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Para-aortic Lymph Nodes (para-aortic + lymph_node)
Selected AbstractsBlueberry muffin rash as a presentation of alveolar cell rhabdomyosarcoma in a neonateACTA PAEDIATRICA, Issue 1 2000SV Godambe Soft tissue sarcomas of childhood continue to present problems with pathologic diagnosis, staging and treatment. Rhabdomyosarcoma, the most common soft tissue sarcoma, represents 4,8% of all malignant solid tumours in children. We report a case of congenital alveolar rhabdomyosarcoma who presented with "blueberry muffin"-like rash. A full-term female infant was noted at birth to have multiple skin lesions resembling blueberry muffin rash and an abdominal mass in the left iliac fossa, which appeared to be fixed to the posterior abdominal wall. There was no enlargement of liver and spleen, but her para-aortic lymph nodes were enlarged. Biopsy from the mass confirmed the diagnosis of alveolar cell rhabdomyosarcoma. Molecular investigation for the t (2:13) translocation was negative. The infant received chemotherapy but died within 1 mo of diagnosis. [source] Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liverPATHOLOGY INTERNATIONAL, Issue 4 2006Daisaku Morita A rare autopsy case of combined hepatocellular and cholangiocarcinoma, occurring in a 54-year-old man with liver cirrhosis, is presented. Initial laboratory data included CEA 52.1 ng/mL, DUPAN-2 1600 U/mL, AFP 2 ng/mL, and negativity for hepatitis B surface antigen, hepatitis B early antigen and hepatitis B core antibody. Ultrasonography and CT scan showed a large tumor node in the liver with ringed enhancement, swelling of several para-aortic lymph nodes, and ascites. Clinically, it was not possible to determine whether the hepatic tumor was an intrahepatic cholangiocarcinoma or a metastatic carcinoma. Histologically, the primary lesion was composed solely of hepatocellular carcinoma (HCC) with a trabecular pattern, and the intrahepatic metastases consisted of a variable admixture of HCC and cholangiocarcinoma (CC) with excessive mucin production. Interestingly, the tumor cell cluster showing a trabecular growth pattern produced mucin and had immunohistochemical expression of hepatocyte, cytokeratins 7 and 8. It is concluded that these hepatic tumor cells had both HCC and CC characters. [source] Uterine papillary serous carcinoma: Patterns of failure and survivalAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Wei WANG Objective: To evaluate the outcome in patients with uterine papillary serous carcinoma (UPSC). Methods: A retrospective review of women treated for UPSC between 1995 and 2006 in Westmead Hospital, Sydney. The patients were treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy and surgical staging. The majority of the patients had platinum-based adjuvant chemotherapy and radiotherapy. Sites of initial recurrence were documented. Overall survival (OS) and progression free survival (PFS) were estimated using Kaplan,Meier method. Univariate and multivariate analysis was performed using Cox regression analysis to test the effects of multiple prognostic factors on survival. Results: Two-year and five-year OS was 65% and 43%. The median OS was 39 months. Two-year and five-year PFS was 60% and 35%. Macroscopic residual disease at the completion of surgery was the only significant prognostic factor associated with worse OS on both univariate and multivariate analysis (P < 0.001). The median OS was only 11 months if patients had macroscopic residual disease, and all patients died within 18 months despite adjuvant therapies. Twenty-one patients relapsed. The site(s) of initial recurrence were: vagina (five patients), pelvic lymph nodes (four patients), abdomen (11 patients), para-aortic lymph nodes (six patients), inguinal lymph nodes (two patients) and distant metastases in seven patients. Only one of 16 patients who received vaginal brachytherapy failed in the vagina, but three of seven patients who received external beam pelvic radiotherapy failed in the vagina. Conclusion: We recommend optimal cytoreduction surgery with the aim of leaving no macroscopic disease at the end of the operation. Vaginal brachytherapy should be considered as a component of adjuvant radiotherapy. Abdominal failure was the commonest mode of failure in our cohort of patients. [source] Laparoscopic debulking of bulky lymph nodes in women with cervical cancer: indication and surgical outcomesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2009R Tozzi Objective, To describe the technique and the surgical outcome of laparoscopic resection of bulky lymph nodes before adjuvant treatment. Design, Prospective pilot study. Setting, Gynaecological oncology cancer centre. Population, From January 2006 to February 2008, 22 consecutive women presented with cervical cancer and bulky metastatic lymph nodes (>2 cm). Methods, All women underwent resection of bulky lymph nodes by laparoscopy. A prospective record of the main surgical outcomes was performed. Main outcome measures, Safety and efficacy of laparoscopic resection of bulky lymph nodes, conversion to laparotomy, intra- and perioperative morbidity. Results, All the operations were completed by laparoscopy. Median operative time was 197 minutes (range 180,320). Median blood loss was 60 cc (range 10,100), two women experienced complications: one thermal injury of the sciatic root provoking postoperative leg palsy and one chylous ascites. The woman with the thermal injury has recovered most leg function with physiotherapy and the woman with chylous ascites recovered within 2 weeks, slightly delaying the adjuvant treatment. All women were discharged within 4 days from the operation (range 2,4). Pathology reports confirmed the presence of tumour metastases and the lymph nodes size. The adjuvant treatment started at a median time of 12 days (range 3,22). Conclusion, Debulking of large pelvic and para-aortic lymph nodes was effectively accomplished by laparoscopy in all 22 women with 9% complication rate. The surgical outcome is similar to historical series on women operated on by laparotomy, with the advantage of a faster recovery and an early start of adjuvant treatment. [source] Prognostic impact of para-aortic lymph node micrometastasis in patients with regional node-positive biliary cancerBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2009A. Yonemori Background: The presence of para-aortic lymph node metastasis in biliary cancer has a negative impact on prognosis. The relevance of para-aortic lymph node micrometastasis is unknown. Methods: A total of 546 para-aortic lymph nodes from 49 patients with biliary cancer with positive regional nodes and negative para-aortic nodes were immunostained with epithelial marker CAM5·2 (specific for cytokeratins 7 and 8). Immunostained tumour foci were classified as micrometastases or isolated tumour cells (ITCs) according to their size (larger or smaller than 0·2 mm). Results: CAM5·2-positive occult carcinoma cells in para-aortic lymph nodes were detected in nine (18 per cent) of 49 patients and in 18 (3·3 per cent) of 546 para-aortic nodes. There was no difference in postoperative survival between patients with and without CAM5·2-positive para-aortic nodes (P = 0·978), but survival for five patients with micrometastases was significantly worse than that for four patients with only ITCs (P = 0·047). Conclusion: In patients with regional node-positive and para-aortic node-negative biliary cancer, and occult cancer cells in para-aortic lymph nodes, prognosis was significantly worse in those with micrometastases than in patients with only ITCs. An efficient method of intraoperative detection of para-aortic lymph node micrometastases larger than 0·2 mm is needed. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma,,CANCER, Issue 9 2008A Gynecologic Oncology Group study§ Abstract BACKGROUND Patients with cervical cancer who had negative para-aortic lymph nodes (PALNs) identified by pretreatment surgical staging were compared with patients who had only radiographic exclusion of PALN metastases before they received treatment with pelvic radiation and brachytherapy (RT) plus cisplatin (C)-based chemotherapy. METHODS Patients who participated in 1 of 3 Phase III Gynecologic Oncology Group (GOG) trials (GOG 85, GOG 120, and GOG 165) and who were assigned randomly to receive either RT plus C or RT plus C combined with 5-fluorouracil with or without hydroxyurea comprised this retrospective analysis. Patients who had negative PALN status determined by surgical sampling (mandatory in GOG 85 and GOG 120 and optional in GOG 165) were compared with patients who had negative PALN status determined radiographically (GOG 165). RESULTS Five hundred fifty-five patients underwent surgical PALN sampling (the S group), and 130 patients underwent radiographic evaluation only (the R group). Age, race, histology, and tumor grade were similar. Patients in the R group had better performance status (P < .01), less advanced stage (P = .023), and smaller tumor size (P = .004) compared with patients in the S group, although patients with stage III and IV disease in the S group had better 4-year progression-free survival (48.9% vs 36.3%) and overall survival (54.3% vs 40%) compared with patients in the R group. In multivariate analysis, the R group was associated independently with a poorer prognosis compared with the S group (for disease progression: hazard ratio [HR], 1.35, 95% confidence interval [95% CI], 1.01,1.81; for death: HR, 1.46, 95% CI, 1.08,1.99). CONCLUSIONS Surgical exclusion (compared with radiographic exclusion) of positive PALNs in patients with cervical cancer who received chemoradiation (RT plus C-based chemotherapy) had a significant prognostic impact. Cancer 2008. © 2008 American Cancer Society. [source] | ||||||||||