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Biomedical subjects

J Pusel

Publications and source records attributed to J Pusel.

At least 19 recordsLinked to original sources
PubMed1993

Influence of mastectomy techniques on estrogen and progesterone receptor analysis in carcinoma of the breast.

Gradual tumor tissue devascularization during mastectomy is thought to decrease estrogen (ER) and progesterone (PgR) receptor activity. To determine whether or not hormone receptor values could be influenced by different mastectomy techniques, 62 patients with carcinoma of the breast had a Tru-cut needle (Baxter Healthcare Corporation) biopsy (premastectomy sample) and underwent modified radical mastectomy (postmastectomy sample) either before (group 1, 40 patients) or after (group 2, 22 patients) axillary lymph node dissection. When the two surgical procedures were compared in 33 patients in whom it could be assessed, no significant tendency (p = 0.51 for ER and p = 0.36 for PgR) for the postmastectomy sample to have hormone receptors levels less than samples taken at biopsy was detected. Overall, in the two groups (44 assessable patients), comparison with respect of each patient, between premastectomy and postmastectomy samples showed that the variations in either ER or PgR receptor values, determined by immunoenzymatic assays, were not statistically significant (p = 0.32 for ER and p = 0.21 for PgR). The current results indicated the relative stability of steroid receptors during the two modified radical mastectomy procedures and suggested that a systematic reference determination of hormone receptors on biopsy before modified radical mastectomy is unnecessary.

Aged↗
PubMed1993

[Insular carcinoma of the thyroid. Apropos of a case and review of the literature].

We present a new case report of "Insular" thyroid carcinoma. The first series was published, in 1984, by Carcangiu et al. The propensity for local recurrence and early distant metastases explains the poor prognosis of this carcinoma and demands aggressive therapy at the time of diagnosis. This includes radical surgery, radiotherapy with possible chemotherapy. Clinical and pathological arguments suggest that this carcinoma could be an intermediate stage in the process of loss of differentiation of some thyroid neoplasms.

Carcinoma↗
PubMed1993

[Malignant hemangioendothelioma of the thyroid. Pathologic study of a case].

The authors report a case of malignant tumor of the thyroid in a 79 years old woman with a long standing goiter for 20 years but who did not live in endemic mountainous goiter area. The right lobe of the thyroid was surgically removed in February 1992 because increasing in size. Pathologic diagnosis was non malignant cystic lesion. Two months later, a recurrence with dyspnea urged a tracheostomy. The patient died 9 days later because of intra bronchial and pleura hemorrhage. The morphological and immuno-histochemical investigations showed angiosarcomatous features and positive reactivity with Factor VIII and UEA 1 markers in the tumour and pulmonary metastases. The diagnosis of Malignant hemangio-endothelioma was concluded.

Aged↗
PubMed1992

[Primary and secondary carcinomas of the thyroid gland with systematic discovery. Apropos of hundred thyroid glands removed at autopsies and review of the literature].

One hundred thyroids from autopsies performed in a Cancer Center were sectioned at 4 mm intervals. Each slice was processed to obtain one or several sections for histologic examination. Five primary microcarcinomas and ten secondary clinically unknown carcinomas were found. This study and the review of the literature confirm that the high prevalence rate of microcarcinomas, most of them papillary, in autopsies does not agree with the clinically diagnosed carcinoma rate. Tumors greater than 5 mm in diameter may sometimes be aggressive. Intrathyroid metastases are relatively frequent in cancerous dissemination observed in autopsies, but raise problems when they precede the primary tumor or are revealed on surgical samples a long time after because of a slow development. The authors emphasize the importance of differential diagnosis between primary and secondary tumors and the value of immunohistochemistry for histological diagnosis.

Adult↗
PubMed1991

[The value of peritoneal cytology in invasive uterine cancers. Analysis of 80 cases].

When they analysed 80 cancers of the uterus, the authors showed how valuable it was both for diagnosis and prognosis to carry out cytological lavage of the peritoneum, particularly in cases of endometrial adenocarcinoma. The results of this study are compared with recent extracts appearing in the international literature. This technique makes it possible to identify groups of patients of high risk for recurrences in the pelvis and abdomen who would benefit from adjuvant therapies, demonstrating that this technique is applicable to the diagnosis of gynaecological cancers with intraperitoneal spread which have long been failed to be recognised. The procedure is innocuous and simple and therefore should be carried out widely in the management of uterine cancers.

Adenocarcinoma↗
PubMed1990

[Extra-skeletal Ewing's sarcoma. A case report with detailed review of the literature].

Extra-skeletal Ewing's Sarcoma (EES): a clinico-pathological entity described in 1975 by L. Angervall and F.M. Enzinger. This article reports a new case in which the primary was localized in the right forearm and metastasized to the left lung fourteen years later. A detailed review of the literature emphasized similarities and differences between osseous and extra-osseous Ewing's Sarcoma.

Bone Neoplasms↗
PubMed1990

[Gastric teratoma in newborn children].

In neonates, teratomas infrequently involve the abdomen: among 51 known cases, 39 were gastric teratomas, which account for less than 2% of all germ cell tumors in the neonatal period. Associated malformations are minor, located in the region of the tumor, and apparently less frequent than in other sites. Malignancy is exceedingly rare (a single case) and well controlled as a result of the anti-tumor processes specific to the neonatal period. Gastric teratomas are diagnosed early and can be cured by tumorectomy removing a thin ring of the surrounding stomach wall.

Humans↗
PubMed1990

[Thyroid microcarcinoma with a fatal outcome and 34 other unusually aggressive cases reported in the literature].

A follicular thyroid microcarcinoma was revealed by scapular metastases. Despite treatment, other metastases were the cause of death after a course of 14 years. In the medical literature there are at least thirty-four other examples of follicular or papillary carcinoma of less than 15 mm (previously called occult) that have either given rise to blood-born metastases or have been the cause of death. Present data from light and electron microscopy, immunohistochemistry and microspectrophotometry cannot differentiate between small and large carcinomas. Microcarcinomas (particularly papillary ones) are frequent in the general population and are found in 5% of thyroids. They are usually not aggressive. Those which show vascular or capsular invasion, a lack of lymphoid infiltrate and large cervical lymph node metastases are more likely to have an unfavorable course. The discovery of a microcarcinoma in a thyroid cells for an extended follow-up.

Adenocarcinoma↗
PubMed1990

[Thyroid function after thyroidectomy for benign goiter. 200 cases explored by ultrasensitive TSH].

Based on a retrospective study of a series of 200 thyroidectomies for benign goitre and a mean follow up period of 12 Months, the authors analysed post-operative thyroid function and correlated it with the degree of surgical excision (47 unilateral lobectomies, 91 classical subtotal bilateral lobectomies and 62 extended bilateral subtotal lobectomies). After a presentation of the results in comparison with data from the literature, the timing and threshold for the institution of replacement therapy are examined and the need for prolonged clinical and laboratory monitoring is also stressed. In terms of changes in laboratory criteria only monitoring of spontaneous changes in US TSH allows opotherapy to be avoided or conversely to accurately define the conditions for institution of definitive replacement therapy. The justification of total thyroidectomy in the treatment of multihetoronodular goitres almost totally involving the glandular parenchyma is acknowledged.

Adolescent↗
PubMed1989

[Gastric metastases of cancer of the breast. Apropos of a case. Review of the literature].

Since they are rare and often latent, gastric metastases from breast cancer, principally lobular, are difficult to diagnose particularly at the isolated stage. The primitive and non specific nature of their symptomatology and the negativity of endoscopic biopsies should lead to early explorative laparotomy. Surgery is often palliative to reduce tumor load and seldom involves complete excision, and can only hope to obtain prolonged survival if followed by chemotherapy, hormone therapy or indeed radiotherapy. Following a recent personal case a review of the worldwide literature was carried out and the principal pathogenic hypotheses were analysed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Hürthle cell tumor of the thyroid gland. Analysis of a series of 33 cases].

Hurthle cell or oxyphil cell tumours of the thyroid, which consist of large cells with eosinophilic granular cytoplasm, rich in mitochondria, have given rise to much controversy in recent years. Difficulty in histological diagnosis (benign or malignant), unexpected evolution, and the possibility of very late recurrence and metastasis occurring in cases which were previously labelled benign, characterise these ambiguous tumours. Their malignant forms are most often classified with vesicular cancers of the thyroid. They differ from the latter by the frequent presence of lymphatic metastases, the lack of effect of I 131 on distant metastases and their poorer prognosis. The experience of the authors is based upon a series of 33 cases of Hurthle cell tumours of the thyroid treated surgically (27 benign, 6 malignant), with a mean age of 44 years for benign lesions and 50 years for cancers (range 17 to 69 years) showing a clear female predominance (66% of cases). They most often presented clinically as a cold thyroid nodule which tended to be larger in the case of cancers (5 out of 6 cases had a diameter of more than 5 cm). The limits of resection were most often dictated by the results of per-operative frozen section: total lobectomy + isthmectomy for benign tumours and total thyroidectomy if macroscopic or histological signs of malignancy were present (spread beyond the capsule, vascular invasion, lymphatic metastases), with cervical node clearance if N+. The 27 cases who underwent surgery for benign tumours have survived (1 single local recurrence after 7 years, without any malignant progression and a median survival of 7 years). No deaths have occurred among the 6 cases of malignant tumours (follow-up ranging from 1 to 9 years, median 5.4 years) but a present metastases. A study of the series published in the literature confirms the difficulty with diagnosis in terms of the benign or malignant nature of the tumours. It also stresses the justification for relatively aggressive surgery on the thyroid parenchyma and the need for a very long period of locoregional and general surveillance in order to assess the results of treatment. Survival rates for malignant forms range from 60 to 65% at 10 years and from 25 to 47% at 15 years.

Adenoma↗
PubMed1989

[Primary or secondary malignant tumors of tonsillar cysts. Apropos of a case of occult papillary cancer of the thyroid disclosed by intracystic metastasis].

The development of a malignant process within a tonsillar cyst is controversial. This phenomenon is exceptionally rare, at present only three cases which have been compatible with anatomo-clinical diagnostic criteria have been clearly established. Based on an original case showing a secondary papillary thyroid cancer in a tonsillar cyst, the authors analyse, in the light of recent data from worldwide literature, the various stages in the diagnostic process in both primary and secondary malignant tumours. The therapeutic and prognostic aspects of the two tumour varieties are also discussed.

Adult↗
PubMed1988

[Secondary cardiac localizations in different cancers. Comparison of clinical, electrocardiographic and autopsy data. Apropos of 51 cases].

The authors have investigated 910 post-mortem examinations of different primary cancers. Fifty-one cases (5.6% of the autopsies) presented cancer lesions of the heart. They have found the accuracy of clinical and paraclinical diagnostics by comparing them with autopsy findings in case of pericardial lesions, but very rarely in case of myocardial location.

Arrhythmias, Cardiac↗
PubMed1988

[190 cancers of the thyroid with a follow-up of more than 5 years].

Outcome in 190 patients operated upon by first intention for thyroid cancer is analyzed after follow up over more than 5 years. No deaths due to cancer occurred in 57 cases of papillary cancer, but 7 cases presented pulmonary metastases, while the global-5-year survival rate in 63 cases of vesicular cancer (including 25% with preoperative metastases) was 60%. In the absence of preoperative metastases, ans if well differentiated forms are separated from moderately differentiated forms, the respective 5-year survivals were 88 and 45%. The 1-year survival rate for the 42 cases of anaplastic cancer was 15%, while the 5-year rate for 15 cases of medullary cancer was 80%.

Adult↗
PubMed1987

Characterization of cell types in human breast tumor primary cultures.

Primary cultures of cells from breast carcinomas were attempted in 74 cases. Growth was observed in 46 cases. Using immunochemical demonstration of keratin proteins (KER), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), three morphologically distinct cell populations were characterized and described. Two cell types (E- and E'-cells) were identified as epithelial by their positive staining for KER and EMA. The third type (F cells) displayed a negative staining for these two epithelial markers; they were considered as stromal cells (fibroblasts). More than 50% of the cultures consisted of pure epithelial cells. Positive CEA staining was observed only in KER- and EMA-positive cells. Out of the 30 cultures, 15 displayed positive staining for CEA. In 7 of these, 30-50% of cells displayed positive, diffuse staining for CEA. The other 8 cultures consisted of more than 50% CEA-positive cells. Strong and homogeneous positivity was restricted to the E-cells, while in the same cultures, E'-cells displayed heterogeneous and diffuse staining. Efficiency and value of this cell culture system are discussed, in comparison with other human breast tumor cell (HBTC) culture techniques. Identification of growing cells and cellular composition of primary cultures are emphasized.

Breast Neoplasms↗
PubMed1987

[Trophoblastic tumor of placental location or trophoblastic pseudotumor. Apropos of 2 cases. Review of the literature].

Two cases of trophoblastic tumor of placental site are reported, less than 30 such lesions being listed in the published literature. Identification of this tumor from among other trophoblastic lesions is facilitated by immunohistochemical and electron microscopy technics, and demonstration of histoprognostic and biologic criteria improves assessment of evolutory potential of this type of tumor and allows adaptation of therapy. Treatment at the localized stage requires early diagnosis and wide surgical excision, results of chemotherapy in metastatic forms being, inversely than with choriocarcinoma, very deceiving.

Adult↗
PubMed1986

[Giant cell lesions of the mandible: problems of differential diagnosis apropos of 3 cases of central giant cell reparative granuloma].

Three cases of central giant cell reparative granulomas of the mandible are reported. The first shows classic manifestations. The second illustrates the role of traumatism in the genesis of these lesions. The third highlights the effect of pregnancy in their growth. The bilateral character of the lesions in this last patient led us to evoke the diagnosis of hyperparathyroidism and cherubism. They were ultimately discarded. A diagnostic approach is proposed which takes into account the location of the lesion and the medical history of the patient. Both experimental data concerning the potential of the cells found in the ramus of the mandible in laboratory animals and notions which apply to the periodontal bone remodelling enable one to better understand and differentiate between the central giant cell reparative granuloma and the genuine cell tumor of the mandible.

Adolescent↗