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EN
The aim of this paper is to present the case of a 70-year-old women with endolymphatic sac tumor and temporal bone destruction treated at Otolaryngology Department of MUG. The patient was admitted to our Department due to a 3-year history of hearing loss, dizziness and ear pain. The first diagnosis was temporal bone tumor connected with von Hippel-Lindau syndrome (VHL). The patient was surgically treated. During intraoperative examination, a neoplasm was determined. The tumor was excised via transmastoid approach with sigmoid sinus skeletonization. After treatment, her pains disappeared. Histopathological and immunohistochemical examination revealed endolymphatic sac tumor. Follow-up CT showed no tumor remission.
EN
Introduction: The paper aims to demonstrate the Clinic’s and own research in the treatment of major salivary gland tumors. Material and method: In the years 2013–2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61–70 (34.7%) and 51–60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016–2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma. Conclusions: The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.
EN
Introduction: The paper aims to demonstrate the Clinic’s and own research in the treatment of major salivary gland tumors. Material and method: In the years 2013–2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61–70 (34.7%) and 51–60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016–2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma. Conclusions: The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.
EN
Preclinical studies conducted over the past 10 years have shown that EPO is not only a hormone that regulates erythropoiesis, a major growth factor, but also a cytoplasm with pleiotropic activity that also affects cancer cells. The expression of EPO and its receptor (EPOR) occurs in many cancers of various origins. The EPO/EPOR system is active in many cancer cells and is involved in the modification of molecular signaling pathways and the stimulation of growth, survival, motility and the ability to create metastases. EPO can also increase the resistance of cancer cells in vitro and in vivo to chemotherapy and radiotherapy.
EN
Alterations in the expression of growth factors and their receptors are associated with the growth and development of human tumors. One such growth factor is IGF-I (insulin-like growth factor I ), a 70-amino-acid polypeptide expressed in many tissues, including brain. IGF-I is also expressed at high levels in some nervous system-derived tumors, especially in glioblastoma. When using IGF-I as a diagnostic marker, 17 different tumors are considered as expressing the IGF-I gene. Malignant glioma, the most common human brain cancer, is usually fatal. Average survival is less than one year. Our strategy of gene therapy for the treatment of gliomas and other solid tumors is based on: 1) diagnostic using IGF-I gene expression as a differential marker, and 2) application of "triple-helix anti-IGF-I " therapy. In the latter approach, tumor cells are transfected with a vector, which encodes an oligoribonucleotide - an RNA strand containing oligopurine sequence which might be capable of forming a triple helix with an oligopurine and/or oligopyrimidine sequence of the promotor of IGF-I gene (RNA-IGF-I DNA triple helix). Human tumor cells transfected in vitro become down-regulated in the production of IGF-I and present immunogenic (MHC-I and B7 expression) and apoptotic characteristics. Similar results were obtained when IGF-I antisense strategy was applied. In both strategies the transfected cells reimplanted in vivo lose tumorigenicity and elicit tumor specific immunity which leads to elimination of established tumors.
EN
Both ghrelin and obestatin are peptides derived from the same precursor – preprohormone – encoded on the 3rd chromosome (3p25-26). Both hormones are secreted to the bloodstream. Ghrelin has 28-amino acids with serine at position 3. It is an endogenous ligand of growth hormone receptor (GHS), which has been discovered in hypophysis and hypothalamus. Ghrelin may occur in active and inactive forms. In order to achieve biological activity, ghrelin must contain a N-octa-acetyl group of serine. Total ghrelin is a sum of active and inactive forms. Ghrelin and its receptors GHS-R1a and 1b (growth hormone secretagogue) are widespread in the body, being present mainly in the gastrointestinal tract, central nervous system, reproductive system, heart and kidneys. Obestatin is a recently discovered 23-amino acids long peptide, produced as a result of proteolytic splitting of the preprohormone ghrelin. Systemic distribution of ghrelin is less well known. Both ghrelin and obestatin play a role in energy management (control appetite, body mass, metabolism of fat and glucose, gastrointestinal function), influence cardiovascular, reproductive and immune systems and participate in modulation of central nervous system function. Ghrelin and obestatin regulate processes of cellular proliferation and apoptosis. Variations of ghrelin and obestatin levels, as well as expression of GHS-R in hypophyseal and neuroendocrine tumors, uterine myomas and both benign and malignant ovarian tumors, confirm their role in tumor development and are a promising topic for future studies in oncology.
PL
Ghrelina i obestatyna są peptydami wywodzącymi się z tego samego prekursora – preprohormonu, który kodowany jest na chromosomie 3. (3p25-26); wydzielane są do krwi. Ghrelina to 28-aminokwasowy peptyd, zawierający serynę w pozycji 3. Jest endogennym ligandem receptora wzrostu (GHS), który wykryto w przysadce i podwzgórzu. Występuje ona w formie aktywnej i nieaktywnej. Aby otrzymać aktywność biologiczną, ghrelina musi zawierać N-oktaacetylową grupę seryny. Ghrelina całkowita to suma form aktywnej i nieaktywnej. Ghrelina i jej receptory GHS-R1a i 1b (growth hormone secretagogue) są szeroko rozpowszechnione w organizmie i występują między innymi w przewodzie pokarmowym, ośrodkowym układzie nerwowym, układzie rozrodczym, sercu i nerkach. Obestatyna to ostatnio wykryty 23-aminokwasowy peptyd powstały na skutek proteolitycznego rozszczepienia preprohormonu ghreliny. Dystrybucja obestatyny w organizmie jest mniej znana. Ghrelina i obestatyna biorą udział w kontroli bilansu energii (apetyt, masa ciała, metabolizm tłuszczów i glukozy, funkcje żołądkowo-jelitowe), a także odgrywają rolę w układzie sercowo-naczyniowym, rozrodczym, modulacji immunologicznej i ośrodkowym układzie nerwowym. Regulują procesy proliferacji i apoptozy komórek. Zmiany stężeń ghreliny i obestatyny oraz/lub ekspresja GHS-R w guzach przysadki mózgowej, guzach neuroendokrynnych przewodu pokarmowego (NET), mięśniakach macicy oraz guzach łagodnych i złośliwych jajnika wskazują na ich udział w rozwoju nowotworów i są obiecującym obiektem badań w onkologii.
Kosmos
|
2017
|
vol. 66
|
issue 2
297-311
PL
Istnieją trzy udokumentowane przypadki zakaźnych nowotworów występujących w środowisku naturalnym: rak pyska diabła tasmańskiego, zakaźny psi guz weneryczny oraz białaczko-podobny nowotwór u małgwi piaskołazu. Komórki zakaźnego nowotworu charakteryzują się podobnym lub takim samym materiałem genetycznym, który jest odmienny od genomu gospodarza. Każdy z opisanych rodzajów nowotworów pochodzi od pierwotnego, wspólnego przodka i szerzy się horyzontalnie miedzy osobnikami. Nowotwór rozprzestrzenia się przez bezpośredni kontakt fizyczny (u psów i diabłów tasmańskich) lub poprzez czynniki środowiskowe, jak np. woda (małże). Mechanizmy, które doprowadziły do wyewoluowania zakaźnej postaci nowotworu i pozwalają nowotworowi unikać odpowiedzi odpornościowej gospodarza, nie są do końca poznane. W tym kontekście, pewne znaczenie może odgrywać poziom zróżnicowania genetycznego populacji zwierząt oraz brak/zaburzenia rozpoznawania swój-obcy. Bardziej dogłębne poznanie biologii tego typu nowotworów, ich dróg rozprzestrzeniania się, tworzenia przerzutów, sposobów unikania mechanizmów odpornościowych gospodarza, może udzielić wielu odpowiedzi na temat biologii innych nowotworów.
EN
There are three documented cases of contagious cancers occurring in natural environment - devil facial tumor disease, canine transmissible venereal tumor and leukemia-like clam cancer. The tumor cells collected from different locations have identical chromosomal rearrangements and they are genetically distinct from their hosts. All the types of transmissible cancers come from an original, common ancestor and they spread through horizontal transmission between individuals. The neoplastic cells are transported through physical contact (dogs and Tasmanian devils) or by environmental factors, e.g. water (soft-shell clams). The mechanisms that led to appearance of the transmissible cancers and that allow the cancer to avoid the host immune response are not yet fully known. In this context, the genetic diversity of animal populations and the lack or disorder of the self/nonself-immune recognition may play a role. In-depth knowledge of biology of this type of cancer: how they can spread, cause metastasis, and avoid immune response, may help to elucidate biology of other cancers.
EN
Proptosis is a characteristic sign that might suggest the diagnosis of different diseases. Proptosis is characterised by the anterior displacement of the eye and its protrusion. The most commonly associated symptoms of proptosis are deteriorated vision, elevated intraocular pressure and inflammation of periocular tissues. The presented study describes two cases of patients with proptosis and periocular pain. In each case, the primary cause of proptosis was initially incorrectly diagnosed and required in-depth diagnostics. In Patient A extrabulbar optic neuritis caused by Lyme disease was suspected and treated with steroids and antibiotics. Subsequently, Graves’ disease was diagnosed and treated with anti-thymocyte globulin. Complete loss of vision was observed after one month of treatment. Radiotherapy and steroid therapy were introduced. Afterwards, the patient’s vision was restored. Patient B, who was treated for hypothyroidism, was admitted to the hospital with elevated intraocular pressure, double vision, a restricted visual field and proptosis. The primary diagnosis was Graves’ ophthalmopathy (GO). However, after in-depth imaging and pathomorphological studies of a specimen taken from the orbit, B-cell lymphoma was diagnosed. After the introduction of correct treatment, significant improvement was noted. Presented work indicates that in-depth diagnostics are crucial when it comes to the differential diagnosis of GO and a tumor of the orbital cavity.
PL
Wytrzeszcz jest objawem charakterystycznym w różnych jednostkach chorobowych. To przemieszczenie gałki ocznej oraz jej wysunięcie do przodu. Pacjentom z wytrzeszczem najczęściej towarzyszą takie objawy, jak pogorszenie widzenia, wzrost ciśnienia śródgałkowego oraz zapalenie tkanek okołooczodołowych. W pracy opisano dwa przypadki pacjentów z objawami wytrzeszczu oraz bólu okołogałkowego, którego pierwotna przyczyna nie została właściwie rozpoznana i wymagała pogłębionej diagnostyki. U pacjenta A wysunięto podejrzenie pozagałkowego zapalenia nerwu wzrokowego w przebiegu choroby z Lyme, leczonego glikokortykosteroidami i antybiotykami. Następnie rozpoznano chorobę Gravesa i zastosowano leczenie globuliną antytymocytarną. Po miesiącu terapii zaobserwowano całkowitą utratę wzroku. Wdrożono radioterapię i sterydoterapię, uzyskując powrót widzenia. Pacjent B, leczony przewlekle na niedoczynność tarczycy, zgłosił się do szpitala z podwyższonym ciśnieniem śródgałkowym, dwojeniem, ograniczeniem pola widzenia oraz wytrzeszczem. Początkowo diagnostyka wskazywała na oftalmopatię Gravesa (Graves’ ophthalmopathy – GO). Jednak po wykonaniu badań obrazowych oraz patomorfologicznych pobranego z oczodołu wycinka stwierdzono chłoniaka z drobnej komórki B. Po wprowadzeniu leczenia nastąpiła znaczna poprawa. W pracy pokazano, jak ważna w przypadku rozpoznania różnicowego pomiędzy chorobami o etiologii zapalnej i nowotworowej jest pogłębiona diagnostyka.
EN
Cervical cancer is the second, after breast cancer, most frequent malignancy in the females worldwide. Annually, about 500 000 new cases are diagnosed and about 275 000 women die thereof. Most cases of cervical cancer are epithelial in origin, while only 15-35% are adenomatous. Recent epidemiological data indicate a gradually increasing incidence of adenocarcinoma with concomitant reduction planoepithelial cancer. The paper presents a case of a 50-year-old patient diagnosed with a cervical adenocarcinoma with bilateral adnexal metastases and concomitant ascites. Clinical signs and intraoperative findings initially suggested an ovarian cancer at FIGO stage IIIC. Based on histological studies, the final diagnosis of adenocarcinoma with adnexal metastases was made. Tumor metastases from the genitals usually originate from ovarian or endometrial cancer. Metastases from the cervical cancer are much less frequent. There are few publications dealing with this issue in the world literature. Furthermore, available papers provide widely divergent data concerning the incidence of metastases to the ovaries and oviducts. Some authors highlight the necessity to exclude the reverse situation – metastases of ovarian cancer to the uterine cervix. Such data only confirm complexity of this issue. Therefore we decided to present the following case report.
PL
Rak szyjki macicy to drugi co do częstości, po raku sutka, nowotwór występujący u kobiet na całym świecie. Obserwujemy około 500 000 zachorowań rocznie, w tym 275 000 zgonów rocznie z powodu tej choroby. Nowotwory nabłonkowe stanowią większość raków szyjki macicy. Jedynie 15-35% nowotworów szyjki to rak gruczołowy. Ostatnie dane epidemiologiczne wskazują na stopniowy wzrost zachorowalności na raka gruczołowego przy jednoczesnym spadku zachorowań na raka płaskonabłonkowego szyjki macicy. W pracy przedstawiono przypadek 50-letniej pacjentki, u której zdiagnozowano raka gruczołowego szyjki macicy z przerzutami do obu jajników i jajowodu oraz towarzyszącym wodobrzuszem. Obraz kliniczny i śródoperacyjny sugerował początkowo raka jajnika w stopniu zaawansowania IIIC wg FIGO. Po uzyskaniu wyniku badania histopatologicznego postawiono diagnozę raka gruczołowego z przerzutami do przydatków. Przerzuty nowotworowe z narządu płciowego występują najczęściej z raków jajnika lub trzonu macicy. Przerzuty z raka szyjki są spotykane zdecydowanie rzadziej. W piśmiennictwie światowym jest niewiele doniesień na ten temat. Ponadto w dostępnych pracach autorzy podają różne dane liczbowe co do częstości występowania przerzutów do jajników i jajowodów. W niektórych pracach wskazuje się na fakt, że istnieje konieczność wykluczenia odwrotnej sytuacji – przerzutów raka jajnika do szyjki macicy. Dane te świadczą o złożoności zagadnienia – był to powód, dla którego postanowiliśmy opisać przypadek naszej pacjentki.
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