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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
A staghorn kidney stone or extraskeletal osteosarcoma of the kidney? A case report and literature review. 是鹿角肾结石还是肾脏骨外骨肉瘤?病例报告及文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231176719
Ali Emadi Torghabeh, Masoumeh Gharib, Siavash Zahed Anaraki, Parisa Rabiei

Extraskeletal osteosarcoma (ESOS) is a very rare entity among renal malignancies. There are few reports of renal ESOS in the database. Renal ESOS was found to have a high rate of local recurrence and distant metastasis. In most reports, the overall survival of patients was less than 1 year. We present a 51-year-old man who presented with gross hematuria and a clinical diagnosis of a staghorn stone in the left kidney. He underwent radical nephrectomy. The pathologic diagnosis of osteosarcoma was evident.

摘要骨骼外骨肉瘤(ESOS)是一种非常罕见的肾脏恶性肿瘤。数据库中关于肾脏ESOS的报道很少。肾脏ESOS有很高的局部复发和远处转移率。在大多数报告中,患者的总生存期小于1年。我们提出一个51岁的男子谁提出肉眼血尿和临床诊断鹿角石在左肾。他接受了根治性肾切除术。骨肉瘤的病理诊断是明确的。
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引用次数: 0
Vorasidenib: A promising therapeutic breakthrough for diffuse isocitrate dehydrogenase mutant gliomas. Vorasidenib:弥漫性异柠檬酸脱氢酶突变型胶质瘤的有希望的治疗突破。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231197991
Abdul Wahid, Amna Tariq, Faiza Ahsan, Fatima Asif
The most common type of major malignant tumor of the brain includes gliomas, which are marked by diffuse invasion of malignant cells in the brain. Grade II and grade III diffuse gliomas classi fi ed by the World health organization (WHO) are also known as lower-grade gliomas LLG. These tumors are seen more frequently in younger people, show a slower growth rate, and mostly does not appear on contrast enhancement on T1-weighted brain MRI in the beginning. Current treatment includes chemotherapy, radiation, and maximally safe tumor resection. However, there is a high chance of recurrence and transformation of LLG into a more aggressive tumor. The advanced treatment outlook is to attack mutant genetic changes that are causing gliomas in the initial stage to minimize the use of harmful therapies and to hinder its progression to a higher tumor grade. 1 Isocitrate dehydrogenase (IDH), is an important enzyme having a major role in the tricarboxylic cycle as well as controlling the redox cofactor in between mitochondria and cytosol. IDH1, IDH2, and IDH3 are the three existing isoforms. 2 Mutations in isoforms of IDH1 and IDH2, that are heterozygous lead to the formation of oncogenic d-2-hy-droxyglutarate (2-HG), 3 causing different malignant growth counting
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引用次数: 0
Breakthrough treatment choice for Acute Myeloid Leukemia in pediatric and adult patients: Revumenib, an oral selective inhibitor of KMTA2Ar. 小儿和成人急性髓系白血病突破性治疗选择:Revumenib,一种口服选择性KMTA2Ar抑制剂。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231183785
Areeba Fareed, Nimrah Inam, Fatima Faraz
Acute myeloid leukemia (AML) represents the predominant manifestation of acute leukemia in the adult population, whereas in children, it ranks second in terms of frequency. It is characterized by genetic mutations and epigenetic dysregulation resulting in a heterogeneous population of malignant cells with blocked differentiation resulting in increased proliferation and self-renewal activity . Every year 20,000 new cases of AML are diagnosed in the United States, whereas the global burden of the disease is believed to range between 119,000 to 352,000 cases per annum. NPM1 gene mutations are the most encountered genetic aberrations in acute myeloid leukemia (AML), being detectable in about one-third of adult AML and 50– 60% of AML patients with normal karyotype. The mutant NPM1 is directly involved in promoting increased expression of homeobox (HOX) genes, which are necessary for maintaining the leukemic cells in undifferentiated state. Recent studies have shown the importance of MLL1Menin interaction in AML with mutated nucleophosmin 1 (NPM1c). MLL1 (also known as lysine methyltransferase 2A [KMT2A]) is located on chromosome 11q23, but chromosomal translocation (MLL1-rearrangement [MLL1-r]) is observed in 5%–10% of acute leukemia cases (AML and ALL) in adults and children. This leads to the expression of chimeric MLL1 fusion proteins (ML-FP) that drive leukemic gene expression and proliferation and prevent hematopoietic differentiation, consequently giving rise to a particularly aggressive subtype of leukemia with an unfavorable outcome. Chromosomal rearrangements involving KMT2A gene are prevalent in neonates with acute leukemia, and affects 75% of newborns with ALL. Research findings suggest that this crucial molecular alternation takes place antenatally, leading to leukemia during the infantile period. Although induction therapy achieves complete remission (CR) in 60–80% cases, no targeted therapies have specifically been approved for acute leukemia with KMT2A rearrangement (KMT2Ar) or mutated NPM1currently. Unfortunately, the median survival is relatively brief at 8.5 months with 2-year and 5-year Overall Survival (OS) rates just 32% and 24%, respectively. Furthermore, existing research has suggested that circRNAs are capable of playing a role in the post-transcriptional regulation of AML by binding miRNAs, activating downstream signaling cascades, and regulating the expression of related genes, closely correlated with a wide variety of processes of AML. AML has a poor prognosis and a considerable tendency to relapse therefore, the need for effective treatment is undeniable.
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引用次数: 1
Hysteroscopic management of molar pregnancy: A series of 36 cases. 宫腔镜治疗磨牙妊娠36例。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231168767
Matthieu de Codt, Pascale Jadoul, Mathieu Luyckx, Jean-Luc Squifflet, Marie-Madeleine Dolmans, Charlotte Maillard, Jean-François Baurain, Etienne Marbaix, Amandine Gerday

Background: Hydatidiform Mole (HM) is the most common form of gestational trophoblastic disease. Dilatation and curettage is the classical treatment of this affection. Hysteroscopic resection (HsR) is an alternative for the treatment of intra-uterine pathology. Objective: To describe the feasibility of HsR for the management of HM. Result: Case series of patients who had a complete or partial HM confirmed by histological examination of the trophoblastic tissue resected by operative hysteroscopy between 2007 and 2019. After approval of our ethics committee, we evaluated 36 patients who underwent hysteroscopic resection for molar pregnancy. Histological analysis showed partial HM in 28 patients (77.8%) and complete HM in 8 (22.2%). Main surgical complications were uterine perforation in one patient and glycine resorption in 10 patients with two cases of hyponatremia corrected by standard treatment. We performed an ultrasound control 1 month after the intervention in 19 patients (52.8%) as they had slow decrease of HCG or bleeding complaints and found retained product of conception (RPOC) in six patients (16.7%). Conclusion: This first report on a small number of patients demonstrate that hysteroscopic resection is a feasible procedure for the management of molar pregnancy. Direct visualization of the procedure helps the surgeon to control the resection. Further studies are mandatory to compare this technique with D&C in term of RPOC and fertility outcomes as it remains the standard treatment.

背景:葡萄胎(HM)是最常见的妊娠滋养细胞疾病。扩张和刮除是治疗这种情感的经典方法。宫腔镜切除术(HsR)是治疗子宫内病理的另一种选择。目的:探讨HsR治疗HM的可行性。结果:2007年至2019年间,经手术宫腔镜切除的滋养细胞组织组织学检查证实患有完全或部分HM的病例系列。经伦理委员会批准,我们评估了36例接受宫腔镜切除磨牙妊娠的患者。组织学分析显示部分HM 28例(77.8%),完全HM 8例(22.2%)。手术主要并发症为子宫穿孔1例,甘氨酸吸收10例,经标准治疗后低钠血症2例。我们在干预1个月后对19例(52.8%)患者进行了超声控制,因为他们的HCG下降缓慢或出血投诉,6例(16.7%)患者发现妊娠产物(RPOC)保留。结论:这是对少数患者的首次报道,表明宫腔镜切除是治疗磨牙妊娠的可行方法。手术过程的直接可视化有助于外科医生控制切除。在RPOC和生育结果方面,需要进一步的研究来比较该技术,因为它仍然是标准的治疗方法。
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引用次数: 0
Ovarian serous borderline tumor with mural nodules of anaplastic carcinoma and omental involvement: A case report. 卵巢浆液性交界性肿瘤伴间变性癌壁结节及网膜受累1例。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231172260
Paula I Hernandez Acevedo, Gloria J Carter, Madeleine Courtney-Brooks, Beth Z Clark

Mural nodules are rarely identified in cystic ovarian neoplasms, and have been categorized into sarcoma-like, sarcomatous, and anaplastic carcinomatous types. Most reports of these mural nodules have been described in mucinous ovarian tumors. In this case report, we describe an ovarian serous borderline tumor with mural nodules composed of high-grade carcinoma with anaplastic features and necrosis, including the morphologic features, immunoprofile, and results of tumor DNA sequencing. Omental involvement was also identified. Recognition of this phenomenon in serous tumors is important, so that thickened areas of cyst wall in ovarian serous tumors will be thoroughly examined.

壁结节在卵巢囊性肿瘤中很少发现,可分为肉瘤样、肉瘤性和间变性癌。大多数关于这些壁结节的报道都是在卵巢粘液性肿瘤中描述的。在这个病例报告中,我们描述了一个卵巢浆液性交界性肿瘤,伴有壁结节,由高级别癌组成,具有间变性特征和坏死,包括形态学特征、免疫谱和肿瘤DNA测序结果。还发现了网膜受累。认识浆液性肿瘤的这种现象是很重要的,因此卵巢浆液性肿瘤的囊肿壁增厚区域将被彻底检查。
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引用次数: 0
Fibrous dysplasia associated with peripheral giant cell granoluma in maxilla in a young patient, a case report of rare hybrid lesion. 年轻患者上颌骨纤维发育不良伴外周巨细胞肉芽肿1例,为罕见的混合型病变。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231165883
Abbas Karimi, Samira Derakhshan, Mahboube Hasheminasab, Sheida Kordi

Benign fibro-osseous lesions are a diverse range of entities that have distinct clinical and radiographic features. They can occur as solitary lesions or concomitant with other pathologies as hybrid lesions. Fibrous dysplasia (FD) accompanied by central giant cell granuloma (CGCG), peripheral giant cell granuloma (PGCG) or peripheral ossifying fibroma (POF) as hybrid lesions, is reported very rarely in the literature. Although we were unable to find any reports of FD with PGCG as a hybrid lesion. Fibro-osseous lesions have certain histopathological features in common with PGCG including multinucleated giant cells. Here we report a 28 year old female with a painless, slow growing and pedunculated swelling of the maxilla for 18 months. Differential diagnosis consisted of FD, cemento-ossifying fibroma (COF), chondrosarcoma and probable PGCG considering radiographic and clinical investigations. Histopathologic findings revealed PGCG and FD as a hybrid lesion. The combination of PGCG and FD has not been reported in the literature so far.

良性纤维骨性病变是多种多样的实体,具有不同的临床和影像学特征。它们可以作为单独的病变发生,也可以作为混合病变与其他病理同时发生。纤维结构不良(FD)合并中央巨细胞肉芽肿(CGCG)、外周巨细胞肉芽肿(PGCG)或外周骨化纤维瘤(POF)为混合型病变,文献报道甚少。虽然我们没有发现任何FD与PGCG作为混合性病变的报道。纤维骨性病变与PGCG有一定的组织病理学特征,包括多核巨细胞。我们在此报告一位28岁的女性患者,她的上颌骨出现无痛、生长缓慢和带蒂的肿胀,持续了18个月。鉴别诊断包括FD,骨质骨化纤维瘤(COF),软骨肉瘤和可能的PGCG结合影像学和临床检查。组织病理学结果显示PGCG和FD为混合型病变。迄今为止,PGCG与FD合用尚未见文献报道。
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引用次数: 0
Solitary amyloid tumor of the palate: A case report and literature review. 上颚单发淀粉样瘤1例报告并文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231166540
Farnoosh Razmara, Samira Derakhshan, Nazanin Mahdavi, Saba Mohammadi

Amyloidosis is often caused by the abnormal extracellular accumulation of amyloid in organs and tissues. This condition, affecting the head and neck region, is typically localized, and may also involve the oral cavity, particularly the tongue and buccal mucosa. As a solitary manifestation, the localized amyloidosis occurring intraosseous is highly infrequent. In addition, localized amyloidosis has a great rate of recurrence. In this paper, a 50-year-old female patient with the chief complaint of pain in the anterior of the maxilla is reported. According to clinical examination, no significant pathologic lesion was seen. The radiographic image showed a radiolucent lesion around teeth four and five. The treatment of choice for the patient was an excisional biopsy. As amyloidosis diagnosis is clinically challenging, biopsy and histologic examination of lesions are necessary in this regard. Accordingly, it is concluded that long-term follow-up is mandatory in case of localized amyloidosis because late recurrence can occur in some cases.

淀粉样变性通常是由器官和组织中淀粉样蛋白的细胞外异常积聚引起的。这种情况影响头颈部,通常是局部的,也可能累及口腔,特别是舌头和颊粘膜。作为一种孤立的表现,局部淀粉样变发生在骨内是非常罕见的。此外,局限性淀粉样变性有很高的复发率。本文报告一位50岁女性患者,主诉为上颌骨前部疼痛。临床检查未见明显病理病变。x线片显示在第四和第五颗牙齿周围有一个透光的病变。患者的治疗选择是切除活检。由于淀粉样变的诊断在临床上具有挑战性,因此对病变进行活检和组织学检查是必要的。因此,我们得出结论,对于局限性淀粉样变性患者,长期随访是必要的,因为某些病例可能出现晚期复发。
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引用次数: 0
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Rare Tumors
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