No abstract available.
Female ; Humans ; Hysterectomy/*methods ; Neoplasms, Glandular and Epithelial/*pathology/*surgery ; Ovarian Neoplasms/*pathology/*surgery ; Pelvic Exenteration/*methods

Objective: To investigate the clinicopathological, immunophenotypic, and molecular genetic features of bronchial sialadenoma papilliferum (BSP). Methods: Four cases of BSP collected at the Shanghai Pulmonary Hospital from May 2018 to June 2021 were retrieved and analyzed. These cases were evaluated for their clinical, histological, immunohistochemical (IHC) and genomic features. The patients were followed up and relevant literature was reviewed. Results: All four patients were male, aged from 55 to 75 years (mean 62 years), with tumor diameter of 6 to 21 mm (mean 13.5 mm), and lesions were located in the left lower lobe (n=2), right lower lobe (n=1), and trachea (n=1). They were characterized by a combination of surface exophytic endobronchial papillary proliferation and an endophytic two-cell layered ductal structure. IHC staining showed that CK7 and EMA were strongly positive in ductal epithelium; p63, p40, CK5/6 were positive in ductal and papillary basal cells; SOX10 was positive in ductal epithelium and basal cells; S-100 was positive in basal cells and ductal epithelium in two cases. Next generation sequencing showed that two cases harbored BRAF V600E mutation. Conclusions: BSP is an extremely rare primary lung tumor arising from the salivary gland under bronchial mucosa. The primary treatment choice of this tumor is complete surgical resection. The diagnosis and differential diagnosis of this tumor depend on classic histomorphologic and IHC features, and BRAF V600E gene mutation can be detected.
Aged ; China ; Epithelium/pathology* ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial/pathology* ; Salivary Gland Neoplasms/surgery*

OBJECTIVE: The aim of this paper was to describe the operative details for en bloc removal of the adnexal tumor, uterus, pelvic peritoneum, and rectosigmoid colon with colorectal anastomosis in advanced epithelial ovarian cancer patients with widespread pelvic involvement. METHODS: The patient presented with good performance status and huge pelvic tumor extensively infiltrating into adjacent pelvic organs and obliterating the cul-de-sac. The patient underwent en bloc pelvic resection as primary cytoreductive surgery. En bloc pelvic resection procedure is initiated by carrying a circumscribing peritoneal incision to include all pan-pelvic disease within this incision. After retroperitoneal pelvic dissection, the round ligaments and infundibulopelvic ligaments are divided. The ureters are dissected and mobilized from the peritoneum. After dissecting off the anterior pelvic peritoneum overlying the bladder with its tumor nodules, the bladder is mobilized caudally and the vesicovaginal space is developed. The uterine vessels are divided at the level of the ureters, and the paracervical tissues (or parametria) are divided. The proximal sigmoid colon is divided above the most proximal extent of gross tumor using a ligating and dividing stapling device. The sigmoid mesentery is ligated and divided including the superior rectal vessels. The pararectal and retrorectal spaces are further developed and dissected down to the level of the pelvic floor. The posterior dissection is progressed and moves to the right and then to the left of the rectum. The rectal pillars including the middle rectal vessels are ligated and divided. Hysterectomy is completed in a retrograde fashion. The distal rectum is divided using a linear stapler. The specimen is removed en bloc with the uterus, adnexa, pelvic peritoneum, rectosigmoid colon, and tumor masses leaving a macroscopically tumor-free pelvis. Colorectal anastomosis was completed using stapling device. RESULTS: En bloc pelvic resection was performed by total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, and rectosigmoid colectomy with colorectal anastomosis using a stapling device. Complete clearance of pelvic disease leaving no gross residual disease was possible using en bloc pelvic resection. CONCLUSION: En bloc pelvic resection is effective for achieving maximal cytoreduction with the elimination of the pelvic disease in advanced primary ovarian cancer patients with extensive pelvic organ involvement.
Anastomosis, Surgical ; Colon, Sigmoid/pathology/surgery ; Disease Progression ; Female ; Humans ; Hysterectomy/*methods ; Neoplasm Invasiveness ; Neoplasm, Residual ; Neoplasms, Glandular and Epithelial/*pathology/*surgery ; Ovarian Neoplasms/*pathology/*surgery ; Ovary/pathology/surgery ; Pelvic Exenteration/*methods ; Pelvis/pathology/surgery ; Rectum/pathology/surgery ; Salpingectomy ; Surgical Stapling

OBJECTIVETo evaluate the different pathological and clinical characteristics of thymomas with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in thymoma patients.

METHODSThe clinical data from 228 consecutive patients (median sternotomy were used in 153, video-assisted thoracoscopic themectomy were used in 75) operated on from January 1992 to December 2007 was analyzed retrospectively. These thymoma patients had been subdivided into two groups: thymoma with MG (n = 125) and thymoma without MG (n = 103). All thymic epithelial tumors were classified according to the WHO histologic classification and the Masaoka clinical staging system. The result was evaluated according to the Myasthenia Gravis Foundation of America's criterion. The clinical features of the 2 test was compared between the two groups by χ² test, and the survival were compared between the two groups by Cox analysis.

RESULTSThere were no peri-operative deaths. 19 cases were inoperable (6 in the group with MG, 13 without MG (χ² = 4.52, P = 0.035)). The proportions of type A and thymic carcinoma were 0 in the group with MG, 10.5% (11/103) and 11.6% (12/103) respectively in the group without MG. According to the Masaoka's clinical staging, in the group MG, 24.8% (31/125) patients were stage III and IV; in the group without MG, 33.0% (34/103) patients were stage III and IV. There was a significant difference between hyperplastic paraneoplastic thymus coexisting in 28.8% (36/125) patients with MG and only 5.8% (6/103) in patients without MG (χ² = 20.91, P = 0.000) Microthymoma was identified in the paraneoplastic thymus of 3 patients with MG. There were 198 patients followed up, the rate was 86.8% (198/228). There was no recurrence in patients with type A and a few patients with type AB, B1, B2, B3 thymoma and thymic carcinoma recurred. The actuarial 5- and 10-year survival rates were 89.3% and 81.2% for patients with MG respectively, and 90.0% and 78.9% for patients without MG respectively. Within 5 years postoperatively, 6 of 9 patients with MG died of myasthenia crisis, while 6 out of 7 deaths in patients without MG were attributable to inoperable tumors (stage IV) and thymic carcinoma.

CONCLUSIONSThe existence of myasthenia gravis has little influence on the prognosis of thymomas, but it is good for early diagnosis and treatment. Extended thymectomy should be performed to all patients with thymoma, no matter they have myasthenia gravis or not. The main cause of death is myasthenia crisis for thymoma patients with MG and stage IV and (or) thymic carcinoma for patients without MG.

Humans ; Myasthenia Gravis ; complications ; pathology ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial ; complications ; pathology ; surgery ; Postoperative Period ; Prognosis ; Retrospective Studies ; Sternotomy ; Survival Rate ; Thoracic Surgery, Video-Assisted ; Thymectomy ; Thymoma ; complications ; pathology ; surgery ; Thymus Neoplasms ; complications ; pathology ; surgery

OBJECTIVE: Distal pancreatectomy with splenectomy may be required for optimal cytoreductive surgery in patients with epithelial ovarian cancer (EOC) metastasized to splenic hilum. This study evaluates the morbidity and treatment outcomes of the uncommon procedure in the management of advanced or recurrent EOC. METHODS: This study recruited 18 patients who underwent distal pancreatectomy with splenectomy during cytoreductive surgery of EOC. Their clinicopathological characteristics and follow-up data were retrospectively analyzed. RESULTS: All tumors were confirmed as high-grade serous carcinomas. The median diameter of metastatic tumors located in splenic hilum was 3.5 cm (range, 1 to 10 cm). Optimal cytoreduction was achieved in all patients. Eight patients (44.4%) suffered from postoperative complications. The morbidity associated with distal pancreatectomy and splenectomy included pancreatic leakage (22.2%), encapsulated effusion in the left upper quadrant (11.1%), intra-abdominal infection (11.1%), pleural effusion with or without pulmonary atelectasis (11.1%), intestinal obstruction (5.6%), pneumonia (5.6%), postoperative hemorrhage (5.6%), and pancreatic pseudocyst (5.6%). There was no perioperative mortality. The majority of complications were treated successfully with conservative management. During the median follow-up duration of 25 months, nine patients experienced recurrence, and three patients died of the disease. The 2-year progression-free survival and overall survival were 40.2% and 84.8%, respectively. CONCLUSION: The inclusion of distal pancreatectomy with splenectomy as part of cytoreduction for the management of ovarian cancer was associated with high morbidity; however, the majority of complications could be managed with conservative therapy.
Adult ; Aged ; *Cytoreduction Surgical Procedures ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial/mortality/pathology/*surgery ; Ovarian Neoplasms/mortality/pathology/*surgery ; *Pancreatectomy/adverse effects ; Postoperative Complications/epidemiology/therapy ; *Splenectomy/adverse effects ; Splenic Neoplasms/pathology/*secondary/*surgery

The aim of this study is to evaluate the clinical feature and pregnancy outcome in patients with ovarian cancer diagnosed during pregnancy. We retrospectively analyzed the medical records of 27 patients diagnosed with ovarian cancer during pregnancy at Cheil General Hospital & Women's Healthcare Center from January 1996 to December 2006. Mean age of the patients was 29.1 yr (range 23-40), and a mean follow-up period was 57 months (range 7-112 months). Of 27 patients, 15 (55.5%) had borderline malignancies, 7 (25.9%) had epithelial malignancies and 5 (18.6%) had germ cell tumors. A total of 26 patients received a conservative surgery preserving pregnancy. The mean time for surgical intervention during pregnancy was 20 weeks of gestational age. Of the 27 patients, 26 had full term delivery of a healthy baby without any congenital malformation. Only one patient with epithelial ovarian cancer had a relapse at 19 months after the first conservative operation with adjuvant chemotherapy. There were few data for managing patients with ovarian cancer diagnosed during pregnancy. This study results could help establish a guideline for management of ovarian malignancy complicating pregnancy.
Adult ; Female ; Gestational Age ; Humans ; Neoplasms, Germ Cell and Embryonal/*diagnosis/pathology/secondary ; Neoplasms, Glandular and Epithelial/*diagnosis/pathology/secondary ; Ovarian Neoplasms/*diagnosis/pathology/surgery ; Pregnancy ; Pregnancy Complications, Neoplastic/*diagnosis/pathology/surgery ; *Pregnancy Outcome ; Retrospective Studies ; Term Birth

OBJECTIVETo investigate the validity of hepatic resection as a treatment option for hepatic parenchymal metastasis in patients with recurrent epithelial ovarian cancer.

METHODSA retrospective review of the clinicopathological and follow up data of 39 patients treated in our hospital from 1996 to 2008 was conducted.

RESULTSTen patients underwent partial hepatic resection for metastatic ovarian cancer. All the 10 patients underwent surgery were with unilobar metastasis and the number of tumors was lower than 3(P < 0.05). No significant difference existed in patient age, the primary pathology type and tumor grade, the rate of optimal primary cytoreductive surgery, the disease free survival after the primary therapy and the serum CA125 level at the liver metastasis when compared with the 29 patients accepted salvage chemotherapy (P > 0.05). There were 7 patients who achieved optional surgery. The operation complication was 3/10 and there was no perioperative mortality. There were 2 patients without postoperative chemotherapy in the 8 recurrent patients with microscopic negative margins. The median recurrence time was 12 (5 - 24) months after the hepatic resection. The overall median survival periods after hepatic metastasis were 26 and 9 months and the 3-years cumulative survival rates were 60.0% and 16.8% for the optimal surgery patients including hepatic surgery and the salvage chemotherapy patients, respectively (P < 0.05).

CONCLUSIONHepatic resection for liver metastatic epithelial ovarian cancer is safe and may achieve long-term survival in patients after optimal second cytoreductive surgery.

CA-125 Antigen ; blood ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms ; pathology ; secondary ; surgery ; Neoplasm Recurrence, Local ; pathology ; Neoplasms, Glandular and Epithelial ; pathology ; Neoplasms, Second Primary ; Ovarian Neoplasms ; pathology ; Retrospective Studies ; Salvage Therapy

Diagnosis, Differential ; Genital Neoplasms, Male ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; metabolism ; pathology ; surgery ; Neprilysin ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Seminal Vesicles ; Stromal Cells ; pathology ; Vimentin ; metabolism

OBJECTIVE: To analyze the clinic and pathologic data of thymic epithelial tumor (TET) and to explore its prognostic factors. METHODS: From June 1997 to September 2007, 137 patients with TET were surgically treated in our hospital. The data included age, gender, symptoms, histological type, stage and grade, pathological findings, and operation reports. The patients were followed up by telephones and mails. The patients were divided into Masaoka I/II group and III/IV group, and WHO A/AB/B1 group and B2/B3/C group. Kaplan-Meier method, log-rank test, and COX regression model were used to analyze the prognostic factors for TET. RESULTS: Among the 137 patients, 124 (90.5%) received complete resection, 9 (6.6%) incomplete resection, and 4 (2.9%) surgical biopsy. The rate of complete resection was significantly higher in Masaoka stages I/II than that in stages III/IV (P<0.001). The overall 5-year and 10-year survival rate was 71.4å and 50.1å, respectively. Patients in stage I/II had better long-term survival than those in stage III/IV (P<0.001). According to WHO histological classification, the 5-year and 10-year survival rate in patients with Type A/AB/B1 TET was significantly higher than that in patients with Type B2/B3/C TET (P<0.001). The 5-year and 10-year survival rate in patients with complete resection was significantly higher than that in patients with incomplete resection and biopsy (P<0.001).Cox regression analysis showed that the prognosis of patients with TET was related to Masaoka stage, WHO histological classification, extent of resection, and age at operation. CONCLUSION Masaoka stage, WHO histological classification, extent of resection, and age at operation are important prognostic factors in patients with TET.
Adolescent ; Adult ; Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; mortality ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate ; Thymus Neoplasms ; mortality ; pathology ; surgery ; Young Adult

Actins ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Epithelial Cells ; metabolism ; pathology ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasms, Complex and Mixed ; metabolism ; pathology ; surgery ; Neoplasms, Glandular and Epithelial ; metabolism ; pathology ; surgery ; Stromal Cells ; metabolism ; pathology ; Vimentin ; metabolism