Liposarcoma of the spermatic cord is a rare entity with only two series and less than 100 cases reported in literature. We report a case of a giant liposarcoma of the spermatic cord.
Liposarcoma of the spermatic cord is a rare entity with only two series and less than 100 cases reported in literature. We report a case of a giant liposarcoma of the spermatic cord.
The document reports a case of a 65-year-old man who presented with a large liposarcoma tumor arising from the spermatic cord that measured 20x12 cm. He underwent a radical orchiectomy and wide local excision to remove the tumor. Histopathological examination found it to be a well-differentiated myxoid liposarcoma, a rare type of liposarcoma occurring in the spermatic cord.
Ewing's sarcoma is the third most common primary malignant bone tumor that arises from endothelial cells of bone marrow. It commonly affects males in their first two decades of life, presenting with pain in the diaphysis of long bones like the femur and tibia. Diagnostic tests include blood tests showing anemia and elevated markers, x-rays revealing moth-eaten bone destruction and onion peel periosteal reaction, and MRI or CT scans assessing tumor extent and staging. Treatment involves a combination of chemotherapy, surgery if possible for debulking or limb preservation, and radiotherapy, with chemotherapy being the mainstay. Prognosis depends on factors like tumor site, stage, size, and response to initial chemotherapy.
Hibernoma is a rare, painless, and benign soft tissue tumor arising from brown fat cells. We present a 28 year old gentleman with a large and tender left anterior neck swelling associated with restricted left shoulder movement for one week duration after he was involved in a motor vehicle accident. Due to the nature of the injury and presentation, it was unexpected to fi nd a well encapsulated fat density suggestive of lipoma from Computed Tomography (CT) scan. Surgical exploration and excision were performed, and the histopathological examination of the excised mass noted to be hibernoma. Patient recovered well and regained full shoulder movement post operatively.
This case illustrated the importance of having broad differentials when approaching patients with post traumatic neck swelling.
Giant Cell Tumors of Bones: Management & Single Author ExperienceMohamed Abdulla
This document discusses giant cell tumor of bone (GCTB) and the potential role of denosumab in its management. It provides background information on GCTB, including its incidence, presentation, histopathology involving RANKL expression, and standard treatment options. It then describes a pilot study of 17 patients with advanced or metastatic GCTB who were treated with denosumab. The majority of patients experienced pain alleviation and stabilization or improvement of neurological deficits and pulmonary metastases. Denosumab represents a promising targeted therapy for salvage treatment of difficult GCTB cases.
1. Ewing's sarcoma is a rare cancer that was first described in 1921 by James Ewing, who believed it originated from blood vessels in bone tissue.
2. It most commonly affects children and young adults under 20, with males being affected more often than females. The most common symptoms are pain and swelling near the tumor.
3. While the exact cause is unknown, it is defined by a specific chromosomal translocation. Treatment involves chemotherapy, sometimes with radiation therapy or surgery. Prognosis depends on factors like metastasis and response to treatment.
Ewing sarcoma and osteosarcoma are two of the most common primary bone cancers in children and adolescents. Ewing sarcoma accounts for about 2% of childhood cancers and most often affects bones of the pelvis, femur, and ribs in the second decade of life. The most frequent genetic abnormality in Ewing sarcoma is a translocation between chromosomes 11 and 22. Osteosarcoma is the most common primary bone tumor in children and makes up about 4% of childhood cancers, typically affecting the distal femur, proximal tibia, and proximal humerus. Both cancers commonly present with pain and swelling and can metastasize to the lungs. Treatment involves chemotherapy, surgery, and sometimes radiation.
This document provides an outline on Ewing sarcoma. It discusses that Ewing sarcoma is a morphologically varied tumor characterized by chromosomal translocations. It most commonly affects children and young adults aged 5-20. The pathology involves a lobulated mass invading the bone marrow and destroying bone. Genetics involve a translocation of the EWS gene with FLI1 transcription factor genes. Diagnosis involves imaging and biopsy to identify the characteristic translocation. Treatment typically involves chemotherapy and surgery or radiation.
Liposarcoma of the spermatic cord is a rare entity with only two series and less than 100 cases reported in literature. We report a case of a giant liposarcoma of the spermatic cord.
The document reports a case of a 65-year-old man who presented with a large liposarcoma tumor arising from the spermatic cord that measured 20x12 cm. He underwent a radical orchiectomy and wide local excision to remove the tumor. Histopathological examination found it to be a well-differentiated myxoid liposarcoma, a rare type of liposarcoma occurring in the spermatic cord.
Ewing's sarcoma is the third most common primary malignant bone tumor that arises from endothelial cells of bone marrow. It commonly affects males in their first two decades of life, presenting with pain in the diaphysis of long bones like the femur and tibia. Diagnostic tests include blood tests showing anemia and elevated markers, x-rays revealing moth-eaten bone destruction and onion peel periosteal reaction, and MRI or CT scans assessing tumor extent and staging. Treatment involves a combination of chemotherapy, surgery if possible for debulking or limb preservation, and radiotherapy, with chemotherapy being the mainstay. Prognosis depends on factors like tumor site, stage, size, and response to initial chemotherapy.
Hibernoma is a rare, painless, and benign soft tissue tumor arising from brown fat cells. We present a 28 year old gentleman with a large and tender left anterior neck swelling associated with restricted left shoulder movement for one week duration after he was involved in a motor vehicle accident. Due to the nature of the injury and presentation, it was unexpected to fi nd a well encapsulated fat density suggestive of lipoma from Computed Tomography (CT) scan. Surgical exploration and excision were performed, and the histopathological examination of the excised mass noted to be hibernoma. Patient recovered well and regained full shoulder movement post operatively.
This case illustrated the importance of having broad differentials when approaching patients with post traumatic neck swelling.
Giant Cell Tumors of Bones: Management & Single Author ExperienceMohamed Abdulla
This document discusses giant cell tumor of bone (GCTB) and the potential role of denosumab in its management. It provides background information on GCTB, including its incidence, presentation, histopathology involving RANKL expression, and standard treatment options. It then describes a pilot study of 17 patients with advanced or metastatic GCTB who were treated with denosumab. The majority of patients experienced pain alleviation and stabilization or improvement of neurological deficits and pulmonary metastases. Denosumab represents a promising targeted therapy for salvage treatment of difficult GCTB cases.
1. Ewing's sarcoma is a rare cancer that was first described in 1921 by James Ewing, who believed it originated from blood vessels in bone tissue.
2. It most commonly affects children and young adults under 20, with males being affected more often than females. The most common symptoms are pain and swelling near the tumor.
3. While the exact cause is unknown, it is defined by a specific chromosomal translocation. Treatment involves chemotherapy, sometimes with radiation therapy or surgery. Prognosis depends on factors like metastasis and response to treatment.
Ewing sarcoma and osteosarcoma are two of the most common primary bone cancers in children and adolescents. Ewing sarcoma accounts for about 2% of childhood cancers and most often affects bones of the pelvis, femur, and ribs in the second decade of life. The most frequent genetic abnormality in Ewing sarcoma is a translocation between chromosomes 11 and 22. Osteosarcoma is the most common primary bone tumor in children and makes up about 4% of childhood cancers, typically affecting the distal femur, proximal tibia, and proximal humerus. Both cancers commonly present with pain and swelling and can metastasize to the lungs. Treatment involves chemotherapy, surgery, and sometimes radiation.
This document provides an outline on Ewing sarcoma. It discusses that Ewing sarcoma is a morphologically varied tumor characterized by chromosomal translocations. It most commonly affects children and young adults aged 5-20. The pathology involves a lobulated mass invading the bone marrow and destroying bone. Genetics involve a translocation of the EWS gene with FLI1 transcription factor genes. Diagnosis involves imaging and biopsy to identify the characteristic translocation. Treatment typically involves chemotherapy and surgery or radiation.
Externalbeam rt in ews3.12.20 - frida yseminar-finallllPRARABDH95
1) Ewing sarcoma and osteosarcoma are rare bone cancers that typically affect children and young adults. Ewing sarcoma is the second most common primary bone cancer while osteosarcoma most commonly presents as a primary bone malignancy.
2) Both cancers are diagnosed through imaging, biopsy and staging workup. Management involves chemotherapy along with local therapy through surgery and/or radiation therapy.
3) Radiation therapy planning aims to adequately cover the tumor volume while sparing nearby organs at risk. Techniques such as 3D conformal radiation therapy and intensity modulated radiation therapy (IMRT) allow for improved dose distribution over conventional radiation.
This document appears to be a series of questions and answers from a diagnostic radiology in-training examination. The questions cover topics in genitourinary tract radiology and ask examinees to identify diagnoses, classifications, or characteristics based on provided radiographic images and clinical scenarios. Rationales are given for each answer that provide additional radiologic and clinical details.
The 48-hour whole body In-111 pentetreotide images showed multiple focal areas of increased tracer uptake in both lobes of the liver, consistent with neuroendocrine tumor hepatic metastases. There was also a large focal area of increased uptake in the epigastric region in the expected location of the pancreas body. The most likely diagnosis given these findings is islet cell carcinoma of the pancreas. Pheochromocytoma, carcinoid tumor, lymphoma, and colon adenocarcinoma are less likely given the imaging findings.
Melanotic schwannoma of adrenal gland - A rare entity/ diagnostic dilemmaApollo Hospitals
Melanotic schwannoma of adrenal gland is very rare entity with only two series and less than 100 cases reported in literature. We report a case of melanotic schwannoma.
Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...Apollo Hospitals
We are reporting a case of squamous cell carcinoma of the native kidney in a renal transplant recipient. A 54-year-old gentleman, a renal transplant recipient for three years, presented with flank pain. On evaluation he was found to have a mass in the upper pole of the left native kidney. Renal angiogram was done which showed a functioning trans-
planted kidney with a large mass arising from the upper pole of the left native kidney. He underwent nephrectomy. The histopathology reported a squamous cell carcinoma. He was given adjuvant radiotherapy to the tumor bed using image guided radiotherapy thereby delivering a differential dose to the high risk areas and preserving the surrounding normal structures. He developed a urethral nodule which was found to be a squamous cell carcinoma. The lesion was excised with clear margins. We present this case because it is rare and to discuss adjuvant management.
An 18-year-old male presented with 3 months of left knee pain and 2 months of swelling above the knee. Examination revealed a hard, ill-defined swelling on the distal left thigh. Radiological investigation and biopsy were needed to confirm a diagnosis of osteosarcoma, which commonly affects long bones in teenagers and young adults. Treatment may involve limb salvage surgery combined with chemotherapy or amputation, with the goal of confirming the diagnosis, evaluating spread, and adequately treating the cancer.
1) A 50-year-old male presented with left leg pain and swelling for 3 months prior to a falling accident. Imaging showed a pathologic fracture of the left tibia.
2) Biopsy revealed high-grade conventional osteosarcoma. The patient received neoadjuvant chemotherapy with cisplatin and adriamycin.
3) After mid-cycle evaluation, the patient underwent surgery for resection of the tumor followed by adjuvant chemotherapy.
Ewing's sarcoma is a rare type of cancer that develops in bone or soft tissue. It is the second most common primary bone cancer in children and adolescents between 10-20 years old. The cancer presents with local swelling and tenderness at the affected site, most commonly the diaphysis of long bones. Metastasis is often present at diagnosis, with the lungs being the most common site. Diagnosis is confirmed through histopathological or cytogenetic testing. Treatment involves neoadjuvant chemotherapy followed by local tumor control through surgery or radiation therapy, along with adjuvant chemotherapy. Five-year survival rates have improved to around 70% with current multi-agent chemotherapy regimens.
Ewing's sarcoma is a rare cancer that affects bones or soft tissue. It is characterized by small, round cancer cells and commonly affects children and young adults. Treatment involves induction chemotherapy, followed by local therapy with surgery or radiation if possible, along with additional maintenance chemotherapy. The multimodal approach has improved survival rates in recent decades, though long-term outcomes remain challenging due to the risk of recurrence or secondary cancers.
Osteosarcoma is a type of bone cancer that arises from bone-forming cells. It is most common in children and older adults. The cause is unknown, but family history is a risk factor. It tends to occur in the large bones around the knee, thigh, or shoulder. Symptoms include bone pain, swelling, and fractures. Diagnostic tests include biopsy, imaging scans, and blood tests. Treatment involves chemotherapy before surgery to remove the tumor, with the goal of preserving the affected limb through limb-sparing surgery. Complications can include amputation, cancer spread to the lungs, and side effects from chemotherapy.
1) Ewing's sarcoma is a rare type of cancer that develops in bones or soft tissue. It is considered a high-grade malignancy and most commonly affects children and young adults between 5-30 years old.
2) The cancer is characterized by small, blue round cells visible under the microscope. It is diagnosed through biopsy and often involves chromosomal translocations.
3) Treatment involves chemotherapy, surgery, and radiation therapy depending on the stage and location of the cancer. The goal is to eliminate the tumor mass while preserving function through either curative or palliative treatments.
Intracranial chordomas are rare, slow-growing tumors that arise from remnants of the embryonic notochord in the skull base. They typically present as soft tissue masses originating in the clivus with associated bone destruction. MR imaging and CT are effective in diagnosing and monitoring these tumors. Treatment involves surgical resection followed by radiation therapy, which provides the best outcomes for patients with intracranial chordomas.
This document provides rationales for questions on the 2005 American College of Radiology Diagnostic In-Training Examination for interventional radiology residents. It includes the questions, images associated with some questions, findings for each image, and rationales for the correct answers. The questions cover topics such as locations of dialysis catheters, diagnoses for angiograms, standards for uterine artery embolization, and indications for percutaneous nephrostomy.
1) Chemotherapy has improved survival rates for osteosarcoma dramatically over the past 30 years from less than 20% to between 40-60% through the use of effective combination chemotherapy and neoadjuvant treatment.
2) Key trials showed that neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy improved relapse-free and overall survival compared to surgery alone.
3) The combination of doxorubicin and cisplatin administered every 3 weeks is now considered the standard first-line chemotherapy regimen based on results from large cooperative trials.
This document discusses extra skeletal Ewing's sarcoma, a rare soft tissue tumor. It belongs to the Ewing's sarcoma family of tumors and shares similar histological and cytogenetic characteristics. Extra skeletal Ewing's sarcoma typically affects young adults and presents as a painful, expanding soft tissue mass, often in the trunk or limbs. Diagnosis involves biopsy and testing to identify translocations. Treatment requires a multimodal approach including aggressive chemotherapy, wide surgical excision of the tumor, and radiotherapy to improve survival rates.
This document provides an overview of osteosarcoma and Ewing's sarcoma, including their genetic basis, clinical presentation, radiological findings, biopsy, management, and prognosis. Osteosarcoma is the second most common primary bone cancer and most commonly affects the metaphysis of long bones in adolescents and young adults. Presentation includes pain, swelling, and sometimes pathological fractures. Diagnosis involves imaging such as X-ray, CT, MRI and biopsy. Treatment typically involves neoadjuvant chemotherapy, surgical resection with wide margins, and additional chemotherapy. Prognosis depends on stage and response to treatment, with 5-year survival rates ranging from 60-80% for localized disease.
1) Ewing's sarcoma is a rare type of cancer that affects bone or soft tissue. It was first described in 1921 and is thought to arise from stem cells or nerve tissue.
2) It most commonly affects children and young adults between 5-30 years old and presents with pain, swelling, fever, weight loss and anemia. Common sites are the lower limbs, pelvis, ribs, and spine.
3) Treatment involves chemotherapy, surgery, and radiation therapy. The standard chemotherapy regimen is VAC or IE. Prognosis is best if the cancer is localized and in younger patients, and worst if it has spread to other organs or the patient is older.
Recent advances in management of osteosarcomaBipulBorthakur
Recent advances in the management of osteosarcoma include improved imaging techniques like MRI and PET/CT that can better assess tumor extent and predict response to chemotherapy. Biopsies can now be performed using less invasive core needle techniques. Advances in local therapy include limb-sparing surgeries using smaller resection margins and joint-sparing techniques along with proton beam and heavy ion radiotherapy for inoperable tumors. Multi-agent chemotherapy continues to be the standard of care, with additions like ifosfamide and mifamurtide. Follow-up now relies more on chest X-rays compared to CT scans. Future areas of research focus on optimizing chemotherapy regimens and targeting pathways like PI3K/
The document evaluates stabilization failure in the thoracolumbar spine. It analyzes 93 patients who underwent spinal stabilization surgery. 9 patients (8.37%) experienced implant failure, mostly screw breakage. Failure was likely due to inadequate bone grafting, poor surgical technique, use of undersized screws, low-quality implants, and inadequate rest after surgery. To prevent failure, the study recommends limiting stabilization to appropriate cases, improving surgical methods, using adequate bone grafts, proper implant selection, and considering spinal biomechanics.
This document describes a case report of a 48-year-old female patient who presented with a large lipoma in her anterior neck region that extended into the mediastinum. Imaging including ultrasound, CT, and MRI confirmed a large fat-density mass measuring 16x14.8x13 cm involving the neck spaces and mediastinum. The patient underwent surgical excision of the giant lipoma, which weighed 1200 grams. Histopathology confirmed it was a lipoma. Lipomas are generally benign fatty tumors, but this case was unique due to the large size and mediastinal extension, which made surgical excision more challenging.
GIANT ANTERIOR NECK LIPOMA WITH MEDIASTINAL EXTENSIONAakanksha Rathor
This document describes a case report of a rare giant anterior neck lipoma with mediastinal extension in a 48-year-old female patient. The large lipoma mass measured 16x14.8x13 cm and extended from the neck into the anterior mediastinum. Imaging including ultrasound, CT scan, and biopsy confirmed the diagnosis of a benign lipoma. The entire lipoma weighing 1200 grams was surgically removed from the neck and mediastinum without complications. The patient recovered well and had no recurrence after 1 year of follow up.
Externalbeam rt in ews3.12.20 - frida yseminar-finallllPRARABDH95
1) Ewing sarcoma and osteosarcoma are rare bone cancers that typically affect children and young adults. Ewing sarcoma is the second most common primary bone cancer while osteosarcoma most commonly presents as a primary bone malignancy.
2) Both cancers are diagnosed through imaging, biopsy and staging workup. Management involves chemotherapy along with local therapy through surgery and/or radiation therapy.
3) Radiation therapy planning aims to adequately cover the tumor volume while sparing nearby organs at risk. Techniques such as 3D conformal radiation therapy and intensity modulated radiation therapy (IMRT) allow for improved dose distribution over conventional radiation.
This document appears to be a series of questions and answers from a diagnostic radiology in-training examination. The questions cover topics in genitourinary tract radiology and ask examinees to identify diagnoses, classifications, or characteristics based on provided radiographic images and clinical scenarios. Rationales are given for each answer that provide additional radiologic and clinical details.
The 48-hour whole body In-111 pentetreotide images showed multiple focal areas of increased tracer uptake in both lobes of the liver, consistent with neuroendocrine tumor hepatic metastases. There was also a large focal area of increased uptake in the epigastric region in the expected location of the pancreas body. The most likely diagnosis given these findings is islet cell carcinoma of the pancreas. Pheochromocytoma, carcinoid tumor, lymphoma, and colon adenocarcinoma are less likely given the imaging findings.
Melanotic schwannoma of adrenal gland - A rare entity/ diagnostic dilemmaApollo Hospitals
Melanotic schwannoma of adrenal gland is very rare entity with only two series and less than 100 cases reported in literature. We report a case of melanotic schwannoma.
Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...Apollo Hospitals
We are reporting a case of squamous cell carcinoma of the native kidney in a renal transplant recipient. A 54-year-old gentleman, a renal transplant recipient for three years, presented with flank pain. On evaluation he was found to have a mass in the upper pole of the left native kidney. Renal angiogram was done which showed a functioning trans-
planted kidney with a large mass arising from the upper pole of the left native kidney. He underwent nephrectomy. The histopathology reported a squamous cell carcinoma. He was given adjuvant radiotherapy to the tumor bed using image guided radiotherapy thereby delivering a differential dose to the high risk areas and preserving the surrounding normal structures. He developed a urethral nodule which was found to be a squamous cell carcinoma. The lesion was excised with clear margins. We present this case because it is rare and to discuss adjuvant management.
An 18-year-old male presented with 3 months of left knee pain and 2 months of swelling above the knee. Examination revealed a hard, ill-defined swelling on the distal left thigh. Radiological investigation and biopsy were needed to confirm a diagnosis of osteosarcoma, which commonly affects long bones in teenagers and young adults. Treatment may involve limb salvage surgery combined with chemotherapy or amputation, with the goal of confirming the diagnosis, evaluating spread, and adequately treating the cancer.
1) A 50-year-old male presented with left leg pain and swelling for 3 months prior to a falling accident. Imaging showed a pathologic fracture of the left tibia.
2) Biopsy revealed high-grade conventional osteosarcoma. The patient received neoadjuvant chemotherapy with cisplatin and adriamycin.
3) After mid-cycle evaluation, the patient underwent surgery for resection of the tumor followed by adjuvant chemotherapy.
Ewing's sarcoma is a rare type of cancer that develops in bone or soft tissue. It is the second most common primary bone cancer in children and adolescents between 10-20 years old. The cancer presents with local swelling and tenderness at the affected site, most commonly the diaphysis of long bones. Metastasis is often present at diagnosis, with the lungs being the most common site. Diagnosis is confirmed through histopathological or cytogenetic testing. Treatment involves neoadjuvant chemotherapy followed by local tumor control through surgery or radiation therapy, along with adjuvant chemotherapy. Five-year survival rates have improved to around 70% with current multi-agent chemotherapy regimens.
Ewing's sarcoma is a rare cancer that affects bones or soft tissue. It is characterized by small, round cancer cells and commonly affects children and young adults. Treatment involves induction chemotherapy, followed by local therapy with surgery or radiation if possible, along with additional maintenance chemotherapy. The multimodal approach has improved survival rates in recent decades, though long-term outcomes remain challenging due to the risk of recurrence or secondary cancers.
Osteosarcoma is a type of bone cancer that arises from bone-forming cells. It is most common in children and older adults. The cause is unknown, but family history is a risk factor. It tends to occur in the large bones around the knee, thigh, or shoulder. Symptoms include bone pain, swelling, and fractures. Diagnostic tests include biopsy, imaging scans, and blood tests. Treatment involves chemotherapy before surgery to remove the tumor, with the goal of preserving the affected limb through limb-sparing surgery. Complications can include amputation, cancer spread to the lungs, and side effects from chemotherapy.
1) Ewing's sarcoma is a rare type of cancer that develops in bones or soft tissue. It is considered a high-grade malignancy and most commonly affects children and young adults between 5-30 years old.
2) The cancer is characterized by small, blue round cells visible under the microscope. It is diagnosed through biopsy and often involves chromosomal translocations.
3) Treatment involves chemotherapy, surgery, and radiation therapy depending on the stage and location of the cancer. The goal is to eliminate the tumor mass while preserving function through either curative or palliative treatments.
Intracranial chordomas are rare, slow-growing tumors that arise from remnants of the embryonic notochord in the skull base. They typically present as soft tissue masses originating in the clivus with associated bone destruction. MR imaging and CT are effective in diagnosing and monitoring these tumors. Treatment involves surgical resection followed by radiation therapy, which provides the best outcomes for patients with intracranial chordomas.
This document provides rationales for questions on the 2005 American College of Radiology Diagnostic In-Training Examination for interventional radiology residents. It includes the questions, images associated with some questions, findings for each image, and rationales for the correct answers. The questions cover topics such as locations of dialysis catheters, diagnoses for angiograms, standards for uterine artery embolization, and indications for percutaneous nephrostomy.
1) Chemotherapy has improved survival rates for osteosarcoma dramatically over the past 30 years from less than 20% to between 40-60% through the use of effective combination chemotherapy and neoadjuvant treatment.
2) Key trials showed that neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy improved relapse-free and overall survival compared to surgery alone.
3) The combination of doxorubicin and cisplatin administered every 3 weeks is now considered the standard first-line chemotherapy regimen based on results from large cooperative trials.
This document discusses extra skeletal Ewing's sarcoma, a rare soft tissue tumor. It belongs to the Ewing's sarcoma family of tumors and shares similar histological and cytogenetic characteristics. Extra skeletal Ewing's sarcoma typically affects young adults and presents as a painful, expanding soft tissue mass, often in the trunk or limbs. Diagnosis involves biopsy and testing to identify translocations. Treatment requires a multimodal approach including aggressive chemotherapy, wide surgical excision of the tumor, and radiotherapy to improve survival rates.
This document provides an overview of osteosarcoma and Ewing's sarcoma, including their genetic basis, clinical presentation, radiological findings, biopsy, management, and prognosis. Osteosarcoma is the second most common primary bone cancer and most commonly affects the metaphysis of long bones in adolescents and young adults. Presentation includes pain, swelling, and sometimes pathological fractures. Diagnosis involves imaging such as X-ray, CT, MRI and biopsy. Treatment typically involves neoadjuvant chemotherapy, surgical resection with wide margins, and additional chemotherapy. Prognosis depends on stage and response to treatment, with 5-year survival rates ranging from 60-80% for localized disease.
1) Ewing's sarcoma is a rare type of cancer that affects bone or soft tissue. It was first described in 1921 and is thought to arise from stem cells or nerve tissue.
2) It most commonly affects children and young adults between 5-30 years old and presents with pain, swelling, fever, weight loss and anemia. Common sites are the lower limbs, pelvis, ribs, and spine.
3) Treatment involves chemotherapy, surgery, and radiation therapy. The standard chemotherapy regimen is VAC or IE. Prognosis is best if the cancer is localized and in younger patients, and worst if it has spread to other organs or the patient is older.
Recent advances in management of osteosarcomaBipulBorthakur
Recent advances in the management of osteosarcoma include improved imaging techniques like MRI and PET/CT that can better assess tumor extent and predict response to chemotherapy. Biopsies can now be performed using less invasive core needle techniques. Advances in local therapy include limb-sparing surgeries using smaller resection margins and joint-sparing techniques along with proton beam and heavy ion radiotherapy for inoperable tumors. Multi-agent chemotherapy continues to be the standard of care, with additions like ifosfamide and mifamurtide. Follow-up now relies more on chest X-rays compared to CT scans. Future areas of research focus on optimizing chemotherapy regimens and targeting pathways like PI3K/
The document evaluates stabilization failure in the thoracolumbar spine. It analyzes 93 patients who underwent spinal stabilization surgery. 9 patients (8.37%) experienced implant failure, mostly screw breakage. Failure was likely due to inadequate bone grafting, poor surgical technique, use of undersized screws, low-quality implants, and inadequate rest after surgery. To prevent failure, the study recommends limiting stabilization to appropriate cases, improving surgical methods, using adequate bone grafts, proper implant selection, and considering spinal biomechanics.
This document describes a case report of a 48-year-old female patient who presented with a large lipoma in her anterior neck region that extended into the mediastinum. Imaging including ultrasound, CT, and MRI confirmed a large fat-density mass measuring 16x14.8x13 cm involving the neck spaces and mediastinum. The patient underwent surgical excision of the giant lipoma, which weighed 1200 grams. Histopathology confirmed it was a lipoma. Lipomas are generally benign fatty tumors, but this case was unique due to the large size and mediastinal extension, which made surgical excision more challenging.
GIANT ANTERIOR NECK LIPOMA WITH MEDIASTINAL EXTENSIONAakanksha Rathor
This document describes a case report of a rare giant anterior neck lipoma with mediastinal extension in a 48-year-old female patient. The large lipoma mass measured 16x14.8x13 cm and extended from the neck into the anterior mediastinum. Imaging including ultrasound, CT scan, and biopsy confirmed the diagnosis of a benign lipoma. The entire lipoma weighing 1200 grams was surgically removed from the neck and mediastinum without complications. The patient recovered well and had no recurrence after 1 year of follow up.
Aggressive angiomyxoma is a rare, benign slow-growing
myxoid neoplasm that occurs almost exclusively in the genital, perineal and pelvic regions of adult women. It mostly occurs during the reproductive years with a peak incidence in the third decade of life. It has propensity for local recurrence,1,2 which varies 9e72%. Female:male ratio is 6:1.
Primary Follicular Lymphoma of the spleen: A Case report and literature reviewiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Rhabdomyosarcoma is the most common soft tissue sarcoma in children. It arises from skeletal muscle and can occur anywhere in the body. The two main histologic subtypes are embryonal and alveolar. Treatment involves chemotherapy, surgery if possible, and radiation therapy. The chemotherapy regimens most often used are VAC or IVA. Prognosis depends on factors like age, location, stage and histology. With multimodal treatment, the 5-year survival rate for localized disease is over 70% while metastatic disease has a lower survival rate of around 25%.
Primary Endometrial Stromal Sarcoma arising from Cervixiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This patient is a 30-year-old female presenting with a 15-year history of a left upper eyelid mass and swelling on the left side of her face for 1 year. Imaging shows a minimally enhancing soft tissue mass involving the left orbit, temporal, and masseteric spaces suggestive of rhabdomyosarcoma. A biopsy is needed for confirmation. Differential diagnoses include malignant melanoma, lymphoma, and infections. Treatment will depend on biopsy results and tumor staging.
This document presents a case report of a 54-year-old Egyptian woman found to have metastatic hepatocellular carcinoma (HCC) to the ovaries. Her initial presentation was an abdominal mass and elevated alpha-fetoprotein levels. Imaging revealed hepatic lesions and involvement of both ovaries. Histopathological examination of biopsy samples from the ovaries and liver showed features consistent with HCC. While rare, metastatic HCC should be considered in the differential diagnosis of hepatoid and oxyphil cell tumors of the ovary, especially in patients with risk factors for HCC such as hepatitis infection and cirrhosis. The case report reviews similar literature cases and discusses diagnostic criteria and distinguishing metastatic HCC from other potential ovarian tumors.
This document presents a case report of a rare bone hemangioma arising from the hyoid bone in a 30-year-old male. Imaging showed a mass occupying the right submandibular region extending to the hyoid bone. Surgical excision was performed and histopathology confirmed a hemangioma originating from the hyoid bone. This represents the first reported case of a primary hemangioma arising specifically from the hyoid bone.
This document presents a case report of a rare occurrence of basal cell adenoma in the palate of a 25-year-old male patient. It describes the clinical findings and diagnostic workup including imaging, biopsy, histopathological examination, and immunohistochemical analysis of the excised tumor. The pathological features were consistent with basal cell adenoma. The tumor was successfully removed surgically and the patient recovered well, with the tumor representing an unusual site for this rare minor salivary gland tumor.
This case report describes a rare case of adenoid cystic carcinoma (ACC) of the cervix in a 57-year-old African woman. ACC is an uncommon type of cervical cancer that arises from reserve cells of the endocervix. Histopathological examination of a cervical biopsy found ACC localized to the superficial endocervix. The patient underwent a hysterectomy and has since had no recurrence of cancer. ACC of the cervix is more aggressive than squamous cell carcinoma with higher recurrence rates. Standard treatment involves surgery and radiation therapy due to the rarity of cases and lack of prospective studies.
This document summarizes a case report of a rare sarcomatoid carcinoma of the prostate in a 60-year-old male patient. The patient presented with symptoms of bladder outlet obstruction and was initially diagnosed with benign prostatic hyperplasia. However, histopathological examination of the prostatectomy specimen revealed a biphasic tumor comprising a malignant epithelial component and a mesenchymal-like spindle cell component, leading to a diagnosis of sarcomatoid carcinoma. Immunohistochemistry showed expression of cytokeratin and EMA in the epithelial and sarcomatoid components. The sarcomatoid carcinoma had a poor prognosis, as the patient developed metastases and was lost to follow up after defaulting on chemotherapy. Sarcom
Dr Anil:AIIMS Patna, Primary leiomyosarcoma of IVC.Anil Kumar
- A 60-year-old female presented with vague right loin pain, weight loss, and weakness. Imaging revealed a 6-7 cm retroperitoneal mass adjacent to the renal portion of the IVC, which was compressing the luminal space.
- The patient underwent surgery involving a right nephrectomy and resection of the tumor along with the involved portion of the IVC. A Dacron graft was implanted to reconstruct the IVC.
- Pathology identified the tumor as a leiomyosarcoma arising from the smooth muscle of the IVC, which is an extremely rare malignancy. Complete surgical resection offers the best chance of survival when the tumor is resectable.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document describes a case report of a 24-year-old woman who presented with low back pain, difficulty defecating, and infertility. Imaging revealed a large retrorectal cyst pushing the rectum anteriorly, along with other anomalies including a hemisacral deficiency, uterus didelphys, and double inferior vena cava. The patient underwent excision of the retrorectal cyst, which pathology confirmed was a tailgut cyst. Tailgut cysts are rare retrorectal developmental cysts. This case was unique due to the associated uterine, sacral, and vascular anomalies not previously reported with tailgut cysts.
Uncommon cause of secondary amenorrhea and hirsutism: Steroid cell tumor of o...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
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The aim of this open access journal is to offer service for scientists and academicians to promote, share, and discuss various new issues and developments by publishing clinical case reports in all aspects.
Austin Journal of case repots are a reflective analysis of one, two, or three clinical cases. All clinical case reports submitted must have been approved by an ethics committee or institutional review board.
Austin Journal of Clinical Case Reports is an open access scholarly journal. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine. Case Reports is an open access journals. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine.
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2. Case Report
Liposarcoma of spermatic cord e A rare entity
Pravin Govardhane a
, Feroz Amir Zafar a
, Ishfaq A. Geelani a
, H. Girish a
,
D.V.S.L.N. Sharma a
, V. Rajagopal a,
*, Meenakshi Swain b
, G. Swarnalatha b
a
Department of Urology, Apollo Hospitals, Hyderabad, India
b
Department of Histopathology, Apollo Hospitals, Hyderabad, India
a r t i c l e i n f o
Article history:
Received 31 January 2013
Accepted 31 January 2013
Available online 6 February 2013
Keywords:
Liposarcoma
Spermatic cord tumors
Paratesticular liposarcoma
Myxoid liposarcoma
a b s t r a c t
Introduction and objective: Liposarcoma of the spermatic cord is a rare entity with only two
series and less than 100 cases reported in literature. We report a case of a giant liposarcoma
of the spermatic cord.
Case report: A 65-year old man presented with a 2-year history of a progressive painless
swelling in the right lower quadrant of the abdomen. He gave a past history of right
inguinal hernia repair and excision of a mass lesion of the spermatic cord 15 years back
(? nature; no HPE report available). Local examination revealed a large smooth solid mass
about 20 Â 12 cm in the right iliac fossa and pelvis, firm, non-tender and mobile from side
to side. Testes were normal. USG revealed a non-homogenous and hyper echoic. CECT
showed a 21 Â 11.2 cm well defined mass lesion with mixed densities (18 HU) and minimal
enhancement with contrast present in the right iliac fossa and pelvic region. On explora-
tion, a lipomatous mass was found arising from the inguinal portion of spermatic cord.
Radical orchiectomy with wide local excision was carried out. Histopathological exami-
nation of the resected specimen showed a well differentiated liposarcoma of the spermatic
cord (myxoid variant). Margins were negative. Patient was advised long-term follow up in
view of high recurrence rate.
Conclusion: Liposarcoma of the spermatic cord is rare. Surgical treatment is the manage-
ment of choice with Radical orchiectomy and wide local excision. Adjuvant radiation
should be given if margin status is in doubt. High incidence of local recurrence mandates
a long period of follow up.
Copyright ª 2013, Indraprastha Medical Corporation Ltd. All rights reserved.
1. Introduction
Malignant lesions of the spermatic cord are rare with only
around 100 cases reported in the world literature.1
Lip-
osarcoma of spermatic cord is a rare entity and only few cases
have been reported in literature.
Sarcomas of the spermatic cord, epididymis, and testis are
the most common genitourinary sarcomas in adults.
Liposarcoma is the most common histologic subtype in adults,
followed by rhabdomyosarcoma, leiomyoma, malignant
fibrous histiocytoma, and fibrosarcoma.2
Sarcomas are most often in the intrascrotal region and
primary mesenchymal tumors of the testis are uncommon.
These tumors usually present as a painless, palpable mass,
and most are large (>5 cm). Sarcomas should be managed
initially through an inguinal approach with wide excision of
* Corresponding author.
E-mail address: raja_urol@rediffmail.com (V. Rajagopal).
Available online at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/apme
a p o l l o m e d i c i n e 1 0 ( 2 0 1 3 ) 8 2 e8 4
0976-0016/$ e see front matter Copyright ª 2013, Indraprastha Medical Corporation Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.apme.2013.01.017
3. the spermatic cord and testis with high ligation.3
Lip-
osarcomas rarely metastasize but tend to recur locally.4
We report a case of a giant liposarcoma of the spermatic
cord.
2. Case report
A 65-year old man presented with a 2-year history of a pro-
gressive painless swelling in the right lower quadrant of the
abdomen. He gave a past history of right inguinal hernia repair
and excision of a mass lesion of the spermatic cord 15 years
back (? nature; no HPE report available).
Local examination revealed a large smooth solid mass
about 20 Â 12 cm in the right iliac fossa and pelvis, firm, non-
tender and mobile from side to side (Fig. 3). Testes were
normal.
Routine blood investigations were within normal limits.
USG revealed a non-homogenous and hyper echoic mass in
right iliac fossa.
CECT showed a 21 Â 11.2 cm well defined mass lesion with
mixed densities (18 HU) and minimal enhancement with
contrast present in the right iliac fossa and pelvic region (Figs.
1 and 2).
Inguinal exploration was done. We found a large lip-
omatous mass arising from the right inguinal cord (Fig. 4). We
performed a Radical orchiectomy with wide local excision.
Mass was sent for histopathological examination.
Histopathological examination of the resected specimen
showed a well differentiated liposarcoma of the spermatic
cord (myxoid variant) as shown in Figs. 5 and 6. Margins were
negative.
3. Discussion
Lesauvage reported the first case of sarcoma of spermatic cord
in 1845.5
Most patients present in their 50s or 60s in the form of
a slow-growing inguinal or inguino-scrotal mass and they can
be mistaken for inguinal hernia or lipoma and CT or MRI is
Fig. 1 e CECT pelvis showing mass in iliac fossa with
mixed density.
Fig. 2 e CECT of pelvis showing mass in iliac fossa with
minimal enhancement on contrast.
Fig. 3 e Mass in right lower abdomen.
Fig. 4 e Large tumor dissected through inguinal
exploration.
a p o l l o m e d i c i n e 1 0 ( 2 0 1 3 ) 8 2 e8 4 83
4. helpful to distinguish between these entities. Embryonal
rhabdomyosarcoma is the most common histologic subtype
in men younger than age 30.3
A relatively higher incidence of this cancer has been
reported in Japanese men (nearly one-fourth of the reported
cases) but the cancer is known to occur all over the world.3
Liposarcoma accounts for 5e7% of paratesticular
sarcomas.2
Liposarcoma are further subdivided into 4 types, including
well differentiated, myxoid, round-cell, and pleomorphic.
Myxoid variety is the most common type and account for
about 50% of all liposarcomas.
Inguinal radical orchiectomy is the standard approach for
sarcomas of spermatic cord with wide resection margins.6
Some authors favor a hemiscrotectomy in addition to the
inguinal orchiectomy.7
Local recurrence can occur in upto 50% patients.8
Since negative margin status can rarely be ensured, some
authors recommend adjuvant radiation9
although the efficacy
of this approach is debated. The long-term survival of men
with paratesticular sarcoma is approximately 50%.
4. Conclusion
Liposarcoma of the spermatic cord is rare
Surgical treatment is the management of choice with Rad-
ical orchiectomy and wide local excision
Adjuvant radiation should be given if margin status is in
doubt10
High incidence of local recurrence mandates a long period of
follow up
This is perhaps a recurrent liposarcoma of the spermatic
cord
Conflicts of interest
All authors have none to declare.
r e f e r e n c e s
1. Chintamani, et al. Liposarcoma of the spermatic cord:
a diagnostic dilemma. JRSM Short Rep. 2010 November;1(6):49.
2. Stephenson Andrew J, Gilligan Timothy D. Tumors of Testis. In:
Campbell-Walsh Urology. 2010;31:869e870.
3. Coleman J, Brennan MF, Alektiar K, et al. Adult spermatic cord
sarcomas: management and results. Ann Surg Oncol.
2003;10:669e675.
4. Montgomery E, Fisher C. Paratesticular liposarcoma:
a clinicopathologic study. Am J Surg Pathol. 2003;27:40e47.
5. Hinman F, Gibson TE. Tumor of the epididymis, spermatic
cord and testicular tunics: a review of literature and report of
three new cases. Arch Surg. 1924;8:100.
6. Wilson N, Davis A, Bell R, Wilson AN, Davis A, Bell RS. Local
control of soft tissue sarcoma of the extremity: the
experience of a multidisciplinary sarcoma group with
definitive surgery and radiotherapy. Eur J Cancer. 1994;30:746.
7. Blitzer PH, Dosoretz DE, Proppe KH. Treatment of malignant
tumors of the spermatic cord: a study of 10 cases and review
of literature. J Urol. 1981;126:611e614.
8. Pisters PW, Leung DH, Woodruff J. Analysis of prognostic
factors in patients with localized soft tissue sarcomas. J Clin
Oncol. 1996;14:1679.
9. Ballo MT, Zagars GK, Pisters PW. Spermatic cord sarcomas:
outcome, patterns of failure and management. J Urol.
2001;166:1306e1310.
10. Fagundes MA, Zietman AL, Althausen AF. The management
of spermatic cord sarcoma. Cancer. 1996;77:1873.
Fig. 5 e Histopathological pictures of well defined
liposarcoma of spermatic cord (myxoid variant).
Fig. 6 e Histopathological pictures of well defined
liposarcoma of spermatic cord (myxoid variant).
a p o l l o m e d i c i n e 1 0 ( 2 0 1 3 ) 8 2 e8 484