The effectiveness of medroxyprogesterone in the treatment of multiple metastasizing leiomyosarcomas: Report of a case

A 51-year-old woman was admitted to our hospital for further investigation of chest X-ray films which showed multiple shadows that had been growing slowly over 2 years. Her only symptom was hemosputa. The lesions were suspected of being metastasizing leiomyoma due to her past history of uterine leiomyoma. Just 1 week before undergoing scheduled open lung biopsy, the lung lesions increased remarkably in size and number. A thoracotomy was performed and six of the numerous nodules were removed. The resected specimens were pathologically diagnosed as metastasizing leimyosarcoma which was positive for the progesterone and estrogen receptors. Thus, 1 month postoperatively, a course of medroxyprogesterone (MPA), 600 mg daily, was commenced. The residual lesions in her chest started to diminish, shortly afterward. She has remained well on this MPA regimen for 45 months. The prognosis of patients with metastasizing leiomyosarcoma is poor because of its low sensitivity to chemotherapy; however, some types of leiomyosarcoma are hormone-sensitive. It is therefore important to examine the hormone receptors of excised tumors from patients suspected of having metastasizing leiomyoma or leimyosarcoma.     

先天性尿道下裂患儿阴茎组织中多种性激素受体的比较研究

为了进一步探讨先天性尿道下裂患儿的内分泌异常,作者应用冰冻切片直接荧光组织化学法对２３例患儿阴茎组织中的雄激素受体、雌激素受体和孕激素受体进行了检测。结果发现：（１）尿道下裂和正常阴茎组织中均有这三种受体的表达,而且它们在尿下裂和正常阴茎组强的含量和分布情况相似,都是ＡＲ含量最高,ＥＲ最低。     

Unusual case of cavitary lung metastasis of esophageal cancer: A case report

Introduction and importanceCavitary lung metastases are rare. We experienced lung metastasis of esophageal cancer with a cavity, which is extremely rare.Case presentationA 69-year-old female diagnosed with thoracic esophageal cancer underwent radical esophagectomy. Pathological diagnosis was T3N0M0-pStageII. Cavitary lesion appeared in the lower lobe of the right lung 12 months after surgery. We suspected an inflammatory change and followed up strictly. On Computed tomography (CT) image 18 months after surgery, the cavitary lesion slightly increased in size, showing wall thickening and fluid inside. Fluid collection disappeared after antibiotic treatment. The patient was followed for 4 weeks without antibiotics and fluid collection reappeared. Cavitary lesion resection for the purpose of diagnosis was planned because malignancy could not be excluded, although the readministration of antibiotics was also considered. Thoracoscopic partial resection of the right lower lobe of the lung was performed. Histopathological examination showed squamous cell carcinoma which was similar in morphology to esophageal cancer. The final diagnosis was lung metastasis of esophageal cancer.Clinical discussionMetastatic lung cancer with a cavity is rare, accounting for approximately 4% of all cases. Moreover, Lung metastasis of esophageal cancer with a cavity is extremely rare.ConclusionsThe specimen collection, including total biopsy, should be aggressively performed when diagnosing cavitary lung disease in patients with a history of neoplastic disease.     

Duodenal metastasis from large cell carcinoma of the lung: Report of a case

Duodenal metastasis from primary lung cancer is extremely rare. It rarely shows any symptoms, and the prognosis for this condition is poor. We herein describe the case of a 46-year-old woman with primary lung cancer who underwent a left upper lobectomy. Severe anemia was observed about 20 days after lobectomy. Gastroduodenoscopy showed duodenal metastasis. Simultaneously, brain metastasis was also detected using magnetic resonance imaging. The patient underwent a local resection of the duodenum and a tumor resection of the brain. Postoperative irradiation of the brain metastases and systemic chemotherapy of the lung metastases were performed, and complete remission occurred. However, abdominal lymph node metastasis recurred, and the patient died 1 year after the lobectomy.     

Spinal haemangioblastoma associated with syringomyelia and multiple lung lesions

Haemangioblastomas involving the spinal cord are uncommon but by no means unknown. It is well established that haemangioblastomas of the central nervous system are commonly associated with lesions in the retinae and in various abdominal organs. The simultaneous occurrence of similar tumours in the lung is less common and not well recognized. The case of a man with a haemangioblastoma of the spinal cord with many small haemangioblastomas of the lung is reported here.     

Immunohistochemical demonstration of gonadotropin-releasing hormone receptors in prostate carcinoma

The antiandrogen and gonadotropin-releasing hormone (Gn-RH) analogue treatment of prostate carcinoma is based on decreased proliferative and increased apoptotic activity of tumor cells, induced by androgen ablation. Gn-RH analogues decrease the serum level of androgens by breaking the pituitary-gonadal axis, but increasing evidence points to the direct effect of Gn-RH analogues on tumor cells. Immunohistochemical demonstration of Gn-RH receptors recently became possible. Cryostat and paraffin sections of prostate biopsy samples of 10 untreated patients with prostate carcinoma (T2−T3, Gleason score 5−8) were investigated for Gn-RH receptors (Gn-RHR) and androgen receptors, respectively, using the immunoperoxidase method. Membrane bound, focal Gn-RHR positivity was found in 5 samples. Nuclear androgen receptor positivity appeared in 7 samples. No correlation between Gn-RHR and androgen receptor positivity was found, neither receptor status and tumor-nodes-metastasis stage nor Gleason score could be related to each other. Correlation between Gn-RHR positivity and response to luteinizing hormone-releasing hormone analogue treatment will be investigated further.     

肾癌组织性激素受体的表达及意义

为探讨性激素受体与肾癌生物学特性的关系及肾癌患者内分泌治疗的实验依据，采用亲和酶标法测定２９例肾癌及其癌肾组织和１２例正常肾组织标本的肾激素受体和雌激素受本。结果发现ＥＲ及ＰＲ均为胞浆型受体，肾癌ＰＲ及ＥＲ阳性率明显低于癌旁肾组织和正常肾组织，癌旁肾组织和正常肾组织间则无明显差异，Ｉ期肾癌组织ＰＲ阳性率明显高于Ⅱ－Ⅳ期肾癌组织阳性率，肾颗粒细胞癌与透明细胞癌之间及男女患者之间 ＰＲ，ＥＲ表达均无差     

Endobronchial leiomyoma: Report of a case treated by bronchoplasty and a review of the literature

Endobronchial leiomyoma is exteemely rare. Most endobronchial leiomyomas reported in the literature have been resected by either lobectomy or pneumonectomy. We herein report a case treated by sleeve bronchoplasty without pulmonary resection. A 42-year-old woman was admitted to our hospital complaining of hemoptysis. Bronchoscopy revealed a lobulated tumor arising from the medial wall of the right main stem bronchus. A sleeve resection of the right main bronchus including the tumor and end-to-end anastomosis was performed. The histological diagnosis of the resected specimen was leiomyoma with no evidence of malignancy. The importance of early diagnosis and appropriate surgical treatment to preserve pulmonary function are emphasized. Similar cases of an endobronchial type of pulmonary leiomyoma reported in the literature are also reviewed.     

甲状旁腺激素及其受体与骨关节炎的关系研究进展

骨关节炎是一种以关节软骨破坏、软骨下骨的硬化和滑膜反应为特征的慢性疾病.目前发现甲状旁腺激素(Parathyroid hormone,PTH)能够抑制骨关节炎患者软骨细胞终末期成熟分化,有明显软骨保护、延缓骨关节炎进展的作用.通过研究PTH、PTHR与骨关节炎的关系,对骨关节炎治疗及预后将起到重要的指导作用.     

Effect of a single injection of high-dose FK506 on lung transplantation in rats

Orthotopic left lung grafts from Brown Norway (BN) donors were transplanted to Lewis (LEW) rat recipients which had been treated with a single dose of FK506 10 mg/kg body weight intramuscularly on postoperative day 3. Although the lungs were rejected with a median survival time of 7 days, with a range of 6–8 days in the untreated controls, maximum survival was prolonged to 60 days. The major adverse effects of this therapy were reduction of feeding, loss of body weight, and diarrhea. One of the 7 rats died on the 21st postoperative day due to anorexia. The effects of this therapy were investigated by histopathological examination and flow cytometric analysis using monoclonal antibodies against rat lymphocytes: OX-39 (anti-interleukin 2 receptor (IL-2R)) and OX-6 (anti-class II MHC). Histopathologically, the lung allografts showed mild perivascular and peribronchiolar cuffs of mononuclear cells, while marked reduction of the thymic medulla with FK506 treatment was also observed. Flow cytometric analysis of the transplanted lung showed no significant changes. Regarding the thymus, the percentages of positive cells labeled with OX-39 and OX-6 were significantly suppressed after this treatment. In the spleen, the number of OX-6-positive cells significantly decreased. The results using this therapy thus suggest that the suppression of IL-2R and MHC class II expression was systemically maintained for a long time.     

Laparoscopic adrenalectomy for solitary metachronous adrenal metastasis from lung cancer: Report of a case

We report herein the case of a 69-year-old man who underwent laparoscopic adrenalectomy for a solitary adrenal metastasis 10 months after a left lower lobectomy for T2N1M0 lung cancer. A 30×20 mm tumor was found in the left adrenal gland, and dissected using an ultrasonically activated scalpel. Histological examination revealed metastatic squamous cell carcinoma. The patient recovered uneventfully and his condition is now stable 18 months after the second operation, with no evidence of local recurrence or metastatic disease. Although laparoscopic resection for malignant adrenal tumors is still controversial, we consider that laparoscopic adrenalectomy may be an optional treatment for metastatic adrenal tumors, provided the tumor is solitary, small in size, and well-localized. To our knowledge, only 14 cases of laparoscopic adrenalectomy for malignant tumors have been reported to date; however, this is the first case of successful laparoscopic adrenalectomy for a metastasis from lung cancer.     

An evaluation of the flow cytometric nuclear DNA analysis of intrahepatic multinodular hepatocellular carcinoma for a diagnosis of their multicentricity

This study aims to evaluate the clinical significance of the nuclear DNA index (DI) for identification of multicentrically occurring (MC) hepatocellular carcinoma (HCC). In 14 multinodular HCC patients, the DI of 30 HCC specimens and 14 non-cancerous liver tissues were analyzed by flow cytometry. Histological studies of the 30 HCCs revealed MC in 6 cases and intrahepatic metastasis (IM) in 7 cases except for a histologically undetermined case who was found to be a hepatitis B virus (HBV) carrier, and the MC of this case was determined by a clonal study using the HBV integration pattern. In four of the seven specimens with MC HCC, the DI of all the intrahepatic tumors was 1.0 (diploid pattern), while the remaining three were different. On the other hand, five of the seven IM cases were identical (3 diploid and 2 aneuploid), one similar level (DI = 1.17 – 1.18) and one different (1.0 and 1.24). Moreover, in one IM case, the possibility of an alteration of the DI during the course of HCC development was investigated. Although the DI of the recurrent main tumor (DI = 1.17) of this case, which was identified as metastasis of the primary tumor by a clonal study, was also similar to that of subsequent metastatic lesions (DI = 1.18), the DI of the primary tumor was 1.0. These results indicate that DI analysis was not enough to make a differential diagnosis of the multicentric occurrence of HCC.     

Stromal sarcoma of the breast with lung metastasis successfully treated by radiotherapy: Report of a case

(Received for publication on Jan. 20, 1999; accepted on Sept. 17, 1999)     

多发内生型骨瘤1例

正患者,女,26岁。曾有妊娠后慢性腰痛史3年。入院10 d前,患者因二次妊娠后出现腰骶部疼痛再发加重,活动时可诱发左侧大腿部抽痛,疼痛在夜间持续存在。查体:腰部各椎体棘突及棘旁未见压痛及叩击痛,左侧骶髂关节压痛,同侧"4"字试验阳性。辅助检查:ESR 30.0 mm/1 h,HLA-B27(+),尿本周蛋白(-)。胸腰椎X线片:T12~L3、S1椎体见片状高密度影,双侧髂骨沿骶髂关节中下见三角形致密影,尖端朝上,未累及关节面。腰椎及骶髂关节CT(见     

多发性膀胱平滑肌瘤误诊为子宫内膜异位症1例并文献复习

目的提高对膀胱平滑肌瘤的认识,探讨其诊治方法。方法分析1例误诊为子宫内膜异位症的多发性膀胱平滑肌瘤患者的临床资料,并在文献复习的基础上对两种疾病的发病情况、临床表现、诊断及治疗方法进行讨论。结果患者经手术治愈,随访18个月,未见复发。结论膀胱颈部平滑肌瘤与子宫内膜异位症均可导致膀胱刺激症状和慢性盆腔痛,诊断主要依靠影像学检查,而剖宫产术导致的膀胱与宫颈粘连可造成诊断上的困难。两病治疗均首选手术,预后良好。     

Lung and bone metastases from renal cell carcinoma responsive to bisphosphonates: A case report

Abstract:   Bisphosphonates (BP) are inhibitors of bone-resorption and have become the current standard of care for preventing skeletal complications associated with bone metastases. Although previous reports have also suggested potent antitumor, antiangiogenic and immunomodulatory properties of BP, there is debate about the clinical relevance of experimental in vitro and in vivo findings. We report a renal cell carcinoma case in which multiple lung and bone metastases displayed remarkable remission to BP therapy using 30 mg pamidronate once, 4 mg zoledronate once, and weekly 10 mg incadronate 10 times for 3 months. This is the first case report to demonstrate that BP therapy is effective to non-osseous visceral metastasis as well as bone metastases in the clinical setting.     

Spontaneous disappearance of multiple lung metastases after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis: A case report

We report a case in which lung metastases disappeared spontaneously after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis. A 58-year-old man presented with gross hematuria. Computed tomography (CT) revealed a left renal tumor and multiple lung metastases. Intravenous pyelography revealed a filling defect in the upper renal calyx. Urine cytology was positive. Left renal pelvic cancer was diagnosed and nephroureterectomy performed. The resected specimen was diagnosed pathologically as sarcomatoid carcinoma of the renal pelvis. Approximately 5 months later, CT revealed that the lung metastases had disappeared. There has been no evidence of disease for 46 months postoperatively.     

Leiomyoma of the left posterior tibial artery: A case report

A case of leiomyoma of the left posterior tibial artery is presented. This tumor produced aneurysmal dilatation of the artery and was treated successfully by surgery. This may be the first documented case of a benign smooth muscle tumor, although nearly 100 leiomyosarcomas arising from large arteries and veins have been described in the literature.