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Sternal chondrosarcoma – a case report
01/2021 MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Michal Reška, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Vladimír Červeňák; prof. MUDr. Jiří Veselý, CSc.; MUDr. Zdeněk Dvořák, Ph.D.; MUDr. Tomáš Hanslík; MUDr. Adam Peštál, Ph.D.; MUDr. Vadym Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.
This case report presents the case of a 68-year-old man, who presented with slow-growing, slightly painful infiltration in the lower half of the sternum observed for two years. According to the performed computed tomography examination, a 7 * 6 * 6.5 cm infiltration of the middle part of the sternum was found. Lesion was extending 1 cm ventrally and 4 cm dorsally into the surrounding soft tissues. An open biopsy was performed with the finding of moderately differentiated (grade 2) conventional chondrosarcoma. Subsequently a multidisciplinary team composed of: the Musculoskeletal tumour committee of the Masaryk Oncology Institute in Brno, the 1st Orthopaedic Clinic of St. Anne's Faculty Hospital in Brno and the 1st Surgical Clinic of St. Anne's Faculty Hospital in Brno had referred the patient to plan and perform the surgical resection of the tumours lesion. A partial resection of the sternum with the tumor was performed, followed by reconstruction of the defect with two condensed polytetrafluoroethylene meshes using the so called „sandwich technique". Then the defect was strengthened using titanium splints and subsequently reconstructed by pectoralis major muscle flap. Definitive histology confirmed the finding of grade 2 conventional sternal chondrosarcoma.
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This case report presents the case of a 68-year-old man, who presented with slow-growing, slightly painful infiltration in the lower half of the sternum observed for two years. According to the performed computed tomography examination, a 7 * 6 * 6.5 cm infiltration of the middle part of the sternum was found. Lesion was extending 1 cm ventrally and 4 cm dorsally into the surrounding soft tissues. An open biopsy was performed with the finding of moderately differentiated (grade 2) conventional chondrosarcoma. Subsequently a multidisciplinary team composed of: the Musculoskeletal tumour committee of the Masaryk Oncology Institute in Brno, the 1st Orthopaedic Clinic of St. Anne's Faculty Hospital in Brno and the 1st Surgical Clinic of St. Anne's Faculty Hospital in Brno had referred the patient to plan and perform the surgical resection of the tumours lesion. A partial resection of the sternum with the tumor was performed, followed by reconstruction of the defect with two condensed polytetrafluoroethylene meshes using the so called „sandwich technique". Then the defect was strengthened using titanium splints and subsequently reconstructed by pectoralis major muscle flap. Definitive histology confirmed the finding of grade 2 conventional sternal chondrosarcoma.
Subsolid lung nodulus in CT imaging in a female patient with colorectal carcinoma – case report
01/2021 MUDr. Vladimír Červeňák; MUDr. Alena Berková, Ph.D.; MUDr. Zdeněk Chovanec, Ph.D.; doc. MUDr. Jiří Vaniček, Ph.D.; MUDr. Tomáš Hanslík; MUDr. Sabina Svobodová
Lung cancer is the third most common malignant process in both women and men. Lung adenocarcinoma with lepidic growth is a variant that is characterized by its proliferative growth along intact alveolar walls. More women and non-smokers tend to be affected. Early diagnosis reveals a tumor process in the non-invasive or mini-invasive stage, and the prognosis for five-year survival is around 100%. The imaging method of choice is computed tomography, where a typical image of carcinoma with lepidic growth is the subsolid nodule. Theoretical information concerning this unusual diagnosis is supplemented in the article by a clear case report of a female patient with colorectal cancer and a subsolid nodulus of the left upper pulmonary lobe, in which histological examination confirmed the diagnosis of lung adenocarcinoma with lepidic growth.
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Lung cancer is the third most common malignant process in both women and men. Lung adenocarcinoma with lepidic growth is a variant that is characterized by its proliferative growth along intact alveolar walls. More women and non-smokers tend to be affected. Early diagnosis reveals a tumor process in the non-invasive or mini-invasive stage, and the prognosis for five-year survival is around 100%. The imaging method of choice is computed tomography, where a typical image of carcinoma with lepidic growth is the subsolid nodule. Theoretical information concerning this unusual diagnosis is supplemented in the article by a clear case report of a female patient with colorectal cancer and a subsolid nodulus of the left upper pulmonary lobe, in which histological examination confirmed the diagnosis of lung adenocarcinoma with lepidic growth.
Mature teratoma of the thymus, random diagnosis in patient with ebrieta
06/2020 MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Vladimír Červeňák; MUDr. Tomáš Hanslík; MUDr. Adam Peštál, Ph.D.; MUDr. Vadym Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.
The case report presents the case of the 23-year-old, an asthmatic man, being investigated for sudden shortness of breath, non-traumatic pain in the left shoulder and back after abuse alcohol. On the X-ray there was dilated mediastinum to the left side and in CT of chest was 4 * 5 * 5 cm size infiltration of anterior mediastinum. A pulmonary examination and fine needle biopsy were performed during the first hospitalization. In differential diagnosis was from low grade myofibroblastic sarcoma to mediastinal teratoma. It was indicated surgery revision. Procedure start uncomplicated diagnostic videothoracoscopy with frozen section and continuing to sternotomy extended to anterior left thoracotomy with extirpation on the mediastinal infiltration. Definitive histology confirms mature teratoma of the thymus.
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The case report presents the case of the 23-year-old, an asthmatic man, being investigated for sudden shortness of breath, non-traumatic pain in the left shoulder and back after abuse alcohol. On the X-ray there was dilated mediastinum to the left side and in CT of chest was 4 * 5 * 5 cm size infiltration of anterior mediastinum. A pulmonary examination and fine needle biopsy were performed during the first hospitalization. In differential diagnosis was from low grade myofibroblastic sarcoma to mediastinal teratoma. It was indicated surgery revision. Procedure start uncomplicated diagnostic videothoracoscopy with frozen section and continuing to sternotomy extended to anterior left thoracotomy with extirpation on the mediastinal infiltration. Definitive histology confirms mature teratoma of the thymus.
Mucinous neoplasms of the appendix – case report
06/2020 MUDr. Alena Berková, Ph.D.; MUDr. Petr Vlček, Ph.D.; MUDr. Ilona Krejčová; MUDr. Tamara Vystrčilová; MUDr. Vladimír Červeňák; MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Sabina Svobodová
Patient, 59year-old, with ulcerative colitis was examined with intermittent abdominal pain. An abdominal ultrasound examination was performed, mucocele of the appendix was suspected, and subsequently confirmed by magnetic resonance imaging. Mucocele is a cystic dilatation of the appendix caused by luminal obstruction leading to intraluminal mucous accumulation. Mucocele is very often asymptomatic. However, due to the potential malignancy and the risk of rupture with development of pseudomyxoma of the peritoneum, mucocele should be surgically removed. Laparoscopic appendectomy was indicated. Histological examination revealed low-grade mucinous neoplasia of appendix, evaluated as pTis according to WHO 2019 and 8th edition of the TNM classification. Surgical margins were without pathological involvement. According to the histological findings, appendectomy was a sufficient treatment mode, and the patient was further followed up in the oncology and gastroenterology outpatient department.
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Patient, 59year-old, with ulcerative colitis was examined with intermittent abdominal pain. An abdominal ultrasound examination was performed, mucocele of the appendix was suspected, and subsequently confirmed by magnetic resonance imaging. Mucocele is a cystic dilatation of the appendix caused by luminal obstruction leading to intraluminal mucous accumulation. Mucocele is very often asymptomatic. However, due to the potential malignancy and the risk of rupture with development of pseudomyxoma of the peritoneum, mucocele should be surgically removed. Laparoscopic appendectomy was indicated. Histological examination revealed low-grade mucinous neoplasia of appendix, evaluated as pTis according to WHO 2019 and 8th edition of the TNM classification. Surgical margins were without pathological involvement. According to the histological findings, appendectomy was a sufficient treatment mode, and the patient was further followed up in the oncology and gastroenterology outpatient department.
Atypical manifestation of non‑small cell lung carcinoma – case report
06/2020 MUDr. Tomáš Hanslík; MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Stanislav Špelda; MUDr. Michal Benej, Ph.D.; MUDr. Adam Peštál, Ph.D.; MUDr. Vadim Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.; MUDr. Vladimír Červeňák; MUDr. Tetiana Shatokhina
The authors acquaint the readers through a case report with a patient in whom non-small cell lung cancer manifested itself in an atypically bulky arching of the chest wall. Initially, it acted clinically and radiologically as chest wall sarcoma, as no tumorous infiltration of the lung parenchyma was evident. There was also a deposit of the right thyroid lobe of uncertain origin. Finally a number of immunohistochemical tests have brought about the resolution and diagnosis. According to genetic examination, the presence of a programmed cell death-ligand 1 (PD-L1) mutation was demonstrated in the cancer, and subsequently immunological therapy was used, which led to a significant regression of the tumor mass of the chest wall.
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The authors acquaint the readers through a case report with a patient in whom non-small cell lung cancer manifested itself in an atypically bulky arching of the chest wall. Initially, it acted clinically and radiologically as chest wall sarcoma, as no tumorous infiltration of the lung parenchyma was evident. There was also a deposit of the right thyroid lobe of uncertain origin. Finally a number of immunohistochemical tests have brought about the resolution and diagnosis. According to genetic examination, the presence of a programmed cell death-ligand 1 (PD-L1) mutation was demonstrated in the cancer, and subsequently immunological therapy was used, which led to a significant regression of the tumor mass of the chest wall.
Epithelial tumors of the thymus and diagnostic options
05/2020 MUDr. Vladimír Červeňák, MUDr. Zdeněk Chovanec, Ph.D., MUDr. Alena Berková, Ph.D., doc. MUDr. Jiří Vaníček, Ph.D., MUDr. Tomáš Hanslík, MUDr. Sabina Svobodová, MUDr. Robert Novák
Epithelial tumors are the most common tumors of the thymus. This group of tumors includes thymomas and thymic carcinoma and these tumors are very rare, although they are among the most common tumors of the anterior mediastinum in adults. The thymus is an organ of the immune system that can be routinely monitored by various chest examination methods. We encounter it more in children, but it is no exception in adults either. The problem in adults is its variable appearance, as it goes through the process of involution. Involution is support by the corticosteroids during excessive stress. Likewise, these conditions can change its shape and size. The basics of embryology, anatomy together with knowledge of imaging methods, are a necessary condition for accurate diagnosis of benign and malignant thyroid tumors. Only the correct identification of these pathologies allows you to choose the appropriate method of therapy.
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Epithelial tumors are the most common tumors of the thymus. This group of tumors includes thymomas and thymic carcinoma and these tumors are very rare, although they are among the most common tumors of the anterior mediastinum in adults. The thymus is an organ of the immune system that can be routinely monitored by various chest examination methods. We encounter it more in children, but it is no exception in adults either. The problem in adults is its variable appearance, as it goes through the process of involution. Involution is support by the corticosteroids during excessive stress. Likewise, these conditions can change its shape and size. The basics of embryology, anatomy together with knowledge of imaging methods, are a necessary condition for accurate diagnosis of benign and malignant thyroid tumors. Only the correct identification of these pathologies allows you to choose the appropriate method of therapy.
Differential diagnosis of presacral tumors
04/2020 MUDr. Alena Berková, Ph.D.; MUDr. Petr Vlček, Ph.D.; MUDr. Tamara Vystrčilová; MUDr. Ilona Krejčová; MUDr. Vladimír Červeňák; MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Sabina Svobodová; prof. MUDr. Ivan Čapov, CSc.
Presacral tumors, whether benign or malignant, are rare and often asymptomatic in adults. Due to its rare incidence and specific placement, they can cause considerable difficulties in the diagnosis and the therapeutic process. The diagnosis is based on a carefully taken anamnesis, clinical findings and display methods. Treatment for presacral tumors is determined by the type of tumor, comorbidities, and age of the patient. It is necessary to take into consideration that with increasing age the size of the tumor increases, the probability of its malignancy increases, and last, but not least, the number of associated comorbidities also increase. Specifically, due to the possibility of growth and the risk of malignant reversal, presacral tumors are primarily indicated for surgical treatment, even though they are small or asymptomatic. Knowledge of the etiology, diagnosis and therapeutic procedures is important in the treatment of these tumors. Incorrect diagnosis or improper treatment can lead to adverse tumor development and significant morbidity.
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Presacral tumors, whether benign or malignant, are rare and often asymptomatic in adults. Due to its rare incidence and specific placement, they can cause considerable difficulties in the diagnosis and the therapeutic process. The diagnosis is based on a carefully taken anamnesis, clinical findings and display methods. Treatment for presacral tumors is determined by the type of tumor, comorbidities, and age of the patient. It is necessary to take into consideration that with increasing age the size of the tumor increases, the probability of its malignancy increases, and last, but not least, the number of associated comorbidities also increase. Specifically, due to the possibility of growth and the risk of malignant reversal, presacral tumors are primarily indicated for surgical treatment, even though they are small or asymptomatic. Knowledge of the etiology, diagnosis and therapeutic procedures is important in the treatment of these tumors. Incorrect diagnosis or improper treatment can lead to adverse tumor development and significant morbidity.
The case of long‑term response with good quality of life at the patient with cholangiocellular carcinoma
01/2019 MUDr. Robert Novák; MUDr. Jana Katolická, Ph.D.; MUDr. Vladimír Červeňák
Cholangiocarcinoma is a disease with poor prognosis with 5-year survival 5-15%. In our case report we are presenting the case of long term response of pacient with intrahepatic cholangicarcinoma, after complete resection, with repeated recurrencies, after repeated surgical inetrventions and administrations of chemotherapy.
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Cholangiocarcinoma is a disease with poor prognosis with 5-year survival 5-15%. In our case report we are presenting the case of long term response of pacient with intrahepatic cholangicarcinoma, after complete resection, with repeated recurrencies, after repeated surgical inetrventions and administrations of chemotherapy.