RESUMEN
BACKGROUND: To compare predicting factors for the diagnosis and clinical course of benign and malign/ borderline phyllodes tumours (PT) of the breast, and to discuss treatment modalities. METHODS: Clinical and demographic characteristics of the patients with histopathological diagnosis of phyllodes tumour were examined. Patients were divided into group 1 (benign PT) and group 2 (borderline/malignant PT). Groups were compared in terms of demographic and clinical characteristics. RESULTS: Of the patients studied, 37 (68.5%) had benign, 7 (12.9%) had borderline and 10 (18.5) had malignant histopathology. A statistically significant relationship was detected between the incidence of malignancy and mass diameter (p = 0.001) and age (p = 0.030) when the two groups were compared. Wide surgical excision was performed on 46 (82.5%) patients, simple mastectomy on 7 (13%) patients and modified radical mastectomy on one (1.9%) patient. Ten (18.5%) patients were re-operated for surgical margin positivity. Local recurrence was determined only in one (1.9%) patient. Distant metastasis due to malignant PT developed in two (3.7%) patients. CONCLUSIONS: Among the patients who were considered to have PT, malignancy was likely to be present, especially if the patient's age was over 40 and the diameter of the mass was above 33.5 mm. Therefore, in patients with similar characteristics, surgical margins should be kept slightly wider or wider excisions should be preferred with or without simultaneous reconstructive surgery in appropriate cases.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/terapia , Tumor Filoide/diagnóstico , Tumor Filoide/terapia , Adolescente , Adulto , Factores de Edad , Anciano , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Tumor Filoide/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: To compare predicting factors for the diagnosis and clinical course of benign and malign/borderline phyllodes tumours (PT) of the breast, and to discuss treatment modalities. METHODS: Clinical and demographic characteristics of the patients with histopathological diagnosis of phyllodes tumour were examined. Patients were divided into group 1 (benign PT) and group 2 (borderline/malignant PT). Groups were compared in terms of demographic and clinical characteristics. RESULTS: Of the patients studied, 37 (68.5%) had benign, 7 (12.9%) had borderline and 10 (18.5) had malignant histopa-thology. A statistically significant relationship was detected between the incidence of malignancy and mass diameter (p = 0.001) and age (p = 0.030) when the two groups were compared. Wide surgical excision was performed on 46 (82.5%) patients, simple mastectomy on 7 (13%) patients and modified radical mastectomy on one (1.9%) patient. Ten (18.5%) patients were re-operated for surgical margin positivity. Local recurrence was determined only in one (1.9%) patient. Distant metastasis due to malignant PT developed in two (3.7%) patients. CONCLUSION: Among the patients who were considered to have PT, malignancy was likely to be present, especially if the patient's age was over 40 and the diameter of the mass was above 33.5 mm. Therefore, in patients with similar characteristics, surgical margins should be kept slightly wider or wider excisions should be preferred with or without simultaneous reconstructive surgery in appropriate cases.
Asunto(s)
Neoplasias de la Mama/patología , Mastectomía/métodos , Tumor Filoide/patología , Tumor Filoide/cirugía , Adulto , Anciano , Biopsia con Aguja , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/fisiopatología , Neoplasias de la Mama/cirugía , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética/métodos , Mamografía/métodos , Persona de Mediana Edad , Tumor Filoide/diagnóstico , Tumor Filoide/mortalidad , Tumor Filoide/fisiopatología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Estadísticas no Paramétricas , Análisis de Supervivencia , Adulto JovenRESUMEN
OBJECTIVES: Soft tissue haemangiomas are common benign vascular lesions that can be accompanied by reactive changes in the adjacent bone structure. This study aimed to discuss the MRI features of soft-tissue haemangiomas with an emphasis on changes in bone. METHODS: The radiographic and MRI findings of 23 patients (9 males, 14 females; mean age 25 years; age range 2-46 years) with soft-tissue haemangiomas were analysed retrospectively. MR images were evaluated for location of the lesion, size, configuration, signal features, contrast patterns, proximity to adjacent bone and changes in the accompanying bone. Excisional biopsy was performed in 15 patients. RESULTS: Radiographs demonstrated phleboliths in 8 patients (34%) and reactive bone changes in 4 (19%). On MRI, T1 weighted images showed that most of the lesions were isointense or isohyperintense, as compared with muscle tissue; however, on T2 weighted images all lesions appeared as hyperintense. Following intravenous gadolinium-diethylene triamine pentaacetic acid (DTPA) administration, homogeneous enhancement was observed in 3 lesions and heterogeneous enhancement was seen in 19. No enhancement was observed in one patient. Bone atrophy adjacent to the lesion was observed in four patients. CONCLUSION: MRI is the most valuable means of diagnosing deep soft-tissue haemangiomas. Bone changes can accompany deeply situated haemangiomas; in four of our patients, we found atrophy of the bone adjacent to the lesion. To our knowledge, this is the first report in the literature regarding atrophy of the bone adjacent to a lesion.
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Huesos/patología , Calcinosis/diagnóstico , Gadolinio DTPA , Hemangioma/diagnóstico , Imagen por Resonancia Magnética , Neoplasias de los Tejidos Blandos/diagnóstico , Adolescente , Adulto , Huesos/diagnóstico por imagen , Calcinosis/diagnóstico por imagen , Niño , Preescolar , Medios de Contraste , Femenino , Hemangioma/diagnóstico por imagen , Hemangioma/patología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/patología , Adulto JovenRESUMEN
INTRODUCTION: Colorectal cancer is the third leading cause of cancer-related deaths in the world. Mostly, death occurs with complications of distant metastases. DISCUSSION: Effective systemic chemotherapy regimen and resultant improved survival for patients are associated with an increased incidence of metastases at uncommon sites. Therefore, incidences of osseous metastases are rising at the last decade. Osseous metastases are mostly diffuse, along with visceral metastases. CONCLUSION: Most common osseous metastatic sites are lumbal, sacral vertebrae, and pelvis region, probably because of colonic anatomical proximity to the paravertebral venous plexus. Herein, we report an uncommon case of isolated solitary tibia metastasis in the colorectal cancer patient and management of disease course.
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Adenocarcinoma/patología , Neoplasias Óseas/secundario , Neoplasias del Colon/patología , Tibia/patología , Adulto , Neoplasias Óseas/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To evaluate choroidal and retinal vascular flow dynamics by means of color Doppler ultrasonography in patients with end-stage renal disease undergoing hemodialysis and to compare these findings with healthy controls. MATERIAL AND METHODS: Color Doppler ultrasonography and spectral analysis of nasal and temporal posterior ciliary and central retinal artery flow of both eyes were performed in 20 patients (40 eyes) and 22 controls (44 eyes) to assess peak systolic flow velocity, end-diastolic flow velocity, and resistive indices (RI). Patients with hypertension, diabetes mellitus, and any cardiac pathology were not included in the study. A general ophthalmologic examination was performed in all patients and controls. RESULTS: The average peak-systolic and end-diastolic blood flow velocities of nasal (12.88 +/- 4.91/6.88 +/- 3.26) and temporal (15.22 +/- 9.59/6.41 +/- 3.97) posterior ciliary artery and central retinal artery (14.94 +/- 8.38/6.7 +/- 4.13) in patients were significantly higher than the corresponding values of the controls. The RI values of nasal (0.52 +/- 0.10) and temporal (0.58 +/- 0.12) posterior ciliary artery and central retinal artery (0.55 +/- 0.11) in patients with end-stage renal disease undergoing hemodialysis were significantly lower than in the controls. CONCLUSION: Choroidal and retinal blood flow velocities are higher and RI values for all three vessels lower in patients with end-stage renal disease undergoing hemodialysis compared to healthy controls. These alterations may be related to either increased choroidal blood flow or vasoconstriction of the proximal vessels.
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Fallo Renal Crónico/fisiopatología , Órbita/irrigación sanguínea , Diálisis Renal , Ultrasonografía Doppler en Color , Adolescente , Adulto , Femenino , Humanos , Fallo Renal Crónico/terapia , Masculino , Estudios Prospectivos , Flujo Sanguíneo RegionalAsunto(s)
Arterias Carótidas/patología , Fallo Renal Crónico/patología , Túnica Íntima/patología , Túnica Media/patología , Disfunción Ventricular Izquierda/fisiopatología , Función Ventricular Izquierda/fisiología , Adolescente , Presión Sanguínea , Niño , Ecocardiografía , Ecocardiografía Doppler en Color , Femenino , Pruebas de Función Cardíaca , Humanos , Fallo Renal Crónico/sangre , Fallo Renal Crónico/complicaciones , Masculino , Válvula Mitral/fisiología , Válvula Mitral/fisiopatología , Valores de Referencia , Disfunción Ventricular Izquierda/epidemiologíaRESUMEN
PURPOSE: We undertook this study to evaluate the frequency of visualization and the sonographic appearances of urachal remnants (URs) in asymptomatic children. METHODS: One hundred eighty-two children without any urachus-related symptoms underwent sonography of the prevesical region and urinary bladder with high-frequency transducers. RESULTS: A UR was visualized in 180 (99%) of the children. The URs had a mean length +/- standard deviation of 13 +/- 5 mm. Most of the URs were ovoid, and most demonstrated a moderate protrusion into the bladder cavity. The URs with a central echogenic area were larger than those without central echogenicity. In 36 (61%) of the 59 URs that were evaluated with color Doppler sonography, vascular signals were demonstrated within the lesion. The URs with internal vascular signals were significantly larger than those without internal vascular signals. CONCLUSIONS: The gray-scale and color Doppler sonographic characteristics of URs seem to be related to their size and their degree of involution rather than to the age of the child. We think that URs are present in almost all children. URs should be considered normal findings if they are asymptomatic and their length is not significantly greater than 22.5 mm, the 95th percentile in our study.
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Ultrasonografía Doppler en Color/métodos , Uraco/anomalías , Uraco/diagnóstico por imagen , Vejiga Urinaria/diagnóstico por imagen , Adolescente , Antropometría , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Sensibilidad y Especificidad , Vejiga Urinaria/anatomía & histologíaRESUMEN
An asymptomatic case of hyaline vascular-type Castleman's disease localized to the mesentery and detected incidentally by ultrasound is presented. Computed tomographic, angiographic, and histologic findings are reported. This type of Castleman's disease predominates in the thorax and is very rare in the mesentery.
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Enfermedad de Castleman/diagnóstico , Mesenterio , Adulto , Angiografía , Diagnóstico Diferencial , Femenino , Humanos , Mesenterio/diagnóstico por imagen , Mesenterio/patología , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler en ColorRESUMEN
Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all cancers of the upper urinary tract. We describe a case in which primary transitional cell carcinoma of the right ureter was sonographically detected in a 45-year-old woman. The mass exhibited tumoral vascularity on power Doppler sonography and spectral analysis.
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Carcinoma de Células Transicionales/diagnóstico por imagen , Neoplasias Ureterales/diagnóstico por imagen , Carcinoma de Células Transicionales/patología , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Ultrasonografía Doppler , Neoplasias Ureterales/patologíaRESUMEN
The blood flow may be diverted from the external to the internal carotid artery via the carotid bulb in the absence of flow in the common carotid artery. We aimed to investigate the prevalence, hemodynamics, and clinical features of this condition. Reviewing the records of color duplex ultrasonographic examinations, we found carotid steal in 12 carotid arteries of 10 patients. In three patients flow in the ipsilateral external carotid artery was bidirectional. The steal had been demonstrated angiographically in six patients. The cause of the phenomenon was atherosclerosis, Takayasu arteritis, or trauma. Awareness of this pathway of collateral circulation may contribute to diagnostic work-up and expand management alternatives.