An Evaluation of Mass Screening Using Fecal Occult Blood Test for Colorectal Cancer in Japan: A Case-Control Study

There is as yet no firm evidence showing that mass screening for colorectal cancer using fecal occult blood tests (FOBTs) reduces the mortality from this cancer. Therefore we evaluated the effectiveness of the screening by a case-control study in Miyagi Prefecture, Japan. The study included as case subjects 28 individuals who had died from colorectal cancer and had had an opportunity to participate in the mass screening before the date of diagnosis as colorectal cancer, and 3 controls for each case subject randomly selected from residents who were alive on the date of death of case subjects and matched by sex, age (within 3 years) and living area using residential files. For each set, i.e., a case subject and 3 controls, screening histories before the date of the diagnosis of the case as colorectal cancer were examined. Both the case subjects and the controls who had participated in the screening at least once within 3 years before the date of diagnosis of the case were classified as "screened." The 28 case subjects consisted of 12 males and 16 females (average age: 60.8 years). The odds ratio of death from colorectal cancer for the screened versus the non-screened persons was 0.24 (95% confidence interval = 0.08–0.76) by the Mantel-Haenszel method. The present study suggests that mass screening using FOBTs for colorectal cancer significantly reduces the mortality from this cancer epidemiologically.     

Syndrome de Pepper et occlusion intestinale révélatrice

Pepper syndrome is defined as a metastatic liver invasion by a neuroblastoma. The primary tumor is mainly of adrenal origin but in such a case, the tumor of the upper kidney is identified as the leading cause of disease. However, the long-term prognosis is good except in the case of complications related to hepatocellular deficiency. We, therefore, report here the case of a 2 months and 15 days old baby girl admitted to the pediatric surgery unit of the teaching hospital center of Joseph-Ravoahangy-Andrianavalona (JRA) for an abdominal swelling and who presented occlusive syndrome three days after her admission. The aim of this observation is to describe this pathology, taking into account its clinical characteristics as well as its evolution in a medical emergency.     

Malacoplakia of a cadaveric renal allograft: a case report.

A case of malacoplakia in a cadaveric renal allograft is presented. Infection and immunotherapy are presented as possible etiologic factors. The pathogenesis of malacoplakia is discussed with reference to histologic findings in this specific case. The suggestion is made that an altered macrophage response in this disease is the reason for this granulomatous lesion of the bladder.     

Cancer-associated hemolytic-uremic syndrome with spontaneous resolution. A case report

A case of cancer-related hemolytic-uremic syndrome is reported. The patient presented a spontaneous recovery, which is unusual in this clinical picture. Mitomycin C is regarded as responsible for this toxic event in most cases. The case history reported here is discussed in relation to dose and scheduling of mitomycin C, and a safe maximum dosage is suggested.     

Lung carcinoma with metastasis to testicular seminoma.

Tumor-to-tumor metastases are uncommon. The most frequent donor tumors are the lung, whereas renal cell carcinoma is by far the most common recipient. In this report the authors describe a lung tumor that metastasized to a testicular seminoma. This is the first reported case of tumor-to-tumor metastases in which seminoma of the testis is the recipient. The authors performed mucin and immunohistochemical studies on this case and on ten cases of nonseminomatous germ cell tumors containing embryonal carcinoma and endodermal sinus tumor for comparison. Mucin positivity as well as immunoreactivity for epithelial membrane and carcinoembryonic antigens were confined to metastatic adenocarcinoma in this case, whereas Ki-1 and alpha-fetoprotein immunostaining were restricted to the ten control cases of germ cell tumors. Although the majority of second malignant components found in a seminoma are other nonseminomatous germ cell components, the rare possibility exists that a second malignant component is a metastasis from elsewhere in the body.     

X;6 translocation in a child with congenital acute lymphocytic leukemia.

A case of congenital acute lymphoblastic leukemia (ALL) displayed an X;6 translocation. This is the third reported case of ALL with an X;6 translocation. In addition, two of the three ALL cases occurred during infancy, at ages 2 months and newborn, and both translocations involved the band q15-16 region of chromosome 6. Anomalies of the long arm of chromosome 6, mainly interstitial and terminal deletions, have been reported as a recurrent karyotypic event in a significant number of ALL cases. The molecular basis and propensity of an X;6 rearrangement in this case of congenital ALL is unclear and merits further investigation. The similarities in this case and the other infant ALL case cited suggest that an X;6 rearrangement with a breakpoint in bands q15-16 of chromosome 6 is characteristic of a form of congenital ALL.     

Child B: a case of just care?

The case of Child B as she became known (UK) brought the issue of resource allocation into the public spotlight. Resource allocation is, however, only one of a number of issues raised by the events of this case of a little girl with leukaemia. Child B appeared on, and was the subject of, a BBC Panorama current affairs documentary broadcast in the UK which made it clear that she was neither informed about her prognosis nor about the ensuing legal battle. The little girl was 10 years old. Adults have a duty to protect and promote the interests of children but a suspicion remains that this child’s views might usefully have been sought before the clinical decision not to offer further treatment was taken. Even without this it is difficult to justify withholding the decision from her. It is the purpose of this paper to consider some of the moral tensions inherent in nursing someone in this child’s position. The ethical arguments that appeared in the press were predictably deontological and utilitarian (relating to duty and the greater good respectively). Watching Child B tell her story served as a reminder that moral decisions are about the lives of people. The case of Child B would seem to be a case to support an ethic of care.     

Metastatic breast cancer presenting as linitis plastica of the stomach

Early detection and treatment of breast cancer, leading to longer survival, has revealed the natural history of this disease process. Linitis plastica of the stomach is a potential long-term sequela of metastatic breast cancer. Here we present a case of metastatic breast cancer presenting as linitis plastica, as well as the treatment algorithm for this rare clinical entity. The world literature describes a clear pattern of linitis plastica for metastatic infiltrating lobular breast cancer and a discrete nodular pattern for infiltrating ductal cancer, in regard to metastasis to the stomach. To our knowledge, this is the first case of infiltrating ductal cancer presenting as linitis plastica of the stomach.     

Lymphoepithelioma-like carcinoma of the lung

Historically lymphoepithelioma was a term used to describe an undifferentiated mucosal carcinoma with a lymphocytic component arising only from the nasopharynx, although recently, lymphoepithelioma-like carcinoma has been found to occur as a primary tumor of the lung. Thus far, five patients have been documented as having this rare anatomical presentation. The patient that is being presented is the latest case of lymphoepithelioma-like carcinoma of the lung and will be compared clinically and histologically with the other four cases. The case is presented in order to discuss optimal methods of diagnoses and treatment for this condition.     

Cryptogenic organizing pneumonia with atypical histopathological features

A case report of cryptogenic organizing pneumonia (COP); also known as bronchiolitis obliterans organizing pneumonia (BOOP) is presented. The histopathologic findings of COP are well documented in the literature and typically consist of organizing pneumonia of uniform appearance. This case report describes, in addition to the classic findings, more acute exudative inflammation not usually associated with this condition. Variation in the evolution of the pneumonic process is one of the reasons for reporting this case. The promotion of awareness of this treatable condition is the other reason for reporting this case. When multifocal areas of consolidation are demonstrated radiologically, particularly when peripheral and basal, and in the correct clinical setting, the possibility of COP should be entertained. This condition responds dramatically to steroid therapy, and has a good prognosis.     

Simultaneous extramedullary plasmacytomas of the vagina and vulva: a case report and review of the literature.

An unusual case of simultaneous plasmacytomas of the vagina and vulva is presented along with a review of the literature on urogenital extramedullary plasmacytoma. The diagnosis in this case was obtained by vaginal cytological smear and later confirmed by histological examination of tumor biopsies. Of the four previously reported cases of malignant plasmacytoma of the vagina, one recurred locally and none was associated with metastases. In the case presented, local recurrence as well as multiple osseous metastases occurred.     

Late Development of Frontal Prolactinoma after Resection of Pituitary Tumor

The unusual case of a patient with a frontal lobe prolactinoma developed 14 years after resection of a histologically benign pituitary adenoma is presented. Sixteen years after resection of this frontal mass, and 30 years after the first intervention, the patient is symptom-free and without evidence of new intracranial tumors. The possibility that frontal tumor resulted as the late proliferation of microscopic tumor seeding that took place in the course of the first surgery, is suggested. Although this case can be considered as a pituitary carcinoma, the clinical course supports that tumor seeding from pituitary tumors not necessarily indicates a poor prognosis.     

Multiple littoral cell angioma of the spleen: a case report and review of the literature

BACKGROUND: Littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen with characteristic histomorphologic features. It is a unique splenic tumor which may present with abdominal pain or as an incidental finding. CASE REPORT: In this case report, we present the case of a 34-year-old woman with multiple splenic LCA. Initially, the patient presented with abdominal pain, weakness and fatigue. After a diagnostic abdominal ultrasound, multiple hemangiomas were observed in the spleen. Computed tomography scans confirmed splenomegaly with multiple round and hyperdense lesions. The patient subsequently underwent splenectomy. Postoperative histological and immunohistochemical profiles confirmed the diagnosis of LCA. CONCLUSION: LCA is a unique splenic tumor diagnosed in patients with abdominal pain or as an incidental finding. Only a few case reports of this tumor have been published, and those accounts are inconsistent. In the present paper, we report on a case and conduct a literature review.     

Trisomy 13 is associated with poor prognosis in idiopathic myelofibrosis with myeloid metaplasia

We report a case of idiopathic myelofibrosis with trisomy 13 as the sole clonal aberration, as demonstrated by metaphase cytogenetics. The clinical course was especially poor in this case, with death in blast crisis occurring within two weeks from diagnosis. The dismal outcome bears striking similarity to two previous cases of idiopathic myelofibrosis and trisomy 13 reported in the literature. Therefore trisomy 13 may be a predictor of a rapidly fatal outcome in this otherwise indolent disease. Fluorescence in situ hybridisation (FISH) with a chromosome 13 specific probe may enhance the detection of this aberration, since only 50% of cases of idiopathic myelofibrosis are karyotyped successfully using conventional techniques.     

Solitary fibrous tumour presenting as a pedunculated lung mass with associated lung atresia: report of a case

This case report describes a solitary fibrous tumour presenting as a pedunculated mass arising from an almost completely atretic right middle lobe of lung. The intraoperative findings and pathologic diagnostic criteria used are described. To our knowledge, this is the first case report of a solitary fibrous tumour associated with partial lung atresia.     

Squamous cell carcinoma of the cecum: a case report.

Squamous cell carcinoma of the colon is a distinctly rare entity. Squamous cell carcinoma and adenoacanthoma occur in the colon and upper rectum 0.05% as frequently as adenocarcinoma. Squamous cell carcinoma of the cecum is an even rarer entity, this case appearing to be the seventh recorded case. A review of the literature concerning this topic is included in this report.     

Management dilemmas in bladder cancer: radical TUR +/- systemic chemotherapy in the treatment of muscle-invasive bladder cancer

This case report follows the course of a highly aggressive bladder cancer that presented with carcinoma in situ and illustrates the rapid rate of progression from superficial to invasive disease that may be observed in some individuals. This case also highlights concerns about alternative management options and the dilemmas that arise when cystectomy is delayed by failed conservative strategies attempting to preserve the native bladder. This discussion focuses on the combination of radical transurethral resection (TUR) and systemic chemotherapy as a therapeutic alternative to cystectomy. The concept, technique, indications, and contraindications of radical TUR, and the rationale for combination systemic chemotherapy are discussed with reference to this case. We consider the value of radical TUR and systemic chemotherapy as an alternative to cystectomy and the reasons why this patient would not have been a suitable candidate for this bladder-sparing approach.     

Primary CNS lymphoma as second malignancy in a case of carcinoma larynx treated with chemoradiation

A 66-year-old male was diagnosed as carcinoma larynx in the year April 2004. He was treated with concurrent chemoradiation and remained disease free for three consecutive years. After 3 years he suddenly complained of giddiness and seizures. Magnetic Resonance Imaging of brain showed features of primary CNS lymphoma (PCNSL) which was confirmed by histopathology test. To the best of our knowledge PCNSL as second malignancy in a case of carcinoma of head and neck has not been reported till date. The PCNSL in this patient may have resulted from depressed immunity due to previous radiotherapy. Whatever may be the predisposing cause, this case is most probably the first reported case of PCNSL in a patient of squamous cell carcinoma of larynx.     

Radiation response of Rosai-Dorfman disease presenting with involvement of the orbits.

The purpose of this study was to review an interesting case of recurrent orbital sinus histiocytosis. The patient initially failed surgery, chemotherapy, and steroid therapy, only to have a durable response to low-dose radiation therapy of the orbits, lasting 6 and 11 years, respectively. Because there are few documented responses to radiotherapy, we present a case report in conjunction with the clinical, radiographic, and histopathologic information as well as a literature review of similar cases.