Neuroendocrine tumours (NET) frequently metastasise to the liver (NLM) and are associated with significant morbidity and mortality. Numerous treatment options have been implemented both for cure, and to implement disease control. Surgical treatment includes curative resection, palliative cytoreductive resection and transplantation. Complete surgical resection is only possible in a subset of people with NLMs due to excessive metastatic burden and anatomical location. Ablative therapies may be used either as an adjunct to surgery or as a primary treatment. The purpose of the following article is to summarise surgical treatment strategies in the management of patients with hepatic neuroendocrine metastases, based on the available literature.
Phyllodes tumors of the breast display a wide variation in histological appearance and are classified into benign, borderline, and malignant categories based on a combination of histological parameters. These tumors may include a malignant heterologous component that is believed to originate through a process of multidirectional differentiation from a cancer stem cell. In these cases, the tumor is classified as a malignant phyllodes tumor. Among the heterologous elements that have been described in malignant phyllodes tumors are rhabdomyosarcoma, chondrosarcoma, osteosarcoma, liposarcoma and angiosarcoma. We present the first case of a phyllodes tumor with a malignant melanoma component in the breast of a 71-year-old lady, discussing the clinical implications of this diagnosis.
Acquired unilateral alacrima as a presenting sign of an intracranial tumor is exceptionally rare, and only described once previously in a case of nasopharyngeal carcinoma. The authors present a 32-year-old female patient who presents with a year-long history of alacrima and arhinorrhea. She was subsequently diagnosed with a petroclival chondrosarcoma extending into Meckel’s cave and the cavernous sinus and underwent surgical debulking. To the authors' knowledge, this is the first reported case of acquired unilateral alacrima as a presenting feature of a skull base chondrosarcoma. This case serves to remind general ophthalmologists and oculoplastic surgeons alike that acquired alacrima may be the presenting feature of serious intracranial disease.
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