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pleomorphic lipoma in the anterior mediastinum: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2899-2904页

作者： Yu-Qiang Mao Xiao-Ying Liu Yun Han Department of Thoracic Surgery Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina Department of Plastic Surgery the First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND pleomorphic lipoma (PL) is a rare benign mesenchymal tumor occurring predominantly in middle-aged and elderly men. It is typically found in the subcutaneous tissue of the posterior neck, back, and shoulders. There have also been a few reported cases in the face, scalp, and upper extremities. Currently, there is no report on its occurrence in the anterior mediastinum. CASE SUMMARY Herein, we report the case of a 67-year-old woman diagnosed with PL in the anterior mediastinum. The tumor was removed by thoracoscopic surgery. There was no recurrence during the 24-mo follow-up period, and the prognosis was good. Most PL are located on the skin surface. However, they may also occur within the body, even in the mediastinum. CONCLUSION PL occurring in the anterior mediastinum is rare, and it may be differentiated from other tumors.

关键词： pleomorphic lipoma Anterior mediastinum Thoracoscopic surgery Case report

Carcinoma ex pleomorphic adenoma of the trachea: A case report

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World Journal of Clinical Cases 2019年第17期7卷 2623-2629页

作者： Heng-Xing Gao Quan Li Wen-Li Chang Ya-Long Zhang Xiao-Zhi Wang Xue-Xue Zou Respiratory Department Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Radiology Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Pathology Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina

BACKGROUND Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma.Only three cases of CXPA of the trachea have been reported in the literature.CASE SUMMARY We report a case of tracheal CXPA in a 55-year-old woman,who presented with a more than 3-mo history of progressive dyspnea.Computed tomography of the neck and thorax revealed an inhomogeneous,broad-based lesion arising from the tracheal wall on the right side.Endoscopy revealed a subglottic neoplasm causing up to 90% luminal stenosis.The tumor was resected using a highfrequency electrosurgical snare combined with argon plasma coagulation.Histopathology and immunohistochemistry revealed that the tumor was a CXPA of the trachea.CONCLUSION We report the fourth case of tracheal CXPA,and present the first instance of resection of CXPA using high-frequency electrosurgical snare and laser ablation.We also discuss the pathogenesis,diagnosis,histopathology,and systemic therapy of this rare disease.

关键词： Case report Carcinoma ex pleomorphic adenoma Trachea pleomorphic adenoma

Effective chemotherapy for submandibular gland carcinoma ex pleomorphic adenoma with lung metastasis after radiotherapy: A case report

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World Journal of Clinical Cases 2019年第6期7卷 792-797页

作者： Zhi-Yuan Chen Yu Zhang Yan Tu Wei Zhao Mei Li Cancer Center West China HospitalSichuan University Oncology Department the Second People’s Hospital of Yunnan Province Radiology Department Yunnan Tumor Hospital Pathology Department West China HospitalSichuan University Department of Head & Neck Cancer Cancer CenterWest China HospitalSichuan University

BACKGROUND Only a few cases of carcinoma ex pleomorphic adenoma arising in the submandibular gland have ever been reported,all with a poor prognosis. The standard treatment for salivary gland carcinoma ex pleomorphic adenoma is surgical resection combined with postoperative radiotherapy,but the necessity of chemotherapy as well as the most appropriate treatment regimen for patients with distant metastasis after radiotherapy remains controversial.CASE SUMMARY This report presents the case of a 73-year-old woman who suffered submandibular gland carcinoma ex pleomorphic adenoma. She accepted surgery to remove the mass; she was found to have lung metastasis after radiotherapy.Her condition was controlled by chemotherapy with liposomal doxorubicin plus cisplatin.CONCLUSION The positive clinical outcome in the patient reveals that this chemotherapy regimen may be an alternative treatment for such a condition.

关键词： Malignant pleomorphic adenoma Salivary gland tumors Chemotherapy Carcinoma ex pleomorphic adenoma Case report

Immunohistochemical features of carcinoma ex pleomorphic adenoma and pleomorphic adenoma in the lacrimal gland

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International Journal of Ophthalmology(English edition) 2019年第8期12卷 1238-1242页

作者： Ping Zhang Li-Juan Tang Huan-Huan Gao Wen-Xin Zhang Jian-Xian Lin Hua-Sheng Yang Department of Ocular Pathology State Key Laboratory ofOphthalmologyZhongshan Ophthalmic CenterSun Yat-senUniversityGuangzhou510060Guangdong ProvinceChina Department of Orbital Disease and Oncology State KeyLaboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat-sen UniversityGuangzhou510060GuangdongProvinceChina

AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them.METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed.RESULTS: Median age of PA was 43.2 y(from 21 to 75). The 35 patients(54.7%) were male and 29 patients(45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%;the average proliferation index of Ki-67 was 3.2%;pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3 y(from 26 to 76). There were 7 male patients(46.7%) and 8 female patients(53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%;the average proliferation index of Ki-67 was 29.2%;pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas.CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-exPA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-exPA and PA.

关键词： carcinoma ex pleomorphic adenoma pleomorphic adenoma C-myc immunohistochemistry

Spontaneous pancreatic undifferentiated pleomorphic sarcoma in a laboratory rat: A case report

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Animal Models and Experimental Medicine 2019年第3期2卷 222-225页

作者： Petros Ypsilantis Soultana Meditskou Maria Lambropoulou Theodora Papamitsou Constantinos Simopoulos Laboratory of Experimental Surgery and Surgical Research School of MedicineDemocritus University of ThraceAlexandroupolisGreece Laboratory of Histology and Embryology Aristotle University of ThessalonikiThessalonikiGreece Laboratory of Histology and Embryology School of MedicineDemocritus University of ThraceAlexandroupolisGreece

We present a case of spontaneous undifferentiated/unclassified sarcoma,of a pleomorphic subtype formerly known as malignant fibrous histiocytoma(UPS/MFH),arising from the pancreas of a laboratory rat.The mass was excised after laparotomy from a 6‐month‐old female laboratory Wistar rat.It presented a giant multilobulated mass of irregular shape,which had arisen from the pancreas and occupied almost the entire peritoneal cavity.Histologically the tumor was characterized by a highly variable morphological pattern,with frequent transitions from storiform to pleomorphic areas.An extensive immunohistochemical examination revealed no specific lines of differentiation.Immunohistochemical positivity was observed only to MIB‐1(high Ki‐67 proliferation index),vimentin and CD68 antibodies.The diagnosis was compatible with UPS/MFH.To the best of our knowledge,the present case is the first report of a spontaneous primary UPS/MFH arising from the pancreas of a laboratory rat.

关键词： malignant fibrous histiocytoma pancreas pleomorphic rat undifferentiated sarcoma

Intermittent facial spasms as the presenting sign of a recurrent pleomorphic adenoma

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World Journal of Clinical Oncology 2017年第1期8卷 86-90页

作者： Rosalie A Machado Sami P Moubayed Azita Khorsandi Juan C Hernandez-Prera Mark L Urken Thyroid Head and Neck Cancer Foundation Department of Otolaryngology-Head and Neck Surgery Mount Sinai Beth Israel Department of Radiology Mount Sinai Beth Israel Department of Pathology Mount Sinai Beth Israel

The intimate anatomical relationship of the facial nerve to the parotid parenchyma has a significant influence on the presenting signs and symptoms, diagnosis and treatment of parotid neoplasms.However, to our knowledge, hyperactivity of this nerve, presenting as facial spasm, has never been described as the presenting sign or symptom of a parotid malignancy.We report a case of carcinoma arising in a recurrent pleomorphic adenoma of the left parotid gland(i.e., carcinoma ex pleomorphic adenoma) that presented with hemifacial spasms.We outline the differential diagnosis of hemifacial spasm as well as a proposed pathophysiology.Facial paralysis, lymph node enlargement, skin involvement, and pain have all been associated with parotid malignancies.To date the development of facial spasm has not been reported with parotid malignancies.The most common etiologies for hemifacial spasm are vascular compression of the ipsilateral facial nerve at the cerebellopontine angle(termed primary or idiopathic)(62%), hereditary(2%), secondary to Bell's palsy or facial nerve injury(17%), and hemifacial spasm mimickers(psychogenic, tics, dystonia, myoclonus, myokymia, myorthythmia, and hemimasticatory spasm)(17%).Hemifacial spasm has not been reported in association with a malignant parotid tumor but must be considered in the differential diagnosis of this presenting symptom.

关键词： Facial spasm pleomorphic adenoma Benign mixed parotid tumor Reconstructive surgery Salivary glands

pleomorphic lobular carcinoma in situ of the breast: Can the evidence guide practice?

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World Journal of Clinical Oncology 2014年第3期5卷 546-553页

作者： Andrew Pieri James Harvey Nigel Bundred Wansbeck General Hospital NorthumbriaNE63 9JJUnited Kingdom Nightingale Centre University Hospital of South ManchesterWythenshawe HospitalManchesterM23 9LTUnited Kingdom

The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic electronic search was performed to identify all English language articles regarding PLCIS management. The data was analysed, specifically looking at: incidence of concurrent disease, recurrence rates, long-term prognosis and PLCIS management. A search was also performed for PLCIS management guidelines for the United Kingdom, United States, Canada, Australia, Germany and pan-European. The results of the evidence analyses were compared to the guidelines in order to establish whether the recommended management is consistent with the published evidence. Nine studies(level 3-4 evidence), involving a total of 176 patients and five management guidelines(from United Kingdom, United States, Australia and pan-European) were included in the review. From the evidence, 46 of 93(49%) patients were found to have PLCIS with concurrent invasive disease on excision specimen analysis. Regarding recurrence rates, 11 of 117(9.4%) patients developed a recurrence of PLCIS. There were no instances of invasive disease or ductal carcinoma in situ(DCIS) on recurrence histology. There were no studies assessing long-term outcomes in PLCIS cases. With regards to the management guidelines, the Association of Breast Surgery(United Kingdom) and the National Breast and Ovarian Cancer Care(Australia) do not mention PLCIS. The National Comprehensive Cancer Network(United States) suggest considering excision of PLCIS with negative margins. The NHS Breast Screening Programme(United Kingdom) and the European Society of Medical Oncology(pan-European) recommend PLCIS should be treated as with DCIS. We conclude that high quality evidence to inform guidance is lacking, thus recommendations are relatively vague. H

关键词： pleomorphic lobular carcinoma in situ Breast cancer Breast carcinoma Carcinoma in situ Guideline Excision margin Recurrence rate

pleomorphic Adenoma with Exuberant Squamous Metaplasia and Keratin Cysts Mimicking Squamous Cell Carcinoma in Minor Salivary Gland

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Open Journal of Pathology 2013年第3期3卷 113-116页

作者： Sharon Lim Inju Cho Jun-Hee Park Sung-Chul Lim Department of Pathology Chosun University College of Medicine Gwangju South Korea

Salivary gland tumors, the second most common neoplasm of the mouth after squamous cell carcinoma, account for a significant proportion of tumors of the oral and perioral regions. An unusual case of adenoma presented as a solitary intraoral palatine mass in a 32-year-old woman is reported here. The tumor was interpreted as an unusual pleomorphic adenoma because of the presence of exuberant squamous metaplasia, clinically mimicking squamous cell carcinoma. Moreover, the presence of cystic structures filled with keratinized material was also salient feature. pleomorphic adenomas may occasionally display focal squamous metaplastic changes;when extensive, it presents the potential for misinterpretation of the histology as indicative of well-differentiated squamous cell carcinoma.

关键词： pleomorphic Adenoma Squamous Metaplasia Keratin Cyst Squamous Cell Carcinoma Salivary Gland

Long-Term Survival after Resection for Primary Undifferentiated pleomorphic Sarcoma of the Jejunum with Lymph Node Metastases: Case Report

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Journal of Cancer Therapy 2017年第12期8卷 1079-1085页

作者： Shigeru Fujisaki Motoi Takashina Kenichi Sakurai Ryouichi Tomita Tadatoshi Takayama Department of Surgery Fujisaki Hospital Tokyo Japan Division of Digestive Surgery Nihon University School of Medicine Tokyo Japan Division of Breast and Endocrine surgery Nihon University School of Medicine Tokyo Japan Department of Surgery Nippon Dental School at Tokyo Tokyo Japan

Primary undifferentiated pleomorphic sarcoma (UPS) of the small intestine is extremely rare. The prognosis of UPS is basically poor, and particular, when accompanied with metastatic lesions. This paper reports the case of a long-term survivor of primary UPS of the jejunum with lymph node metastases and a skip lesion in the jejunum. The patient was a 50-year-old Japanese man who presented with a chief complaint of breathlessness. Small bowel X-ray series revealed an approximately 4-cm size with protruded lesion (image shows a filling defect) in the proximal jejunum. Based on a presumptive diagnosis of the hemorrhagic small bowel tumor, he underwent a laparotomy. A tumor was observed in the jejunum at approximately 90-cm from the Treitz ligament;some swollen mesenteric lymph nodules were also observed. Segmental resection of the jejunum was performed 20-140 cm from the Treitz ligament. A complete surgical excision with en-bloc regional lymph node dissection was performed. The final histopathological diagnosis was UPS of the jejunum with metastatic lymph nodes and a skip lesion in the jejunum. The postoperative course was uneventful. The patient was not given adjuvant chemotherapy and was discharged on postoperative day 16. He is currently well without any evidence of recurrence for >10 years after the operation.

关键词： Undifferentiated pleomorphic Sarcoma Jejunum Metastatic Lymph Nodes