Granular cell myoblastoma of larynx with papillary adenocarcinoma of thyroid.
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Only five granular cell myoblastomas affecting the cervical trachea have been previously reported. Two of these tumors appear to be primary lesions of the trachea, while the remaining three appear to involve it only secondarily. We report a case of an intraluminal granular cell myoblastoma arising from the right tracheal wall in a 45-year-old woman. The tumor extended into the partition wall between trachea and esophagus. Treatment was by surgical excision of the tumor and the involved tracheal ring. The patient was free of recurrence one year after treatment.
OBJECTIVE: To compare computed tomography (CT) with open neck exploration in determining prevertebral invasion by squamous cell carcinoma of the oropharynx or hypopharynx. DESIGN: Retrospective analysis using the findings at open neck exploration and results of histopathologic studies as the criterion standards. SETTING: Tertiary care referral center. PATIENTS: Twenty-nine of 40 patients with advanced squamous cell carcinoma of the oropharynx or hypopharynx treated between January 1, 1986, and December 31, 1994, were selected for analysis based on CT findings of posterolateral extension of the primary tumor placing the prevertebral muscle (PVM) at risk. All study patients had no previous therapy and underwent neck exploration to determine resectability. RESULTS: Overall accuracy of CT in predicting PVM status was 55.2%. The sensitivity of preoperative CT for PVM invasion was 50%; the specificity was 61%. Using an estimate of 21% for the prevalence of PVM invasion, the predictive value of a positive CT scan was 0.254 and the predictive value of a negative CT scan was 0.821. Open neck exploration correctly predicted PVM status in all cases. CONCLUSIONS: Open neck exploration is superior to CT to evaluate possible PVM invasion by squamous cell carcinoma of the oropharynx or hypopharynx. The predictive value of a negative CT scan for PVM invasion is high, so it may be useful in treatment planning. Patients with advanced squamous cell carcinoma of the oropharynx or hypopharynx at risk for PVM invasion who are otherwise surgical candidates should be considered for open neck exploration to determine resectability most accurately.
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Two cases of plexiform tumor of the uterus are presented. Both were incidental microscopic findings in leiomyomatous uteri and had the typical branching cords of small, polygonal cells with scanty cytoplasm and vesicular nuclei. Ultrastructurally the cells had features of smooth muscle differentiation such as actin-like filaments, dense bodies, peripheral dense plaques, pinocytotic vesicles, and incomplete basal lamina. Their close relationship to capillaries resembled the structure of glomus tumor and vascular leiomyoma and suggested histogenetic kinship among these neoplasms.
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Inflammatory myofibroblastic tumors are lesions that most often affect young adults and children. These tumors have been found in numerous extrapulmonary sites but rarely in the stomach. It is unknown whether this process is reactive or neoplastic. They are infiltrative lesions and often extend through the gastric wall, sometimes reaching adjacent organs including the esophagus, duodenum, peritoneal cavity, spleen. pancreas, and liver. These features mimic malignancy on endoscopy and radiology. We report the ultrasound, color Doppler ultrasound, and helical computed tomographic findings of a gastric inflammatory myofibroblastic tumor with peritoneal dissemination in a young adult. To our knowledge, this is the first report of color Doppler ultrasound and helical computed tomographic findings of this rare disease entity.
Inflammatory myofibroblastic tumors are lesions that usually affect young adults and children. Numerous extrapulmonary sites of these tumors have been found, but the mesentery is a very unusual location for an inflammatory myofibroblastic tumor and it is extremely rare in an older patient. Inflammatory myofibroblastic tumor of the mesentery is often demonstrated as a large and infiltrative lesion with heterogeneous enhancement. Its diagnosis is recognized as difficult and it often mimics malignant tumor. We report a case of mesenteric inflammatory myofibroblastic tumor mimicking a necrotized malignant mass in a 55-year-old man who was examined with magnetic resonance imaging. To our knowledge, this is the first report of magnetic resonance imaging of mesenteric inflammatory myofibroblastic tumor with extensive central necrosis in an older patient.