Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution

Okubo, Yoichiro; Yamamoto, Yayoi; Sato, Shinya; Yoshioka, Emi; Suzuki, Masaki; Washimi, Kota; Osaka, Kimito; Suzuki, Takahisa; Yokose, Tomoyuki; Kishida, Takeshi; Miyagi, Yohei

doi:10.1007/s00428-022-03272-0

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…Further analysis is required to define the number of cells counted and cutoff values. There are also smooth muscle tumors of uncertain malignant potential [ 14 , 15 , 27 , 28 ]. However, it is unclear whether it can be considered in all cases arising from deep soft tissue, even in cases with no findings indicating malignancy.…”

Section: Discussionmentioning

confidence: 99%

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Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Ono,

Okubo,

Washimi

et al. 2024

J Med Case Reports

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Background The greater omentum comprises peritoneal, adipose, vascular, and lymphoid tissues. Most omental malignancies are metastatic tumors, and the incidence of primary tumors is rare. We report on a prior omental smooth muscle tumor case in an adult male patient. Case presentation A 54-year-old Japanese male patient with no relevant medical history was diagnosed with an abdominal mass during a routine medical checkup. Subsequent contrast-enhanced computed tomography revealed a mass of approximately 3 cm in size in the greater omentum, and a laparotomy was performed. A 27 × 25 × 20 mm raised lesion was found in the omentum. Microscopically, spindle cells were observed and arranged in whorls and fascicles. Individual tumor cells had short spindle-shaped nuclei with slightly increased chromatin and were characterized by a slightly eosinophilic, spindle-shaped cytoplasm. The mitotic count was less than 1 per 50 high-power fields. The tumor cells showed positive immunoreactivity for α smooth muscle actin, HHF35, and desmin on immunohistochemical examination. The Ki-67 labeling index using the average method was 1.76% (261/14806). No immunoreactivity was observed for any of the other tested markers. We considered leiomyoma owing to a lack of malignant findings. However, primary omental leiomyoma has rarely been reported, and it can be difficult to completely rule out the malignant potential of smooth muscle tumors in soft tissues. Our patient was decisively diagnosed with a primary omental smooth muscle tumor considering leiomyoma. Consequently, the patient did not undergo additional adjuvant therapy and was followed up. The patient was satisfied with treatment and showed neither recurrence nor metastasis at the 13-month postoperative follow-up. Discussion and conclusion We encountered a primary smooth muscle tumor of the greater omentum with no histological findings suggestive of malignancy in an adult male patient. However, omental smooth muscle tumors are extremely difficult to define as benign, requiring careful diagnosis. Further case reports with long-term follow-up and case series are required to determine whether a true omental benign smooth muscle tumor (leiomyoma) exists. In addition, proper interpretation of the Ki-67 labeling index should be established. This case study is a foundation for future research.

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Section: Discussionmentioning

confidence: 99%

“…However, the proportion of these cells varies among cases, and wholly spindle-shaped tumor cells have been reported [ 45 ]. Therefore, it is important to confirm the immunoreactivity of markers, such as HMB45 and Melan A [ 28 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Ono,

Okubo,

Washimi

et al. 2024

J Med Case Reports

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“…In addition, histological grading has important prognostic implications. Therefore, exact histological grading is critical for guiding the following management ( 54 ). In future research, we will strengthen cooperation with the Pathology department, conducting a large pathological review of the adrenal myelolipoma and consequently better individual treatment and prognosis.…”

Section: Discussionmentioning

confidence: 99%

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Feng

Chen

et al. 2022

Front. Oncol.

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IntroductionAdrenal myelolipomas are benign tumors composed mainly of lipomatous elements with myeloid cells. With the development of medical imaging technology, the detection rate has gradually increased. We report a case of adrenal myelolipoma successfully excised through the laparoscope and reviewed existing literature in recent ten years to summarize the feasibility of the laparoscopic approach for this tumor.Case presentationHerein, we described a case of adrenal myelolipoma resected by laparoscope in a 63-year-old male patient. He did not have any other symptoms except the incidental finding of a left adrenal mass. An abdominal CT examination revealed a mixed-density lesion containing some amount of adipose tissue. In conjunction with the patient’s willingness, we performed a laparoscopic operation to remove the lump. The definite diagnosis was confirmed as an adrenal myelolipoma according to the pathology. The patient recovered well postoperatively and without signs of recurrence at a 5-month follow-up.ConclusionAdrenal myelolipoma is commonly benign, asymptomatic, and hormonal inactivity. A surgical strategy is suggested for high-complication-risk patients. The laparoscopic approach is safe and effective with an obvious advantage over open procedures.

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“…The en-bloc resection rate of EMR in this study (112/114, 98.25%) is slightly higher than those reported in previous study ( 6 , 15 – 20 ), this may be because the lesions size (average size was 1.11 ± 0.60 cm) managed by EMR in our study is relatively small. What’s more, our institution is a high-volume institution that actively carries out endoscopic treatment, which may obtain better curative effect ( 13 , 21 ). These data show that ER is an effective and safe treatment for SDELs.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Non-en Bloc Resection and Non-R0 Resection During Endoscopic Resection in the Treatment of Superficial Duodenal Epithelial Lesions

Gong

Zhou

et al. 2022

Front. Oncol.

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BackgroundSuperficial duodenal epithelial lesions are precancerous lesions of duodenal carcinoma. Upper gastrointestinal endoscopy has been widely used in the screening and treatment of this disease. This article will collect the data of patients who underwent endoscopic resection of superficial duodenal epithelial lesions in our hospital from 2010 to 2021, aiming to describe the efficacy and safety of endoscopic resection, as well as to explore the risk factors of non-en bloc resection and non-R0 resection.MethodsPatients who underwent endoscopic resection for superficial duodenal epithelial lesions in our hospital from January 2010 to September 2021 were selected. The curative effect was expressed by the en bloc resection rate and R0 resection rate. The safety was expressed by intra- or postoperative complications, such as bleeding and perforation. The potential risk factors of curative effect were analyzed by logistic regression.ResultsA total of 137 patients were included. The en bloc resection rate was 95.62% (131/137), R0 resection rate was 91.97% (126/137), the postoperative bleeding rate was 2.19% (3/137), and no postoperative perforation was found. The histology result of ectopic gastric mucosa was the risk factor of non-en bloc resection (OR: 8.86, 95% CI: 1.38-56.92); the lesion size ≥2 cm was the risk factor of non-R0 resection (OR: 12.55, 95% CI: 2.95-53.38).ConclusionEndoscopic resection is a safe and effective method for the treatment of superficial duodenal epithelial lesions. The histology result of ectopic gastric mucosa was the risk factor of non-en bloc resection and the lesion size ≥2 cm was the risk factor of non-R0 resection.

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Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution

Cited by 9 publications

References 30 publications

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Risk Factors of Non-en Bloc Resection and Non-R0 Resection During Endoscopic Resection in the Treatment of Superficial Duodenal Epithelial Lesions

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