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Toferer A, Truschnegg A, Kashofer K, Beham-Schmid C, Beham A. First presentation of a frameshift mutation in the SETD2 gene of a juvenile psammomatoid ossifying fibroma (JPOF) associated with an aneurysmal bone cyst. Diagn Pathol 2021; 16:91. [PMID: 34657606 PMCID: PMC8520634 DOI: 10.1186/s13000-021-01160-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022] Open
Abstract
Background The rarity of juvenile psammomatoid ossifying fibroma (JPOF) and lack of cytogenetic studies prompted us to report a novel SETD2 gene mutation in a benign odontogenic tumour. Case presentation A 21-year-old man presented with a hard, expanded mandibular cortex. Computed tomography revealed multilocular radiopacity in the mandible; this was reconstructed via segmental mandibulectomy using a vascularised iliac crest flap. Based on the clinical and histological findings, we diagnosed JPOF associated with an aneurysmal bone cyst. Microscopically, the solid area was characterised by many rounded or angular ossicles in a cellular fibrous stroma. The stromal cells were spindle-like or stellate. Next-generation sequencing detected a frame shift mutation of the SETD2 gene, while the copy number was normal. Conclusions Our findings suggest further genetic studies should be performed to assess whether this mutation is related to tumour genesis.
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Affiliation(s)
- A Toferer
- Division of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
| | - A Truschnegg
- Division of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - K Kashofer
- Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - C Beham-Schmid
- Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - A Beham
- Medical University of Graz, Neue Stiftingtalstraße 6, 8036, Graz, Austria
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Truschnegg A, Acham S, Kqiku L, Jakse N, Beham A. Ectomesenchymal chondromyxoid tumor: a comprehensive updated review of the literature and case report. Int J Oral Sci 2018; 10:4. [PMID: 29491357 PMCID: PMC5944469 DOI: 10.1038/s41368-017-0003-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/10/2017] [Accepted: 12/01/2017] [Indexed: 11/09/2022] Open
Abstract
Prompted by a unique case of an ectomesenchymal chondromyxoid tumor (ECT) of the palate in a 54-year-old female, we reviewed the English and German literature on this entity until the end of 2016 using PubMed. The search produced 74 lingual cases with a nearly equal sex distribution and a mean age of 39.3 years, and two extra-lingual cases sharing histological and immunohistological features including nodular growth, round, fusiform or spindle-shaped cellular architecture, and chondromyxoid stroma. Immunophenotyping showed the majority of cases to be positive for glial fibrillary acidic protein (GFAP), S-100 protein, glycoprotein CD57, pancytokeratin (AE1/AE3), and smooth muscle actin (SMA); in isolated cases there was molecular-genetic rearrangement or gain of Ewing sarcoma breakpoint region 1 (EWSR1) but no rearrangement of pleomorphic adenoma gene 1 (PLAG1). At present, ectomesenchymal cells that migrate from the neural crest are considered to play a pivotal role in tumor origin. All cases had a benign course, although there were three recurrences. Because of the rarity of this tumor and the need for differential diagnostic differentiation from myoepithelioma and pleomorphic adenoma, both oral surgeons and pathologists should be aware of this entity.
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Affiliation(s)
- Astrid Truschnegg
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University Graz, Billrothgasse 4, 8010, Graz, Austria.
| | - Stephan Acham
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Lumnije Kqiku
- Department of Dental Medicine and Oral Health, Division of Preventive an Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Medical University Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Norbert Jakse
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Alfred Beham
- IMAH, Institute of Morphological Analytics and Human Genetics, Grabenstraße 23, 8010, Graz, Austria
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Truschnegg A, Acham S, Kqiku L, Jakse N, Beham A. Minimally Invasive Excision of Epulides with a CO 2 Laser: A Retrospective Study of 90 Patients. Photomed Laser Surg 2017; 35:472-478. [PMID: 28375684 DOI: 10.1089/pho.2016.4192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE It is the aim of this study to evaluate if the CO2 laser can beneficially be applied for excising epulides. BACKGROUND DATA The standard procedure for treating epulides involves the excision of the hyperplastic tissue followed in most cases by the removal of parts of the underlying bone and the final closure of the wound by a flap. The use of the CO2 laser for the treatment of epulides has been documented only in isolated case reports and very few case series. PATIENTS AND METHODS Ninety patients with different subtypes of epulides were treated with a CO2 laser (Lasram, model OPAL 25, 25 W, 10.600 nm, gas laser); power setting 4 W, continuous wave. The surgery was performed only after a pretreatment could remedy any gingivitis or occlusal trauma. A new surgical way of working using a special applicator that allowed tangential application of the laser beam was applied for all patients. Patients were followed up to 3 years. RESULTS No perioperative complications or recurrences after 4 weeks could be found. Six patients were lost to further follow-up, whereas 84 patients were followed up to 36 months. In 71 cases there were no recurrences over the entire observation period. Thirteen patients developed a relapse, usually a fibroma/fibrosis according to histopathological evaluation. CONCLUSIONS Overall CO2 laser seems to be an adequate tool for minimally invasive excision of epulides, although the respective histopathological entity could possibly influence the recurrence rate and so should be considered.
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Affiliation(s)
- Astrid Truschnegg
- 1 Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz , Graz, Austria
| | - Stephan Acham
- 1 Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz , Graz, Austria
| | - Lumnije Kqiku
- 2 Division of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, Department of Dental Medicine and Oral Health, Medical University Graz , Graz, Austria
| | - Norbert Jakse
- 1 Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz , Graz, Austria
| | - Alfred Beham
- 3 IMAH, Institute of Morphological Analytics and Human Genetics , Graz, Austria
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Abstract
Esophagectomy and subsequent reconstruction represent major physiological insults to the upper gastrointestinal (GI) tract, which as a consequence can lead to malnutrition, dysphagia and reflux. From a technical perspective, operative reconstruction involving gastric pull-up with a 2-3 cm wide tube and an anastomosis cranial to the azygos vein may minimize the symptoms. Overall, the problems tend to improve approximately 6 months after the operation. Newly occurring delayed physical functional impairments with previously known underlying malignant disease may be indicative of cancer relapse. Interventional techniques, such as stent placement or brachytherapy may be better suited for treatment of recurrent disease.
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Affiliation(s)
- A Beham
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - S Dango
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - B M Ghadimi
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
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Truschnegg A, Acham S, Kqiku L, Beham A, Jakse N. CO2 Laser Excision of a Pyogenic Granuloma Associated with Dental Implants: A Case Report and Review of the Literature. Photomed Laser Surg 2016; 34:425-31. [PMID: 27420917 DOI: 10.1089/pho.2016.4089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This article reports the CO2 laser excision of a pyogenic granuloma related to dental implants and reviews the current literature on this pathology in association with dental implants. BACKGROUND DATA Five publications describe pyogenic granulomas related to dental implants, and a further one describes the removal of such a lesion with an Er:YAG laser; removal with a CO2 laser is not reported. PATIENTS AND METHODS A 67-year-old male patient presented with a hyperplastic gingival lesion around two implants in the left lower jaw. The hyperplastic tissue was removed with a CO2 laser (Lasram; model OPAL 25, 25 W continuous wave, 10.600 nm, gas laser), and a vestibuloplasty was performed. The excised tissue was examined histopathologically. The patient was followed up after 4 weeks, 6 weeks, 6 months, and 1 year, and a panoramic X-ray was also made. RESULTS There were no complications during surgery or follow-up. The panoramic X-ray taken 1 year after excision showed neither vertical bone loss nor impaired osseointegration of the implant. Histopathology reported a pyogenic granuloma. After vestibuloplasty, the height of the fixed mucosa was satisfactory. CONCLUSIONS The CO2 laser seems to be a safe and appropriate tool for removal of a pyogenic granuloma in close proximity to dental implants. The laser parameters must, however, be chosen carefully and any additional irritants should be excluded to prevent a recurrence.
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Affiliation(s)
- Astrid Truschnegg
- 1 Department of Oral Surgery and Orthodontics, Medical University Graz , Graz, Austria
| | - Stephan Acham
- 1 Department of Oral Surgery and Orthodontics, Medical University Graz , Graz, Austria
| | - Lumnije Kqiku
- 2 Department of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, University Clinic of Dental Medicine and Oral Health, Medical University Graz , Graz, Austria
| | - Alfred Beham
- 3 IMAH, Institute of Morphological Analytics and Human Genetics , Graz, Austria
| | - Norbert Jakse
- 1 Department of Oral Surgery and Orthodontics, Medical University Graz , Graz, Austria
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Abstract
The implementation of robot-assisted surgery requires a multi disciplinary approach with appropriate training and cooperation of surgical, anesthetic and technical staff. Besides acquiring the technical skills and getting used to complex technique, patient selection and an appropriate frequency of procedures are required to avoid complications.
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Affiliation(s)
- J-H Egberts
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Deutschland
| | - A Beham
- Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Deutschland
| | - M Ghadimi
- Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Deutschland
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Agaimy A, Bauer S, Beham A, Bertolini J, Haller F, Koschny R, Maier J, Montemurro M, Perez D, Schaefer IM, Schildhaus HU, Wurst C, Cameron S. Gastrointestinale Stromatumoren (GIST) – Neues zu Pathologie, Chirurgie und medikamentöser Therapie. Z Gastroenterol 2015; 53:235-43. [DOI: 10.1055/s-0034-1385711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - S. Bauer
- Innere Klinik (Tumorforschung), Universitätsklinik Essen
| | - A. Beham
- Allgemein-Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen
| | | | | | - R. Koschny
- Medizinische Klinik IV, Universität Heidelberg
| | - J. Maier
- Hämatologie und Hämostaseologie, Universität Leipzig
| | | | - D. Perez
- Allgemein-Viszeral- und Thoraxchirurgie, Universität Hamburg
| | | | | | - C. Wurst
- Allgemein- und Viszeralchirurgie, Universitätsklinikum Jena
| | - S. Cameron
- Gastroenterologie und Endokrinologie, Universitätsmedizin Göttingen
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Woltsche N, Gilg MM, Fraissler L, Liegl-Atzwanger B, Beham A, Lackner H, Benesch M, Leithner A. Is wide resection obsolete for desmoid tumors in children and adolescents? Evaluation of histological margins, immunohistochemical markers, and review of literature. Pediatr Hematol Oncol 2015; 32:60-9. [PMID: 25264623 DOI: 10.3109/08880018.2014.956905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Desmoid fibromatosis is a benign fibroblastic neoplasm with high recurrence rates predominantly observed in pediatric and adolescent patients. The use of wide resection margins has been discussed controversially in literature. In addition, data on non-surgical treatment is limited as phase III studies are still missing. Nineteen patients under the age of 18 years were identified. Tumor location, surgical treatment for primary or recurrent tumors, resection margins, medical neo-/adjuvant treatment, time to recurrence as well as immunohistochemical markers (estrogen receptor, ER α and β, progesterone and androgen receptors, somatostatin, Ki-67, c-kit, platelet-derived growth factor receptors, PDGFRs, α and β, β-catenin) were evaluated. The mean age at diagnosis was 6.6 years, with a mean follow-up of 114 months. Recurrences were detected in four out of nineteen patients. Surprisingly, the recurrence rate was not influenced by type of resection used (R0, R1/2). All samples were tested negative for ER α, somatostatin, and progesterone receptor. In contrast, a majority of tumors showed positive results for PDGFR α and β and β-catenin. No correlation between positive immunohistochemical markers and tumor recurrences was detectable. In conclusion, recurrence rates are not depending on resection type and immunohistochemical markers seem to behave differently in children and adolescents in contrast to adult patients.
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Affiliation(s)
- Nora Woltsche
- Department of Orthopedic Surgery, Medical University of Graz , Graz , Austria
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Wultsch G, Nersesyan A, Kundi M, Jakse R, Beham A, Wagner KH, Knasmueller S. The sensitivity of biomarkers for genotoxicity and acute cytotoxicity in nasal and buccal cells of welders. Int J Hyg Environ Health 2014; 217:492-8. [DOI: 10.1016/j.ijheh.2013.09.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 12/22/2022]
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Hammer GP, Tomazic PV, Beham A, Friedrich G. [Clinical management of a rare hypervascular soft tissue tumor of the neck]. Laryngorhinootologie 2013; 93:332-3. [PMID: 24363191 DOI: 10.1055/s-0033-1361169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Scheipl S, Lohberger B, Rinner B, Froehlich EV, Beham A, Quehenberger F, Lazáry A, Pal Varga P, Haybaeck J, Leithner A, Liegl B. Histone deacetylase inhibitors as potential therapeutic approaches for chordoma: an immunohistochemical and functional analysis. J Orthop Res 2013; 31:1999-2005. [PMID: 23893747 DOI: 10.1002/jor.22447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 06/26/2013] [Indexed: 02/04/2023]
Abstract
Chordomas are rare malignancies of the axial skeleton. Therapy is mainly restricted to surgery. This study investigates histone deacetylase (HDAC) inhibitors as potential therapeutics for chordomas. Immunohistochemistry (IHC) was performed using the HDAC 1-6 antibodies on 50 chordoma samples (34 primary tumors, 16 recurrences) from 44 patients (27 male, 17 female). Pan-HDAC-inhibitors Vorinostat (SAHA), Panobinostat (LBH-589), and Belinostat (PXD101) were tested for their efficacy in the chordoma cell line MUG-Chor1 via Western blot, cell cycle analysis, caspase 3/7 activity (MUG-Chor1, UCh-1), cleaved caspase-3, and PARP cleavage. p-Values below 0.05 were considered significant. IHC was negative for HDAC1, positive for HDAC2 in most (n = 36; 72%), and for HDACs 3-6 in all specimens available (n = 43; 86%). HDAC6 expression was strongest. SAHA and LBH-589, but not PXD101 caused a significant increase of G2/M phase cells and of cleaved caspase-3 (p = 0.0003, and p = 0.0014 after 72 h, respectively), and a peak of caspase 3/7 activity. PARP cleavage confirmed apoptosis. The presented chordoma series expressed HDACs 2-6 with strongest expression of HDAC6. SAHA and LBH-589 significantly increased apoptosis and changed cell cycle distribution in vitro. HDAC-inhibitors should be further evaluated as therapeutic options for chordoma.
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Affiliation(s)
- Susanne Scheipl
- Department of Orthopaedics and Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
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Aigelsreiter A, Pichler M, Pixner T, Janig E, Schuller M, Lackner C, Scheipl S, Beham A, Regauer S. Clusterin expression in elastofibroma dorsi. Histol Histopathol 2013; 28:597-603. [PMID: 23344911 DOI: 10.14670/hh-28.597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Elastofibroma dorsi is a benign soft tissue lesion composed of abnormal elastic fibers. Degenerated elastic fibers in skin and liver are associated with clusterin, an apoprotein that shares functional properties with small heat shock proteins. We evaluated the staining pattern and possible role of clusterin in elastofibroma dorsi. MATERIAL AND METHODS Twenty-one subcutaneous elastofibromas from the scapular region were evaluated with Elastica van Gieson and Orcein stains, immunohistochemically with antibodies to clusterin, smooth muscle actin, S-100, vimentin and CD34 and correlated with clinical data with respect to physical trauma. RESULTS Clusterin correlated with the staining pattern of Elastica van Gieson and labelled abnormal broad coarse fibrillar and globular elastic fibers in all elastofibromas. Orcein stains additionally identified fine oxytalan fibers which were not stained by clusterin. Clusterin staining was observed only on the outside of the elastin fibers, while the cores of fibers and globules were unstained. 4/21 elastofibromas showed cellular nodules with a myxoid/collagenous stroma. The round to oval cells showed cytoplasmic staining with vimentin and clusterin; CD34 labelled mostly cell membranes. The cells lacked SMA and S-100 expression. The central areas of the nodules were devoid of elastic fibers, but the periphery contained coarse fibers and globules. 9/ 11 patients, for whom clinical data were available, reported trauma to the scapular region. CONCLUSION Many investigated ED were associated with trauma, which supports a reactive/degenerative etiology of ED. The abnormal large elastic fibers in all ED were enveloped by clusterin. Clusterin deposition may protect elastic fibers from degradation and thus contribute indirectly to the tumor-like presentation of ED.
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Hoenigl M, Aspeck E, Valentin T, Heiling B, Seeber K, Krause R, Stammberger H, Beham A, Buzina W. Sinusitis and frontal brain abscess in a diabetic patient caused by the basidiomycete Schizophyllum commune: case report and review of the literature. Mycoses 2013; 56:389-93. [PMID: 23331262 DOI: 10.1111/myc.12040] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Martin Hoenigl
- Section of Infectious Diseases, Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Scheipl S, Froehlich EV, Leithner A, Beham A, Quehenberger F, Mokry M, Stammberger H, Varga PP, Lazáry A, Windhager R, Gattenloehner S, Liegl B. Does insulin-like growth factor 1 receptor (IGF-1R) targeting provide new treatment options for chordomas? A retrospective clinical and immunohistochemical study. Histopathology 2012; 60:999-1003. [DOI: 10.1111/j.1365-2559.2012.04186.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tomazic PV, Stammberger H, Habermann W, Schmid C, Koele W, Mokry M, Gellner V, Beham A. Aggressive inverted papilloma with intracranial invasion and short malignization time. Skull Base Rep 2011; 1:111-4. [PMID: 23984212 PMCID: PMC3743604 DOI: 10.1055/s-0031-1280738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/28/2011] [Indexed: 11/09/2022]
Abstract
Inverted papillomas (IP) are considered benign lesions with a prevalence up to 4% among all sinunasal tumors; however, invasive growth and varying tendency for malignization are reported in literature. We report the case of a 69-year-old woman suffering from a large, aggressively growing IP invading the orbit, skull base, and frontal lobe of the brain. Within only 3 months' time the papilloma showed transformation into an invasive carcinoma, leaving surgical therapy in vain due to explosive recurrence. Intracranial and intraorbital expansion by IP is possible despite histology not showing signs of malignancy initially. In “regular” IP close endoscopic follow-up is mandatory to not overlook recurrence harboring malignancy.
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Affiliation(s)
- Peter Valentin Tomazic
- Department for General Otolaryngology, Head and Neck Surgery, Medical University Graz, Graz, Austria
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Töppler G, Röper H, Cameron S, Füzesi L, Beham A, Ramadori G. Endoscopic and endosonographic staging in the management of cancer of the stomach and the esophagogastric junction. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Töppler G, Röper H, Cameron S, Füzesi L, Beham A, Ramadori G. Endoscopic and endosonographic staging in the management of cancer of the stomach and the esophagogastric junction. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
140 Background: Staging of the primary tumor in patients with advanced adenocarcinoma of the stomach or the esophagogastric junction under chemotherapy is not generally recommended [ESMO clinical recommendations; Ann Oncol 2009]. RECIST criteria do not detect local tumor regression adequately. Standards for endoscopic staging throughout therapy have not yet been established. Methods: Here we report on20 consecutive patients with locally advanced esophago or gastric adenocarcinoma which were treated with EOX or EOF (epirubicin, oxaliplatin, capecitabine or 5-FU). After two cycles of chemotherapy, therapeutic efficacy was assessed by gastroscopy (EGD), endosonography (EUS), ultrasonography (US) and CT-scan. EGD staging criteria included luminal occlusion, the aboral length of tumor involvement, tumor exulceration, formation of polypoid tissue or superficial ulcers, and gut motility. EUS-staging criteria included uT-staging of the different layers of the esophagogastric wall as well as of the adjacent lymph-nodes. Surgery was then performed within 2 to 4 weeks after the end of the third chemotherapy cycle. Results: In all patients, an early response to chemotherapy was observed by EGD and EUS, including regression of tumor size (length and depth), and appearance: former exulcerative tissue became rather polypoid and less vulnerable, and motility was regained in areas were tumor regression was observed. For the assessment of local tumor behaviour under chemotherapy, CT-scan was of limited help, as it was only able to monitor lymphadenopathy. Only in 3/20 cases there was a concordance between the EUS and CT-scan, as verified by histopathological review of the surgical specimen. Conclusions: EGD and EUS monitor early tumor response of the primary to chemotherapy adequately in all our cases of locally advanced esophago or gastric adenocarcinoma. Endoscopic measures are helpful for the assessment of early treatment response, and might help to direct therapeutic strategies. No significant financial relationships to disclose.
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Affiliation(s)
- G. Töppler
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
| | - H. Röper
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
| | - S. Cameron
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
| | - L. Füzesi
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
| | - A. Beham
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
| | - G. Ramadori
- Department of Gastroenterology and Endocrinology, University of Goettingen, Goettingen, Germany; Department of Pathology, University of Goettingen, Goettingen, Germany; Department of General and Visceral Surgery, University of Goettingen, Goettingen, Germany
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Aigelsreiter A, Gerlza T, Deutsch AJ, Leitner E, Beham-Schmid C, Beham A, Popper H, Borel N, Pospischil A, Raderer M, Kessler HH, Neumeister P. Chlamydia psittaci Infection in nongastrointestinal extranodal MALT lymphomas and their precursor lesions. Am J Clin Pathol 2011; 135:70-5. [PMID: 21173126 DOI: 10.1309/ajcpxmdrt1sy6kiv] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) are associated with various infectious pathogens. We analyzed the presence of Chlamydia psittaci, Chlamydia pneumoniae, and Chlamydia trachomatis DNA in 47 nongastrointestinal and 14 gastrointestinal MALT lymphomas, 37 nonmalignant control samples, and 27 autoimmune precursor lesions by polymerase chain reaction amplification and direct sequencing. In 47 nongastrointestinal MALT lymphomas, 13 (28%) were positive for C psittaci DNA compared with 4 (11%) of 37 nonmalignant control samples (P = .09). C psittaci was detected at variable frequencies in MALT lymphomas of different sites: lung, 100% (5/5; P < .01); thyroid gland, 30% (3/10; P > .05); salivary gland, 13% (2/15; P > .05); ocular adnexa, 15% (2/13); and skin, 25% (1/4). Of 27 autoimmune precursor lesions (11 Hashimoto thyroiditis and 16 Sjögren syndrome), 11 (41%) contained C psittaci DNA. Only 1 (7%) of 14 gastrointestinal MALT lymphomas was positive for C psittaci. All specimens were negative for C trachomatis and C pneumoniae. Besides ocular adnexal lymphomas, C psittaci infection is associated with nongastrointestinal MALT lymphomas and autoimmune precursor lesions, suggesting possible involvement of C psittaci-induced antigenic-driven MALT lymphomagenesis.
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Tomazic PV, Beham A, Lackner A, Ropposch T, Stockreiter U, Walch C. Neuroendocrine adenoma of the middle ear (NAME) mimicking as chronic otitis media with an episode of facial nerve palsy. B-ENT 2011; 7:121-125. [PMID: 21838097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES To increase awareness of neuroendocrine adenomas of the middle ear (NAME), rare lesions often mistaken for other entities or chronic otitis media. Histogenesis remains controversial, although the consensus tends toward a pluripotent stem cell of the middle ear mucosa as the origin of the lesion. The tumour is characterised by dual differentiation with exocrine and endocrine components. The most common symptoms are conductive hearing loss, tinnitus and vertigo. The treatment of choice is complete surgical removal of the tumour with no adjuvant radiotherapy being required. CASE REPORT We report the case of a 23-year-old man presenting with chronic otitis media, conductive hearing loss, vertigo and tinnitus who, some years previously, had suffered from an episode of facial nerve palsy. Conservative therapy failed and so surgery was performed. Tumour-like masses were encountered and histological and immunohistochemical examination revealed a neuroendocrine adenoma of the middle ear. CONCLUSION This rare entity should be considered as differential diagnosis when treating chronic inflammatory disease not responding to conservative therapy or dealing with unclear expansive processes of the middle ear. MRI scans should be performed since CT scans are inconclusive.
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Affiliation(s)
- P V Tomazic
- ENT-University Hospital Graz, Division of Neurootology, Medical University Graz.
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Abstract
Schwannomas occurring in the pancreatic head are rare benign non-recurring mesenchymal neoplasms and are reported to show classic morphologic features. Herein we report a case of a 62 year old male presenting with a 5 cm mass in the pancreatic head encasing the portal vein and the truncus coeliacus. Preoperative fine needle aspiration revealed malignant tumour cells consistent with a moderately differentiated adenocarcinoma. A Whipple surgery was performed after palliative chemotherapy. Histological evaluation revealed a multinodular unencapsulated tumour with focal infiltration into pancreas parenchyma and a striking microcystic/reticular growth pattern. Anastomosing and intersecting strands of spindle cells with eosinophilic cytoplasm set in a myxoid partly collagenous stroma were observed. The tumour cell nuclei were round oval and tapered and showed inconspicuous small nucleoli. Degenerative nuclear atypia was seen. Mitotic activity was sparse (1/50 HPF). Pleomorphism or necrosis was absent. The tumour cells showed strong nuclear and cytoplasmic positivity for S-100 protein, and focal positivity for glial fibrillary acidic protein. The diagnosis of a microcystic/reticular schwannoma was made. The awareness of and, to some extent, the knowledge about this rare tumour are needed to achieve the correct diagnosis and to avoid confusion, especially with malignant pancreatic neoplasms.
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Kruegel J, Blaschke S, Beham A, Urlaub H, Bode C, Sadowski B, Koelling S, Miosge N. Migratory progenitor cells in osteoarthritis and rheumatoid arthritis are driven by inflammatory mediators and sex hormones. J Stem Cells Regen Med 2010; 6:65. [PMID: 24693085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- J Kruegel
- UMG, Tissue regeneration work group , Göttingen, Germany
| | | | | | - H Urlaub
- UMG, Tissue regeneration work group , Göttingen, Germany
| | - C Bode
- UMG, Tissue regeneration work group , Göttingen, Germany
| | - B Sadowski
- UMG, Tissue regeneration work group , Göttingen, Germany
| | - S Koelling
- UMG, Tissue regeneration work group , Göttingen, Germany
| | - N Miosge
- UMG, Tissue regeneration work group , Göttingen, Germany
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Knechtel G, Stoeger H, Szkandera J, Dorr K, Beham A, Samonigg H. Desmoid tumor treated with polychemotherapy followed by imatinib: a case report and review of the literature. Case Rep Oncol 2010; 3:287-93. [PMID: 21347195 PMCID: PMC3042021 DOI: 10.1159/000318873] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Desmoid tumors, also known as aggressive fibromatosis, are tumors of intermediate dignity, which grow slowly but are locally aggressive. These tumors do not metastasize but can be potentially life threatening when infiltrating vital structures. The therapy strategy consists of surgery, radiation and systemic therapy with non-steroidal anti-inflammatory drugs, antiestrogen compounds and cytotoxic chemotherapy. We report on a 40-year-old male patient with advanced fibromatosis of the neck who has been treated with 7 cycles of polychemotherapy (adriablastin, ifosfamide and dacarbazine) followed by targeted therapy with imatinib. Tumor response was evaluated clinically and by magnetic resonance imaging. The tumor decreased significantly after the first cycle of chemotherapy and tumor-related symptoms declined. The response continued after switching to targeted therapy with imatinib, which is currently ongoing. The best treatment for this rare tumor remains under discussion. Doxorubicin and dacarbazine are frequently used agents. We included ifosfamide in our therapy, which is standard in the treatment of soft tissue tumors. The tyrosine kinase inhibitor imatinib seems to offer new possibilities and is currently investigated in randomized trials. We conclude that combination chemotherapy including doxorubicin, ifosfamide and dacarbazine in the treatment of aggressive fibromatosis should be considered for patients suffering from unresectable, advanced disease and clinical symptoms which require a rapid response to therapy.
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Affiliation(s)
- Gudrun Knechtel
- Department of Internal Medicine, Division of Oncology, Medical University Graz, Graz, Austria
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24
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Lund VJ, Stammberger H, Nicolai P, Castelnuovo P, Beal T, Beham A, Bernal-Sprekelsen M, Braun H, Cappabianca P, Carrau R, Cavallo L, Clarici G, Draf W, Esposito F, Fernandez-Miranda J, Fokkens W, Gardner P, Gellner V, Hellquist H, Hermann P, Hosemann W, Howard D, Jones N, Jorissen M, Kassam A, Kelly D, Kurschel-Lackner S, Leong S, McLaughlin N, Maroldi R, Minovi A, Mokry M, Onerci M, Ong YK, Prevedello D, Saleh H, Sehti DS, Simmen D, Snyderman C, Solares A, Spittle M, Stamm A, Tomazic P, Trimarchi M, Unger F, Wormald PJ, Zanation A. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010; 22:1-143. [PMID: 20502772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Tumours affecting the nose, paranasal sinuses and adjacent skull base are fortunately rare. However, they pose significant problems of management due their late presentation and juxtaposition to important anatomical structures such eye and brain. The increasing application of endonasal endoscopic techniques to their excision offers potentially similar scales of resection but with reduced morbidity. The present document is intended to be a state-of-the art review for any specialist with an interest in this area 1. to update their knowledge of neoplasia affecting the nose, paranasal sinuses and adjacent skull base; 2. to provide an evidence-based review of the diagnostic methods; 3. to provide an evidence-based review of endoscopic techniques in the context of other available treatments; 4. to propose algorithms for the management of the disease; 5. to propose guidance for outcome measurements for research and encourage prospective collection of data. The importance of a multidisciplinary approach, adherence to oncologic principles with intent to cure and need for long-term follow-up is emphasised.
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Affiliation(s)
- Valerie J Lund
- Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
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Kiesler K, Friedrich G, Beham A, Ebner F, Gugatschka M. First report of intralaminar tumorlike lipomatous lesions of the thyroid cartilage. J Voice 2010; 25:487-9. [PMID: 20189347 DOI: 10.1016/j.jvoice.2010.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 01/18/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION We present two cases of tumorlike lipomatous lesions in the thyroid cartilage. Both presented as circumscribed tumors by ultrasonography and were identified accidentally. METHODS Two tumorlike lesions were identified in two different patients. Additionally, computed tomography and magnetic resonance imaging scans of the laryngeal skeleton were performed. Surgery was performed in one patient, and the lesion was excised. Histopathology revealed fatty tissue with several foci of hematopoietic cells. CONCLUSION This is the first report of intralaminar tumorlike lipomatous lesions in the thyroid cartilage. These should be included in the differential diagnoses of primary cartilaginous lesions of the laryngeal skeleton.
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Affiliation(s)
- Karl Kiesler
- Department of Phoniatrics, Speech and Swallowing, Ear, Nose and Throat University Hospital, Graz, Austria
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27
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Gugatschka M, Beham A, Stammberger H, Schmid C, Friedrich G. First case of a myxofibrosarcoma of the vocal folds: case report and review of the literature. J Voice 2009; 24:374-6. [PMID: 19664897 DOI: 10.1016/j.jvoice.2008.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 10/14/2008] [Indexed: 01/01/2023]
Abstract
We present the first case of an endolaryngeal manifestation of a myxofibrosarcoma. These tumors represent a distinct clinicopathologic entity and are fibroblast-derived soft-tissue neoplasms usually arising in late adulthood. The tumor presented as an edematous swelling of the right vocal fold, appearing as a common Reinke edema. Surgery is the most common form of therapy, only a limited number of papers dealing with radio/chemotherapy exist due to the small number of cases. Unilateral cordectomy was performed, tumor was resected with negative surgical margins. This is the first report of an endolaryngeal myxofibrosarcoma. The tumor presented clinically as a unilateral swelling of the right vocal fold.
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Affiliation(s)
- Markus Gugatschka
- ENT University Hospital Graz, Medical University Graz, Graz, Austria.
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28
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Glehr M, Leithner A, Scheipl S, Zacherl M, Quehenberger F, Maurer-Ertl W, Gruber G, Beham A, Windhager R. Liposarcomas: treatment and outcome, a retrospective single-center study. Eur Surg 2009. [DOI: 10.1007/s10353-009-0477-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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29
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Tiran B, Wawschinek O, Eber O, Beham A, Lax S, Dermelj M. Simple determination of iodine in small specimens of thyroid tissue. Exp Clin Endocrinol 2009; 98:32-6. [PMID: 1936145 DOI: 10.1055/s-0029-1211097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This work describes a simple photometric determination of the iodine concentration in thyroid tissue, a method based on the well-known catalytic Sandell-Kolthoff reaction. The modified ceric arsenite reaction is very sensitive and does not require complicated laboratory equipment. It can be performed in any routine clinical laboratory if instructions are followed strictly. By means of this method iodine concentration can be determined even in small specimens, for instance puncture samples of thyroid tissue or thyroid glands of small animals (mouse). Previous to the analysis, the tissue is digested in a mixture of sodium chlorate and perchloric acid at 100 degrees C. Using this manner of digestion between 94 and 110% of iodine in the sample were recovered. Comparison with neutron activation analysis showed excellent agreement of the obtained values.
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Affiliation(s)
- B Tiran
- Institute of Medical Biochemistry, University of Graz, Hospital Krankenhaus der Barmherzigen Brüder, Graz, Austria
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30
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Pfragner R, Behmel A, Höger H, Beham A, Ingolic E, Stelzer I, Svejda B, Moser VA, Obenauf AC, Siegl V, Haas O, Niederle B. Establishment and characterization of three novel cell lines - P-STS, L-STS, H-STS - derived from a human metastatic midgut carcinoid. Anticancer Res 2009; 29:1951-1961. [PMID: 19528452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Carcinoids are rare tumors derived from enterochromaffin (EC) cells of the embryonic neural crest. They have malignant potential and their incidence is steadily increasing. The only curative treatment option is surgery. We have focused on cultivation of human neuroendocrine tumors (NET) as relevant models for the study of potential therapy. Only a few cell lines from human carcinoids have been established so far, among them our earlier KRJ-I cell line from a human ileal carcinoid. The reason for the poor success in establishing carcinoid cell lines is due to the small amount of tissue available and the low mitotic activity in primary cultures. We have successfully established three continuously growing cell lines from tissue obtained from a metastatic human carcinoid of the terminal ileum (midgut carcinoid): P-STS was derived from the primary tumor, L-STS from a lymph node metastasis and H-STS from a hepatic metastasis. Immunocytochemistry proved the maintenance of characteristic neuroendocrine properties. Electron microscopy confirmed the presence of neuroendocrine granules. The three cell lines were tumorigenous in SCID-mice. Cytogenetic analyses revealed clonal tetraploidy, inversion and deletion in chromosome 18q, and non-clonal numerical and structural aberrations. Array CGH did not show notable imbalances. Mutation screening of P-STS excluded a MEN1-gene-associated genetic predisposition with high probability. The novel cell lines P-STS, L-STS and H-STS may be useful in vitro and in vivo models for further studies of biological characteristics and the development of new therapeutic agents.
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Affiliation(s)
- Roswitha Pfragner
- Institute of Pathophysiology, Medical University of Graz, A-8010 Graz, Austria.
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31
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Roll P, Beham A, Beham-Schmid C. Post-mortem histopathological investigations of the bone marrow in forensic medicine: an important issue for both the forensic and clinical pathologist. Forensic Sci Int 2009; 186:e17-20. [PMID: 19231118 DOI: 10.1016/j.forsciint.2008.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 12/01/2008] [Accepted: 12/02/2008] [Indexed: 11/28/2022]
Abstract
In the forensic literature only a few scientific reports are dealing with series of histopathological bone marrow (BM) investigations, mainly concerning changes after drug abuse and alcoholic consumption. In a period of 13 years (1995-2008) we routinely investigated 225 BM specimens from anterior iliac crests taken at forensic autopsies if the cause of death was unclear or vague, septicaemia was suspected or known, in cases of presumed haemorrhagic diathesis or bleeding tendencies, spleens were found to be enlarged or intoxications were suspected or proofed. In 78 cases (34.66%) abnormal histopathologic changes were found. Forty of those revealed neoplastic, mainly haematological diseases, which were unknown during lifetime. Referring to our findings, extraction of post-mortem BM specimens for histopathological investigations should become an essential issue for both the forensic and clinical pathologist.
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Affiliation(s)
- P Roll
- Institute of Forensic Medicine, Medical University of Graz, Universitätsplatz 4/II, A-8010 Graz, Austria.
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32
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Zacherl M, Sourij H, Beham A, Emberger W, Leithner A, Windhager W. [Cerebrotendinous xanthomatosis. Hereditary lipid storage disease leading to bilateral swelling of Achilles tendon]. Orthopade 2008; 37:704-8. [PMID: 18483801 DOI: 10.1007/s00132-008-1275-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cerebrotendinous xanthomatosis is a rare hereditary lipid storage disease characterised by deposits of cholestanol. In a female patient with bilateral swelling of the Achilles tendon who underwent biopsy, cerebrotendinous xanthomatosis was confirmed by combining disease patterns. She suffered from ataxia, depression, epilepsy, reduced intelligence, bilateral cataracts, gallstones, and atherosclerosis. Concentration of serum cholestanol was 10 times higher than normal. As causal therapy, ursodeoxycholic acid and statin drugs were prescribed to halt progression.
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Affiliation(s)
- M Zacherl
- Universitätsklinik für Orthopädie, Medizinische Universität, Graz.
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33
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Zacherl M, Sourij H, Beham A, Emberger W, Leithner A, Windhager W. [Cerebrotendinous xanthomatosis. Hereditary lipid storage disease leading to bilateral swelling of Achilles tendon]. Orthopade 2008. [PMID: 18483801 DOI: 10.1007/s00132‐008‐1275‐8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cerebrotendinous xanthomatosis is a rare hereditary lipid storage disease characterised by deposits of cholestanol. In a female patient with bilateral swelling of the Achilles tendon who underwent biopsy, cerebrotendinous xanthomatosis was confirmed by combining disease patterns. She suffered from ataxia, depression, epilepsy, reduced intelligence, bilateral cataracts, gallstones, and atherosclerosis. Concentration of serum cholestanol was 10 times higher than normal. As causal therapy, ursodeoxycholic acid and statin drugs were prescribed to halt progression.
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Affiliation(s)
- M Zacherl
- Universitätsklinik für Orthopädie, Medizinische Universität, Graz.
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34
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Moinfar F, Beham A, Friedrich G, Deutsch A, Hrzenjak A, Luschin G, Tavassoli FA. Macro-environment of breast carcinoma: frequent genetic alterations in the normal appearing skins of patients with breast cancer. Mod Pathol 2008; 21:639-46. [PMID: 18264084 DOI: 10.1038/modpathol.2008.28] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Genetic abnormalities in microenvironmental tissues with subsequent alterations of reciprocal interactions between epithelial and mesenchymal cells play a key role in the breast carcinogenesis. Although a few reports have demonstrated abnormal fibroblastic functions in normal-appearing fibroblasts taken from the skins of breast cancer patients, the genetic basis of this phenomenon and its implication for carcinogenesis are unexplored. We analyzed 12 mastectomy specimens showing invasive ductal carcinomas. In each case, morphologically normal epidermis and dermis, carcinoma, normal stroma close to carcinoma, and stroma at a distant from carcinoma were microdissected. Metastatic-free lymphatic tissues from lymph nodes served as a control. Using PCR, DNA extracts were examined with 11 microsatellite markers known for a high frequency of allelic imbalances in breast cancer. Losses of heterozygosity and/or microsatellite instability were detected in 83% of the skin samples occurring either concurrently with or independently from the cancerous tissues. In 80% of these cases at least one microsatellite marker displayed loss of heterozygosity or microsatellite instability in the skin, which was absent in carcinoma. A total of 41% of samples showed alterations of certain loci observed exclusively in the carcinoma but not in the skin compartments. Our study suggests that breast cancer is not just a localized genetic disorder, but rather part of a larger field of genetic alterations/instabilities affecting multiple cell populations in the organ with various cellular elements, ultimately contributing to the manifestation of the more 'localized' carcinoma. These data indicate that more global assessment of tumor micro- and macro-environment is crucial for our understanding of breast carcinogenesis.
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Affiliation(s)
- Farid Moinfar
- Department of Pathology, Medical University of Graz, Graz, Austria.
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35
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Gugatschka M, Kiesler K, Beham A, Rechenmacher J, Friedrich G. Hyperplastic epithelial lesions of the vocal folds: combined use of exfoliative cytology and laryngostroboscopy in differential diagnosis. Eur Arch Otorhinolaryngol 2007; 265:797-801. [DOI: 10.1007/s00405-007-0549-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 11/20/2007] [Indexed: 10/22/2022]
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36
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Aigelsreiter A, Leitner E, Deutsch AJA, Kessler HH, Stelzl E, Beham-Schmid C, Beham A, Krugmann J, Dinges HP, Linkesch W, Neumeister P. Chlamydia psittaci in MALT lymphomas of ocular adnexals: the Austrian experience. Leuk Res 2007; 32:1292-4. [PMID: 18061259 DOI: 10.1016/j.leukres.2007.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 10/12/2007] [Accepted: 10/21/2007] [Indexed: 10/22/2022]
Abstract
The presence of Chlamydia (C.) psittaci, C. pneumoniae and C. trachomatis DNAs in MALT lymphomas of ocular adnexals from 13 Austrian patients were studied. Gastrointestinal MALT lymphomas and gastritis specimens served as controls. Of 13 MALT lymphomas of the ocular adnexals, seven were positive for C. psittaci DNA. In contrast, one of 17 gastrointestinal specimens tested positive. All specimens were negative for C. trachomatis and C. pneumoniae DNAs. In conclusion, C. psittaci infection was observed in the majority of MALT lymphomas of ocular adnexals in Austrian patients.
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Liegl B, Gülly C, Reich O, Nogales FF, Beham A, Regauer S. Expression of platelet-derived growth factor receptor in low-grade endometrial stromal sarcomas in the absence of activating mutations. Histopathology 2007; 50:448-52. [PMID: 17448020 DOI: 10.1111/j.1365-2559.2007.02634.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIMS To investigate platelet-derived growth factor receptor (PDGFR)alpha and PDGFRbeta expression and a mutational analysis of PDGFRalpha (exons 11, 12, 17 and 18) and PDGFRbeta (exon 12) genes in endometrial stromal sarcomas (ESS). Gastrointestinal stromal tumours (GISTs), which have somatic mutations of the transmembrane tyrosine kinase receptor, respond to tyrosine kinase inhibitors, which act through an inhibitory effect on class 3 receptor tyrosine kinase members such as PDGFRalpha, PDGFRbeta and c-kit. METHODS AND RESULTS The immunohistochemical expression of PDGFRalpha and PDGFRbeta was investigated in 37 archival c-kit- ESS. Staining was scored as negative (0-10% positive tumour cells) and positive (weakly positive 11-50% positive cells; strongly positive > 50% positive cells). PDGFRalpha was expressed in 24/37 ESS [65%; strongly by 19/37 (51.5%) and weakly by 5/37 ESS (13.5%)]. ESS tumour cells were negative for PDGFRbeta, but endothelial cells stained positive. A mutational analysis of PDGFRalpha (exons 11, 12, 17 and 18) and PDGFRbeta (exon 12) genes on frozen metastatic ESS from three patients detected no mutations leading to amino acid changes in the mature protein. CONCLUSIONS Patients with PDGFRalpha+ ESS may benefit from treatment with tyrosine kinase inhibitors by blocking autocrine and paracrine stimulation loops, blocking neovascularization and enhancing the effects of chemotherapy.
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Affiliation(s)
- B Liegl
- Institute of Pathology, Medical University of Graz, Graz, Austria
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38
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Lackner A, Raggam RB, Stammberger H, Beham A, Braun H, Kleinhappl B, Buzina W, Kittinger C, Reinisch S, Berghold A, Freudenschuss K, Barth S, Marth E. The role of interleukin-16 in eosinophilic chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2007; 264:887-93. [PMID: 17431659 DOI: 10.1007/s00405-007-0300-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 03/12/2007] [Indexed: 10/23/2022]
Abstract
Eosinophilic granulocytes (Eos) are found in great numbers both in the tissue and in the mucus of patients suffering from chronic rhinosinusitis with polyposis (ECRS). Interleukin-16 (IL-16) is known as a highly potent chemotactic and chemoattractant molecule (ED 10-11) for Eos. In an open, explorative, controlled study we examined the presence of IL-16 in mucosa tissue, mucus and serum in patients suffering from ECRS and its association to Eos activation. Tissue and nasal mucus specimen from 10 previously untreated, non allergic ECRS-patients undergoing paranasal sinus surgery and from 10 healthy non sinusitis subjects, undergoing nasal surgery because of anatomic nasal obstruction were investigated by real-time (RT-) PCR targeting human IL-16 mRNA. Haematoxylin-eosin (HE) staining and immunohistochemistry of formalin embedded tissue and mucus were applied for detection and determination of the proportion of activated Eos (aEos) and IL-16. Serum IL-16 was analyzed by enzyme-linked-immunosorbent assay (ELISA). IL-16 mRNA and IL-16 protein levels were elevated in nasal mucus, polyp tissue and in the serum of ECRS patients compared to healthy controls. There was a high proportion of aEos in ECRS patients compared to healthy subjects. Serum IL-16, IL-16 mRNA expression and IL-16 protein in mucus and tissue specimens were significantly associated with the presence of aEos in polyps of ECRS patients. Immunohistochemically IL-16 protein was mainly expressed in aEos, mast cells, lymphocytes and epithelial cells. In conclusion our data indicate that IL-16 may stimulate the migration and persistence of activated Eos in ECRS. IL-16 production in ECRS patients is not mediated by Immunglobuline-E (IgE).
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Affiliation(s)
- Andreas Lackner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Graz, Auenbruggerplatz 26-28, 8036, Graz, Austria.
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Deutsch AJA, Aigelsreiter A, Staber PB, Beham A, Linkesch W, Guelly C, Brezinschek RI, Fruhwirth M, Emberger W, Buettner M, Beham-Schmid C, Neumeister P. MALT lymphoma and extranodal diffuse large B-cell lymphoma are targeted by aberrant somatic hypermutation. Blood 2006; 109:3500-4. [PMID: 17197434 DOI: 10.1182/blood-2006-06-030494] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recently, a novel mechanism introducing genetic instability, termed aberrant somatic hypermutation (ASHM), has been described in diffuse large B-cell lymphoma. To further investigate whether ASHM also occurs in mucosa-associated lymphoid tissue type (MALT) lymphoma, we studied the mutation profile of PIM1, PAX5, RhoH/TTF, and c-MYC in 17 MALT lymphomas and 17 extranodal diffuse large B-cell lymphomas (DLBCLs) still exhibiting a low-grade MALT lymphoma component (transformed MALT lymphoma). Mutations in one or more genes were detected in 13 (76.5%) of 17 cases of MALT lymphomas and in all of 17 (100%) cases of extranodal DLBCL. A total of 100 sequence variants were found in 30 of 34 cases, 28 in the MALT lymphomas and 72 in extranodal DLBCL. Further, in PIM1 and c-MYC some of the mutations were found to affect coding exons, leading to amino acid exchanges, thus potentially altering gene function. Expression levels of activation-induced cytidine deaminase (AID), an enzyme essential for somatic hypermutation (SHM), was associated with the mutational load. These data indicate that aberrant SHM is associated with extranodal DLBCL and MALT lymphoma, likewise. By mutating regulatory and coding sequences of the targeted genes, ASHM may represent a major contributor to their pathogenesis.
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Affiliation(s)
- Alexander J A Deutsch
- Division of Haematology, Medical University Graz, Auenbruggerplatz 38, A-8036 Graz, Austria
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Liegl B, Leithner A, Bauernhofer T, Windhager R, Guelly C, Regauer S, Beham A. Immunohistochemical and mutational analysis of PDGF and PDGFR in desmoid tumours: is there a role for tyrosine kinase inhibitors in c-kit-negative desmoid tumours? Histopathology 2006; 49:576-81. [PMID: 17163842 DOI: 10.1111/j.1365-2559.2006.02562.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM To determine the platelet-derived growth factor (PDGF) alpha and beta status of desmoid tumours. Desmoid tumours are rare monoclonal neoplasms that appear to have no metastatic potential. Surgical resection and radiotherapy in the event of a positive surgical margin is the first-line treatment. Recurrences are frequent. Treatment results using non-steroidal anti-inflammatory agents, anti-oestrogen compounds and other agents such as Imatinib mesylate have been published. Therapy with Imatinib has been proposed as a therapeutic option, although in most reports desmoid tumours are reported to be c-kit-. METHODS AND RESULTS We performed immunohistochemical analysis on 124 archived samples (85 patients) of desmoid tumours using antibodies to PDGFalpha, PDGFbeta, PDGFRalpha and PDGFRbeta. All desmoid tumours showed immunoreactivity with antibodies to PDGFalpha and PDGFRalpha, whereas with antibodies to PDGFbeta and PDGFRbeta no specific reaction could be detected. Mutational analysis of PDGFRalpha (exons 11, 12, 17 and 18) and PDGFRbeta (exon 12) on frozen material from 14 patients was performed, but no mutations leading to amino acid changes in the mature protein were identified. CONCLUSION The absence of an activating mutation in a protooncogene does not exclude the efficacy of tyrosine kinase inhibitors through other possible mechanisms, and these might be a therapeutic option for patients with desmoid tumours in whom established local and systemic approaches fail to control the disease.
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Affiliation(s)
- B Liegl
- Institute of Pathology, Medical University of Graz, Graz, Austria.
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Beham A, Rentsch M, Püllmann K, Mantouvalou L, Spatz H, Schlitt HJ, Obed A. Survival benefit in patients after palliative resection vs non-resection colon cancer surgery. World J Gastroenterol 2006; 12:6634-8. [PMID: 17075976 PMCID: PMC4125668 DOI: 10.3748/wjg.v12.i41.6634] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate survival in patients undergoing palliative resection versus non-resection surgery for primary colorectal cancer in a retrospective analysis.
METHODS: Demographics, TNM status, operating details and survival were reviewed for 67 patients undergoing surgery for incurable colorectal cancer. Palliative resection of the primary tumor was performed in 46 cases in contrast to 21 patients with non-resection of the primary tumor and bypass surgery. Risk factors for postoperative mortality and poor survival were analyzed with univariate and multivariate analyses.
RESULTS: The two groups were comparable in terms of age, gender, preoperative presence of ileus and tumor stage. Multivariate analysis showed that median survival was significantly higher in patients with palliative resection surgery (544 vs 233 d). Differentiation of the tumor and tumor size were additional independent factors that were associated with a significantly poorer survival rate.
CONCLUSION: Palliative resection surgery for primary colorectal cancer is associated with a higher median survival rate. Also, the presence of liver metastasis and tumor size are associated with poor survival. Therefore, resection of the primary tumor should be considered in patients with non-curable colon cancer.
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Affiliation(s)
- A Beham
- Department of Surgery, The University of Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany.
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Spatz H, Zülke C, Beham A, Agha A, Bolder U, Krenz D, Fürst A, Lattermann R, Gröppner G, Hemmerich B, Piso P, Schlitt H. „Fast-Track” bei laparoskopisch assistierter Rektumresektion - was kann erreicht werden? Erste Ergebnisse einer Machbarkeitsstudie. Zentralbl Chir 2006; 131:383-7. [PMID: 17089286 DOI: 10.1055/s-2006-949659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM "Fast-track" multimodal rehabilitation is increasingly entering the perioperative management strategies in colon surgery aiming at minimized perioperative morbidity and accelerated recovery. So far little is known about the complementary effects of minimally invasive surgery along with "fast-track" rehabilitation in the treatment of rectal cancer. The aim of this pilot study was to investigate the influence of "fast-track" perioperative management on morbidity, recovery and length of hospital stay in laparoscopically-assisted rectum resections and to compare those data to earlier results. METHODS An interdiciplinary "fast-track" multimodal rehabilitation strategy with avoidance of mechanical bowel cleansing, with a restrictive intravenous intra- and postoperative fluid regimen, forced mobilisation, and early enteral nutrition was introduced into clinical practice and applied in 16 laparoscopically-assisted rectum resections. Data were collected in the course af a prospective analysis. The mean patient age was 62 (42-79) years. RESULTS Mean time of surgery was 245 (SD 46) min, and the mean intraoperative infusion rate was 11.2 (SD 2.6) ml/kg/BW. On day 2, 14 of the 16 patients tolerated solid food and 12 patients had had bowel movements. All patients returned to their initial body weight by day 4. The median postoperative hospital stay was 7.5 days (6-20), 12 patients were discharged between day 6 and 8. Two patients were readmitted for intestinal atony, one patient developed an anastomotic leakage. CONCLUSIONS "Fast-track" rehabilitation is feasible in rectum surgery and seems to complement the beneficial effects of minimally invasive surgery without increasing the complication rate.
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Affiliation(s)
- H Spatz
- Klinik und Poliklinik für Chirurgie, Klinikum der Universität Regensburg
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Cassidy J, Douillard JY, Twelves C, McKendrick JJ, Scheithauer W, Bustová I, Johnston PG, Lesniewski-Kmak K, Jelic S, Fountzilas G, Coxon F, Díaz-Rubio E, Maughan TS, Malzyner A, Bertetto O, Beham A, Figer A, Dufour P, Patel KK, Cowell W, Garrison LP. Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes' C colon cancer: the X-ACT trial. Br J Cancer 2006; 94:1122-9. [PMID: 16622438 PMCID: PMC2361258 DOI: 10.1038/sj.bjc.6603059] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Oral capecitabine (Xeloda®) is an effective drug with favourable safety in adjuvant and metastatic colorectal cancer. Oxaliplatin-based therapy is becoming standard for Dukes' C colon cancer in patients suitable for combination therapy, but is not yet approved by the UK National Institute for Health and Clinical Excellence (NICE) in the adjuvant setting. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (UK National Health Service (NHS)) and societal perspectives. We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine than 5-FU/LV, but higher 5-FU/LV administration costs resulted in 57% lower chemotherapy costs for capecitabine. Capecitabine vs 5-FU/LV-associated adverse events required fewer medications and hospitalisations (cost savings £3653). Societal costs, including patient travel/time costs, were reduced by >75% with capecitabine vs 5-FU/LV (cost savings £1318), with lifetime gain in QALMs of 9 months. Medical resource utilisation is significantly decreased with capecitabine vs 5-FU/LV, with cost savings to the NHS and society. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. Cost savings and better outcomes make capecitabine a preferred adjuvant therapy for Dukes' C colon cancer. This pharmacoeconomic analysis strongly supports replacing 5-FU/LV with capecitabine in the adjuvant treatment of colon cancer in the UK.
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Affiliation(s)
- J Cassidy
- Cancer Research UK, Department of Medical Oncology, University of Glasgow, Garscube Estate, Bearsden, Glasgow G61 1DB, UK, and Centre René Gauducheau, Site Hospitalier Nord, Nantes, France.
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Rentsch M, Beham A, Schlitt HJ, Jauch KW. Crohn's disease activity index and Vienna classification--is it worthwhile to calculate before surgery? Dig Surg 2006; 23:241-9. [PMID: 16943672 DOI: 10.1159/000095397] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 07/06/2006] [Indexed: 12/29/2022]
Abstract
BACKGROUND Crohn's disease (CD) patients with increased disease activity may reveal an increased risk for perioperative complications. The "Crohn's disease activity index" (CDAI) and the "Vienna classification" (VC) were developed for standardized disease activity estimations. The significance of these scores to predict extent, type and early outcome of surgery in CD patients was analyzed. METHODS In 179 surgically treated CD patients, the CDAI and VC were assessed from a prospective database. Relations of the scores with CD risk factors, type, number, location and complications of surgery were analyzed. RESULTS VC behavior and location subtypes were associated with distinct types of surgery (i.e. "strictureplasty" in "stricturing disease", "colon surgery" in "colon involvement"), but not with surgery type and extent or outcome. Surgery extent (i.e. with 5 vs. 3 "surgical sites" 425 +/- 25 vs. 223.3 +/- 25) and complications (357.1 +/- 36.9 (with) vs. 244.4 +/- 13 (without)) were associated with elevated CDAI levels; however, nicotine abuse remained the only significant risk factor for perioperative complications after multiple logistic regression. CONCLUSION The significance of VC or CDAI for predicting the extent of surgery or complications is limited. None of the tested variables except preoperative nicotine abuse influenced the likelihood for perioperative complications.
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Affiliation(s)
- M Rentsch
- Department of Surgery, Ludwig-Maximilians University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, DE-81377 Munich, Germany.
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Aigelsreiter A, Stelzl E, Deutsch A, Beham-Schmid C, Beham A, Lanzer G, Linkesch W, Kessler H, Neumeister P. Association between Chlamydia psittaci infection and extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT)-lymphomas. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7568 Background: MALT-lymphomas are often associated with infectious organisms. Microbial species associated with MALT lymphomas are: Helicobacter pylori (H.pylori), Campylobacter jejuni, Borrelia burgdorferi, and Hepatitis C Virus. Recent studies showed evidence of Chlamydia psittaci (C. psittaci) infection in 80% of ocular adnexal lymphoma and tumor regression following eradication therapy. We studied the presence of C. trachomatis, C. pneumoniae, and C. psittaci DNAs in MALT lymphomas of various sites and in non-malignant controls. Methods: MALT lymphomas from the following sites were selected for analysis: salivary gland (n=13), thyroid gland (n=4), skin (n=2), ocular adnexa (n=2), stomach (n=6), intestinum (n=4). Samples of Sjoegren syndrome (n=10) and samples of H. pylori positive gastritis (n=7) were included as non-malignant controls. Macrodissected tissue containing >80% lymphoma cells from paraffin embedded tissue was processed for DNA isolation. For the presence of C. psittaci and C. pneumoniae DNA real time PCR assays were used. For C. trachomatis a commercially available PCR assay (Roche Molecular Diagnostics) was employed. All samples were tested twice. A sample was regarded as positive if at least one positive result was obtained. Results: C. psittaci was found at variable frequencies in MALT lymphomas of different sites: 4/13 (31%) salivary gland, 2/4 (50%) thyroid gland, 2/2 (100%) skin, 2/2 (100%) ocular adnexa, 1/6 (17%) gastric, and 0/4 intestinal MALT lymphomas. Among the non-malignant specimens, C. psittaci DNA was detected in 4/10 (40%) samples of Sjoegren syndrome and in 0/7 samples of H. pylori positive gastritis. All nongastric MALT lymphomas tested were negative for C. trachomatis and C. pneumoniae. Conclusion: Our data reveal a clear association of C. psittaci infection with extragastric MALT lymphoma. However, no evidence could be established for C. trachomatis and C. pneumoniae infection. Moreover, the high prevalence of Sjoegren syndromes - the most frequent precursor lesion for MALT lymphomas of salivary gland and ocular adnexa - may suggest an involvement of C. psittaci induced antigenic driven lymphomagenesis in a significant proportion of extragastric MALT lymphomas. No significant financial relationships to disclose.
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Affiliation(s)
- A. Aigelsreiter
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - E. Stelzl
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - A. Deutsch
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - C. Beham-Schmid
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - A. Beham
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - G. Lanzer
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - W. Linkesch
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - H. Kessler
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
| | - P. Neumeister
- Institute of Pathology, Medical University Graz, Graz, Austria; Institute of Hygiene, MUG, Graz, Austria; Medical University Graz, Graz, Austria
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Abstract
BACKGROUND/AIMS Although the standard treatment for desmoid tumours is complete surgical resection with wide margins, the optimal adjuvant treatment for recurrent or inoperable disease is unclear, often being based on sporadic immunohistochemical reports with a low number of cases. Therefore, a large immunohistochemical study was performed, to provide a theoretical basis for adjuvant treatment regimens. METHODS One hundred and sixteen tissue samples from 80 patients (49 female, 31 male; mean age, 34 years; range, 0-83) with desmoid tumours (46 extra-abdominal, 21 abdominal, 13 intra-abdominal) were tested for oestrogen receptors alpha and beta, progesterone and androgen receptors, and somatostatin, in addition to HER2, cathepsin D, Ki-67, and c-KIT by immunohistochemistry. RESULTS All samples were negative for oestrogen receptor alpha, HER2, and the progesterone receptor. Positive staining for the androgen receptor was found in six extra-abdominal cases. Staining for oestrogen receptor beta was positive in four extra-abdominal, two abdominal, and one intra-abdominal case. Staining for somatostatin was positive in six extra-abdominal, two abdominal, and one intra-abdominal case, and staining for cathepsin D was positive in all cases. Positive staining for Ki-67 was found in 14 extra-abdominal, three abdominal, and three intra-abdominal cases. C-KIT was detectable in one abdominal case only. CONCLUSIONS The data from this immunohistochemical study show that the published effects of antioestrogens and imatinib mesylate in the treatment of aggressive fibromatoses may not be attributable to oestrogen receptor alpha or c-KIT expression.
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MESH Headings
- Abdominal Neoplasms/chemistry
- Abdominal Neoplasms/drug therapy
- Abdominal Neoplasms/pathology
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Cathepsin D/analysis
- Chemotherapy, Adjuvant
- Child
- Child, Preschool
- Female
- Fibromatosis, Aggressive/drug therapy
- Fibromatosis, Aggressive/metabolism
- Fibromatosis, Aggressive/pathology
- Humans
- Infant
- Infant, Newborn
- Ki-67 Antigen/analysis
- Male
- Middle Aged
- Neoplasm Proteins/analysis
- Proto-Oncogene Proteins c-kit/analysis
- Receptors, Androgen/analysis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Soft Tissue Neoplasms/chemistry
- Soft Tissue Neoplasms/drug therapy
- Soft Tissue Neoplasms/pathology
- Somatostatin/analysis
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Affiliation(s)
- A Leithner
- Department of Orthopaedic Surgery, Medical University Graz, Auenbruggerplatz 5, A-8036 Graz, Austria
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Kienle K, Rentsch M, Müller T, Engelhard N, Vogel M, Jauch KW, Beham A. Expression of BCL-2 in liver grafts after adenoviral transfer improves survival following prolonged ischemia and reperfusion in rat liver transplantation. Transplant Proc 2005; 37:439-41. [PMID: 15808669 DOI: 10.1016/j.transproceed.2004.12.268] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED Apoptosis represents a crucial mechanism of ischemia-reperfusion injury after liver transplantation. Bcl-2 may inhibit apoptosis. This study investigates the effect on ischemia/reperfusion injury and survival after rat liver transplantation of adenoviral bcl-2 transfer into donor livers. METHODS A nonreplicative adenovirus, expressing bcl-2 under control of a tetracyclin-inducible promoter (adv TetOn bcl-2) was used to treat male Lewis rats in combination with a second adenovirus transferring the TetOn repressor protein under control of a cytomegalovirus promoter (advCMVRep). Virus induction was achieved by addition of doxycyclin to the drinking water. Controls were pretreated with a control adenovirus (advCMV GFP) or with doxycycline. Liver transplantations were performed after 16-hour graft storage. Bcl-2 expression was evaluated by Western blot and immunohistology. Survival was monitored for 7 days, and tissue specimens were collected at 24 hours and 7 days post reperfusion. RESULTS After pretreatment with advTetOn bcl-2/adv CMVRep, intrahepatic bcl-2 expression was evident at 24 hours and 7 days but was absent among controls. Bcl-2 expression was detected in hepatocytes and, to a high degree, in sinusoidal lining cells. TUNEL-positive sinusoidal lining cells were strikingly reduced after bcl-2 transfer (0.1 +/- 0.3 cells/hpf, mean +/- SD) compared to control virus (4.8 +/- 2.3) or doxycyclin-treated grafts (1.3 +/- 0.2); P < .05. After bcl-2 treatment, survival after transplantation was 100%, whereas it was 50% in both control groups (P = .035). CONCLUSION The study shows the feasibility of transient, doxycyclin-controlled adenoviral gene transfer in a transplantation model. Bcl-2 expression increased survival after ischemia/reperfusion in rat liver transplantation, potentially through protection of sinusoidal lining cells.
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Affiliation(s)
- K Kienle
- Department of Surgery, University of Regensburg, Munich, Germany
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Leithner A, Weinhaeusel A, Zeitlhofer P, Koch H, Radl R, Windhager R, Beham A, Haas OA. Evidence of a polyclonal nature of myositis ossificans. Virchows Arch 2005; 446:438-41. [PMID: 15761759 DOI: 10.1007/s00428-004-1169-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2004] [Accepted: 10/31/2004] [Indexed: 11/26/2022]
Abstract
Myositis ossificans is a localized, self-limiting, reparative lesion that is composed of reactive hypercellular fibrous tissue and bone. Although it is clearly a benign lesion, its clinical, radiological, and histological appearance may sometimes mimic a malignant tumor. Whether myositis ossificans represents a monoclonal or polyclonal hyperplastic proliferation is not yet known. To address this question, we therefore extracted DNA from the respective paraffin-embedded tumor tissues of nine women with a median age of 50 years at diagnosis (range: 20-84 years) and studied the X inactivation pattern by means of methylation-sensitive polymerase chain reaction and primers that target the polymorphic CGG trinucleotide repeat of the FMR1 gene. The fact that we did not detect any skewing of the X inactivation pattern in the five successfully analyzed cases corroborates the notion that myositis ossificans results from a polyclonal proliferation and confirms that it is a reactive, reparative process. Analysis of the X inactivation pattern may, thus, supplement the differential diagnostic work-up of cases with an uncertain histology, at least in the informative proportion of female patients.
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Affiliation(s)
- Andreas Leithner
- Department of Orthopedic Surgery, Medical University Graz, Graz, Austria
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Alborno T, Hofmann T, Beham A, Stammberger H. Giant hamartoma of the retro- and parapharyngeal region. Case report and review of literature. Int J Pediatr Otorhinolaryngol 2004; 68:511-5. [PMID: 15013622 DOI: 10.1016/j.ijporl.2003.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2003] [Revised: 11/12/2003] [Accepted: 11/19/2003] [Indexed: 11/29/2022]
Abstract
Hamartoma designates a tumor-like, non-neoplastic malformation, or in-born error of tissue development, often with an abnormal mixture of tissue indigenous to the region. In the head and neck, epithelial and mesenchymal hamartomas are uncommon. We present the case of a 9-year-old boy with a huge hamartoma of 800ml (cm(3)) volume of the right retro- and parapharyngeal region. It had fully occluded the nasopharynx, indented the base of the tongue and left a minimal airway passage transorally. Food uptake was severely hampered by the lesion. The patient underwent a combined transoral and external approach for complete resection of the tumor. This is the first reported case of a retro- and parapharyngeal hamartoma with metaplastic bone formation in the literature and further more, the largest hamartoma in head and neck ever reported in this age group.
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Affiliation(s)
- Tarek Alborno
- Department of ORL, H and NS, University Medical School, Graz Auenbruggerplatz 26, Graz A-8036, Austria.
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Abstract
BACKGROUND Oncocytes are epithelial cells characterized by an granular, eosinophilic cytoplasma, and a centrally situated, pycnotic nucleus. These cells were first observed by Hamperl 1931 in the salivary glands. Ultrastructural studies have shown that the cytoplasma of these cells is filled with numerous large and bizarre mitochondria. The exact biological significance of oncocytes is unknown - Becker, Donath and Seifert suggest an intracellular metabolic disturbance associated with mitochondriopathy, caused by an age dependent metabolic defect. Oncocytes are not specific for the salivary glands; they are also found in the thyroid gland, parathyroid gland, liver, pancreas, esophagus and the kidney. Solitary oncocytes appear most often as incidental findings in aging salivary tissue, they are present in persons older than 70 years up to 80 %. The diffuse hyperplastic oncocytosis of the parotid gland represents an extremely rare, non-tumorous alteration of the parotid gland. Caused by an extensive metaplasia of acinic and ductal cells nearly the entire gland consists of oncocytes. Clinically it is characterized by swelling of the parotid gland. Oncocytic adenomatous hyperplasia is a different disease. It represents a multifocal oncocytic proliferation of the duct system. In contrast to diffuse oncocytosis remnants of the original salivary tissue with acini and fatty tissue are usually present between the oncocytic nodules. Typical oncocytomas may possibly develop from such oncocytic proliferation by a tendency to confluent growth. METHODS Cases of diffuse hyperplastic oncocytosis of the parotid gland were identified by literature review. RESULTS Worldwide diffuse hyperplastic oncocytosis of the parotid gland has been observed in 8 cases (Fig. ) as of today. PATIENT We report and discuss the case of a 78-year-old male, who was refered to our hospital because of a painless mass of the left parotid gland. MRI showed a tumorous lesion with a diameter of about 5 cm. Lateral parotidectomy was performed. Histology revealed an extremely rare case of diffuse hyperplastic oncocytosis. There has been no recurrence of tumor after 2 years. CONCLUSIONS Diffuse hyperplastic oncocytosis of the parotid gland is an extremely rare benign disorder, complete excision of the tumor-like lesion is curative. In literature there has been no report of recurrence, malignant transformation or metastasizing illness.
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