RESUMO
Patients with hepatocellular carcinoma (HCC), the fifth most common cancer worldwide, display a highly variable clinical course, suggesting that HCC encompasses several biologically distinct subtypes. This heterogeneity has the potential to impede both treatment decisions and prognostic predictions for patients with HCC. One distinct, albeit rare, subtype of HCC is combined hepatocellular-cholangiocarcinoma (cHCC-CC), which overall carries a poorer prognosis than HCC and cholangiocarcinoma (CC) alone. This review discusses predominantly the histopathologic and pathogenetic intricacies of this tumor and highlights the need for an accurate diagnosis of this specific HCC subtype.
Assuntos
Carcinoma Hepatocelular/patologia , Colangiocarcinoma/patologia , Neoplasias Hepáticas/patologia , Tumor Misto Maligno/patologia , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/cirurgia , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/cirurgia , Humanos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/cirurgia , Tumor Misto Maligno/epidemiologia , Tumor Misto Maligno/cirurgiaRESUMO
Germ cell tumors (GCT) are a heterogeneous group of lesions whose origin is not well established. Several cases of primary intrasellar germinomas have been reported, however non-germinomatous GCT have rarely been described. We report the case of a young adult male patient with a mixed GCT that presented with a sellar tumor with suprasellar extension. The patient seeked medical attention because of seizures and magnetic resonance imaging evidenced a tumor of the sellar region. Hyperprolactinemia was also present and dopamine agonist therapy was started. As there was a rapid tumor growth and the patient had concomitant central diabetes insipidus and elevated testosterone levels, a GCT was suspected and confirmed by elevated serum concentration of ß-human chorionic gonadotrophin. Patient underwent surgical resection of the tumor and histopathological examination confirmed the diagnosis of a mixed GCT. Chemotherapy was initiated, followed by conventional radiotherapy. In conclusion, although pituitary adenomas respond for the vast majority of sellar tumors, concomitant symptoms such as central diabetes insipidus and rapid tumor growth should raise the suspicion of a diverse diagnosis. The present report intend not only to show a rare case of sellar and suprasellar mixed GCT but also to remind clinicians that if laboratory findings do not fit into patient's diagnosis (such as high testosterone levels in our patient), then the diagnosis should be reviewed.
Assuntos
Adenoma/diagnóstico , Tumor Misto Maligno/diagnóstico , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Sela Túrcica/patologia , Adenoma/patologia , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Tumor Misto Maligno/patologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Hipofisárias/patologiaRESUMO
Malignant mixed Mullerian tumors (MMMTs) are rare neoplasms. We report the clinical, pathologic, and immunohistochemical features of an MMMT primary of uterine cervix. This lesion was composed of a poorly differentiated epithelial component (cytokeratin positive) and a spindle cell component (vimentin positive) with heterologous (myoblastic) differentiation (focal 1A4 positive). There were also cells with neuroendocrine features that expressed S-100 and chromogranin A. Along with a brief review of this amazing neoplasm, some histogenetic concepts relevant to this case are discussed. To our knowledge this is the first report of a malignant mixed Mullerian tumor of the uterine cervix with neuroendocrine differentiation.
Assuntos
Carcinoma Neuroendócrino/patologia , Tumor Misto Maligno/patologia , Tumor Mulleriano Misto/patologia , Neoplasias do Colo do Útero/patologia , Idoso , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/terapia , Quimioterapia Adjuvante , Feminino , Humanos , Histerectomia , Imuno-Histoquímica , Tumor Misto Maligno/diagnóstico , Tumor Misto Maligno/terapia , Tumor Mulleriano Misto/diagnóstico , Tumor Mulleriano Misto/terapia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapiaRESUMO
Se analizaron retrospectivamente, 104 lesiones de la glándula lagrimal en un período de 40 años comprendido entre 1957 y 1996. Del total, 21 casos correspondieron a neoplasias malignas, todas ellas de origen epitelial; 38 casos a quistes (dacriops), 16 casos a tumores benignos y 28 casos a glándula lagrimal normal. Sólo se encontró un caso de proceso inflamatorio o dicrioadenitis crónica
Assuntos
Humanos , Carcinoma/patologia , Adenocarcinoma/patologia , Tumor Misto Maligno/patologia , Cistos , Dacriocistite/patologia , Aparelho Lacrimal/patologia , Doenças do Aparelho Lacrimal/patologiaRESUMO
Sarcomatoid carcinomas of the lung are very uncommon tumors and their biological behavior remains controversial. Here we describe a case of a 62 year old male with an endobronchial mass and subjected thereafter to right upper and middle bilobectomy. A squamous carcinoma with a sarcomatous component resembling a fibrosarcoma was found at microscopic examination. Although there is neither agreement on the denomination nor on the histogenesis of these tumours, it is recognized that they are highly aggressive. Therefore, in order to provide the best possible treatment it appears recommendable to supply a detailed description of the different components of the tumor at the time of the histopathological diagnosis.