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Diagnostic Approach to Soft Tissue Tumour of the Breast and Phyllodes Tumour in Ilorin, North Central with Review of Institutional Experience
Rasheed Mumini Wemimo,
Afolayan Enoch Abiodun,
Adegboye Adeyemi Taiwo
Issue:
Volume 2, Issue 3, September 2021
Pages:
29-34
Received:
13 May 2021
Accepted:
7 June 2021
Published:
9 July 2021
DOI:
10.11648/j.wjmcr.20210203.11
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Abstract: Background: Primary soft tissue tumour (primary mesenchymal tumour) of the breast comprised of spectrum of neoplasm that arise from mammary stroma with comparable tumour biology of primary mesenchymal tumour at other sites. There are palpable diagnostic challenges which can be resolved by considering histomorphologic analysis that characterized each tumour entity regardless of the site and the use immunohistochemical markers. Methodology: This is an analytical hospital based retrospective study of patients with primary breast mesenchymal tumour and phyllodes diagnosed during 2014–2019 at the Department of Pathology, University of Ilorin Teaching Hospital. The histopathological diagnosis of primary mesenchymal tumour of the breast and phyllodes tumours with documented age and other inclusion criteria were used for the study but excluded patients with incomplete information. Result: This study analysed 39 patients with histological diagnosis of soft tissue tumour of the breast and phyllodes. The youngest patients was found to be 16 years of age while the oldest patients was 70 years with the mean age of 37.82±12.86. Benign phyllodes tumour accounted for 19 (48.7%), followed by borderline phyllodes 3 (7.7%) and 1 case of malignant phyllodes. Fibrosarcoma is the most common primary mesenchymal tumour of the breast which accounted for 6 (15.4%), followed by undifferentiated pleomorphic sarcoma 3 (7.7%) and 1 (2.5%) case of the following tumours, Neurofibroma, Granular cell tumour, Myofibroblastoma, Dermatofibroma, Low grade fibromyxoid sarcoma, Rhabdomyosarcoma and, Malignant phyllodes and Angiosarcoma. Conclusion: Primary mesenchymal tumour of the breast are rare or underdiagnosed, biopsy must be interpreted with caution in order to rule out their mimics that is phyllodes and metaplastic carcinoma with histomorphological analysis and complementary ancillary test.
Abstract: Background: Primary soft tissue tumour (primary mesenchymal tumour) of the breast comprised of spectrum of neoplasm that arise from mammary stroma with comparable tumour biology of primary mesenchymal tumour at other sites. There are palpable diagnostic challenges which can be resolved by considering histomorphologic analysis that characterized eac...
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Use of Anti-coagulants in Cancer Patients with Superficial Thrombophlebitis to Prevent Pulmonary Embolism
Pratikkumar Vekaria,
Mansi Satasia,
Tejas Raiyani,
Rekha Rao,
Chandrika Raiyani,
Kevin Dan Phillips
Issue:
Volume 2, Issue 3, September 2021
Pages:
35-40
Received:
20 September 2020
Accepted:
12 July 2021
Published:
21 July 2021
DOI:
10.11648/j.wjmcr.20210203.12
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Abstract: Superficial thrombophlebitis (STP) is an inflammation of superficial veins with associated venous thrombosis. It is a benign condition usually and can be managed with a conservative approach with non-steroidal anti-inflammatory drugs (NSAIDs) and warm compression. When STP is associated with high-risk medical conditions such as cancer and chemotherapy, fatal complications such as pulmonary embolism (PE) and deep venous thrombosis (DVT) may ensue. The severity of thromboembolic complications of STP as well as the multiple common risk factors between DVT and STP has led to further research interest in exploring the efficacy of anticoagulation treatment in DVT and STP. Traditionally, low molecular weight heparin (LMWH) and warfarin have been used for the treatment of venous thromboembolism (VTE), but recently direct oral Anticoagulants (DOACs) have emerged as a potential alternative considering better or equivalent efficacy, safety, and ease of use compared to LMWH and warfarin. A few case reports have described the advancement of STP to PE in cancer patients while on chemotherapy. We report a case of a 56-year old female with colon cancer on chemotherapy who developed PE after two episodes of STP. We recommend that when cancer patients on chemotherapy develop STP, prophylactic use of anti-coagulants should be considered to reduce the risk of serious complications.
Abstract: Superficial thrombophlebitis (STP) is an inflammation of superficial veins with associated venous thrombosis. It is a benign condition usually and can be managed with a conservative approach with non-steroidal anti-inflammatory drugs (NSAIDs) and warm compression. When STP is associated with high-risk medical conditions such as cancer and chemother...
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Combination Endoscopy Remove Esophageal Metal Foreign Body
Tianyu Liu,
Meiling Shu,
Xiaoqi Long,
Zheng Zou
Issue:
Volume 2, Issue 3, September 2021
Pages:
41-45
Received:
17 July 2021
Accepted:
27 July 2021
Published:
2 August 2021
DOI:
10.11648/j.wjmcr.20210203.13
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Abstract: Background: Esophageal foreign body (EFB) incarceration is a rare but devastating disorder. The most maximum risk is aortic injury. Most of the EFBs could be removed out by only one endoscopy with several accessories if there is no pierce to the aorta. Some EFBs removing needs multidisciplinary co-operation. Herein a case of successful removing by combination of two types of endoscopies is presented. Case presentation: A 40-years-male criminal swallowed a type “c” metal wire deliberately to try to escape capturing. He was diagnosed of EFB incarceration in esophagus. Ordinary chest computerized tomography (CT) in local hospital showed a type “c” metal wire was incarcerated in the esophageal muscle, and the upper hook of the wire was very close to the arch of the aorta. It was hard to remove the metal wire only by gastric endoscopy, since it was likely to occur iatrogenic injury. After combination of gastric endoscopy and rigid esophagoscopy used, the metal wire was removed successfully, and the criminal was discharged and gradually returned to normal diet. Conclusion: More co-operation or various types of endoscopy may be used in the removing of EFB, multidisciplinary and any other tools are necessary whatever works.
Abstract: Background: Esophageal foreign body (EFB) incarceration is a rare but devastating disorder. The most maximum risk is aortic injury. Most of the EFBs could be removed out by only one endoscopy with several accessories if there is no pierce to the aorta. Some EFBs removing needs multidisciplinary co-operation. Herein a case of successful removing by ...
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Use a Novel Hemoperfusion Cartridge Efferon LPS for Simultaneous Adsorption of Cytokines and Endotoxin in Septic Shock: A Case Report
Mikhail Ivanovich Gromov,
Ludmila Pavlovna Pivovarova,
Irina Viktorovna Osipova,
Olga Borisovna Ariskina,
Alexey Valerievich Fedorov
Issue:
Volume 2, Issue 3, September 2021
Pages:
46-50
Received:
27 July 2021
Accepted:
17 August 2021
Published:
27 August 2021
DOI:
10.11648/j.wjmcr.20210203.14
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Abstract: A patient (age 75, male) with diffuse peritonitis (cecum rupture resulted from tumor obturation) was hospitalized and underwent emergency surgery. He was hypotensive (norepinephrine 0.56 mg/kg*min) and exhibited multiple organ failure syndrome (SOFA=10), so a septic shock diagnosis was concluded. Standard of care treatment didn’t result in improvement of his condition and so he was subjected to extracorporeal hemoperfusion with Efferon LPS adsorber. Efferon LPS is single-use therapeutic device, certified in Russia, a cartridge with selective adsorbent polymeric beads, which provide simultaneous lipopolysaccharide (LPS) and cytokines adsorption (“multimodal” action). Two conclusive hemoperfusions led to quick improvements in hemodynamic parameters and improvement of patient’s condition. IL-6 serum level dropped from 1640 to 480 pG/mL, followed by subsequent decrease down to 350 pG/mL within next few days. Procalcitonin levels dropped from 98 nG/mL down to 5 nG/mL. Significant decrease in CD14+ blood monocytes also was noted during each hemoperfusion session. The patient stayed in ICU for 8 days. He has survived and was discharged on day 24 in satisfactory condition. Extracorporeal sequestration of LPS, cytokines and which is extremely important CD14+ monocytes from the bloodstream can dampen the systemic inflammation’s crippling action in patients with sepsis. Efferon LPS hemoperfusion is prominent option for extracorporeal treatment of septic shock.
Abstract: A patient (age 75, male) with diffuse peritonitis (cecum rupture resulted from tumor obturation) was hospitalized and underwent emergency surgery. He was hypotensive (norepinephrine 0.56 mg/kg*min) and exhibited multiple organ failure syndrome (SOFA=10), so a septic shock diagnosis was concluded. Standard of care treatment didn’t result in improvem...
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Squamous Cell Lung Cancer in a Non-smoking Woman: A Case Report with Review of the Literature
Zongo Esdras,
Khoaya Ayoub,
Sidki Sanaa,
Kaddouri Hajar,
Talib Hatim,
Chekrine Tarek,
Bourhafour Mouna,
Bouchbika Zineb,
Benchakroun Nadia,
Jouhadi Hassan,
Sahraoui Souha,
Karkouri Mehdi,
Tawfik Nezha,
Benider Abdellatif
Issue:
Volume 2, Issue 3, September 2021
Pages:
51-54
Received:
31 July 2021
Accepted:
16 August 2021
Published:
27 August 2021
DOI:
10.11648/j.wjmcr.20210203.15
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Abstract: Objective: The objective of this paper is to present, from a case, clinical parameters, imaging and anatomopathological assessments of the pulmonary squamous carcinomatous process in a non-smoking woman with a survival of more than 5 years. Case presentation: A 52-year-old patient who has had a pulmonary squamous carcinomatous process since 2014, revealed from a dry cough associated with mild dyspnoea without hemoptysis or chest pain. The imaging showed a left lung seat of two large masses, one of which extended towards the diaphragmatic dome, penetrating extensively into the abdomen, with a large abdominal contingent. Anatomopathological examination and the Immuno study -history -chemical evidence of a moderately differentiated squamous carcinoma infiltrating the lung. According to the TNM and AJCC 2016 classification, the patient was classified as T4N0M0 and she benefited from a navelbine cisplatin type chemotherapy with a minimal response of approximately 10% according to the RECIST criteria then two other lines of chemotherapy with initiation therapeutic pose. In 2019, she had a histologically confirmed metastatic relapse to the liver, treated with paclitaxel-carboplatin-type chemotherapy with clinical and radiological stability at assessment. Discussion: Squamous cell carcinoma is present in both smokers and non-smokers. Non-smoking females are two to three times more likely to develop lung cancer than non-smoking males, but female gender is a favourable risk factor. Conclusion: lung cancer in non-smoker females is becoming more and more frequent with genetic susceptibility as one of the etiological factors. The search for molecular alterations allows an increase in survival with the use of targeted therapies. Molecular biology is becoming an essential tool in the management of lung cancer with the presence of metastases.
Abstract: Objective: The objective of this paper is to present, from a case, clinical parameters, imaging and anatomopathological assessments of the pulmonary squamous carcinomatous process in a non-smoking woman with a survival of more than 5 years. Case presentation: A 52-year-old patient who has had a pulmonary squamous carcinomatous process since 2014, r...
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Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding
Juan Jose Andrade-Rojas,
María José Lizardo-Thiebaud,
Guillermo Andrade-Orozco,
Leonel Contreras-Loera,
Nelsy Liseth Garza-Hinojosa,
Maria Guadalupe Jazmín De Anda-Gonzalez
Issue:
Volume 2, Issue 3, September 2021
Pages:
55-61
Received:
13 August 2021
Accepted:
24 August 2021
Published:
31 August 2021
DOI:
10.11648/j.wjmcr.20210203.16
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Abstract: Background: Teratomas are tumors that arise from germ cells in mature gonads and along the midline as extragonadal teratomas. The latter are infrequent, with few cases having been described in the pancreas. Objective: Our aim is to emphasize the importance of determining the histological features of extragonadal teratomas. Case presentation: We present the case of a mature cystic teratoma in the pancreas with focal neuroendocrine differentiation identified in a thirty-five year old male patient with no apparent symptomatology of a pancreatic tumor. The tumor was an unexpected finding made upon a diagnostic approach for SARS-CoV-2 infection. Discussion: At present, there are around fifty reported cases of teratomas in the pancreas. The majority of these are dermoid cysts. Few are mature cystic teratomas, and there is one reported case of an immature teratoma. Of the mature cystic teratomas reported in the literature, one presented a somatic neoplasm. Conclusion: The case highlights the importance on determining the histological features of extragonadal teratomas, including each type of tissue, the degree of differentiation and the presence of benign or malignant neoplasms, as these elements are key to classify teratomas appropriately.
Abstract: Background: Teratomas are tumors that arise from germ cells in mature gonads and along the midline as extragonadal teratomas. The latter are infrequent, with few cases having been described in the pancreas. Objective: Our aim is to emphasize the importance of determining the histological features of extragonadal teratomas. Case presentation: We pre...
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