Lhermitte-Duclos disease (LDD) is a type of rare brain tumor located in posterior fossa. A patient with LDD located in the left cerebellum and vermis was admitted by the Department of Neurosurgery, Xiangya Hospital, Central South University. MRI scan showed slightly heterogeneous enhancement at the region close to vermis. The patient underwent partial resection on August 11, 2016 without postoperative chemoradiotherapy. The progress free survival was 11 months and the overall survival was 17 months. What the case reveals is that the partial resection is not beneficial to these patients with LDD as the residual lesion probably recurs in a short term after operation. The pathogenesis, diagnosis and treatment of LDD are explored and summarized in combination with relevant literature.
Cerebellar Neoplasms/surgery* ; Cerebellum ; Hamartoma Syndrome, Multiple/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local

OBJECTIVETo investigate the way of diagnosis and therapy of parosteal osteosarcoma.

METHODSA retrospective review was conducted of 48 patients treated at our department between June 1964 and December 2001. The average age of patients in this study was 29.2 years (13 - 47 years). Thirty-two of the patients were female; sixteen were male. The single most common site is the posterior aspect of the distal femur (in 36 patients), followed by the femur shaft (in 6 patients), the proximal tibia (in 2 patients), etc. Nine patients had been operated on before referral to our department.

RESULTSThe average follow-up period from the first operation was 5.2 (0.25 - 24) years. In 36 of the 39 patients in whom a limb-salvage procedure was performed, a segment of the tumor-bearing bone was excised along with the tumor, whereas in 3 patients only the subadjacent cortex was excised with the tumor. In the limb-sparing group, the reconstruction was achieved by means of attenuated tumor bone or allograft in 23 cases, by endoprosthetic replacement in 9 cases, and by allograft replacement in 4 cases. The local resections were wide in 35 cases, and marginal in 13 cases. After marginal surgery, local recurrence occurred in 5/13 patients, whereas it occurred in 3/35 patients treated with wide resection. Pulmonary metastases developed in 6 patients, four patients died, and 2 patients are alive with disease. There were 4 cases of fractures of bone grafts. Four patients developed an infection. Long-term survival rate is 85.8%. For tumors that invaded the medullary canal there was no statistical association with local recurrence or metastasis. There is statistical significance between surgical margin and local recurrence.

CONCLUSIONSWide surgical excision alone is adequate treatment for patients with conventional parosteal osteosarcoma. A tumor-free margin remains the critical factor determining overall prognosis. When a marginal excision was knowingly done to preserve a major neurovascular bundle, the risk of recurrence was less than when it was done to shell-out a presumptively benign lesion. Repeated recurrence probably increases the risk of dedifferentiation and thereby worsens the prognosis. Recurrent lesions with multiple soft-tissue satellite nodules or involvement of the neurovascular structures may however require amputation to provide sufficient local control when a wide margin cannot be achieved. An individualized resection will be performed in the future probably under the help of the advanced technique of image to distinguish the reactive zone from the normal tissue precisely.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Osteosarcoma, Juxtacortical ; diagnostic imaging ; surgery ; Prognosis ; Radiography

OBJECTIVETo evaluate salvage surgical approaches and efficacy for post-radiation local recurrent nasopharyngeal carcinoma (NPC).

METHODSThirteen patients with post-radiation local recurrent NPC underwent salvage surgical treatment by routes as transpalatal approach, nasal medial swing approach, maxillary swing approach and infratemporal fossa approach. All cases were followed up for 2 to 5 years. Analysis was done on the indications and efficacy of these 4 different approaching routes.

RESULTSNo immediate operative complications occurred for all these 13 cases. Four patients with T1 and T2a operated via transpalatal approach and nasal medial swing approach survived more than 3 years. Five patients with T2b and T3 operated via maxillary swing approach. Among them, two patients died at second and 24th month after operation, one survived with tumor and died at 13rd month after operation, two were alive free of tumor for 2 and 4 years after operation. Four patients with T4 operated via infratemporal fossa approach. Among them, three died in 1 year, one was alive free of tumor for 2 years.

CONCLUSIONSSurgical approaches were decided by a comprehensive consideration of recurrent tumor site and invasive range to achieve the best operative site exposure with minimal traumatic damage.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; surgery ; Radiography ; Salvage Therapy

Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Multimodal Imaging ; Neoplasm Recurrence, Local ; diagnostic imaging ; surgery ; Nerve Sheath Neoplasms ; diagnostic imaging ; surgery ; Positron-Emission Tomography ; Retroperitoneal Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

ObjectiveTo investigate the diagnosis and treatment of ejaculatory duct cyst.

METHODSThis study included 2 male patients present at the hospital for hemospermia and abnormal sensation in the perineal region in July and August 2014. Both underwent transrectal ultrasonography, routine semen examination, CT, MRI, cystoscopy, and vesiculography before transurethral fenestration of the cysts and pathological examination of the cyst wall specimens. Analyses were made on the clinical presentations, imaging features, pathological characteristics, differential diagnosis and treatment of ejaculatory duct cyst and relevant literature was reviewed.

RESULTSThe cyst wall was mainly composed of smooth muscle, the inner wall lined with pseudostratified ciliated columnar epithelia, and with positive expressions of CD10 and Muc6 proteins on immunohistochemical staining, which indicated renal iatrogenic ejaculatory duct cyst. The patients were followed up for 18 and 20 months, respectively. All symptoms disappeared and no recurrence occurred after surgery. Routine semen examination for the two patients showed the semen volumes to be 3.5 and 3.1 ml, sperm concentrations 35 and 32 ×10⁶/ml, grade a sperm 32.0 and 26.0%, grade b sperm 18.0 and 31.0%, and semen liquidation time 30 and 34 minutes, respectively.

CONCLUSIONSPelvic cystic masses can be detected by transrectal ultrasonography, CT and MRI, but definite diagnosis relies on vesiculography, pathological examination and immunohistochemical staining. Transurethral fenestration is safe and effective for the treatment of ejaculation duct cyst.

Cysts ; diagnostic imaging ; pathology ; surgery ; Ejaculation ; Ejaculatory Ducts ; diagnostic imaging ; pathology ; surgery ; Genital Diseases, Male ; diagnostic imaging ; pathology ; surgery ; Hemospermia ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Recurrence, Local ; Semen ; Semen Analysis ; Sperm Count ; Spermatozoa ; Tomography, X-Ray Computed ; Ultrasonography

Bone Cysts, Aneurysmal ; diagnostic imaging ; pathology ; surgery ; Cartilage Diseases ; diagnostic imaging ; pathology ; surgery ; Female ; Hamartoma ; diagnostic imaging ; pathology ; surgery ; Humans ; Infant ; Mesoderm ; diagnostic imaging ; pathology ; surgery ; Nasal Cavity ; diagnostic imaging ; pathology ; surgery ; Neoplasm Recurrence, Local ; Nose Diseases ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

Adult ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; secondary ; Mediastinal Neoplasms ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Mediastinum ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; Osteosarcoma ; diagnostic imaging ; drug therapy ; pathology ; secondary ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo explore and evaluate the effect of radio frequency ablation (RFA) in treatment of hepatic VX(2) tumor in rabbits.

METHODSThe hepatoma was treated with RFA in rabbits. The complete necrotic rate of the tumors, pathological changes, CT images and the animals' survival time were observed.

RESULTS(1) ALT in serum increased significantly on the first day and decreased to the control level during 4th-7th day following RFA. (2) On the second week, CT scans showed that complete necrotic foci became larger, and the density of which was asymmetrical. Enhanced CT scans showed no obvious intensification inside; however, ringed intensification appeared along edges of the foci. Biopsy showed that the dark necrotic tissue was surrounded by ringed granulation tissue. Incomplete necrotic tumor foci resembled the complete necrotic foci in no enhanced CT images; however, asymmetrical intensification was observed in enhanced CT scans in the incomplete necrotic foci. Macroscopic observation showed irregular tumor tissue between the necrotic tissue and the peripheral normal tissue. Biopsy showed tumor recurrence in it. (3) Compared with the control, survival time of the animals was longer, and metastases rate in lungs and the fatality rate were lower in the treatment group.

CONCLUSIONSRFA, with little injury, is an effective method in the treatment of hepatoma. Enhanced CT scans are consistent with pathological morphometrics of the tumor foci after RFA. The enhanced CT scan is a valuable check-up, which could be used to observe the therapeutic effect after RFA.

Animals ; Carcinoma, Hepatocellular ; Catheter Ablation ; Liver Neoplasms ; diagnostic imaging ; surgery ; Necrosis ; Neoplasm Recurrence, Local ; Rabbits ; Radionuclide Imaging ; Tomography, X-Ray Computed

OBJECTIVETo investigate the way of sacral tumors surgical treatment.

METHODSThis retrospective study included 119 cases of sacral tumors surgically treated from July, 1996 to December, 2001. The age of patients ranged from 18 to 80 years (mean 57 years), including of 72 male and 47 female. Out of the patients, there were 52 chordomas, 16 giant cell tumor, 5 neurofibroma, 23 metastases tumors, 9 myeloma, 2 osteoblastomas, 5 aneurysmal bone cysts, 3 osteosarcomas, 4 chondrosarcomas. Posterior approach and combined anterior-posterior approach were used in 83 and 36 cases respectively. Twenty-nine patients had received surgical management at least once and 16 of them had received radiation therapy before came to our department.

RESULTSThree patients died on the complication around the surgery. Most of the patients with metastases tumor or multiple myeloma died 1 to 3 years after the surgery. Out of three osteosarcoma patients, 2 died and one alive with tumor. Three chondrosarcoma patients died, and one alive with tumor. Out of 52 chordoma patients, 3 patients had died of metastatic chordoma, 3 patients died of many times recurrence. Among the other 46 patients who were stay alive, 31 were free from disease with average follow-up time of 42 months. In the patients whose sacral nerve roots had been reserved bilaterally at and above S(3) level, the sphincter muscle function of bladder and bowl was good. While the function of sphincter muscle impaired in 2 patients with nerve roots reserved only at and above S(1) level. To manage these 2 patients, indwelling bladder catheters were used, but colostomy had not been performed.

CONCLUSIONSComplete resection of tumor (radical surgery when possible) is the most effective way to manage sacral tumors. Postoperative adjuvant radiation therapy can reduce the tumor recurrence rate, but it also can cause troubles that would hinder further surgical managements. Even if the tumor is relatively huge and the upper resection margin is as high as at S(1) or S(2) level, the tumor can be removed successfully by posterior approach and the postoperative complications could be accepted. To the patients with aneurysmal cyst or giant cell tumor on sacrum, for control bleeding purpose, anterior approach should be performed to ligate the bilateral internal iliac artery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Radiography ; Retrospective Studies ; Sacrum ; surgery ; Spinal Neoplasms ; diagnostic imaging ; surgery

Actins ; metabolism ; Adrenal Gland Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Leiomyosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Reoperation ; Tomography, X-Ray Computed ; Vimentin ; metabolism