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Endosalpingiosis is a rare benign gynaecologic condition characterised by the presence of epithelial inclusions resembling tubal epithelium outside the fallopian tubes. It is usually found incidentally in postmenopausal women. The ovary... more
Endosalpingiosis is a rare benign gynaecologic condition characterised by the presence of epithelial inclusions resembling tubal epithelium outside the fallopian tubes. It is usually found incidentally in postmenopausal women. The ovary seems to be the most common site of the lesions; however it can develop almost in any pelvic or abdominal organ including the lymphatic structures. We present the case of a 49-year-old patient who was submitted to surgery for bilateral ovarian tumors strongly resembling to malignant tumors. A total hysterectomy with bilateral adnexectomy, pelvic lymph node dissection and omentectomy were performed. The histopathological studies revealed the presence of bilateral ovarian endosalpingiosis associated with lymph node involvement.
Research Interests: Medicine and Lymph Node
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Introduction: The epithelioid trophoblastic tumor (ETT) is a rar e, unusual trophoblastic proliferation, relatively recently defined as a pathological entit y and generally described in women in the reproduct ive period, far less... more
Introduction: The epithelioid trophoblastic tumor (ETT) is a rar e, unusual trophoblastic proliferation, relatively recently defined as a pathological entit y and generally described in women in the reproduct ive period, far less frequently in the postmenopausal women. Case report: This paper presents the case of a 60 years old pa tient who was examined by the gynecologist for vaginal discharge and metrorrhagia whose c ause could not be established following the examina tio of the material obtained by uterine currettage. The tu mor, placed in the lower uterine segment and the up per art of the uterine cervix, was discovered during surgery w ith total hysterectomy for persistent metrorrhagia. The diagnosis, originally established in another pathology service, was that of a poorly differentiated squam ous cell carcinoma. Further reassessment of the case, by puttin g together gross, microscopic and immunohistochemic al aspects with serological data, established the diagno sis f epithel...
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Endosalpingiosis is a rare benign gynaecologic condition characterised by the presence of epithelial inclusions resembling tubal epithelium outside the fallopian tubes. It is usually found incidentally in postmenopausal women. The ovary... more
Endosalpingiosis is a rare benign gynaecologic condition characterised by the presence of epithelial inclusions resembling tubal epithelium outside the fallopian tubes. It is usually found incidentally in postmenopausal women. The ovary seems to be the most common site of the lesions; however it can develop almost in any pelvic or abdominal organ including the lymphatic structures. We present the case of a 49-year-old patient who was submitted to surgery for bilateral ovarian tumors strongly resembling to malignant tumors. A total hysterectomy with bilateral adnexectomy, pelvic lymph node dissection and omentectomy were performed. The histopathological studies revealed the presence of bilateral ovarian endosalpingiosis associated with lymph node involvement.
Research Interests: Medicine and Lymph Node
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Introduction/Background Tumor infiltrating lymphocytes (TILs) are mononuclear immune cells (mainly CD8+ cytotoxic T lymphocytes), infiltrating tumor and surrounding tissues. High levels of TILs might be associated with better response to... more
Introduction/Background Tumor infiltrating lymphocytes (TILs) are mononuclear immune cells (mainly CD8+ cytotoxic T lymphocytes), infiltrating tumor and surrounding tissues. High levels of TILs might be associated with better response to chemotherapy and better overall survival and disease free survival in patients with particular subtypes of breast cancer. Methodology Our study comprised of an analysis of 45 consecutive patients with HER2 positive or triple negative breast cancer (TNBC), treated in the neoadjuvant setting with chemotherapy (antracycline-based chemotherapy and taxanes) and Trastuzumab (if HER2 positive). TILS were assessed using HE staining on core biopsies (cut-off 5%), in chemo-naive patients. Postoperative, pathological complete response (pCR) was assessed for all specimens. Results The median age of our population was 58 years old. 96% of cases were invasive ductal carcinoma NST, 3% - invasive lobular carcinoma and 1% - mixt type. Regarding the molecular subtype, 63.6% were HER2 amplified and 37.4% were TNBC. In our population, 60% of patients had pCR. Of the pCR patients, 81% had TILs positive, while 67% of non-pCR patients had TILs positive. In the HER2 positive subpopulation, 81% of the TILs positive and 40% of the TILs negative had pCR, while in the TNBC subpopulation 55.5% of the TILs positive had pCR. Level of TILs expression did not show a significant difference between pCR and non-pCR groups (39% vs 38%), only the presence or absence of TILs. Conclusion In conclusion, increasing pCR in HER2 positive and triple negative breast cancer correlated with the presence, but not with the levels of TILs. TILs presence on biopsy specimen could be used as a marker of therapy response and insertion of a radiopaque marker in tumor bed in patients with increased likelihood of pCR should be considered, to make breast conserving surgery possible. TILs definite role in breast cancer should be established in future trials. Disclosure Nothing to disclose.
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Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is a rare tumor, which exceptionally occurs at pediatric age. CMV-PTC may develop in patients with familial adenomatous polyposis (FAP) or may be a sporadic tumor. The... more
Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is a rare tumor, which exceptionally occurs at pediatric age. CMV-PTC may develop in patients with familial adenomatous polyposis (FAP) or may be a sporadic tumor. The authors present a case of CMV-PTC in a 10-year-old girl patient without FAP history, who presented with a left neck mass. The patient underwent total thyroidectomy with central compartment neck dissection. Histopathological diagnosis was compatible with cribriform-morular variant of papillary thyroid carcinoma and Hashimoto's thyroiditis. Immunostaining was positive for thyroglobulin, β-catenin, CD10 and p53. Molecular test showed the absence of BRAF, K-RAS mutations, deletions or duplications of APC (adenomatosis polyposis coli) gene and showed the presence of RET÷PTC (rearranged during transfection÷papillary thyroid carcinoma) rearrangements. At 32 months follow-up, the patient was without signs of recurrence. This particular form of thyroid carcinoma should raise suspicion of a possible familial cancer syndrome, therefore early diagnosis and thoroughly evaluation, which includes colonoscopy and genetic screening are mandatory.
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"Collision tumors, rare neoplasms underlying two distinct histological types of carcinomas (with different origins) separated by normal tissue, are described in many organs including the thyroid gland, but to a lesser extent. We aim... more
"Collision tumors, rare neoplasms underlying two distinct histological types of carcinomas (with different origins) separated by normal tissue, are described in many organs including the thyroid gland, but to a lesser extent. We aim to overview the current published data concerning collision tumors of the thyroid (CTT). This is a narrative review considering papers published on PubMed through a search starting from the terms “collision” and “thyroid”. Inclusion criteria are full-length articles, the English language, the timeline from inception to December 2022, and original studies with different levels of statistical evidence. We followed the main types of thyroid carcinomas: differentiated thyroid carcinoma of papillary and follicular type, anaplastic/ undifferentiated/poorly differentiated carcinoma, respectively medullary thyroid carcinoma. We identified 92 papers based on the mentioned key words criteria. We excluded 54 papers (reviews or non-thyroid CTT or other topics outside our purpose). We included in the final analysis 38 papers: 34 case reports (1 patient per paper), 2 case series (2 individuals per each article), one case series of 3 subjects, and a single study of retrospective type (including 21 subjects) – a total of 62 patients on published cases which represents the largest study on published cases to our knowledge (according to our methodology) "
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This is a 36-year old menstruating female who accused abdominal pain of non-specific pattern during the last days. Abdominal ultrasound and computer tomography confirmed a left adrenal mass of 6 centimetres with cystic appearance without... more
This is a 36-year old menstruating female who accused abdominal pain of non-specific pattern during the last days. Abdominal ultrasound and computer tomography confirmed a left adrenal mass of 6 centimetres with cystic appearance without solid elements. No other causes of abdominal pain were identified. Adrenalectomy was performed. The pre- and post-operatory panel of endocrine assessments was normal. Pathological report confirmed an endothelial cyst at the level of a normal adrenal gland. The endothelial cells are introduced in hematoxylin eosin stain at histological report (Figure I: 4X, Figure II: 40X). The immunochemistry reaction is positive for factor VIII in cyst cells of adrenal origin. (Figure III: FVIII positive immunostain in fused and cubic cells, 20X, Figure IV: FVIII in fused cells, 20X). Further on the clinical evolution was good. Adrenal cysts may be endothelial related, epithelial derived and pseudocysts. They are found in both adults and children but the level of e...
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Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Most PTC secretes thyroglobulin, a useful marker in monitoring preoperative staging and postoperative progression; in addition to serum thyroglobulin, fine... more
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Most PTC secretes thyroglobulin, a useful marker in monitoring preoperative staging and postoperative progression; in addition to serum thyroglobulin, fine needle aspiration washout thyroglobulin (FNA-Tg) is also used. Our aim was to determine the cut-off value for FNA-Tg in our center and to describe major discrepancies between FNA-Tg, cytology and pathology results of the lymph nodes. Methods: We retrospectively retrieved from the electronic database of our endocrinology center all the FNA-Tg measurements between December 10, 2019 and September 2021. For each measurement we also retrieved the corresponding sex, FNAB results and the pathology reports. FNA-Tg was measured by ECLIA immunoelectro-chemiluminescent method. Results: There were 58 FNAB and FNA-Tg of suspect cervical lymph nodes in 40 patients. There were 17 cytologically benign lymph nodes of which 13 had low and 4 had high FNA-Tg; 3 non-diagnost...
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Glucagonomas are neuroendocrine tumors (NETs) that arise from the alpha cells of the pancreatic islets. They are typically slow-growing tumors associated with abnormal glucagon secretion, resulting in one or more non-specific clinical... more
Glucagonomas are neuroendocrine tumors (NETs) that arise from the alpha cells of the pancreatic islets. They are typically slow-growing tumors associated with abnormal glucagon secretion, resulting in one or more non-specific clinical features, such as necrolytic migratory erythema (NME), diabetes, diarrhea, deep vein thrombosis, weight loss, and depression. Here, we report the case of a 44-year-old male with a history of diabetes mellitus, presenting with a pruritic and painful disseminated cutaneous eruption of erythematous plaques, with scales and peripheral pustules, misdiagnosed as disseminated pustular psoriasis and treated for 2 years with oral retinoid and glucocorticoids. During this period, the patient complained of weight loss of 32 kg and diarrhea and developed deep vein thrombosis. These symptoms, together with an inadequate response to therapy of the skin lesions, led to the reassessment of the initial diagnosis. Laboratory tests confirmed elevated plasma glucagon leve...
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Osteoporosis represents a worldwide problem due to under diagnosis, and under treatment. The major complications are fragility fractures as vertebral, etc. some of them requiring orthopedic and neurosurgical procedures. We introduce a... more
Osteoporosis represents a worldwide problem due to under diagnosis, and under treatment. The major complications are fragility fractures as vertebral, etc. some of them requiring orthopedic and neurosurgical procedures. We introduce a case of a female adult who was first referred for spine surgery because of osteoporosis complications and then she was followed for a few years based on background skeleton condition. This is a 70-year old subject admitted for a new vertebral fracture assessment and therapy adjustment. She had 3 spine surgeries for multiple vertebral fractures (thoracic 7, 8, 9,10, and 12) during the last 5 years; she was intermittently treated with specific anti-osteoporotic drugs. On admission, the patient has severe kyphosis and secondary walk difficulties; intermittent non-specific lumbar pain. The mineral metabolism indicated no anomaly. DXA confirmed low T-score with reduced values compare to prior analysis. X-Ray assays at spine levels showed diffuse demineraliz...
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cristina Dumitrescu1, anda Dumitrascu1, corina chirita2, eugenia petrova1,3, nicoleta Dumitru1,3, adina Ghemigian1,3, Mara carsote1,3, Dana terzea1,4, ana valea5,6 1 “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania 2... more
cristina Dumitrescu1, anda Dumitrascu1, corina chirita2, eugenia petrova1,3, nicoleta Dumitru1,3, adina Ghemigian1,3, Mara carsote1,3, Dana terzea1,4, ana valea5,6 1 “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania 2 MedicZone Medical Centre, Bucharest, Romania 3 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 4 Oncoteam, Bucharest, Romania 5 Clinical County Hospital, Cluj-Napoca, Romania 6 “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Menopause comes with different changes including estrogen deficiency – related qualitative and quantitative progressive skeleton deterioration. The physiological process turns to pathology, respective osteopenia and osteoporosis at... more
Menopause comes with different changes including estrogen deficiency – related qualitative and quantitative progressive skeleton deterioration. The physiological process turns to pathology, respective osteopenia and osteoporosis at central DXA (Dual-Energy X-Ray Absorptiometry) or low lumbar – DXA derived TBS (Trabecular Bone Score) or increased 10-year probability of major osteoporotic/hip fractures provided by FRAX. We aim to briefly introduce the methods of menopausal fracture risk assessment if back pain is presented from an endocrine point of view. This is a vignette type of manuscript focusing on imagery tools. A 60-year old smoker woman with 10 years since menopause and prior corticotherapy accuses persistent back pain for a few weeks, with mild to medium intensity and responsive to small doses of pain medication. Profile plain X-Ray showed no vertebral fractures. FRAX estimated risk was low. Lumbar DXA (GE Lunar Prodigy) showed osteopenia (a T-score of -1.9 SD) while TBS sho...
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Background and aimThe cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults.General dataThree major types have been described:... more
Background and aimThe cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults.General dataThree major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression. Adrenal hemorrhage represents a particular condition associating precipitating factors such as: coagulation defects as Factor IX or X deficiency, von Willebrand disease, thrombocytopenia; antiphospholipid syndrome; previous therapy with clopidogrel or corticosteroids; the rupture of a prior tumour. At birth, the most suggestive features are abdominal palpable mass, anemia, and persistent ja...