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Biomedical subjects

R Caduff

Publications and source records attributed to R Caduff.

At least 19 recordsLinked to original sources

Late solitary bone metastasis of a primary pulmonary synovial sarcoma with SYT-SSX1 translocation type: case report with a long follow-up.

Primary synovial sarcoma outside its classical presentation in para-articular soft tissue of young patients is rare but regularly reported. One of the rarest primary locations is the lung. We describe a 73-year-old female patient who presented with a solitary malignant bone tumor 8 years after the resection of a lung neoplasm. The bone tumor was classified as an osteosarcoma and the lung tumor as an atypical carcinoid tumor at their first respective diagnostic work-ups. The resection of the affected humerus with allograft and endoprosthesis implantation followed. Reevaluation of the tumor samples at the time of the local recurrence of the bone tumor 6 years following the initial symptoms of the bone tumor lead to the reclassification of both specimens as synovial sarcomas. Both neoplasms contained the SYT-SSX1 type of the diagnostic translocation t(X;18) as detected by the reverse-transcription polymerase chain reaction analysis. The patient died 14 years after the resection of the primary synovial sarcoma of the lung and 6 years following the occurrence of the bone metastasis. This prolonged clinical course is uncommon for the SYT-SSX1 translocation, which, in other locations, is usually associated with an unfavorable prognosis.

Aged↗

[Vaginal granulocytic sarcoma: CT and MR imaging].

A 30-year-old female patient with vaginal bleeding was referred to the gynecological unit of our hospital. Speculum examination showed a lobulated tumor, 5 cm in size, at the vaginal fornix. MRI demonstrated a tumor encompassing the ventral part of the vagina and the entire cervix. Computed tomography diagnosed pathologically enlarged mediastinal lymph nodes. Subsequent examinations revealed an acute myeloic leukemia, synchronous histopathological examination of the vaginal tumor led to the rare diagnosis of a granulocytic sarcoma.

Adult↗

Prognostic and predictive significance of ErbB-2 breast tumor levels measured by enzyme immunoassay.

PURPOSE: A retrospective analysis to assess the prognostic and predictive clinical value of breast tumor ErbB-2 receptor expression quantified by enzyme immunoassay (EIA), to compare levels measured by EIA with ErbB-2 status determined by immunohistochemistry (IHC), and to correlate receptor content with levels of phosphorylated (Y1248-P) ErbB-2, a measure of functional tyrosine kinase activity. MATERIALS AND METHODS: EIA quantification of ErbB-2 was performed on membrane extracts from 3,208 well-characterized primary breast cancers. Overall, relapse-free, distant disease-free, and local/regional-free patient survival data were available on 1,123 of these tumors. IHC scoring for ErbB-2 status (HercepTest; DAKO, Glostrup, Denmark) was performed on adjacent sections of 151 cases, and receptor functionality was measured in 230 tumors by an antibody specific for phosphorylated (Y1248-P) ErbB-2. RESULTS: Unlike nonmalignant breast tissues, breast tumors showed increased ErbB-2 levels in a bimodal distribution, with 12% constituting a distinct set of ErbB-2-overexpressing tumors. The intermodal threshold value for ErbB-2 overexpression distinguished tumors with reduced estrogen and progesterone receptor content, high IHC score for ErbB-2, and significantly increased levels of phosphorylated (Y1248-P) ErbB-2 receptor. By multivariate analysis, EIA-determined ErbB-2 overexpression predicted significantly reduced patient survival that was unaffected by tamoxifen or cyclophosphamide, methotrexate, and fluorouracil adjuvant therapy. CONCLUSION: Determination of ErbB-2 receptor expression by EIA offers a clinically valuable alternative to semiquantitative IHC assessment of breast tumor ErbB-2 overexpression and affords the opportunity to evaluate ErbB-2 phosphorylation, which may represent an important predictive parameter of receptor functionality.

Adult↗

Clustered microcalcification following breast implant removal mimicking malignancy.

On mammography, clustered microcalcification can be an early and sensitive sign of malignancy, although it is also commonly seen in benign alterations of the breast. We report on a 52-year-old woman with mammographically suspicious granular calcification as a late result of a short-term silicone augmentation. Plain film, surgical, and histopathological features are demonstrated.

Breast Diseases↗

Pleomorphic lobular carcinoma of the breast: its cell kinetics, expression of oncogenes and tumour suppressor genes compared with invasive ductal carcinomas and classical infiltrating lobular carcinomas.

AIMS: The study addresses whether pleomorphic lobular breast carcinomas represent a distinct entity with respect to proliferation and apoptosis as well the expression of the p53, bcl-2 and Her2 protein. METHODS AND RESULTS: The study included 30 cases of pleomorphic lobular carcinoma (PLC; G2 n=15, G3 n=15). Poorly differentiated invasive ductal carcinomas (IDC; n=15) and well-differentiated infiltrating lobular carcinomas (ILC; n=15) were used as controls. Lymph node metastases were present equally in all groups. MIB-1 labelling was counted as: PLC (G2) 8.36%; PLC (G3) 11.3%; IDC 44.26%; ILC 2.19% (P=0.0001, P=0.004, P=0.001). Apoptotic index was: PLC (G2) 0.82%; PLC (G3) 1.2%; IDC 2.09%; ILC 0.6% (P=0.009, P=0.001). Over-expression of Her2 protein was detected in 53% of PLC (G3) tumours and was present only in scattered cases in the other groups. PLCs and ILCs were strongly positive for bcl-2 and for hormone receptors, while p53+ cells were rare. IDCs exhibited a heterogeneous staining pattern for bcl-2 and for hormone receptors, while p53+ cells occurred considerably more frequently. Stage could not be linked directly to proliferation or apoptosis. CONCLUSION: Our data suggest that more frequent over-expression of Her2 among PLCs (G3) as well as the generally low apoptosis can contribute to their aggressive behaviour.

Adult↗

Comparative genomic hybridization of fine needle aspirates from breast carcinomas.

Detailed knowledge of chromosomal aberrations in a specific tumor may facilitate the development of individually tailored chemotherapy, hormone or gene therapy. Unfortunately, karyotype analysis requires living cells and is complicated by the low number of good metaphase spreads obtained. Comparative genomic hybridization (CGH), however, is capable of detecting and mapping genome-wide amplifications and deletions using an equimolar mixture of normal and tumor cell DNA. We show here that even the few cells from a fine needle aspirate of a tumor are sufficient for a direct CGH assay, independent of DNA amplification. Ten primary breast cancers were analyzed by CGH. A fresh frozen fine needle aspirate and a formalin-fixed and paraffin-embedded section were used for each tumor. Metaphases from each CGH reaction were imaged, and a sum ratio profile was determined for every chromosome. The ratio profiles of DNA isolated from the 2 material sources were then compared. Fine needle aspirates and the paraffin-embedded material of a single tumor yielded the same fluorescence ratio profiles, albeit with slightly different confidence intervals. Different tumors showed a variety of aberrations. The most frequently observed changes were 1q+, 8q+, 14q-, 16p+, 16q-, 17p-, 17q+, 19q+, 20q+, 21q- and 22q-. The ability of CGH to assess chromosomal changes in breast cancer from fine needle aspirates could facilitate genetic evaluation of tumors prior to surgery.

Adult↗

[Breast imaging after augmentation with homologous adipose tissue implant].

The implantation of cadaveric fat for breast augmentation, which has been performed up to the Seventies, is nowadays considered obsolete. Since complications frequently arise many years later, we are, however, occasionally confronted with the problematic consequences of the technique. The present case report describes the clinical, mammographic and for the first time to our knowledge MR-mammographic findings of a mammoplasty with cadaveric fat in a 57-year-old patient with a history of breast cancer.

Adipose Tissue↗

Sebaceous carcinoma of the breast.

We report on a rare distinctive variant of infiltrating ductal carcinoma characterized by sebaceous differentiation of tumor cells. The neoplasm was identified in a lumpectomy specimen from a 45-year-old woman with extensive metastatic disease. In addition to conventional in situ and invasive ductal components, approximately half of the tumor cells exhibited a phenotype resembling tumors of the sebaceous skin appendage with coarsely vacuolated cytoplasm and peripherally displaced nuclei. The sebaceous moiety was also present in the distant metastatic deposits. There was no evidence of mucin production by tumor cells. Ultrastructurally, empty-appearing non-membrane bound vacuoles attested to the sebaceous cells' lipid content. The immunoprofile of the lesion included positivity for cytokeratin and epithelial membrane antigen. Vimentin, S100 protein and carcinoembryonic antigen were not expressed. Most tumor cell nuclei reacted with antibodies to oestrogen and progesterone receptors but failed to show overexpression of the HER2/neu protein. The MIB-1 labeling index averaged 16%. At variance with sebaceous breast carcinomas on record, the present case is notable for its prolonged clinical course.

Adenocarcinoma, Sebaceous↗

[Ultrasound-guided biopsy of non-palpable breast lesions: correlation with the results of fine-needle aspiration biopsy].

PURPOSE: The purpose of this study was the clinical evaluation of ultrasound-guided biopsy in comparison with ultrasound-guided fine-needle aspiration biopsy of identical, non-palpable breast lesions. MATERIALS AND METHODS: From August 1997 until July 1998, 73 ultrasound-guided biopsies were performed in 66 patients with non-palpable lesions of the breast. In 18 patients (age 33-77 years) with 20 non-palpable lesions, fine-needle aspiration biopsy (20-G needle) and biopsy (18-G biopsy needle) were performed on a single occasion. This was the patient selection of our retrospective study. RESULTS: One malignant neoplasm was found among the 20 biopsied lesions, while the remaining 19 lesions were of a benign nature. In 20% of the cases, the material obtained by fine-needle biopsy was not sufficient for a cytologic diagnosis, while biopsy allowed a diagnosis in 19/20 cases. No complications were observed. CONCLUSIONS: Ultrasound-guided biopsy using an 18-G needle is a suitable method for the evaluation of non-palpable lesions that are only visible on ultrasound. It represents an attractive alternative to fine-needle aspiration in the absence of experienced cytologic diagnosticians.

Adult↗

[Krukenberg syndrome in metastatic gallbladder adenocarcinoma with unknown primary tumor].

The casuistic describes a female patient, in whom a metastatic adenocarcinoma of the ovary was diagnosed 3 years after cholecystectomy due to cholecystolithiasis, which was compatible with metastases of a carcinoma of the gallbladder or the bile ducts. While clinical and imaging results suggested a primary ovarian carcinoma with inapparent primary tumor, the final diagnosis was obtained on the basis of histological findings. The case demonstrates that an ovarian metastasis can simulate a primary tumor according to clinical and imaging results. This fact can be of serious therapeutic consequences for the respective patient. Therefore, in the presence of a clinically inapparent primary tumor, the differential diagnosis of unclear ovarian masses should include metastatic adenocarcinoma in addition to primary ovarian carcinoma and other ovarian lesions.

Adenocarcinoma↗

Glycogen-rich carcinomas of the breast display unique characteristics with respect to proliferation and the frequency of oligonucleosomal fragments.

We determined the proliferation rate and apoptotic activity of glycogen-rich carcinomas of the breast as opposed to non-clear cell tumors by means of MIB-1 immunohistochemistry and in situ detection of oligonucleosomal fragments (TUNEL reaction). The retrospective biopsy series included six invasive clear cell carcinomas of the glycogen-rich type as well as 15 randomly selected cases of invasive ductal carcinoma without evidence of glycogen storage. Three patients in the clear cell group and seven patients in the control cohort developed lymph-node metastasis. The MIB-1 labeling index of glycogen-rich carcinomas averaged 9.05%, while that of the controls was 30.03%. Apoptotic nuclei were present in a mean of 1.26% of glycogen-rich carcinoma cells. The control tumors exhibited an average apoptotic frequency of 5.85%. Tumor size, hormone receptor status, and presence or absence of lymph node involvement were found not to correlate with either proliferation or apoptosis. We conclude that glycogen-rich breast carcinomas are characterized by a peculiar 'low proliferation-low apoptosis' cell kinetic profile. The aggressive clinical behavior of these neoplasms may possibly be accounted for by an ineffective apoptotic elimination of otherwise slowly proliferating tumor cells.

Adenocarcinoma, Clear Cell↗

[Megacolon and megarectum in adults. Abdominal proctectomy with colo-anal anastomosis].

Severe constipation in adults with megarectum may be a manifestation of Hirschsprung's disease or idiopathic megarectum. The differential diagnosis is discussed in the light of two case histories. Total abdominal proctectomy with coloanal anastomosis eliminated the aganglionic rectal segment in Hirschsprung's disease and the adynamic distal colorectum of idiopathic megarectum respectively. The surgical and functional results of a hand-sewn transanal end-to-end-anastomosis were excellent in both patients.

Adult↗

Metaplastic lipid-rich carcinoma of the breast.

A case of lipid-rich mammary carcinoma identified in a lumpectomy specimen from a 56-year-old female is presented. The tumor showed features of poorly differentiated invasive ductal carcinoma of clear-cell phenotype. Cytoplasmic lucency was mainly accounted for by the accumulation of neutral fat and, to a lesser degree, glycogen. Tinctorial properties included positivity of tumor cells with Sudan III dye and diastase-sensitive periodic acid-Schiff staining. Ultrastructural examination confirmed the presence of abundant cytoplasmic lipid droplets and some glycogen rosettes. On immunohistochemistry, most tumor cells reacted for cytokeratin, vimentin and S-100 protein, and there was focal expression of carcinoembryogenic antigen. A minority of tumor cell nuclei expressed progesterone receptors. As an additional feature, part of the lesion exhibited chondroid metaplasia. Lipid-rich carcinoma of the breast is exceedingly rare and, to our knowledge, no such example harboring metaplastic elements has been described previously.

Biopsy, Needle↗

[Ovarian metastasis of extragenital tumors at the Zurich University Gynecologic Clinic 1978-1990].

37 cases of extragenital tumours metastatic to the ovaries are analysed from a clinicopathological viewpoint. In 25 out of 334 patients who were operated on between 1978 and 1990 because of a palpable malignant ovarian tumour, ovarian involvement from extragenital cancer was diagnosed. The most frequent primary sites were the stomach (n = 7), colon (n = 6) and breast (n = 6). 4 of the 6 patients with metastatic colon carcinoma had previously documented diagnosis of colon cancer with a time interval between diagnosis of primary tumours and secondary ovarian tumour ranging up to 11 years. Only one patient had a previously known stomach cancer, operated on 32 months earlier. All our patients with gastrointestinal primary tumour died within 1 year (gastric origin) of detection of metastases and 2 years (colon carcinoma) except for one patient with metastasis of colon carcinoma, who is still living after more than 4 years and one patient with gastric carcinoma who survived 34 months after oophorectomy. Surprisingly, ovarian metastases of breast cancer were detected before the primary tumour in 2 out of 6 cases. The other 4 patients were operated on because of an ovarian tumour but had a known and previously operated breast cancer. 27 patients had therapeutic ovarian ablation in metastatic breast cancer without a palpable pelvic mass. None of these patients had symptoms related to the ovaries. In 12 (40%) patients we found microscopic metastases which were bilateral in 9 cases. Metastases to the ovary may not infrequently mimic primary ovarian tumour and are difficult to diagnose preoperatively. We hope that some clinical features described by us (nationality, patient's history, bilateral ovarian tumours in young women) will alert the clinician to investigate further in order to achieve the best possible therapeutic management, because some patients may benefit from adequate treatment and survive for a long time.

Adult↗