Primary angiosarcoma of the testis with retroperitoneal metastasis.
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ABSTRACT:
SUBMITTER: Piotrowski JT
PROVIDER: S-EPMC6168964 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:We report a novel observation of a cardiac hemangioma possible transformation into cardiac angiosarcoma. This report should give a new insight on the pathogenesis of the tumor, always thought to have a de-novo genesis. We emphasize in our report the value of combining imaging modalities to examine the anatomic and metabolic properties of cardiac tumors providing a valuable tool for comprehensive assessment. <Learning objective: Assessment of cardiac tumors should combine different imaging modalities to examine the anatomic and metabolic properties of the lesions. We report a novel observation on cardiac angiosarcoma possible transformation from a cardiac hemangioma. This report should give a new insight into the pathogenesis of the tumor, always thought to have a de-novo genesis.>.
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Project description:Angiosarcoma is an extremely rare and aggressive malignancy. Standard of care of localized tumors includes surgery ± radiation. Despite this multimodal treatment, >50% of the angiosarcoma patients develop local or distant recurrent disease. The role of neoadjuvant systemic therapy is still controversial and we therefore performed a systematic review of the literature to define the role of neoadjuvant systemic therapy based on available evidence. We focused on the effects of neoadjuvant systemic therapy on: 1. The success of surgical resection and 2. the long-term survival. All articles published before October 2019 on Ovid Medline, Ovid Embase, Cochrane library and Scopus were evaluated. Eighteen case reports and six retrospective cohort studies were included. There were no randomized controlled trials. This literature showed a beneficial role of neoadjuvant chemotherapy on downsizing of the tumor resulting in an improvement of the resection margins, especially in patients with cardiac or cutaneous angiosarcoma. However, no definitive conclusions on survival can be drawn based on the available literature lacking any prospective randomized studies in this setting. We advise that neoadjuvant chemotherapy should be considered, since this could lead to less mutilating resections and a higher rate of free resection margins. An international angiosarcoma registry could help to develop guidelines for this rare disease.
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Project description:Primary angiosarcoma of the brain is extremely rare; only 15 cases have been reported in adults over the last 25 years.We describe two cases of primary angiosarcoma of the brain that are well characterized by imaging, histopathology, and immunohistochemistry. Case 1: our first patient was a 35-year-old woman who developed exophthalmos. Subtotal resection of a left extra-axial retro-orbital mass was performed. Case 2: our second patient was a 47-year-old man who presented to our facility with acute visual loss, word-finding difficulty and subtle memory loss. A heterogeneously-enhancing left sphenoid wing mass was removed. We also review the literature aiming at developing a rational approach to diagnosis and treatment, given the rarity of this entity.Gross total resection is the standard of care for primary angiosarcoma of the brain. Adjuvant radiation and chemotherapy are playing increasingly recognized roles in the therapy of these rare tumors.
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Project description:RationaleAngiosarcoma is a rare malignant tumors. The objective of this study is to report a patient who suffered from a progressive low back pain and left lower extremities radiation pain for about 8 months, After diagnoses, this was identified as an extremely rare case of primary multiple angiosarcoma of vertebra.Patient concernsA 54-year-old man with a history of 2-year hypertension and 8-year diabetes, both of which were well controlled by drug management. Lately, he suffered from a progressive low back pain and left lower extremities radiation pain for about 8 months.DiagnosesMagnetic resonance imaging of lumbar showed a clear pathological fracture and primary multiple angiosarcoma of all vertebra. Postoperative pathology and High-throughput sequencing confirmed the diagnosis of primary multiple angiosarcoma of vertebra.InterventionsThe patient underwent minimally invasive pedicle screw fixation combined with bone cement augmentation for the purpose of stabilizing the damaged vertebrae. Following operation, he received both radiotherapy and chemotherapy for a period of time.OutcomesThe operation has achieved positive results in relieving pain and stabilizing the spine. No wound problem or operative complications occurred after operation. The patient reported an obvious remission of low back pain and was only capable to perform restricted physiological activities. A long-term palliative radiotherapy and chemotherapy were performed after operation. Unfortunately, the patient died 18 months later.ConclusionThis article emphasizes primary multiple angiosarcoma of vertebra. Despite being rare, it should be part of the differential when the patient manifested back pain and radiculopathy. We recommended the minimally invasive pedicle screw fixation for angiosarcoma of vertebra. Osteoplasty by bone cement augmentation was also an ideal choice for surgical treatment. It also advocates the use of specific targeted radiotherapy drugs based on gene analysis of tumors.
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Project description:Tuberculosis in endemic areas is likely to be overdiagnosed in patients with atypical clinical and imaging findings mimicking tuberculosis, as in our case of angiosarcoma. Detailed history, physical examination, imaging, and histopathology avert diagnosis of tumors as tuberculosis in resource-limited settings, where countless diseases have common clinical and imaging presentations.
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Project description:A previously fit and well 30-year-old man presented with palpitations, fever, and pleuritic chest pain. Multimodality imaging and histopathology confirmed the diagnosis of primary cardiac angiosarcoma. We present the details of the presentation, diagnostic process using multimodality imaging, and clinical management. (Level of Difficulty: Beginner.).
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Project description:BackgroundBreast Angiosarcoma can be divided into primary breast angiosarcoma (PBA) and second breast angiosarcoma (SBA). PBA is rare malignant breast cancer with poor outcomes. PBA usually occurs in women between 30-40 years old. PBA does not have a specific clinical manifestation. Clinically, PBA presents with a rapidly enlarging breast mass and skin involvement with skin color changes. Ultrasonography of PBA can be hypoechoic or hyperechoic, or mixed disordered areas. Microscopically, PBA can be classified into three grades according to the degree of differentiation, and the grade is related to the prognosis. And PBA can also express vascular endothelial markers. The main treatment for PBA is surgery, especially mastectomy. There are other treatments, such as chemotherapy and radiotherapy, but their effectiveness needs further confirmation. Targeted drugs may be helpful.Case descriptionA 32-year-old woman with main clinical presentation of a rapidly growing mass located in the upper inner quadrant of the right breast with skin involvement. PBA was diagnosed with first extended local resection, and then the patient underwent a second right mastectomy. The patient is now undergoing chemotherapy.ConclusionsSince this is a rare form of breast cancer, we report this case to raise the attention of breast surgeons to avoid misdiagnoses.
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Project description:Pulmonary angiosarcomas are usually secondary tumors, and a primary angiosarcoma of the lung is extremely rare. The present study reports a case of an elderly patient diagnosed with primary pulmonary angiosarcoma (PPA). A 78-year-old man presented with a 3-month history of cough and blood in phlegm. A computed tomography scan of the chest indicated pulmonary infection with ground-glass opacity in the right upper lobe. The patient underwent lobectomy of the right upper lobe as his clinical symptoms did not significantly improve after anti-infection treatment. The postoperative pathological examination confirmed a diagnosis of PPA. He developed left lung and pelvic metastases 1 month after surgery. After four cycles of liposomal doxorubicin therapy, the patient achieved partial remission. The patient remained in sustained remission after 6 months of follow-up. The present case report is intended to provide diagnostic insight into PPA. In addition, the findings indicate that timely diagnosis and treatment of PPA are very important due to its increased risk of local recurrence and distant metastasis.
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Project description:Objectives. Retroperitoneal lymph node dissection (RPLND) outcomes for testis cancer originate mostly from single-center series. We characterized population-based utilization, costs, and outcomes and assessed whether higher volume affects outcomes. Methods and Materials. Using the US Nationwide Inpatient Sample from 2001-2008, we identified 993 RPLND and used propensity score methods to assess utilization, costs, and inpatient outcomes based on hospital surgical volume. Results. 51.6% of RPLND were performed at hospitals where there were two or fewer cases per year. RPLND was more commonly performed at large urban teaching hospitals, where men were younger, more likely to be white and earning incomes exceeding the 50th percentile (all P ≤ .05). Higher hospital volumes were associated with fewer complications and more routine home discharges (all P ≤ .047). However, higher volume hospitals had more transfusions (P = .004) and incurred $1,435 more in median costs (P < .001). Limitations include inability to adjust for tumor characteristics and absence of outpatient outcomes. Conclusions. Sociodemographic differences exist between high versus low volume RPLND hospitals. Although higher volume hospitals had more transfusions and higher costs, perhaps due to more complex cases, they experienced fewer complications. However, most RPLND are performed at hospitals where there were two or fewer cases per year.
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Project description:Primary retroperitoneal serous cystadenomas (PRSCs) are rare cystic lesions whose pathogenesis is currently not well understood. Although the vast majority of tumors are benign, early recognition and resection is necessary to avoid malignant transformation, rupture, and secondary infection. Here we present the case of a 79-year-old woman who presented with confusion, visual hallucinations, and a history of fall. As part of the work-up for abdominal distension, computed tomography scan of the abdomen and pelvis was performed, which revealed a right-sided retroperitoneal cystic lesion measuring 26.6 × 16.7 cm in size. The lesion was resected laparoscopically, and the surgical specimen measured 28 × 17 cm. Histology revealed a serous cystadenoma. The postsurgical course was uneventful, and no radiological recurrence was noted on 3 months follow-up. Very few primary retroperitoneal cystic lesions have been reported in the literature. Most lesions are benign and predominantly occur in females. They may remain asymptomatic for long periods of time and are usually discovered when they reach very large in size. In rare cases, these lesions may have malignant potential. Diagnosis of PRSC should be considered in the differential diagnosis of all retroperitoneal cysts.
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