Introduction. Undifferentiated pleomorphic sarcoma, previously known as malignant fibrous histiocytoma, is the most common soft tissue sarcoma in adults, and retroperitoneum is the second most common location. Case Report. We present a case of a 60-year-old female patient with a painless mass in the left hemiabdomen. Computed tomography revealed a well defined retroperitoneal mass, while magnetic resonance showed a lobulated hypointense mass on T1-weighted and heterogeneous on T2-weighted images 180 x 230 x 250 mm in size, with intense peripheral enhancement. The patient underwent complete tumor excision, as well as reoperation after local recurrence. After histopathological and immunohistochemical analysis of the operating material, the diagnosis of malignant fibrous histiocytoma (giant cell type) was made. Conclusion. Radiological imaging has a limited diagnostic accuracy in undifferentiated pleomorphic sarcomas and definitive diagnosis relies on histopathological confirmation.
Introduction. According to the latest data from International Agency for Research on Cancer from 2018, global burden of cancer cervical cancer is the fourth most common cancer in women worldwide. The aim of this article was to present the contributions of the new, revised 2018 International Federation of Gynecology and Obstetrics staging of carcinoma of the cervix uteri, allowing much more precise staging with the use of any imaging modalities and/or pathological findings to allocate the stage and provide more effective treatment. International Federation of Gynecology and Obstetrics staging system. The main changes in the new staging system were made in IB stage of the disease, which now includes 3 subgroups i.e. substages for every 2 cm increments in tumor size: stage IB1 (< 2 cm), stage IB2 disease (2 to < 4 cm), and stage IB3 (? 4 cm). This system also incorporates the lymph node status into stage III cervical cancer, allowing imaging and/or pathological findings of lymph nodes to the pelvic and/or para-aortic nodes to assign stage IIIC disease. Conclusion. The main goal of the new staging system revision was to improve the accuracy of staging in order to provide more refined understanding of prognostic groups and facilitate better treatment for women with invasive cervical cancer.
IntroductionMagnetic resonance imaging (MRI) with its innovative techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), increases the diagnostic accuracy in distinguishing between malignant and benign lesions of the endometrium. The aim of the study was MRI differentiation between malignant and benign endometrial lesions and correlation with histopathological findings with a special emphasis on quantitative analysis. An additional aim was to correlate the ADC values and histological tumor grades.MethodsThe prospective study included 119 female patients with or without vaginal bleeding and pathological values of endometrial thickness, who underwent MRI examinations. According to MRI reports the patients were divided into 45 suspicious malignant and 74 suspicious benign endometrial lesions. The radiological diagnosis was compared to the histopathological evaluation, which confirmed 37 malignant lesions while the rest were benign.ResultsThe mean ADC value for malignant lesions was 0.761 ± 0.13×10−3 mm2/s and for benign lesions was 1.318 ± 0.20×10−3 mm2/s. The ADC values for malignant lesions were expectedly lower than those of benign lesions (p<0.001). The ADC cut-off value was 1.007×10−3 mm2/s with a sensitivity of 100%, specificity of 92.7%, a positive predictive value of 60.3%, and a negative predictive value of 100%. In comparison with the histopathological findings, the sensitivity of MRI was 100%, specificity 90.2%, positive predictive value was 82.2%, and negative predictive value was 100%. Observing the histological grades 1, 2, and 3 of endometrial carcinoma, no statistically significant differences of mean ADC values were found. The mean ADC values for histological tumor grades 1,2 and 3 were 0.803 ± 0.13×10−3 mm2/s, 0.754 ± 0.12×10−3 mm2/s and 0.728 ± 0.13×10−3 mm2/s, respectively.ConclusionDWI and ADC values represent clinically useful tools for the differentiation between malignant and benign endometrial lesions with high sensitivity and good specificity, but the results failed to demonstrate their usefulness in differentiating histological grades of endometrial cancer.
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