Tag Archives: malignancy

Giant Brunner glands hyperplasia of the duodenum: Case report of an uncommon malignancy mimicker

Georgian-Nicolae Radu1, Adela Nechifor-Boilă2, Emőke – Andrea Szász1,2

1. Department of Pathology, Mureș County Clinical Hospital, Târgu Mureș, Romania
2. Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Romania

DOI: 10.2478/amma-2025-0019

Introduction: Brunner’s glands hyperplasia (BGH) is an uncommon benign proliferative lesion found in the proximal duodenum. It is typically discovered incidentally during surgery or endoscopic examinations, and it can often be mistaken for a malignant process.
Case presentation: We report the case of a 59 years-old man who presented in the surgical department with a 5-days history of upper gastrointestinal tract symptoms associated with mild increase in serum amylase level. An esophagogastroduodenoscopy was performed, which showed a large infiltrating-type mass located in the proximal duodenum rising the suspicion for a pancreatic head tumor with duodenal wall involvement. Consequently, Whipple procedure was conducted. The resection specimen was further sent and processed in the Pathology department of Mureș County Clinical Hospital. On macroscopy a large polypoid-sessile mass located in the proximal duodenum was described, while the adjacent pancreatic tissue exhibited areas of extensive necrosis and hemorrhage. Microscopic evaluation revealed a benign proliferation composed of closely packed clusters of Brunner’s glands separated by thin fibrous septa located in the duodenal submucosa, with no evidence of atypia or mitotic figures.
Conclusions: Large diffuse BGH is a rare benign condition that poses diagnostic challenges due to its potential to mimic malignant processes. Given the indolent character of the lesion, it is crucial to consider BGH as part of the differential diagnosis in routine pathological activity when evaluating lesions of the duodeno-pancreatic region.

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Unveiling rhabdomyosarcoma: A rare cause of ischialgia

Rizaldy Taslim Pinzon1,2, Kenzie Ongko Wijaya1, Nunki Puspita Utomo1, Putu Jeremia Dani Bramanta1

1. Faculty of Medicine Duta Wacana Christian University, Yogyakarta, Indonesia
2. Bethesda Hospital, Yogyakarta, Indonesia

DOI: 10.2478/amma-2024-0039

Rhabdomyosarcoma (RMS) represents a rare subset of mesodermal malignancies characterized by skeletal muscle differentiation, exhibiting a notably low incidence among adults and demonstrating inferior prognosis compared to pediatric counterparts. The 5- and 10-year overall survival rates were determined to be 30% and 18%, respectively, with a median age of onset at 46.5 years and median overall survival duration of 2.3 years. Current challenges in RMS research encompass optimizing local control, managing systemic disease, refining risk stratification methods, and elucidating disease progression patterns. While aggressive therapeutic interventions remain imperative, novel and individualized treatment modalities are imperative to enhance long-term outcomes. This research reported an elderly female patient presenting persistent lower back pain, persisting over several months, despite seeking medical consultation from multiple sources. Subsequent diagnostic investigations confirmed the diagnosis of rhabdomyosarcoma, denoting the relatively rare etiology of said initial symptoms. Hence, it is imperative to reconsider many differential diagnoses in the case of ischialgia.

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Clinical Presentation of Thyroid Nodules in Patients Submitted to Surgery

Cătană Ramona1, Genes Ionela2, Sala Tatiana3, Borda Angela4

1 Department of Endocrinology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 Department of Otorhinolaryngology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
3 Department of Surgery, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
4 Department of Histology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Background: Thyroid nodules can be discovered in the most varied circumstances. There are very few published data demonstrating the way in which thyroid nodules come to medical attention. This study aims to evaluate the clinical presentation of thyroid nodular disease, and to assess whether the presence of malignancy influences the presentation.
Methods: This paper is a prospective analysis of 164 patients diagnosed with thyroid nodular disease who underwent thyroid surgery in the two Departments of Surgery of the Tîrgu Mureş Emergency County Hospital. Face-to-face interviews were conducted to obtain data on how these patients with thyroid nodules come to medical attention. The patients were classified in the following categories: no symptoms and no signs; only symptoms, no signs; no symptoms, only signs (cervical tumor); symptoms and signs. The final pathological diagnoses of the thyroid resected specimens were obtained from database registries of the Department of Pathology.
Results: Most of the patients (64.01%) with thyroid nodular disease require a medical advice when they have cervical symptomatology, in the presence or not of a clinically apparent cervical tumor. 23.18% were patients in which the thyroid nodules were found incidentally by imaging tests performed for other purposes. The higher proportion of malignancy was recorded in patients with thyroid evident growth 52.38%.
Conclusion: The presence of a cervical tumor represents a clear invitation to a medical examination. The incidental discovery of thyroid nodules should not be overlooked. The cervical symptoms might have anything to do with the presence or with the size of thyroid nodules.

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