Case Of Synchronous Carcinoma Research Articles

Epithelial Carcinomas Arising within Phyllodes Tumours of the Breast: A Review of Their Pathological Characteristics.

Epithelial proliferation is a common feature of phyllodes tumours (PTs), but epithelial malignancy is rare. This review seeks to further our understanding of epithelial malignancy within PTs by analysing their histopathological characteristics in previously reported cases and providing an overview of studies on their pathological features. PubMed and DeepDyve were searched for case reports, case series, and literature reviews of in situ and invasive carcinoma within PTs. Only cases where the carcinoma was within the PT were included. Cases of synchronous carcinoma in the ipsilateral or contralateral breast were excluded. Ninety-eight cases of in situ or invasive carcinoma within a PT were identified. Across the grades of PTs, there was a similar proportion of invasive carcinomas compared to in situ lesions. Malignant PT correlates with a higher likelihood of epithelial malignancy, and molecular studies support a possible causal pathophysiological relationship. This higher likelihood may suggest interactions between malignant stroma and the transforming epithelium that could potentially play a significant role in the phenomenon, which remains to be elucidated. Encasement within a PT likely improves the prognosis of breast carcinoma due to earlier detection. The presence of carcinoma within a malignant PT has uncertain prognostic implications. Thorough sampling of all PTs is recommended for appropriate prognostication and management.

Successful one-stage operation for ipsilateral, synchronous carcinomas of the breast and lung: A case report

Abstract The incidence of double primary malignancies is very low, particularly, a case of synchronous carcinomas of the ipsilateral breast and lung. Determining whether to have a one-stage operation for ipsilateral breast cancer and lung cancer is a challenge for the surgeon. The current study presents a case of a 56-year-old female, with a rigid textured mass measuring approximately 18×20 mm above the areola of the right breast and chest CT showing a mass of 20 × 14 mm at the tip segment of right upper lobe of the lung. A diagnosis of a synchronous dual primary carcinoma of the right lung (cT1N0M0) and right breast (cT1N0M0) was made. The patient underwent a right breast-conserving surgery, sentinel node biopsy, and right upper lobectomy and lymphadenectomy with a video-assisted thoracoscopic technique simultaneously. To our knowledge, in the previous literature, there was no one-stage operation for ipsilateral, synchronous carcinomas of the breast and lung and only one reported case with left breast and right lung cancer underwent a one-stage operation. This report first presents the successful treatment of a case with synchronous primary breast and lung carcinomas on the same side of the body with a one-stage operation and therefore is educational.

Todani Type II Congenital Bile Duct Cyst: European Multicenter Study of the French Surgical Association and Literature Review.

The purpose of the study was to analyze clinical presentation, surgical management, and long-term outcome of patients suffering from biliary diverticulum, namely Todani type II congenital bile duct cyst (BDC). The disease incidence ranges between 0.8% and 5% of all reported BDC cases with a lack of information about clinical presentation, management, and outcome. A multicenter European retrospective study was conducted by the French Surgical Association. The patients' medical records were included in a Web site database. Diagnostic imaging studies, operative and pathology reports underwent central revision. Among 350 patients with congenital BDC, 19 type II were identified (5.4%), 17 in adults (89.5%) and 2 in children. The biliary diverticulum was located at the upper, middle, and lower part of the extrahepatic biliary tree in 11, 4, and 4 patients (58%, 21%, and 21%, respectively). Complicated presentation occurred in 6 patients (31.6%), including one case of synchronous carcinoma. Surgical techniques included diverticulum excision in all patients. Associated resection of the extrahepatic biliary tree was required in 11 cases (58%) and could be predicted by the presence of complicated clinical presentation. There was no mortality. Long-term outcome was excellent in 89.5% of patients (median follow-uptime: 52 months). According to the present largest Western series of Todani type II BDC, the type of clinical presentation rather than BDC location, was able to guide the extent of biliary resection. Excellent long-term outcome can be achieved in expert centers.

Prognostic analysis of 53 patients with multiple primary upper gastrointestinal cancer

Objective To investigate the clinical characteristics, the principles of diagnosis, treatment and the prognosis of primary esophageal cancer. Methods 53 patients with esophageal cancer were analyzed, including in 28 cases of synchronous carcinoma (SC) and 25 cases of metachronous carcinoma (MC). 8 patients received simple operation without following chemotherapy, 28 patients with esophageal and stomach lesion were treated by operation and radiation and chemotherapy, and only 17 patients were treated with simple chemotherapy. Total cases were followed up for survival time. Results The 1-, 3-and 5-year survival rates were 64.3 % (18/28), 7.1 % (2/28), 7.1 % (2/28) in SC, and were 100.0 % (25/25), 80.0 % (20/25), 40.0 % (10/25) in MC (P<0.05). For different treatments, the 1-, 3-and 5-year survival rates were 75.0 % (6/8), 25.0 % (2/8), 25.0 % (2/8) in simple operation, 52.9 % (9/17), 0, 0 in simple chemoradiotherapy, and 100.0 % (28/28), 71.4 % (20/28), 35.7 % (10/28) in operation plus chemoradiotherapy. The results from multiple factors regression analysis showed that the pathogenesis, pathological type, the time interval of onset were the independent prognostic factors which can influence the survival time (chi square values were 1.330, 0.023, 0.056, all P<0.05). Conclusions MC patients have longer survival time and higher survival rate than SC patients. There is no difference of the 1-, 3-, 5-year survival rates of patients with different treatments. Key words: Multiple primary upper gastrointestinal cancer; Treatment; Prognosis

Primary squamous cell carcinoma of the ovary associated with endometriosis

Objective To analyze the clinical, therapeutic, and pathologic features of published cases presenting primary squamous cell carcinoma (SCC) of the ovary associated with endometriosis. Methods A case report, 15 cases of infiltrating SCC of the ovary associated with or arising from endometriosis, and 1 case of synchronous carcinoma in situ in the cervix and ovary from a review of the literature were studied. Results Young age, advanced stage of the disease, and hypogastric pain were frequent at the time of diagnosis. There was no ascites, but infiltration of neighboring organs was common. The tumor was associated with 80% patient mortality in the first few months. Adjuvant chemotherapy with paclitaxel and carboplatin or cisplatin appeared to improve the results. Conclusion Primary SCC of the ovary associated with endometriosis is extremely rare and has a poor prognosis. The best therapeutic results are obtained with paclitaxel and carboplatin or cisplatin after radical surgery.

Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy

Inverted papillomas are relatively rare, benign epithelial tumours of the nasal cavity which generate considerable interest because they are locally aggressive, have a tendency to recur and are associated with malignancy. To review our experience of the management of inverted papillomas, and to review the literature in order to evaluate recurrence rates, rates of synchronous and metachronous carcinoma, and outcomes of treatment, both endoscopic and conventional. We retrospectively reviewed all cases of inverted papilloma that presented to our unit, a tertiary referral centre, over a 20-year period from 1985 to 2005. A Medline review of the literature was performed to identify published case series of inverted papillomas. We undertook a critical analysis of the literature. We treated 65 patients with inverted papilloma over the 20-year period, with a mean follow up of five years (range one to 20 years). Fifty-eight patients initially underwent nasal biopsy, often with polypectomy. Thirty-six had endoscopic surgery, with five (14 per cent) suffering recurrence, whilst 16 had a lateral rhinotomy and medial maxillectomy, of which four (25 per cent) suffered a recurrence. Seven septal inverted papillomas required local resection, with no subsequent recurrences. There were seven (11 per cent) synchronous and two metachronous malignancies.Sixty-three case series with adequate data were identified from the literature. There were 163 (7.1 per cent) cases of synchronous carcinoma, out of 2297 cases. Metachronous carcinomas were reported in 74 out of 2047 cases, representing a transformation rate of 3.6 per cent. However, the true population base for these figures is uncertain, given that many series were reported from tertiary centres, where recurrent and problematic cases are likely to be over-represented. The recurrence rates were 12.8 per cent for endoscopic procedures, 17.0 per cent for lateral rhinotomy with medial maxillectomy, and 34.2 per cent for limited resections such as nasal polypectomy and Caldwell-Luc approaches. No significant association between atypia or dysplasia and recurrence or malignant transformation was found. The mean time taken to develop a metachronous carcinoma was 52 months (range six to 180 months). The estimated malignant potential for recurrent disease was up to 11 per cent. Patients with inverted papilloma should undergo thorough surgery to remove all mucosal disease, most probably by the endoscopic, endonasal route when complete resection is possible. Cases demonstrating atypia or dysplasia may be treated by the endoscopic route. Recurrent disease and metachronous carcinoma can develop after a prolonged period of time. Long-term follow up is recommended to detect recurrence, as disease can become quite extensive before it becomes symptomatic.

Synchronous carcinomas of endometrium and ovary

Five cases of synchronous carcinomas of uterine endometrium and ovary are reported. All uterine cancers were typical endometrial adenocarcinomas. Among the ovarian cancers, four were serous papillary cystadenocarcinomas and one was an endometrioid carcinoma. There is much controversy with respect to staging and management of such cases since these tumors may represent either two synchronously occurring primaries or a single primary with metastases. It is suggested that when each tumor is confined within the limits of its tissue of origin the tumors may be considered as two separate primaries and surgery may be less aggressive. When there is evidence that at least one tumor is spreading to adjacent tissues and organs the question of two separate primaries or one metastatic tumor becomes academic only and aggressive surgical treatment with adjuvant chemotherapy is indicated.