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Mediastinal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
For the vast majority (more than two-thirds), primary mediastinal tumours in adults occur in the anterior mediastinum and are benign in pathology. In contrast, children are more often in the posterior mediastinum and malignant (5). The factors most often associated with malignant mediastinal tumours are location, patient age, the presence or absence of symptoms, and the presence or absence of known malignant disease elsewhere. Malignant masses are most commonly situated in the anterior compartment, accounting for 60% of such lesions compared with 29% and 16% in the middle and posterior compartments, respectively (Table 5.2) (6,7). With respect to age, the malignant mediastinal lesions lymphoma and neuroblastoma are the most frequent in the first and second decades, and lymphomas and germ cell tumours are present in the second to fourth decades of life. Malignant lesions are more likely to be symptomatic (85%) than benign neoplasms (46%) (7). In the setting of patients with known extramediastinal primary lesions, metabolically active masses are most often due to metastatic disease rather than incidental benign mediastinal nodes or masses.
The Many Faces of Neoplasia
Published in Jeremy R. Jass, Understanding Pathology, 2020
It can be stated that in comparison with malignant neoplasms, benign neoplasms are more likely to be small, slow-growing, well circumscribed and similar in microscopic structure to the tissue of origin. Benign tumours are often stated to be encapsulated, but this applies only to a small subset of those growing within solid organs or connective tissues. The capsule is usually little more than a thin layer of compressed connective tissue derived from the surrounding structures. The majority of benign neoplasms develop within epithelial surfaces and are not encapsulated.
The locomotor system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Aneurysmal bone cyst may affect any bone but typically occurs in the posterior elements of vertebrae and the metaphysis of long bones. Patients, usually children and young adults, complain of pain and swelling which often increases rapidly. X-rays show a well-circumscribed area of bone lysis, often with very marked eccentric expansion. Anastomosing blood-filled spaces are seen (Figure 13.30), separated by fibrous septa containing bony trabeculae and osteoclastic giant cells. Although aneurysmal bone cysts may mimic a malignant tumour clinically and radiologically, they are benign. Recent evidence indicates that they are benign neoplasms and not simply reactive conditions. They are associated with specific translocations resulting in the fusion of the USP6 gene on chromosome 17 with an active promoter of another gene. FISH for USP6 can be used to aid diagnosis. A variety of benign and malignant tumours may contain areas of secondary aneurysmal bone cyst change, so the pathologist must examine the entire specimen for any pre-existing lesion.
Safety evaluations of adalimumab for childhood chronic rheumatic diseases
Published in Expert Opinion on Drug Safety, 2020
Ilaria Maccora, Maria Pia dell’Anna, Alfredo Vannacci, Gabriele Simonini
A Finnish cohort including 348 consecutive JIA patients, 94 of whom treated with Adalimumab, a reported 167/100 PY AEs: the most common were infections and injection-site reactions [41]. Upper-respiratory tract infections resulted in the most frequent infections (38.3%, 31.4/100 PY), without significant differences between Adalimumab and other biologics. Three patients on Adalimumab (2.1/100 PY) experienced serious infectious AEs: septicemia in one, pneumonias in 2. No cases of Mycobacterium tuberculosis were observed, although there was a case of Mycobacterium avium pneumonia after 12 months on Adalimumab associated with Methotrexate and Hydrossiclorochine. In 11 patients increased liver function tests were reported. Two benign neoplasms were observed, no malignancies. One case of new onset of uveitis and three cases of new onset psoriasis and two of alopecia were reported in this cohort of patients. Growth delay was detected in one patient (1.1%) on Adalimumab, but it is not known whether the disorder occurred before or after therapy. No other autoimmune diseases or death were reported [41].
Therapeutic options for conjunctival neoplasia
Published in Expert Review of Ophthalmology, 2018
Oliver Niels Klefter, Marie Louise Roed Rasmussen, Peter Bjerre Toft, Steffen Heegaard
Benign neoplasms that do not exhibit growth and are easily controlled do not necessarily require referral to a secondary or tertiary center. It seems appropriate, however, to recommend referral to a specialized ocular oncology clinic if there is any suspicion that a conjunctival neoplasm could be pre-malignant or malignant or when advanced surgical management, radiotherapy, or local or systemic chemotherapy could become necessary (Table 1). All excised material must be sent for histopathological evaluation. Hence, clinics that perform surgical excision of conjunctival neoplasms should have access to a pathology service, preferably with expertise in ophthalmic pathology. Specialized ocular oncology clinics should have established co-operations with radiology, oncology, hematology, and radiotherapy services.
Surgical management of primary parapharyngeal space tumors in 103 patients at a single institution
Published in Acta Oto-Laryngologica, 2018
Fenglin Sun, Yan Yan, Dongmin Wei, Wenming Li, Shengda Cao, Dayu Liu, Guojun Li, Xinliang Pan, Dapeng Lei
PPS tumors are rare, comprising only 0.5% of the neoplasms of the head and neck [1]. A variety of primary tumors arise from the normal structures of the PPS; ∼80% are benign and 20% malignant. The most common benign neoplasms are salivary pleomorphic adenomas [3], followed by paragangliomas and neurogenic tumors. Salivary gland neoplasms are the most common primary malignant tumor [4]. Various surgical approaches have been reported, including transcervical, transparotid, and transoral approaches – separately or combined for more exposure and resection of PPS tumors – as well as the use of a robot [5]. Because primary PPS tumors are hidden and have diverse characteristics and anatomical complexities, they are challenging to treat for otorhinolaryngology head and neck surgeons. There is currently little information about the clinical features, diagnoses, surgical approaches, and treatment outcomes of PPS tumors. The purpose of this study was to collect data on these tumors by analyzing our institution’s 15-year experience in the treatment of PPS tumors.