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The enigmatic ear: Unveiling a rare case of a primary cutaneous CD8+ acral T-cell lymphoproliferative disorder with a literature review. 神秘的耳朵:揭示一例罕见的原发性皮肤CD8+肢端T细胞淋巴增生性疾病的文献综述。
IF 0.9 Q4 Medicine Pub Date : 2023-09-22 eCollection Date: 2023-01-01 DOI: 10.1177/20363613231204046
Ghada Sahraoui, Farah Sassi, Lamia Charfi, Raoudha Doghri, Karima Mrad

Introduction: Primary cutaneous CD8+ acral T-cell lymphoproliferative disorder (CD8+ ATCLPD) is a rare form of cutaneous T-cell lymphoma that commonly presents on the acral regions of the body. We report a case of a 61-year-old man diagnosed with primary cutaneous CD8+ ATCLPD of the ear. Case presentation: A 61-year-old man presented with a non-healing, erythematous painful macule on the ear that had been evolving for the past 3 months. The lesion was resected, and histopathological examination revealed a primary cutaneous CD8+ ATCLPD with acral localization. Further investigations including CT scan of the thorax, abdomen and pelvis were done to stage the disease. The results showed no extracutaneous involvement. Conclusion: Accurate identification of primary cutaneous CD8+ ATCLPD is crucial due to its distinct prognostic and therapeutic implications compared to other CD8+ cytotoxic lymphoid proliferations. Primary cutaneous CD8+ ATCLPD can be treated conservatively and typically follows a slow clinical course, regardless of the treatment method. Understanding the clinical context, as well as the morphological and immunophenotypic characteristics, can assist in making a precise diagnosis.

简介:原发性皮肤CD8+肢端T细胞淋巴增生性疾病(CD8+ATLPD)是一种罕见的皮肤T细胞淋巴瘤,通常出现在身体肢端区域。我们报告了一例61岁的男性,被诊断为耳朵原发性皮肤CD8+ACLPD。病例介绍:一名61岁的男子在过去3个月里,耳朵上出现了一个无法愈合的红斑疼痛性黄斑。病变被切除,组织病理学检查显示原发性皮肤CD8+TCLPD伴肢端定位。进一步的研究包括胸部、腹部和骨盆的CT扫描,以分期疾病。结果显示没有皮肤外受累。结论:与其他CD8+细胞毒性淋巴增生相比,准确鉴定原发性皮肤CD8+ATLPD具有明显的预后和治疗意义,因此至关重要。原发性皮肤CD8+TCLPD可以保守治疗,通常遵循缓慢的临床过程,无论治疗方法如何。了解临床情况以及形态学和免疫表型特征,有助于做出准确的诊断。
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引用次数: 0
Teratocarcinosarcoma of the head and neck: Clinicopathologic review of a rare entity. 头颈部畸胎瘤肉瘤:一种罕见实体的临床病理回顾。
IF 0.9 Q4 Medicine Pub Date : 2023-09-21 eCollection Date: 2023-01-01 DOI: 10.1177/20363613231204047
Rana S Al-Zaidi

Teratocarcinosarcoma is a rare, highly aggressive malignancy of the head and neck, characterized by multiphenotypic and triphasic growth of epithelial, mesenchymal, and primitive neuroepithelial elements. Owing to its rarity and morphological heterogeneity, as well as the lack of experience with this neoplasm, teratocarcinosarcoma is often misdiagnosed, particularly in small biopsy samples when only some of the elements are identified, thus leading to delayed management. Aggressive clinical behavior and poor survival outcomes, necessitate an accurate diagnosis and appropriate treatment. This review describes the main demographic and clinicopathological features of teratocarcinosarcoma, with an emphasis on the recent advances that have attempted to identify the molecular signature of this neoplasm.

畸胎瘤是一种罕见的、高度侵袭性的头颈部恶性肿瘤,其特征是上皮、间充质和原始神经上皮细胞的多表型和三相生长。由于畸胎癌肉瘤的罕见性和形态异质性,以及缺乏这种肿瘤的经验,它经常被误诊,尤其是在小的活检样本中,当只确定了一些成分时,从而导致治疗延迟。积极的临床行为和不良的生存结果,需要准确的诊断和适当的治疗。这篇综述描述了畸胎癌肉瘤的主要人口统计学和临床病理特征,并强调了试图确定该肿瘤分子特征的最新进展。
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引用次数: 0
Recurrent pineal parenchymal tumor of intermediate differentiation with intratumoral hemorrhage: A case report and review of the literature. 复发性中等分化松果体实质肿瘤合并瘤内出血1例并文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231177537
Yu-Li Chen, Li-Hsin Tai, Ann-Shung Lieu

Pineal apoplexy is a rare clinical condition. Its common symptoms include headaches, nausea, vomiting, ataxia, and gaze paralysis. These symptoms are mainly caused by obstructive hydrocephalus or direct compression of the cerebellum or midbrain. There have been no previous reports on the development of a recurrent pineal parenchymal tumor of intermediate differentiation (PPTID) with intratumoral hemorrhage. We report a case of PPTID with intratumoral hemorrhage. A 44-year-old woman developed recurrent PPTID following tumor removal and ventriculoperitoneal shunting in 2010. She visited the emergency department in April 2021 for sudden-onset dizziness and generalized weakness. Blurring of vision occurred and progressed over the previous month. Neurological examination revealed upward conjugate gaze paralysis. Brain computed tomography revealed a hyperdense lesion in the pineal region, and a recurrent tumor with hemorrhage was suspected. Magnetic resonance imaging of the brain confirmed a pineal tumor with intratumoral hemorrhage. The pineal tumor and hematoma were surgically removed via the suboccipital transtentorial approach. The patient was discharged from the hospital 2 weeks after the surgery. The pathological findings were consistent with the diagnosis of recurrent PPTID. PPTID is a rare tumor, accounting for less than 0.1% of primary central nervous system tumors. Pineal apoplexy is rare, and its incidence and clinical significance remain unclear. There have only been nine reported cases of pineal apoplexy, associated with pineal parenchymal tumors. The recurrence of PPTID with apoplectic hemorrhage after 10 years has not been reported. Despite its rarity, PPTID with apoplexy should be considered in patients with PPTID who develop sudden-onset neurological symptoms.

松果体中风是一种罕见的临床疾病。其常见症状包括头痛、恶心、呕吐、共济失调和凝视瘫痪。这些症状主要由梗阻性脑积水或直接压迫小脑或中脑引起。目前还没有关于复发性中间分化松果体实质肿瘤(PPTID)合并瘤内出血的报道。我们报告一例PPTID合并瘤内出血。一名44岁女性在2010年肿瘤切除和脑室-腹膜分流术后复发PPTID。她于2021年4月因突发性头晕和全身无力而去急诊室就诊。在过去的一个月里,视力开始模糊并不断恶化。神经学检查显示向上共轭注视麻痹。脑部电脑断层扫描显示松果体区有高密度病变,怀疑为复发性肿瘤并出血。脑部核磁共振影像证实为松果体肿瘤伴瘤内出血。松果体肿瘤及血肿经枕下经脑幕入路手术切除。病人术后两周出院。病理结果与复发性PPTID的诊断一致。PPTID是一种罕见的肿瘤,占原发性中枢神经系统肿瘤的不到0.1%。松果体中风是罕见的,其发病率和临床意义尚不清楚。目前仅有9例与松果体实质肿瘤相关的松果体中风病例报道。PPTID合并中风性出血10年后复发未见报道。尽管罕见,但在出现突发性神经系统症状的PPTID患者中,应考虑卒中。
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引用次数: 1
Axillary chest wall solid-papillary carcinoma: A case report on presentation and management. 腋窝胸壁实体乳头状癌1例表现及处理。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231155957
Harper E Niver, Priscilla Strom

Papillary breast carcinomas comprise <1% of all breast cancers. They are notorious among surgical pathologists for posing diagnostic difficulty, especially with small sample sizes, such as a core-needle biopsy and carry potential for overtreatment. Solid-papillary carcinoma is a subtype of papillary breast carcinomas that affects elderly females and generally has a favorable diagnosis in its in-situ form. This report focuses on the unique and clinically aggressive presentation and treatment of invasive solid-papillary carcinoma that was discovered along the axillary chest wall after an ipsilateral mastectomy for multifocal ductal carcinoma in situ.

乳头状乳腺癌包括
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引用次数: 0
Epithelioid hemangioendothelioma of the distal lower extremity and the role of radiotherapy: A report of two cases. 下肢远端上皮样血管内皮瘤及放疗的作用:附2例报告。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231172611
Robin Go, Linus Lee, Gayathri Vijayakumar, Sarah Tepper, Steven Gitelis, Alan Blank

We report two cases of epithelioid hemangioendothelioma (EHE) in the distal lower extremity. Our first patient had unicentric EHE of the left os calcis initially treated with an intralesional procedure; however, later developed two recurrences which were managed with radiation therapy. Our second patient had multicentric EHE of the distal tibia and fibula managed with primary radiation therapy. Although EHE is typically treated with wide resection or an intralesional procedure, we present two cases of EHE in the distal lower extremity to discuss the therapeutic role of radiation therapy in the management of distal EHE.

我们报告两例上皮样血管内皮瘤(EHE)在远端下肢。我们的第一位患者患有左肾钙单中心EHE,最初采用局内手术治疗;然而,后来出现了两次复发,用放射治疗进行了治疗。我们的第二例患者在胫骨和腓骨远端有多中心EHE,采用初级放射治疗。虽然EHE通常采用广泛切除或病灶内手术治疗,但我们提出了两例下肢远端EHE病例,以讨论放射治疗在远端EHE治疗中的治疗作用。
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引用次数: 0
Unusual cause of mediastinal tumor: A case of calcified pericardial cyst. 纵隔肿瘤的不寻常病因:钙化心包囊肿1例。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231177539
S M Tajdit Rahman, Mofizur Rhaman Mia, Mohammad Anamul Hoque, Sanghita Banik Proma

Pericardial cysts are rare benign intrathoracic lesions, and calcified pericardial cysts are even more uncommon. Most pericardial cysts are asymptomatic, but patients may present with chest pain, dyspnea and any complications of pericardial effusion. We present a case of a left-sided calcified pericardial cyst, highlighting its rarity and symptoms in relation to its location.

心包囊肿是少见的胸部良性病变,钙化的心包囊肿更是罕见。大多数心包囊肿是无症状的,但患者可能出现胸痛、呼吸困难和任何心包积液的并发症。我们报告一个左侧钙化心包囊肿的病例,强调其罕见性和症状与其位置的关系。
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引用次数: 0
A qualitative study to assess the psychological experiences and coping strategies of families affected with Li-Fraumeni syndrome in the Indian population. 一项定性研究评估心理经验和应对策略的家庭与李-弗劳梅尼综合征在印度人口。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231186300
Poonam Joshi, Sunidhi Bhandari, Ajesh Tk, Simran Kaur, Rachna Bhargava, Ghazal Tansir, Sameer Rastogi

Background: Li-Fraumeni syndrome (LFS) is a rare autosomal dominant hereditary cancer syndrome. Due to the high risk of occurrence of multiple cancers, families with LFS may have an overwhelming psychosocial burden. Methods: This cross-sectional study was conducted at a tertiary care center using face-to-face interviews through a grounded theory approach. Statistical analysis was done using Smith's Interpretative Phenomenological Approach. Themes and sub-themes were extracted, and a thematic schema was developed. Results: A total of five themes were identified. The extracted themes were psychological experiences, behavioural responses, stressors, coping strategies and perceived needs. The interlay of the themes deepened the impact of LFS on the affected ones and brought into light the turmoil of emotions and difficulties that these individuals were going through in the face of the disease. Conclusions: LFS-affected individuals had a range of experiences with this rare and little-known disease. The lack of information seems to be a precursor to the denial of diagnosis. Their experience with the illness sheds light on the grey areas like guilt and helplessness that demand immediate attention. Future policies need to be developed in accordance with the identified perceived needs to potentially guide the treatment and rising needs of LFS-affected individuals.

背景:Li-Fraumeni综合征(LFS)是一种罕见的常染色体显性遗传性癌症综合征。由于多种癌症发生的高风险,患有LFS的家庭可能会有巨大的社会心理负担。方法:本横断面研究采用面对面访谈的方式,通过扎根理论的方法在三级保健中心进行。统计分析使用史密斯的解释性现象学方法。提取主题和子主题,形成主题图式。结果:共确定了五个主题。提取的主题是心理体验、行为反应、压力源、应对策略和感知需求。这些主题的相互作用加深了LFS对受影响者的影响,并揭示了这些人在面对疾病时所经历的情绪动荡和困难。结论:lfs患者有一系列罕见且鲜为人知的疾病经历。缺乏信息似乎是否认诊断的前兆。他们的患病经历揭示了需要立即关注的内疚和无助等灰色地带。未来的政策需要根据已确定的感知需求来制定,以潜在地指导治疗和受慢性疲劳综合症影响的个人日益增长的需求。
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引用次数: 0
Posterior fossa giant adenoid cystic carcinoma with skull base invasion mimicking glomus jugulare: A case report and review of literature. 后窝巨大腺样囊性癌伴颅底侵犯模拟颈静脉球:1例报告及文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613221150218
Anand Kumar Das, Saraj Kumar Singh, Kranti Bhavana, Subhash Kumar

The author describes a rare case of giant adenoid cystic carcinoma (ACC) mimicking large paraganglioma with lower cranial nerve palsy. A 60-year-old female presented with a progressive increase in postauricular swelling with unilateral hearing loss, facial deviation, difficulty in swallowing, and hoarseness of voice. MRI brain showed highly vascular infiltrating and osteolytic mass suggestive of large glomus jugulare versus sarcoma. It was completely engulfing the jugular foramen and lower cranial nerves with bony erosion of the jugular foramen and occipital condyle. The whole mastoid was filled with the tumor. On digital subtraction angiography the majority of blood supply was from the occipital branch of the external carotid artery and vertebral artery. The patient underwent percutaneous embolization followed by external carotid ligation and resection of the mass. The postoperative course was uneventful. Histopathology was suggestive of mixed ACCs. The patient received radiotherapy. After 1 year of follow up no recurrence or distant metastasis was noted.

作者报告一例罕见的巨大腺样囊性癌(ACC),类似于大副神经节瘤合并下颅神经麻痹。一位60岁女性,表现为耳后肿胀进行性增加,伴有单侧听力丧失、面部偏斜、吞咽困难和声音嘶哑。脑MRI显示高度血管浸润和溶骨肿块提示颈内血管球与肉瘤。它完全吞没了颈静脉孔和下颅神经颈静脉孔和枕髁的骨质侵蚀。整个乳突充满了肿瘤。数字减影血管造影显示颈外动脉枕支和椎动脉供血最多。患者接受了经皮栓塞,随后进行了颈外动脉结扎和肿块切除。术后过程平淡无奇。组织病理学提示混合性acc。病人接受放射治疗。随访1年,无复发及远处转移。
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引用次数: 0
Nirogacestat and its potential impact on desmoid tumor. 硝加司他及其对硬纤维瘤的潜在影响。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231182485
Samia Rohail, Areeba Fareed, Muskaan Asim Taimuri, Alishba Adnan
Desmoid tumors (DT) are rare, benign, and invasive soft tissue tumors affecting 3–5 people in one million each year. Also known as desmoid fibromatosis, they present usually in the second and fourth decade of life, with an unpredictable prognosis and a risk of significant impairment in quality of life. According to estimates there are 1000 to 1650 new diagnoses in the United States each year. Habitually, these tumors are found in the abdomen, arms, and legs, however, they can affect vital organs as well. Desmoid tumors do not metastasize but painful disfigurement and problems in functioning due to local, aggressive growth can occur. Since desmoid tumors lack the ability to metastasize, local control using surgery and radiation has traditionally been the mainstay of therapy for these tumors. However, recurrence rate is very high, especially after surgery and in rare cases, it can be fatal. Therefore, the need for effective treatment is undeniable. The Food and Drug Administration (FDA) recently awarded Nirogacestat’s new drug application (NDA) for the treatment of adult patients with desmoid tumours a priority evaluation. The FDA has also given desmoid tumours in adult patients Fast Track and Breakthrough Therapy classifications. Nirogacestat is an oral, specific, small-molecule gamma secretase inhibitor that works by cleaving a variety of transmembrane protein complexes, including Notch, which may be involved in pathways that support the development of desmoid tumours. Inhibition of γ-secretase preserves membrane-bound B-cell maturation antigen (BCMA) and increases target density by reducing the levels of soluble BCMA, thus serving as a decoy receptor for BCMA-targeted therapy. The ability of Nirogacestat to potentiate the activity of BCMA-targeted therapy has been observed in preclinical models of multiple myeloma. A DeFi study, the largest and most rigorous randomized controlled trial was conducted in which 142 patients with advanced desmoid tumors were recruited. Patients were randomized to receive either Nirogacestat 150 mg or placebo twice daily in cycles of 28 days until they developed symptoms on radiologic imaging. The results showed a statistically significant improvement in progression of survival in patients randomized to Nirogacestat compared to placebo, with an average 71% reduction in risk of disease advancement. Participants taking Nirogacestat improved by 41% in their response within 5.6 months, compared to 8% in a longer period of 11.1 months by the placebo group. However, treatment was stopped due to ovarian dysfunction, which is defined by investigator-reported events of amenorrhea, premature menopause, menopause, and ovarian failure and was seen in 75% of women of childbearing potential receiving Nirogacestat. Nirogacestat demonstrated a manageable safety profile in DeFi studies, with 95% of all treatment-emergent adverse events. Therefore, treatment should be individualized for each patient to optimize tumor control and impro
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引用次数: 0
PARP inhibition utilized in combination therapy with Olaparib-Temozolomide to achieve disease stabilization in a rare case of BRCA1-mutant, metastatic myxopapillary ependymoma. 在罕见的brca1突变、转移性黏液乳头状室管膜瘤病例中,利用PARP抑制与奥拉帕尼-替莫唑胺联合治疗实现疾病稳定。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231152333
Preethika Mahalingam, Sam Smith, Juanita Lopez, Rajaei K Sharma, Thomas Millard, Khin Thway, Cyril Fisher, David A Reardon, Robin Jones, Andrew G Nicholson, David Cunningham, Liam Welsh, Bhupinder Sharma

Myxopapillary ependymoma (MPE) is a primary tumor of the central nervous system (CNS), characteristically an indolent malignancy involving the spinal conus medullaris, Filum terminale or cauda equina. We present a rare case of MPE, recurrent in the pelvic soft tissue with eventual pleural and intra-pulmonary metastasis. Refractory to repeated gross resection, adjuvant radiotherapy, platinum-based chemotherapy and temozolomide exploitation of mutant somatic BRCA1 status with the addition of a poly (ADP-ribose); polymerase inhibitor (PARPi) in a novel combination regimen with olaparib-temozolomide (OT) has achieved stable radiological disease after 10 cycles.

黏液乳头状室管膜瘤(MPE)是一种中枢神经系统(CNS)的原发性肿瘤,以累及脊髓圆锥、终丝或马尾的惰性恶性肿瘤为特征。我们报告一个罕见的MPE病例,在盆腔软组织复发,最终胸膜和肺内转移。反复大体切除、辅助放疗、铂基化疗和替莫唑胺难以耐受的突变体BRCA1状态,并添加聚adp核糖;聚合酶抑制剂(PARPi)与奥拉帕尼-替莫唑胺(OT)联合使用的新方案在10个周期后获得了稳定的放射学疾病。
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引用次数: 2
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Rare Tumors
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