Majority Of Benign Tumors Research Articles

Intracardiac masses: Single center experience within 12 years: I-MASS Study

ObjectiveThe aim of this cross-sectional, retrospective, descriptive study was to review and classify cardiac masses systematically and to determine their frequencies. MethodsThe medical records of 64,862 consecutive patients were investigated within 12 years. Every patient with a cardiac mass imaged by transthoracic echocardiography (TTE) and confirmed with an advanced imaging modality such as transesophageal echocardiography (TEE), computed tomography (CT) and/or cardiac magnetic resonance imaging (CMR) was included. Acute coronary syndromes triggering thrombus formation, vegetations, intracardiac device and catheter related thrombi were excluded. ResultsData demonstrated 127 (0.195%) intracardiac masses consisting of 33 (0.050%) primary benign, 3 (0.004%) primary malignant, 20 (0.030%) secondary tumors, 3 (0.004%) hydatid cysts and 68 (0.104%) thrombi respectively. The majority of primary cardiac tumors were benign (91.67%), predominantly myxomas (78.79%), and the less malignant (8.33%). Secondary cardiac tumors were common than the primary malignant tumors (20:3), with male dominancy (55%), lymphoma and lung cancers were the most frequent. Intracardiac thrombi was the majority of the cardiac masses, thrombi accompanying malignancies were in the first range (n = 17, 25%), followed by autoimmune diseases (n = 13, 19.12%) and ischemic heart disease with low ejection fraction (n = 12, 17.65%). ConclusionsThis retrospective analysis identified 127 patients with cardiac masses. The majority of benign tumors were myxoma, the most common tumors that metastasized to the heart were lymphoma and lung cancers, and the thrombi associated with malignancies and autoimmune diseases were the most frequent.

Primary Cardiac Tumors: A Retrospective Study

Objectives:Primary cardiac tumors are rare and account for 0.001 to 0.03% of cardiac lesions. The authors aim to describe the clinical, the microscopic and the therapeutic characteristics of these tumors through a 13-year-experience in order to highlight the diagnostic challenges faced.Methods:We report 10 primary cardiac tumors diagnosed in the Departments of Pathology and Thoracic Surgery of the same hospital through a 13-year-period.Results:Our study was conducted on 7 women and 3 men. The mean age of the patients was 54.22 years (average, 12 to 79 years). Dyspnea represented the most frequent symptom. Physical examination was normal in all patients. Trans-thoracic ultra-sound examination was performed in all patients. Cardiac MRI allowed localizing the tumors in 2 patients. They were located into the left auricle (6 cases), the right auricle (1 case) and the pericardium (3 cases). The microscopic examination was concluded to myxoma (7 cases), haemangioma (2 cases) and hemangioendothelioma (1 case). Surgical resection was possible in 9 patients. It was impossible in the case of hemangioendothelioma because of the adherence. One death was recorded secondary to postoperative arrhythmia. The other patients presented no complications after a follow-up period ranging from 2 months to 5 years.Conclusion:Cardiac tumors are challenging in their diagnosis and management. A positive diagnosis is based on microscopic examination. Surgical treatment plays a key role and is possible in the majority of benign tumors. The prognosis of malignant tumors remains poor even if a complete surgical resection is possible.

Pathological nature of renal tumors - does size matter?

Introduction:We examined the relationship between the size and nature of renal masses in term of malignant potential, histological grading, pathological staging and presence of necrosis and sarcomatoid changes.Materials and Methods:Retrospectively, we reviewed 323 consecutive nephrectomies between 2000 and 2010. Final pathology was correlated with tumour size. The renal tumours were stratified into three groups according to the largest diameter, defined as 4 cm or smaller, greater than 4 cm to 7 cm, and greater than 7 cm. We recorded the proportion of benign tumours, tumour grade and stage, presence of necrosis and sarcomatoid change.Results:Small renal masses ≤4 cm (SRMs) were more likely to be localised to the kidney (90%) and of lower histological grade (75%). The proportion of benign tumours in SRMs (15%) was higher than other two groups with the majority of benign tumours being oncocytomas. There was a statistically significant trend with greater necrosis and sarcomatoid change for the large size group.Conclusions:SRMs are likely to be low grade and organ confined with little or no adverse pathological features. There is increased likelihood of benignity in SRTs with the majority of benign tumours being oncocytomas.

Prevalence of Head and Neck Tumors in Children under 12 Years of Age Referred to the Pathology Department of Children’s Hospital in Tabriz during a 10-year Period

Background and aims. Head and neck tumors are the most common complaints of people referring to different medical sections, especially in children. The aim of this study was to evaluate the prevalence of these tumors in children less than 12 years of age to provide a better perspective for future studies.Materials and methods. All the files in Department of Pathology at Tabriz Pediatric Hospital from 2001 to 2011 were screened for head and neck tumors in children under 12 years of age. Data including age and gender as well as the type, the location, and benign/malignant characteristic of the tumor were recorded. Data were analyzed by SPSS 15 statistical software, using descriptive statistics and chi-square test.Results. A total of 160 cases were identified. Most of the tumors were benign (68%) and most of the tumors occurred in the neck region (41%). The most frequent benign and malignant tumors were lymphangioma and non-Hodgkin lymphoma, respectively. The majority of benign tumors were found in children younger than 2 years old (P=0.007), but there was no age predilection for malignant tumors.Conclusion. According to our results, benign tumors were more prevalent than malignant ones. Although a low rate of benign tumors in males shows that more attention should be paid to the early diagnosis of head and neck tumors.

Endobronchial lipomatous polyp: a rare benign tumor of the lung.

Endobronchial lipomatous polyp is a rare nonmalignant tumor of the lung. It comprises 5% of the benign lung tumor, with the majority of benign tumors being hamartoma. Lipomatous polyp often leads to endobronchial lesion, associated with postobstructive pneumonia, hemoptysis, and atelectasis. We hereby present a case and discussion of an elderly man with endobronchial lipomatous polyp, presenting as recurrent pneumonia.

Étude du contenu en ADN nucléaire dans les nodules thyroïdiens: Intérêt diagnostique et pronostique

Thyroid nodules are frequent and sometimes they pose a diagnostic and prognostic problem. DNA ploidy study and cell cycle analysis could be of value in the distinction between benign tumors and malignant tumors. Formalin-fixed and paraffin-embedded tissues from 69 patients with different benign and neoplastic lesions were investigated. Nuclear DNA content in thyroid cells was measured after Feulgen staining using SAMBA 200 image analysis system. A diploid DNA stemline was revealed in 75% of histologically proven benign thyroid tumors (15/20) and aneuploidy was found in 57.2% of malignant tumors (28/49). There is a significant correlation between aneuploidy and extra-thyroid extension (p=0.007) and bilateral and/or mediastinal lymph node metastasis (p=0.02). In the majority of benign tumors (19/20), the proliferation index was lower than 3% (< or =3%) however, this index value was higher than 3% (>3%) in more than 83% of malignant tumors (41/49) (p<0.001). The S phase fraction analysis revealed that the threshold of 14% divide the near whole of benign and malignant tumors (p<0.001). Our findings show that in follicular lesions, proliferation index and S phase fraction study appears interesting and helpful in the distinction between benign and malignant tumors, and aneuploidy seems more interesting in prognosis evaluation of these tumors.

BRCA1 Expression in Canine Mammary Dysplasias and Tumours: Relationship with Prognostic Variables

BRCA1 is a nuclear phosphoprotein that participates in the regulation of the cell cycle. The role of the BRCA1 gene in canine mammary tissue and mammary tumours has not been studied. The present study examined immunohistochemically the expression and intracellular distribution of BRCA1 protein in two normal, seven dysplastic and 44 neoplastic canine mammary glands and its relationship with clinical and pathological variables and other prognostic parameters. Strong nuclear immunolabelling of BRCA1 protein was observed in the epithelial cells of the normal mammary glands and mammary dysplasias. The majority of benign tumours, and more especially of malignant tumours, showed a significant reduction in the nuclear expression of BRCA1 protein and an increase in cytoplasmic expression. Loss of BRCA1 expression was associated with high proliferation marker Ki-67 and ER-α negative tumours. The reduction and aberrant distribution of BRCA1 in canine mammary tumours were significantly associated with malignant characteristics. The results may indicate that BRCA1 has a role in the malignant behaviour of these tumours.

Oral and maxillofacial tumours in North Jordanian children and adolescents: a retrospective analysis over 10 years

This study evaluates the types and distribution of oral and maxillofacial tumours in north Jordanian children and adolescents. The records of the Department of Pathology at Jordan University of Science & Technology, during the period 1991–2000, were reviewed for patients younger than 19 years with oral and maxillofacial tumours. The tumours were analysed for age, sex, site and type. Out of all maxillofacial tumours, 23% occurred in children and adolescents, of these 10% were malignant and 90% were benign. 73% of the latter were soft tissue tumours and 17% were jaw tumours (58% odontogenic and 42% non-odontogenic). The most common benign soft tissue and jaw tumours were haemangioma and odontoma, respectively. 58% of malignant tumours were sarcomas and 42% were carcinomas. The mean age was 11 years with a female to male ratio of 1:1.2. The intraoral and extraoral sites most commonly affected by benign soft tissue tumours were the lower lip and face, respectively. While the total number of benign jaw tumours was slightly larger in the maxilla than the mandible, odontogenic tumours were more in the maxilla, and nonodontogenic tumours were more in the mandible. Differences found in this study between Jordanian children and adolescents and those from other countries may be attributable to genetic and geographic differences.The majority of benign tumours in the young are probably developmental rather than true neoplasms.

Loss of expression of transforming growth factor beta in skin and skin tumors is associated with hyperproliferation and a high risk for malignant conversion.

Mouse skin carcinomas arise from a small subpopulation of benign papillomas with an increased risk of malignant conversion. These papillomas arise with limited stimulation by tumor promoters, appear rapidly, and do not regress, suggesting that they differ in growth properties from the majority of benign tumors. The transforming growth factor beta (TGF-beta) proteins are expressed in the epidermis and are growth inhibitors for mouse keratinocytes in vitro; altered TGF-beta expression could influence the growth properties of high-risk papillomas. Normal epidermis, tumor promoter-treated epidermis, and skin papillomas at low risk for malignant conversion express TGF-beta 1 in the basal cell compartment and TGF-beta 2 in the suprabasal strata. In low-risk tumors, 90% of the proliferating cells are confined to the basal compartment. In contrast, the majority of high-risk papillomas are devoid of both TGF-beta 1 and TGF-beta 2 as soon as they arise; these tumors have up to 40% of the proliferating cells in the suprabasal layers. Squamous cell carcinomas are also devoid of TGF-beta, suggesting that they arise from the TGF-beta-deficient high-risk papillomas. In some high-risk papillomas, TGF-beta 1 loss can occur first and correlates with basal cell hyperproliferation, while TGF-beta 2 loss correlates with suprabasal hyperproliferation. Similarly, TGF-beta 1-null transgenic mice, which express wild-type levels of TGF-beta 2 in epidermis but no TGF-beta 1 in the basal layer, have a hyperproliferative basal cell layer without suprabasal proliferation. In tumors, loss of TGF-beta is controlled at the posttranscriptional level and is associated with expression of keratin 13, a documented marker of malignant progression. These results show that TGF-beta expression and function are compartmentalized in epidermis and epidermal tumors and that loss of TGF-beta is an early, biologically relevant risk factor for malignant progression.

Flow cytometric analysis of nuclear DNA content in ovarian tumors association of ploidy with tumor type, histologic grade, and clinical stage

The authors undertook a prospective, flow cytometric study of nuclear DNA ploidy in 140 fresh ovarian tumors. There were 43 benign tumors, 27 borderline tumors, and 70 malignant tumors. Results of DNA ploidy analysis were compared to age at diagnosis, menopausal status, tumor size, histologic type, grade, and International Federation of Gynecology and Obstetrics (FIGO) stage. Although the majority of benign tumors were diploid, 19% were aneuploid. Among the benign tumors, DNA ploidy was significantly associated with tumor type and tumor size. All borderline tumors were diploid. Of the 70 malignant tumors, 64% were aneuploid. In the malignant tumors, DNA aneuploidy had significant univariate associations with histologic type, grade, and FIGO stage. By multivariate analysis, DNA aneuploidy remained significantly associated with stage and grade, both known predictors of survival in ovarian cancer. These results indicate that DNA ploidy varies with the aggressive potential of an ovarian cancer and may, at the time of initial diagnosis, provide additional information about tumor prognosis.

Primary epithelial tumors of the appendix and a reappraisal of the appendiceal "mucocele".

A 28-year review of the records at Hines V.A. Medical Center revealed 17 primary epithelial tumors of the appendix. Five of these tumors were benign and 12 malignant. It is suggested that the term mucocele be abandoned, because it represents the end result rather than a definite pathologic entity. The majority of benign tumors and carcinoid tumors of the appendix are discovered incidentally to other procedures. The majority of adenocarcinomas cause symptoms and signs of appendicitis. Simple appendectomy is sufficient treatment of all benign tumors of the appendix, and for all carcinoids that show no gross local metastases and are less than 2 cm in diameter. Simple appendectomy followed by right hemicolectomy or initial right hemicolectomy is the treatment of choice for all carcinoids of the appendix that show gross local metastases and are 2 cm or more in diameter and for all adenocarcinomas of the appendix, whether mucinous or colonic, in the absence of distant metastasis. A new classification for primary epithelial tumors of the appendix is suggested.

Arteriography in tumors of the soft parts of the extremities

Arteriography was carried out on 54 patients with benign and malignant tumors of soft tissues of the extremities. Results are reported and the most significant angiographic pictures of 28 cases are illustrated in detail. These include 2 neurilemmomas, 1 gigantocellular tumor (sesamoid tumor), 1 synovial gigantocellular tumor, 1 venous racemose hemangioma, 1 capillary-racemose hemangioma, 8 fibrosarcomas, 1 rhabdomyosarcoma, 1 neurosarcoma, 3 synovialsarcomas, 1 malignant mesehnchimoma, 1 mixed epithelioconnectival tumor, 5 ablastic sarcomas, 2 epitheliomas. The arteriographic aspects observed are compared with those described in the literature in order to outline the present knowledge on arteriographic semeiology and diagnosis in benign and malignant tumors of soft tissues. As concerns arteriographic semieology, seven main radiological signs are recognized by the authors, or: 1) displacement of vessels surrounding the growth; 2) dilatation of centripetal and centrifugal vessels; 3) changes in the circulation time; 4) vessels neoformation. Four main angiographic aspects of the newly formed intratumoral vascular network are described; 5) tumor impregnation by the contrast medium; 6) intratumoral blood collections; 7) arterovenous shunts. The frequency and extend of the mentioned radiological features are varying, and different arteriographic pictures may be seen according to tumors type and malignancy. In the majority of benign tumors nearly similar pictures are seen, characterized by absent or scarce vessels of normal appearance. Fibromatous tumors show a homogeneous moderate retention of the contrast medium. Vascular tumors, and particularly some types of angioma, may exhibit rather typical features which consent an angiographic diagnosis of the tumor type. As concerns malignant tumors, rather polymorphic arteriographic pictures are seen in fibrosarcomas, as to tumor vascularization and structural arrangement. Occasionally, vessels are scarce and of normal appearance, and the angiographic pattern resembles that of fibroma; in other cases vessels are more abundant. with irregular caliber and course. The greatest vascular atypia seems to correspond to the histologically most malignant variety of fibrosarcoma. A characteristic common to all observed cases of fibrosarcomas was an evident homogeneous impregnation by the contrast medium. The presence of intratumoral lacune and arterovenous shunts is exceptional. Mention is given of pictures obtained in lipo- and mixosarcomas, sarcomas of muscular origin and angiosarcomas, whereas synovialsarcomas and ablastic sarcomas are more thoroughly considered. Synovialsarcomas are scarcely known in the arteriographic literature. In the three cases observed by the authors, the arteriographic picture resembled that of some types of fibrosarcoma, with abundant and rather atypical vessels, absence of blood lacunae or shunts, regular retention of the contrast medium. These angiographic features, the site, and the roent-genographically visualized skeletal changes ought to consent a radiological diagnosis of the tumor type. In ablastic sarcomas the arteriographic picture is always characterized by a very marked vascular atypia. The frequent occurrence of intratumoral lacunae and arterovenous shunts is suggestive of the high malignancy of these forms. Side effects at the level of limb circulation are also frequently encountered. Tumor impregnation by the contrast medium varies from case to case. To conclude, arteriography is claimed to be able to reveal, in many cases, the presence of a tumor, and to determine its malignancy. The type of the tumor is hardly recognizable, except for some particular cases. Caution is needed in interpreting arteriographic pictures, for the presence of several factors may invalidate the findings. Error causes are analyzed and discussed. Arteriography cannot replace biopsy, but rather complete it as a method of diagnostic ascertainment. Arteriography seems to be clinically indicated: 1) in early diagnosis of cancer of soft tissues of extremities, mainly when the lesion is still scarcely extended or deeply situated; 2) to ascertain tumor extent, to outline its limits towards healthy soft tissues and its anatomical relationships to the bone and vessels. These findings are very significant from a therapeutical, either surgical or radiological, standpoint. 3) to check therapy results. After radiotherapy, arteriography may show a gradual normalization of the angiographic picture of malignancy. In surgically treated cases arteriography may occasionally differentiate between recurrence and cicatricial hardening or granulomatous processes at the operation site. 4) to study tumor vascularization and impregnation; number, site, and course of the supplying vessels. These data are valuable not only for surgical purposes, but also for the application of modern therapeutical methods, such as the introduction of antimitotic or radioactive substances into the afferent circulation.