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Article: Breast implant-associated anaplastic large cell lymphoma presenting as a breast mass: A case report and literature review.

Galván, Joab Rafael / Cordera, Fernando / Arrangoiz, Rodrigo / Paredes, Luis / Pierzo, Jean Enrique

International journal of surgery case reports

2023 Volume 108, Page(s) 108482

Abstract: Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare neoplasm most frequently associated with textured implant placement. The classic presentation consists of a persistent periprosthetic seroma. Implant removal and ...

Abstract	Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare neoplasm most frequently associated with textured implant placement. The classic presentation consists of a persistent periprosthetic seroma. Implant removal and individualized adjuvant treatment are potentially curative interventions. Most BIA-ALCL present with a seroma, not with a breast and/or axillary mass. Knowledge of this presentation and how to manage it allows an adequate diagnosis, and appropriate treatment with excellent results. Presentation of case: A 44-year-old woman presented with a 3-month history of a right breast mass located in the lower medial quadrant, with associated right axillary lymphadenopathy. Medical history was significant for a mastoplasty with textured implants 15 years before the onset of her symptoms. Imaging studies and histological analysis helped to confirm the diagnosis of BIA-ALCL. A bilateral capsulectomy was performed and adjuvant chemotherapy and immunotherapy were administered. With these interventions, the patient had complete resolution of her symptoms, good cosmetic results, and absence of tumor activity detectable by positron emission tomography with fluorodeoxyglucose (PET-CT FDG) at a 2.5-year follow-up. Discussion: This case describes an atypical presentation of BIA-ALCL as a breast mass, as well as lymph node and bone marrow involvement. Knowledge of the different presentation modalities of this pathology is necessary for a correct diagnosis and treatment. Through a multidisciplinary approach, adequate treatment was given with excellent results. Conclusion: Anaplastic large cell lymphoma associated with breast implants is a clinicopathological entity still little known in some medical fields. A variety of presentations must be considered, and high clinical suspicion must be maintained in patients with a history of textured breast implant placement to optimize diagnosis and avoid delays in treatment.
Language	English
Publishing date	2023-07-07
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2023.108482
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Laparoscopic resection of gastric schwannoma: A case report.

Cordera, Fernando / Salazar-Vitale, Andrea / Mejía-Sánchez, Estephany / Arrangoiz, Rodrigo / Caba-Molina, David / Muñoz-Juárez, Manuel / Luque-de-León, Enrique / Moreno-Paquentín, Eduardo

International journal of surgery case reports

2019 Volume 65, Page(s) 271–274

Abstract: Introduction: Gastric schwannomas are an extremely rare presentation of mesenchymal tumors originating from Schwann cells, accounting for 0.2% of all gastric tumors. Patients are usually asymptomatic, so these tumors are frequently detected incidentally. ...

Abstract	Introduction: Gastric schwannomas are an extremely rare presentation of mesenchymal tumors originating from Schwann cells, accounting for 0.2% of all gastric tumors. Patients are usually asymptomatic, so these tumors are frequently detected incidentally. Presentation of case: 68-year old male patient found to have a 5 cm mass in the lesser curvature of the stomach. After a careful preoperative evaluation, complete laparoscopic resection was performed. Pathology review confirmed a completely resected gastric Schwannoma. The patient's recovery was uneventful. At a one-year follow-up he remains asymptomatic and with no evidence of disease. Discussion: We present the uncommon case of a gastric schwannoma that was appropriately treated with a laparoscopic approach and present a current literature review focusing on diagnostic and treatment methods of these rare tumors. Conclusion: Schwannomas should be included in the differential diagnosis of gastric tumors and can be appropriately treated with a laparoscopic approach.
Language	English
Publishing date	2019-10-25
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2019.10.037
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Article ; Online: Metastatic cervical carcinoma from an unknown primary: literature review.

Arrangoiz, Rodrigo / Galloway, Tom J / Papavasiliou, Pavlos / Ridge, John A / Lango, Miriam N

Ear, nose, & throat journal

2014 Volume 93, Issue 4-5, Page(s) E1–10

Abstract: Carcinoma of an unknown primary (CUP) encompasses a heterogeneous group of tumors for which no primary site can be detected following a thorough history, physical examination, and noninvasive and invasive testing. CUP presenting with metastasis to the ... ...

Abstract	Carcinoma of an unknown primary (CUP) encompasses a heterogeneous group of tumors for which no primary site can be detected following a thorough history, physical examination, and noninvasive and invasive testing. CUP presenting with metastasis to the neck (metastatic cervical carcinoma from an unknown primary [MCCUP]) has been an enigma since von Volkmann first described it in 1882 as a cancer arising in a branchial cleft cyst. Genetic studies have shed some light on this unusual entity. In most cases, clinical features, imaging studies, and a meticulous assessment of the upper aerodigestive tract should assist in identifying the source of disease. Molecular testing of cytologic specimens for Epstein-Barr virus and human papillomavirus (HPV) can facilitate identification of the primary site in the nasopharynx and oropharynx. At least 25% of MCCUPs are directly attributable to HPV-related malignancies, and this number can be expected to increase. Minimally invasive transoral mucosal sampling can identify an otherwise clinically and radiologically occult cancer. We performed a literature review with the objective of discussing the history, epidemiology, clinical presentation, diagnostic workup, and management of MCCUP.
MeSH term(s)	Head and Neck Neoplasms/diagnosis ; Head and Neck Neoplasms/epidemiology ; Head and Neck Neoplasms/secondary ; Head and Neck Neoplasms/therapy ; Humans ; Neoplasms, Unknown Primary ; Prognosis
Language	English
Publishing date	2014-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	750153-5
ISSN	1942-7522 ; 0145-5613
ISSN (online)	1942-7522
ISSN	0145-5613
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Article ; Online: Case report and literature review: Metastatic lobular carcinoma of the breast an unusual presentation.

Arrangoiz, Rodrigo / Papavasiliou, Pavlos / Dushkin, Holly / Farma, Jeffrey M

International journal of surgery case reports

2011 Volume 2, Issue 8, Page(s) 301–305

Abstract: Introduction: Invasive lobular carcinoma is the second most common type of invasive breast carcinoma (between 5% and 15%). The incidence of invasive lobular carcinoma has been increasing while the incidence of invasive duct carcinoma has not changed in ... ...

Abstract	Introduction: Invasive lobular carcinoma is the second most common type of invasive breast carcinoma (between 5% and 15%). The incidence of invasive lobular carcinoma has been increasing while the incidence of invasive duct carcinoma has not changed in the last two decades. This increase is postulated to be secondary to an increased use of combined replacement hormonal therapy. Patients with invasive lobular carcinoma tend to be slightly older than those with non-lobular invasive carcinoma with a reported mean age of 57 years compared to 64 years. On mammography, architectural distortion is more common and microcalcifications less common with invasive lobular carcinoma than invasive ductal carcinoma. The incidence of extrahepatic gastrointestinal (GI) tract metastases observed in autopsy studies varies in the literature from 6% to 18% with the most commonly affected organ being the stomach, followed by colon and rectum. Gastric lesions seem to be slightly more frequent, compared to colorectal lesions (6-18% compared to 8-12%, respectively). Presentation of case: We present the case of a 70-year-old woman who was referred to our institution with a concurrent gastric and rectal cancer that on further evaluation was diagnosed as metastatic invasive lobular carcinoma of the breast. She has a stage IV clinical T3N1M1 left breast invasive lobular carcinoma (ER positive at 250, PR negative, HER-2/neu 1+ negative) with biopsy proven metastases to left axillary lymph nodes, gastric mucosa, peritoneum, rectal mass, and bone who presented with a partial large bowel obstruction. She is currently being treated with weekly intravenous paclitaxel, bevacizumab that was added after her third cycle, and she is also receiving monthly zoledronic acid. She is currently undergoing her 12-month of treatment and is tolerating it well. Discussion Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years. It accounts for 26% of all newly diagnosed cancers in females and is responsible for 15% of the cancer-related deaths in women.(9) Breast cancer is one of the most common malignancies that metastasize to the GI tract, along with melanoma, ovarian and bladder cancer. Conclusion: We present one of the first reports of metastatic lobular breast cancer presenting as a synchronous rectal and gastric tumors. Metastatic lobular carcinoma of the breast is a rare entity with a wide range of clinical presentations. A high level of suspicion, repetition of endoscopic procedures, and a detailed pathological analysis is necessary for early diagnosis, which might help to avoid surgical treatment due to incorrect diagnosis. Patients with a history of breast cancer who present with new gastrointestinal lesions should have these lesions evaluated for evidence of metastasis through histopathologic evaluation and immunohistochemical analysis. Differentiating between a primary GI lesion and metastatic breast cancer will allow initiation of appropriate treatment and help prevent unnecessary operations.
Language	English
Publishing date	2011-10-12
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN (online)	2210-2612
DOI	10.1016/j.ijscr.2011.06.010
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Article: Pulmonary extraskeletal myxoid chondrosarcoma: A case report and literature review.

Balanzá, Ricardo / Arrangoiz, Rodrigo / Cordera, Fernando / Muñoz, Manuel / Luque-de-León, Enrique / Moreno, Eduardo / Molinar, Lourdes / Somerville, Nicole

International journal of surgery case reports

2016 Volume 27, Page(s) 96–101

Abstract: Background: Extraskeletal myxoid chondrosarcoma (EMC) accounts for the 3% of all soft tissue sarcomas and it's categorized as a tumour of uncertain differentiation. This entity has shown to have the recurrent balanced chromosomal translocation t(9;22) ( ... ...

Abstract	Background: Extraskeletal myxoid chondrosarcoma (EMC) accounts for the 3% of all soft tissue sarcomas and it's categorized as a tumour of uncertain differentiation. This entity has shown to have the recurrent balanced chromosomal translocation t(9;22) (q22;q12.2), which leads to the oncogenic fusion gene EWSR1-NR4A3. This sarcoma usually presents as a slow growing, palpable mass in the extremities. EMC arising from the lung is extremely infrequent. We report one case of pulmonary extraskeletal mixoid chondrosarcoma and a review of the world literature. Case report: A 69-year-old male patient presented with intermittent hemoptysis for the last 6 months. A PET/CT scan showed a hypermetabolic solid mass with lobulated borders of approximately 29×26mm in the inferior right lobe. We performed a right thoracotomy with inferior lobectomy and lymphadenectomy of levels VII, VIII, X, and XI levels. The neoplasm was constituted by cords of small cells with small round nucleus and scarce cytoplasm immerse in an abundant myxoid matrix. The immunophenotype was positive for MUM-1, CDK4, MDM2, and showed focal expression for S-100 protein and CD56. The final pathology report revealed a pulmonary extraskeletal mixoid chondrosarcoma. No further surgical interventions or adjuvant therapies were needed. Conclusion: EMC is an intermediate-grade neoplasm, characterized by a long clinical course with high potential for local recurrence and distant metastasis. Treatment for EMC is surgical and non-surgical treatment is reserved for recurrence or metastatic disease. Pulmonary extraskeletal myxoid chondrosarcoma is a rare neoplasm with only isolated case reports found in the literature.
Language	English
Publishing date	2016-08-26
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2016.08.025
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Article: Mammary analog secretory carcinoma of the parotid gland: A case report and literature review.

Balanzá, Ricardo / Arrangoiz, Rodrigo / Cordera, Fernando / Muñoz, Manuel / Luque-de-León, Enrique / Moreno, Eduardo / Toledo, Carlos / González, Edgar

International journal of surgery case reports

2015 Volume 16, Page(s) 187–191

Abstract: Background: Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic ...

Abstract	Background: Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic mass in the parotid gland and predominantly affects men. This tumor is considered a low-grade carcinoma but has the potential for high-grade transformation. We report one MASC case and a review of world literature. Case report: A 66-year-old male patient presented because he noticed a mass of approximately 3×3cm on the right pre-auricular region. Physical examination demonstrated a 3×3.5cm, firm, fixed, non-tender mass in the right pre-auricular region. An MRI of the head and neck showed an ovoid heterogeneous lesion, dependent of the right parotid gland of 27×28mm. We performed a superficial parotidectomy with identification and preservation of the facial nerve. The immunophenotype was positive for epithelial membrane antigen (EMA), CK8/18, vimentin, S-100 protein, and mammoglobin. No further surgical interventions or adjuvant therapies were needed. The patient will have a close follow up. Conclusion: The presence of t(12;15) (p13;q25) translocation which results in the ETV6-NTRK3 gene fusion or positive immunochemical studies for STAT5, mammoglobin and S100 protein, are necessary to confirm the diagnosis of MASC. MASC treatment should mimic the management of other low-grade malignant salivary gland neoplasms. The inhibition of ETV6-NTRK3 gene fusion could be used as treatment in the future.
Language	English
Publishing date	2015-10-01
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2015.09.031
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Article ; Online: The anatomic course of the first jejunal branch of the superior mesenteric vein in relation to the superior mesenteric artery.

Papavasiliou, Pavlos / Arrangoiz, Rodrigo / Zhu, Fang / Chun, Yun Shin / Edwards, Kristin / Hoffman, John P

International journal of surgical oncology

2012 Volume 2012, Page(s) 538769

Abstract: Introduction. The purpose of this study is to determine the anatomic course of the first jejunal branch of the superior mesenteric vein (SMV) in relation to the superior mesenteric artery (SMA). Methods. Three hundred consecutive contrast-enhanced ... ...

Abstract	Introduction. The purpose of this study is to determine the anatomic course of the first jejunal branch of the superior mesenteric vein (SMV) in relation to the superior mesenteric artery (SMA). Methods. Three hundred consecutive contrast-enhanced computed tomography (CT) scans were reviewed by a surgical oncologist with confirmation of findings by a radiologist. Results. The overall incidence of a first jejunal branch coursing anterior to the SMA was 41%. There was no correlation between patient gender and position of the jejunal branch. In addition, there was no correlation between size of the first jejunal branch and its location in relation to the SMA. The IMV drained into the SMV in 27% of the patients. The IMV drained into the SMV-portal vein confluence in 17% of patients and inserted into the splenic vein in 54%. An anterior coursing first jejunal branch statistically correlated with an IMV that drained into the SMV-portal vein confluence (P = 0.009). Conclusion. The first jejunal branch of the SMV has a highly variable course in relation to the SMA and has a higher incidence of an anterior location in this population than previously reported.
Language	English
Publishing date	2012-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2584964-5
ISSN	2090-1410 ; 2090-1402
ISSN (online)	2090-1410
ISSN	2090-1402
DOI	10.1155/2012/538769
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Article: Hematocrit, systolic blood pressure and heart rate are not accurate predictors for surgery to control hemorrhage in injured patients.

Opreanu, Razvan C / Arrangoiz, Rodrigo / Stevens, Penny / Morrison, Chet A / Mosher, Benjamin D / Kepros, John P

The American surgeon

2010 Volume 76, Issue 3, Page(s) 296–301

Abstract: Hematocrit (Hct), systolic blood pressure (SBP), and heart rate (HR) are considered to closely correlate with hypovolemia in injured patients. The clinical importance of these parameters in the early recognition of occult but clinically significant ... ...

Abstract	Hematocrit (Hct), systolic blood pressure (SBP), and heart rate (HR) are considered to closely correlate with hypovolemia in injured patients. The clinical importance of these parameters in the early recognition of occult but clinically significant hemorrhage remains to be demonstrated. We undertook this study to assess the clinical importance of these parameters in the early recognition of occult hemorrhage in injured patients. A retrospective study of 7880 patients admitted to a Level I trauma center was carried out. Patients who underwent surgery were divided into the hemorrhage (n = 160) and no-hemorrhage group (n = 228). Hematocrit, SBP, and HR were correlated and receiver operating characteristic (ROC) curves were plotted. The ROC curves for Hct, SBP, and HR showed suboptimal areas under the graph. Even for different Hct thresholds and for hypotension and tachycardia, low predictive values were found. Although Hct, SBP, and HR levels were significantly altered among patients who require surgery for hemorrhage, the low predictive values of each parameter renders them as clinically unreliable individual tools for recognition of hemorrhagic patients who need surgery. Although useful in aggregate, as a pattern, or as indications for further diagnostic studies, these common parameters have limited usefulness individually.
MeSH term(s)	Adult ; Blood Pressure ; Case-Control Studies ; Female ; Heart Rate ; Hematocrit ; Hemorrhage/diagnosis ; Hemorrhage/etiology ; Hemorrhage/prevention & control ; Hemorrhage/surgery ; Humans ; Male ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Wounds and Injuries/complications
Language	English
Publishing date	2010-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article: Reduction of radiation dose in pediatric brain CT is not associated with missed injuries or delayed diagnosis.

Arrangoiz, Rodrigo / Opreanu, Razvan C / Mosher, Benjamin D / Morrison, Chet A / Stevens, Penny / Kepros, John P

The American surgeon

2010 Volume 76, Issue 11, Page(s) 1255–1259

Abstract: Increased accuracy of CTs in the identification of traumatic injuries compared with physical examination or conventional radiography is well documented. Our goal was to identify the most effective strategy for decreasing radiation exposure while ... ...

Abstract	Increased accuracy of CTs in the identification of traumatic injuries compared with physical examination or conventional radiography is well documented. Our goal was to identify the most effective strategy for decreasing radiation exposure while retaining the benefits of computerized imaging. Based on a literature review and our trauma registry, the mortality risk of untreated injuries was compared with that of patients who received treatment of injuries diagnosed by CT. Because automated exposure control of tube current is not routinely used with brain CT, this region was identified as the initial focus for a dose-saving algorithm. CT settings were adjusted for children studies and the new settings were implemented into four protocols based on age. Images were compared and reviewed by radiologists for the ability to identify traumatic injuries. Effective dose (ED) was estimated using Monte Carlo simulations. The lifetime incidence and mortality for thyroid cancer and leukemia were assessed. In-hospital mortality of unidentified injury in trauma patients is 8.0%. Forty dose-saving CTs were performed and no injuries were missed. The ED decreased by 5.2-, 4.5-, 2.62-, and 2.5-fold in each group. Decreasing the ED is achievable, theoretically decreases the cancer risk and does not increase the missed injury rate.
MeSH term(s)	Adolescent ; Algorithms ; Child ; Child, Preschool ; Craniocerebral Trauma/diagnostic imaging ; Craniocerebral Trauma/mortality ; Delayed Diagnosis ; Diagnostic Errors ; Female ; Hospital Mortality ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukemia/epidemiology ; Male ; Monte Carlo Method ; Neoplasms, Radiation-Induced/epidemiology ; Radiation Dosage ; Registries ; Retrospective Studies ; Risk Assessment ; Thyroid Neoplasms/epidemiology ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2010-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article ; Online: Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation.

Arrangoiz, Rodrigo / Papavasiliou, Pavlos / Singla, Smit / Siripurapu, Veeraiah / Li, Tianyu / Watson, James C / Hoffman, John P / Farma, Jeffrey M

American journal of surgery

2013 Volume 206, Issue 3, Page(s) 333–339

Abstract: Background: In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis.: Methods: A ... ...

Abstract	Background: In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis. Methods: A retrospective review of patients undergoing PSPG for malignant obstruction from 1999 to 2011 was performed. Ability to tolerate oral intake in the postoperative period and at last follow-up was the criterion for a successful bypass. Results: Fifty-five patients with locally advanced or metastatic tumors underwent PSPG. The median follow-up period was 8 months. No patient developed signs of gastric outlet obstruction after PSPG. Seventy-five percent of patients had pancreatic or duodenal and 25% had nonpancreatic cancers. Nine patients developed postoperative complications. The perioperative mortality rate was zero. Median overall survival was 9 months. All patients were tolerating an enteral diet on the day of discharge, and as of the last follow-up, 95% were tolerating their enteral diets. Conclusions: This and a previous study from the authors' institution show that PSPG is a good alternative for palliative bypass in the setting of malignant gastric outlet obstruction over classic gastrojejunostomy.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Duodenal Obstruction/pathology ; Duodenal Obstruction/surgery ; Female ; Gastric Bypass/methods ; Gastric Outlet Obstruction/pathology ; Gastric Outlet Obstruction/surgery ; Gastrointestinal Neoplasms/pathology ; Gastrointestinal Neoplasms/surgery ; Humans ; Male ; Middle Aged ; Palliative Care ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Language	English
Publishing date	2013-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2012.11.015
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