Primary aldosteronism due to adrenocortical adenoma with concurrent ileum carcinoid tumor: case report

Primary aldosteronism (PA) with synchronous carcinoid syndrome is extremely rare occurrence. In this article, we describe a case of PA due to adrenocortical adenoma ("aldosteronoma") and concurrent malignant carcinoid tumor of ileum. The patient was treated with synchronous right adrenalectomy and resection of the ileum. This case is an example of concomitant presence of two types of tumors, effectively managed surgically. We report a case of a nonclassical form of multiple endocrine neoplasia type 1 (MEN 1) syndrome.     

Palliative chemoirradiation for transitional carcinoma of the bladder: a case report

Palliation of locally advanced transitional carcinoma of the bladder is a major problem that has not been well investigated. Recent reports from the curative literature suggest improved tumor response rates using platinum based chemoirradiation over radiotherapy alone. Because of the poor symptomatic responses seen with conventional palliative radiotherapy, we have been treating selected cases of locally advanced bladder carcinoma palliatively with low dose chemoirradiation. We present a case of an elderly female treated this way with an excellent clinical response.     

Synchronous transitional cell carcinoma and metastatic hepatocellular carcinoma in the urinary bladder: a case report

An 83- year-old male presented with intermittent hematuria and obstructive symptoms. A CT scan of the abdomen and pelvis showed diffuse thickening of the urinary bladder and a large 10 cm liver mass. Histopathological examination of bladder biopsy demonstrated two distinct lesions. The surface showed non-invasive urothelial carcinoma and the submucosa demonstrated metastatic hepatocellular carcinoma showing bile pigment and expressed Hep Par 1 and CD10. To the best of our knowledge, this is the first case report of synchronous transitional cell carcinoma and metastatic hepatocellular carcinoma of the urinary bladder.     

Gall bladder carcinoid: a case report and review of literature.

Gall bladder carcinoid tumours are rare and usually lack specific symptoms. In most instances, they are incidentally detected after a cholecystectomy and rarely do they manifest with carcinoid syndrome. We report a case of gall bladder carcinoid in a patient who had undergone surgery for rectal carcinoid 10 years back. Occurrence of rectal carcinoid and gall bladder carcinoid in the same patient has not been reported before.     

Primary squamous cell carcinoma of the liver associated with hepatolithiasis: A case report

Primary squamous cell carcinoma (SCC) of the liver is rare and reported sporadically. Up to date, only 24 such cases have been reported in the literature. It is associated with hepatic teratoma, congenital cysts, solitary benign non-parasitic hepatic cysts, hepatolithiasis/Caroli’s disease or cirrhosis. We reported a case of primary SCC of the liver associated with multiple intrahepatic cholesterol gallstones. The patient underwent hepatectomy followed by radiotherapy, and has survived for over 19 mo without recurrence.     

双侧肺腺癌合并胃原发性腺癌1例

肺腺癌较为常见,但双侧腺癌(肺泡样腺癌)不多见,合并胃原发性腺癌就极为罕见了,尤其是有肺腺癌病史的患者,症状往往误导临床首先考虑胃转移性的腺癌.本例胃腺癌术前诊断明确,术后经病理免疫组化证实为原发性的腺癌,现将此例报道如下.     

Primary hepatic carcinoid： A case report and literature review

Carcinoids are tumors derived from neuroendocrine cells and often produce functional peptide hormones. Approximately 54.5% arise in the gastrointestinal tract and frequently metastasize to the liver. Primary hepatic carcinoid tumors （PHCT） are extremely rare;only 95 cases have been reported. A 65-year-old man came to our attention due to occasional ultrasound findings in absence of clinical manifestations. His previous medical history, since 2003, included an echotomography of the dishomogeneous parenchymal area but no focal lesions. A computed tomography scan performed in 2005 showed an enhanced pseudonodular-like lesion of about 2 cm. Cholangiomagnetic resonance imaging identified the lesion as a possible cholangiocarcinoma. No positive findings were obtained with positron emission tomography.Histology suggested a secondary localization in the liver caused by a low-grade malignant neuroendocrine tumor. Immunohistochemistry was positive for anti chromogranin antibodies, Ki67 antibodies and synaptophysin. Octreoscan scintigraphy indicated intense activity in the lesion. Endoscopic investigations were performed to exclude the presence of extrahepatic neoplasms. Diagnosis of PHCT was established.The patient underwent left hepatectomy, followed by hormone therapy with sandostatine LAR. Two months after surgery he had a lymph nodal relapse along the celiac trunk and caudate lobe, which was histologically confirmed. The postoperative clinical course was uneventful, with a negative follow-up for hematochemical, clinical and radiological investigations at 18 mo post-surgery. Diagnosis of PHCT is based principally on the histopathological confirmation of a carcinoid tumor and the exclusion of a non-hepatic primary tumor. Surgical resection is the recommended primary treatment for PHCT. Recurrence rate and survival rate in patients treated with resection were 18% and 74%, respectively.     

A rare case of rectal prolapse associated with rectal adenocarcinoma: case report.

Despite the fact that colorectal polyps and solitary rectal ulcers may be present in conjunction with rectal prolapse, association between rectal prolapse and rectal cancer is very rare. As far as we could determine, there are only a few articles concerning rectal cancer in association with rectal prolapse in the literature. This case, a 63-year-old female patient, had suffered from a rectal prolapse since childhood and presented as a case of rectal cancer. At presentation, she complained of constipation and rectal bleeding for the previous six months. At physical examination there was a relaxed anal sphincter and a large reddish mass protruding via the anal canal when the patient strained. There was a fungating lesion in the upper left part of the rectal mucosa. An incisional biopsy was performed, the histopathological result of which was adenocarcinoma of the rectum. Changes in bowel habits, chronic constipation and chronic irritation seen in rectal prolapse may be responsible for the development of rectal cancer. Thus, a detailed history, digital rectal examination and rectosigmoidoscopic examination are important, particularly in patients with long-term rectal prolapse.     

Primary cholesterol hepatolithiasis associated with cholangiocellular carcinoma: a case report and literature review

Hepatolithiasis associated with cholangiocellular carcinoma is occasionally a calcium bilirubinate stone. Primary cholesterol hepatolithiasis associated with cholangiocellular carcinoma is rare; only 6 cases have been reported in the literature. A 55-year-old man was admitted to our hospital because of an elevated level of carbohydrate antigen 19-9. Various imaging studies demonstrated a mass in the segment VII of the liver. The patient underwent a curative surgical operation. Histopathological examination revealed that it was cholangiocellular carcinoma located in the periphery of the liver. A cholesterol stone was present, encircled by the cholangiocellular carcinoma. Minor inflammatory changes were observed around the stone.     

Primary hepatic carcinoid tumor with carcinoid syndrome and carcinoid heart disease: a case report of a patient on long-term follow-up

We report a 57-year-old woman with a primary hepatic carcinoid tumor who had been suffering from symptoms due to carcinoid syndrome and carcinoid heart disease for more than 9 years. Long-term injection of octreotide acetate was fairly effective to relieve the symptoms due to carcinoid syndrome, but its tumor contraction effect was not confirmed. The massive ascites in the follow-up period appeared to be diminished to a certain extent by timely chemotherapy including cisplatin. The patient died of multi-organ failure about 9 years after the onset of disease. Autopsy confirmed a primary hepatic carcinoid tumor with limited distant metastases.     

Primary retrorectal adenocarcinoma: report of a case

Primary adenocarcinomas of the retrorectal (presacral) space are uncommon and usually arise from cystic lesions developing from remnants of the embryological postanal gut (tail gut cysts) containing mucous-secreting epithelium. A singular case of a patient who presented with a retrorectal mass is described. A 70-year-old previously healthy man had a four-month history of perianal pain during defecation. Preoperative colonoscopy showed external compression of the lower rectum with normal mucosa; pelvic computed tomography demonstrated a 5.5×4.5 cm² retrorectal oval mass, originating from the posterior lower rectal wall, containing cystic components and some small calcifications. The tumor, after complete resection via transanal approach, was shown to be a very rare case of primary adenocarcinoma of the presacral space. The patient had an uneventful postoperative course and he is free from disease 4 years after surgery. Clinicopathological features and surgical treatment of this unusual tumor are discussed. Received: 29 January 2002 / Accepted: 20 November 2002 Correspondence to M. Solazzo     

Solitary giant sarcomatoid carcinoma of the bladder. A case report

A case of sarcomatoid carcinoma of the bladder (SCB) presenting as a giant intravesical mass in a 75-year-old man complaining of lower urinary tract swmptoms (LUTS), abdominal pain and fever is reported. SCB is a rare (0.1% of all primary bladder tumors), aggressive cancer with a complex histology (a biphasic tumor with malignant epithelial and mesenchymal elements) and poor prognosis.     

Primary cardiac angiosarcoma associated with cardiac tamponade: case report.

A 57-year-old male with primary cardiac angiosarcoma was initially admitted for cardiac tamponade. Pericardiocentesis was performed twice preoperatively, but the bloody pericardial fluid was cytologically negative for malignant cells. The tumor in the right atrium was resected during cardiopulmonary bypass. The resected tumor was 5.5x4.5x3.0cm in size and the diagnosis of cardiac angiosarcoma was made histologically. There were no tumor cells in the surgical margin. Unfortunately the patient died 3.5 months after surgery due to multiple recurrence in the pericardium. A suitable therapy for cardiac angiosarcoma is still controversial, but early antemortem diagnosis and more aggressive combined treatment should be considered.     

Intestinal ischaemia associated with carcinoid tumour: A case report with review of the pathogenesis

A case of ischaemic ileal perforation associated with a macroscopically unapparent ileal carcinoid is described. The mesenteric vessels were non-pulsatile at operation but were anatomically patent when examined by the pathologist. The characteristic elastic perivascular sclerosis of mesenteric vessels, which probably caused a functional vascular obstruction, was only discovered after the histological sections were reviewed. The true incidence of this rare condition may be higher than previously suspected because the perivascular sclerosis can easily be overlooked. Awareness of the association between carcinoid tumour and mesenteric ischaemia may lead to early surgery and an improved outcome.