Malignant Tendency Research Articles

Response to isolated limb perfusion and chemotherapy with epirubicin plus ifosfamide in a metastatic malignant ossifying fibromyxoid tumor

BackgroundOssifying fibromyxoid tumor (OFMT) is a rare soft tissue neoplasm of uncertain lineage and intermediate biological potential. It is more common in middle-aged men, usually arising from the deep tissues of the extremities. It is now established that it is a translocation related tumor, most often marked by translocation of PHF1 gene. Surgery is the mainstay of treatment and proves usually curative, although, in rarer cases the disease shows malignant features and tendency to recur both locally and at distant sites. In such cases, no standard treatment exists.Case presentationWe report on a case of malignant advanced OFMT of the hand with lung metastases responding to isolated limb perfusion with human recombinant tumor necrosis factor and melphalan and chemotherapy with epirubicin and ifosfamide.ConclusionsTo our knowledge, this is the first report of activity of soft tissue sarcoma-oriented chemotherapy in advanced OFMT.

Subcellular localization of β-arrestin1 and its prognostic value in lung adenocarcinoma.

β-Arrestins play important roles in cancer progression, and the subcellular localization of β-arrestin1 has been receiving increasingly more attention. Intriguingly, several studies, including some of our previous work, showed that the effects of β-arrestin1 on outcomes of cancer patients were controversial.Specimens were obtained from 133 patients with lung adenocarcinoma. Immunohistochemistry was used to detect the expression of β-arrestin1 and p300 in the collected tissues. The Kaplan-Meier analysis and Cox proportional hazards regression were used to examine the relationship between β-arrestin1 and patient survival.We found no significant association between β-arrestin1 and clinicopathological variables. The Kaplan-Meier plot showed that patients with high expression of β-arrestin1 (especially in the nucleus) had a poorer overall survival (OS) and shorter disease-free survival (DFS) (P = .026, P = .015). Additionally, high p300 expression also resulted in worse OS (P = .039). Following the univariate analysis, high expressions of nuclear β-arrestin1 and p300 were classed as poor prognostic factors for both OS (P = .016) and DFS (P = .025).The expression of β-arrestin1 in the nucleus is associated with increased malignant tendency of lung adenocarcinoma, and the predictive value of β-arrestin1 may be optimized by combining information about the expression of p300 acetyltransferase.

AGGRESSIVE BORDERLINE FUSOCELLULAR GROWTH OF THE MANDIBLE IN CHILD: CASE REPORT

Borderline tumors are non-invasive neoplasms that have nuclear abnormalities and mitotic activity intermediate between benign and malignant tumors of similar cell types. Its diagnosis poses a problem because of its malignant tendencies and non-specific routine light microscopic features. The present case aims to report a malignant mesenchymal neoplasm with suggestive histopathologic diagnosis of fibrosarcoma of mandible in a 13-year-old female patient. Microscopically, the tumor showed proliferation of spindle-shaped cells, varying little in size and shape, and arranged in parallel bands, partly crossing each other. Immunohistochemical profile was AML positive and S100 - HHF35 negative. Based on clinical, radiologic and histologic findings the diagnosis was suggestive of intraosseous fibrosarcoma and the patient was referred for treatment in a reference center. Patient refused surgical resection of mandible as first choice treatment, opting for chemotherapy and radiotherapy to restaging the tumor. The patient currently is under treatment.

Clinicopathological features of malignant transformation of craniopharyngiomas

Objective To study the clinicopathological features of malignant transformation of craniopharyngioma. Methods Two cases of craniopharyngioma with malignant transformation were operated in Beijing Tiantan Hospital, Capital Medical University and were confirmed at Beijing Neurosurgical Institute during the period from January 2015 to December 2016, whose clinical data and histopathological features were retrospectively analyzed. The histological features of 1 case were compared before and after appearance of malignance. The immunohistochemical results of the malignant cases were compared with those of 10 cases of ameloblastic craniopharyngioma enrolled to the study during the same study period. Results The 2 cases with malignant transformation included 1 male and 1 female, and they were both 25 years old. They had both received radiotherapy before malignant transformation. They were both ameloblastic craniopharyngioma and squamous cell carcinoma before and after malignant transformation, respectively. After malignant transformation, large hyperchromatism nuclei with clear nucleolus, increased nuclear-cytoplasmic ratios, and increased mitotic activities were seen in the malignance. The tumor cells were arranged in solid sheets, and the stellate reticulum was rare. The wet keratins were frequently found in the cancer nests and in the stroma. The tumor cells infiltrated the brain tissue. The basement membranes were destroyed or disappeared. Compared with the pre-malignance, the tumors had higher cell density, more cellular polymorphism and more mitotic activity. All cases showed immunoreactivity for CK and CK5/6. Compared with the pre-malignant condition, the Ki-67 index was significantly elevated after appearance of malignance(50% vs.5%). The Ki-67 indexes of malignant transformation were significantly higher than those of ameloblastic craniopharyngiomas(50% vs.2%~10%). Conclusion The malignant transformation of craniopharyngioma seems to have an obvious malignant tendency, but it may still keep some features of craniopharyngioma, which is helpful for the differential diagnosis with similar tumors. Key words: Craniopharyngioma; Pathology; Diagnosis, Differential; Malignant transformation

Overexpression of STMN1 is associated with the prognosis of meningioma patients.

There is a small part of the pathological type of the meningioma has a malignant tendency and patients have the poor prognosis. Looking for effective biomarkers to predict the degree of malignancy of the tumors, will help us to better manage the patient and guide the treatment. The present study aims at investigating the prognostic value of the expression of Stathmin in a series of meningiomas of different grade. We integrated eight published microarray datasets of meningiomas to screen grade biomarkers in meningiomas patients using the WebArrayDB platform. We focused on Stathmin, Using formalin-fixed paraffin-embedded (FFPE) tumor samples, we corroborated the relationship between Stathmin and patient outcomes using qRT-PCR for gene expression. We also found expression of Stathmin that atypical/anaplastic meningiomas have higher expression than benign meningiomas (p<0.01). No correlation between Stathmin expression and age, gender and tumor extent of resection was found (p>0.05). Moreover, increased Stathmin expression was correlated to higher meningioma grade and shorter disease-free survival (DFS) of meningioma patients with Simpson I resection. Stathmin might be promising targets to improve the cure rates in meningiomas.

Hepatic perivascular epithelioid cell neoplasm: A clinical and pathological experience in diagnosis and treatment.

Hepatic perivascular epithelioid cell neoplasm (PEComa) is a rare type of neoplasm derived from mesenchymal tumors that is often misdiagnosed as hepatocellular carcinoma (HCC), hepatic hemangioma or other liver malignancies. The clinical and histological characteristics of PEComa have yet to be fully documented. To optimize the diagnosis and treatment of the disease, a retrospective analysis was performed to investigate the clinicopathological characteristics of 7 patients diagnosed with hepatic PEComa in the Sun Yat-Sen Memorial Hospital between January 2004 and December 2015. Briefly, all the patients lacked specific symptoms, and a serological examination provided no further useful information. Additionally, non-specific imaging manifestations were observed. Microscopically, detection of epithelioid or spindle-shaped cells with adipocytes was suggestive of the disease, and an analysis of biomarkers, including the monoclonal antibody HMB-45, the melanocytic differentiation marker, Melan-A, and smooth muscle α-actin (SMA), helped to confirm the diagnosis. Regarding the treatment, 6 patients (85.7%) received surgical resection procedures, and 1 patient (14.3%) was admitted for tumor arterial embolization and percutaneous microwave coagulation therapy. After a follow-up period of 12–20 months, no recurrence was observed. Taken together, hepatic PEComa should be suspended in patients with a liver tumor with asymptomatic manifestation and normal serological test results. In imaging studies, hepatic PEComa was able to mimic HCC, hepatic hemangioma and metastatic tumor, although the mass did not invade the adjacent organs and vessel. The definitive diagnosis was made on the basis of the typical morphological features and notable markers of the tumor tissue. It is recommended that patients with PEComa in a benign pattern deserve serial imaging follow-up, but surgery is indicated in patients suffering from large tumors (>5 cm), or progressive enlargement or malignant tendency.

Clinical and pathological characteristics of vocal fold leukoplakia and influential factors of recurrence and malignancy

Objective:To investigate the clinical and pathological characteristics of vocal fold leukoplakia and influential factors of recurrence and malignancy. Method:The study included 555 cases of vocal fold leukoplakia. All patients received surgical treatment. The relationship between the clinical and pathological features, and influential factors of recurrence and malignancy were analyzed. Result:The pathological types included squamous epithelial simple hyperplasia in 58.0%, mild hyperplasia in 15.5%, moderate hyperplasia in 10.1%, severe hyperplasia and carcinoma in situ in 8.1%, infiltrative carcinoma in 8.3%. The different pathological types varied among different ages significantly(P<0.01). The tobacco and alcohol abuse had no relationship with pathological types(P>0.05). The more severe the pathology were, the more decreasing of the mucosal waves would be(P<0.01). The pathologic severity had an apparent correlation with p53 positivity and the level of p53 and Ki67 positivity. The p53 positive proportion may increase with the increasing pathological severity(P<0.01), so were the p53 and Ki67 positive levels(P<0.01).Among 232 cases of postoperation follow-ups, 83 cases(35.8%) relapsed while 8 cases(3.4%) malignancy. Bilateral lesions had a higher rate of relapse and malignancy than unilateral lesions(95%CIOR 0.378 ［0.197-0.723］，P<0.01). The relapse and malignancy had a relationship with the pathologic severity. The incidence of disease recurrence and malignancy were positively correlated with pathological severity(P<0.05). p16 positive patients relapsed for more times(P<0.01) and with an uprising tendency of relapse and malignancy（P>0.05）. Conclusion:Pathological types of vocal fold leukoplakia are different. The older men, decreasing of mucosal wave of vocal folds and bilateral lesions were very important factors to predict disease severity. p53 and Ki67 positive rating and pathological severity were positively correlated. The bilateral lesions, pathological severity and p16 positivity had a tendency to increasing relapse and malignancy.

Standard surgical approach of testis-sparing surgery for testicular tumour with benign or malignant tendency.

No abstract

Clinical pathological features of primary bladder mucinous adenocarcinoma

Objective To analyze the features of onset, clinical pathological characteristics about the primary bladder mucinous adenocarcinoma. Methods From January 1990 to June 2015, we retrospectively reviewed the data from 15 patients diagnosed as primary bladder mucinous adenocarcinoma, including 10 male patients and 5 female patients. Their mean age was 58 years old, ranged from 41 to 78 years old. Among the fifteen patients, the initial symptoms included hematuria in 13 cases, lower abdominal pain in 1 case and urinary irritation symptom in 1 case. The ultrasound and CT scan revealed bladder tumors, which the size ranged from 2 to 6 cm. The location of bladder tumors included front wall in 12 cases, trigone zone in 2 cases and top wall in 1 case. Nine cases was suspected as tumor from urachal remnants. Eleven patients underwent partial cystectomy, three patients accepted the radical cystectomy and one case accepted transurethral resection of bladder tumor (TURBT). Result Pathological diagnosis was bladder mucinous adenocarcinoma in all patients, including nine from urachal remnant and the others from urothelium. The tumor exhibited the mushroom liked prominence, which was associated with surface ulceration and infiltrated into the depth of bladder. Meanwhile, it was covered with thick mucinous substances. The histologic examination revealed the presence of andenoid structure, composed by various degree of differentiated mucinous cells. In cases with adenocarcinomas from urachus, the residue of urachal tissue could be noticed. The bladder mucous was intact or ulcerated. No sign of metaplasia was observed. In the pathological diagnosis, the classification included grade Ⅲ in 3 cases, gradeⅡ in 7 cases and gradeⅠ in 5 cases. Ten persons reported the information of the follow up. Eight of them, whose tumor originated from urachus, accepted bladder-sparing surgery. One died from acute myocardial infarction after 23 months postoperatively. And one died from cerebral hemorrhage 45 months postoperatively. The others have been followed up from 8 to 65 months with no sign of recurrence. In two cases with urothelial carcinoma, one was found the new urothelial carcinoma 50 months after TURBT and one died from cancer metastasis 29 months after partial cystectomy. Conclusions Primary mucinous adenocarcinoma of the bladder possess the relatively high malignant tendency. The hematuria is the main initial symptoms. The histologic examination revealed the presence of different differentiated mucinous cells and formed the andenoid structure. The case with urachal remnant adenocarcinoma has the better prognosis than other types. Key words: Bladder tumor; Mucinous adenocarcinoma; Pathology, clinical

Pathological features of clinical T1b renal cell carcinoma

Objective To investigate the pathological characters of clinical T1b (4<diameter≤7 cm) renal cell carcinoma and provide reference basis for the nephron sparing surgery (NSS). Methods From January 2002 to December 2014, the pathological features of clinical T1b renal cell carcinoma were studied in 710 cases, including 505 male cases and 205 female cases. The mean age was 58 years old, ranged from 26 to 88 years old. The location of tumor included 377 in left side and 383 in right side. In the recorded 372 cases, the accurate site of tumor included 137 in upper portion, 96 in middle portion and 139 in lower portion. The initial symptom included hematuria in 103 cases, back pain in 62 cases, hematuria accompanied with back pain in 34 cases and asymptom in 511 cases. The diameter of tumor ranged from 4.0 to 7.0 cm, mean 5.4 cm. We analyzed pathological features, Fuhrman grades, histologic subtype, tumor metastasis, perirenal fat invasion and vein tumor thrombosis in all patients. Results The proportions of the clear cell, papillary, chromophobe, unclassified and mixed cell histologic subtype were 75.8% (538/710), 5.1% (36/710), 4.6% (33/710), 1.1% (8/710) and 13.4% (95/710), respectively. The proportions of hemorrhage, necrosis, cystic degeneration and fibrosis were 51.0% (362/710), 30.1% (214/710), 35.4% (251/710) and 7.8% (55/710), respectively. The rates of perirenal fat invasion and vein tumor thrombosis were 4.1% (29/710) and 3.1% (22/710). Among the 710 clinical T1b renal cell carcinoma, 144 (20.3%) were Fuhrman gradeⅠ, 513 (72.3%) were grade Ⅱ, 43 (6.1%) were grade Ⅲ, 10 (1.4%) were grade Ⅳ. In 657 cases with low Fuhrman grade(Ⅰ/Ⅱ), 17 cases were noticed perirenal fat invasion.In 53 cases with high Fuhrman grade (Ⅲ/Ⅳ), 10 cases were noticed perirenal fat invasion. The analysis showed that high Fuhrman grading was concerned with the perirenal fat invasion. Conclusions Clinical T1b renal cell carcinoma has obvious heterogeneity in its biological behavior. Most of them has characters of high differentiation, low malignant tendency and good biological behavior. Rare carcinoma exhibits the aggressive character or early distant metastasis. During the nephron sparing surgery, perirenal fat should be removed and perform pathological examination. Vein tumor thrombosis should be bolt out and radical nephrectomy is recommended at the same time. Key words: Carcinoma, renal cell; Pathology; Nephron sparing surgery

Cystic lesions of the pancreas.

Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple retention cysts, pseudocysts and cystic neoplasms. Mucinous cystic neoplasm is a frequent type of cystic neoplasm and has a malignant potential. Serous cystadenoma follows in frequency and is usually benign. Intraductal papillary mucinous neoplasms are the most commonly resected cystic pancreatic neoplasms characterized by dilated segments of the main pancreatic duct and/or side branches, the wall of which is covered by mucus secreting cells. These neoplasms can occupy the pancreatic head or any part of the organ. Solid pseudopapillary tumor is rare, has a low tendency for malignancy, and is usually located in the pancreatic body or tail. Endoscopic ultrasound with the use of fine-needle aspiration and cytology permits discrimination of those lesions. In this review, the main characteristics of those lesions are presented, as well as recommendations regarding their follow up and management according to recent guidelines.

Application of polyflaps perforator flaps in surgical treatment of malignant conversion of oral submucous fibrosis

Objective To investigate the clinical features of malignant conversion of oral submucous fibrosis (OSF) and the application value of polyflaps perforator flaps in its surgical treatment. Methods Ten patients who suffered from malignant conversion of OSF underwent simultaneous multiple defects reconstruction using polyflaps perforator flaps after radical tumor resection from August 2012 to October 2014. The fibrous bands leading to severe trismus near the pterygomandibular ligament as well as other intraoral lesions with malignant tendency were also resected besides from the known carcinoma. Patients with synchronous multiple primary cancers underwent radical resection and neck dissection of all other malignant lesions. The flaps were cut and tailored between adjacent perforators according to the amount and size of defects, forming several independent paddles for each defect reconstruction. Results Twenty-two defects were formed in 10 patients with malignant conversion of OSF. All of them were repaired with polyflaps anterolateral thigh (ALT) perforator flaps, including 8 cases of bipaddled ALT flaps and 2 cases of tripaddled ALT flaps. The total size of the flaps ranges from 3 cm~8 cm×6 cm~24 cm, and the pedicle length ranges from 5~12 (9.7±2.1)cm. Thirty-five perforator vessels were dissected, and each paddle included 1.6 perforators on average. All flaps survived after transplantation, and only 1 patient had infection of the neck incision. Post-operative adjuvant radio-chemotherapy was applied in 2 patients. All patients showed satisfactory accepting-site morphology with good speech function and swallowing recovery, and their trismus was improved during 6 to 30 (11.6±3.7)months. One patient died from lung metastasis 10 months after the surgery while local recurrent or metastasis did not occur in others. The donor sites were closed primarily without skin-grafting, leaving no obvious surgical donor-site complications. Conclusions Polyflaps perforator flaps can reconstruct multiple and sizable complicate defects, increase month opening by one stage operation. They are worth being applied in surgical treatment of malignant conversion of OSF. Key words: Oral submucous fibrosis/SU; Surgical flaps

TNF-α, a good or bad factor in hematological diseases?

Tumor necrosis factor-alpha (TNF-α) is a highly pleiotropic cytokine involved in a spectrum of physiological processes that control inflammation, anti-tumor responses and homeostasis through two receptors, TNF-R1 and TNF-R2. In general, TNF-R1 mediates cytotoxicity, resistance to infection and stimulation of NF-κB. By contrast, TNF-R2 has been implicated in proliferation of T-cell line, thymocytes and human mononuclear cells. Hematological malignancies are the types of cancer that affect normal hematopoiesis, have a speedy development, high lethal rate and until now still have no effective treatment. Several studies have shown that inflammatory cytokines play an important role in the onset and progress of these diseases. In this review, we summarize the recent studies and evaluate the positive or negative role of TNF-α in some hematological malignancies or diseases with a malignant tendency.

Nature and outcomes of the increased incidence of colorectal malignancy after liver transplantation in Australasia

To examine whether incidence of colorectal malignancy is increased in Australasian liver transplant recipients compared with the general population of Australia, and to assess the characteristics and outcomes of colorectal malignancy in this patient group. Data on patients who underwent orthotopic liver transplantation (OLTx) and had a diagnosis of de-novo colorectal malignancy after transplantation during the period 1985-2011 were obtained from the Australia and New Zealand Liver Transplant Registry, and these data were compared with colorectal malignancy data from the Australian Institute of Health and Welfare. Time from OLTx to diagnosis of colorectal malignancy, stage of colorectal malignancy at diagnosis, patient survival, and standardised incidence ratio (SIR) for colorectal malignancy. Forty-eight of 3735 recipients (1.3%) were diagnosed with colorectal malignancy at a median of 7.3 years after OLTx. More advanced colorectal malignancy (regional or metastatic disease) was evident at diagnosis in 20 of the 48 patients; these patients tended to be younger than patients with less advanced malignancy (P = 0.01) and diagnosed sooner after OLTx (P = 0.005). Despite treatment predominantly with surgery, 19 of the 48 patients died from the malignancy. The overall SIR for colorectal malignancy liver transplant recipients compared with the general population of Australia was 2.80 (95% CI, 2.06-3.71). The incidence of colorectal malignancy is increased in liver transplant recipients in comparison with the general population. Of concern is the tendency for advanced malignancy to be diagnosed in younger patients. These data highlight the importance of considering whether specific guidelines for colorectal malignancy screening in the Australasian adult liver transplant population are needed.

Clinical Risk Factor Analysis for Breast Cancer: 568,000 Subjects Undergoing Breast Cancer Screening in Beijing, 2009

Although there are many reports about the risk of breast cancer, few have reported clinical factors including history of breast-related or other diseases that affect the prevalence of breast cancer. This study explores these risk factors for breast cancer cases reported in Beijing in 2009. Data were derived from a Beijing breast cancer screening performed in 2009, of 568,000 women, from 16 districts of Beijing, all aged between 40 and 60 years. In this study, multilevel statistical modeling was used to identify clinical factors that affect the prevalence of breast cancer and to provide more reliable evidence for clinical diagnostics by using screening data. Those women who had organ transplants, compared with those with none, were associated with breast cancer with an odds ratio (OR) = 65.352 [95% confidence interval (CI): 8.488-503.165] and those with solid breast mass compared with none had OR = 1.384 (95% CI: 1.022- 1.873). Malignant tendency was strongly associated with increased risk of breast cancer, OR = 207.999(95% CI: 151.950-284.721). The risk of breast cancer increased with age, OR1 = 2.759 (95% CI: 1.837-4.144, 56-60 vs. 40-45), OR2 = 2.047 (95% CI: 1.394-3.077, 51-55 vs. 40-45), OR3 = 1.668 (95% CI: 1.145-2.431). Normal results of B ultrasonic examination show a lower risk among participants, OR= 0.136 (95% CI: 0.085-0.218). Those women with ductal papilloma compared with none were associated with breast cancer, OR=6.524 (95% CI: 1.871-22.746). Therefore, this study suggests that clinical doctors should pay attention to these high-risk factors.

Giant Proliferating Trichilemmal Tumor

Giant Proliferating Trichilemmal Tumor

Overexpression of N-cadherin is correlated with metastasis and worse survival in colorectal cancer patients

N-cadherin is related to the progression and metastases of several solid carcinomas. However, it was still unclear whether N-cadherin is overexpressed in colorectal malignant tumors that have stronger malignant tendency. In this study, we used immunohistochemistry to detect the expression patterns of N-cadherin in both the primary tumors and their normal mucosa tissues of 120 patients with colorectal cancer. We revealed that N-cadherin was expressed in 78.3% (94/120) of colorectal tumor tissues and in only 9.2% (11/120) of paired distant normal mucosa tissues with a significant difference (P=0.000). The low, moderate, and high expression of N-cadherin protein was 42.5%, 30.8%, and 26.7%, respectively. N-cadherin overexpression was associated with advanced TNM stage, lymph nodes metastasis and distant metastasis (P<0.05). Patients with N-cadherin overexpressed showed the obvious lower overall survival rate than those with moderate and low expression, and patients with low expression had a better survival rate than those with moderate and high expression (P<0.05). In conclusion, high N-cadherin expression may lead to tumor aggressiveness and metastatic potential in colorectal cancer, and may prove to be a possible prognostic factor.

Occurrence of trichoepithelioma in a cat: Histopathologic and immunohistochemical study

Trichoepitheliomas are benign follicular appendage tumors with differentiation to all three segments of the hair follicle. A 2 years old female domestic short hair cat presented with a mass on the tail. The mass was surgically excised and for histopathologic and immunohistochemical studies, was sent to Department of Pathology. Histologically, the tumor was encapsulated and consisted of many islands of follicular epithelium and also cysts structures which varied in size and shape. The cells of epithelium islands were round to oval and had variable amounts of slightly, eosinophilic cytoplasm and euchromatic nuclei. The cystic structures were lined by a complex layer of squamous epithelium. Often, cells under went an abrupt transition between basal layers and keratinization without the development of a granular cell layer. No tendency of malignancy was seen in this case. According to mentioned characteristics, trichoepithelioma was diagnosed. By immunohistochemical study it was confirmed that this tumor had epithelial origin because squamous tumor cells reacted with the pan-cytokeratin antibody. The expression of β-catenin was predominately cytoplasmic and also together with numerous positive nuclei but membranous expression was inconsistenet. Distribution of neoplastic cells with β-catenin expression was more than 75% and labeling intensity was strong in both cytoplasm and nuclei. According to author's knowledge, this is the first report of trichoepithelioma in cat in Iran and also investigation of β-catenin expression in feline trichoepithelioma in veterinary literature.

Huge malignant solitary fibrous tumor of the pleura

Solitary fibrous pleural tumors are rare mesenchymal tumors that can be mistaken for mesothelioma. A positive staining of vimentin, negative staining of cytoplasmic keratin, and expression of the CD34 antigen can confirm their diagnosis. These tumors should be surgically excised although they are benign because they have malignant potential and tendency for recurrence. We present here a 63-year-old patient who had an inconclusive biopsy of a huge right intrathoracic lesion. Further testing after radical surgical resection revealed a malignant solitary fibrous pleural tumor. Surgery was complicated with injury of the thoracic duct. Patient was re-operated upon for ligation of the thoracic duct. He is doing well with no recurrence after 18 months of follow-up. In conclusion, definitive treatment for solitary fibrous tumor is radical surgical resection with close follow-up for the recurrences. Follow-up of this tumor is essential especially when it showed malignant features on pathological examination.

Value of endoscopic ultrasonographic features in predicting the malignancy of pancreatic mucinous cystic neoplasms and intraductal papillary mucinous neoplasms

IntroductionPancreatic mucinous neoplasms, which mainly include mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs), possess a potentially malignant tendency. It remains difficult to adopt reliable methods in predicting...