Bladder tumours in Chinese: A 6 year study

Specimens from 334 Chinese patients who underwent surgical treatment for bladder tumours over a 6 year period were studied retrospectively. Transitional cell carcinoma (TCC) accounted for 91.3% of all the bladder tumours. The male to female ratio was 3:1 and the mean age was 69 years. Papillary TCC, which represented 67.5% of all TCC, were more often of a lower grade compared to non-papillary tumours. The staging of tumours was done for the 102 cystectomy specimens with TCC only. Among these, 28% were superficial while 72% were muscle-invasive and the papillary TCC usually presented at an earlier stage. Infiltration into the prostate gland was identified in 11% of male patients while coexisting adenocarcinoma of the prostate was observed in another 4.2%. Other types of carcinoma were uncommon. Squamous cell carcinoma, adenocarcinoma and small cell carcinoma accounted for 2.7, 1.8 and 0.6% of all bladder tumours, respectively. A rare case of sarcomatoid carcinoma was also found, but no true sarcoma was documented in this series. Benign lesions included five inverted papillomas, three nephrogenic adenomas, two paragangliomas and one haemangioma.link_to_subscribed_fulltex

Giant adrenal lipoma: A report of two cases and review of the literature

Lipoma of the adrenal gland is extremely rare. We report two cases of adrenal lipomas, one in a 64-year-old female and the other a 78-year-old male. The sizes of these tumours (4.5 cm and 8 cm) were larger than those reported in the literature. Both cases were found incidentally, one at autopsy and the other during ultrasonographic examination for unrelated condition. The histogenesis, clinicopathological features, differential diagnosis and management of these cases are discussed.link_to_subscribed_fulltex

A review of clinicopathologic features of pheochromocytomas in Hong Kong Chinese

Twenty-two Chinese patients with pheochromocytomas incuding 18 surgical and four autopsy cases were reported. The incidence at autopsy was 0.048%. The tumours were most common in the sixth and the fourth decades in males and females respectively. There was no sex predilection. The incidence of bilaterality was 4.5% and the tumours were more common on the right side. 9.1% of the the tumours were malignant and they were larger than their benign counterparts. Solid and diffuse pattern and mixed pattern were the most common histologic patterns. Minor histological features included hyaline globules (64%) nuclear pseudo-inclusions (55%) lipid degeneration (4.5%) and peri-adrenal brown fat (18%). All of them were strongly positive for the three pan-neuroendocrine markers (neuron-specific enolase synaptophysin and chromogranin) confirming the usefulness of these markers in diagnosing pheochromocytoma.link_to_subscribed_fulltex

Clinicopathological analysis of local spread of carcinoma of the tongue

BACKGROUND: The aims of the study are three-dimensional analysis of mode and distance of local spread of oral tongue carcinoma. METHODS: The glossectomy specimens were examined in the coronal plane in 3 mm thickness section. RESULTS: There were 50 glossectomy specimens. The maximum spread was 1.8 cm. Ninety-six percent of specimens had local spread within 1.2 cm. The distance of spread was not correlated with tumor size, including the diameter, depth, and volume. The incidence of local recurrence was 27% with positive histological margin. Perineural Infiltration was the most important prognostic factor for local recurrence and survival. CONCLUSIONS: A minimum of 1.5-cm surgical resection margin is recommended. A smaller margin is not recommended as it has significant risk of local recurrence. A maximum of 2- cm surgical resection margin is recommended; larger margins Will increase the surgical morbidity without a significant advantage of local control.link_to_subscribed_fulltex

Cardiac tumors in Hong Kong a clinicopathological study of 66 cases

A retrospective analysis of cardiac tumors surgically excised in a 14- year period in Hong Kong was performed. The study showed 65 primary tumors (64 cardiac myxomas, one unclassified sarcoma), and one metastatic leiomyosarcoma. All patients were Chinese except a Filipino woman who had a cardiac sarcoma. The incidence of primary cardiac tumors in Hong Kong Chinese was estimated to be 0.83 per million population per year. The mean age of patients at operation was 50. There were 37 females and 27 males with no difference in mean ages between the two groups. The average size of myxoma was 4.7 cm. The anatomic locations of the 64 myxomas were left atrium (60), right atrium (2), mitral valve (1), and atrial septum on both sides (1). The main presenting clinical features were dyspnea (46%), cerebral embolism (32%), and palpitation (27%). No familial or syndromatic case was noted. Well-differentiated glandular structures were found in one right atrial myxoma. The findings were compared with those of a local series of cardiac tumors found at autopsy.link_to_subscribed_fulltex

Absence of Epstein-Barr virus in penile carcinoma: A study of 42 cases using in situ hybridization

Background. The relationship between Epstein-Barr virus (EBV) and carcinomas of the lower female genital tract has been the focus of some studies in recent years. However, the association between EBV and penile carcinoma never has been investigated. The aim of this study was to identify the possible role of EBV in penile carcinoma of Chinese patients. Methods. Formalin fixed, paraffin embedded tissue of 42 cases of penile carcinoma (including 7 verrucous, 14 well differentiated, 15 moderately differentiated, and 6 poorly differentiated squamous cell carcinomas), 6 penile warts, and 9 normal penile samples were analyzed for EBV using in situ hybridization for EBV-encoded RNA (EBER). Results. Epstein-Barr virus was only found in a few lymphocytes adjacent to the tumor epithelium in 12% (5 cases) of penile carcinoma. Conversely, the tumor cells, penile warts, and normal penile tissue were negative for EBV. Conclusions. The results suggest that EBV does not play a major role in the etiology of penile carcinoma.link_to_OA_fulltex

Desmoplastic variant of ameloblastoma in Chinese patients

Desmoplastic ameloblastoma is a rare tumour, and we know of only 43 previously reported cases. We report seven Chinese patients (five men and two women) with the desmoplastic variant of ameloblastoma, which makes up 9% of all ameloblastomas diagnosed during the years 1981-1995. The age ranged from 18 to 68 years (mean 43). Five of the tumours were in the maxilla and two were in the mandible. Five of them were situated anteriorly, the remaining two cases involving both anterior and posterior maxilla. The features of the 42 cases previously reported were reviewed and were compared with those in the present study. Our results differ in that we found a male predominance, wider age range and more tumours in the maxilla. Histologically, this variant of ameloblastoma is characterized by abundant collagenous stroma. Because the epithelial clusters may show prominent squamous metaplasia or may be compressed into thin strands in most areas, the appearance may mimic a squamous odontogenic tumour or odontogenic fibroma. The behaviour of this variant of ameloblastoma is likely to be the same as that of the classic ameloblastoma.link_to_subscribed_fulltex

Clinicopathological analysis of elective neck dissection for no neck of early oral tongue carcinoma

BACKGROUND: The study aims at evaluation of the efficacy of elective neck dissection as a staging and therapeutic procedure for NO neck of early carcinoma of the oral tongue by whole organ serial sectioning. METHODS: There were 50 stage I and II patients. The neck dissection specimens were whole organ sectioned in 3-mm intervals for the evaluation of nodal metastasis. RESULTS: There were 18 (36%) patients with subclinical nodal metastasis. The total number of metastatic nodes were 31 (1%) among all 2,826 nodes being examined. The metastatic foci had a median size of 3 mm and occupied a median of 6% of the cross Sectional area of the involved nodes. The ipsilateral level II nodes were the commonest (26%) site of metastasis. Metastatic nodes were present in 34% patients who had negative preoperative radiological assessment and in 20% patients who had negative intraoperative frozen section sampling of neck nodes. Patients with subclinical nodal metastasis had a high incidence of regional recurrence (62%) and low survival (27%) when postoperative radiotherapy was not given after elective neck dissection. CONCLUSIONS: Ipsilateral level I,II,III neck dissection is an adequate diagnostic procedure for staging of the NO neck of early oral tongue carcinoma. Its diagnostic role cannot be replaced by the available pre- operative radiological screening and intra-operative frozen section sampling. However, elective selective neck dissection is an effective but not adequate therapeutic procedure, and post-operative adjuvant radiotherapy and chemotherapy have to be considered for all pathologically positive necks.link_to_subscribed_fulltex