed PPRT with 30-39 Gy were prospectively included. Primary endpoint was patient-reported improvement or complete resolution of the TS twelve weeks after PPRT. HRQOL changes were explored. Toxicity was physician-evaluated.
RESULTS
Lower urinary tract symptoms (LUTS) (45%), hematuria (26%) and pain (19%) were the most common TS. In the 40 evaluable patients, overall TS response twelve weeks after PPRT was 70%. TS responses were 8/18 for LUTS, 11/12 for hematuria, and 7/9 for pain. Global HRQOL improved transiently. The most common toxicity was grade 1 or 2 diarrhea (50%). There was no grade 4 toxicity.
CONCLUSIONS
In the majority of patients with CRPC and a symptomatic pelvic tumor, PPRT with 30-39 Gy contributes to relief of hematuria, pain and other pelvic symptoms, with acceptable toxicity. Future studies should investigate whether PPRT regimens can be simplified.
Topics: Aged; Aged, 80 and over; Humans; Male; Middle Aged; Pain; Palliative Care; Pelvic Neoplasms; Prospective Studies; Prostatic Neoplasms; Quality of Life
PubMed: 26091575
DOI: 10.1016/j.radonc.2015.05.021 -
Medicine Mar 2017Lymphangioleiomyomatosis (LAM) is a rare disease affecting young women caused by abnormal proliferation of smooth muscle-like cells (LAM cells) in the lungs and... (Review)
Review
BACKGROUND
Lymphangioleiomyomatosis (LAM) is a rare disease affecting young women caused by abnormal proliferation of smooth muscle-like cells (LAM cells) in the lungs and extrapulmonary sites (extrapulmonary LAM). The objective of this case series is to demonstrate marked regression in 2 cases of retroperitoneal LAM after treatment with everolimus, an mTOR inhibitor.
METHODS
We enrolled 2 cases with large volume, extrapulmonary pelvic LAM, and evaluated them with contrast-enhanced abdominal computed tomographic (CT) scans at presentation and serially during treatment with everolimus. Results were objectively quantified using the Response Evaluation Criteria in Solid Tumors, RECIST, Version 1.1.
RESULTS
After 12 to 18 months of treatment with everolimus, both patients showed substantial reduction in the volume of their tumors. The first had about 50% regression of the pelvic LAM and renal angiomyolipoma (AML). The second patient had extensive abdomino-pelvic LAM which after treatment showed complete remission. Both patients have not demonstrated disease progression after nearly 4 and 2 years of follow-up, respectively.
CONCLUSIONS
This case series demonstrates the enormous value of mTOR inhibitors (specifically everolimus) in the management of extrapulmonary pelvic LAM, of which there is no effective treatment currently available.
Topics: Adult; Antineoplastic Agents; Everolimus; Female; Humans; Lymphangioleiomyomatosis; Middle Aged; Pelvic Neoplasms; Pelvis
PubMed: 28272193
DOI: 10.1097/MD.0000000000004562 -
JMIR MHealth and UHealth Jul 2019Mobile health (mHealth) technologies are increasingly used in various medical fields. However, the potential of mHealth to improve patient care in radiotherapy by...
BACKGROUND
Mobile health (mHealth) technologies are increasingly used in various medical fields. However, the potential of mHealth to improve patient care in radiotherapy by acquiring electronic patient reported outcome measures (ePROMs) during treatment has been poorly studied so far.
OBJECTIVE
The aim of this study was to develop and implement a novel Web app (PROMetheus) for patients undergoing radiotherapy. Herein, we have reported our experience with a focus on feasibility, patient acceptance, and a correlation of ePROMs with the clinical course of the patients.
METHODS
In the period between January and June 2018, 21 patients used PROMetheus to score side effects, symptoms, and quality of life-related parameters during and after their treatment. Items of the Patient Reported Outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were chosen based on the primary site of disease, 27 items for head and neck tumors, 21 items for thoracic tumors, and 24 items for pelvic tumors.
RESULTS
In total, 17 out of the 21 patients (81%) regularly submitted ePROMs and more than 2500 data points were acquired. An average of 5.2, 3.5, and 3.3 min was required to complete the head and neck, thorax, and pelvis questionnaires, respectively. ePROMS were able to detect the occurrence of both expected and unexpected side effects during the treatment. In addition, a gradual increase in the severity of side effects over the course the treatment and their remission afterward could be observed with ePROMs. In total, 9 out of the 17 patients (53%), mostly those with head and neck and thoracic cancers, reported PRO-CTCAE grade III or IV fatigue with severe impairments of activities of daily life.
CONCLUSIONS
This study shows the successful implementation of an ePROM system and a high patient acceptance. ePROMs have a great potential to improve patient care in radiotherapy by providing a comprehensive documentation of symptoms and side effects, especially of ones that are otherwise underreported.
Topics: Activities of Daily Living; Aged; Big Data; Electronic Data Processing; Fatigue; Feasibility Studies; Female; Head and Neck Neoplasms; Humans; Implementation Science; Male; Middle Aged; Neoplasm Staging; Patient Acceptance of Health Care; Patient Reported Outcome Measures; Pelvic Neoplasms; Quality of Life; Radiation Oncology; Radiotherapy; Surveys and Questionnaires; Telemedicine; Thoracic Neoplasms; Workflow
PubMed: 31342906
DOI: 10.2196/12345 -
World Journal of Surgical Oncology Oct 2015Previous reports about laparoscopic total pelvic exenteration (LTPE) are still limited. In the present study, we described our single-center experience of the initial 11...
BACKGROUND
Previous reports about laparoscopic total pelvic exenteration (LTPE) are still limited. In the present study, we described our single-center experience of the initial 11 cases.
METHODS
Between April 2011 and September 2015, eight males and three females diagnosed as pelvic malignancies underwent LTPE by the same operation team. We retrospectively collected all cases' parameters about surgical technique. Thirty-seven patients who received open surgery were also retrospectively collected. A comparison between LTPE and open surgery was performed to evaluate the feasibility and safety of LTPE.
RESULTS
Eleven cases successfully underwent the LTPE without any intraoperative complication. No open conversion was required. Eight patients underwent Bricker's procedure. Three patients were performed with the cutaneous ureterostomy. Anus preservation operation was performed in three patients. Compared with open surgery, LTPE had longer mean operative time (565.2 vs 468.2 min, p = 0.004) but less mean blood loss (547.3 vs 1033.0 ml, p < 0.001) and shorter postoperative hospitalization time (15.3 vs 22.4 days, p = 0.004). One patient died of pulmonary embolism in the 7th month of follow-up time. One patient died of recurrence in the 12th month of follow-up time. Nine patients are still alive without recurrence and metastasis. The mean follow-up time was 11.1 months.
CONCLUSIONS
The technique of LTPE seems to be feasible and safe in the treatment of carefully selected patients of pelvic malignancies. LTPE can also decrease the blood loss, the recovery time, and the hospital stay. But the oncological safety and long-term outcome of LTPE still need to be explored.
Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Laparoscopy; Length of Stay; Male; Middle Aged; Neoplasm Staging; Pelvic Exenteration; Pelvic Neoplasms; Postoperative Complications; Prognosis; Retrospective Studies; Robotics
PubMed: 26472147
DOI: 10.1186/s12957-015-0715-2