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1
Alvegård, T. A., and N. O. Berg. "Histopathology peer review of high-grade soft tissue sarcoma: the Scandinavian Sarcoma Group experience." Journal of Clinical Oncology 7, no. 12 (1989): 1845–51. http://dx.doi.org/10.1200/jco.1989.7.12.1845.
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From 1981 to 1986, a total of 240 patients with a primary soft tissue sarcoma with malignancy grade III or IV were entered into an adjuvant chemotherapy multicenter trial conducted by the Scandinavian Sarcoma Group (SSG). Histopathologic peer review of all the specimens was performed by an expert pathology committee. The most common soft tissue sarcoma after review was malignant fibrous histiocytoma (MFH) (40%), followed by synovial sarcoma (15%), leiomyosarcoma (9%), liposarcoma (8%), and malignant Schwannoma (6%). In 25% of the cases the histologic type of sarcoma was reclassified, and in 40% of the cases the malignancy grade was changed. By survival analyses, the reclassification of malignancy grade seemed to be valid. Also, grading highly malignant soft tissue sarcoma in two grades (III and IV) increased the prognostic information. Of 164 tumors from the centers with the most reported cases (five centers with 25 to 51 tumors each), eight tumors were found to be ineligible for the adjuvant study (5%); of 76 tumors from 13 centers with few tumors (one to 16 tumors per center), 12 tumors were ineligible (16%). We conclude that histologic peer review is important in studies of soft tissue sarcoma.
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Liang, Yuanxin, Robert S. Heller, Julian K. Wu, Carl B. Heilman, Arthur S. Tischler, and Knarik Arkun. "High p16 Expression Is Associated with Malignancy and Shorter Disease-Free Survival Time in Solitary Fibrous Tumor/Hemangiopericytoma." Journal of Neurological Surgery Part B: Skull Base 80, no. 03 (2018): 232–38. http://dx.doi.org/10.1055/s-0038-1669419.
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Objective Solitary fibrous tumors (SFT) and hemangiopericytomas (HPC) are now classified along a single spectrum of fibroblastic mesenchymal tumors with NAB2–STAT6 fusion. This fusion acts as a driver mutation that constitutively activates EGR1, which is known to be involved in the p16 pathway. Overexpression of p16 is associated with malignancy and worse prognosis in multiple mesenchymal tumors. The authors sought to investigate p16 immunoexpression in association with malignancy and prognosis of SFT/HPC tumors. Design Twenty-three SFT/HPC tumors (central nervous system [CNS]: 12, non CNS: 11) diagnosed at our institution from 2002 to 2016 were assigned into 3 grades. Data from microarray immunohistochemistry for STAT6, synaptophysin, CD56, chromogranin, SST2A, EGR1, Ki67, and p16, grade and survival were analyzed. Results CNS SFT/HPCs tend to be malignant (grade 3; 67 vs. 18%, p = 0.036) and more likely to express synaptophysin (33 vs. 0%, p = 0.035) than non CNS tumors. Overexpression of p16 (immunopositivity ≥ 50% tumor cells) was associated with malignant (grade 3) tumors, and has a sensitivity of 70% (7/10), and a specificity of 77% (10/13), as a predictive marker for malignancy. SFT/HPC patients with low p16 expression demonstrated significantly longer disease-free survival time (median survival > 113 months) than those with high p16 expression (median survival = 30 months, p = 0.045). Conclusions SFT/HPCs in the CNS are more likely to be malignant than the tumors in other sites. High p16 expression is also associated with malignancy and shorter disease-free survival time in SFT/HPC tumors in our study cohort. Clinically, p16 overexpression can be used as predictive marker for malignancy and prognosis and a possible therapeutic target.
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Paul, Prasad, Karatparambil Abid Ali, and Mohammed Jasir. "Predictors of malignancy in solitary nodule thyroid." International Surgery Journal 4, no. 2 (2017): 703. http://dx.doi.org/10.18203/2349-2902.isj20170217.
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Background: Solitary nodule thyroid is one of the common surgical problems and incidence of malignancy is also high compared to multinodular goiter. If you can avoid aggressive surgery in benign cases, we can reduce the occurrence of complications. So it’s important to look for the malignant predictors. The aim of the study was to evaluate the malignant predictors in solitary nodule thyroid.Methods: Total of 80 patients with solitary thyroid nodule were included in prospective study. The study was done from January 2015 to January 2016.Results: Most of the malignant cases are occurring in females’ middle age group. Most common one found to be papillary. Experienced radiologist can clearly detect malignancy preoperatively. Most common finding in USS is solid internal architecture.Conclusions: Solitary thyroid nodule is a common problem encountered in the surgical department and it has got a high malignant potential.
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Black, Keith L., Randall A. Hawkins, Kenneth T. Kim, Donald P. Becker, Carole Lerner, and Donna Marciano. "Use of thallium-201 SPECT to quantitate malignancy grade of gliomas." Journal of Neurosurgery 71, no. 3 (1989): 342–46. http://dx.doi.org/10.3171/jns.1989.71.3.0342.
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✓ A quantitative preoperative technique using thallium-201 single-photon emission computerized tomography is described which predicts whether specific gliomas are of high- or low-grade malignancy. An index, based on the ratio of thallium uptake in the tumor versus the homologous contralateral brain, was calculated and compared with tumor histology. The index in 14 patients with low-grade malignant gliomas was 1.27 ± 0.40 in contrast to an index of 2.40 ± 0.61 in 11 patients with high-grade malignant gliomas (p < 0.0005). Whether gliomas were of low- or high-grade malignancy could be predicted with 89% accuracy using a threshold of 1.5. Low-grade gliomas with an index higher than 1.5 acted biologically more like high-grade tumors, and no tumor histologically classified as being of high-grade malignancy had an index lower than 1.7. This technique could help to reduce unrecognized sampling errors during needle biopsies of brain tumors, particularly of high-grade lesions classified in error as low-grade tumors due to inadequate biopsy material.
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Bhardwaj, Rajeev, and Rishabh Kumar Rana. "Exploring the Diagnostic Efficacy of Fine-Needle Aspiration Cytology in Thyroid Nodules ≥ 4 cm: Results from a Tertiary Health Care Center in Jharkhand." International Journal of Recent Surgical and Medical Sciences 4, no. 02 (2018): 054–56. http://dx.doi.org/10.1055/s-0038-1676561.
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Abstract Background Any nodules of the thyroid, ≥ 4 cm, are generally associated with false-negative results for malignancy on fine-needle aspiration cytology (FNAC), which generally are confirmed cases of malignancy after histopathologic examinations. Methods A retrospective hospital-based study was done in which data of patients having thyroid lesions ≥ 4 cm were reviewed. We checked the FNAC and histopathologic examination done on these lesions. Ultrasonography (USG)–guided aspiration records were also assessed. Sensitivity and specificity of FNAC for the detection of neoplastic or malignant lesions was determined. Results A total of 192 patients (57 female) were included in study. Preoperative fine-needle aspiration (FNA) biopsies were categorized as negative for malignancy (n = 183, 63%), suspicious (n = 6, 4%), and malignant (n = 4, 2%). Final pathology of nodule was found to be benign in 157 (81.35%) patients, whereas in 36 (18.65%) patients, nodules were found to be malignant. Conclusion In this study, we found the malignancy rate of thyroid nodules ≥ 4 cm to be similar to the accepted malignancy rate of smaller thyroid nodules. We missed 32 cases of malignancy on FNAC. Because of high incidence of thyroid malignancy, all nodules ≥ 4 cm must undergo histopathologic examination.
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Mahalingappa, Y. B., and H. S. Khalil. "Sinonasal malignancy: presentation and outcomes." Journal of Laryngology & Otology 128, no. 7 (2014): 654–57. http://dx.doi.org/10.1017/s0022215114001066.
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AbstractObjective:We wanted to identify the presentation, diagnostic work-up and treatment outcomes of patients with sinonasal malignancy at Derriford Hospital, Plymouth, UK and compare these with the European Position Paper on Endoscopic Management of Tumours of the Nose, Paranasal Sinuses and Skull Base.Materials and methods:This was a retrospective audit of all patients diagnosed with sinonasal malignancy over a five-year period. The clinical records and picture archiving and communications system data of the patients were reviewed.Results:Thirty patients with sinonasal malignancy were identified out of 570 head and neck cancer patients. The nasal cavity was the most common site for presentation, followed by the maxillary sinuses. Fifty per cent of patients had a squamous cell carcinoma and 27 per cent had a malignant melanoma. Half of the patients presented at stage IV of the cancer and 20 per cent at stage III. Thirty-seven per cent of patients underwent surgical management and only 20 per cent of the total patient group underwent endoscopic surgery. The mortality in our series was 30 per cent over the studied period.Conclusion:Late-stage presentation of sinonasal malignancy has resulted in increased patient mortality in our case series. Also, we found a high incidence of malignant melanoma with high recurrence and survival rates.
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Rorive, Sandrine, Nicky D'Haene, Caroline Fossion, et al. "Ultrasound-guided fine-needle aspiration of thyroid nodules: stratification of malignancy risk using follicular proliferation grading, clinical and ultrasonographic features." European Journal of Endocrinology 162, no. 6 (2010): 1107–15. http://dx.doi.org/10.1530/eje-09-1103.
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ObjectiveTo evaluate the diagnostic value of fine-needle aspiration (FNA) cytology and the additive contribution brought by clinical and ultrasound (US) features.MethodCytological and histological diagnoses were compared in a series of 924 patients who underwent US-guided FNA before surgery. We additionally developed a grading system for follicular proliferation (FP) FNA diagnosis, and investigated its impact on the malignancy risk as well as the additive contribution of clinical and US features by means of decision tree analysis.ResultsExcluding FP cases (n=395), our data demonstrated that strictly benign or malignant FNA diagnoses exhibit great concordance with benign or malignant histological diagnoses (97.8% accuracy). Our grading system that was applied to the 395 FP cases revealed that grades 1, 2 and 3 were associated with a 7.7, 17.7 and 45.7% incidence of malignancy respectively. Decision tree analysis resulted in a classification model which involved FP grade, patient's age, serum thyroglobulin level, nodule size and nodule uniqueness. This model identified a subgroup of patients with grade 1 FP nodules who were older than 50 years, and who had a higher risk of malignancy (17.9%). In addition, high serum thyroglobulin levels were associated with a very high malignancy risk (75.0%) for patients with grade 3 FP nodules. Finally, among grade 2 FP patients, unique and large nodules were associated with a high malignancy risk of 36.1%.ConclusionsThe integration of FP grade, clinical and US features allows the stratification of patients with FP cytology according to their risk of malignancy.
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Rai, Rojna, Pema Choden Bhutia, and Ugyen Tshomo. "Clinicopathological profile of adnexal masses presenting to a tertiary-care hospital in Bhutan." South Asian Journal of Cancer 08, no. 03 (2019): 168–72. http://dx.doi.org/10.4103/sajc.sajc_303_18.
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Abstract Context: Adnexal masses of ovarian origin are of growing concern due to high fatality associated with ovarian malignancy because they are diagnosed at advanced stage due to vague symptoms and absence of recommended screening tests. Aims: The aim was to study the prevalence of histopathologic types of adnexal masses in different age groups and to analyze the accuracy of preoperative evaluation in diagnosing ovarian malignancy. Settings and Design: This was a cross-sectional study carried out in the Department of Obstetrics and Gynecology of a tertiary care hospital in Bhutan with gynecologic-oncology services, from January to December 2017. Subjects and Methods: Women presenting with adnexal mass were evaluated and those meeting criteria were enrolled. They were evaluated preoperatively with complete history, examination, ultrasound, and tumor markers. Risk of malignancy index (RMI) was calculated for all patients. Following surgery, histopathology results were compared with preoperative evaluation. Statistical Analysis Used: Chi-square test, t-test, Cohen's Kappa, and receiver operating characteristic curve analysis were used for statistical analysis. Results: Of 165 patients evaluated, 127 fulfilling criteria were enrolled. Adnexal masses of ovarian origin were most common (n = 102, 80.3%), of which 12.7% were malignant. Epithelial ovarian malignancy was the most common malignant ovarian tumor, serous cystadenocarcinoma being the most common. Malignancy was significantly more in older, postmenopausal women with high RMI. Seven out of 11 women with high RMI were diagnosed in Stage 3 or 4. RMI score at cutoff of 200 was 54.6% sensitive and 85.7% specific. Conclusions: Adnexal mass of ovarian origin was the most common. Malignancy was significantly more in older, postmenopausal women with high RMI. RMI showed moderate correlation in diagnosing epithelial ovarian malignancies.
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Hui, Kathleen K., John G. Batsakis, Mario A. Luna, Bruce MacKay, and Robert M. Byers. "Salivary duct adenocarcinoma: a high grade malignancy." Journal of Laryngology & Otology 100, no. 1 (1986): 105–14. http://dx.doi.org/10.1017/s0022215100098807.
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AbstractSalivary duct carcinomas of the major salivary glands have two major distinguishing features. They closely resemble ductal carcinomas of the breast and they are high-grade malignancies. In general, but particularly for carcinomas measuring three or more centimeters in size, the clinical course is one characterized by a resistance to local control, metastases to regional lymph nodes and distant sites, and death within a few years after primary surgical treatment.
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Lucas, Fletcher, Adsay, and Zalupski. "High-grade extraskeletal myxoid chondrosarcoma: a high-grade epithelioid malignancy." Histopathology 35, no. 3 (1999): 201–8. http://dx.doi.org/10.1046/j.1365-2559.1999.00735.x.
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Hakala, T., I. Kholová, J. Sand, R. Saaristo, and P. Kellokumpu-Lehtinen. "A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy." Journal of Clinical Pathology 66, no. 12 (2013): 1046–50. http://dx.doi.org/10.1136/jclinpath-2013-201559.
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Background and aimsThe most commonly used diagnostic method for the preoperative diagnosis of thyroid nodules is ultrasound-guided fine-needle aspiration biopsy (FNA), which often yields non-diagnostic or non-definitive results and seldom produces definite malignant diagnoses. To improve upon the malignancy-specific sensitivity, we tested core needle biopsies (CNBs) of thyroid lesions taken from surgical specimens.Material and methods52 consecutive patients with malignant or malignant-suspicious thyroid nodules were referred to Tampere University Hospital between May 2010 and December 2011. Preoperative FNAs were categorised as follicular neoplasm (48%), suspicion for malignancy (46%) or malignancy (6%). Intraoperative FNA and CNB samples were acquired from surgical specimens removed during surgery. The results of the needle biopsies were compared with the final pathological diagnosis.ResultsCNBs had a high definitive sensitivity for malignancy (61%, CI 41% to 78%) whereas the definitive sensitivity for malignancy of FNAs was significantly lower (22%, CI 10% to 42%). CNB was not beneficial in the diagnosis of follicular thyroid lesions. When all suspected follicular tumours were excluded, the definitive sensitivity of CNB rose to 70% (CI 48% to 86%).ConclusionsCNB may be beneficial for the diagnosis of papillary thyroid carcinoma and other non-follicular thyroid lesions. CNB may be considered as an additional diagnostic procedure in cases with FNA suspicious for malignancy.
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Zhu, Jianwei, Jianhua Zou, Zhanjie Zhang, et al. "An NIR triphenylamine grafted BODIPY derivative with high photothermal conversion efficiency and singlet oxygen generation for imaging guided phototherapy." Materials Chemistry Frontiers 3, no. 8 (2019): 1523–31. http://dx.doi.org/10.1039/c9qm00044e.
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Osteosarcoma, the most common malignant bone tissue tumor, with a high degree of malignancy, strong metastasis, and early lung metastasis, can result in extremely high mortality, and is a serious threat to human health.
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Hjorth, Lisbet, Hans Dommerby, Steen Kruse, and Annemarie Nielsen. "Primary Malignant Lymphoma of the Salivary Glands." Tumori Journal 72, no. 5 (1986): 491–97. http://dx.doi.org/10.1177/030089168607200507.
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Five cases of primary malignant lymphomas of the salivary glands are reported. Four lymphomas arose in the parotid gland and one in the submandibular gland. All were non-Hodgkin lymphomas. In 4 cases the lymphomas were of low-grade malignancy, viz. 2 immunocytomas and 2 centroblastic/centrocytic malignant lymphomas, and 1 was a T-immunoblastic malignant lymphoma of high-grade malignancy. Four patients with localized disease were treated with radiotherapy and 1 patient with disseminated disease was treated with chemotherapy. One patient died from a disease unrelated to the malignant lymphoma, and 4 patients were alive at 66-136 months after treatment.
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Möröy, T., P. E. Fisher, G. Lee, P. Achacoso, F. Wiener, and F. W. Alt. "High frequency of myelomonocytic tumors in aging E mu L-myc transgenic mice." Journal of Experimental Medicine 175, no. 2 (1992): 313–22. http://dx.doi.org/10.1084/jem.175.2.313.
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Transgenic mice that contain constructs of the L-myc gene under the transcriptional control of the immunoglobulin heavy chain enhancer (E mu) develop thymic hyperplasia and are predisposed to T cell lymphomas. Here we describe a second form of malignancy that occurs in aging E mu L-myc transgenic mice. The mean latency period for the development of this malignancy is longer compared with the E mu L-myc T cell lymphomas but the overall incidence is increased threefold. The histopathological morphology is that of a highly malignant mesenchymal neoplasm that closely resembles human fibrous histiocytoma. The tumor cells were classified as myelomonocytic on the basis of several lineage-specific markers and the lack of rearrangements of the immunoglobulin heavy chain and the T cell receptor beta loci. Cultured tumor cells produce macrophage colony-stimulating factor (M-CSF) protein and express the M-CSF receptor, suggesting the involvement of an autocrine loop in this malignancy. Similar to the E mu L-myc T cell lymphomas, these tumors show high-level transgene expression but no detectable levels of endogenous c-myc mRNA, directly implicating the deregulated expression of L-myc in the generation of this malignancy. E mu L-myc myelomonocytic tumors show consistent trisomy of chromosome 16, implicating this as a secondary event in the development of this tumor. In the light of recent findings that L-myc is expressed in human myeloid leukemias and in several human myeloid tumor cell lines, the results described here might implicate L-myc in the development of naturally occurring myeloid neoplasias.
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Wong, Michael, Nikolaos Thanatsis, Federica Nardelli, Tejal Amin, and Davor Jurkovic. "Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis." Diagnostics 11, no. 6 (2021): 1094. http://dx.doi.org/10.3390/diagnostics11061094.
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Background and aims: Postmenopausal endometrial polyps are commonly managed by surgical resection; however, expectant management may be considered for some women due to the presence of medical co-morbidities, failed hysteroscopies or patient’s preference. This study aimed to identify patient characteristics and ultrasound morphological features of polyps that could aid in the prediction of underlying pre-malignancy or malignancy in postmenopausal polyps. Methods: Women with consecutive postmenopausal polyps diagnosed on ultrasound and removed surgically were recruited between October 2015 to October 2018 prospectively. Polyps were defined on ultrasound as focal lesions with a regular outline, surrounded by normal endometrium. On Doppler examination, there was either a single feeder vessel or no detectable vascularity. Polyps were classified histologically as benign (including hyperplasia without atypia), pre-malignant (atypical hyperplasia), or malignant. A Chi-squared automatic interaction detection (CHAID) decision tree analysis was performed with a range of demographic, clinical, and ultrasound variables as independent, and the presence of pre-malignancy or malignancy in polyps as dependent variables. A 10-fold cross-validation method was used to estimate the model’s misclassification risk. Results: There were 240 women included, 181 of whom presented with postmenopausal bleeding. Their median age was 60 (range of 45–94); 18/240 (7.5%) women were diagnosed with pre-malignant or malignant polyps. In our decision tree model, the polyp mean diameter (≤13 mm or >13 mm) on ultrasound was the most important predictor of pre-malignancy or malignancy. If the tree was allowed to grow, the patient’s body mass index (BMI) and cystic/solid appearance of the polyp classified women further into low-risk (≤5%), intermediate-risk (>5%–≤20%), or high-risk (>20%) groups. Conclusions: Our decision tree model may serve as a guide to counsel women on the benefits and risks of surgery for postmenopausal endometrial polyps. It may also assist clinicians in prioritizing women for surgery according to their risk of malignancy.
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Sharma, Pooja, Prashant Ramteke, Abhishek Satapathy, and MD Ray. "Xanthogranulomatous Orchitis Presenting as a Scrotal Mass in an Elderly Male: Malignancy or Mimicker?" Clinical Medicine Insights: Case Reports 12 (January 2019): 117954761989029. http://dx.doi.org/10.1177/1179547619890295.
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Xanthogranulomatous inflammation is a rare, destructive pattern of inflammation, affecting different organs, that often produces a mass-like lesion, simulating malignancy. Although benign, it can coexist with malignancy. We, herein, report the case of a 60-year-old male patient, who presented with a testicular mass that was partly necrotic and showed heterogeneous enhancement on contrast study. Testicular tumor markers were normal. In view of clinicoradiological suspicion of a malignant cause, high inguinal orchidectomy was performed. However, histopathology showed features of a xanthogranulomatous orchitis with no evidence of any malignancy. Pathologists must be aware of this entity as definitive diagnosis requires histopathologic examination and adequate sampling must be done to rule out a coexistent malignancy.
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Bent, Talitha, Derya Yakar, and Thomas C. Kwee. "Clinical and FDG-PET/CT Suspicion of Malignant Disease: Is Biopsy Confirmation Still Necessary?" Diagnostics 11, no. 3 (2021): 559. http://dx.doi.org/10.3390/diagnostics11030559.
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Background: Biopsy of 18F-fluoro-2-deoxy-D-glucose (FDG)-avid lesions suspected for malignancy remains an invasive procedure associated with a variety of risks. It is still unclear if the positive predictive value (PPV) of positron emission tomography (PET)/computed tomography (CT) is sufficiently high to avoid tissue sampling. Therefore, the purpose of this study was to determine the PPV of 18F-FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease. Methods: This single-center retrospective study included 83 patients who had undergone FDG-PET/CT within 60 days before CT- or ultrasonography-guided tissue sampling and whose request form for CT- or US-guided tissue sampling requested mutation analyses. The latter implies a high clinical suspicion of active malignant disease. The nature of each biopsied lesion was determined based on the results of the pathological analysis and/or clinical and imaging follow-up of at least 12 months. Results: In total, eighty-eight FDG-avid lesions were biopsied. The PPV of FDG-PET/CT for malignancy was 98.9% (95% CI: 93.8–99.8%). For patients with an oncological history, the PPV was 98.7% (95% CI: 92.9–99.8%), and for patients with no oncological history, the PPV was 100% (95% CI: 74.1–100.0%). There was no significant difference between the PPV of the group with and without an oncological history (p = 0.71). In two cases, an unsuspected malignancy was diagnosed. Conclusion: Although the PPV of FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease is high, biopsy remains recommended to avoid inappropriate patient management due the non-negligible chance of dealing with FDG-avid benign disease or unexpected malignancies.
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Crespo, Manuel, Bernardo Sopeña, John J. Orloff, et al. "Immunohistochemical Detection of Parathyroid Hormone–Related Protein in a Cutaneous Squamous Cell Carcinoma Causing Humoral Hypercalcemia of Malignancy." Archives of Pathology & Laboratory Medicine 123, no. 8 (1999): 725–30. http://dx.doi.org/10.5858/1999-123-0725-idophr.
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Abstract Humoral hypercalcemia of malignancy is a cancer-related hypercalcemia caused by production of humoral factors by malignant cells in patients without bone metastases. Squamous cell carcinomas are the tumors most frequently associated with humoral hypercalcemia of malignancy, and parathyroid hormone–related protein is the main humoral factor implicated. In spite of the fact that normal keratinocytes produce parathyroid hormone–related protein, it is highly unusual for patients with squamous cell carcinomas of the skin to present with humoral hypercalcemia of malignancy. We present a well-documented case of cutaneous squamous cell carcinoma complicated by hypercalcemia in a patient with high levels of plasma parathyroid hormone–related protein and immunohistochemical evidence of high parathyroid hormone–related protein production by the tumoral cells.
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Milos, Ruxandra Iulia, Francesca Pipan, Anastasia Kalovidouri, et al. "The Kaiser score reliably excludes malignancy in benign contrast-enhancing lesions classified as BI-RADS 4 on breast MRI high-risk screening exams." European Radiology 30, no. 11 (2020): 6052–61. http://dx.doi.org/10.1007/s00330-020-06945-z.
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Abstract Objectives MRI is an integral part of breast cancer screening in high-risk patients. We investigated whether the application of the Kaiser score, a clinical decision-support tool, may be used to exclude malignancy in contrast-enhancing lesions classified as BI-RADS 4 on breast MRI screening exams. Methods This retrospective study included 183 consecutive, histologically proven, suspicious (MR BI-RADS 4) lesions detected within our local high-risk screening program. All lesions were evaluated according to the Kaiser score for breast MRI by three readers blinded to the final histopathological diagnosis. The Kaiser score ranges from 1 (lowest, cancer very unlikely) to 11 (highest, cancer very likely) and reflects increasing probabilities of malignancy, with scores greater than 4 requiring biopsy. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy. Results There were 142 benign and 41 malignant lesions, diagnosed in 159 patients (mean age, 43.6 years). Median Kaiser scores ranged between 2 and 5 in benign and 7 and 8 in malignant lesions. For all lesions, the Kaiser score’s accuracy, represented by the area under the curve (AUC), ranged between 86.5 and 90.2. The sensitivity of the Kaiser score was high, between 95.1 and 97.6% for all lesions, and was best in mass lesions. Application of the Kaiser score threshold for malignancy (≤ 4) could have potentially avoided 64 (45.1%) to 103 (72.5%) unnecessary biopsies in 142 benign lesions previously classified as BI-RADS 4. Conclusions The use of Kaiser score in high-risk MRI screening reliably excludes malignancy in more than 45% of contrast-enhancing lesions classified as BI-RADS 4. Key Points • The Kaiser score shows high diagnostic accuracy in identifying malignancy in contrast-enhancing lesions in patients undergoing high-risk screening for breast cancer. • The application of the Kaiser score may avoid > 45% of unnecessary breast biopsies in high-risk patients. • The Kaiser score aids decision-making in high-risk breast cancer MRI screening programs.
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Gunay, Yusuf, Ebru Demiralay, and Alp Demirag. "Pancreatic Metastasis of High-Grade Papillary Serous Ovarian Carcinoma Mimicking Primary Pancreas Cancer: A Case Report." Case Reports in Medicine 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/943280.
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Introduction. Reports of epithelial ovarian carcinomas metastatic to the pancreas are very rare. We herein present a metastasis of high grade papillary serous ovarian cancer to mid portion of pancreas.Case. A 42-year-old patient was admitted with a non-specified malignant cystic lesion in midportion of pancreas. She had a history of surgical treatment for papillary serous ovarian adenocarcinoma. A cystic lesion was revealed by an abdominal computerized tomography (CT) performed in her follow up . It was considered as primary mid portion of pancreatic cancer and a distal pancreatectomy was performed. The final pathology showed high-grade papillary serous adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer.Discussion. Metastatic pancreatic cancers should be considered in patients who present with a solitary pancreatic mass and had a previous non-pancreatic malignancy. Differential diagnosis of primary pancreatic neoplasm from metastatic malignancy may be very difficult. A biopsy for tissue confirmation is required to differentiate primary and secondary pancreatic tumors. Although, the value of surgical resection is poorly documented, resection may be considered in selected patients.Conclusion. Pancreatic metastasis of ovarian papillary serous adenocarcinoma has to be kept in mind when a patient with pancreatic mass has a history of ovarian malignancy.
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Musawwir, Raihana, Sheuly Akhter, and Fatema Begum. "High CA-125 in Endometrioma: An Unusual Presentation." KYAMC Journal 9, no. 3 (2018): 139–40. http://dx.doi.org/10.3329/kyamcj.v9i3.38788.
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CA-125 (cancer antigen 125, carcinoma antigen 125, or carbohydrate antigen 125) also known as mucin 16 or MUC16 is a protein of mucin family glycoprotein that is encoded by the MUC16 gene. It is the most frequently used biomarker for ovarian cancer. It may also be elevated in other cancers, including endometrium, fallopian tube, lung, breast and gastrointestinal cancer and in a number of relatively benign conditions, such as endometriosis, menstruation and pregnancy. High plasma levels of more than 200 U/mL are usually suggestive of malignancy but rarely found in benign conditions of female genital tract, like endometriosis. Very high CA- 125 level is suggestive of ovarian malignancy, was noted in case of ovarian endometrioma. This paper describes a case of a 36 years old lady, mother of 2 children, was admitted with large abdominal mass and abdominal pain. CA-125 was found 3500 U/ML. Ovarian malignancy was suspected. During laparotomy, ruptured endometrioma was noted and it was supported by histopathological report which mentioned," No malignancy seen". Endometrioma can't be excluded in high CA-125 level even without features of endometriosis.KYAMC Journal Vol. 9, No.-3, October 2018, Page 139-140
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Munitiz, Vicente, Pascual Parrilla, Angeles Ortiz, Luisa F. Martinez-de-Haro, Jose Yelamos та Joaquin Molina. "High Risk of Malignancy in Familial Barrettʼs Esophagus". Journal of Clinical Gastroenterology 42, № 7 (2008): 806–9. http://dx.doi.org/10.1097/mcg.0b013e3180329015.
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NAPOLI, DENISE. "Risk High for Second Primary Malignancy After Melanoma." Skin & Allergy News 41, no. 6 (2010): 5. http://dx.doi.org/10.1016/s0037-6337(10)70151-0.
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Inoue, K. i. "Is the Discordance Rate of Malignancy Still High?" Archives of Internal Medicine 159, no. 9 (1999): 1013. http://dx.doi.org/10.1001/archinte.159.9.1013.
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Nahar, Begum Afrin, Rama Saha, Chhanda Das, and Gourishankar Kamilya. "Immunohistochemical expression of human epididymis 4 in ovarian malignancy." International Journal of Research in Medical Sciences 7, no. 12 (2019): 4493. http://dx.doi.org/10.18203/2320-6012.ijrms20195506.
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Background: Ovarian malignancies has the highest mortality rate among all gynaecological malignancies. Surface epithelial tumors form two thirds of all ovarian neoplasm and 90% of all ovarian cancers are surface epithelial carcinomas. Mortality in case of ovarian malignancy is high due to late diagnosis. Early and accurate diagnosis can improve the case specific management. HE4 (Human Epididymis Protein 4) which is proved to be overexpressed in the ovarian cancer cells, is considered a new biomarker for ovarian cancer diagnosis which helps in early diagnosis and patient management. Aims and objectives of the study was to evaluate the immunohistochemical expression of HE4 in various ovarian malignancies.Methods: It was a cross sectional, prospective, single institution-based study, conducted in the department of Pathology in collaboration with the Department of Gynaecology and Obstetrics, from December 2016 to January 2019 in institution. A total 74 ovarian malignancies were selected for this study.Results: Serous carcinoma was the most common ovarian malignancy followed by endometrioid carcinoma. Highest percentage of expression of HE4 was seen in high grade serous cancer and malignant endometrioid tumor.Conclusions: HE4 was highly expressed in malignant ovarian tumour especially serous and endometrioid carcinoma and can be used as an important biomarker for malignant ovarian neoplasm. Expression in high grade ovarian serous cancer support its prognostic value also.
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Alcázar, Juan Luis, Laura Pineda, and Jesús Utrilla-Layna. "Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings, Clinical Complaints and Biochemical Parameters: A Retrospective Study." Donald School Journal of Ultrasound in Obstetrics and Gynecology 7, no. 1 (2013): 80–85. http://dx.doi.org/10.5005/jp-journals-10009-1273.
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ABSTRACT Purpose To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses. Materials and methods Clinical, biochemical and other sonographic features from 227 women diagnosed as having an entirely solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy. Results A total of 227 masses were analyzed. Patients’ mean age was 52.9 years (range: 15-84 years). A total of 150 masses were malignant and 77 were benign. In 52 cases carcinomatosis was observed on ultrasound scan and all theses cases were malignant. In the remaining 175 cases, univariate analysis showed statistical differences between benign and malignant tumors all parameters except tumor's volume. After logistic regression analysis tumor contour, acoustic shadowing, amount of color and CA 125 were identified as independent predictors of malignancy. Using a logistic model 94.4% of malignant tumors and 85.7% of benign tumors would be correctly identified. Conclusion The presence of carcinomatosis is invariably associated to malignancy. In absence of carcinomatosis, irregular tumor contour, absence of acoustic shadowing, moderate or abundant blood flow and a high CA 125 are associated to malignancy. How to cite this article Utrilla-Layna J, Olartecoechea B, Aubá M, Ruiz-Zambrana A, Pineda L, Alcázar JL. Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings, Clinical Complaints and Biochemical Parameters: A Retrospective Study. Donald School J Ultrasound Obstet Gynecol 2013;7(1):80-85.
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Alcázar, Juan Luis, Pedro Royo, Rosendo Galván, et al. "Assessment of an Ultrasound-based Scoring System for Triaging Ovarian Tumors in Symptomatic Women." Donald School Journal of Ultrasound in Obstetrics and Gynecology 3, no. 1 (2009): 9–14. http://dx.doi.org/10.5005/jp-journals-10009-1003.
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Abstract Objective To evaluate prospectively an ultrasound-based scoring system as a method for triaging symptomatic women presenting with an adnexal mass for surgical treatment. Methods 151 symptomatic women scheduled for surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound prior to surgery. Patients were classified as low-risk or high-risk for malignancy according an ultrasound-based scoring system. Patients with low risk for malignancy were scheduled for laparoscopy and patients for high risk for malignancy were scheduled for laparotomy. Some patients with high-risk were scheduled for advanced oncologic laparoscopic surgery. Patients with low risk but tumor size > 10 cm were scheduled for laparotomy. Results 82 women presented with pelvic pain, 8 had uterine bleeding and 61 referred symptoms suggestive for ovarian malignancy, such as abdominal swelling, bloating and abdominal discomfort. 75 (49.7%) masses were considered as “low-risk” and treated by laparoscopy in 58 cases and by laparotomy in 7 cases, because emergency or associated pathology (All tumors were benign). 76 (50.3%) masses were considered as “high-risk” and all treated by laparotomy (56 malignant and 4 benign tumors) or by advanced laparoscopy (16 malignant tumors). Ten (6.7%) tumors were considered as “low-risk” but scheduled for primary laparotomy because of size > 10 cm (9 benign and 1 malignant). Sensitivity, specificity, PPV and NPV for this scoring system were 98.6%, 94.9%, 94.7% and 98.7%, respectively. The scoring system were more sensitive than patient's complaints (98.6% vs 79.5%, p < 0.0001) and more specific than physical examination (94.9% vs 85.9%, p < 0.0001) Conclusions Ultrasound based triage of symptomatic women diagnosed, as having an adnexal mass is effective for selecting surgical approach.
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Bansal, Dhananjay, Anubhav Gupta, Sameek Bhattacharya, Sudesh Kumar, Vijay Kumar Gupta, and Palash Aiyer. "Recurrent high-grade chondrosarcoma abutting the right ventricular outflow tract." Asian Cardiovascular and Thoracic Annals 27, no. 6 (2019): 501–4. http://dx.doi.org/10.1177/0218492319840967.
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Chondrosarcoma is the most common malignancy of the sternum. Removal of the sternum for a malignant tumor results in large defects in bone and soft tissue, causing deformity and paradoxical chest wall movement, making subsequent repair of the thorax very important. Herein we report a rare case of recurrent anterior chest wall chondrosarcoma after surgery 4 years earlier. The patient underwent resection of the chondrosarcoma followed by three-layer chest wall reconstruction with a split rib graft for the bony defect. He had an uneventful postoperative course and was healthy at 9 months postoperatively.
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TARRAR, AIMEL MUNIR, MADIHA SAEED WAHLA, SOHAIL ILYAS, Obaid Ullah Khan, Ahmed Waqas, and Ahmed Raza. "SOLITARY THYROID NODULE." Professional Medical Journal 17, no. 04 (2010): 598–602. http://dx.doi.org/10.29309/tpmj/2010.17.04.2978.
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Objectives: To determine frequency of malignancy in solitary thyroid nodule. Design: Case-series study. Place and Duration of Study: The study was conducted at Department of Surgery, Combined Military Hospital Rawalpindi, from April 2002 till April 2003. Patients and Methods: Sixty patients with clinical solitary thyroid nodule fulfilled the selection criteria and were included in the study. Thyroid function tests, ultrasonography and thyroid scanning was done. Finally FNAC and histopathology were done in all the operated cases and record was evaluated. Results: Out of 60 cases studied, 8 (13.33%) were found to have malignant lesions. The remaining 52 (86.67%) cases had benign pathology. Male patients with solitary thyroid nodule showed a higher incidence of malignancy 17.65% as compared to females 11.63%. Maximum malignant cases (50%) were found between the ages of 31 to 40 years. Papillary carcinoma was the most common malignancy (50%)found in our study. Conclusions: The incidence of malignancy in solitary thyroid nodule is quite high (13.33%). So people should be educated to attend thyroid clinics for early diagnosis and adequate treatment.
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Kakudo, Kennichi, Kaori Kameyama, Mitsuyoshi Hirokawa, Ryohei Katoh, and Hirotoshi Nakamura. "Subclassification of Follicular Neoplasms Recommended by the Japan Thyroid Association Reporting System of Thyroid Cytology." International Journal of Endocrinology 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/938305.
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Background. The Japan Thyroid Association recently published guidelines for clinical practice for the management of thyroid nodules, which include a diagnostic system for reporting thyroid fine needle aspiration cytology. It is characterized by the subclassification of follicular neoplasms, which is different from other internationally accepted reporting systems.Materials and Methods. This study examined observer variability in the subclassification of follicular neoplasms among 4 reviewers using Papanicolaou-stained smear samples from 20 surgically treated patients with indeterminate cytology.Results. The favor malignant subcategory had high predictive value of malignancy (risk of malignancy: 60–75%) and good agreement among the 4 reviewers(κ=0.7714).Conclusion. These results clearly confirmed that the risk stratification of follicular neoplasms, which was adapted from cytology practice of high-volume thyroid centers in Japan, can provide clinically helpful information to estimate the risk of malignancy and to triage patients for surgery.
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Karaki, Shino, Joji Mochida, Yoon Hwan Lee, Kazuhiro Nishimura, and Yutaka Tsutsumi. "Low-grade malignant perineurioma of the paravertebral column, transforming into a high-grade malignancy." Pathology International 49, no. 9 (1999): 820–25. http://dx.doi.org/10.1046/j.1440-1827.1999.00948.x.
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Creo, Ana, Fares Alahdab, Alaa Al Nofal, Kristen Thomas, Amy Kolbe, and Siobhan T. Pittock. "Ultrasonography and the American Thyroid Association Ultrasound-Based Risk Stratification Tool: Utility in Pediatric and Adolescent Thyroid Nodules." Hormone Research in Paediatrics 90, no. 2 (2018): 93–101. http://dx.doi.org/10.1159/000490468.
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Background: Pediatric thyroid nodules are more likely to be malignant compared to those in adults and may have different concerning ultrasound (US) features. Recent adult guidelines stratify malignancy risk by US features. Our aim is to (1) describe and confirm US features that predict pediatric malignancy, and (2) apply the Adult American Thyroid Association (ATA) Risk Stratification Guidelines to a large pediatric cohort. Methods: We identified 112 children with 145 thyroid nodules from 1996 to 2015. Two blinded pediatric radiologists independently read all US images, described multiple features, and reported their overall impression: benign, indeterminate, or malignant. Each nodule was assigned an ATA risk stratification category. Radiologists’ impressions and ATA risk stratification were compared to histology and cytology results. Results: Multiple US features including a solid composition, presence of microcalcifications, irregular margins, increased blood flow, and hypoechogenicity were associated with increased odds of malignancy. ATA risk stratification correlated with the radiologists’ overall impression (p < 0.001). The sensitivity for detecting malignancy was comparable between both ATA stratification (91%) and the radiologists’ overall impression (90%). The specificity of the radiologists’ malignant overall impression (80%) was better compared to the ATA high risk stratification (54%). Conclusions: At our institution, pediatric radiologists’ overall impressions had similar sensitivity but better specificity for detecting malignancy than the ATA risk stratification tool by our convention. However, neither US-based methods perfectly discriminated benign from malignant nodules, supporting the continued need for fine needle aspiration for suspicious nodules. Further work is needed to develop an US-based scoring system specific to pediatric patients.
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Nieto, Hannah, and Kristien Boelaert. "WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter?" Endocrine-Related Cancer 23, no. 11 (2016): T109—T121. http://dx.doi.org/10.1530/erc-16-0328.
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Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours are critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer, and although there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid-stimulating hormone (TSH) is higher in patients with malignant thyroid nodules than in those with benign disease, and TSH is proportionally increased in more aggressive tumours. Importantly, we have shown that the pre-operative serum TSH concentration independently predicts the presence of malignancy in subjects presenting with thyroid nodules. Establishing the use of TSH measurements in algorithms identifying high-risk thyroid nodules in routine clinical practice represents an exciting, cost-efficient and non-invasive approach to optimise thyroid cancer diagnosis. Binding of TSH to receptors on thyrocytes stimulates a number of growth promoting pathways both in normal and malignant thyroid cells, and TSH suppression with high doses of levothyroxine is routinely used after thyroidectomy to prevent cancer recurrence, especially in high-risk tumours. This review examines the relationship between serum TSH and thyroid cancer and reflects on the clinical potential of TSH measurements in diagnosis and disease monitoring.
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Langen, H. J., S. Koehler, J. Bielmeier, et al. "Microradiography of Microcalcifications in Breast Specimen: A New Histological Correlation Procedure and the Effect of Improved Resolution on Diagnostic Validity." Radiology Research and Practice 2012 (2012): 1–13. http://dx.doi.org/10.1155/2012/526293.
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Introduction. Does high-resolution visualization of microcalcifications improve diagnostic reliability?Method. X-rays were taken of mamma specimens with microcalcifications in 32 patients (10 malignant; 22 benign) using conventional radiography (12 Lp/mm) and high-resolution radiography (2000 Lp/mm). Histological sections were subsequently prepared and correlated to the microradiographic image and every calcification was assigned an exact malignant or benign histological diagnosis. Five radiologists classified single groups of calcifications in both methods according to the BIRADS classification system.Results. Using microradiography microcalcifications can be shown in high resolution at the cell level including histological correlation. In some cases, the diagnostic validity was improved by the high resolution in microradiography. In other cases, the high resolution resulted in more visible calcifications, thus giving benign calcifications a malignant appearance. In the BIRADS 2 and 3 group, the probability of malignancy was 28.6% in the conventional radiography evaluation and 37.8% in the microradiography evaluation. In the BIRADS 4 and 5 group, the probability of malignancy was 34.2% in the conventional radiography evaluation and 24.4% in the microradiography evaluation. The differences were not significant.Summary. Overall, the improved resolution in microradiography did not show an improvement in diagnostic accuracy compared to conventional radiography.
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Hanselaar, A. G. J. M. "Additional Techniques in Serous Effusions." Analytical Cellular Pathology 24, no. 1 (2002): 1–4. http://dx.doi.org/10.1155/2002/376731.
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Cytological examination is a valuable diagnostic tool in case of a serous effusion. The firstmanifestation of malignancy may be an effusion of the pleural, pericardial, or peritoneal cavity, especially in carcinoma of the ovary, or lung, and malignant mesothelioma. In other malignancies effusions may occur in the course of the disease. The contribution by Motherby et al. in this issue of ACP focuses on the contribution of image and flow cytometry to establish the presence or absence of malignancy in serous effusions [16]. They point out that the sensitivity of DNA image cytometry in equivocal effusions may be as high as 87.5%, and that for the detection of malignancy, DNA image cytometry is superior to flow cytometry.
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Cohen, David S., Jane E. Tongson-Ignacio, Christopher M. Lolachi, Vanessa S. Ghaderi, Babak Jahan-Parwar, and Lester D. R. Thompson. "Rethinking Malignancy Risk in Indeterminate Thyroid Nodules with Positive Molecular Studies: Southern California Permanente Experience." Otolaryngology–Head and Neck Surgery 161, no. 3 (2019): 419–23. http://dx.doi.org/10.1177/0194599819842859.
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Objectives To recognize that thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; Bethesda III) have different risks of malignancy based on genetic mutation and to consider molecular testing of nodules with AUS/FLUS to help avoid unnecessary morbidity or cost. Study Design Retrospective cohort study. Setting Multiple locations within Southern California Permanente Medical Group. Subjects and Methods Patients included those with indeterminate thyroid nodules and AUS/FLUS on 2 separate fine-needle aspirations with positive ThyGenX testing from 2014 to 2017 who underwent thyroid surgery. Patients were classified as having benign or malignant disease. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features was considered benign. Results A total of 231 patients had repeat AUS/FLUS with positive molecular testing and surgery. The most frequent type of malignancy was papillary carcinoma, followed by follicular carcinoma. The overall prevalence of malignancy in nodules with mutations was 74.0%, although there was considerable variation: BRAF = 100%, RET = 100%, PAX8-PPARγ = 84.6%, HRAS = 70.7%, NRAS = 63.4%, and KRAS = 33%—a statistically significant finding ( P < .001). Conclusions Not all molecular mutations in thyroid nodules with AUS/FLUS have a high risk of malignancy. Of note, patients with BRAF and RET mutations in our population had a 100% risk of malignancy. Patients with PAX, HRAS, or NRAS mutations had a high risk of malignancy, while patients with KRAS mutations had a lower risk of malignancy. Further studies are needed to determine if the presence of certain molecular mutations can help personalize care and aid in the decision for thyroid surgery.
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Shoda, Waseem A. "Combine preoperative estimation of serum thyroglobulin and ACR-thyroid imaging reporting and data system scoring could accurately define malignant thyroid nodules." International Surgery Journal 8, no. 1 (2020): 32. http://dx.doi.org/10.18203/2349-2902.isj20205866.
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Background: Evaluation of diagnostic ability of preoperative estimation of serum thyroglobulin (TG) to detect malignant thyroid nodules (TN) in comparison to the American College of Radiology, Thyroid imaging reporting and data system (ACR-TIRADS), fine needle aspiration cytology (FNAC) and intraoperative frozen section (IO-FS).Methods: 34 patients with ACR-TIRADS 2-4 TN were evaluated preoperatively for identification of malignancy and all underwent total thyroidectomy with bilateral neck block dissection if indicated. Results of preoperative investigations were statistically analyzed using the Receiver operating characteristics (ROC) curve analysis as predictors for malignancy in comparison to postoperative paraffin sections.Results: Preoperative serum TG levels had 100% sensitivity and negative predictive value, while ACR-TIRADS scoring had 100% specificity and positive predictive value with accuracy rates of 95.35% and 97.67% for TG and TIRADS, respectively. ROC curve analysis defined preoperative ACR-TIRADS class and serum TG as highly diagnostic than FNAC for defining malignancy with non-significant difference between areas under curve for TIRADS and TG. For cases had intermediate risk of malignancy on TIRADS, IO-FS had missed 3, FNAC missed 4, while serum TG levels were very high in the 13 cases and were defined by ROC curve as the only significant predictor for malignancy.Conclusions: Preoperative estimation of serum TG showed higher diagnostic validity than FNAC, high predictability of cancer and ability to verify the intermediate findings on TIRADS. Combined preoperative TIRADS and TG estimation could accurately discriminate malignant TN with high accuracy and spare the need for preoperative FNAC or IO-FS.
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Nikolic, B., and R. Lukic. "Choriocarcinoma – postdisease ultrasonographic findings." International Journal of Gynecologic Cancer 14, no. 4 (2004): 677–79. http://dx.doi.org/10.1136/ijgc-00009577-200407000-00017.
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This is a case report of consequences that malignant gestational trophoblastic disease (GTD) can cause on reproductive health protruding into uterine wall and damaging uterine tissue. Transvaginal Doppler ultrasound examination can be of great value in detecting molar tissue, protrusion of malignant trophoblast in uterine wall, and neovasularization in malignant tissue. It is expected to measure a low resistance index in a field of neovascularization, because neovascularization in malignancy is not rare and those vessels do not have muscular stratum. This case is an example of possible irreversible serious and large damages that can be seen after successful treatment of GTD. They are warning on possible high degree of malignancy in GTD as well as on possible serious impact on reproductive health.
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Barman, Geetanjali, Kabita Bujarbaruah, Binoy Kumar Choudhury, and Amal Chandra Kataki. "Ultrasound evaluation of biopsy proven malignant breast mass." International Journal of Research in Medical Sciences 8, no. 2 (2020): 706. http://dx.doi.org/10.18203/2320-6012.ijrms20200261.
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Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy.
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WASEER, MUHAMMAD HUSSAIN, JAVAID IQBAL, and SAJID REHMAN RANDHAWA. "THYROID MALIGNANCY." Professional Medical Journal 14, no. 04 (2007): 573–79. http://dx.doi.org/10.29309/tpmj/2007.14.04.4807.
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Objectives: (1). Audit of our one year experience of management of thyroidcarcinoma in accordance with latest approved guidelines. (2) To point-out high risks of malignancy in population withthyroid diseases. Design: Prospective study. Setting: Surgical Unit-IV of DHQ Hospital Faisalabad with cooperationof Department of Pathology, Punjab Medical Collage, Faisalabad. Period: From 2000– 2001. Patients & method. Allpatients irrespective of age and sex with suspicious of thyroid malignancy were included in this study . Out of total 56patients of thyroid diseases 13 cases were proved thyroid carcinoma on histopathology. Results: Carcinoma of thyroidwas found more common in females. Papillary carcinoma was found in early age group. Follicular carcinoma was foundin younger age group. All patients with anaplastic carcinoma were above, the age of 50 years. Total thyroidectomy wasfound the treatment of choice for the management of carcinoma thyroid. Modified neck dissection was done in selectedcases. We offered lobectomy for one patient with young age with 1.5cm lesion in one lobe. Most patients were placedon TSH suppression thyroxine therapy. Postoperative follow– up was done for one year. The most important prognosticfactor was age of patient, size, type and extent of tumor. Another important factor was the treatment of the diseaseoffered to the patient. Conclusions: Screening programme at least in goitrous areas should be done to detectmalignancy at early stage and then early management should be offered in hope of good survival and least morbidity.
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Sugita, Reiji. "Magnetic resonance evaluations of biliary malignancy and condition at high-risk for biliary malignancy: Current status." World Journal of Hepatology 5, no. 12 (2013): 654. http://dx.doi.org/10.4254/wjh.v5.i12.654.
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Howard, Daniel, Ryan Rigby, and Kevin Winegar. "Primary High-Grade Squamous Cell Carcinoma of the Foot." Journal of the American Podiatric Medical Association 104, no. 5 (2014): 514–17. http://dx.doi.org/10.7547/0003-0538-104.5.514.
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Squamous cell carcinoma is the second most common type of skin cancer and may present in the distal extremities including the foot. We present a case in which a primary squamous cell carcinoma of the foot, which presented as a granulomatous ulcerating lesion, was diagnosed and successfully treated with a radical resection. Our case shows an atypical presentation of a very common malignancy and, it is therefore essential for health-care providers to consider malignancy in all suspicious lesions of the foot.
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Baral, Gehanath, Rijuta Joshi, and Benju Pandit. "Diagnostic Accuracy of Risk of Malignancy Indices in Ovarian Tumor." Journal of Nepal Health Research Council 18, no. 2 (2020): 253–58. http://dx.doi.org/10.33314/jnhrc.v18i2.2627.
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Background: Screening test for ovarian cancer has not been developed yet but several tools exist to predict it. The aim is to find out the relative accuracy of commonly practiced versions of Risk of Malignancy Indices to predict ovarian malignancy pre-operatively.Methods: Intention to treat cross sectional study at Paropakar Maternity and Women’s Hospital in Kathmandu during last six months of year 2018. Cases with ovarian mass were taken pre-operatively with serum tumor markers, ultrasound and tumor Doppler study report. Pregnancy and diagnosed malignancy were excluded. Histopathology report traced post-operatively. All five versions of Risk of Malignancy Indices were analyzed by their predictive efficiency and different cut-off value of CA-125.Results: 116 cases of ovarian tumor from 14 to 76 years (mean=35.2±11.7) were studied. There were 8.6% (n=10) malignant pathology; and isolated high vascular flow and solid component may predict malignancy (p=0.000). Up to 12 multiples of normal CA-125 value could not demonstrate clear predictive value for malignancy (p=0.061). By sensitivity, specificity, diagnostic accuracy and predictive values were similar for Risk of Malignancy Indices-1 and RMI-5 as well as Risk of Malignancy Indices-2 and Risk of Malignancy Indices-3. Cut-off of 250 is efficient by >90% and best at 300. Sensitivity of all Risk of Malignancy Indices versions were similar at cut-off level of 200, 250 and 300.Conclusions: Isolated value of CA-125 and size of tumor are not useful. All Risk of Malignancy Indices versions are reasonably good. Risk of Malignancy Indices value of 250 or more is the best predictive cut-off. Risk of Malignancy Indices-1 and Risk of Malignancy Indices-5 as well as Risk of Malignancy Indices-2 and Risk of Malignancy Indices-3 have similar predictive accuracy. Doppler study is not mandatory.Keywords: Cut-off value; diagnostic accuracy; ovarian cancer; RMI
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Woon, Tian K., Sarat K. Sanamandra, Parag R. Salkade, et al. "Subcentimetre thyroid nodules: Sonographic features associated with malignancy." Ultrasound 28, no. 3 (2020): 155–63. http://dx.doi.org/10.1177/1742271x20902159.
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Introduction The aim of this study was to identify the ultrasound features which are associated with malignancy in subcentimetre thyroid nodules. Methods This retrospective study included 454 thyroid nodules <10 mm in size in 413 patients from 2012 to 2016, which were subjected to fine needle aspiration cytology. Each nodule was classified according to the ultrasound patterns of the 2015 American Thyroid Association guidelines and the high suspicion ultrasound features (solid, hypo-echogenicity, irregular margins, microcalcifications, taller-than-wide, interrupted rim calcifications, and extrathyroidal extension) were identified for evaluation of their diagnostic performance. Results Of the American Thyroid Association high suspicion ultrasound features, univariate analysis showed that hypo-echogenicity (sensitivity 81.6% (95% CI 65.7–92.3%), specificity 50.0% (95% CI 43.4–56.6%)), irregular margins (sensitivity 34.2% (95% CI 19.6–51.4%), specificity 92.2% (95% CI 88.0–95.3%)), microcalcifications (sensitivity 23.7% (95% CI 11.4–40.2%), specificity 91.0% (95% CI 86.5–94.3%)), and taller-than-wide (sensitivity 23.7% (95% CI 11.4–40.2%), specificity 92.2% (95% CI 88.0–95.3%)) were significantly associated with a malignant diagnosis. Amongst the above features, subsequent multivariate analysis identified a combination of hypo-echogenicity and irregular margins as significantly associated with malignancy. Our malignancy rates based on American Thyroid Association ultrasound patterns from benign to high suspicion were 0.0, 8.3, 3.9, 15.7, and 40.4%, respectively. The American Thyroid Association high suspicion ultrasound pattern had a sensitivity of 50.0% (95% CI 33.4–66.7%) and specificity of 84.5% (95% CI 79.2–88.9%). Conclusion The presence of both hypo-echogenicity and irregular margins was significantly associated with malignancy in subcentimetre thyroid nodules in our study. Hence, subcentimetre nodules which are hypoechoic with irregular margins may warrant further follow-up.
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Mlika, Mouna, Adel Marghli, Ines Souilem, et al. "A single-institution experience of neurogenic tumors of the mediastinum." Asian Cardiovascular and Thoracic Annals 27, no. 8 (2019): 661–69. http://dx.doi.org/10.1177/0218492319878575.
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Background Neurogenic tumors of the mediastinum are rare tumors located mainly in the posterior mediastinum. The aim of this study was to report a single-institution experience of these tumors. Methods This study was conducted between 2005 and 2017. Bivariate analysis was performed to assess correlations between the cellularity, mitotic index, presence of a capsule, and potential for malignancy of peripheral nerve sheath tumors. Results There were 86 patients enrolled in the study. The mean age was 42.51 years. Nineteen patients were asymptomatic and their tumors were discovered incidentally. Microscopic diagnosis confirmed a schwannoma in 45 cases, neurofibroma in 12, malignant peripheral nerve sheath tumor in 9, ganglioneuroma in 14, ganglioneuroblastoma in 4, and neuroblastoma in 2. Bivariate analysis showed a significant correlation between the absence of a capsule, the degree of atypia, a high mitotic index, and high cellularity with the potential for malignancy ( p < 0.05). Surgical resection was the main treatment modality in 84 cases. The mean survival was estimated to be 51.309 months. The log-rank test showed a significant difference in survival according to histologic subtype and between benign and malignant tumors ( p < 0.0001). Conclusion Even if radiologic means are helpful in suggesting the diagnosis, a positive diagnosis of neurogenic tumors is based on microscopic features. High mitotic activity and cellularity, and severe cytonuclear atypia are the features most suggestive of malignancy.
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Negro, Roberto, Gabriele Greco, and Ermenegildo Colosimo. "Ultrasound Risk Categories for Thyroid Nodules and Cytology Results: A Single Institution’s Experience after the Adoption of the 2016 Update of Medical Guidelines by the American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi." Journal of Thyroid Research 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/8135415.
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Objectives. In 2016, the American Association of Clinical Endocrinologists (AACE) and Associazione Medici Endocrinologi (AME) released updated guidelines for the diagnosis and management of thyroid nodules. The aim of this study was to evaluate the AACE/AME recommendations for FNA in clinical practice, by comparing the (US) stratification risk and indications for FNA with cytologic results. Methods. From May to December 2016, we collected the cytologic results from FNAs of nodules that were classified using a three-tier US category system (low, intermediate, and high risk). Results. We obtained 859 FNAs from 598 patients: 341 (39.7%) from low, 489 (56.9%) from intermediate, and 29 (3.4%) from high risk nodules. Of these, 88.5% and 74.9% of low and intermediate risk nodules, respectively, were cytologically benign, whereas 84.6% of high risk nodules had a moderate-to-elevated risk of malignancy or were malignant. If FNAs had been limited to intermediate risk nodules >20 mm, we would have missed 13/17 (76.5%) nodules that had moderate-to-elevated risk of malignancy or were malignant (11/13 were malignant based on histology). Conclusions. A nonnegligible number of cytologically malignant nodules or nodules that were suspected to be malignant would be missed if intermediate US risk nodules <20 mm were not biopsied.
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Hunter, Alasdair. "High risk of malignancy in mosaic variegated aneuploidy syndrome." American Journal of Medical Genetics Part A 117A, no. 2 (2002): 199. http://dx.doi.org/10.1002/ajmg.a.10904.
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Schembri, J., MS Lau, and J. Hebden. "PTH-144 Anaemia of Chronic Disease: High Malignancy Yield." Gut 65, Suppl 1 (2016): A290.3—A291. http://dx.doi.org/10.1136/gutjnl-2016-312388.547.
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