Objective: To investigate the clinicopathological characteristics, diagnosis, and treatment of primary seminal vesicle adenocarcinoma (SVAC). METHODS: We analyzed the clinical data and clinicopathological characteristics of 4 cases of primary SVAC treated in the Department of Urology of the Second Hospital of Tianjin Medical University and reviewed relevant literature. RESULTS: All the 4 patients were treated by open radical resection of the seminal vesicle and prostate and pathologically diagnosed with SVAC. Preoperative prostatic biopsy had shown 1 of the cases to be negative, while preoperative CT and transrectal ultrasound had revealed a huge pelvic cystic neoplasm in another patient. Immunohistochemistry manifested that the 4 cases were all negative for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and cytokeratin 20 (CK20), but positive for cancer antigen 125 (CA125) and CK7. All the patients recovered smoothly after surgery and experienced no recurrence or metastasis during 154, 41, 20, and 12 months of follow-up. CONCLUSIONS Primary seminal vesicle carcinoma is extremely rare and presents in an advanced stage. Immunohistochemistry plays a valuable role in its differential diagnosis. Various combinations of radical surgery, radiotherapy, androgen-deprivation therapy, and chemotherapy are recommended for the treatment of the disease.
Adenocarcinoma ; chemistry ; pathology ; surgery ; Biopsy ; CA-125 Antigen ; analysis ; Diagnosis, Differential ; Genital Neoplasms, Male ; chemistry ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Neoplasm Recurrence, Local ; Pelvic Neoplasms ; diagnostic imaging ; Prostate-Specific Antigen ; analysis ; Prostatectomy ; Seminal Vesicles ; pathology ; surgery

The occurrence of hepatocellular carcinoma (HCC) is closely associated with viral hepatitis or alcoholic hepatitis. Although active surveillance is ongoing in Korea, advanced or metastatic HCC is found at initial presentation in many patients. Metastatic HCC presents with a hypervascular intrahepatic tumor and extrahepatic lesions such as lung or lymph node metastases. Cases of HCC presenting as carcinoma of unknown primary have been rarely reported. The authors experienced a case of metastatic HCC in a patient who presented with a metastatic bone lesion but no primary intrahepatic tumor. This case suggests that HCC should be considered as a differential diagnosis when evaluating the primary origin of metastatic carcinoma.
Antineoplastic Agents/therapeutic use ; Bone Neoplasms/*diagnosis/diagnostic imaging/secondary ; Carcinoma, Hepatocellular/*diagnosis/drug therapy ; Cervical Cord/pathology ; Chemoembolization, Therapeutic ; Gamma Rays ; Humans ; Liver Neoplasms/*diagnosis/drug therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Unknown Primary/pathology ; Niacinamide/analogs & derivatives/therapeutic use ; Pelvic Bones/pathology ; Phenylurea Compounds/therapeutic use ; Tomography, X-Ray Computed

Reports of metastatic hepatocellular carcinoma (HCC) without a primary liver tumor are rare. Here we present a case of isolated HCC that had metastasized to the pelvic bone without a primary focus. A 73-year-old man presented with severe back and right-leg pain. Radiological examinations, including computed tomography (CT) and magnetic resonance imaging (MRI), revealed a huge mass on the pelvic bone (13x10 cm). He underwent an incisional biopsy, and the results of the subsequent histological examination were consistent with metastatic hepatocellular carcinoma. The tumor cells were positive for cytokeratin (AE1/AE3), hepatocyte paraffin 1, and glypican-3, and negative for CD56, chromogranin A, and synaptophysin on immunohistochemical staining. Examination of the liver by CT, MRI, positron-emission tomography scan, and angiography produced no evidence of a primary tumor. Radiotherapy and transarterial chemoembolization were performed on the pelvic bone, followed by systemic chemotherapy. These combination treatments resulted in tumor regression with necrotic changes. However, multiple lung metastases developed 1 year after the treatment, and the patient was treated with additional systemic chemotherapy.
Aged ; Bone Neoplasms/*diagnosis/*pathology/radiotherapy ; Carcinoma, Hepatocellular/*pathology/radiography/*secondary ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Glypicans/metabolism ; Humans ; Keratin-1/metabolism ; Keratin-3/metabolism ; Liver Neoplasms/*pathology/radiography/*secondary ; Magnetic Resonance Imaging ; Male ; Paraffin/metabolism ; Pelvic Bones/*pathology/radiography ; Positron-Emission Tomography ; Tomography, X-Ray Computed

No abstract available.
Colectomy/methods ; Colonic Neoplasms/*diagnosis ; Colonoscopy ; Endometriosis/complications/*diagnosis/pathology/surgery/ultrasonography ; *Endosonography ; Female ; Humans ; Laparoscopy ; Middle Aged ; Muscle Neoplasms/*diagnosis ; Pelvic Pain/etiology ; Predictive Value of Tests ; Sigmoid Diseases/complications/*diagnosis/pathology/surgery/ultrasonography

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.
Abdominal Neoplasms/diagnosis/*pathology ; Abdominal Wall ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Mesothelioma/diagnosis/*pathology ; Muscle Neoplasms/diagnosis/pathology ; Pelvic Neoplasms/diagnosis/*pathology ; Thoracic Neoplasms/diagnosis/*pathology ; Tomography, X-Ray Computed

Adnexa Uteri ; surgery ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Melanoma ; drug therapy ; pathology ; secondary ; surgery ; Melanosis ; pathology ; Middle Aged ; Ovarian Neoplasms ; drug therapy ; pathology ; surgery ; Pelvic Neoplasms ; secondary ; Peritoneal Neoplasms ; secondary ; Teratoma ; drug therapy ; pathology ; secondary ; surgery

OBJECTIVETo investigate the imaging features, clinical manifestations and pathological characteristics of solitary fibrous tumors (SFT).

METHODSThe clinicopathological manifestations and medical imaging findings were analyzed retrospectively in 27 patients with surgically confirmed SFT.

RESULTSThe SFTs originated from different parts of the body, including 18 in the chest, 4 in the abdomen, 1 in the lumboscral area, 3 in the pelvis, and 1 in the left shoulder. Twenty-three cases were found by CT scan, among which there were 16 benign diseases, presented with well-defined round or elliptic margins, with homogeneous attenuation and clearly surrounding; 6 malignant cases with unclear demarcations, invasive surrounding, heterogeneous attenuation due to calcification and/or irregular necrosis, and 1 junctional case with well-defined margins, which was enlarged during follow-up. There were 4 SFTs scanned by MRI with clear margin and homogeneous or heterogeneous signal intensity. All of the 4 cases were isointense or hyperintense to muscle on T1-weighted images, and were hyperintense on the T2-weighted images. All tumors showed heterogeneously intense enhancement with geographic pattern. Immunohistochemical staining showed that CD34-positive was 81.5%, vimentin (100.0%), CD99 (100.0%) and bcl-2 (96.3%), as well as negative CK (100.0%) and S-100 (96.3%).

CONCLUSIONThe location of SFT is varying. Though its clinical manifestations vary, the diagnosis is depended on pathology and immunohistochemistry. There are certain specific features related to SFTs on CT or MRI. These imaging techniques may serve to provide helpful information as to the location and vicinal anatomic structure of the tumor, which is of substantial importance for planning surgery.

12E7 Antigen ; Abdominal Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Adult ; Aged ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pelvic Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Retrospective Studies ; Solitary Fibrous Tumor, Pleural ; diagnosis ; metabolism ; pathology ; surgery ; Solitary Fibrous Tumors ; diagnosis ; metabolism ; pathology ; surgery ; Tomography, Spiral Computed ; Vimentin ; metabolism ; Young Adult

A 38-year-old woman who had undergone pelvic lymphangioma resection two months previously presented with cough and dyspnea. Transthoracic echocardiography and CT demonstrated the presence of a mixed cystic/solid component tumor involving the inferior vena cava, heart and pulmonary artery. Complete resection of the cardiac tumor was performed and lymphangioma was confirmed based on histopathologic examination. To the best of our knowledge, this is the first report of lymphangiomatosis with cardiac and pelvic involvement in the published clinical literature.
Adult ; Female ; Heart Neoplasms/diagnosis/*pathology ; Humans ; Lymphangioma/diagnosis/*pathology/surgery ; Neoplasm Invasiveness ; Neoplasms, Second Primary/diagnosis/*pathology ; Pelvic Neoplasms/*pathology/surgery ; Pulmonary Artery/*pathology ; Vena Cava, Inferior/*pathology

OBJECTIVETo investigate the CT and MRI features of peripheral primitive neuroectodermal tumors (pPNETs) and evaluate its diagnostic value.

METHODSThe clinicopathological data of 9 surgically treated patients with peripheral primitive neuroectodermal tumors confirmed by pathology were collected, spiral CT (4/9) and MRI (6/9) plain scanning and dynamic enhancement scanning were performed preoperatively. Both CT and MRI scannings were performed in 1 case. Those CT and MR images were retrospectively reviewed and analyzed together with clinicopathological findings.

RESULTSThe 9 lesions were located in skeletal muscles (n = 6), pelvic cavity (n = 2) and thoracic cavity (n = 1). The tumor size was 7.4-18.3 cm in diameter with a mean diameter of 11.6 cm. The shape of those lesions was round or ellipse (4 lesions) and irregular (5 lesions). The tumor usually presented as ill-defined masses, with homogeneous (n = 2) or inhomogeneous density (n = 7). Seven cases, including the 3 lesions located in the chest and pelvis, showed obvious necrosis and multilocular cyst formation. The tumors showed iso-density as that of the adjacent muscles on CT plain scans and moderate heterogeneous enhancement after intravenous injection of contrast agents. The features of the tumors on the MRI including slightly low signal intensity on SE T1-weighted imaging, iso-signal intensity or slightly high signal intensity on FSE T2-weighted imaging and heterogeneous dynamic delayed contrast-enhancement with obvious necrosis in most of them. Six cases had a lesion in the skeletal muscles, presented as a giant ill-defined masse surrounding bone and extended along neural route with bone destruction to varying degrees.

CONCLUSIONPrimitive neuroectodermal tumor is a kind of malignant tumor with proliferation of small, undifferentiated neuroectodermal cells, usually occurring in children or adolescent and frequently located in the extremities, chest cavity, pelvic cavity and chest wall. It typically presents as a large, ill-defined masse extending along neural route with heterogeneous and obvious enhancement after intravenous injection of contrast agents. The tumors located in the chest and pelvic cavities and some in the extremities show obvious necrosis and multilocular cyst formation, while some of the tumors in the extremities appear as homogeneous solid masses.

Adolescent ; Adult ; Child ; Diagnostic Errors ; Female ; Histiocytoma, Malignant Fibrous ; diagnosis ; Humans ; Male ; Muscle Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Muscle, Skeletal ; Neuroectodermal Tumors, Primitive, Peripheral ; diagnosis ; diagnostic imaging ; pathology ; Pelvic Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Radiography ; Retrospective Studies ; Thoracic Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVETo explore the feasibility of CT guided percutaneous incisional needle biopsy (PINB) for deep pelvic masses at different locations via various puncture approaches.

METHODSPINBs under CT guidance were performed in 70 patients with 72 pelvic lesions through different puncture approaches. Their pathological findings and safety were evaluated after follow-up of a period of 1-34 months.

RESULTSPINBs were performed through transpiriform-muscle in 27 cases, 16 through transgluteal approach, 5 through posterior oblique approach in prone position, 8 by anterior or lateral transabdominal route, 8 through iliopsoas muscle and 8 by direct transosseous approach, respectively. Sixty-four malignant lesions were confirmed by pathology, including 30 adenocarcinomas, 19 squamous cell carcinomas, 5 unclassified malignant tumors, 3 small cell carcinomas, 2 malignant giant cell tumors of bone, 2 hepatocellular carcinomas and 3 false negative lesions which were confirmed at the second PINBs as malignant tumors, respectively. Benign neoplasms were confirmed in 8 cases, including fibrosis tissue in 6 lesions, bone tuberculosis in 1 and ovarian cyst in 1. The sensitivity, specificity, and accuracy rate were 95.3% (61/64), 100% (8/8), and 95.8% (69/72), respectively. Twenty-two cases via transpiriform-muscle approach suffered from transient deep pelvic pain which radiated to the lower limbs of the same side. No hematoma, nerve damage, infection, and tumor transplantation in pelvic cavity developed after the PINB procedure.

CONCLUSIONCT guided percutaneous incisional needle biopsy through different puncture approaches is safe and feasible for the patients with deep masses at different locations in the pelvic cavity.

Adenocarcinoma ; diagnostic imaging ; pathology ; secondary ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; secondary ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; Diagnosis, Computer-Assisted ; methods ; Feasibility Studies ; Female ; Fibrosis ; diagnostic imaging ; pathology ; Follow-Up Studies ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Pelvic Neoplasms ; diagnostic imaging ; pathology ; secondary ; Pelvis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Uterine Neoplasms ; diagnostic imaging ; pathology