Case Of Malignant Transformation Research Articles

レーザー治療後の経過観察中に悪性化を認めた口腔白板症3例の検討

Oral leukoplakia is a common precancerous lesion of the oral mucosa that appears as areas of white plaque in the oral cavity. Various treatments for oral leukoplakia have so far been reported, including excisional surgery, electrocoagulation, cryosurgery and medication. Especially, carbon dioxide laser surgery has been reported to be useful for treating the lesions of oral leukoplakia. However, some cases of malignant transformation following laser treatment in patients with oral leukoplakia have been reported. In this study, we report three cases of leukoplakia in which malignant transformation occurred after laser treatment. In the period from 2000 to 2012, a total of 98 patients with l14 oral leukoplakia were treated with carbon dioxide laser. During the observation period after laser treatment, malignant transformation of leukoplakia occurred in three cases (2.6%). Of the three patients, two were female and one was male, with an age range of 69 to 87 years. The sites of the lesions included the tongue in two cases and the buccal mucosa in one case, and all patients exhibited a movable oral mucosa. Regarding the style of outbreak, all three cases included multiple outbreaks. According to the classification based on ocular inspection, the white-spotted type, verrucous type and erythroleukoplakia type were observed in one case each. Two patients were treated with laser excision and one patient was treated with both laser excision and vaporization. As for the incidence of epithelial dysplasia, mild dysplasia was observed in all three cases. Malignant transformation occurred between 3 and 28 months after the laser treatment. In conclusion, continuous fo1low-up of leukoplakia is important, even after laser treatment. Because there are few reports on the malignant transformation rate by type of treatment procedure, a comparison of safety in terms of malignant transformation is difficult. However, the rate of malignant transformation of leukoplakia after laser treatment was lower than that in past reports of the malignant transformation rate of oral leukoplakia, so the use of carbon dioxide laser treatment for oral leukoplakia seems to be safe in terms of malignant transformation.

Metastatic squamous-cell carcinoma of the lung arising in a 12-year-old boy with juvenile recurrent respiratory papillomatosis of neonatal onset

Juvenile recurrent respiratory papillomatosis is the most common benign neoplastic disease of the larynx in children, characterized by numerous squamous papillomas caused by Human Papilloma Virus type 6 and 11. HPV is thought to be acquired at the time of vaginal delivery from maternal genital condylomas. Juvenile recurrent respiratory papillomatosis can be protracted by surgical interventions performed to avoid airway obstruction and extend below the vocal cords as far as the main stem bronchi. Lung involvement in Juvenile recurrent respiratory papillomatosis seems to be more prevalent than non-systematic reviews have reported until now and progression to cancer occurs in a significant proportion of these cases at a younger age than previously reported. This would suggest that closer attention should be paid to these children. We report a case of malignant transformation in a 12 year-old boy followed-up since the birth for an invasive juvenile recurrent respiratory papillomatosis with pulmonary involvement. The presence of HPV 6/11 was demonstrated by PCR analysis performed on material obtained from a metastatic vertebral lesion.

Therapeutic Effect of Mesenchymal Multipotent Stromal Cells on Memory in Animals with Alzheimer-Type Neurodegeneration

Transplantation of human mesenchymal multipotent stromal cells improved spatial memory in bulbectomized mice with Alzheimer-type neurodegeneration. The positive effect was observed in 1 month after intracerebral transplantation and in 3 months after systemic injection of mesenchymal multipotent stromal cells. No cases of malignant transformation were noted. These findings indicate prospects of using mesenchymal multipotent stromal cells for the therapy of Alzheimer disease and the possibility of their systemic administration for attaining the therapeutic effect.

Rhabdomyosarcoma and chondrosarcoma arising in a mature cystic teratoma of the ovary and osteosarcoma arising in its recurrence

A case of malignant transformation within a mature cystic teratoma (MCT) including two different sarcoma types (rhabdomyosarcoma and chondrosarcoma) in the initial tumor and a third new type (osteosarcoma) in the second recurrence 16 months later in a 64-year-old postmenopausal woman is presented. To our knowledge, this is the only second case with multiple sarcomas developed within an MCT since 1954. Also this is the first case that shows synchronous rhabdomyosarcomatous and chondrosarcomatous transformation within the MCT at the time of primary surgery and osteosarcomatous differentiation in the recurrence.

Establishment and characterization of METON myoepithelioma cell line derived from human palatal myoepithelioma: apical reference to the diverse differentiation potential

Myoepithelioma is an extremely rare condition that accounts for 1–1.5 % of salivary gland tumors. It was formerly regarded as a subtype of pleomorphic adenoma, in which myoepithelial structural components predominated, but was listed as a separate disease entity in the 1991 World Health Organization classification (Seifert in Histological typing of salivary gland tumours. Springer, Berlin, 1991). Its histology is highly varied and recurrence is frequent (El-Naggar et al. in J Larygol Otol 103:1192–1197, 1989), with cases of malignant transformation having been reported (Seifert in Histological typing of salivary gland tumours. Springer, Berlin, 1991; Barnes et al. in Pathology and Genetics of head and neck tumours. IARC Press, Lyon, 2005), making this a difficult tumor to control in many cases. This is thought to be due to the multiple differentiation potential of myoepithelial cells, but the details are unknown. There have been a number of reports of the establishment of cell lines (Shirasuna et al. Cancer. 45:297–305, 1980; Jaeger et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84:663–667, 1997), but numerous points remain unclear. We established a myoepithelial cell line designated METON, and investigated its characteristics. METON consists of cells with two different morphologies: spindle-shaped cells and epithelial-like cells. Then. we also used single-cell cloning method to establish various subclones (epithelial-like, spindle-like, and mixed epithelial-like/spindle-like cell lines). Among these, pluripotency markers were expressed by the mixed epithelial-like/spindle-like cell lines. The newly established cell line expressing these pluripotency markers will be extremely useful for elucidating the diverse histologies of salivary gland tumors.

Giant Cell Tumor of the Larynx: A Case of Malignant Sarcomatous Transformation

We report what is to the best of our knowledge the first case of malignant transformation of a giant cell tumor of the larynx. The patient, a 34-year-old man, presented to our tertiary care university teaching hospital where he underwent hemilaryngopharyngectomy with radial forearm free flap reconstruction and 11 of 15 cycles of chemotherapy. He remained disease-free at approximately 6 years and 4 months of follow-up. The patient is decannulated and continues to have a good voice with excellent quality of life to this day. We discuss the patient's clinical course and subsequent treatment within the context of a review of the current literature regarding this disease entity. Our experience demonstrates that giant cell tumor of the larynx may present as a malignant neoplasm without adversely affecting the patient's prognosis when treated aggressively with surgical resection and adjunct chemotherapy.

Malignant transformation of nasal chondromesenchymal hamartoma in adult: a case report and review of the literature.

Nasal chondromesenchymal hamartoma (NCMH) is an extremely rare benign tumor arising in the sinonasal tract, predominantly involving infants and children. To date, only 27 cases are reported in the international literature and there have been no reported cases of malignant transformation. We present a 40-year-old female patient with nasal obstruction and bloody rhinorrhea. Computed tomography (CT) of the nose and paranasal sinuses confirmed a heterogeneous polypoid soft-tissue mass filling the nasal cavity and extending into the maxillary and ethmoid sinus. The patient underwent a complete radical resection. Histological and immunohistochemical analyses showed a portion of the mass was consistent with typical NCMH. However, some areas of mass exhibited cytological atypia, marked mitotic activity and foci of necrosis. The atypical mesenchymal spindle cells were immunoreactive for vimentin, CD99 and smooth muscle actin (SMA) diffusely. The cartilaginous cells were immunopositive for S-100 protein. Ki-67 index was high in atypical areas, accounting for 50%. A rapid mass recurrence was observed at the original site only 3 months after surgery. The final diagnosis of NCMH with malignant transformation was made. To our knowledge, this is the first report of malignant transformation occurring in an adult with NCMH. Although NCMH commonly develops in the neonate or young infants and exhibits benign histological appearance and favorable prognosis, there is a possibility of malignant transformation in adult patients. Thoroughly histological inspections are suggested to be necessary to accurately diagnose this tumor when it is encountered in adults.

Malignant transformation in pediatric spinal intramedullary tumors: case-based update

In children, intramedullary spinal cord neoplasms are rare. These are typically low-grade neuroepithelial tumors, most commonly astrocytomas, ependymomas, and gangliogliomas. Malignant transformation, while common in recurrent adult low-grade gliomas, is an unusual event in pediatric low-grade neoplasms, specifically in intramedullary spinal cord tumors. We report two cases of malignant transformation in low-grade neuroepithelial tumors of the pediatric intramedullary spinal cord. Two children with intramedullary tumors, one with a WHO grade I ganglioglioma and one with a low-grade astrocytoma, were treated surgically, diagnosed histologically, and followed through the course of their disease. Both patients' tumors transformed to higher grades without prior irradiation or chemotherapy, and without a genetic predisposition to tumorigenesis. Malignant transformation can occur in low-grade intramedullary neoplasms in children. This is a novel documented event for pediatric intramedullary spinal cord tumors and a rare event for all pediatric low-grade neuroepithelial tumors without induction by irradiation. A survey of the relevant literature reveals an underwhelming number of studies focusing on malignant transformation in children's CNS tumors relative to adults. Further investigation into molecular mechanisms of pediatric low-grade neoplasms may reveal more aggressive tumor sub-variants predisposed to malignant degeneration.

A retrospective analysis of the clinicopathologic characteristics of uterine cellular leiomyomas in China

ObjectiveTo investigate the clinicopathologic features of uterine cellular leiomyomas (CLs) by comparing them with those of uterine leiomyosarcomas (LMSs). MethodsA case–control study comparing 78 cases of CL with 10 cases of LMS was conducted. The patients’ records were reviewed to abstract information on tumors features and treatment, immunohistochemical findings, and disease prognosis. ResultsThe mean age at diagnosis was 45.3±8.41years in the CL group. The main clinical CL manifestations were menstrual abnormalities (56.4%), abdominal pain or distension (14.1%), and pelvic pressure (8.9%). Abdominal pain or distension was significantly more common in the LMS than in the CL group (P<0.05). Generally, CL tumors were smaller in diameter than LMS tumors (P<0.05). Moreover, lower levels of Ki-67 and PCNA expression were measured in CL than in LMS tumors (P<0.05). There were no cases of malignant transformation or metastasis in 41 patients with CL who adhered to long-tern follow-up. ConclusionNo symptoms were found to be specifically associated with CL, and management of CL does not need to differ from that of ordinary leiomyoma. In contrast to malignant disease, CL has a favorable long-term prognosis. However, given its “borderline” pathologic nature, patients with CL require clinical surveillance.

Long-Term Outcome of Surgical Excision of Leukoplakia in a Screening Intervention Trial, Kerala, India

Oral cancer is often preceeded by precancerous lesions and conditions, such as leukoplakia, erythroplakia and oral submucous fibrosis. One of the approaches for control of oral cancer is to detect oral precancerous lesions early in the development and prevent their malignant transformation to invasive cancer either by chemoprevention or by surgical excision of the lesions with concurrent control of tobacco and alcohol use and other specific etiological factors. However, the value of specific approaches, such as surgery in long-term control of lesions and prevention of malignant transformation is not known. We describe our experience with cold knife surgical excision of oral leukoplakia diagnosed in the context of a community-based oral cancer cluster randomized oral cancer screening trial in Kerala, jointly organized by the Regional Cancer Centre, Trivandrum and the International Agency for Research on Cancer of the WHO, Lyon, France. During the period from January 1997 to December 2002, 111 subjects underwent surgical excision. Thirteen patients were found to have malignancy on histopathology and were not considered for further analysis. At the last follow-up, 9 (13%) patients could not be traced and 19 (27%) patients died due to causes other than oral cancer. Of the remaining 70 cases, 48 (68.6%) were remaining disease free with no evidence of recurrence or new lesions, 16 (16.9%) developed new leukoplakic lesions, (one patient developed recurrence as well), three (4.2%) developed recurrence. Recurrence was more common among those who continued the habits, but this was not statistically significant. There were four (5.7%) cases of malignant transformation during the mean follow-up period of 8.1 years. The superiority of surgical excision over other modalities of management of leukoplakia could not be established in the present study.

Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review)

Multifocal epithelial hyperplasia (MEH), also known as Heck's disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported.

Pancreatic adenocarcinoma in paraduodenal pancreatitis: a note of caution for conservative treatments

Paraduodenal pancreatitis in heterotopic pancreas is a rare condition and few cases of malignant transformation are described. A case of cystic dystrophy of the duodenal wall in heterotopic pancreas complicated with pancreatic adenocarcinoma is described. Computed tomography, magnetic resonance and endoscopic ultrasonography failed to show preoperatively, the locally advanced adenocarcinoma raising reasonable doubts on the effectiveness and safety of conservative treatments for paraduodenal pancreatitis.

Squamous Cell Carcinoma Developing in a Diabetic Foot Ulcer

Documented cases of malignant transformation of foot ulcer in a diabetic patient in medical literature are very few. This study presents 2 interesting cases of long-standing diabetic foot ulcer, which were subsequently diagnosed to have squamous cell carcinoma on histopathological examination.

Basal cell carcinoma arising in association with a maxillary keratocyst in a patient with Gorlin–Goltz syndrome. Report of a case

Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder which is characterized by the presence of multiple basal cell carcinomas, maxillary keratocysts, and musculoskeletal anomalies. We present a case of a patient suffering from Gorlin-Goltz syndrome who developed an intraosseous basal cell carcinoma associated with a recurrent maxillary keratocyst. To our knowledge, this is the first case of malignant transformation of a keratocyst into a basal cell carcinoma described in the literature. This case highlights the importance of careful histologic examination of keratocysts excised in patients suffering from Gorlin-Goltz syndrome.

Spontaneous resolution of multiple lymphangiomas of the colon: A case report

Lymphangioma of the colon is a relatively rare non-epithelial tumor and usually presents as a submucosal polypoid lesion. Many cases incidentally discovered are usually asymptomatic. However, they may present as abdominal pain or bleeding, and their resection is normally required. Lymphangioma itself is generally recognized as a benign tumor and no cases of malignant transformation have yet been reported, although its natural history is currently unknown. To the best of our knowledge, this study is the first to describe a case of spontaneous resolution in multiple colonic lymphangiomas without any specific treatment.

A rare case of malignant transformation of endometrioma: a case report

Endometriosis of the abdominal wall, arising in a surgical scar, is a rare event. Its malignant transformation is an uncommon complication. We report a case of a suspected endometrioma in a caesarean section scar that was radically resected. The histopathologic diagnosis, surprisingly, was metastasis from papillary cystadenocarcinoma. A hysterosalpingo-oophorectomy was performed. One year later, she presented with a mass involving the left rectus abdominis muscle. Histopathologic re-evaluation revealed a carcinoma on endometriosis. A wide resection of the abdominal wall was performed, and reconstruction was undertaken with a Goretex mesh and two tensor fascia lata musculocutaneous flaps. Histopathological diagnosis was adenocarcinoma with invasion into the parietal peritoneum. Despite aggressive surgical treatment and adjuvant chemotherapy, 5 months after surgery, she presented peritoneal dissemination of the disease. The diagnosis of malignancy arising on endometrioma is often difficult because of the lack of pathognomonic signs. Prognosis is strictly related to the time of diagnosis. We believe that an early and aggressive treatment on the sole suspicion of an endometrial origin of an abdominal mass would allow a much earlier diagnosis and treatment for those patients, improving their prognosis, which is otherwise very poor.

Melanotic neuroectodermal tumor of infancy—A report of two cases

The melanotic neuroectodermal tumor of infancy (MNTI) is a rare childhood neoplasm with a classical clinical presentation. It appears as a rapidly enlarging pigmented mass in the upper jaw and can be easily mistaken for a malignant neoplasm. Although possessing an aggressive growth rate and radiographic appearance, the MNTI almost always behaves in a benign fashion and can be treated with local excision. However, few cases of malignant transformation and recurrences have been reported in literature and that makes follow-up very important. This paper describes two cases of MNTI with classical histological presentation.

Malignant transformation of chronic limb wounds. three cases reported.

We report three cases of malignant transformation of chronic wound and from thermal burn scar. The first is characterized by total destruction of the tibial diaphysis; the second appeared 22 years after skin healing and the third also occurred after skin healing. The three cases were differentiated spinocellular epithelioma and they were all treated by amputation of the limb concerned. The authors stress the necessity of repeated biopsies of any chronic wound if the patient has to have a conservative surgery. Key words: chronic wound, Marjolin ulcer, spinocellular epithelioma.

Adenocarcinoma arising in a heterotopic pancreas (Heinrich type III): a case report

IntroductionHeterotopic pancreatic cancer in the duodenum is a very rare disease. Only twelve cases have been reported worldwide to date. We report a rare case of malignant transformation of heterotopic pancreas (Heinrich type III) in the duodenum with long-term survival of the patient, and review the 12 cases in the literature.Case presentationA 75-year-old Japanese man was admitted to our hospital complaining of nausea and vomiting. Endoscopy and upper gastrointestinal contrast study showed marked duodenal stenosis. A pylorus-preserving pancreaticoduodenectomy was performed. Histopathological examination of the surgically resected specimen showed malignant transformation of heterotopic pancreas (Heinrich type III) in the duodenum. The postoperative course was uneventful, and the patient was discharged from the hospital on postoperative day 30. He is well and shows no signs of recurrence at the time of writing, six years after the surgery.ConclusionAdenocarcinoma arising within the heterotopic pancreas appears to be rare. It is difficult to obtain a correct diagnosis preoperatively. The management of heterotopic pancreas depends on the presence or absence of symptoms. If the patient is asymptomatic or benign, conservative treatment with regular follow-up is recommended. When the patient is symptomatic or there is a suspicion of malignancy, surgical management with intra-operative frozen section diagnosis is indicated.

Kyste bronchogénique lingual chez un adulte

Choristoma are non-malignant embryonic tumors, defined by ectopic tissues different from the organ on which they develop. The bronchogenic cyst is a choristoma affecting the upper aero digestive tract. It is lined with respiratory epithelium. The tongue is a rare localization for choristoma.We report the case of a 22-year old male patient who consulted in maxillofacial surgery for painful macroglossia. Imaging revealed a median lesion, suggesting an abscessed embryonic tumor. Pathologic examination after surgical exeresis confirmed the diagnosis of lingual choristoma of the bronchogenic cyst type.Embryonic tumors of the tongue are generally diagnosed during childhood. Adult cases are rare. Surgical removal is the only treatment. Post-operative complications and relapse are rare. Only one case of malignant transformation has been reported; systematic radical exeresis is thus always recommended.