RESUMEN
Background Atypical choroid plexus papilloma (APP) is a rare, newly introduced entity with intermediate characteristics. To date, few reports have revealed the magnetic resonance (MR) findings. Purpose To analyze the clinicopathological and MR features of APP. Material and Methods The clinicopathological data and preoperative MR images of six patients with pathologically proven APP were retrospectively reviewed. The MR features including tumor location, contour, signal intensity, degree of enhancement, intratumoral cysts, and necrosis; and flow voids, borders, peritumoral edema, and associated hydrocephalus were analyzed. Results The APP were located in the ventricle (n = 4) and cerebellopontine angle (CPA, n = 2). Tumor dissemination along the spinal subarachnoid space was found in one patient. The tumors appeared as milt-lobulated (n = 5) or round mass (n = 1), with slightly heterogeneous signals (n = 5) or mixed signals (n = 1) on T1-weighted and T2-weighted images. Heterogeneous and strong enhancement were found in five cases on contrast-enhanced images. Three of four intraventricular tumors had a partly blurred border with ventricle wall. Four tumors had mild to moderate extent of surrounding edema signals. A slight hydrocephalus was seen in four patients. Incomplete capsule was seen in four tumors at surgery. Histopathologically, mild nuclear atypia was seen in all tumors with a mitotic rate of 2-5 per 10 high-power fields. Conclusion APP should be included in the differential diagnosis when an intraventricular or CPA tumor appearing as a multi-lobulated solid mass with slight heterogeneity, heterogeneous strong enhancement, partly blurred borders, mild to moderate peritumoral edema, or slight hydrocephalus are present.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Papiloma del Plexo Coroideo/diagnóstico por imagen , Papiloma del Plexo Coroideo/patología , Adulto , Medios de Contraste , Diagnóstico Diferencial , Femenino , Gadolinio DTPA , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
PURPOSE: We aimed to evaluate the therapeutic effect and safety of transcatheter arterial embolization with various volume ratios of lipiodol and ethanol in a rabbit VX2 tumor model to identify the optimal volume ratio. METHODS: Eighteen adult male New Zealand white rabbits implanted with VX2 tumors in their left liver lobes were randomly divided into six groups based on volume ratios of lipiodol to ethanol: group A, 3:1; group B, 2:1; group C, 1:1; group D, 1:2; group E, 1:3; and group F, 1:4. Pre- and post-treatment unenhanced magnetic resonance imaging was used to detect tumor formation and evaluate tumor growth rates. Liver samples were harvested one week after the procedure, and apoptosis index of tumor tissues was evaluated by pathologic examination and TUNEL assay. RESULTS: Tumor size decreased in groups B, C, and D, but increased in groups A, E, and F. Tumor growth rates in groups A-F were 0.40±0.03, -0.11±0.21, -0.08±0.09, -0.12±0.07, 0.06±0.12, and 0.05±0.09, respectively. The change in tumor size was significantly different in group A compared with the rest of the groups, but no significant difference was observed among groups B-F. Apoptosis indexes of the six groups were 4.7±2.1%, 6.7±2.1%, 11.7±3.1%, 11.0±2.0%, 10.7±3.2%, and 12±3%, respectively. Apoptosis index was significantly lower in group A compared with groups C-F (P < 0.05). Apoptosis index of group B was significantly lower than groups C and F. There was no significant difference among the other groups. CONCLUSION: The volume ratios of lipiodol to ethanol ranging from 2:1 to 1:4 were equally effective, the ratios 2:1 and 1:3 had equal safety, and the ratios 1:1 and 1:2 indicated better long-term therapeutic effect. Increasing ethanol in the mixture caused more severe liver injury. Optimal efficacy and safety was achieved with a lipiodol to ethanol volume ratio of 1:1.
Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Antineoplásicos/administración & dosificación , Embolización Terapéutica/métodos , Etanol/administración & dosificación , Aceite Etiodizado/administración & dosificación , Neoplasias Hepáticas Experimentales/terapia , Animales , Antiinfecciosos Locales/efectos adversos , Antineoplásicos/efectos adversos , Apoptosis/efectos de los fármacos , Imagen de Difusión por Resonancia Magnética/métodos , Etanol/efectos adversos , Aceite Etiodizado/efectos adversos , Inyecciones Intraarteriales , Neoplasias Hepáticas Experimentales/tratamiento farmacológico , Neoplasias Hepáticas Experimentales/patología , Imagen por Resonancia Magnética/métodos , Masculino , Conejos , Distribución Aleatoria , Resultado del TratamientoRESUMEN
Esophageal cancer is mainly divided into squamous cell carcinoma and adenocarcinoma. Epidemiologically, the former contributes to 90% of worldwide esophageal cancer cases, while adenocarcinoma contributes to two-thirds of cases in developed countries. Although other rare types and collision with multiple histological types of tumors do occur in the esophagus, it is very rare for a gastrointestinal stromal tumor (GIST) to collide with an epithelial malignant tumor. To date, only three cases have been reported in the literature. The current study reported a 69-year-old male patient with squamous cell carcinoma and GIST in the middle esophagus. There was no merging of tissue components between these tumors. This study together with a literature review indicates that esophageal collision tumors have been increasingly reported in recent years. Histology and immunohistochemistry are needed to make a differential diagnosis. The exact oncogenic mechanism or the interaction of two independent neoplasms still remains to be determined, and further investigation, such as electron microscopy and genetic analysis, may help to elucidate the pathogenesis of the colliding tumors.