Composite pheochromocytoma of the adrenal gland-a review of published cases

Composite pheochromocytoma (CP) is a rare adrenal tumor, composed of ordinary pheochromocytoma and neuroblastic components. There is a paucity of information in the literature regarding this entity. We report the case of a 56-year-old woman with a CP of the left adrenal gland with a ganglioneuroma component. A review of the published literature found 110 cases of CP. The median age was 51.5 (5.86) years, and 59/110 (53.6%) were female. Association with genetic predisposition syndromes was found in 22/110 (20%), the most common of which was neurofibromatosis type 1, in 15/110 (13.6%). The most common histologic type of the neuroblastic component was ganglioneuroma in 83/110 (75.5%). Twenty-seven cases reported SDHB immunohistochemistry results; none of which was positive. Nine patients (8.2%) presented/developed metastatic disease, and 9 patients (8.2%) died from disease. To our knowledge, this is the largest review describing clinical, histopathological, molecular, and prognostic features of CP.

Mixed medullary-papillary thyroid carcinoma with mixed lymph node metastases: A case report

Mixed medullary-follicular-derived carcinoma is a very rare event. It is extremely important to make the correct diagnosis, due to prognostic and treatment implications. A genetic study of these patients is advisable to exclude the presence of MEN 2.

Local Air Quality Issues and Research Priorities Through the Lenses of Chilean Experts: An Ontological Analysis

Air pollution problems can be large, complex, and ill-structured. They can vary from location to location and combine many complex components: urban expansion, increasing vehicles and industrial emissions, biomass burning, geographic and meteorological conditions, cultural aspects, and economic effects. However, the existing research, accumulated knowledge, and local research priorities are spread over many disciplines and lack a systematic mapping to help manage and develop new strategies for researchers and policy makers. Ontological analysis can be used as a tool to capture this complexity through simple natural-language descriptions and a structured terminology. We describe the development of an ontological framework for "Air Quality Management in Chile" and its application to evaluate the current state of the research. The process was based on focus groups and validated by a panel of multidisciplinary experts. We used the developed framework to highlight the topics that have been heavily emphasized, lightly emphasized, or overlooked in the Chilean research. The framework developed can help researchers, practitioners, and policy makers systematically navigate the domain and provide the opportunity to correct blind spots by enabling more informed hypotheses that deal with air quality issues at a national level. We believe that applying this same process to different countries will yield different results (due to differences in local knowledge and experience). The framework presented could be used to evaluate other important stakeholders (government, media, NGOs, etc.), which will provide a complete picture of how local societies deal with air quality issues at different levels. Additionally, local government institutions will benefit from this analysis by improving funding allocation and opening new research opportunities to improve the distribution of the local body of knowledge. Integr Environ Assess Manag 2021;17:273-281. © 2020 SETAC.

Liver metastasis of ethmoid sinus adenocarcinoma

INTRODUCTION

Sinonasal cancer is an uncommon neoplasm, often associated with exposure to occupational hazards and delayed diagnosis.

CASE REPORT

The authors report a rare case of solitary liver metastasis from ethmoid sinus adenocarcinoma treated by surgical resection. No clinical or radiological sign of recurrence was observed with a follow-up of 3 months.

DISCUSSION

Adenocarcinoma of the ethmoid sinus is characterized by its aggressiveness and its tendency to recurrence. Metastases are rare and can be found in unexpected organs due to dissemination via collateral venous plexuses. The role of chemotherapy has not been clearly established. Due to their rarity, the treatment of metastases has not yet been defined.

Long-term follow-up after endoscopic resection of gastric superficial neoplastic lesions in Portugal

BACKGROUND AND STUDY AIMS

Although endoscopic resection for the treatment of gastric superficial neoplastic lesions is an established first-line treatment in Eastern countries, its role has yet to be considered in Western guidelines, mostly due to a lack of long-term studies. The aim of this study was to describe long-term outcomes for endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of gastric neoplasias in Portugal.

PATIENTS AND METHODS

This was a single-center, retrospective, cohort study between March 2003 and April 2013. A total of 162 consecutive patients with 195 gastric superficial neoplasias underwent EMR (n = 54) or ESD (n = 141) and were followed up for a median of 3.2 years.

RESULTS

Resection was feasible in 97 %, with en bloc and R0 resection rates of 85 % (94 % ESD vs. 61 % EMR; P = 0.001) and 81 % (91 % ESD vs. 54 % EMR; P < 0.001), respectively. The recurrence rate was 7 %, and recurrence was associated with Rx/R1 resection irrespective of resection technique (OR 5.8; 95 % confidence interval 3.9 - 8.8). The long-term curative resection rate was 86 % after one procedure and 91 % after two procedures. Adverse events were observed in 13 % of cases: 8 % bleeding and 2 % of perforations (EMR = ESD). Surgery was performed in 7 %: 6 % after noncurative endoscopic resection and 1 % due to complications. Metachronous lesion detection rate was 1 % - 1.5 % per patient year. Cancer-specific survival rate was 100 % at follow-up.

CONCLUSIONS

For the first time in a Western country, results are reported to be similar to those in Eastern countries. Endoscopic resection, particularly ESD, is a highly effective treatment for gastric superficial lesions, without compromising cancer survival. Endoscopic resection should also be considered as first-line treatment for gastric neoplasias in Western countries.

DOTS strategy and community participation: an experience in the Ecuadorian Andes

SETTING

The Chine community in Angamarca parish, Cotopaxi Province, in the Ecuadorian Andes.

OBJECTIVE

To relate the DOTS strategy to the world view of the indigenous community in the diagnosis and treatment of smear-positive pulmonary tuberculosis (TB) patients.

DESIGN

Cross-sectional study involving all inhabitants of Chine.

RESULTS

Aspects of the community's world view were considered in the community-based application of DOTS. A cure rate of 100% was attained, with 0% defaulting from treatment.

CONCLUSION

The results obtained indicate that involving the world view of the community in the management of tuberculosis has several advantages.