http://www.issoonline.com The most accessed research articles published by International Seminars in Surgical Oncology 2010-02-28T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Breast papilloma is a term that describes an intraductal papillary configuration of the mammary epithelium on macroscopic or microscopic examination. It includes solitary intraductal papillomas, multiple papillomas, papillomatosis, and juvenile papillomatosis (JP).Recent advances in mammary ductoscopy (MD) have raised new possibilities in the diagnosis and treatment of breast papillomas. This technique represents an important diagnostic adjunct in patients with pathological nipple discharge (PND) by allowing direct visualisation and biopsy of intraductal lesions and guiding duct excision surgery.Treatment of breast papillomas often entails surgical duct excision for symptomatic relief and histopathological examination. Recently, more conservative approach has been adapted. MD-assisted microdochectomy should be considered the procedure of choice for a papilloma-related single duct discharge. Furthermore, there is increasing evidence that MD has the potential to reduce the number of duct excision procedures and minimise the extent of surgical resection. Imaging-guided vacuum-assisted core biopsy can be diagnostic and therapeutic for papillomas seen on mammography and/or ultrasound.Patients with multiple papillomas do have an increased risk of developing cancer and should be kept under annual review with regular mammography (preferably digital mammography) if treated conservatively. Magnetic resonance (MR) can be also used in surveillance in view of its high sensitivity. Because the risk is small, long term and affects both breasts, long-term follow-up is more appropriate than prophylactic mastectomy. Patients who prove to have solitary duct papilloma have insufficient increase in the risk of subsequent malignancy to justify routine follow-up. http://www.issoonline.com/content/3/1/1 Wail Al Sarakbi Dawit Worku Pedro Escobar Kefah Mokbel International Seminars in Surgical Oncology 2006, 3:1 2006-01-17T00:00:00Z doi:10.1186/1477-7800-3-1 International Seminars in Surgical Oncology 1477-7800 3 1 2006-01-17T00:00:00Z XML Skeletal muscle metastases from tumors are a rare occurrence and can present difficult management decisions. We report here on a patient that had been previously treated for squamous cell laryngeal cancer with surgical resection and adjuvant systemic chemotherapy that presented with a metastasis to the rectus abdominis muscle without evidence of recurrent disease at the primary site. After a metastatic workup with PET/CT scan suggested this to be an isolated lesion, surgical excision with negative margins was performed based upon limited treatment options secondary to the location of the tumor and his favorable prognosis suggested by his pathological staging at the time of the initial resection. Here we discuss the incidence of distant metastases from laryngeal cancer and appropriate screening methods. Additionally, skeletal muscle metastases and treatment considerations are discussed. http://www.issoonline.com/content/7/1/1 John Klune Brian Zuckerbraun Allan Tsung International Seminars in Surgical Oncology 2010, 7:1 2010-02-28T00:00:00Z doi:10.1186/1477-7800-7-1 International Seminars in Surgical Oncology 1477-7800 7 1 2010-02-28T00:00:00Z PDF Background: Cystosarcoma phylloides (CP) is an extremely rare form of breast cancer with an unpredictable clinical course. The histological characteristics of this neoplasm have not proved to offer much in the estimation of prognosis of these patients.Patients and methodsIn our clinics, in a time period of 38 years, 22 patients with cystosarcoma phylloides were treated. There were 5 cases of malignancy, 15 cases with benign tumors, and two cases histologically characterized as borderline neoplasia. Metastases were manifested in one patient. All patients were on a 5-year follow-up, except in five cases, one operated three years ago and four operated within the last two years. Results: 16 of 22 patients did not present any signs of local recurrence or metastases. There were three patients that manifested local recurrence and underwent supplementary ongectomy or mastectomy and are free of recurrence ever since. One patient with metastatic CP died. Conclusion: Independently of its histopathological behavior, CP is a tumor difficult to be treated. Meticulous follow-up is mandatory in order to manage possible recurrence of the neoplasm. http://www.issoonline.com/content/6/1/6 Michael Stamatakos Sofia Tsaknaki Konstantinos Kontzoglou John Gogas Alkiviades Kostakis Michael Safioleas International Seminars in Surgical Oncology 2009, 6:6 2009-02-20T00:00:00Z doi:10.1186/1477-7800-6-6 International Seminars in Surgical Oncology 1477-7800 6 6 2009-02-20T00:00:00Z XML A presacral mass can present a diagnostic dilemma for the surgical oncologist. Differential diagnoses include congenital causes such as teratoma or chordoma, neurological causes such as neurilemoma or neurofibroma or other malignancies such as lymphoma or sarcoma. Diagnosis usually requires imaging such as CT and MRI and tissue biopsy. We present an unusual cause of a presacral mass being extramedullary haematopoiesis, found incidentally in a 71 year old female. Extramedullary haematopoiesis is defined as the production of myeloid and erythroid elements outside of the bone-marrow. This diagnosis is extremely rare in the presacral area especially in a patient with no haematological abnormalities. A review of the literature is presented. http://www.issoonline.com/content/6/1/18 Sina Babazadeh Matthew Broadhead John Slavin Peter Choong International Seminars in Surgical Oncology 2009, 6:18 2009-11-08T00:00:00Z doi:10.1186/1477-7800-6-18 International Seminars in Surgical Oncology 1477-7800 6 18 2009-11-08T00:00:00Z XML Background: Nowadays, more breast cancer patients want to have children after the diagnosis of cancer. The purpose of this study is to review the possibility and risks of giving birth among women with breast cancer previously treated by chemotherapy.Case presentationTwo young women aged 28 and 34 respectively, were treated in our clinic for breast cancer, the first (negative hormonal receptors) by surgery, chemotherapy and radiotherapy and the second (positive hormonal receptors) by surgery, radiotherapy and tamoxifen. They both became pregnant, 1 and 8 years after completion of the therapy respectively. Results: Laboratory testing during pregnancy was negative in both cases and after an uneventful course each woman gave birth to a perfectly healthy child. The first patient breastfed her baby for three months, while the second one did not breastfeed her baby at all. Conclusion: Women undergoing chemotherapy for breast cancer can maintain their fertility and get pregnant. Previous chemotherapy for breast cancer does not present any supplementary risks for the child's mental or physical health. http://www.issoonline.com/content/6/1/7 Kontantinos Kontzoglou Michael Stamatakos Sofia Tsaknaki Helen Goga Alkiviades Kostakis Michael Safioleas International Seminars in Surgical Oncology 2009, 6:7 2009-03-02T00:00:00Z doi:10.1186/1477-7800-6-7 International Seminars in Surgical Oncology 1477-7800 6 7 2009-03-02T00:00:00Z XML Background: Idiopathic granulomatous mastitis is an uncommon, benign entity with a diagnosis of exclusion. The typical clinical presentation of idiopathic granulomatous mastitis often mimics infection or malignancy. As a result, histopathological confirmation of idiopathic granulomatous mastitis combined with exclusion of infection, malignancy and other causes of granulomatous disease is absolutely necessary.Case PresentationWe present a case of a young woman with idiopathic granulomatous mastitis, initially mistaken for mastitis as well as breast carcinoma, and successfully treated with a course of corticosteroids. Conclusion: There is no clear clinical consensus regarding the ideal therapeutic management of idiopathic granulomatous mastitis. Treatment options include expectant management with spontaneous remission, corticosteroid therapy, immunosuppressive agents and extensive surgery for refractory cases. http://www.issoonline.com/content/4/1/21 Richard Tuli Brian O'Hara Janet Hines Anne Rosenberg International Seminars in Surgical Oncology 2007, 4:21 2007-07-27T00:00:00Z doi:10.1186/1477-7800-4-21 International Seminars in Surgical Oncology 1477-7800 4 21 2007-07-27T00:00:00Z XML Myxofibrosarcoma is one of the most common sarcomas in elderly patients showing a slight male prevalence. The tumor is mainly located in lower and upper extremities and rarely in trunk, neck and feet. We present a case of a 84-year-old man referred to our tumour center with a giant and neglected high-grade tibial myxofibrosarcoma in the anteromedial side of tibial mid-diaphysis. Large size lesions in association with older age may jeopardise the maintenance of limb vitality, vascularity and stability.Authors performed a complete tumour resection, followed by reconstruction of bone and soft tissue defects with cement, plate and a musculocutaneous gastrocnemius flap, in order to cover the underlying bone and promote uneventful healing and perfusion of the operated extremity.At 2 years postoperatively, limb salvage, good functional outcome and no tumour recurrence were reported while the patient was able to effectively perform the majority of the daily activities. http://www.issoonline.com/content/6/1/16 Domenico Marotta Marina Angeloni Marzia Salgarello Maria Lucia Ricciardella Byron Chalidis Giulio Maccauro International Seminars in Surgical Oncology 2009, 6:16 2009-09-17T00:00:00Z doi:10.1186/1477-7800-6-16 International Seminars in Surgical Oncology 1477-7800 6 16 2009-09-17T00:00:00Z XML Myoepitheliomas of the extremity are rare and usually benign, while a minority display malignant features. This case demonstrates the diagnosis and management of myoepithelioma within the carpal tunnel. Clinical and radiological tumour features were evaluated. Hematoxylin and eosin stained tumour sections were examined, and immunohistochemistry was performed. Histology revealed a nodular mass of epithelioid cells in clusters within a myxoid/chondroid stroma. No mitoses were noted. Cytokeratins, neuron-specific enolase, synaptophysin, glial fibrillary acidic protein, and S100 were positive on immunohistochemistry. A literature review revealed very few prior reports of myoepithelioma in the wrist, and limited data concerning any relationship between recurrence and quality of surgical margins. In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features. Surgical margins noted in future case reports will aid clinical decision making. http://www.issoonline.com/content/6/1/15 Jonathan Clark Stuart Galloway Stephen Schlicht Ross McKellar Peter Choong International Seminars in Surgical Oncology 2009, 6:15 2009-09-09T00:00:00Z doi:10.1186/1477-7800-6-15 International Seminars in Surgical Oncology 1477-7800 6 15 2009-09-09T00:00:00Z XML Peritoneal carcinomatosis from gastrointestinal cancer has new treatment options for surgical management. The approach uses cytoreductive surgery which combines peritonectomy and visceral resection in an effort to remove all visible cancer within the abdomen and pelvis. Then the peritoneal cavity is flooded with chemotherapy solution in an attempt to eradicate residual disease. In order to select patients for this approach the quantitative prognostic indicators for carcinomatosis were reviewed, compared and contrasted. Prognostic indicators to be used to select patients for this aggressive approach at the initiation of surgery and after completion of cytoreduction were studied. Four quantitative assessments to be used at the time of abdominal exploration were the Gilly staging, Japanese gastric cancer P score, peritoneal cancer index (PCI), and the simplified peritoneal cancer index (SPCI). All have value with the PCI being the most validated and most precise. Preoperative assessments include the tumor histopathology and the prior surgical score. The completeness of cytoreduction score is an assessment of residual disease after a maximal surgical effort. An opportunity for long-term survival following treatment for carcinomatosis requires a complete cytoreduction in all reports for gastrointestinal cancer. Quantitative prognostic indicators need to be knowledgeably employed when patients with carcinomatosis are being treated. Improved patient selection with greater benefit and reduced morbidity and mortality should result. http://www.issoonline.com/content/2/1/3 Rhonda Harmon Paul Sugarbaker International Seminars in Surgical Oncology 2005, 2:3 2005-02-08T00:00:00Z doi:10.1186/1477-7800-2-3 International Seminars in Surgical Oncology 1477-7800 2 3 2005-02-08T00:00:00Z XML Background: Gastrointestinal stromal tumours are rare (GIST). However, the incidence of GIST among neurofibromatosis type 1 (NF-1) patients is approximately 3.9-25%. GIST can present clinically in different ways such as abdominal pain, gastrointestinal bleeding and obstruction.Case reportWe present 51 year female patient admitted with Background of neurofibromatosis type 1 admitted with melena. OGD has been done and showed duodenitis with large volume fresh blood in distal duodenum but no obvious bleeding point. Exploratory laparotomy revealed smooth nodular masses on the serosal surface of jejunum. Small bowel resection and side-to-side anastomosis were performed. Histopathoogical examination revealed small bowel gasrointestinal stromal tumour with low risk malignant potential. Conclusion: The incidence of GIST among neurofibromatosis type 1 (NF-1) patients is not uncommon and we should pay attention to gastrointestinal manifestation in such patients. http://www.issoonline.com/content/6/1/17 Esam Aboutaleb Manish Kothari Osama Damrah Ruben Canelo International Seminars in Surgical Oncology 2009, 6:17 2009-10-23T00:00:00Z doi:10.1186/1477-7800-6-17 International Seminars in Surgical Oncology 1477-7800 6 17 2009-10-23T00:00:00Z XML