Anterior abdominal wall metastasis following curative resection and chemoradiation of rectal cancer masquerading as a desmoid tumour: A clinical conundrum

Desmoid tumour of the anterior abdominal wall (rectus sheath) commonly occurs in women post abdominal surgery. Metastasis from colorectal cancer to the anterior abdominal wall, on the other hand, is rare and produces a complex management dilemma. This Case study presents a 57-year-old woman who received a curative laparoscopic low anterior resection and adjuvant chemoradiation in 2013. Seven years later, she presented with an asymptomatic anterior abdominal wall lump. Clinically, the lump appeared to be a desmoid tumour. A wide local excision of the lump was carried out and the final histopathology showed a metastatic lesion (adenocarcinoma). With adjuvant chemotherapy, the patient is now disease-free and doing well. A possibility of distant metastasis must be kept in mind for all patients, even when they have undergone curative resection with adjuvant chemoradiation for colorectal cancer.

Oxidative damage to mouse lens in culture. Protective effect of pyruvate

Studies have been conducted to examine the feasibility of preventing oxyradical-dependent oxidative stress to mouse lens in culture, using pyruvate as an antioxidant. The extent of oxidative damage to the tissue was assessed by measurement of the status of Na(+)-K(+) ATPase dependent active transport of rubidium 86Rb(+). The tissue levels of adenosine triphosphate (ATP), glutathione (GSH), malonaldehyde (MDA) and catalase were also determined. While the measurement of 86Rb(+) uptake provides an assessment of the integrity of the primary active transport system, measurement of the other components reflects the status of intracellular oxidative stress. ATP measurement also reflected on the overall status of metabolic integrity. Incubation of the lens with xanthine (XA)/xanthine oxidase (XO) system had an adverse effect on all these parameters. Incorporation of pyruvate was strikingly protective. The protective effect of pyruvate is apparently due to its ability to scavenge ROS generated in the medium with the possibility of its action on tissue metabolism as well. The findings are hence considered useful for further studies on the prevention of oxidative stress to tissues by exogenous supplementation with pyruvate, specially the human lens where the biochemistry of its antioxidant mechanisms is similar to the mouse lens, contrary to the rat lens.

Self-efficacy for coping with cancer: revision of the Cancer Behavior Inventory (version 2.0)

The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was revised by adding a new stress management scale and reducing its length from 43 to 33 items. The 33-item CBI was administered to 280 cancer patients. A principal factors analysis with varimax rotation yielded the hypothesized seven factors (alphas in parentheses): (1) maintenance of activity and independence (alpha=0.86), (2) seeking and understanding medical information (alpha=0.88), (3) stress management (alpha=0.86), (4) coping with treatment-related side-effects (alpha=0.82), (5) accepting cancer/maintaining positive attitude (alpha=0.86), (6) affective regulation (alpha=0.81), and (7) seeking support (alpha=0.80). The alpha for the entire CBI was 0.94, the test-retest (1 week) reliability coefficient was 0.74, and correlations with measures of quality of life and coping supported its validity. The CBI may be useful to researchers and clinicians and can be integrated into a self-regulation model of coping.

Hashimoto's thyroiditis simulating De Quervain's thyroiditis

A 13-year-old adolescent girl with Hashimoto's thyroiditis presented with a painful, diffuse goiter. The clinical features simulated those of subacute, or De Quervain's, thyroiditis. The markedly elevated titers of thyroid antibodies together with clinical and biochemical evidence of hypothyroidism resulted in a diagnosis of Hashimoto's thyroiditis with a subacute exacerbation.