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Sbragia E, Boffa G, Varaldo R, Raiola AM, Ghiso A, Gambella M, Benedetti L, Angelucci E, Inglese M. An aggressive form of MOGAD treated with aHSCT: A case report. Mult Scler 2024; 30:612-616. [PMID: 38116593 DOI: 10.1177/13524585231213792] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Although myelin-oligodendrocyte-glycoprotein (MOG)-antibody-associated disease (MOGAD) has been considered a more favorable demyelinating central nervous system disorder, recent data evidence that some patients might experience severe relapses and high disability. Actual treatment-options are acquired mostly from anti-aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder and rely on clinical experience. Therefore, treatment of aggressive forms of MOGAD can be challenging. OBJECTIVES AND METHODS To describe a patient with an aggressive MOGAD treated with autologous hematopoietic stem cell transplantation (aHSCT). RESULTS A 56-year-old man was diagnosed with MOGAD in 2017 because of right optic-neuritis and anti-MOG-antibody positivity. In the following 2 years, he experienced two optic neuritis with good recovery after high-dose steroid. At the end of 2019, he presented sensory and motor impairment at lower limbs with evidence of several spinal, longitudinally extended, tumefactive inflammatory lesions. Despite sequential treatment with rituximab and tocilizumab alongside high-dose steroid, intravenous immunoglobulins and plasma-exchange, he experienced several clinical relapses and exhibited persistent magnetic resonance activity. He was finally addressed to intense immunosuppression with myeloablative conditioning regimen followed by autologous hematopoietic stem cell transplantation (aHSCT). After 2 years follow-up, he is free from disease-activity. CONCLUSIONS In a patient affected by aggressive, treatment-refractory MOGAD, aHSCT resulted as safe and was able to suppress disease-activity for over 2 years.
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Affiliation(s)
- Elvira Sbragia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Department of Neurology, Galliera Hospital, Genoa, Italy
| | - Giacomo Boffa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Riccardo Varaldo
- Division of Hematology and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Maria Raiola
- Division of Hematology and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Ghiso
- Division of Hematology and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Massimiliano Gambella
- Division of Hematology and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Neurology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emanuele Angelucci
- Division of Hematology and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Neurology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Golob N, Oblak T, Čavka L, Kušar M, Šeruga B. Aggressive anticancer treatment in the last 2 weeks of life. ESMO Open 2024; 9:102937. [PMID: 38471241 PMCID: PMC10944113 DOI: 10.1016/j.esmoop.2024.102937] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND There is a concern that terminally ill cancer patients may be aggressively treated due to the rapidly growing possibilities of anticancer treatment. The aim of this study was to evaluate the use of anticancer treatment at the end of life (EoL). MATERIALS AND METHODS This retrospective study included adult patients with advanced solid cancers who were treated at the Institute of Oncology Ljubljana and died of cancer between January 2015 and December 2019. A multiple logistic regression model was used to assess an association between the aggressiveness of anticancer treatment (i.e. systemic therapy, radiotherapy and surgery) in the last 2 weeks of life and year of death, age at death, sex, prognosis of cancer and enrolment into the specialist palliative care (SPC). RESULTS We included 1736 patients in our analysis. Overall, 13.7% of patients were enrolled into the SPC and 14.4% received anticancer treatment in the last 2 weeks of life. The odds of receiving anticancer treatment significantly increased over time [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.04-1.27]. There was an increased use of novel systemic therapy (e.g. small-molecule targeted therapy and immunotherapy) at the EoL. Older patients had significantly lower odds to receive anticancer treatment in the last 2 weeks of life as compared to younger patients (OR 0.96, 95% CI 0.95-0.98). As compared to patients receiving only a standard oncology care, those also enrolled into the SPC had significantly lower odds for anticancer treatment in the last 2 weeks of life (OR 0.22, 95% CI 0.12-0.43). CONCLUSIONS Terminally ill cancer patients have increased odds for receiving anticancer treatment, especially novel systemic therapies, in the last 2 weeks of life. Younger patients and those not enrolled into the SPC are at particular risk for anticancer treatment at the EoL.
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Affiliation(s)
- N Golob
- Faculty of Medicine, University of Ljubljana, Ljubljana; Department of Acute Palliative Care, Institute of Oncology Ljubljana, Ljubljana
| | - T Oblak
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana
| | - L Čavka
- Faculty of Medicine, University of Ljubljana, Ljubljana; Department of Oncology, University Medical Center Maribor, Maribor
| | - M Kušar
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana
| | - B Šeruga
- Faculty of Medicine, University of Ljubljana, Ljubljana; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
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Yamada H, Yamada R, Komohara Y, Mito R, Nishitsuji K, Yano H, Fujiwara Y, Ikeda K, Suzuki M. A Case of Aggressive Lung Squamous Cell Carcinoma With Aberrant Cytoplasmic p53 Aggregation. Cancer Diagn Progn 2024; 4:204-208. [PMID: 38434916 PMCID: PMC10905281 DOI: 10.21873/cdp.10309] [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] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 03/05/2024]
Abstract
Background Immunohistochemistry for p53 was a well-established method for cancer diagnosis in pathology. Aberrant cytoplasmic p53 positivity reflects the accumulation of p53 aggregates, which has been shown to be associated with chemoresistance and to be a predictive marker of a worse clinical course in ovarian cancer. Case Report A 65-year-old Japanese man was diagnosed with lung cancer, and surgical resection was performed. Multiple metastasis were found 21 months post-surgery. The lesions were resistant to chemotherapy, and he succumbed to the disease 29 months post-surgery. The resected primary lesion was pathologically diagnosed as squamous cell carcinoma, with notable cytoplasmic p53 positivity indicated by immunohistochemistry. Conclusion Notable aberrant cytoplasmic accumulation of p53 aggregate was observed in the cancer cells of this case. Chemotherapy was ineffective for the recurrent lesions, suggesting a role of p53 aggregates in chemoresistance. Pathological analysis of p53 via immunohistochemistry may be useful in predicting chemoresistance of lung squamous cell carcinoma.
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Affiliation(s)
- Hiroyuki Yamada
- Department of Thoracic and Breast Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Rin Yamada
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshihiro Komohara
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Remi Mito
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazuchika Nishitsuji
- Department of Biochemistry, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiromu Yano
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yukio Fujiwara
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koei Ikeda
- Department of Thoracic and Breast Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Makoto Suzuki
- Department of Thoracic and Breast Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Pardanani A, Reichard K, Tefferi A. Advanced systemic mastocytosis-Revised classification, new drugs and how we treat. Br J Haematol 2024; 204:402-414. [PMID: 38054381 DOI: 10.1111/bjh.19245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023]
Abstract
Mastocytosis constitutes the neoplastic proliferation of mast cells and is broadly classified into systemic mastocytosis (SM), cutaneous mastocytosis and mast cell sarcoma. SM is further partitioned into advanced (AdvSM) and non-advanced (SM-non-Adv) subcategories. AdvSM includes aggressive SM (ASM), SM with an associated haematological neoplasm (SM-AHN) and mast cell leukaemia (MCL). In 2022, two separate expert committees representing the 5th edition of the World Health Organization (WHO5) and the International Consensus (ICC) classification systems submitted revised classification criteria for SM, highlighted by the ICC-proposed incorporation of mast cell cytomorphology in the diagnostic criteria for MCL and myeloid-lineage restriction for the AHN component in SM-AHN. Recent developments in SM also include the introduction of KIT-targeting tyrosine kinase inhibitors (KITi), including midostaurin and avapritinib, both drugs have shown potent activity in reducing mast cell and mutant KIT burden and alleviating mast cell-associated organopathy and mediator symptoms; however, their overall impact on survival or superiority over pre-KITi era treatment options (e.g. cladribine) has not been studied in a controlled setting. In the current review, we provide a summary of recent changes in disease classification and an analysis of recent clinical trials and their impact on our current treatment approach in AdvSM.
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Affiliation(s)
| | - Kaaren Reichard
- Division of Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
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Davis MP, Vanenkevort E, Young A, Wojtowicz M, Gupta M, Lagerman B, Liu E, Mackley H, Panikkar R. Radiation Therapy in the Last Month of Life: Association With Aggressive Care at the End of Life. J Pain Symptom Manage 2023; 66:638-646. [PMID: 37657725 DOI: 10.1016/j.jpainsymman.2023.08.024] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
CONTEXT Half of the patients with cancer who undergo radiation therapy do so with palliative intent. OBJECTIVES To determine the proportion of undergoing radiation in the last month of life, patient characteristics, cancer course, the type and duration of radiation, whether palliative care was involved, and the of radiation with aggressive cancer care metrics. METHODS One thousand seven hundred twenty-seven patients who died of cancer between January 1, 2018, and December 31, 2019, were included. Demographics, cancer stage, palliative care referral, advance directives, use of home health care, radiation timing, and survival were collected. Type of radiation, course, and intent were reviewed. Chi-square analysis was utilized for categorical variables, and Kruskal-Wallis tests for continuous variables. A stepwise selection was used to build a Cox proportional hazard model. RESULTS Two hundred thirty-three patients underwent radiation in the last month of life. Younger patients underwent radiation 67.3 years (SD 11.52) versus 69.2 years (SD 11.96). 42.6% had radiation within two weeks of death. The average fraction number was 5.5. Individuals undergoing radiation were more likely to start chemotherapy within the last 30 days of life, continue chemotherapy within two weeks of death, be admitted to the ICU, and have two or more hospitalizations or emergency room visits. Survival measured from the date of diagnosis was shorter for those undergoing radiation, 122 days (IQR 58-462) versus 474 days (IQR 225-1150). Palliative care consultations occurred later in those undergoing radiation therapy. CONCLUSION Radiation therapy in the last month of life occurs in younger patients with rapidly progressive cancer, who are subject to more aggressive cancer care, and have late palliative care consults.
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Affiliation(s)
- Mellar P Davis
- Department of Palliative Care (M.P.D.), Geisinger Medical Center, Danville, Pennsylvania.
| | - Erin Vanenkevort
- Department of Population and Health Science (E.V., A.Y.), Research Institute Geisinger Health System, Danville, Pennsylvania
| | - Amanda Young
- Department of Population and Health Science (E.V., A.Y.), Research Institute Geisinger Health System, Danville, Pennsylvania
| | - Mark Wojtowicz
- Oncology Research Department (M.W.), Cancer Institute, Geisinger Medical Center, Danville, Pennsylvania
| | - Mudit Gupta
- Department of Phenomics Analytics and Clinical Data Core (M.G., B.L.), Geisinger Health System, Danville, Pennsylvania
| | - Braxton Lagerman
- Department of Phenomics Analytics and Clinical Data Core (M.G., B.L.), Geisinger Health System, Danville, Pennsylvania
| | - Edward Liu
- Geisinger Commonwealth School of Medicine (E.L.), Danville, Pennsylvania
| | - Heath Mackley
- Department of Radiation Oncology (H.M.), Geisinger Medical Center, Danville, Pennsylvania
| | - Rajiv Panikkar
- Knapper Cancer Center, Geisinger Medical Center (R.P.), Danville, Pennsylvania
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Paxson AI, Chang LH, Gard JMC, Harryman WL, Nelson CS, Salmon SB, Marr KD, Wachsmuth LM, Ramanathan A, Ran J, Kapoor A, Marugan JJ, Henderson MJ, Sanchez TW, Cress AE. Phenotype plasticity and altered sensitivity to chemotherapeutic agents in aggressive prostate cancer cells. Front Cell Dev Biol 2023; 11:1285372. [PMID: 38046670 PMCID: PMC10690371 DOI: 10.3389/fcell.2023.1285372] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/24/2023] [Indexed: 12/05/2023] Open
Abstract
In 2023, approximately 288,300 new diagnoses of prostate cancer will occur, with 34,700 disease-related deaths. Death from prostate cancer is associated with metastasis, enabled by progression of tumor phenotypes and successful extracapsular extension to reach Batson's venous plexus, a specific route to the spine and brain. Using a mouse-human tumor xenograft model, we isolated an aggressive muscle invasive cell population of prostate cancer, called DU145J7 with a distinct biophysical phenotype, elevated histone H3K27, and increased matrix metalloproteinase 14 expression as compared to the non-aggressive parent cell population called DU145WT. Our goal was to determine the sensitivities to known chemotherapeutic agents of the aggressive cells as compared to the parent population. High-throughput screening was performed with 5,578 compounds, comprising of approved and investigational drugs for oncology. Eleven compounds were selected for additional testing, which revealed that vorinostat, 5-azacitidine, and fimepinostat (epigenetic inhibitors) showed 2.6-to-7.5-fold increases in lethality for the aggressive prostate cancer cell population as compared to the parent, as judged by the concentration of drug to inhibit 50% cell growth (IC50). On the other hand, the DU145J7 cells were 2.2-to-4.0-fold resistant to mitoxantrone, daunorubicin, and gimatecan (topoisomerase inhibitors) as compared to DU145WT. No differences in sensitivities between cell populations were found for docetaxel or pirarubicin. The increased sensitivity of DU145J7 prostate cancer cells to chromatin modifying agents suggests a therapeutic vulnerability occurs after tumor cells invade into and through muscle. Future work will determine which epigenetic modifiers and what combinations will be most effective to eradicate early aggressive tumor populations.
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Affiliation(s)
- Allan I. Paxson
- Partnership for Native American Cancer Prevention, University of Arizona, Tucson, AZ, United States
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Loren H. Chang
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Jaime M. C. Gard
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - William L. Harryman
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Colin S. Nelson
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Stella B. Salmon
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Kendra D. Marr
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
- Medical Scientist Training MD/PhD Program, College of Medicine Tucson, University of Arizona, Tucson, AZ, United States
| | - Leah M. Wachsmuth
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Anita Ramanathan
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Jing Ran
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Abhijeet Kapoor
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Juan J. Marugan
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Mark J. Henderson
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Tino W. Sanchez
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, United States
| | - Anne E. Cress
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, United States
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Wei Z, Huang Y, Li X, Shao M, Qian H, He B, Meng J. The influence of aggressive exercise on responses to self-perceived and others' pain. Cereb Cortex 2023; 33:10802-10812. [PMID: 37715469 PMCID: PMC10629897 DOI: 10.1093/cercor/bhad324] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/17/2023] Open
Abstract
Previous studies have reported relationships between exercise and pain. However, little is known about how aggressive exercise modulates individuals' responses to their own and others' pain. This present study addresses this question by conducting 2 studies employing event-related potential (ERP). Study 1 included 38 participants whose self-perceived pain was assessed after intervention with aggressive or nonaggressive exercises. Study 2 recruited 36 participants whose responses to others' pain were assessed after intervention with aggressive or nonaggressive exercise. Study 1's results showed that P2 amplitudes were smaller, reaction times were longer, and participants' judgments were less accurate in response to self-perceived pain stimuli, especially to high-pain stimuli, after intervention with aggressive exercise compared to nonaggressive exercise. Results of study 2 showed that both P3 and LPP amplitudes to others' pain were larger after intervention with aggressive exercise than with nonaggressive exercise. These results suggest that aggressive exercise decreases individuals' self-perceived pain and increases their empathic responses to others' pain.
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Affiliation(s)
- Zilong Wei
- Research Center for Brain and Cognitive Science, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
| | - Yujuan Huang
- Guizhou Light Industry Technical College, No. 3, Dongqing Road, Guiyang 550025, China
| | - Xiong Li
- Faculty of Psychology, Southwest University, No. 2, Tiansheng Road, Chongqing 400715, China
| | - Min Shao
- Research Center for Brain and Cognitive Science, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
| | - Huiling Qian
- Research Center for Brain and Cognitive Science, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
| | - Bojun He
- Research Center for Brain and Cognitive Science, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
| | - Jing Meng
- Research Center for Brain and Cognitive Science, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, No. 37, Middle Road, University Town, Chongqing 401331, China
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Mahanta D, Banerjee A, Kumar A, Deb P, Malla SR, Pramanik S, Das D. The Rescuing Role of Aggressive Thrombosuction in Elective Coronary Angioplasty. Cureus 2023; 15:e47414. [PMID: 38021732 PMCID: PMC10658211 DOI: 10.7759/cureus.47414] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Thrombosuction plays a controversial role during primary percutaneous intervention (PCI). Landmark trials have demonstrated no additional role of thrombosuction during primary percutaneous intervention towards improving mortality and outcome during primary percutaneous intervention. We describe a rare elective coronary angioplasty where only aggressive thrombosuction (almost 150-200 mL) of blood from the coronary artery established the antegrade coronary flow and saved an octogenarian from impending sudden cardiac death (SCD). The present case describes the promising role of aggressive thrombosuction even during elective coronary intervention when a large dissection ends in acute total thrombotic occlusion of a coronary artery jeopardizing the antegrade coronary perfusion.
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Affiliation(s)
| | - Anindya Banerjee
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Abhinav Kumar
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Pranjit Deb
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Sindhu Rao Malla
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Subhas Pramanik
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Debasish Das
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
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9
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Li Z, Zhang H, Yan Y, Li X, Jia M, Zhou H, Lu X. Clinical relevance and outcome of familial papillary thyroid cancer: a single institution study of 626 familial cases. Front Endocrinol (Lausanne) 2023; 14:1200855. [PMID: 37780622 PMCID: PMC10539583 DOI: 10.3389/fendo.2023.1200855] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/29/2023] [Indexed: 10/03/2023] Open
Abstract
Background Whether familial thyroid cancer is more aggressive than sporadic thyroid cancer remains controversial. Additionally, whether the number of affected family members affects the prognosis is unknown. This study focused mainly on the comparison of the clinicopathological characteristics and prognoses between papillary thyroid cancer (PTC) patients with and without family history. Methods A total of 626 familial papillary thyroid cancer (FPTC) and 1252 sporadic papillary thyroid cancer (SPTC) patients were included in our study. The clinical information associated with FPTC and SPTC was recorded and analyzed by univariate analysis. Results Patients in the FPTC group had a higher rate of multifocality (p=0.001), bilaterality (p=0.000), extrathyroidal invasion (p=0.000), distant metastasis (p=0.012), lymph node metastasis (p=0.000), recurrence (p=0.000), a larger tumor size (p=0.000) and more malignant lymph nodes involved (central: p=0.000; lateral: p=0.000). In addition, our subgroup analysis showed no significant difference (p>0.05) between patients with only one affected family member and those with two of more group in all clinicopathological characteristics. In papillary thyroid microcarcinoma (PTMC) subgroup analysis, we found that FPTMC patients harbored significantly larger tumors (p=0.000), higher rates of multifocality (p=0.014), bilaterality (p=0.000), distant metastasis (p=0.038), lymph node metastasis (p=0.003), greater numbers of malignant lymph nodes (central: p=0.002; lateral: p=0.044), higher rates of I-131 treatment (p=0.000) and recurrence (p=0.000) than SPTMC patients. Conclusion Our results indicated that PTC and PTMC patients with a positive family history had more aggressive clinicopathological behaviors, suggesting that more vigilant screening and management for FPTC may be helpful.
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Affiliation(s)
- Zhuyao Li
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Hongri Zhang
- Department of Neurosurgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Henan, China
| | - Yu Yan
- School of Electrical and Information Engineering, Zhengzhou University, Henan, China
| | - Xiang Li
- Department of Urology Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Meng Jia
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Honglong Zhou
- Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiubo Lu
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
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10
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Simon J, Perez-Rivas LG, Zhao Y, Chasseloup F, Lasolle H, Cortet C, Descotes F, Villa C, Baussart B, Burman P, Maiter D, von Selzam V, Rotermund R, Flitsch J, Thorsteinsdottir J, Jouanneau E, Buchfelder M, Chanson P, Raverot G, Theodoropoulou M. Prevalence and clinical correlations of SF3B1 variants in lactotroph tumours. Eur J Endocrinol 2023; 189:372-378. [PMID: 37721395 DOI: 10.1093/ejendo/lvad114] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/30/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE A somatic mutational hotspot in the SF3B1 gene was reported in lactotroph tumours. The aim of our study was to examine the prevalence of driver SF3B1 variants in a multicentre independent cohort of patients with lactotroph tumours and correlate with clinical data. DESIGN AND METHODS This was a retrospective, multicentre study involving 282 patients with lactotroph tumours (including 6 metastatic lactotroph tumours) from 8 European centres. We screened SF3B1 exon 14 hotspot for somatic variants using Sanger sequencing and correlated with clinicopathological data. RESULTS We detected SF3B1 variants in seven patients with lactotroph tumours: c.1874G > A (p.Arg625His) (n = 4, 3 of which metastatic) and a previously undescribed in pituitary tumours variant c.1873C > T (p.Arg625Cys) (n = 3 aggressive pituitary tumours). In two metastatic lactotroph tumours with tissue available, the variant was detected in both primary tumour and metastasis. The overall prevalence of likely pathogenic SF3B1 variants in lactotroph tumours was 2.5%, but when we considered only metastatic cases, it reached the 50%. SF3B1 variants correlated with significantly larger tumour size; higher Ki67 proliferation index; multiple treatments, including radiotherapy and chemotherapy; increased disease-specific death; and shorter postoperative survival. CONCLUSIONS SF3B1 variants are uncommon in lactotroph tumours but may be frequent in metastatic lactotroph tumours. When present, they associate with aggressive tumour behaviour and worse clinical outcome.
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Affiliation(s)
- Julia Simon
- Medizinische Klinik und Poliklinik IV, LMU Klinikum, LMU München, Munich 80336, Germany
| | | | - Yining Zhao
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Fanny Chasseloup
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Le Kremlin-Bicêtre 94275, France
| | - Helene Lasolle
- Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, Claude Bernard Lyon 1 University, "Groupement Hospitalier Est" Hospices Civils de Lyon, Bron 69500, France
| | | | - Francoise Descotes
- Service de Biochimie Biologie Moléculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite Cedex 69495, France
| | - Chiara Villa
- Neuropathology Department, Pitié-Salpêtrière University Hospital, AP-HP, Sorbonne Université and Université Paris Cité, CNRS UMR8104, INSERM U1016, Institut Cochin, Paris 75014, France
| | - Bertrand Baussart
- Department of Neurosurgery, Assistance Publique-Hopitaux de Paris, Pitié-Salpetrière University Hospital and Université Paris Cité, CNRS UMR8104, INSERM U1016, Institut Cochin, Paris 75014, France
| | - Pia Burman
- Department of Endocrinology, Skåne University Hospital, Lund University, Malmö 214 28, Sweden
| | - Dominique Maiter
- Department of Endocrinology and Nutrition, UCLouvain Cliniques Universitaires Saint-Luc, Bruxelles 1200, Belgium
| | - Vivian von Selzam
- Medizinische Klinik und Poliklinik IV, LMU Klinikum, LMU München, Munich 80336, Germany
| | - Roman Rotermund
- Department of Neurosurgery, Division of Pituitary Surgery, University Medical Center Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Jörg Flitsch
- Department of Neurosurgery, Division of Pituitary Surgery, University Medical Center Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Jun Thorsteinsdottir
- Neurochirurgische Klinik und Poliklinik, LMU Klinikum, LMU München, Munich 81377, Germany
| | - Emmanuel Jouanneau
- Pituitary and Skull Base Neurosurgical Department, Reference Center for Rare Pituitary Diseases HYPO, "Groupement Hospitalier Est" Hospices Civils de Lyon, "Claude Bernard" Lyon 1 University, Hôpital Pierre Wertheimer, Lyon, Bron 69677, France
| | - Michael Buchfelder
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Philippe Chanson
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Le Kremlin-Bicêtre 94275, France
| | - Gerald Raverot
- Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, Claude Bernard Lyon 1 University, "Groupement Hospitalier Est" Hospices Civils de Lyon, Bron 69500, France
| | - Marily Theodoropoulou
- Medizinische Klinik und Poliklinik IV, LMU Klinikum, LMU München, Munich 80336, Germany
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Oka N, Hashimoto K, Shinyashiki Y, Nishimura S, Akagi M. Aggressive intraosseous lipoma of the scapula: A case report. Exp Ther Med 2023; 26:400. [PMID: 37522061 PMCID: PMC10375447 DOI: 10.3892/etm.2023.12099] [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: 01/10/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
The details of the pathogenesis of intraosseous lipomas are not fully elucidated, although most cases do not require surgical treatment. The present report describes the case of a 79-year-old female patient diagnosed with intracapsular lipoma who also exhibited an extraosseous extension. Chest computed tomography revealed an abnormal shadow or a mass in the right scapula and destruction of the glenoid bone. Magnetic resonance imaging revealed a high-intensity mass on T1-weighted and T2-weighted images in the same area. Marginal resection of the mass was performed. The histopathology confirmed that the mass was a lipoma. No postoperative recurrence was observed. Oncologists must be aware that lipoma arising within the scapula may extend outside the bone.
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Affiliation(s)
- Naohiro Oka
- Department of Orthopedic Surgery, Kushimoto Municipality Hospital, Kushimoto-Cho, Wakayama 649-3510, Japan
| | - Kazuhiko Hashimoto
- Department of Orthopedic Surgery, Kushimoto Municipality Hospital, Kushimoto-Cho, Wakayama 649-3510, Japan
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Yu Shinyashiki
- Department of Orthopedic Surgery, Kushimoto Municipality Hospital, Kushimoto-Cho, Wakayama 649-3510, Japan
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shunji Nishimura
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Masao Akagi
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
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12
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Lenders NF, Earls PE, Wilkinson AC, Costin M, Hofer M, Shein TT, Harvey RJ, Krishnan G, Picallo M, Pal A, Wass J, McCormack AI. Predictors of pituitary tumour behaviour: an analysis from long-term follow-up in 2 tertiary centres. Eur J Endocrinol 2023; 189:106-114. [PMID: 37461224 DOI: 10.1093/ejendo/lvad079] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To determine the clinical utility of assessment of tumour invasion, markers of proliferation, and the French clinicopathological classification in pituitary tumour prognostication. METHODS This is a retrospective evaluation of adult patients undergoing pituitary surgery at Oxford University and St Vincent's Hospitals, between 1989 and 2016, with at least 12 months of clinical data. Invasion was assessed radiologically, proliferative markers (Ki67, mitotic count, p53) by immunohistochemistry. Tumours were graded according to the clinicopathological classification. Intra- and interlaboratory variability of histopathology reporting was evaluated. OUTCOMES (1) Tumour recurrence (radiological or reintervention ≥12 months postoperatively) and/or (2) "aggressive behaviour" (≥4 interventions and/or invasive tumour with recurrence/reintervention between 12 and 24 months postoperatively). RESULTS A total of 386 patients were included, age at surgery was 56 (interquartile range [IQR] 41-67) years, 54% were male, and median follow-up was 90 months (range 44-126). Tumours were predominantly clinically nonfunctioning (252, 65%), with overall 53% invasive, and 10% that demonstrated ≥2 proliferative marker positivity. Recurrence was predicted by invasiveness (hazards ratio [HR] 1.6 [1.10-2.37], P .02), elevated mitotic count (HR 2.17 [1.21-3.89], P .01), grade (2b vs 1a HR 2.32 [1.06-5.03], P .03), and absence of gross total resection (HR 3.70 [1.72-8.00], P .01). Clinically defined aggressiveness was associated with elevated Ki67, mitotic count, and invasiveness. Ki67 reporting methodologies showed moderate correlation across laboratories (Phi 0.620), whereas p53 reporting reproducibility was poor (Phi 0.146). CONCLUSIONS Proliferative markers, including Ki67 and mitotic count, but not p53, are important in predicting the development of aggressive pituitary tumour behaviour.
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Affiliation(s)
- Nèle F Lenders
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2010, Australia
| | - Peter E Earls
- Department of Anatomical Pathology and Cytopathology, St Vincent's Pathology, Sydney, NSW 2010, Australia
| | - Adam C Wilkinson
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2010, Australia
| | - Monique Costin
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
| | - Monika Hofer
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ, United Kingdom
| | - Tint T Shein
- Department of Anatomical Pathology and Cytopathology, St Vincent's Pathology, Sydney, NSW 2010, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW 2010, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2010, Australia
| | | | - Maria Picallo
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ, United Kingdom
| | - Aparna Pal
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ, United Kingdom
| | - John Wass
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ, United Kingdom
| | - Ann I McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2010, Australia
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13
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Medina EJ, Zohdy YM, Porto E, Revuelta Barbero JM, Bray D, Maldonado J, Rodas A, Mayol M, Morales B, Neill S, Read W, Pradilla G, Ioachimescu A, Garzon-Muvdi T. Therapeutic response to pazopanib: case report and literature review on molecular abnormalities of aggressive prolactinomas. Front Endocrinol (Lausanne) 2023; 14:1195792. [PMID: 37529607 PMCID: PMC10388536 DOI: 10.3389/fendo.2023.1195792] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Aggressive prolactinomas (APRLs) pose a significant clinical challenge due to their high rate of regrowth and potentially life-threatening complications. In this study, we present a case of a patient with an APRL who had a trial of multiple therapeutic modalities with the aim to provide a review of molecular abnormalities and management of APRLs by corroborating our experience with previous literature. Methods A total of 268 articles were reviewed and 46 were included. Case reports and series, and studies that investigated the molecular and/or genetic analysis of APRLs were included. Special care was taken to include studies describing prolactinomas that would fall under the APRL subtype according to the European Society of Endocrinology guidelines; however, the author did not label the tumor as "aggressive" or "atypical". Addiontionally, we present a case report of a 56-year-old man presented with an invasive APRL that was resistant to multiple treatment modalities. Results Literature review revealed multiple molecular abnormalities of APRLs including mutations in and/or deregulation of ADAMTS6, MMP-9, PITX1, VEGF, POU6F2, CDKN2A, and Rb genes. Mismatch repair genes, downregulation of microRNAs, and hypermethylation of specific genes including RASSF1A, p27, and MGMT were found to be directly associated with the aggressiveness of prolactinomas. APRL receptor analysis showed that low levels of estrogen receptor (ER) and an increase in somatostatin receptors (SSTR5) and epidermal growth factor receptors (EGFR) were associated with increased invasiveness and higher proliferation activity. Our patient had positive immunohistochemistry staining for PD-L1, MSH2, and MSH6, while microarray analysis revealed mutations in the CDKN2A and POU6F2 genes. Despite undergoing two surgical resections, radiotherapy, and taking dopamine agonists, the tumor continued to progress. The patient was administered pazopanib, which resulted in a positive response and the patient remained progression-free for six months. However, subsequent observations revealed tumor progression. The patient was started on PD-L1 inhibitor pembrolizumab, yet the tumor continued to progress. Conclusion APRLs are complex tumors that require a multidisciplinary management approach. Knowledge of the molecular underpinnings of these tumors is critical for understanding their pathogenesis and identifying potential targets for precision medical therapy.
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Affiliation(s)
- Eduardo J. Medina
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Youssef M. Zohdy
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Edoardo Porto
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - David Bray
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Justin Maldonado
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Alejandra Rodas
- Department of Otolaryngology, Emory University, Atlanta, GA, United States
| | - Miguel Mayol
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | - Bryan Morales
- Department of Pathology, Emory University, Atlanta, GA, United States
| | - Stewart Neill
- Department of Pathology, Emory University, Atlanta, GA, United States
| | - William Read
- Department of Oncology, Emory University, Atlanta, GA, United States
| | - Gustavo Pradilla
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
| | | | - Tomas Garzon-Muvdi
- Department of Neurosurgery, Emory University, Atlanta, GA, United States
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14
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Sheikh TA, Kamble PP, Deshmukh G, Vermani A, Verma M. A Curious Case of Hybrid Ameloblastoma. Cureus 2023; 15:e42512. [PMID: 37637513 PMCID: PMC10457431 DOI: 10.7759/cureus.42512] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/29/2023] Open
Abstract
Ameloblastoma is one of the most prevalent odontogenic tumors of epithelial origin, with several histological variations. However, among these variants, 'hybrid ameloblastoma' is infrequent and anomalous. The current case study demonstrates the existence of hybrid ameloblastoma in a 27-year-old female patient, which included desmoplastic, follicular, and acanthomatous patterns. The right side of the mandible was affected by tumor growth, with extensive bone involvement and neural invasion, resulting in a loss of sensation on that side. Although the tumor grows at a gradual pace, its enigmatic manifestation highlights the significance of a meticulous diagnosis. The course of treatment involved comprehensive resection of the tumor segment, followed by the recommended reconstructive surgery during the postoperative follow-up period.
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Affiliation(s)
- Tauseef A Sheikh
- Oral and Maxillofacial Surgery, Aditya Dental College, Beed, IND
| | - Priyanka P Kamble
- Oral Pathology and Microbiology, Jawahar Medical Foundation's ACPM Dental College, Dhule, IND
| | | | - Akshit Vermani
- Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College, Sunam, IND
| | - Mohit Verma
- Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College, Sunam, IND
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15
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Tomassen T, Versleijen-Jonkers YMH, Hillebrandt-Roeffen MHS, Van Cleef PHJ, van Dalen T, Weidema ME, Desar IME, Flucke U, van Gorp JM. Prognostic Factors in Epithelioid Hemangioendothelioma: Analysis of a Nationwide Molecularly/Immunohistochemically Confirmed Cohort of 57 Cases. Cancers (Basel) 2023; 15:3304. [PMID: 37444414 DOI: 10.3390/cancers15133304] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma with variable aggressive clinical behavior. In this retrospective study, we aimed to investigate prognostic factors based on clinicopathologic findings in a molecularly/immunohistochemically confirmed nationwide multicenter cohort of 57 EHE cases. Patients had unifocal disease (n = 29), multifocal disease (n = 5), lymph node metastasis (n = 8) and/or distant metastasis (n = 15) at the time of diagnosis. The overall survival rate was 71.4% at 1 year and 50.7% at 5 years. Survival did not correlate with sex, age or histopathological parameters. No survival differences were observed between multifocal and metastatic disease, suggesting that multifocality represents early metastases and treatment options are limited in comparison to unifocal disease. In unifocal tumors, survival could be predicted using the risk stratification model of Shibayama et al., dividing the cases into low- (n = 4), intermediate- (n = 15) and high- (n = 3) risk groups. No clinical or histopathological parameters were associated with progressive unifocal disease course. Lymph node metastases at the time of diagnosis occurred in 14.0% of the cases and were mainly associated with tumor localization in the head and neck area, proposing lymph node dissection. In conclusion, our results demonstrate the aggressive behavior of EHE, emphasize the prognostic value of a previously described risk stratification model and may provide new insights regarding tumor focality, therapeutic strategies and prognosis.
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Affiliation(s)
- Tess Tomassen
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Yvonne M H Versleijen-Jonkers
- Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Melissa H S Hillebrandt-Roeffen
- Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Patricia H J Van Cleef
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Thijs van Dalen
- Department of Surgery, Utrecht University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Marije E Weidema
- Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Ingrid M E Desar
- Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Uta Flucke
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands
| | - Joost M van Gorp
- Department of Pathology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
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16
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Mremi A, Mwakyembe T, Wampembe E, Serventi F, Lodhia J. Primary breast squamous cell carcinoma: A case report at a tertiary hospital in Northern Tanzania. Clin Case Rep 2023; 11:e7586. [PMID: 37346880 PMCID: PMC10279938 DOI: 10.1002/ccr3.7586] [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: 05/02/2023] [Revised: 05/24/2023] [Accepted: 06/03/2023] [Indexed: 06/23/2023] Open
Abstract
Key Clinical Message Primary SCC of the breast is a very rare disease.Metastasis from elsewhere should be excluded first.The tumor is a very aggressive with poor prognosis.No standard treatment approaches are available.Managed by surgical excision followed by chemotherapy and radiotherapy. Abstract Primary squamous cell carcinoma of the breast is an exceedingly rare disease, and its management is still unclear. A-65-year-old lady presented with a progressive swelling of her right breast that started spontaneously. Other potential primary sites were ruled out. She was kept on a neo-adjuvant chemotherapy (AC-T protocol) of doxorubicin, adriamycin, and paclitaxel. Later, she was underwent modified radical mastectomy with axillary lymph node dissection. Her post-operative recovery was uneventful. Currently, she is followed up at oncology outpatient clinic.
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Affiliation(s)
- Alex Mremi
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Theresia Mwakyembe
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | - Elizabeth Wampembe
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | - Furaha Serventi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Cancer Care Center, Kilimanjaro Christian Medical CentreMoshiTanzania
| | - Jay Lodhia
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
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17
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Mahmood S, Borkar AN, Khan FA, Naab T. Aggressive Malignant Paraganglioma Involving the Pancreas and Vertebral Column. Cureus 2023; 15:e40985. [PMID: 37503488 PMCID: PMC10370504 DOI: 10.7759/cureus.40985] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 07/29/2023] Open
Abstract
Paraganglioma (PGL) is a rare neuroendocrine tumor arising from chromaffin cells outside the adrenal medulla. The most common sites are the abdomen and head and neck. Seventy percent (70%) of PGLs are sporadic, and 30% are hereditary; the latter are more often aggressive and malignant and occur in young adults. We report a case of a 36-year-old woman with a history of hypertension and abdominal pheochromocytoma resected at the age of 10 years who presented with back pain. Magnetic resonance imaging of the spine showed vertebral metastasis at L2-L5. Computed tomography of the abdomen showed a mass in the body of the pancreas and a laparoscopic biopsy was performed. The tumor cells had granular eosinophilic/basophilic cytoplasm and showed a nested pattern (Zellballen) with a prominent vascular network and infiltration of dense fibrous connective tissue. Strong and diffuse expression of synaptophysin in tumor cells, S100 expression in sustentacular cells at the periphery of nests, and lack of pancytokeratin expression supported the diagnosis of PGL. Due to limited tissue, it was difficult to determine metastatic vs primary neoplasm of the pancreas. The earlier age of onset and history of abdominal pheochromocytoma suggested the possibility of hereditary PGL associated with succinate dehydrogenase (SDH) deficiency. The tumor cells lacked SDHB expression. Germline mutation testing for SDH was recommended. The patient underwent palliative radiotherapy and systemic chemotherapy. Most PGLs are benign and asymptomatic, but there is an increased risk of cardiovascular mortality secondary to catecholamine secretion, and surgical excision is curative. Malignant PGLs are rare (10-40%), have poor prognosis, and are incurable. Increased size of the tumor, deep tissue infiltration, and high proliferative index increase the risk of malignancy, but metastasis is required for the diagnosis of malignant PGL. The advanced disease is treated with surgical removal of the tumor and combined radiotherapy and chemotherapy.
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Affiliation(s)
- Salahudin Mahmood
- Internal Medicine, Nishtar Medical University and Hospital, Multan, PAK
| | - Abhilasha N Borkar
- Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Farhan A Khan
- Pathology and Laboratory Medicine, Pathology Specialists of Memphis, Memphis, USA
- Pathology and Laboratory Medicine, Methodist Le Bonheur Healthcare, Memphis, USA
| | - Tammey Naab
- Pathology and Medical Microbiology, Athari Bio + Sciences, Washington DC, USA
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18
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Rix K, Monks CP, O'Toole S. Theory of Mind and Young Children's Behaviour: Aggressive, Victimised, Prosocial, and Solitary. Int J Environ Res Public Health 2023; 20:ijerph20105892. [PMID: 37239617 DOI: 10.3390/ijerph20105892] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023]
Abstract
Theory of mind (ToM) undergoes significant developments during childhood, particularly between the ages of four and seven years. A growing body of research has indicated that children's social understanding may be related to their social behaviour with peers, in line with Theory Theory which proposes that children's social cognition is influenced by and influences their peer interactions. The current study examined the relationship between ToM and behaviour among 193 children aged 4-7 years. Children carried out a battery of ToM tasks, and teaching staff reported on children's aggressive, prosocial, and solitary behaviour and victimisation experiences. Aggression was not directly related to ToM; prosocial behaviour was positively associated with ToM for girls but not boys. Solitary behaviour and victimisation were negatively related to ToM. When this was broken down by gender, there was only a significant association between solitary behaviour and ToM for boys. When controlling for the relationship between behaviours, the only significant predictor of ToM was solitary behaviour for boys. ToM was also a significant predictor of solitary behaviour for boys, demonstrating that there is a bidirectional relationship at play. The findings highlight the importance of looking across these four behaviour types and understanding the relationship between behaviour profiles and ToM for boys and girls separately.
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Affiliation(s)
- Katie Rix
- School of Psychology & Counselling, Faculty of Arts & Social Sciences, The Open University, Milton Keynes MK7 6AA, UK
| | - Claire P Monks
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London SE10 9LS, UK
| | - Sarah O'Toole
- Department of Civil, Environmental & Geomatic Engineering, Faculty of Engineering Science, University College London, London WC1E 6BT, UK
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Sereno M, Cabezón-Gutiérrez L, Higuera O, Mielgo-Rubio X, Cervera-Calero R. High tumor burden in patients with non-small-cell lung cancer: a Delphi survey among Spanish oncologists. Future Oncol 2023. [PMID: 37170838 DOI: 10.2217/fon-2022-1016] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Aim: To define high tumor burden (HTB) in non-small-cell lung cancer. Methods: A total of five oncologists initiated the project, selecting 66 participants, and elaborated a questionnaire with 26 statements using the Delphi method with a 9-point Likert scale of agreement. Results: Factors with moderate strength of consensus were identified, including a sum of the longest diameter of lesions ≥10 cm, elevated LDH, hepatic involvement, lymphangitis carcinomatosis, brain involvement unapproachable with local techniques and pericardial effusion. There was a consensus against increases in tumor markers and asymptomatic brain involvement being related to HTB. HTB was considered a relevant factor for treatment selection supporting the choice of combination regimens versus immunotherapy only. Conclusion: In this Delphi study, experts defined several factors associated with HTB in non-small cell lung cancer.
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Affiliation(s)
- María Sereno
- Medical Oncology, Sofía University Hospital, European University of Madrid, Madrid, 28702, Spain
| | - Luis Cabezón-Gutiérrez
- Medical Oncology, Hospital Universitario de Torrejón, Universidad Francisco Vitoria, Madrid, 28309, Spain
| | - Oliver Higuera
- Medical Oncology, Hospital Universitario La Paz, Madrid, 28701, Spain
| | - Xabier Mielgo-Rubio
- Medical Oncology, Hospital Universitario Fundación de Alcorcón, Alcorcón, 28405, Spain
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Charii H, Boudouh A, Lakhal M, Moueqqit O, Kouismi H. Lung Sarcomatoid Carcinoma: An Intriguing Case Report of a Rare Malignancy. Cureus 2023; 15:e39669. [PMID: 37261368 PMCID: PMC10227236 DOI: 10.7759/cureus.39669] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/02/2023] Open
Abstract
Sarcomatoid carcinoma (SC) is a rare primary malignant tumor belonging to the group of non-small cell lung cancer (NSCLC). The diagnosis requires proper tumor sampling to exclude sarcoma, which is the main differential diagnosis. However, the prognosis of these tumors is poor, with a median survival rate lower than other NSCLC cases, mainly due to their aggressiveness and resistance to chemotherapy, especially platinum salts. In this report, we discuss a case of a 62-year-old male patient who presented at admission with hemoptysis and dyspnea. The diagnosis process involved thoracic computed tomography (CT) and fiberoptic bronchoscopy, which revealed tissue thickening at the carina and a mass extending from the lower end of the trachea to the carina, which was confirmed by biopsy. Unfortunately, despite receiving neoadjuvant radiotherapy and having endotracheal prosthesis, the patient succumbed to tumor progression. Our case highlights the aggressive nature of this tumor and underscores the importance of early detection.
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Affiliation(s)
- Hajar Charii
- Respiratory Diseases, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Asmae Boudouh
- Respiratory Diseases, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Mohamed Lakhal
- Respiratory Diseases, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Othman Moueqqit
- General Medicine, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Hatim Kouismi
- Respiratory Diseases, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
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Tal O, Ben Shem E, Peled O, Elyashiv O, Levy T. Age Disparities in End of Life Symptom Management Among Patients with Epithelial Ovarian Cancer. J Palliat Care 2023; 38:184-191. [PMID: 35225068 DOI: 10.1177/08258597221083418] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the symptoms of women with epithelial ovarian cancer (EOC) during their last admission before death and analyze invasive palliative management administered in relation to symptom control and survival. MATERIALS & METHODS A retrospective review of Israeli patients with EOC, primary peritoneal cancer (PPC) and tubal cancer, admitted to our department prior to death between 2008-2018. Basic palliative treatment was defined as administration of IV fluids, analgesics, oxygen, antiemetics, antibiotics and/or blood transfusions. Procedures regarded as invasive included: peritoneal or pleural fluid drainage; placement of an indwelling catheter, administration of total parenteral nutrition (TPN), chemotherapy and ventilation. RESULTS 82 patients were included. Most suffered from weakness and fatigue, gastrointestinal complaints, pain and shortness of breath. 34 patients (41.5%) required only basic palliative treatment to alleviate their symptoms; however, in 48 patients (58.5%) invasive interventions were needed. Patients treated with invasive procedures were younger at death by almost 9 years (mean age of 65.73 ± 9.5 vs. 74.78 ± 9.8; p = 0.001). There were significantly more women with platinum sensitive disease in the invasive interventions group compared to the basic palliative care (60.42% vs. 32.35%; p = 0.012). No survival difference was found between the groups from diagnosis to death, relapse to death, last chemotherapy to death and last admission to death. CONCLUSIONS EOC patients suffer from high disease burden and multiple symptoms before death. We found that physicians tend to use more invasive care in dying younger patients. However, this aggressive treatment does not prolong survival. Futile treatments influencing quality of life should be avoided.
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Affiliation(s)
- Ori Tal
- E. Wolfson Medical Center, Holon, Sackler Medicine, Tel Aviv University, Holon, Israel
| | - Erez Ben Shem
- E. Wolfson Medical Center, Holon, Sackler Medicine, Tel Aviv University, Holon, Israel
| | - Ofri Peled
- E. Wolfson Medical Center, Holon, Sackler Medicine, Tel Aviv University, Holon, Israel
| | - Osnat Elyashiv
- E. Wolfson Medical Center, Holon, Sackler Medicine, Tel Aviv University, Holon, Israel
| | - Tally Levy
- E. Wolfson Medical Center, Holon, Sackler Medicine, Tel Aviv University, Holon, Israel
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Bhattacharya S, Koshy AV, Baldawa P, Thakur S, Shah A, Bhagwat H. A case report of angiosarcoma of the tongue: A diagnostic dilemma at presentation. Indian J Dent Res 2023; 34:226-228. [PMID: 37787218 DOI: 10.4103/ijdr.ijdr_741_22] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Rationale Angiosarcoma is a malignant mesenchymal tumor arising from vascular endothelial cells. This is an aggressive malignancy associated with poor prognosis. Angiosarcoma in the head and neck is exceedingly rare, accounting for less than 4 % of tumors.[1]. Patient Concern We report a unique case of angiosarcoma involving the tongue underlying the diagnostic conundrum and pointers towards an accurate diagnosis. Take-away lesson Due to rarity of the disease, consensus on optimal treatment approach is lacking and multicenter prospective studies would be helpful to set clinical guidelines.
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Affiliation(s)
- Shilajit Bhattacharya
- Department of General Pathology and Microbiology, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Ajit V Koshy
- Department of Oral Pathology and Microbiology, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Prachi Baldawa
- Department of Oral Pathology and Microbiology, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Samantha Thakur
- Department of Oral Pathology and Microbiology, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Amisha Shah
- Department of Oral Pathology and Microbiology, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Harshad Bhagwat
- Department of Oral Surgery, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Goh Q, Low Y, Abd Rani NHB, Tong C. An Aggressive Plurihormonal Pituitary Adenoma With Thyrotropin, Growth Hormone, and Prolactin Excess. JCEM Case Rep 2023; 1:luad016. [PMID: 37908485 PMCID: PMC10580478 DOI: 10.1210/jcemcr/luad016] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Indexed: 09/01/2023]
Abstract
A 31-year-old gentleman presented with clinical hyperthyroidism, goiter, bitemporal hemianopia, and discordant thyroid function test. The high α-subunit and absence of throtropin (thyroid-stimulating hormone; TSH) response to thyrotropin-releasing hormone stimulation indicated a TSH-secreting pituitary tumor. Elevation in prolactin and growth hormone as well as secondary hypogonadism were also observed. A sellar-suprasellar mass displacing the optic chiasm was revealed upon magnetic resonance imaging. The patient was rendered euthyroid with carbimazole and Lugol's iodine before undergoing endoscopic transsphenoidal surgery. Due to the incomplete tumor excision during surgery, patient experienced recurrence of symptoms and rising thyroxine (T4) with nonsuppressed TSH. The histopathology examination demonstrated a plurihormonal tumor with positive immunohistochemical stain for TSH, growth hormone, and prolactin, with invasive and proliferative features. Subsequently he was initiated with a long-acting somatostatin analogue and underwent stereotactic radiosurgery. To date, his symptoms have improved, with a reduction of insulin-like growth factor 1 and normalization of other pituitary hormones as well as a slightly reduced size of the pituitary tumor.
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Affiliation(s)
- QingCi Goh
- Department of Medicine, Hospital Melaka, 75400 Melaka, Malaysia
| | - YenNee Low
- Department of Medicine, Hospital Melaka, 75400 Melaka, Malaysia
| | | | - ChinVoon Tong
- Department of Medicine, Hospital Melaka, 75400 Melaka, Malaysia
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Mokhtar EA, Fatima Q, Akbar S, Equbal S, Salahudeen A. Rhino-Orbital Cerebral Mucormycosis Causing Temporomandibular Joint Ankylosis: A Case Series of Two Patients. Cureus 2023; 15:e35194. [PMID: 36960262 PMCID: PMC10030649 DOI: 10.7759/cureus.35194] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/22/2023] Open
Abstract
Temporomandibular joint ankylosis is caused by trauma, infection, autoimmune, inflammatory joint diseases, and several other minor causes. Mucormycosis causing temporomandibular joint ankylosis has not been reported. We report two cases of temporomandibular joint ankylosis caused by mucormycosis from 2018 to 2022. In both cases, the infection started in the maxilla, then progressed to orbit. After that, involvement of the mastoid process, styloid process, and base of the skull was observed in the first case, while in the second case, there was the involvement of the base of the skull and mandibular ramus. As the temporomandibular joint (TMJ) components are contiguous to the base of the skull, it got affected causing temporomandibular joint ankylosis. Mucormycosis was diagnosed by KOH mount. The smear examination showed aseptate hyphae at 900. Histopathology examination further confirmed mucormycosis. Glycemic control was done by infusing Insulin (both Lantus and regular). The case was managed with aggressive debridement and interpositional arthroplasty with a buccal fat pad. Liposomal amphotericin infusion was also started pre-operatively and continued in the post-operative phase. After 4 years of follow-up, the patient is well and had adequate mouth opening. Mucormycosis infection affecting the TMJ has been reported in the literature. However, this is the first report of a mucormycosis infection resulting in TMJ ankylosis in the literature. The infection should be aggressively managed. Reversals of an immunocompromised state, aggressive surgical management, and antifungal medication are the key factors for the success of the deadly fungal infection.
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Affiliation(s)
- Ejaz A Mokhtar
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Patna, IND
| | - Qalbi Fatima
- Periodontics, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Shahrukh Akbar
- Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, IND
| | - Sharique Equbal
- Oral and Maxillofacial Surgery, Buddha Institue of Dental Sciences, Patna, IND
| | - Ameera Salahudeen
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Patna, IND
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Tabbal M, Hachim MY, Jan RK, Adrian TE. Using publicly available datasets to identify population-based transcriptomic landscape contributing to the aggressiveness of breast cancer in young women. Front Genet 2023; 13:1039037. [PMID: 36685821 PMCID: PMC9845274 DOI: 10.3389/fgene.2022.1039037] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction: Although the risk of breast cancer increases with advancing age, some regions have larger number of young breast cancer patients (≤45 years-old), such as the Middle East, Eastern Asia, and North Africa, with more aggressive and poorly differentiated tumors. We aimed to conduct an in-silico analysis in an attempt to understand the aggressive nature of early-onset breast cancer, and to identify potential drivers of early-onset breast cancer using gene expression profiling datasets in a population-dependent manner. Methods: Functional genomics experiments data were acquired from cBioPortal database for cancer genomics, followed by the stratification of patients based on the age at representation of breast cancer and race. Differential gene expression analysis and gene amplification status analysis were carried out, followed by hub gene, transcription factor, and signalling pathway identification. Results: PAM50 subtype analysis revealed that young patients (≤45 years-old) had four-fold more basal tumors and worst progression-free survival (median of 101 months), compared with the 45-65 years group (median of 168 months). Fourteen genes were amplified in more than 14% of patients with an early-onset breast cancer. Interestingly, FREM2, LINC00332, and LINC00366 were exclusively amplified in younger patients. Gene expression data from three different populations (Asian, White, and African) revealed a unique transcriptomic profile of young patients, which was also reflected on the PAM50 subtype analysis. Our data indicates a higher tendency of young African patients to develop basal tumors, while young Asian patients are more prone to developing Luminal A tumors. Most genes that were found to be upregulated in younger patients are involved in important signaling pathways that promote cancer progression and metastasis, such as MAPK pathway, Reelin pathway and the PI3K/Akt pathway. Conclusion: This study provides strong evidence that the molecular profile of tumors derived from young breast cancer patients of different populations is unique and may explain the aggressiveness of these tumors, stressing the need to conduct population- based multi-omic analyses to identify the potential drivers for tumorigenesis and molecular profiles of young breast cancer patients.
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Iska S, Sokol G, Sawani A, Patibandla P. Massive Presentation of a Neglected Basal Cell Ulcer on the Forehead and Outcome With Radiation Therapy: A Case Report and Literature Review. Cureus 2023; 15:e34383. [PMID: 36874684 PMCID: PMC9977204 DOI: 10.7759/cureus.34383] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Basal cell carcinoma (BCC) of the scalp is the most common cancer of the skin and is locally invasive. The patched/hedgehog intracellular signaling pathway is responsible for regulating cell growth and tumor formation by inactivating mutation of protein patched homolog 1 (PTCH1) or activating mutation of Smoothened (SMOm). BCC can cause significant morbidity from local destruction if neglected. The risk of metastasis and death is 6.5% in tumors greater than or equal to 2 cm in size. The gold standard treatment is surgical excision. Radiation therapy is used to treat skin cancers as an adjuvant or in patients who are not candidates for surgical intervention or who refuse therapy. It works by using low-energy X-rays or electron beam radiation. They work on the superficial skin and do not affect the organs deeper. Here, we describe the case of a man who presented with an unwitnessed seizure and was found to have a large ulcer on his forehead, which was later diagnosed to be BCC of the scalp eroding the calvarium. The base of the ulcer was the patient's dura and brain. He was successfully treated with electron beam radiation therapy for six weeks with careful preservation of brain tissue. The patient's skin was re-epithelialized and the bone was recalcified. The ulcer on the forehead has completely regressed. This case report and literature review illustrates the evidence to propose the importance of radiation therapy and its potential to be the first-line treatment in BCC, especially in similar cases like ours. Multimodality treatment with a radiation oncologist, dermatologist, and medical oncologist can save patients from devastating outcomes.
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Affiliation(s)
- Sindu Iska
- Internal Medicine, Cleveland Clinic Florida, Weston, USA
| | - Gerald Sokol
- Radiation Oncology, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Ali Sawani
- Internal Medicine, Cleveland Veterans Affairs Medical Center, Cleveland, USA
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Harahap AS, Lay FK, Kodariah R, Wongkar FJ, Ham MF. Association of Programmed Death-Ligand 1 Expression with Aggressive Histological Types of Thyroid Carcinoma. Cancer Manag Res 2022; 14:3539-3550. [PMID: 36583030 PMCID: PMC9793731 DOI: 10.2147/cmar.s392475] [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: 10/06/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Immunohistochemical expression of programmed death-ligand 1 (PD-L1) has become a biomarker to predict the usefulness of cancer immunotherapy using PD-1/PD-L1 blockade in a variety of advanced-stage tumours. This emerging biomarker may serve to generate novel therapies for aggressive thyroid carcinoma (TC), which has not shown optimal results with existing treatments. Methods The present study investigated the relevance of PD-L1 expression in aggressive histological types of TC compared with that found in less aggressive types. Surgically resected specimens were investigated, including 52 cases of TC consisting of 26 cases of aggressive histological types and 26 cases of less aggressive histological types. Immunohistochemical examinations were carried out on paraffin blocks of both groups using a mouse monoclonal primary antibody against PD-L1 (clone 22C3). PD-L1 expression was evaluated by calculating the tumour proportion score (TPS) in both groups. Results The results revealed a significant difference in the median TPS value of PD-L1 expression between the two groups. The TPS values were found to be higher in the group of aggressive histological types of TC compared with those in the group of less aggressive histological types. A significant difference in TPS value was also found for the extrathyroidal extension variable. Discussion In conclusion, the present study found a significant association between PD-L1 expression and the aggressive histological type of TC. In addition, a potential association between PD-L1 expression and the presence of extrathyroidal extension of TC was observed. These findings provide novel approaches for immunotherapy as a potential new treatment modality in patients with aggressive histological types of TC.
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Affiliation(s)
- Agnes Stephanie Harahap
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia,Human Cancer Research Center - Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Fanny Kamarudy Lay
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ria Kodariah
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Fresia Juwitasari Wongkar
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Maria Francisca Ham
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia,Human Cancer Research Center - Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia,Correspondence: Maria Francisca Ham, Email
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Ojelade OC, Durosaro SO, Akinde AO, Abdulraheem I, Oladepo MB, Sopein CA, Bhadmus AS, Olateju M. Environmental enrichment improves the growth rate, behavioral and physiological response of juveniles of Clarias gariepinus under laboratory conditions. Front Vet Sci 2022; 9:980364. [PMID: 36311662 PMCID: PMC9597454 DOI: 10.3389/fvets.2022.980364] [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: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 11/04/2022] Open
Abstract
Environmental enrichment (EE) improves the growth rate and welfare of some cultured fishes. However, most cultured fish species are raised in non-enriched housing conditions. Clarias gariepinus is an important commercial fish species, but little is known about the effect of EE on their welfare. This study examined the effect of different EE on the survival rate (SR), growth [mean weight gain (MWG), specific growth rate (SGR) and feed conversion ratio (FCR)], behavioral (feed response, aggressive acts and shoaling time) and physiological responses (blood glucose) of C. gariepinus. One hundred and twenty juveniles of C. gariepinus (31.65 ± 0.69 g) were randomly allocated at 10 fish/tank and subjected to either Plant Enriched (PE), Substratum Enriched (SE), Plant and Substratum Enriched (PSE) and Non-Enriched (NE) tanks in triplicates for 56-days. Behavioral acts were observed for 10 min twice daily, and glucose level in blood samples was evaluated. Data were checked for normality using the Shapiro-Wilk test before being analyzed with the Kruskal-Wallis test. SR and MWG were significantly higher in Clarias gariepinus exposed to SE, with no significant differences among PE, PSE and NE treatments. There was no significant difference between the SGR of PSE and NE. FCR was similar between treatments. The highest condition factor (k) was recorded in SE tanks. Duration of feed response was shorter in SE, but there was no significant difference between the feed response of C. gariepinus exposed to PE and PSE. C. gariepinus exposed to PE, SE and PSE displayed a similar frequency of aggressive acts. African catfish reared in NE (barren) tanks had the least duration of shoaling period. The experiment consistently found the highest and least glucose values in PSE and SE. In conclusion, environmentally enriched housing tanks with SE resulted in the best MWG with a reduced level of aggression in C. gariepinus under laboratory conditions. Thus, EE might be applicable to boost fish productivity on a commercial scale.
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Affiliation(s)
- Oluwaseun Christianah Ojelade
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria,*Correspondence: Oluwaseun Christianah Ojelade
| | - Samuel Olutunde Durosaro
- Department of Animal Breeding and Genetics, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Abiodun O. Akinde
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Ikililu Abdulraheem
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Mathew B. Oladepo
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Comfort A. Sopein
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Abiodun S. Bhadmus
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
| | - Mary Olateju
- Department of Aquaculture and Fisheries Management, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
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Yuan S, Lu H. Examining a conceptual framework of aggressive and humorous styles in science YouTube videos about climate change and vaccination. Public Underst Sci 2022; 31:921-939. [PMID: 35491908 DOI: 10.1177/09636625221091490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The current study investigated how individuals process aggressive and humorous video messages communicating childhood vaccination and climate change. Employing psychological reactance, message discounting and expectancy violation, we built a theoretical model that explains the effects of communication styles on individuals' activism intentions. Two online experiments in the United States (N = 441 and N = 533) using self-created videos on the topics of childhood vaccination and climate change were conducted to examine this model. The results showed that both perceived aggressiveness and humorousness of the videos led to higher message discounting, which then resulted in stronger activism intentions. Perceived aggressiveness led to higher expectancy violation, while perceived humorousness led to lower expectancy violation, which negatively affected activism intentions. The role played by psychological reactance was inconsistent across the two contexts. The findings provide theoretical implications for understanding how individuals process aggressive and humorous communication styles, especially in relation to discussions on science issues.
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Wang W, Xi Y, Li S, Liu X, Wang G, Wang H, Pei M, Zhang J, Gui J, Ni X. Restricted Recruitment of NK Cells with Impaired Function Is Caused by HPV-Driven Immunosuppressive Microenvironment of Papillomas in Aggressive Juvenile-Onset Recurrent Respiratory Papillomatosis Patients. J Virol 2022;:e0094622. [PMID: 36154611 DOI: 10.1128/jvi.00946-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Laryngopharynx epithelium neoplasia induced by HPV6/11 infection in juvenile-onset recurrent respiratory papillomatosis (JO-RRP) causes a great health issue characteristic of frequent relapse and aggressive disease progression. Local cell-mediated immunity shaped by the recruitment and activation of cytotoxic effector cells is critical for viral clearance. In this study, we found that NK cells in the papillomas of aggressive JO-RRP patients, in contrast to massive infiltrated T cells, were scarce in number and impaired in activation and cytotoxicity as they were in peripheral blood. Data from cell infiltration analysis indicated that the migration of NK cell to papilloma was restricted in aggressive JO-RRP patients. Further study showed that the skewed chemokine expression in the papillomas and elevated ICAM-1 expression in hyperplastic epithelia cells favored the T cell but not NK cell recruitment in aggressive JO-RRP patients. In parallel to the increased CD3+ T cells, we observed a dramatical increase in Tregs and Treg-promoting cytokines such as IL-4, IL-10 and TGFβ in papillomas of aggressive JO-RRP patients. Our study suggested that likely initialized by the intrinsic change in neoplastic epithelial cells with persistent HPV infection, the aggressive papillomas built an entry barrier for NK cell infiltration and formed an immunosuppressive clump to fend off the immune attack from intra-papillomas NK cells. IMPORTANCE Frequent relapse and aggressive disease progression of juvenile-onset recurrent respiratory papillomatosis (JO-RRP) pose a great challenge to the complete remission of HPV 6/11 related laryngeal neoplasia. Local immune responses in papillomas are more relevant to the disease control considering the locale infected restriction of HPV virus in epitheliums. In our study, the restricted NK cell number and reduced expression of activating NKp30 receptor suggested one possible mechanism underlying impaired NK cell defense ability in aggressive JO-RRP papillomas. Meanwhile, the negative impact of HPV persistent infection on NK cell number and function represented yet another example of a chronic pathogen subverting NK cell behavior, affirming a potentially important role for NK cells in viral containment. Further, the skewed chemokine/cytokine expression in the papillomas and the elevated adhesion molecules expression in hyperplastic epithelia cells provided important clues for understanding blocked infiltration and antiviral dysfunction of NK cells in papilloma.
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Abstract
Desmoid tumors (DTs) are rare soft tissue mesenchymal neoplasms that may be associated with impairments, disfigurement, morbidity, and (rarely) mortality. DT disease course can be unpredictable. Most DTs are sporadic, harboring somatic mutations in the gene that encodes for β-catenin, whereas DTs occurring in patients with familial adenomatous polyposis have germline mutations in the APC gene, which encodes for a protein regulator of β-catenin. Pathology review by an expert soft tissue pathologist is critical in making a diagnosis. Magnetic resonance imaging is preferred for most anatomic locations. Surgery, once the standard of care for initial treatment of DT, is associated with a significant risk of recurrence as well as avoidable morbidity because spontaneous regressions are known to occur without treatment. Consequently, active surveillance in conjunction with pain management is now recommended for most patients. Systemic medical treatment of DT has evolved beyond the use of hormone therapy, which is no longer routinely recommended. Current options for medical management include tyrosine kinase inhibitors as well as more conventional cytotoxic chemotherapy (e.g., anthracycline-based or methotrexate-based regimens). A newer class of agents, γ-secretase inhibitors, appears promising, including in patients who fail other therapies, but confirmation in Phase 3 trials is needed. In summary, DTs present challenges to physicians in diagnosis and prognosis, as well as in determining treatment initiation, type, duration, and sequence. Accordingly, evaluation by a multidisciplinary team with expertise in DT and patient-tailored management are essential. As management strategies continue to evolve, further studies will help clarify these issues and optimize outcomes for patients.
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Affiliation(s)
- Richard F Riedel
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Mark Agulnik
- Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Singh RK, Mishra GV. Aggressive squamous cell carcinoma of lip in a village woman. Pan Afr Med J 2021; 39:224. [PMID: 34630836 PMCID: PMC8486927 DOI: 10.11604/pamj.2021.39.224.30137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/24/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
- Rohan Kumar Singh
- Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, India
| | - Gaurav Vedprakash Mishra
- Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, India
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Furtado ARR, Moris LM, Esmieu S, Cherubini GB, Mantis P. Low-field magnetic resonance imaging characteristics of multifocal vertebral lesions in dogs. Vet Rec 2021; 189:e78. [PMID: 34505679 DOI: 10.1002/vetr.78] [Citation(s) in RCA: 1] [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] [Received: 06/29/2020] [Revised: 11/10/2020] [Accepted: 12/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is a lack of information regarding magnetic resonance imaging (MRI) features of polyostotic vertebral lesions in dogs. The aim of this retrospective study was to identify and differenciate low-field MRI features of aggressive versus benign multifocal vertebral diseases in dogs. METHODS MRI examinations from 49 dogs with polyostotic vertebral lesions were reviewed. Images were evaluated for vertebral intensity changes, expansile lesions, new bone formation, cortical bone interruption, paravertebral musculature changes, lymphadenomegaly, spinal cord compression and spinal cord signal changes. RESULTS Twenty-nine dogs with non-aggressive bone lesions and 20 dogs with aggressive vertebral lesions were included. Non-aggressive lesions had variable T2-weighted fast spin-echo (T2W) signal intensity and the majority displayed low signal intensity on short tau inversion recovery (STIR). Aggressive lesions predominantly had high T2W and STIR signal intensity, with variable signal intensity on T1-weighted spin-echo and contrast enhancement. Aggressive lesions were associated with spinal pain (p < 0.01), new bone formation (p = 0.02), spinal cord compression (p < 0.01) and lymphadenomegaly (p < 0.01). Cortical interruption (p < 0.01) and paravertebral musculature changes (p < 0.01) were the strongest indicative imaging features for aggressive lesions. CONCLUSION Spinal pain, spinal cord compression, new bone formation, lymphadenomegaly and especially cortical interruption and paravertebral musculature signal intensity changes were the best discriminators for differentiating malignant from benign vertebral lesions.
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Felippe RM, Oliveira GM, Barbosa RS, Esteves BD, Gonzaga BMS, Horita SIM, Garzoni LR, Beghini DG, Araújo-Jorge TC, Fragoso VMS. Experimental Social Stress: Dopaminergic Receptors, Oxidative Stress, and c-Fos Protein Are Involved in Highly Aggressive Behavior. Front Cell Neurosci 2021; 15:696834. [PMID: 34489642 PMCID: PMC8418094 DOI: 10.3389/fncel.2021.696834] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/17/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022] Open
Abstract
Aggression is defined as hostile behavior that results in psychological damage, injury and even death among individuals. When aggression presents itself in an exacerbated and constant way, it can be considered escalating or pathological. The association between social stress and the emergence of exacerbated aggressiveness is common and is suggested to be interconnected through very complex neurobiological factors. For example, alterations in the expression of the dopaminergic receptors D1 and D2, reactive oxygen species (ROS) and the c-Fos protein in the cortex have been observed. Our objective was to analyze which factors are involved at the neurobiological level in the highly aggressive response of Swiss Webster adult male mice in a vivarium. In this work, we investigated the relationship among dopaminergic receptors, the production of ROS and the expression of c-Fos. Mice with exacerbated aggression were identified by the model of spontaneous aggression (MSA) based on the grouping of young mice and the regrouping of the same animals in adulthood. During the regrouping, we observed different categories of behavior resulting from social stress, such as (i) highly aggressive animals, (ii) defeated animals, and (iii) harmonic groups. To evaluate the dopaminergic system and the c-Fos protein, we quantified the expression of D1 and D2 dopaminergic receptors by Western blotting and fluorescence immunohistochemistry and that of the c-Fos protein by fluorescence immunohistochemistry. The possible production of ROS was also evaluated through the dihydroethidium (DHE) assay. The results showed that aggressive and subordinate mice showed a reduction in the expression of the D1 receptor, and no significant difference in the expression of the D2 receptor was observed between the groups. In addition, aggressive mice exhibited increased production of ROS and c-Fos protein. Based on our results, we suggest that exacerbated aggression is associated with social stress, dysregulation of the dopaminergic system and exacerbated ROS production, which leads to a state of cellular oxidative stress. The overexpression of c-Fos due to social stress suggests an attempt by the cell to produce antioxidant agents to reduce the toxic cellular concentration of ROS.
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Affiliation(s)
- Renata M Felippe
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Gabriel M Oliveira
- Laboratory of Cell Biology, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rafaela S Barbosa
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Betina D Esteves
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz M S Gonzaga
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Samuel I M Horita
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratory on Thymus Research, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luciana R Garzoni
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Daniela G Beghini
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Tânia C Araújo-Jorge
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Viviane M S Fragoso
- Laboratory of Innovations in Therapies, Education and Bioproducts, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Martin-Palacio ME, Avilés-Dávila AF, Di-Giusto C, Bueno-Álvarez JA, García-Rodríguez MS, Cedeira-Costales JM. Comparison of Emotional Behaviour of Spanish, Chilean and England Adolescents, and Their Relationship with Effective Personality. Int J Environ Res Public Health 2021; 18:8611. [PMID: 34444361 DOI: 10.3390/ijerph18168611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022]
Abstract
Analysing the emotional behaviour of adolescents is fundamental because of its relationship with maladaptive behaviour and even possible psychological maladjustments. For this reason, this study had two objectives: to analyse the existence of significant differences in socio-emotional behaviour in English, Spanish, and Chilean adolescents, taking gender into account, and to analyse the relationship between emotional behaviour and the effective personality model in the Spanish and Chilean samples. A total of 2534 adolescents participated (609 English, 1677 Spanish, and 248 Chilean). The Abbreviated Scale of Emotional Behaviour (ECEA_R: aggressive tendency, social reactivity, and social support) and the Effective Personality Questionnaire-Adolescents (CPE-A: academic self-realisation, socio-affective self-realisation, and resolute efficacy) were applied. A MANOVA was carried out to study the differences in adolescents' socio-emotional behaviour, taking gender and nationality into account, and a correlational analysis was undertaken to explore the relationship between the variables of emotional behaviour (aggressive tendency, social reactivity, and social support) and effective personality (academic self-realisation, socio-affective self-realisation, and resolute efficacy). Regarding the first objective, for aggressive tendency, English male adolescents stood out, followed by Spanish and Chilean male adolescents and females of all nationalities. In terms of social reactivity, female adolescents stood out over male adolescents and, with regard to social support, Spanish adolescents (male and female) stood out over other nationalities, followed by Chilean and English adolescents (males and females). The results of the second objective indicated a negative relationship between aggressive tendency and academic self-realisation, but a positive relationship for social reactivity and social support (only in the Spanish sample) with most of the effective personality factors. The results are relevant for the application of prevention and intervention programs that improve or implement social and affective competencies in adolescents who develop the effective personality construct.
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Onsun N, Dizman D, Emiroğlu N, Yildiz P, Akaslan TÇ, Tosuner Z, Çetin G, Demirkesen C. Challenges in early diagnosis of primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma: a case series of four patients. Eur J Dermatol 2020; 30:358-61. [PMID: 32969796 DOI: 10.1684/ejd.2020.3843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma (AECTCL) is a rare and aggressive lymphoma characterised by ulcerated lesions and a poor prognosis. OBJECTIVES To present a case series of four previously misdiagnosed AECTCL patients and discuss the importance of early diagnosis. MATERIALS AND METHODS All patients in this study were identified from the database of the Dermatology Department of the Medical School of Bezmialem Vakif University, based on clinical and histopathological diagnosis of AECTCL between 2010 and 2018. RESULTS AECTCL cases may mimic many benign dermatoses and accurate diagnosis may be delayed. CONCLUSION Because of its poor prognosis, early diagnosis of AECTCL may be helpful in improving the likelihood of patient survival, but further study is needed to address the challenges in diagnosing this rare and aggressive lymphoma.
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Yosif AA, Bakhiet SM, Abdalla TH, Mhmoud NA, Siddig EE, Fahal AH. Invasive, aggressive mastoid bone eumycetoma: a treatment challenge. Trans R Soc Trop Med Hyg 2021; 115:431-435. [PMID: 33682008 DOI: 10.1093/trstmh/trab031] [Citation(s) in RCA: 1] [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] [Received: 09/22/2020] [Revised: 11/11/2020] [Accepted: 02/12/2021] [Indexed: 11/14/2022] Open
Abstract
Mycetoma is a chronic granulomatous disease that significant affects the subcutaneous tissue and deep structures. Mycetoma is caused by certain fungi (eumycetoma) or higher bacteria (actinomycetoma). The clinical presentation is variable and depends on the causative agent. For proper treatment and patient management, an accurate diagnosis of the species is mandatory. The disease mainly involves the extremities and it is rarely seen in the head and neck or other sites. In this communication, we present an interesting case of both invasive and aggressive mastoid bone eumycetoma caused by Madurella mycetomatis. Such cases are defied by complex challenges in finding effective surgical and medical treatments when the patient does not respond to both prolonged and different antifungal therapies.
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Affiliation(s)
| | - Sahar Mubarak Bakhiet
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.,Institute for Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Tagwa Hayder Abdalla
- Otolaryngology, Head and Neck Surgery Department, Soba University Hospital, University of Khartoum, Khartoum, Sudan
| | - Najwa Adam Mhmoud
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.,Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Emmanuel Edwar Siddig
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.,Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
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Affiliation(s)
- Naman Kirit Pandya
- Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences Sawangi, Wardha, Maharastra, India
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Goel D, Rana C, Babu S, Ramakant P. Primary squamous cell carcinoma, breast: A challenging diagnosis. Cancer Rep (Hoboken) 2021; 4:e1391. [PMID: 33951352 PMCID: PMC8551986 DOI: 10.1002/cnr2.1391] [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: 08/03/2020] [Revised: 02/23/2021] [Accepted: 03/26/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Primary squamous cell carcinoma of the breast is an extremely rare malignancy constituting less than 0.1% of all breast cancers with very few cases reported in literature. It is an aggressive, triple-hormone negative tumor, and its appropriate management is still debated. It is diagnostically challenging on both histopathology as well as radiology. Different diagnostic criteria are established for its definite diagnosis. As squamous cells are not found normally in the breast, various theories have been proposed regarding its origin. But the exact pathogenesis is still unclear. We report one such case encountered. CASE A 54-year-old female presented with gradually progressive painless lump in the right breast for 3 months with no other clinical features. There was neither any history of chronic or malignant disease in the patient nor in her family. On clinical examination, there was well-defined, firm and nontender swelling in upper inner quadrant measuring 3 × 2 cm with overlying skin being normal. There was no swelling in the contralateral breast as well as in the bilateral axillary region. A suspicion of malignancy was raised on initial core needle biopsy and, on repeat biopsy, was diagnosed as metaplastic carcinoma with squamous differentiation. Later, on final resection, specimen was reported as primary squamous cell carcinoma of the breast without any nodal metastasis. All the metastatic causes were ruled out through proper clinical, radiological, and histopathological correlation. CONCLUSION Primary squamous cell carcinoma of the breast is an aggressive tumor with its treatment protocol being still unclear, owing to its rarity. It is important to rule out the metastatic causes. It is relatively resistant to conventional chemotherapy, and its prognosis is also unpredictable. Hence, this requires further studies in terms of management and prognosis.
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Affiliation(s)
- Divya Goel
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Chanchal Rana
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Suresh Babu
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Pooja Ramakant
- Department of Endocrine surgery, King George's Medical University, Lucknow, India
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Song J, Ma S, Sokoll LJ, Eguez RV, Höti N, Zhang H, Mohr P, Dua R, Patil D, May KD, Williams S, Arnold R, Sanda MG, Chan DW, Zhang Z. A panel of selected serum protein biomarkers for the detection of aggressive prostate cancer. Theranostics 2021; 11:6214-6224. [PMID: 33995654 PMCID: PMC8120218 DOI: 10.7150/thno.55676] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/05/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Current PSA-based tests used to detect prostate cancer (PCa) lack sufficient specificity, leading to significant overdetection and overtreatment. Our previous studies showed that serum fucosylated PSA (Fuc-PSA) and soluble TEK receptor tyrosine kinase (Tie-2) had the ability to predict aggressive (AG) PCa. Additional biomarkers are needed to address this significant clinical problem. Methods: A comprehensive Pubmed search followed by multiplex immunoassays identified candidate biomarkers associated with AG PCa. Subsequently, multiplex and lectin-based immunoassays were applied to a case-control set of sera from subjects with AG PCa, low risk PCa, and non-PCa (biopsy negative). These candidate biomarkers were further evaluated for their ability as panels to complement the prostate health index (phi) in detecting AG PCa. Results: When combined through logistic regression, two panel of biomarkers achieved the best performance: 1) phi, Fuc-PSA, SDC1, and GDF-15 for the detection of AG from low risk PCa and 2) phi, Fuc-PSA, SDC1, and Tie-2 for the detection of AG from low risk PCa and non-PCa, with noticeable improvements in ROC analysis over phi alone (AUCs: 0.942 vs 0.872, and 0.934 vs 0.898, respectively). At a fixed sensitivity of 95%, the panels improved specificity with statistical significance in detecting AG from low risk PCa (76.0% vs 56%, p=0.029), and from low risk PCa and non-PCa (78.2% vs 65.5%, p=0.010). Conclusions: Multivariate panels of serum biomarkers identified in this study demonstrated clinically meaningful improvement over the performance of phi, and warrant further clinical validation, which may contribute to the management of PCa.
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Affiliation(s)
- Jin Song
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Shiyong Ma
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lori J. Sokoll
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Rodrigo V. Eguez
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Naseruddin Höti
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Hui Zhang
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Phaedre Mohr
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Renu Dua
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Kristen Douglas May
- Department of Urology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Sierra Williams
- Department of Urology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Rebecca Arnold
- Department of Urology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Martin G. Sanda
- Department of Urology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Daniel W. Chan
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Zhen Zhang
- Center for Biomarker Discovery and Translation, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
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Piciu A, Cainap C, Sur D, Havasi A, Fetica B, Balacescu O, Mester A, Cainap S. RARE MALIGNANT FEMALE ADNEXAL TUMOR OF WOLFFIAN ORIGIN (FATWO) WITH MULTIPLE RELAPSES AND CHEMOTHERAPY REGIMENS. Acta Endocrinol (Buchar) 2021; 17:259-265. [PMID: 34925577 PMCID: PMC8665256 DOI: 10.4183/aeb.2021.259] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
CONTEXT Female adnexal tumors of probable Wolffian origin (FATWO) represent very rare borderline ovarian tumors with low malignant potential. Only 15 cases of malignant FATWO are described in the current literature, among which, only 5 are reported as being recurrent. OBJECTIVE Due to the rare presentation of the recurrence of the malignant FATWO and the few cases reported in the scientific database, there are no clear therapy recommendations. This paper should help practitioners to choose the best therapy approach. DESIGN This paper presents the 6th case of malignant recurrent FATWO and will compare all the cases available in the literature. SUBJECTS AND METHODS We present a review of the literature comparing the therapeutic approaches and outcomes of all the five cases of recurrent malignant FATWOs. Also, we introduce the case of a stage III Wolffian origin adnexal tumor with multiple recurrences appeared after 6 years of disease free interval. RESULTS Our case presents the longest survival reported in the literature and underwent most surgical procedures of the recurrences and more than 4 lines of chemotherapy regimens. CONCLUSIONS This paper shows possible therapeutic approaches to be used as example by the practitioners according to the drug availability in their centers.
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Affiliation(s)
- A. Piciu
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Medical Oncology, Cluj-Napoca, Romania
| | - C. Cainap
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Medical Oncology, Cluj-Napoca, Romania
| | - D. Sur
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Medical Oncology, Cluj-Napoca, Romania
| | - A. Havasi
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Medical Oncology, Cluj-Napoca, Romania
| | - B. Fetica
- “Prof Dr Ion Chiricuta” Oncology Institute - Pathology and Molecular Biology, Cluj-Napoca, Romania
| | - O. Balacescu
- “Prof Dr Ion Chiricuta” Oncology Institute - Pathology and Molecular Biology, Cluj-Napoca, Romania
| | - A. Mester
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Oral Health, Cluj-Napoca, Romania
| | - S. Cainap
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Faculty of Medicine - Mother & Child, Emergency County Hospital, 2 Pediatric Clinic, Cluj-Napoca, Romania
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Li Y, Wu L, Quan T, Fu J, Cao L, Li X, Liang S, Huang M, Deng Y, Yu J. Characteristic of Tumor Regrowth After Gamma Knife Radiosurgery and Outcomes of Repeat Gamma Knife Radiosurgery in Nonfunctioning Pituitary Adenomas. Front Oncol 2021; 11:627428. [PMID: 33763363 PMCID: PMC7982800 DOI: 10.3389/fonc.2021.627428] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/21/2021] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to report the characteristic of tumor regrowth after gamma knife radiosurgery (GKRS) and outcomes of repeat GKRS in nonfunctioning pituitary adenomas (NFPAs). Design and Methods This retrospective study consisted of 369 NFPA patients treated with GKRS. The median age was 45.2 (range, 7.2–84.0) years. The median tumor volume was 3.5 (range, 0.1–44.3) cm3. Results Twenty-four patients (6.5%) were confirmed as regrowth after GKRS. The regrowth-free survivals were 100%, 98%, 97%, 86% and 77% at 1, 3, 5, 10 and 15 year, respectively. In multivariate analysis, parasellar invasion and margin dose (<12 Gy) were associated with tumor regrowth (hazard ratio [HR] = 3.125, 95% confidence interval [CI] = 1.318–7.410, p = 0.010 and HR = 3.359, 95% CI = 1.347–8.379, p = 0.009, respectively). The median time of regrowth was 86.1 (range, 23.2–236.0) months. Previous surgery was associated with tumor regrowth out of field (p = 0.033). Twelve patients underwent repeat GKRS, including regrowth in (n = 8) and out of field (n = 4). Tumor shrunk in seven patients (58.3%), remained stable in one (8.3%) and regrowth in four (33.3%) with a median repeat GKRS margin dose of 12 (range, 10.0–14.0) Gy. The actuarial tumor control rates were 100%, 90%, 90%, 68%, and 68% at 1, 3, 5, 10, and 15 years after repeat GKRS, respectively. Conclusions Parasellar invasion and tumor margin dose (<12 Gy) were independent risk factors for tumor regrowth after GKRS. Repeat GKRS might be effective on tumor control for selected patients. For regrowth in field due to relatively insufficient radiation dose, repeat GKRS might offer satisfactory tumor control. For regrowth out of field, preventing regrowth out of field was the key management. Sufficient target coverage and close follow-up might be helpful.
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Affiliation(s)
- Yanli Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lisha Wu
- Department of Medical Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tingting Quan
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Junyi Fu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Linhui Cao
- Department of Traditional Chinese Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Li
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shunyao Liang
- Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Minyi Huang
- Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yinhui Deng
- Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinxiu Yu
- Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Shen XZ, Wang W, Luo ZY. 18F-FDG PET/CT imaging for aggressive melanotic schwannoma of the L3 spinal root: A case report. Medicine (Baltimore) 2021; 100:e24803. [PMID: 33663098 PMCID: PMC7909145 DOI: 10.1097/md.0000000000024803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Melanotic schwannoma (MS) is an unusual variant of a nerve sheath neoplasm that accounts for less than 1% of all primary peripheral nerve sheath tumors. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has unique value in detecting malignant MS lesions. To date, only 4 cases of MS with hepatic metastasis have been reported. Herein, we report the fifth case, which is the first reported patient with MS of Asian ethnicity with hepatic metastasis. PATIENT CONCERNS A 29-year-old woman with a 1-day history of backache was admitted to our hospital. PET/CT showed a paravertebral heterogeneous soft tissue mass along the spinal nerve at the L2-L3 level with strong FDG uptake, and a nodule with increased FDG uptake in the lateral lobe of the left liver. DIAGNOSIS A puncture biopsy of the L3 bony destruction and surrounding soft tissue mass was performed. The final diagnosis was spinal MS with hepatic metastasis. INTERVENTIONS The patient underwent 6 courses of systemic chemotherapy. OUTCOMES The patient did not receive further treatment for half a year after the end of chemotherapy and recovered well. LESSONS Unlike conventional schwannomas, which are completely benign, MS has an unpredictable prognosis. It is thought to have low malignant potential, and the malignant type tends to metastasize. FDG PET/CT has a unique and important value in the differential diagnosis of benign and malignant lesions, in detecting occult metastases, monitoring the treatment response, and assessing the prognosis of MS.
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Affiliation(s)
- Xun-Ze Shen
- PET/CT Center, Shaoxing People's Hospital, the First Affiliated Hospital of Shaoxing University, 568 Zhongxing North Rd, Shaoxing City
| | - Wei Wang
- Wei Wang, Department of Pathology, Zhejiang Provincial People's hospital, Hangzhou City, Zhejiang Province, China
| | - Zhou-Ye Luo
- PET/CT Center, Shaoxing People's Hospital, the First Affiliated Hospital of Shaoxing University, 568 Zhongxing North Rd, Shaoxing City
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Rezaei Z, Sadri F. MicroRNAs Involved in Inflammatory Breast Cancer: Oncogene and Tumor Suppressors with Possible Targets. DNA Cell Biol 2021; 40:499-512. [PMID: 33493414 DOI: 10.1089/dna.2020.6320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Inflammatory breast cancer (IBC) as a rare and highly aggressive type of breast cancer displays phenotypic characteristics. To date, the IBC-associated molecular mechanisms are entirely unknown. In addition, there is an urgent need to identify the new biomarkers involved in the diagnosis and therapeutic purposes of IBC. MicroRNAs, a category of short noncoding RNAs, are capable of controlling the post-transcriptional expression of genes and thus can act as diagnostic predictive tools. In this review, we addressed the status of oncogenic and tumor suppressor miRNA-mediated IBC in current studies. Furthermore, based on their targets, their involvement in cancer progression, angiogenesis, metastasis, and apoptosis were determined.
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Affiliation(s)
- Zohreh Rezaei
- Department of Biology, University of Sistan and Baluchestan, Zahedan, Iran.,Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farzad Sadri
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Young Researchers and Elite Club, Yasooj Branch, Islamic Azad University, Yasooj, Iran
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Krackeler ML, Broome C, Lai C. Complete remission of aggressive T-cell LGL leukemia with pentostatin therapy: first case report. Stem Cell Investig 2021; 7:24. [PMID: 33437844 DOI: 10.21037/sci-2020-035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/10/2020] [Indexed: 11/06/2022]
Abstract
This is the first report of a complete remission in aggressive T-cell large granular lymphocytic (T-LGL) leukemia after treatment with pentostatin. The aggressive variant of the disease is rare, and traditional therapies include immunosuppressive agents, however, there is no standard consensus for treatment. Cytotoxic chemotherapy has led to remission in a few reported cases. We present this unique case as an alternative treatment for individuals refractory to chemotherapy. A 55-year-old African American male with hypertension, type II diabetes mellitus, hyperlipidemia, and gout presented with symptoms of multiple ecchymosis, fatigue, and weight loss. He was found to have splenomegaly (SM) and significant leukocytosis to 101 k/µL with 30% blasts on peripheral smear. Following bone marrow aspiration and biopsy with flow cytometry, he was diagnosed with aggressive T-LGL leukemia. The chemotherapy regimen hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone) was initially chosen based on his clinical presentation but was refractory to treatment. His therapy was changed to alemtuzumab; however, patient tolerated poorly and did not respond. Pentostatin was added to alemtuzumab with improvement in clinical symptoms and laboratory parameters. The patient was transitioned to pentostatin monotherapy and achieved complete remission after 1 month. This report provides support for pentostatin as an effective treatment for patients with aggressive T-cell malignancies refractory to cytotoxic chemotherapy. Pentostatin has previously been studied to treat T-cell prolymphocytic leukemia (T-PLL), hairy cell leukemia, and marginal zone lymphoma. This case suggests an alternative, well-tolerated option that could be considered for initial therapy of aggressive T-LGL leukemia.
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Affiliation(s)
| | - Catherine Broome
- Medstar Georgetown University Hospital, Lombardi Cancer Center, Washington, DC, USA
| | - Catherine Lai
- Medstar Georgetown University Hospital, Lombardi Cancer Center, Washington, DC, USA
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Gilgunn S, Murphy K, Stöckmann H, Conroy PJ, Murphy TB, Watson RW, O’Kennedy RJ, Rudd PM, Saldova R. Glycosylation in Indolent, Significant and Aggressive Prostate Cancer by Automated High-Throughput N-Glycan Profiling. Int J Mol Sci 2020; 21:ijms21239233. [PMID: 33287410 PMCID: PMC7730228 DOI: 10.3390/ijms21239233] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022] Open
Abstract
The diagnosis and treatment of prostate cancer (PCa) is a major health-care concern worldwide. This cancer can manifest itself in many distinct forms and the transition from clinically indolent PCa to the more invasive aggressive form remains poorly understood. It is now universally accepted that glycan expression patterns change with the cellular modifications that accompany the onset of tumorigenesis. The aim of this study was to investigate if differential glycosylation patterns could distinguish between indolent, significant, and aggressive PCa. Whole serum N-glycan profiling was carried out on 117 prostate cancer patients’ serum using our automated, high-throughput analysis platform for glycan-profiling which utilizes ultra-performance liquid chromatography (UPLC) to obtain high resolution separation of N-linked glycans released from the serum glycoproteins. We observed increases in hybrid, oligomannose, and biantennary digalactosylated monosialylated glycans (M5A1G1S1, M8, and A2G2S1), bisecting glycans (A2B, A2(6)BG1) and monoantennary glycans (A1), and decreases in triantennary trigalactosylated trisialylated glycans with and without core fucose (A3G3S3 and FA3G3S3) with PCa progression from indolent through significant and aggressive disease. These changes give us an insight into the disease pathogenesis and identify potential biomarkers for monitoring the PCa progression, however these need further confirmation studies.
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Affiliation(s)
- Sarah Gilgunn
- School of Biotechnology, Dublin City University, D09 V209 Dublin 9, Ireland; (S.G.); (R.J.O.)
- National Centre for Sensor Research, Biomedical Diagnostics Institute, Dublin City University, D09 V209 Dublin 9, Ireland
| | - Keefe Murphy
- Department of Mathematics and Statistics, Maynooth University, Maynooth, W23 F2K8 Co. Kildare, Ireland;
| | - Henning Stöckmann
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Fosters Avenue, Mount Merrion, Blackrock, A94 X099 Co. Dublin, Ireland; (H.S.); (P.M.R.)
| | - Paul J. Conroy
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC 3800, Australia;
| | - T. Brendan Murphy
- UCD School of Mathematics and Statistics, University College Dublin, D04 V1W8 Dublin 4, Ireland;
| | - R. William Watson
- Conway Institute of Biomolecular and Biomedical Research, University College Dublin, D04 V1W8 Dublin 4, Ireland;
- UCD School of Medicine, College of Health and Agricultural Science, University College Dublin, D04 V1W8 Dublin 4, Ireland
| | - Richard J. O’Kennedy
- School of Biotechnology, Dublin City University, D09 V209 Dublin 9, Ireland; (S.G.); (R.J.O.)
- National Centre for Sensor Research, Biomedical Diagnostics Institute, Dublin City University, D09 V209 Dublin 9, Ireland
- Research, Development and Innovation, Qatar Foundation, Luqta Street, Doha 5825, Qatar
| | - Pauline M. Rudd
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Fosters Avenue, Mount Merrion, Blackrock, A94 X099 Co. Dublin, Ireland; (H.S.); (P.M.R.)
- Bioprocessing Technology Institute, 20 Biopolis Way, #06-01 Centros, Singapore 138668, Singapore
| | - Radka Saldova
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Fosters Avenue, Mount Merrion, Blackrock, A94 X099 Co. Dublin, Ireland; (H.S.); (P.M.R.)
- UCD School of Medicine, College of Health and Agricultural Science, University College Dublin, D04 V1W8 Dublin 4, Ireland
- Correspondence: ; Tel.: +353-1215-8147
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Jafri ZA, Reddy SP, Cassarino DS. KRAS 117N positive Rosai-Dorfman disease with atypical features. J Cutan Pathol 2020; 48:147-150. [PMID: 32974961 DOI: 10.1111/cup.13883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/22/2020] [Accepted: 09/12/2020] [Indexed: 11/28/2022]
Abstract
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare disease typically characterized by a histiocytic proliferation within lymph nodes, which is due to an unknown etiology. Extranodal involvement can occur, and it more rarely can involve the skin. RDD generally presents with an indolent nature and follows a benign disease course, although more aggressive cases have been reported. The condition predominately affects children and young adults. It is classically characterized by massive, bilateral painless lymphadenopathy and accumulation of CD68-positive, S100-positive, CD1a-negative histiocytes, with the presence of emperipolesis as a hallmark. Herein, we present an aggressive case in a 76-year-old male with past medical history significant for prostate cancer, who presented with a 7-month history of lymphadenopathy and new onset of multiple large abdominal wall, cutaneous, lymph node, liver, and lung masses, all of which were histopathologically atypical, but showed features consistent with RDD, including emperipolesis and strong S100 positivity. Molecular studies showed a KRAS 117N mutation, which has been recently reported in RDD. While most cases present as a benign tumor, this case demonstrated aggressive features clinically, showed partial response to MEK inhibitor immunotherapy in the setting of a KRAS mutation, and demonstrated atypical cytologic features on histopathology.
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Affiliation(s)
- Zainab A Jafri
- Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | - Shivani P Reddy
- Departments of Pathology and Dermatology, Kaiser Permanente, Sunset Medical Center, Los Angeles, California, USA
| | - David S Cassarino
- Departments of Pathology and Dermatology, Kaiser Permanente, Sunset Medical Center, Los Angeles, California, USA
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Crombé A, Kind M, Ray-Coquard I, Isambert N, Chevreau C, André T, Lebbe C, Cesne AL, Bompas E, Piperno-Neumann S, Saada E, Bouhamama A, Blay JY, Italiano A; French Sarcoma Group. Progressive Desmoid Tumor: Radiomics Compared With Conventional Response Criteria for Predicting Progression During Systemic Therapy-A Multicenter Study by the French Sarcoma Group. AJR Am J Roentgenol 2020; 215:1539-48. [PMID: 32991215 DOI: 10.2214/AJR.19.22635] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE. The response of desmoid tumors (DTs) to chemotherapy is evaluated with Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) in daily practice and clinical trials. MRI shows early change in heterogeneity in responding tumors due to a decrease in cellular area and an increase in fibronecrotic content before dimensional response. Heterogeneity can be quantified with radiomics. Our aim was to develop radiomics-based response criteria and to compare their performances with clinical and radiologic response criteria. MATERIALS AND METHODS. Forty-two patients (median age, 38.2 years) were included in this retrospective multicenter study because they presented with progressive DT and had an MRI examination at baseline, which we refer to as "MRI-0," and an early MRI evaluation performed after the first chemotherapy cycle (mean time after first chemotherapy cycle, 3 months [SD, 28 days]), which we refer to as "MRI-1." After signal intensity normalization, voxel size standardization, discretization, and segmentation of DT volume on fat-suppressed contrast-enhanced T1-weighted imaging, 90 baseline and delta 3D radiomics features were extracted. Using cross-validation and least absolute shrinkage and selection operator-penalized Cox regression, a radiomics score was generated. The performances of models based on the radiomics score, modified Response Evaluation Criteria in Solid Tumors, European Association for the Study of the Liver criteria, Cheson criteria, Choi criteria, and revised Choi criteria from MRI-0 to MRI-1 to predict progression-free survival (PFS, as defined by RECIST 1.1) were assessed with the concordance index. The results were adjusted for performance status, tumor volume, prior chemotherapy, current chemotherapy, and β-catenin mutation. RESULTS. There were 10 cases of progression. The radiomics score included four variables. A high score indicated a poor prognosis. The radiomics score independently correlated with PFS (adjusted hazard ratio = 5.60, p = 0.003), and none of the usual response criteria independently correlated with PFS. The prognostic model based on the radiomics score had the highest concordance index (0.84; 95% CI, 0.71-0.96). CONCLUSION. Quantifying early changes in heterogeneity through a dedicated radiomics score could improve response evaluation for patients with DT undergoing chemotherapy.
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Piciu A, Mester A, Rusu G, Piciu D. Challenges in the Correct Assessment of a Case of Aggressive Thyroid Carcinoma with Synchronous Breast Cancer: A Case Report and Review of the Literature of Essential Role of Radiopharmaceuticals. Curr Radiopharm 2020; 14:85-91. [PMID: 32988358 DOI: 10.2174/1874471013666200928105151] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Thyroid carcinoma represents a complex pathology that can still be considered a medical challenge, despite having a better prognosis and life expectancy than most other neoplasms; also the scenario of multiple malignancies involving thyroid cancer is nowadays a common reality. MATERIALS AND METHODS We reviewed the literature regarding the aggressive presentation of synchronous thyroid and breast cancer. In the current paper, we report the case of a 59 years-old woman, diagnosed with invasive ductal breast carcinoma and papillary thyroid carcinoma, presenting a natural history of both aggressive synchronous tumors. At the moment of hospitalization, the diagnosis was breast carcinoma with multiple secondary lesions, suggestive of lung and bone metastases, and nodular goiter. RESULTS Searching the literature in PUBMED with the terms "thyroid carcinoma and synchronous breast carcinoma, we found 86 studies; introducing the term "aggressive," the result included 4 studies, among which, none showed to be relevant to the terms aggressive and synchronous. A similar search was done in SCOPUS finding 92 documents and after introducing the term aggressive, the number of papers was 8, none including the literature on synchronous aggressive metastatic thyroid and breast carcinoma. A majority of imaging diagnostic tools were used in this particular medical case in order to ensure the best potential outcome. The final diagnosis was papillary thyroid carcinoma with lung and unusual multiple bone metastases and synchronous invasive ductal breast carcinoma with subcutaneous metastases. CONCLUSION The case illustrates the challenges in the correct assessment of oncologic patients, despite the advances in medical imaging and technologies and underlines the essential role of nuclear medicine procedures in the diagnostic and therapy protocols.
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Affiliation(s)
- Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Alexandru Mester
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - George Rusu
- Department of Endocrine Tumors and Nuclear Medicine Institute of Oncology Ion Chiricuta 400015 Cluj-- Napoca, Romania
| | - Doina Piciu
- Department of Endocrine Tumors and Nuclear Medicine Institute of Oncology Ion Chiricuta 400015 Cluj-- Napoca, Romania
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Soliman M, Mowafy K, Elsaadany NA, Soliman R, Elmetwally A. Thromboangiitis obliterans: Aggressive angioplasty provides a potential solution (randomized pilot study). SAGE Open Med 2020; 8:2050312120927636. [PMID: 32551111 PMCID: PMC7278296 DOI: 10.1177/2050312120927636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/03/2019] [Accepted: 04/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Thromboangiitis obliterans is an inflammatory disease affecting both medium- and small-sized vessels. Vasodilators, antiplatelets were proposed for treatment but the effect was minimal. Objective This study was conducted to investigate the effect of balloon angioplasty on patients with Buerger's disease compared to medical treatment. Methods Between January 2006 and December 2016, 82 patients with Buerger's disease were enrolled in the study, of whom 52 were randomized to the aggressive endovascular intervention and 30 were randomized medically by cilostazol and aspirin as a control group. In all, 23% of the patients presented with severe claudication, 50% with ischemic rest pain and 27% with ischemic ulcers. Randomization was done using the opaque envelope method. Allocation concealment was maintained to ensure no selection bias. Patient groups were compared for the duration of ulcer healing, ankle-brachial index, peak systolic velocity changes and transcutaneous oximetry (TcPO2) level for 30 months. Results No major procedural complications occurred in the endovascular group. Angiographic success was achieved in 100% of supragenicular lesions but in 90% of infrapopliteal lesions. The endovascular group showed a statistically significant improvement in the ulcer healing size and duration at 6 months after the procedure with a mean time of 3 ± 0.9 months compared to 5.8 ± 1.69 months for the medical treatment group (p < 0.001), the mean TcPO2 from 27.23 ± 16.75 mm Hg (range: 0-56 mm Hg) before the procedure to 71.32 ± 12.94 mm Hg (range: 52-92 mm Hg) following revascularization (p < 0.01). The mean ankle-brachial index significantly improved from 0.54 ± 0.14 preoperatively to 0.82 ± 0.08 at final follow-up (p < 0.01). Conclusion The endovascular therapy should be considered as an effective, safe, minimally invasive method in the light of the promising results after a modification of the standard technique.
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Affiliation(s)
- Mosaad Soliman
- Department of Vascular Surgery, Mansoura University, Mansoura, Egypt
| | - Khaled Mowafy
- Department of Vascular Surgery, Mansoura University, Mansoura, Egypt
| | - N A Elsaadany
- Department of Vascular Surgery, Mansoura University, Mansoura, Egypt
| | - Reem Soliman
- Department of Vascular Surgery, Mansoura University, Mansoura, Egypt
| | - Ahmed Elmetwally
- Department of Vascular Surgery, Mansoura University, Mansoura, Egypt
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