• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.345-349
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• 2015

Background: To determine the cut-off values of the preoperative risk of malignancy index (RMI) used in differentiating benign or malignant adnexal masses and to determine their significance in differential diagnosis by comparison of different systems. Materials and Methods: 191 operated women were assessed retrospectively. RMI of 1, 2, 3 and 4; cut-off values for an effective benign or malignant differentiation together with sensitivity, specificity, negative and positive predictive values were calculated. Results: Cut-off value for RMI 1 was found to be 250; there was significant (p<0.001) compatibility at this level with sensitivity of 60%, positive predictive value (PPV) of 75%, specificity of 93%, negative predictive value (NPV) of 88% and an overall compliance rate of 85%. When RMI 2 and 3 was obtained with a cut-off value of 200, there was significant (p<0.001) compatibility at this level for RMI 2 with sensitivity of 67%, PPV of 67%, specificity of 89%, NPV of 89%, histopathologic correlation of 84% while RMI 3 had significant (p<0.001) compatibility at the same level with sensitivity of 63%, PPV of 69%, specificity of 91%, NPV of 88% and a histopathologic correlation of 84%. Significant (p<0.001) compatibility for RMI 4 with a sensitivity of 67%, PPV of 73%, specificity of 92%, NPV of 89% and a histopathologic correlation of 86% was obtained at the cut-off level 400. Conclusions: RMI have a significant predictability in differentiating benign and malignant adnexal masses, thus can effectively be used in clinical practice.

• 대한세포병리학회지
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• 제16권2호
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• pp.98-101
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• 2005

Eccrine spiradenoma is a rare adnexal tumor of the skin and its cytomorphology has seldom been described in literature. To evaluate the cytologic features and diagnostic pitfalls of eccrine spiradenoma, we report a case of 33-year-old male whose clinical presentation was a painful subcutaneous mass at the right preauricular area. Fine needle aspirates revealed tight clusters of multilayered, uniform, cuboidal cells arranged around hyalinized perivascular spaces. Some epithelial cells showed tubules or rosette formations. The background showed scattered, naked nuclei. The histologic findings confirmed the eccrine spiradenoma. The recognition of peculiar cytologic features and clinical correlation could be helpful in the diagnosis of skin adnexal tumors.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5455-5459
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• 2013

Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.2037-2041
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• 2015

Background: Relationships between poor prognosis of ovarian malignancies and changes in complete blood count parameters have been proposed previously. In this work, we aimed to evaluate clinicopathologic features in adolescents with adnexal masses and sought to establish any predictive value of the platelet to lymphocyte ratio (PLR) in diagnosis. Materials and Methods: This retrospective study was conducted on 196 adolescent females with adnexal masses. Three groups were constituted with respect to clinical or histopathology results: group 1, non-neoplastic patients (n:65); group 2, neoplastic patients (n:68); and group 3 expectantly managed patients (n:63). The main parameters recorded from the hospital database and patient files were age, body mass index (BMI), chief symptoms, diameter of the mass (DOM), tumor marker levels, complete blood count values including absolute neutrophil, lymphocyte, and platelet counts, mean platelet volume, platelet distribution width, and platecrit, surgical features, and postoperative histopathology results. Results: The expectantly managed patients were younger than the other groups (p=0.007). The mean body mass index (BMI) was higher in the neoplastic group (p=0.016). Preoperative DOM, CA125, mean platelet volume and PLR were statistically significantly different between the groups (p<0.05). ROC curve analysis demonstrated that increased PLR (AUC, 0.609; p=0.011) and BMI (AUC, 0.611; p=0.011) may be discriminative factors in predicting ovarian neoplasms in adolescents preoperatively. When the cut-off point for the PLR level was set to 140, the sensitivity and specificity levels were found to be 65.7% and 57.6%, respectively. Conclusions: We suggest that beside a careful preoperative evaluation including clinical characteristics, ultrasonographic features and tumor markers, PLR may predict ovarian neoplasms in adolescents.

• BLOOD RESEARCH
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• 제53권4호
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• pp.307-313
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• 2018

Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.275-278
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• 2018

Trichoblastic carcinoma usually occurs as a malignant transformation of the trichoblastoma, but is very rare. A 25-year-old man was admitted with trichoblastoma in the nuchal area with frequent recurrences since birth. The preoperative neck magnetic resonance image revealed lobulated soft tissue lesions involving superficial fascia and infiltrating into both proximal trapezius muscles. In our department, wide excision and reconstruction with a free anterolateral thigh flap were performed. Histological examination revealed skin adnexal carcinoma, originating from the hair follicles, consistent with trichoblastic carcinoma. There was no palpable mass 5 years postoperatively, and there was no recurrence on follow-up positron emission tomography-computed tomography. Trichoblastic carcinomas are rare and difficult to diagnose, but histopathological findings include atypical basaloid keratinocytes with crowded, hyperchromatic nuclei, and increased mitotic activity. The presence of hypercellular stroma is a criterion for distinguishing trichoblastic carcinoma from basal cell carcinoma. A rare giant trichoblastic carcinoma was reported, which was the biggest one in the literature.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.32-35
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• 2014

Sebaceous carcinoma is a rare malignant tumor differentiated from the adnexal epithelium of sebaceous glands and forms less than 1% of all cutaneous malignancies. We present a case of a 93-year-old woman with a rapidly growing mass on the right cheek. Initial histiopathologic finding was basal cell carcinoma. The mass was widely excised and superficial parotidectomy was performed while preserving the facial nerve branches. The resulting defect was covered with a transposition flap from the ipsilateral posterior auricular area and the donor site was closed primarily. However, histopathologic examination of the excised mass showed a poorly differentiated sebaceous carcinoma with a clear resection margin. The diagnosis of sebaceous carcinoma can be difficult to make at initial presentation. This report describes a rare case of a rapidly growing extraocular sebaceous carcinoma, which resulted in a good treatment outcome, and provides a review of relevant literature.

• 대한청각학회지
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• 제24권2호
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• pp.99-102
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• 2020

Trichofolliculoma (TF) is a follicular hamartoma in which hairs protruding out of single orifice. To the best of my knowledge, only two auricular TF has been reported in the English literature. Moreover, clinically TF have been described to mimic malignancy. I present a case of an adult female with mass at the intertragal notch of the left auricle for several years. The clinical diagnosis was thought to be epidermoid cyst, accessory tragus, and other benign skin adnexal tumor. To prevent recurrence, the wide local excision of the mass was performed. The final diagnosis of TF was made. No recurrence was noted during the follow-up of 1 year. It is important for otologists to be familiar with the clinical and pathologic characterization of TF, to make the correct diagnosis.

• Journal of Audiology & Otology
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• 제24권2호
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• pp.99-102
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• 2020

Trichofolliculoma (TF) is a follicular hamartoma in which hairs protruding out of single orifice. To the best of my knowledge, only two auricular TF has been reported in the English literature. Moreover, clinically TF have been described to mimic malignancy. I present a case of an adult female with mass at the intertragal notch of the left auricle for several years. The clinical diagnosis was thought to be epidermoid cyst, accessory tragus, and other benign skin adnexal tumor. To prevent recurrence, the wide local excision of the mass was performed. The final diagnosis of TF was made. No recurrence was noted during the follow-up of 1 year. It is important for otologists to be familiar with the clinical and pathologic characterization of TF, to make the correct diagnosis.

• 대한세포병리학회지
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• 제10권1호
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• pp.91-96
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• 1999

Sometimes a pilomatrixoma on upper neck can be misdiagnosed as primary salivary gland tumor, skin adnexal tumor or metastatic carcinoma. On fine needle aspiration cytology(FNAC), characteristic features are ghost cells, basaloid cells, and calcium deposits, among which presence of ghost cells seems to be the key to recognize it. Here we present a cytologically misdiagnosed case of pilomatrixoma. A 32-year-old man presented a subcutaneous mass on the right posterior neck. It has grown slowly for 1 year, and was nontender, well circumscribed, hard, and movable mass. An Initial FNAC yielded only monomorphic population of highly mitotic basaloid cells, without anucleated ghost cells, chronic inflammatory cells or foreign-body giant cells, suggestive of a poorly differentiated carcinoma. However, that was inconsistent with patient's clinical findings. For further correct diagnosis, FNAC was repeated, which yielded the basaloid cells and foreign-body giant cells. The diagnosis of pilomatrixoma could be made and the mass was excised. This case demonstrates that the pilomatrixoma should be considered in the differential diagnosis of subcutaneous aspirates containing not ghost cells but a dominant population of basaloid cells.