Trousseau sign of malignancy

a medical sign found in certain cancers that is associated with venous thrombosis and hypercoagulopathy.

related to factors secreted by the tumors.

malignancy-associated hypercoagulable states, the blood may spontaneously form clots in the portal vessels, the deep veins of the extremities (such as the leg), or the superficial veins anywhere on the body.

These clots present as visibly swollen blood vessels, vasculitis.

Myxoid Liposarcoma

A subtype of liposarcoma,  is a malignant tumor that arises in fat cells in deep soft tissue.

Myxoid liposarcomas occur most commonly in the lower extremity, particularly the thigh.

Liposarcomas originate from primitive mesenchymal cells rather than from mature fat cells.

At histologic analysis, they can be classified as well-differentiated, myxoid, pleomorphic, or round cell

abnormalities occur in myxoid liposarcoma, depending on:

• the amount of fat and myxoid material
• the degree of cellularity and vascularity
• the presence of necrosis.
• Most myxoid liposarcomas have lacy or linear, amorphous foci of fat.

Dx:

• MRI
• CT

A myxoid liposarcoma that contains abundant water can mimic a cystic lesion, producing diagnostic confusion. Myxoid liposarcomas must be differentiated from cystic lesions because the former can be limb threatening.

Prognosis

• varies with the histologic subtype.
• The well-differentiated variant is considered a low-grade malignancy
• the pleomorphic and round cell types are regarded as highly malignant tumors with a tendency toward local recurrence and metastasis.

Mi-Sook Sung, Heong S. Kang, Jin S. Suh, Jung H. Lee, Jeong M. Park, Jee Y. Kim, and Hae G. Lee. 2000. Mxoid Liposarcoma: Appearance at MR imaging with hisotlogic correlation. Radiographics. 20: 1007-1019.

http://radiographics.rsna.org/content/20/4/1007.full

Brain Tumors

 

Localized intracranial space occupying lesions.

• Tumors usually grow as a spherical mass or diffuse and infiltrate tissue

 

Tumor Effects

• occur from the compression and infiltration of tissue
• increased intracranial pressure
• cerebral edema
• seizure activity
• focal neurologic signs
• hydrocephalus
• altered pituitary function

 

Effects of Neoplasm depend on the region of the brain occupied by the tumor:

Primary tumors: originate from cells and structures within the brain

Secondary (metastatic) tumors: develop from structures outside the brain

• occur in 20-40% of all patients with cancer
• brain tumors rarely metastasize outside the CNS
• metastasis origin

1. lungs
2. breast
3. lower GI tract
4. pancreas
5. kidneys
6. skin

 

Etiology:

Glial and Meningeal tumors: linked to ionizing radiation exposure

Incidence

•  in adults – higher incidence in the fifth, sixth and seventh decades
•  higher incidence in men than women
•  Adult brain tumors originate most often originate from glial cells (forming the supportive structures of the spinal cord and CNS)

MRI of Brain tumor:

The Universal Fatigue Assessment Scale

Zollinger-Ellison Tumor

These tumors produce high levels of the hormone gastrin.

These tumors cause a hypersecretion of gastric acid that prodices peptic ulcers as a result of a non-beta cell tumor of the pancreatic islets.

Symptoms:

• Abdominal pain
• Diarrhea
• Ulcers in the stomach and small bowel
• Hematemesis (Vomiting blood), rare

Tumor Lysis Syndrome (TLS)

Tumor lysis syndrome (TLS) is a group of metabolic complications that can occur after treatment of cancer. TLS is caused by the fast breakdown of certain types of cancer cells. TLS can cause kidney failure and the need for dialysis treatment.

Symptoms:

	Irregular heartbeat
	Impairment of mental ability, and loss of consciousness
	Kidney failure
	Shortness of breath
	High Potassium levels (lab test)
	High Uric acid levels (lab test)
	Low calcium levels (lab test)

characterized by:

• hyperuricemia due to deoxyribonucleic acid (DNA) breakdown
• hyperkalemia because of cytosol breakdown
• hyperphosphatemia because of protein breakdown
• hypocalcemia secondary to the hyperphosphatemia.

 

As phoshate levels increase, serum calcium decreases.

 These derangements can result in acute renal failure secondary to urate nephropathy,  xanthine nephropathy, and the altered calcium phosphate blood levels.

Diagram of resultant acute renal failure:

Cardiac dysrhythmias can occur secondary to hyperkalemia and hypocalcemia

• Symptoms such as cramps can occur as a result of the increased blood calceum levles (hypocalcemia)

Sudden death may occur as a resultfrom hyperkalemia (increased blood potassium levels) or hypocalcemia (increased blood calceum levels).

Lymphomation. 2004. Tumor Lysis Syndrome. Retrieved Aug. 21, 2009 from http://www.lymphomation.org/side-effect-tumor-lysis.htm