1
|
Russell DH, Epstein JI. Intraductal Adenocarcinoma of the Prostate With Cribriform or Papillary Ductal Morphology: Rare Biopsy Cases Lacking Associated Invasive High-grade Carcinoma. Am J Surg Pathol 2022; 46:233-240. [PMID: 34619708 DOI: 10.1097/pas.0000000000001819] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Prostatic duct adenocarcinoma, characterized by pseudostratified columnar epithelium, has historically been considered invasive carcinoma, although it may commonly have an intraductal component. Usual (acinar) intraductal carcinoma of the prostate (IDC-P) is a noninvasive high-risk lesion typically associated with high-grade, high-stage prostate cancer. Whereas there have been rare biopsy studies of pure acinar IDC-P or IDC-P associated with only low-grade carcinoma, there have been no analogous series of IDC-P with cribriform or papillary ductal morphology on biopsy unassociated with invasive high-grade carcinoma. We identified 14 patients with biopsies showing IDC-P with ductal morphology, defined as prostatic duct adenocarcinoma confined to glands/ducts with immunohistochemically proven retention of basal cells. Our series includes 12 patients with pure IDC-P and 2 patients with concurrent low-volume Grade Group 1 invasive cancer in unassociated cores. Three patients underwent radical prostatectomy: 2/3 had high-grade cancer in their resection specimen (Grade Group 3, Grade Group 5), including 1 with advanced stage and nodal metastases; 1/3 had Grade Group 1 organ-confined carcinoma and spatially distinct IDC-P with ductal morphology. Five men had only follow-up biopsies: 2/5 had cancer (Grade Group 2, Grade Group 4); 1/5 had IDC-P (on 2 repeat biopsies); and 2/5 had benign transurethral resection of the prostate. In all 5 cases with invasive cancer, the invasive portion was comprised purely of acinar morphology; no invasive ductal component was identified. Five patients did not have follow-up biopsies and were treated with radiation therapy±androgen deprivation. One patient had no follow-up information. In an analogous situation to acinar IDC-P, we propose that rarely there is a precursor form of ductal adenocarcinoma that can exist without concurrent invasive high-grade carcinoma and propose the term "IDC-P with ductal morphology," consistent with the terminology for acinar prostate adenocarcinoma. Until more evidence is accumulated, we recommend reporting and treating patients with IDC-P with ductal morphology in a manner analogous to those with acinar IDC-P. As with pure IDC-P with acinar morphology, we would also recommend not grading pure IDC-P with ductal morphology. Finally, we propose a new addition to the diagnostic criteria of IDC-P to include intraductal lesions with ductal morphology consisting of papillary fronds or cribriform lesions lined by cytologically atypical pseudostratified epithelium.
Collapse
Affiliation(s)
| | - Jonathan I Epstein
- Departments of Pathology
- Urology
- Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD
| |
Collapse
|
2
|
Chow P, Goddard L, Greenway HT, Kelley BF. Squamoid Eccrine Ductal Carcinoma: The Scripps Experience. Dermatol Surg 2021; 47:1115-1117. [PMID: 34115678 DOI: 10.1097/dss.0000000000002906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
MESH Headings
- Aged
- Aged, 80 and over
- Biopsy
- Carcinoma, Ductal/diagnosis
- Carcinoma, Ductal/pathology
- Carcinoma, Ductal/therapy
- Carcinoma, Skin Appendage/diagnosis
- Carcinoma, Skin Appendage/pathology
- Carcinoma, Skin Appendage/therapy
- Eccrine Glands/pathology
- Eccrine Glands/radiation effects
- Eccrine Glands/surgery
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Mohs Surgery/statistics & numerical data
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/prevention & control
- Radiotherapy, Adjuvant/statistics & numerical data
- Sweat Gland Neoplasms/diagnosis
- Sweat Gland Neoplasms/pathology
- Sweat Gland Neoplasms/therapy
- Treatment Outcome
- Tumor Burden
Collapse
Affiliation(s)
- Peter Chow
- Department of Internal Medicine, Scripps Mercy Hospital, San Diego, California
| | - Lindsey Goddard
- Bighorn Mohs Surgery and Dermatology, Scripps Clinic, La Jolla, California
| | - Hubert T Greenway
- Bighorn Mohs Surgery and Dermatology, Scripps Clinic, La Jolla, California
| | - Benjamin F Kelley
- Bighorn Mohs Surgery and Dermatology, Scripps Clinic, La Jolla, California
| |
Collapse
|
3
|
Nakaguro M, Tada Y, Faquin WC, Sadow PM, Wirth LJ, Nagao T. Salivary duct carcinoma: Updates in histology, cytology, molecular biology, and treatment. Cancer Cytopathol 2020; 128:693-703. [PMID: 32421944 PMCID: PMC7541685 DOI: 10.1002/cncy.22288] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [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: 02/21/2020] [Revised: 03/31/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Abstract
Salivary duct carcinoma (SDC) is an aggressive subtype of primary salivary gland carcinoma, often with an advanced stage at presentation and high rates of metastasis and recurrence. It most commonly arises in the parotid gland of older men and microscopically resembles high-grade breast ductal carcinoma. While 50 years have lapsed since the first report of this entity, recent intensive studies have shed light on its biologic, genetic, and clinical characteristics. The diagnosis of SDC is aided by the immunohistochemical expression of androgen receptor (AR) coupled with its characteristic histomorphology. Fine-needle aspiration typically reveals cytologic features of high-grade carcinoma, and ancillary studies using cell block material can facilitate the specific diagnosis of SDC. In surgical specimens, certain histologic features are important prognostic factors, including nuclear pleomorphism, mitotic counts, vascular invasion, and the morphology at the invasion front. Several clinical studies have shown promising results using targeted therapy for AR and human epidermal growth factor receptor 2 (HER2), and the latest version of the National Comprehensive Cancer Network guidelines recommends the evaluation of AR and HER2 status before treatment. Recent molecular analyses have revealed multiple heterogeneous alterations in well-known oncogenes and tumor suppressor genes, including TP53, HRAS, PIK3CA, PTEN, and BRAF. Clinical trials of drugs targeting these genes may broaden the treatment options for SDC in the near future.
Collapse
Affiliation(s)
- Masato Nakaguro
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - William C. Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter M. Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lori J. Wirth
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
4
|
Affiliation(s)
- Kristen Pallok
- From Rush Medical College (K.P., D.A.A.), DePaul University (F.D.M.), and Metropolitan Chicago Breast Cancer Taskforce (D.A.A.) - all in Chicago
| | - Fernando De Maio
- From Rush Medical College (K.P., D.A.A.), DePaul University (F.D.M.), and Metropolitan Chicago Breast Cancer Taskforce (D.A.A.) - all in Chicago
| | - David A Ansell
- From Rush Medical College (K.P., D.A.A.), DePaul University (F.D.M.), and Metropolitan Chicago Breast Cancer Taskforce (D.A.A.) - all in Chicago
| |
Collapse
|
5
|
Affiliation(s)
| | - Anju Nohria
- From the Department of Medicine, Brigham and Women's Hospital, Boston
| | - Harold J Burstein
- From the Department of Medicine, Brigham and Women's Hospital, Boston
| | - Leona A Doyle
- From the Department of Medicine, Brigham and Women's Hospital, Boston
| | - Amy L Miller
- From the Department of Medicine, Brigham and Women's Hospital, Boston
| | - Joseph Loscalzo
- From the Department of Medicine, Brigham and Women's Hospital, Boston
| |
Collapse
|
6
|
Tsai FD, Haddad RI. Toward a Personalized Approach in the Treatment of Salivary Ductal Carcinoma. J Natl Compr Canc Netw 2018; 16:1269-1270. [PMID: 30323095 DOI: 10.6004/jnccn.2018.7089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Zhou Z, Zhang B, Wang H, Yuan A, Hu Y, Wu J. Two-stage oxygen delivery for enhanced radiotherapy by perfluorocarbon nanoparticles. Theranostics 2018; 8:4898-4911. [PMID: 30429876 PMCID: PMC6217071 DOI: 10.7150/thno.27598] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [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] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023] Open
Abstract
Tumors are usually hypoxic, which limits the efficacy of current tumor therapies, especially radiotherapy in which oxygen is essential to promote radiation-induced cell damage. Herein, by taking advantage of the ability of perfluorocarbon (PFC) to promote red blood cell penetration, we developed a simple but effective two-stage oxygen delivery strategy to modulate the hypoxic tumor microenvironment using PFC nanoparticles. Methods: We first examined the two-stage oxygen delivery ability of PFC nanoparticles on relieving tumor hypoxia through platelet inhibition. To evaluate the effect of PFC nanoparticles on radiation sensitization, CT26 tumor and SUM49PT tumor model were used. Results: In this study, PFC was encapsulated into albumin and intravenously injected into tumor-bearing mice without hyperoxic breathing. After accumulation in the tumor, PFC nanoparticles rapidly released the oxygen that was physically dissolved in PFC as the first-stage of oxygen delivery. Then, PFC subsequently promoted red blood cell infiltration, which further released O2 as the second-stage of oxygen delivery. Conclusion: The hypoxic tumor microenvironment was rapidly relieved via two-stage oxygen delivery, effectively increasing radiotherapy efficacy. The safety of all substances used in this study has been clinically demonstrated, ensuring that this simple strategy could be rapidly and easily translated into clinical applications to solve the clinical problems associated with tumor hypoxia.
Collapse
Affiliation(s)
- Zaigang Zhou
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
| | - Baoli Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
| | - Haoran Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
| | - Ahu Yuan
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
| | - Yiqiao Hu
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
- Jiangsu Provincial Key Laboratory for Nano Technology, Nanjing University, Nanjing 210093, China
| | - Jinhui Wu
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University & School of Life Sciences, Nanjing University, Nanjing 210093, China
- Institute of Drug R&D, Nanjing University, Nanjing 210093, China
- Jiangsu Provincial Key Laboratory for Nano Technology, Nanjing University, Nanjing 210093, China
| |
Collapse
|
8
|
Maloney E, Khokhlova T, Pillarisetty VG, Schade GR, Repasky EA, Wang YN, Giuliani L, Primavera M, Hwang JH. Focused ultrasound for immuno-adjuvant treatment of pancreatic cancer: An emerging clinical paradigm in the era of personalized oncotherapy. Int Rev Immunol 2017; 36:338-351. [PMID: 28961038 PMCID: PMC6224292 DOI: 10.1080/08830185.2017.1363199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Indexed: 12/13/2022]
Abstract
Current clinical treatment regimens, including many emergent immune strategies (e.g., checkpoint inhibitors) have done little to affect the devastating course of pancreatic ductal adenocarcinoma (PDA). Clinical trials for PDA often employ multi-modal treatment, and have started to incorporate stromal-targeted therapies, which have shown promising results in early reports. Focused ultrasound (FUS) is one such therapy that is uniquely equipped to address local and systemic limitations of conventional cancer therapies as well as emergent immune therapies for PDA. FUS methods can non-invasively generate mechanical and/or thermal effects that capitalize on the unique oncogenomic/proteomic signature of a tumor. Potential benefits of FUS therapy for PDA include: (1) emulsification of targeted tumor into undenatured antigens in situ, increasing dendritic cell maturation, and increasing intra-tumoral CD8+/ T regulatory cell ratio and CD8+ T cell activity; (2) reduction in intra-tumoral hypoxic stress; (3) modulation of tumor cell membrane protein localization to enhance immunogenicity; (4) modulation of the local cytokine milieu toward a Th1-type inflammatory profile; (5) up-regulation of local chemoattractants; (6) remodeling the tumor stroma; (7) localized delivery of exogenously packaged immune-stimulating antigens, genes and therapeutic drugs. While not all of these results have been studied in experimental PDA models to date, the principles garnered from other solid tumor and disease models have direct relevance to the design of optimal FUS protocols for PDA. In this review, we address the pertinent limitations in current and emergent immune therapies that can be improved with FUS therapy for PDA.
Collapse
Affiliation(s)
- Ezekiel Maloney
- a Department of Radiology , University of Washington , Seattle WA , USA
| | - Tanya Khokhlova
- b Department of Medicine Division of Gastroenterology , University of Washington , Seattle WA , USA
| | | | - George R Schade
- d Department of Urology , University of Washington , Seattle WA , USA
| | - Elizabeth A Repasky
- e Department of Immunology , Roswell Park Cancer Institute , Buffalo NY , USA
| | - Yak-Nam Wang
- f Applied Physics Laboratory , University of Washington , Seattle WA , USA
| | - Lorenzo Giuliani
- g School of Medicine , The Sapienza University of Rome , Rome , Italy
| | - Matteo Primavera
- h School of Medicine , The Sapienza University of Rome , Rome , Italy
| | - Joo Ha Hwang
- i Department of Medicine Division of Gastroenterology , University of Washington , Seattle WA , USA
| |
Collapse
|
9
|
Inoue T, Shimomura A, Sugimoto T, Wakamiya S, Chou U, Fujiwara A, Uchikoshi F, Watanabe T, Kitamura N. [Local Control of Advanced Breast Cancer with Giant Ulcer]. Gan To Kagaku Ryoho 2017; 44:1062-1064. [PMID: 29394534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study reports the treatment and local control of advanced breast cancer with a giant ulcer. A 53-year-old woman presented with a large left breast tumor and an associated giant ulcer, with massive exudates, bleeding, and an offensive odor. Histopathological examination revealed an invasive ductal carcinoma(Luminal B type). Computed tomography(CT) showed multiple metastases to the lymph nodes, lungs, liver and bones. The patient received chemotherapy with a combina- tion of paclitaxel(PTX 90mg/m / 2)and bevacizumab(BEV 10 mg/kg). After 4 courses of chemotherapy, there was a significant reduction in the tumor size, the discharge of exudates and bleeding as well as lumbago and femoral pain. High CEA and CA15-3 levels had been normalized and CT showed a remarkable decrease in metastases. Compared to the tumor itself, the ulcer associated with it had shown a smaller decrease in size, and there was the possibility of perforation in the thin chest wall. Suspecting these outcomes to the adverse events of BEV, its use was discontinued, and starting with course 5 of chemothera- py, we administrated only PTX(90mg/m2). Subsequently, the ulcer showed obvious granulation and was infected. CT of the chest prior to the second course of PTX revealed pleurisy, pneumonia and atelectasis. Following the administration of antibiotics, while infection in the ulcer had subsided, pleurisy and pneumonia continued, with increased right pleural effusion, which finally required drainage. We had to discontinue the administration of PTX. BEV, although effective as first-line therapy, has the adverse effect of slowing wound healing. Therefore, even though the combination therapy of BEV and PTX is markedly effective for systemic therapy, it should be altered for local wound healing as in this case.
Collapse
Affiliation(s)
- Tomoo Inoue
- Dept. of Breast Surgery, Kansai Medical Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Hosseini Ghatar R, Soltantoyeh T, Bahadori M, Khoshnoodi J, Golsaz Shirazi F, Jeddi Tehrani M, Amiri MM, Shokri F. Polyclonal Antibody against Different Extracellular Subdomains of HER2 Induces Tumor Growth Inhibition in vitro. Iran J Immunol 2017; 14:200-214. [PMID: 28919583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2) has a crucial role in several malignancies. The extracellular domain of HER2 (HER2-ECD) has been extensively employed as an important target in passive and active immunotherapy. Isolated recombinant prokaryotic HER2-ECD subdomains were previously found to be ineffective in inducing anti-tumor antibody response. OBJECTIVE To employ recombinant eukaryotic HER2-ECD subdomains to raise anti-HER2 antibodies and determine their anti-tumor activity in vitro. METHODS Two paired subdomains of HER2-ECD (DI+II and DIII+IV), representing Pertuzumab and Trastuzumab binding domains, respectively, along with the full extracellular domain of HER2 were generated in CHO-K1 cells. Polyclonal antibodies were raised against these subdomains and characterized using ELISA, flow cytometry, and immunoblot and their anti-tumor activity was assessed by XTT assay. The cross-reactivity of these antibodies was specified along with other members of the human HER family. RESULTS Similar to Trastuzumab and anti-HER2-ECD antibody, anti-DI+II and DIII+IV polyclonal antibodies reacted with recombinant HER2-ECD and native HER2 expressed on tumor cells. These two polyclonal antibodies were able to inhibit the binding of Pertuzumab and Trastuzumab to HER2, respectively, and did not cross-react with other members of HER family. These antibodies were able to inhibit tumor cell growth in vitro, similar to Trastuzumab. CONCLUSION The high immunogenicity of human HER2 DI+II and DIII+IV subdomains in rabbits and the tumor inhibitory activity of the purified specific antibodies imply that they might be suitable for active immunotherapy in formulation with appropriate adjuvants and in combination with other HER2 specific therapeutics.
Collapse
Affiliation(s)
- Reza Hosseini Ghatar
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Lin X, Hong S, Huang J, Chen Y, Chen Y, Wu Z. Plasma apolipoprotein A1 levels at diagnosis are independent prognostic factors in invasive ductal breast cancer. DISCOVERY MEDICINE 2017; 23:247-258. [PMID: 28595037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Strong evidence exists indicating that the risk of breast cancer (BC) occurrence is influenced by complex internal environmental factors, including blood lipid and lipoprotein components. However, the roles of these components in BC development and progression remain controversial. This study examined whether serial serum lipid and lipoprotein measurements were associated with breast cancer risk and whether lipoproteins had BC prognostic properties. We compared the plasma-related parameter levels, including lipid and lipoprotein levels between 299 patients with invasive ductal breast cancer, also known as invasive ductal carcinoma (IDC), and 200 healthy donors. We performed univariate and multivariate logistic regression analyses to assess overall survival (OS) and disease-free survival (DFS). We found that the serum glucose, triacylglycerol, and low-density lipoprotein levels were significantly higher in patients with IDC than in healthy donors. However, high-density lipoprotein and apolipoprotein A1 (apoA1) levels were lower in patients with IDC than in healthy donors. Multivariate regression analysis demonstrated that elevated apoA1 levels were associated with a reduced risk of IDC, and univariate analysis showed that patients with IDC with lower apoA1 levels at diagnosis had larger tumors than patients with high apoA1 levels. Moreover, patients with IDC with lower apoA1 levels were more likely to have positive axillary lymph nodes, and were diagnosed at more advanced disease stages than patients with high apoA1 levels. We used a Cox regression model to assess the relationships between the above parameters and DFS and OS, after adjusting for tumor T and N stages, which were determined using the TNM classification system, and immunohistochemical subtypes. We found that lower apoA1 levels at diagnosis were associated with poor DFS and OS. At 60 months of follow-up, the DFS rate is 74.5% in the apoA1 L1 group, 89.9% in apoA1 L2 group, and 93.1% in apoA1 L3 group (p=0.0002). Similarly, the OS rate is 78.2% in apoA1 L1 group, 91.3% in apoA1 L2 group, and 93.7% in apoA1 L3 group (p=0.0012). In conclusion, our data indicate that low apoA1 levels are an independent predictor of the poor clinical outcomes in IDC patients.
Collapse
Affiliation(s)
- Xiaorong Lin
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Diagnosis and Treatment Center of Breast Diseases, Shantou Affiliated Hospital of Sun Yat-Sen University, Shantou, Guangdong, China
- These authors contributed equally to this article
| | - Shubin Hong
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
- These authors contributed equally to this article
| | - Jiefeng Huang
- Diagnosis and Treatment Center of Breast Diseases, Shantou Affiliated Hospital of Sun Yat-Sen University, Shantou, Guangdong, China
| | - Yi Chen
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yufeng Chen
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhiyong Wu
- Diagnosis and Treatment Center of Breast Diseases, Shantou Affiliated Hospital of Sun Yat-Sen University, Shantou, Guangdong, China
| |
Collapse
|
12
|
Franklin AE, Lovell MR, Boyle F. A Case of Opioid Toxicity on Conversion From Extended-Release Oxycodone and Naloxone to Extended-Release Oxycodone in a Patient With Liver Dysfunction. J Pain Symptom Manage 2017; 53:e1-e2. [PMID: 27825847 DOI: 10.1016/j.jpainsymman.2016.10.354] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/27/2016] [Accepted: 10/07/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Abigail E Franklin
- HammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, New South Wales, Australia.
| | - Melanie R Lovell
- HammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, New South Wales, Australia; Northern Clinical School and Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Frances Boyle
- Department of Medical Oncology, The University of Sydney, Sydney, New South Wales, Australia; Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Affiliation(s)
- Jennifer P Morton
- Cancer Research UK Beatson Institute, Switchback Rd, Glasgow, G61 1BD, UK
- Institute of Cancer Sciences, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
| | - Owen J Sansom
- Cancer Research UK Beatson Institute, Switchback Rd, Glasgow, G61 1BD, UK
- Institute of Cancer Sciences, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
| |
Collapse
|
14
|
Affiliation(s)
- Andrew H Ko
- Division of Hematology/Oncology Gastrointestinal Oncology Program, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco CA 94143, USA.
| |
Collapse
|
15
|
Uesaka K, Boku N, Fukutomi A, Okamura Y, Konishi M, Matsumoto I, Kaneoka Y, Shimizu Y, Nakamori S, Sakamoto H, Morinaga S, Kainuma O, Imai K, Sata N, Hishinuma S, Ojima H, Yamaguchi R, Hirano S, Sudo T, Ohashi Y. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet 2016; 388:248-57. [PMID: 27265347 DOI: 10.1016/s0140-6736(16)30583-9] [Citation(s) in RCA: 645] [Impact Index Per Article: 80.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although adjuvant chemotherapy with gemcitabine is standard care for resected pancreatic cancer, S-1 has shown non-inferiority to gemcitabine for advanced disease. We aimed to investigate the non-inferiority of S-1 to gemcitabine as adjuvant chemotherapy for pancreatic cancer in terms of overall survival. METHODS We did a randomised, open-label, multicentre, non-inferiority phase 3 trial undertaken at 33 hospitals in Japan. Patients who had histologically proven invasive ductal carcinoma of the pancreas, pathologically documented stage I-III, and no local residual or microscopic residual tumour, and were aged 20 years or older were eligible. Patients with resected pancreatic cancer were randomly assigned (in a 1:1 ratio) to receive gemcitabine (1000 mg/m(2), intravenously administered on days 1, 8, and 15, every 4 weeks [one cycle], for up to six cycles) or S-1 (40 mg, 50 mg, or 60 mg according to body-surface area, orally administered twice a day for 28 days followed by a 14 day rest, every 6 weeks [one cycle], for up to four cycles) at the data centre by a modified minimisation method, balancing residual tumour status, nodal status, and institutions. The primary outcome was overall survival in the two treatment groups, assessed in the per-protocol population, excluding ineligible patients and those not receiving the allocated treatment. The protocol prespecified that the superiority of S-1 with respect to overall survival was also to be assessed in the per-protocol population by a log-rank test, if the non-inferiority of S-1 was verified. We estimated overall and relapse-free survival using the Kaplan-Meier methods, and assessed non-inferiority of S-1 to gemcitabine using the Cox proportional hazard model. The expected hazard ratio (HR) for mortality was 0.87 with a non-inferiority margin of 1.25 (power 80%; one-sided type I error 2.5%). This trial is registered at UMIN CTR (UMIN000000655). FINDINGS 385 patients were randomly assigned to treatment between April 11, 2007, and June 29, 2010 (193 to the gemcitabine group and 192 to the S-1 group). Of these, three were exlcuded because of ineligibility and five did not receive chemotherapy. The per-protocol population therefore consisted of 190 patients in the gemcitabine group and 187 patients in the S-1 group. On Sept 15, 2012, following the recommendation from the independent data and safety monitoring committee, this study was discontinued because the prespecified criteria for early discontinuation were met at the interim analysis for efficacy, when all the protocol treatments had been finished. Analysis with the follow-up data on Jan 15, 2016, showed HR of mortality was 0.57 (95% CI 0.44-0.72, pnon-inferiority<0.0001, p<0.0001 for superiority), associated with 5-year overall survival of 24.4% (18.6-30.8) in the gemcitabine group and 44.1% (36.9-51.1) in the S-1 group. Grade 3 or 4 leucopenia, neutropenia, aspartate aminotransferase, and alanine aminotransferase were observed more frequently in the gemcitabine group, whereas stomatitis and diarrhoea were more frequently experienced in the S-1 group. INTERPRETATION Adjuvant chemotherapy with S-1 can be a new standard care for resected pancreatic cancer in Japanese patients. These results should be assessed in non-Asian patients. FUNDING Pharma Valley Center, Shizuoka Industrial Foundation, Taiho Pharmaceutical.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Koji Imai
- Asahikawa Medical University, Asahikawa, Japan
| | | | | | | | | | - Satoshi Hirano
- Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takeshi Sudo
- National Hospital Organization Kure Medical Center, Kure, Japan
| | | |
Collapse
|
16
|
Chandrasekaran R, Lee ASW, Yap LW, Jans DA, Wagstaff KM, Cheng W. Tumor cell-specific photothermal killing by SELEX-derived DNA aptamer-targeted gold nanorods. Nanoscale 2016; 8:187-196. [PMID: 26646051 DOI: 10.1039/c5nr07831h] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite widespread availability of cytotoxic chemotherapeutic agents, the killing of tumour cells without affecting healthy surrounding tissue remains elusive, although recent developments in terms of plasmonic nanoparticles capable of photothermal killing have some promise. Here we describe novel DNA aptamer-tethered gold nanorods (GNRs) that act as efficient photothermal therapeutics against tumour cells, but not their isogenic normal cell counterparts. A modified Cell-SELEX process was developed to select a novel DNA aptamer (KW16-13) that specifically recognised and was internalised by cells of the MCF10CA1h human breast ductal carcinoma line but not by those of its isogenic normal counterpart (MCF10A). GNRs conjugated to KW16-13 were readily internalized by the MCF10CA1h tumour cells with minimal uptake by MCF10A normal cells. Upon near infrared (NIR) light irradiation, tumour cell death of >96%, could be effected, compared to <1% in the normal cells or cells incubated with GNRs alone, our KW16-13 aptamer-targeted GNRs thus showing >71-fold tumor cell death than GNRs-targeted with a previously described aptamer. This demonstrates the significant potential for aptamer functionalised-GNRs to be used effective and above all selective anti-cancer photothermal therapeutics.
Collapse
Affiliation(s)
| | | | - Lim Wei Yap
- Department of Chemical Engineering, Monash University, VIC 3800 Australia.
| | - David A Jans
- Department of Biochemistry and Molecular Biology, Monash University, VIC3800, Australia.
| | - Kylie M Wagstaff
- Department of Biochemistry and Molecular Biology, Monash University, VIC3800, Australia.
| | - Wenlong Cheng
- Department of Chemical Engineering, Monash University, VIC 3800 Australia.
| |
Collapse
|
17
|
Nakamura K, Terada N, Kobayashi T, Sugino Y, Yamasaki T, Matsui Y, Imamura M, Okubo K, Kamba T, Yoshimura K, Ogawa O. [Clinical Characteristics of Prostate Ductal Adenocarcinoma in Kyoto University Hospital]. Hinyokika Kiyo 2015; 61:487-491. [PMID: 26790762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Prostate ductal adenocarcinoma is a rare variant of prostate cancer and considered to be more aggressive than the common acinar type of adenocarcinoma. The appropriate treatment guideline for prostate ductal adenocarcinoma has not been established. The aim of the present study was to examine the clinical characteristics and the effectiveness of treatment for prostate ductal adenocarcinoma. From 2005 to 2012, 41 patients were diagnosed to have prostate ductal adenocarcinoma in Kyoto University Hospital. The mean±SD age was 68.6±7.0 years, and the median (range) initial serum PSA level was 9.3 (3.7-217) ng/ml. Among 17 patients who underwent radical prostatectomy, 10 (58.8%) had pT3 disease and 5 (29.4%) had biochemical recurrence during median follow-up of 22.9 months. Out of 19 patients treated with definitive EBRT with endocrine therapy, 2 patients (10.5%) experienced biochemical recurrence with median follow-up of 37.3 months. Five patients were treated with endocrine therapy alone, and 2 (40.0%) of them died of prostate ductal adenocarcinoma. In conclusion, patients with prostate ductal adenocarcinoma were more likely diagnosed as locally advanced diseases than those with prostate acinar adenocarcinoma. However, for patients without metastasis, either surgery or EBRT with endocrine therapy is effective with good prognosis.
Collapse
Affiliation(s)
- Kenji Nakamura
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Naoki Terada
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Takashi Kobayashi
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Yoshio Sugino
- The Department of Urology, Kyoto University Graduate School of Medicine
| | | | - Yoshiyuki Matsui
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Masaaki Imamura
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Kazutoshi Okubo
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Tomomi Kamba
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Koji Yoshimura
- The Department of Urology, Kyoto University Graduate School of Medicine
| | - Osamu Ogawa
- The Department of Urology, Kyoto University Graduate School of Medicine
| |
Collapse
|
18
|
Miyazawa K, Yoshioka S, Shiobara M, Wakatsuki K, Kataoka M, Arai S, Yamazaki K. [Long-term survival following postoperative combined modality therapy for pancreatic cancer]. Gan To Kagaku Ryoho 2014; 41:2190-2192. [PMID: 25731466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 69-year-old woman with back pain underwent distal pancreatectomy with left adrenectomy for advanced pancreatic cancer pathologically diagnosed as poorly differentiated invasive ductal carcinoma with retroperitoneal and perineural invasion, pT3N0M0, Stage III. The patient received adjuvant chemotherapy with S-1 for 6 months. However, 3 years after surgery, computed tomography (CT) revealed para-aorticlymph node (LN) recurrence. Treatment with gemcitabine (GEM) was begun and continued for 3 years. Following progression of the LN recurrence 5 and half years after surgery, administration of radiotherapy reduced diarrhea and back pain. Supportive care combined with radio-frequency ablation(RFA)was provided for multiple liver metastasis 5 years 7 months after surgery. The patient died due to gastrointestinal hemorrhage 6 years after surgery. We report long-term postoperative survival of a patient with recurrent pancreatic cancer following combined modality therapy.
Collapse
|
19
|
Morawiec J, Dziki A, Morawiec Z, Kołacińska A. Retrospective analysis of local recurrence rate in breast cancer patients treated at the department of surgical oncology in Łódź between 2009 and 2013. Pol Przegl Chir 2014; 86:77-81. [PMID: 24670338 DOI: 10.2478/pjs-2014-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED The aim of the study was to analyze clinicopathological features in breast cancer patients with local recurrence (LR). MATERIAL AND METHODS A retrospective analysis of database of breast cancer patients operated on in the Department of Surgical Oncology in Łódź from 2 January 2009 to 30 June 2013, identified 1080 women with primary breast cancer and 11 patients with LR. RESULTS LR rate was 0.23% per year. True recurrence (TR) occurred more frequently in patients with luminal B molecular subtype, in HER-2 positive and in triple-negative subgroups. In one patient with luminal -A subtype new primary (triple negative) occurred. TR were noted predominantly in patients with axillary lymph nodes metastases and with luminal B subtype who did not receive adjuvant chemotherapy but were given only endocrine therapy. LR were observed more frequently in patients who did not receive adjuvant radiotherapy or this treatment was delayed. Minimal surgical margins in postoperative specimens measured by pathologist were 4-25 mm, mean 9.5 mm. CONCLUSIONS The LR rate in patients operated on breast cancer in the Department of Surgical Oncology between 2009 and 2013 was low. TR was diagnosed in patients with non- luminal A breast cancer despite wide surgical margins, especially if the patients did not receive optimal adjuvant systemic treatment or radiotherapy was delayed or omitted. Complete cancer excision followed by an immediate implementation of optimal adjuvant treatment seems to be crucial especially in patients with poor tumor biology.
Collapse
MESH Headings
- Adult
- Aged
- Breast Neoplasms/epidemiology
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal/epidemiology
- Carcinoma, Ductal/pathology
- Carcinoma, Ductal/secondary
- Carcinoma, Ductal/therapy
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/therapy
- Chemoradiotherapy
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Mastectomy
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/therapy
- Retrospective Studies
- Sentinel Lymph Node Biopsy
- Triple Negative Breast Neoplasms/epidemiology
Collapse
|
20
|
Akbulut S, Yagmur Y, Gumus S, Babur M, Can MA. Alternative medicine for management of breast masses: more harm than good. Am J Case Rep 2014; 15:304-7. [PMID: 25050141 PMCID: PMC4103812 DOI: 10.12659/ajcr.890694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 04/06/2014] [Indexed: 02/05/2023]
Abstract
UNLABELLED CASE SERIES. PATIENT -. FINAL DIAGNOSIS Breast cancer. SYMPTOMS -. MEDICATION -. CLINICAL PROCEDURE - SPECIALTY -. OBJECTIVE Diagnostic/therapeutic accidents. BACKGROUND Several well-established, evidence-based treatment modalities are currently available and widely applied to breast cancer patients, but it is known that some of the cancer patients use traditional/alternative medicine other than their treatments. CASE REPORT Herein, we report the cases of 2 middle-aged women (45 and 50 years old) with malignant breast masses who experienced serious complications in response to self-prescribed use of alternative medicine practices to treat their condition in lieu of evidence-based medical treatment. Specifically, the use and/or inappropriate application of alternative medical approaches promoted the progression of malignant fungating lesions in the breast for these 2 patients. The first patient sought medical assistance upon development of a fungating lesion 7∼8 cm in diameter and involving 1/3 of the breast, with a palpable mass of 5×6 cm immediately beneath the wound. The second patient sought medical assistance upon development of a wide, bleeding, ulcerous area with patchy necrotic tissue that comprised 2/3 of the breast and had a 10×6 cm palpable mass under the affected area. Use of some non-evidence-based medical treatments as complementary to evidence-based medical treatments may benefit the patient on an emotional level; however, this strategy should be used with caution, as the non-evidence-based therapies may cause physical harm or even counteract the evidence-based treatment. CONCLUSIONS A malignant, fungating wound is a serious complication of advanced breast cancer. It is critical that the public is informed about the potential problems of self-treating wounds such as breast ulcers and masses. Additionally, campaigns are needed to increase awareness of the risks and life-threatening potential of using non-evidence-based medical therapies exclusively.
Collapse
|
21
|
Eichhorn W, Precht C, Wehrmann M, Hickmann E, Eichhorn M, Zeuch J, Löning T, Friedrich RE, Heiland M, Hoffmann J. First description of a hybrid tumor of the sublingual gland. Anticancer Res 2013; 33:4567-4571. [PMID: 24123032] [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: 06/02/2023]
Abstract
BACKGROUND Hybrid tumours of the salivary glands are rare neoplasms. They are composed of at least two different tumour entities located in the same topographic area and account for only 0.1% of all salivary gland tumours. The most common component is an adenoid cystic carcinoma. There are several possible forms of hybrid tumours, which are most commonly located in the parotid gland. CASE REPORT We report on a 59-year-old female, who presented with a lesion of the caruncula of the left sublingual gland. The biopsy showed an adenoid cystic carcinoma in combination with a salivary duct carcinoma. Treatment consisted of tumour resection, bilateral selective neck dissection and adjuvant radiotherapy. Histopathologically, at least 30% of the tumour mass was composed of a salivary duct carcinoma and 70% of an adenoid cystic carcinoma. At 58 months after treatment, the patient is alive without evidence of recurrent disease. CONCLUSION To our knowledge, the presented case is the first description of a hybrid tumour of the sublingual gland. Furthermore, the post-therapeutic course is encouraging, as hybrid tumours of the salivary glands usually have a poor prognosis.
Collapse
Affiliation(s)
- Wolfgang Eichhorn
- PD Dr. Dr., Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Yokoyama J, Kobayashi T, Nakamura T, Nakajima Y. [A case of male breast cancer in which oncotype DX was used to determine the therapeutic strategy]. Gan To Kagaku Ryoho 2012; 39:2057-2059. [PMID: 23267975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Male breast cancer is rare, and reportedly to accounts for less than 1% of all breast cancers. Postoperative therapy of male breast cancer is similar to that for female cancer. We experienced a male patient and used oncotype DX to determine the therapeutic strategy. A 60-year-old man was diagnosed with breast cancer Stage I. He underwent sentinel lymph node biopsy and mastectomy, but lymph node dissection was omitted. However, micro-metastases were found in the permanent specimen. Later, axillary node dissection was performed. The patient was finally diagnosed with Stage IIA (T1c, N1mi, M0) and luminal A type breast cancer. From using oncotype DX to determine the therapeutic strategy, the recurrence score was 8 and within the low recurrence score group. Currently, we are only administering endocrine therapy.
Collapse
Affiliation(s)
- Junko Yokoyama
- Dept. of Gastroenterology and General Surgery, Nara Medical University, Japan
| | | | | | | |
Collapse
|
23
|
Hwang ES, Nelson H. Reframing treatment for ductal carcinoma in situ: could less be more? Bull Am Coll Surg 2012; 97:50-51. [PMID: 22745990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
24
|
Koga C, Tanemura M, Wada H, Kobayashi S, Marubashi S, Eguchi H, Mori M, Doki Y, Nagano H. [A case report of port-site metastasis of pancreatic cancer after laparoscope assistted distal pancreatectomy]. Gan To Kagaku Ryoho 2011; 38:2454-2456. [PMID: 22202411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Laparosopic port-site metastasis is rare, but a well recognized outcome following surgery in gastroenterological surgery for gastric cancer, colon cancer and gallbladder cancer with its etiology was not clearly understood. We report a port-site metastasis of pancreatic cancer diagnosed by position emission tomography( PET). A 49-year-old man was diagnosed as splenic tumor with pancreatic tail invasion due to malignant lymphoma, and received a laparoscope assisted distal pancreatectomy. Unsuspected pancreatic cancer was discovered with histological result of moderate differentiated invasive ductal adenocarcinoma of the pancreas infiltrating spleen. Systemic chemotherapy with 1,000 mg/m² of gemcitabine (GEM) was performed for six months. Unfortunately, our patients relapsed one year after the surgery with multiple lesions in the peritoneum, abdominal wall, as well as a laparoscopic port-site metastasis. He was started on 100 mg/body of S-1 daily, subsequently, combined chemotherapy with GEM( 80 mg/m²) and S-1( 80 mg/body) was also performed. Furthermore, he underwent palliative radiation therapy( 40 Gy) to care the pain. Fortunately, a long-term survival of 3 years was elicited by these systemic treatments and radiography. Laparoscopic port-site metastases are associated with presence of advanced cancer. Therefore, we should carefully precede a laparoscopic resection against pancreatic cancer.
Collapse
Affiliation(s)
- Chikato Koga
- Dept. of Gastroenterological Surgery, Osaka University Graduate School of Medcine
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Suzuki T, Shinbo H, Kurita Y, Furuse H, Mugiya S, Ozono S. [A case of ductal adenocarcinoma of the prostate treated with endocrine therapy and radiation therapy]. Hinyokika Kiyo 2011; 57:261-264. [PMID: 21743285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report a case of ductal adenocarcinoma of the prostate. A 81-year-old man presented with a complaint of microhematuria. Serum prostate specific antigen (PSA) was 18. 44 ng/ml. A cystourethroscopic examination revealed a papillary tumor near the verumontanum. Transurethral resection of the tumor and transrectal prostatic needle biopsy was carried out. The pathological diagnosis was ductal adenocarcinoma and acinar adenocarcinoma of the prostate. The tumor responded to endocrine therapy and radiation therapy. At the follow up at 18 months, the PSA level was in the undetectable range (<0.01 ng/ml), and no reccurence of the tumor was seen. Pathogenesis and management of this rare condition is discussed.
Collapse
Affiliation(s)
- Takahisa Suzuki
- The Department of Urology, Hamamatsu University School of Medicine
| | | | | | | | | | | |
Collapse
|
26
|
Sakurai K, Enomoto K, Amano S. [Microdochectomy for elderly patient of ductal carcinoma in situ]. Gan To Kagaku Ryoho 2010; 37:2778-2780. [PMID: 21224710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report an elderly patient with ductal carcinoma in situ (DCIS). The patient was an 82-year-old woman who had spontaneous nipple discharge. We did not detect the origin of nipple discharge by CT, MRI, mammography, ductal endoscopy, and ultrasonography. Microdochectomy was performed under the local anesthesia. A resected specimen led to a diagnosis of a DCIS positive for estrogen receptor and progesteron receptor, and negative for HER2/neu protein expression. After operation, she was administered aromatase inhibitor. After three years and two months from the operation, she is well without metastases. The less invasive operation by local anesthesia is useful for elderly breast cancer patients. This case suggested that microdochectomy is useful for DCIS in elderly patients.
Collapse
Affiliation(s)
- Kenichi Sakurai
- Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine
| | | | | |
Collapse
|
27
|
Goodarzi M, Rashid A, Maru D. Invasive ductal adenocarcinoma arising from pancreatic heterotopia in rectum: case report and review of literature. Hum Pathol 2010; 41:1809-13. [PMID: 20869744 DOI: 10.1016/j.humpath.2010.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 05/21/2010] [Accepted: 06/09/2010] [Indexed: 01/01/2023]
Abstract
Pancreatic heterotopia has been described at several abdominal and intrathoracic locations, most commonly in the stomach and upper part of the small intestine. Its occurrence in the rectum is unusual, and malignant transformation in the rectum has not been reported. We report a case of ductal adenocarcinoma arising in a rectal pancreatic heterotopia in a 42-year-old woman with delayed local recurrence. The tumor was composed of well to moderately differentiated ductal adenocarcinoma infiltrating through the full thickness of the anorectal wall with extension into the vaginal septum. A focus of ectopic pancreas consisting of exocrine acini and small ducts adjacent to the tumor with some ducts showing mild to severe dysplasia reminiscent of pancreatic intraepithelial neoplasia was also observed. Although our literature search found 31 documented reports of tumors arising in the heterotopic pancreas, the present case is the first case of ductal adenocarcinoma arising in a focus of pancreatic heterotopia in the rectum.
Collapse
Affiliation(s)
- Mahmoud Goodarzi
- Department of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | |
Collapse
|
28
|
Dziuba K. A case study: ductal adenocarcinoma of the prostate. Urol Nurs 2009; 29:422-424. [PMID: 20088233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ductal carcinoma of the prostate (generally arising from prostatic ducts) is a rare but often aggressive variant of prostate cancer. In ductal prostate cancer, digital rectal examination and prostate specific antigen level can be unreliable because both may be normal. This article presents a case study following the diagnosis and successful treatment of a patient through two clinics, and stresses how nurses can ensure continuity of care from one facility to another.
Collapse
|
29
|
Kenne Sarenmalm E, Ohlén J, Odén A, Gaston-Johansson F. Experience and predictors of symptoms, distress and health-related quality of life over time in postmenopausal women with recurrent breast cancer. Psychooncology 2008; 17:497-505. [PMID: 17886259 DOI: 10.1002/pon.1258] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to explore the symptom experience and predictors of distress and quality of life over time in women with recurrent breast cancer. Fifty-six women completed questionnaires at the diagnosis of recurrence, 1 month, 3 and 6 months after recurrence. A majority of women reported multiple, concurrent and distressing symptoms such as lack of energy, difficulty sleeping, pain, worry and problems with sexual interest or activity during the recurrent breast cancer trajectory. The highest level of symptom burden and distress and decreased quality of life was reported 3 months after recurrence. Although distress declined and quality of life improved over time, patients reported persistent symptoms. Of the patients at increased risk of vulnerability to distress were women who experienced multiple and concurrent symptoms. Other risk factors were co-morbidity, prehistory of anxiety and depression and progressive or terminal disease. Fatigue, pain and depression explained 68-72% of the variance in distress. Distress explained 44-46% of the variance in quality of life. These findings suggest that symptoms are important contributors to the distress experience, and that distress has a severe impact on quality of life. The care of women with recurrent breast cancer must be based upon the awareness of critical factors that exacerbate the vulnerability to distress throughout the disease trajectory.
Collapse
|
30
|
Cottu PH, Asselah J, Lae M, Pierga JY, Diéras V, Mignot L, Sigal-Zafrani B, Vincent-Salomon A. Intratumoral heterogeneity of HER2/neu expression and its consequences for the management of advanced breast cancer. Ann Oncol 2008; 19:596-597. [PMID: 18272907 DOI: 10.1093/annonc/mdn021] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Nabili V, Tan JW, Bhuta S, Sercarz JA, Head CS. Salivary duct carcinoma: a clinical and histologic review with implications for trastuzumab therapy. Head Neck 2008; 29:907-12. [PMID: 17563907 DOI: 10.1002/hed.20614] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is an aggressive tumor of the head and neck with a poor prognosis. The objective was to study SDC and recommend the use of trastuzumab as adjuvant therapy. METHODS A retrospective chart review of patients seen between 1993 and 2006 was performed. Tumor specimens were examined for HER-2 protein overexpression via immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods. RESULTS Of the 7 patients with SDC, 57% had tumors arising in the parotid gland, the majority having facial nerve paralysis, 71% with nodal disease, and 43% having recurrence. All samples were HER-2 positive on IHC. Three patients had FISH-positive tumors, recurrent disease, and received trastuzumab therapy; 1 of the 3 died after 20 months and a second has shown disappearance of metastatic disease. CONCLUSIONS Trastuzumab is effective in treating HER-2-positive breast cancer. Given immunohistochemical similarities between SDC and ductal carcinoma of the breast, patients with FISH-positive HER-2/neu SDC should be considered for trastuzumab therapy.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carboplatin/administration & dosage
- Carcinoma, Ductal/metabolism
- Carcinoma, Ductal/mortality
- Carcinoma, Ductal/therapy
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/mortality
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Chemotherapy, Adjuvant
- Facial Paralysis/etiology
- Female
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/therapy
- Paclitaxel/administration & dosage
- Radiotherapy, Adjuvant
- Receptor, ErbB-2/metabolism
- Retrospective Studies
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/therapy
- Trastuzumab
Collapse
Affiliation(s)
- Vishad Nabili
- Division of Head and Neck Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 LeConte Avenue, Los Angeles, California 90095, USA
| | | | | | | | | |
Collapse
|
32
|
Dedes I, Ziogas V. Simultaneous diagnosis and treatment of bilateral breast carcinoma and endometrial adenocarcinoma. Implications for screening. EUR J GYNAECOL ONCOL 2008; 29:515-517. [PMID: 19051825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The association of breast and endometrial carcinoma has been demonstrated by many studies. Most of the cases are related to the previous use of tamoxifen for the treatment of breast carcinoma. However, triple primary malignancies on the same individual are very rare. This is an unusual case regarding simultaneous diagnosis and treatment of bilateral breast carcinoma and endometrial adenocarcinoma. The clinical aspects and treatment of this unique case are presented.
Collapse
Affiliation(s)
- I Dedes
- Iaso Women's Hospital, Marousi, Greece.
| | | |
Collapse
|
33
|
Pinsky RW, Rebner M, Pierce LJ, Ben-David MA, Vicini F, Hunt KA, Helvie MA. Recurrent Cancer After Breast-Conserving Surgery with Radiation Therapy for Ductal Carcinoma in Situ: Mammographic Features, Method of Detection, and Stage of Recurrence. AJR Am J Roentgenol 2007; 189:140-4. [PMID: 17579163 DOI: 10.2214/ajr.06.1281] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to determine the mammographic appearance, detection method, and stage of ipsilateral breast tumor recurrence in women treated with breast-conserving surgery and whole-breast radiation therapy for ductal carcinoma in situ (DCIS). MATERIALS AND METHODS Following institutional review board approval, records of women treated with breast-conserving surgery and radiation therapy for DCIS who developed an ipsilateral breast tumor recurrence from 1981 to 2003 were reviewed retrospectively. Multiinstitutional database records showed 513 women were treated, of whom 42 (8.2%) developed local recurrence. Study criteria were fulfilled and complete records were available for 32 women. Mean age at initial diagnosis was 49 years (range, 26-73 years). RESULTS Of the 32 patients included in our study, 31 (97%) recurrences were mammographically apparent. Twenty-nine (91%) of 32 were diagnosed exclusively by mammography. Mammographic findings at recurrence were calcifications in 24 (75%) of 32, mass in six (19%) of 32, and distortion in one (3%) of 32. The mean time to recurrence was 4.5 years. Twelve (40%) of 30 had the recurrence in a remote quadrant from the original cancer. Recurrences were DCIS in 17 (53%) of 32, DCIS with microinvasion in six (19%) of 32, invasive ductal cancer in three (9%) of 32, invasive lobular cancer in two (6%) of 32, and mixed DCIS and invasive cancer in four (13%) of 32. Six (67%) of nine patients with invasive cancer (excluding microinvasion) had tumors smaller than 1 cm. Ninety-one percent of recurrences were minimal cancers. All recurrences were stage 0 or 1. CONCLUSION Mammography successfully detected ipsilateral breast tumor recurrence, predominantly as calcifications or masses, after breast-conserving surgery with radiation therapy for DCIS in 97% of cases. The recurrences were located at variable distances from the lumpectomy site. Ninety-one percent of recurrences were minimal cancers and all were early stage, connoting excellent prognosis.
Collapse
Affiliation(s)
- Renee W Pinsky
- Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr., Ann Arbor, MI 48109-0302, USA
| | | | | | | | | | | | | |
Collapse
|
34
|
Torres JJ, Medel R, Alonso T, Morral M, García-Arumí J, Myint S, Nesi FA, Shields JA. Orbital Metastases From Male Breast Cancer in Two Cases. Ophthalmic Plast Reconstr Surg 2007; 23:154-6. [PMID: 17413637 DOI: 10.1097/iop.0b013e31803316cb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present 2 cases of orbital metastases of male breast cancer, a very rare association in the context of a rare disease. We also provide a review of the literature on this topic including the 4 previously reported cases. Our cases presented with diplopia and proptosis. Orbital biopsies were performed that revealed metastases of infiltrative ductal carcinoma (ICD).
Collapse
Affiliation(s)
- Jesús J Torres
- Ophthalmology Department, Hospital Valle de Hebron, Barcelona, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
BACKGROUND The breast is an unusual site for primary non-Hodgkin's lymphoma. Carcinoma in the same breast after treatment for lymphoma poses therapeutic challenges, but there is only 1 case report in Japanese, which describes this occurrence. PATIENT AND METHODS A 59-year-old woman was diagnosed with infiltrating ductal carcinoma of the breast after receiving doxorubicinand vincristine-based chemotherapy for ipsilateral primary large cell breast lymphoma. The cancer was of high grade histology, with immunohistochemistry staining 3+ positive for HER2/neu. RESULTS After lumpectomy and sentinel node biopsy, adjuvant paclitaxel without anthracyclines was given but had to be stopped early because of neurotoxicity. Radiotherapy to the breast was administered, and a 1-year course of trastuzumab was planned. CONCLUSION Breast cancer can occur after breast lymphoma. For primary breast lymphoma, cumulative doses of cardiotoxic and neurotoxic drugs should be limited to 3-4 cycles of chemotherapy, using treatment protocols for stage I-II large cell lymphoma. Consolidation radiotherapy should be considered at a dose curative for microscopic breast cancer.
Collapse
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Breast/pathology
- Carcinoma, Ductal/diagnosis
- Carcinoma, Ductal/pathology
- Carcinoma, Ductal/therapy
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Mastectomy, Segmental
- Middle Aged
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/therapy
- Radiotherapy, Adjuvant
- Receptor, ErbB-2/analysis
- Retreatment
Collapse
Affiliation(s)
- David B Geffen
- Department of Oncology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | | | | | | | | |
Collapse
|
36
|
Bień S, Sygut J, Kopczyński J, Postuła S, Ziółkowska M. Rak przewodowy gruczołów ślinowych (salivary duct carcinoma) – charakterystyka kliniczna i patologiczna 5 przypadków. Otolaryngol Pol 2007; 61:33-8. [PMID: 17605416 DOI: 10.1016/s0030-6657(07)70380-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 5 cases of salivary duct carcinoma (SDC); very rare, but distinct group of highly malignant salivary gland tumor are presented, and difficulties with pathological and clinical diagnosis is discussed. The SDC developed in single cases in parotid salivary gland, submandibular salivary and in mucosa of maxillary sinus, pyriform fossa and oral cavity (check). In 3 cases the second malignant tumor was present--synchronously (SDC + pleomorphic adenoma in parotid gland; SDC + squamous cell carcinoma in hypopharynx) or metachroneously (squamous cell carcinoma of upper lip followed by SDC). In one case the high levels of PSA suggesting of metastases from unknown primary within the prostate gland, or PSA expression related to SDC was observed. The four patients received radical treatment - surgical resection followed by radiotherapy; in one case only palliative treatment was applied, due to patient's poor general condition and high advancement of the primary disease. The observation ranged from 10 to 77 months (average time--31 months). The one patient died 13 months after diagnosis and palliative treatment. The three patients are alive with distant metastases to the lung and bones (77, 38 and 18 months after primary treatment was completed). Only one patient with 10 months observation after treatment is living without symptoms of recurrence or metastases.
Collapse
Affiliation(s)
- Stanisław Bień
- Dial Chirurgii Głowy i Szyi Swietokrzyskiego Centrum Onkologii w Kielcach.
| | | | | | | | | |
Collapse
|
37
|
Affiliation(s)
- Sue Rimes
- Gynecologic Oncology Department, University of Texas M.D. Anderson Cancer Center, Houston, USA.
| | | | | | | | | |
Collapse
|
38
|
Abstract
Intraductal carcinoma of the prostate (IDC-P) has been described in radical prostatectomies. However, there is limited information as to its histologic features and clinical significance when seen on prostate biopsy. A total of 27 cases of prostate biopsies with only IDC-P (ie no infiltrating cancer anywhere on the biopsy) were studied from the consult files of one of the authors. IDC-P was defined as malignant epithelial cells filling large acini and prostatic ducts, with preservation of basal cells forming either: (1) solid or dense cribriform patterns or; (2) loose cribriform or micropapillary patterns with either marked nuclear atypia (nuclear size 6 x normal or larger) or comedonecrosis. The numbers of cores involved by IDC-P in the biopsies ranged from 1 to 7, with >1 core involved in 17 cases. The architectural patterns of IDC-P were solid (12), dense cribriform (19), loose cribriform (17), and micropapillary (5). More than one pattern was present in 24 of 27 cases. The cytological features frequently observed in IDC-P were marked pleomorphism (18), non-focal comedonecrosis (22), and mitoses (20). Basal cells were observed on regular hematoxylin and eosin stained slides in 14 cases; in all the cases, basal cells were confirmed by immunohistochemical stains for high molecular weight cytokeratin (n=25) and/or p63 (n = 4). After the diagnosis of IDC-P on prostate biopsies, patients were treated by radical prostatectomy (6), radiation (7), hormone (5), combined radiation and hormone (1), or watchful waiting (2). The follow-up information was not available for six patients. The follow-up times ranged up to 4 years with an average of 2.1 years. In all six radical prostatectomy specimens, high-grade infiltrating carcinoma with Gleason score 8 or 9 was present with five cases also revealing prominent IDC-P. Non-focal extraprostatic extension of carcinoma was observed in five of the six prostatectomy cases with two cases also demonstrating vascular invasion. Three of 16 patients who did not receive radical prostatectomy developed bone metastases. Our study indicates that IDC-P on prostate biopsies is frequently associated with high-grade cancer and poor prognostic parameters at radical prostatectomy as well as potentially advanced disease following other therapies. These findings support prior studies that IDC-P represents an advanced stage of tumor progression with intraductal spread of tumor. Consideration should be given to treat patients with IDC-P on biopsy aggressively even in the absence of documented infiltrating cancer.
Collapse
Affiliation(s)
- Charles C Guo
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | | |
Collapse
|
39
|
Sakurai K, Amano S, Enomoto K, Matsuo S. [A case of advanced breast cancer with meningeal carcinomas and orbital metastasis successfully treated with multi-disciplinary therapy]. Gan To Kagaku Ryoho 2006; 33:1913-5. [PMID: 17212145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We report a case of advanced breast cancer with meningeal metastasis and orbital metastasis (T4bN3cM1, Stage IV) achieving a significant improvement in QOL by multi-disciplinary therapy. The patient was a 51-year-old woman who had headaches and an ulcerative breast lump with meningeal metastasis and orbital metastasis. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for HER2/neu protein expression. She received 9 cycles of weekly trastuzumab and radiation therapy for meningeal metastasis and orbital metastasis. Although the size of breast tumor, orbital metastasis lesion, and meningeal metastasis lesion exhibited no change, clinical symptoms were improved. One year later, she received paclitaxel so that the sensitivity of HER2/neu dropped. However, the tumor markers relapsed and we then changed paclitaxel to TS-1. Eighteen-months later, she had no neurological symptoms. Multi disciplinary therapy can improve patient's QOL and the clinical outcomes in Stage IV advanced breast cancer.
Collapse
Affiliation(s)
- Kenichi Sakurai
- Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine
| | | | | | | |
Collapse
|
40
|
Abstract
BACKGROUND Lichen ruber planus is an inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. The etiology is unknown. PATIENTS AND METHODS A 56-year-old female was treated with standard local radiotherapy after breast-conserving surgery due to high-grade ductal carcinoma in situ (DCIS) of the breast. RESULTS During radiotherapy, the patient began to complain about increasing disseminated itching papules of the breast. The efflorescences appeared as flat-topped, solid, purplish papules spreading to the limbs and trunk. A thorough clinical examination revealed additionally suspicious cob-web like and white-coated mucosal lesions of the oral cavity consistent with the clinical diagnosis of a generalized lichen ruber planus with an oral manifestation. CONCLUSION To our knowledge, this is the first report of a generalized manifestation of lichen ruber planus presumably induced by radiation therapy.
Collapse
Affiliation(s)
- Michael Eichbaum
- Department of Gynecology and Obstetrics, University of Heidelberg Medical School, Heidelberg, Germany.
| | | | | | | | | |
Collapse
|
41
|
Ishikawa O, Ohigashi H, Eguchi H, Yamada T, Sasaki Y, Imaoka S, Nishiyama K. [Pre- and post-operative chemoradiation therapies for pancreatic cancers]. Nihon Geka Gakkai Zasshi 2006; 107:182-6. [PMID: 16878411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Due to a high incidence of local recurrence, the long-term outcome after resection of locally advanced pancreatic cancer is still pessimistic. Many previous reports showed that locoregional control was partly improved by intraoperative radiation or postoperative chemoradiation, while others suggested its insufficient effects for patients with R1- or R2-resections. Therefore some recent authors have recommended preoperative chemoradiation for more promising results in advanced pancreatic cancer. Since patient survival is influenced not only by local control but also by distant (the liver is the most common) metastases, we should develop other strategies that can prevent liver metastases, in addition to the combination of chemoradiation with sur-
Collapse
Affiliation(s)
- Osamu Ishikawa
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
| | | | | | | | | | | | | |
Collapse
|
42
|
Sakurai K, Enomoto K, Amano S, Kitajima A, Suzuki M, Matsuo S, Sakamoto A, Kashio M, Tani M, Negishi N. [A case of advanced breast cancer with multiple lung and liver metastases successfully treated with multi-disciplinary therapy]. Gan To Kagaku Ryoho 2005; 32:1792-4. [PMID: 16315943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We report a case of advanced breast cancer with multiple lung and liver metastases (T4bN1M1) achieving a significant improvement of QOL by multi-disciplinary therapy. The patient was a 63-year-old woman with slight jaundice who had ascites and an ulcerative breast lump with multiple lung and liver metastases. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for HER2/neu protein expression. She received 6 cycles of tri-weekly docetaxel (60 mg/m2) and weekly trastuzumab. Although the ascites and the jaundice disappeared after chemotherapy, the response for breast tumor, metastatic sites in the lung and the liver were less satisfactory. Fifteen-months later, she received radiation therapy so that metastasis in the brain was recognized. But she had no neurological symptoms. Multi-disciplinary therapy can improve patient's QOL and the clinical outcomes in Stage IV advanced breast cancer.
Collapse
Affiliation(s)
- Kenichi Sakurai
- Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
PURPOSES (a) to summarize views of the interface of technology, genomic technology, and nursing; (b) provide an overview of current and emerging genomic technologies; (c) present clinical exemplars of uses of genomic technology in two disease conditions; and (d) list genomic-focused nursing research on genomic technologies. ORGANIZING FRAMEWORK A discussion of genomic technology in the context of nurses' views of technology, the importance of genomic technology for nurses, linking the central dogma of molecular biology to state-of-the-art tests and assays, and nurses' current use of technologies. CONCLUSIONS Human genome discoveries will continue to be an integral part of disease prevention, diagnosis, treatment, and management. These discoveries also have the potential for being integrated into nursing science. Genomic technologies are becoming a driving force in patient management, so that nurses will be unable to provide quality care without knowledge of the types of genomic technologies, the rationale for their use, and the possible sequelae that can result from genetic diagnosis or treatment. Many nurses already are using genomic technologies to conduct genomic-focused nursing research. The biobehavioral nature of much of this research further indicates the important contributions of nurses in genomics.
Collapse
MESH Headings
- Breast Neoplasms/diagnosis
- Breast Neoplasms/genetics
- Breast Neoplasms/therapy
- Carcinoma, Ductal/diagnosis
- Carcinoma, Ductal/genetics
- Carcinoma, Ductal/therapy
- Child, Preschool
- Female
- Genetic Techniques/nursing
- Genetic Techniques/trends
- Genetic Therapy/nursing
- Genetic Therapy/trends
- Genetics, Medical/organization & administration
- Genomics/organization & administration
- Humans
- Male
- Middle Aged
- Models, Genetic
- Molecular Biology/organization & administration
- Muscular Dystrophy, Duchenne/diagnosis
- Muscular Dystrophy, Duchenne/genetics
- Muscular Dystrophy, Duchenne/therapy
- National Institutes of Health (U.S.)/organization & administration
- Nurse's Role
- Nursing/organization & administration
- Nursing Research/organization & administration
- Research Support as Topic/organization & administration
- Technology Assessment, Biomedical/organization & administration
- United States
Collapse
Affiliation(s)
- Lois J Loescher
- College of Nursing, University of Arizona, PO Box 210203, Tucson, AZ 85721-0203, USA.
| | | |
Collapse
|
44
|
Lörincz T, Tóth J, Szendröi M, Tímár J. Microvascular density of breast cancer in bone metastasis: influence of therapy. Anticancer Res 2005; 25:3075-81. [PMID: 16080568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Bone is the most frequent site of systemic progression of breast cancer (BRC). Angiosuppressive therapy has now entered the management of progressing cancers, therefore it is clinically important to obtain information on vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) of bone metastasis of BRC. MATERIALS AND METHODS VEGF expression and MVD were evaluated in bone metastases of BRC immunohistochemically in paraffin samples of 18 patients and compared to their primary tumors. MVD was determined by using the hot-spot method and the endothelial marker, CD34. RESULTS Chemo- and/or endocrine therapy-naïve BRC cases progressed to the bone with a concomitant increase in their angiogenic potential, suggesting that this is the "natural history" of BRC progression. On the other hand, this study revealed that vascularization of the bone metastases of BRC patients that had received adjuvant (chemo- and/or endocrine) therapy was significantly decreased compared to the corresponding primary tumors, also supported by a decreased VEGF expression in metastases, both suggesting that the treatment significantly affected the angiogenic phenotype of the progressing disease. CONCLUSION Angiosuppressive therapy is a new approach to cancer management including BRC and is frequently applied in the advanced stage of disease. Tumors with a prominent angiogenic phenotype (high MVD and VEGF) are primary candidates for such regimes. The fact that chemo-endocrine adjuvant therapy of BRC resulted in a weaker angiogenic phenotype in bone metastases compared to non-treated cases may suggest that these latter patients are better candidates for angiosuppressive interventions.
Collapse
Affiliation(s)
- Támas Lörincz
- Department of Orthopedics, Semmelweis University, Budapest, Hungary
| | | | | | | |
Collapse
|
45
|
Robles-Frías A, González-Cámpora R, Martínez-Parra D, Robles-Frías MJ, Vázquez-Cerezuela T, Otal-Salaverri C, Fernández-Palacín A. Robinson cytologic grading of invasive ductal breast carcinoma: correlation with histologic grading and regional lymph node metastasis. Acta Cytol 2005; 49:149-53. [PMID: 15839618 DOI: 10.1159/000326123] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the importance of cytologic grading of breast carcinoma and its association with histologic grading and the existence of axillary lymph node metastasis. STUDY DESIGN Aspirates and surgical samples from 100 patients with invasive ductal breast carcinoma not otherwise specified were studied. In 50 patients, > or = 1 metastatic nodes were identified. The cytologic grade was evaluated using the Robinson method and the histologic grade using the Elston modification of the Bloom-Richardson method. A study was undertaken to establish the association between histologic and cytologic grades and to compare the various parameters used to evaluate cytologic grade with the presence of axillary node metastasis. RESULTS A statistically significant association was observed between cytologic and histologic grades (p < 0.0005) and between cytologic grade and presence of axillary metastasis (p < 0.0005). Similarly, cell dissociation (p < 0.0005), cell uniformity (p = 0.0010) and the appearance of nuclear margins (p < 0.0005) all displayed a positive correlation with regional metastasis. CONCLUSION Cytologic grade may provide relevant information on the aggressiveness of invasive ductal breast carcinoma and could be a useful parameter to take into consideration when selecting neoadjuvant therapy.
Collapse
|
46
|
Gonzalez-Angulo AM, Cristofanilli M, Strom EA, Buzdar AU, Kau SW, Broglio KR, Smith TL, Hortobagyi GN. Central nervous system metastases in patients with high-risk breast carcinoma after multimodality treatment. Cancer 2004; 101:1760-6. [PMID: 15386311 DOI: 10.1002/cncr.20530] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The current study was performed to determine the incidence of central nervous system (CNS) metastases and to examine associated disease characteristics in a group of patients with locally advanced breast carcinoma (LABC) or inflammatory breast carcinoma (IBC) treated at The University of Texas M. D. Anderson Cancer Center (Houston, TX). METHODS Seven hundred sixty-eight patients treated with multimodality therapy between 1982 and 2000 in any of 6 neoadjuvant trials were eligible for the current study. Five hundred ninety-two patients (77%) had LABC, and 176 (23%) had IBC. CNS disease was defined as the presence of brain metastases or leptomeningeal disease. Time to detection of CNS disease and overall survival were estimated using the Kaplan-Meier product-limit method, and differences were evaluated using log-rank tests. RESULTS The median patient age was 48 years. Most tumors were classified as T4 lesions (58%) and exhibited lymph node involvement (78%). Fifty-one percent of all tumors had positive hormone receptor status. At a median follow-up duration of 9.5 years, 61 patients (8%) had developed CNS metastases, with the CNS representing the first site of recurrence for 38 of these 61 (63%). Characteristics associated with the development of CNS metastases over time included negative hormone receptor status (P = 0.03), Grade 3 disease (P = 0.01), and larger tumor size (P = 0.02). The median time to detection of CNS metastases was 2.3 years. Ten patients (16%) remained alive after treatment for CNS metastases. The median survival from the time of diagnosis of CNS metastases was 8 months. CONCLUSIONS CNS metastases from breast carcinoma were relatively uncommon and were strongly associated with more aggressive clinical presentation. Survival from the time of diagnosis of such metastases generally was short.
Collapse
Affiliation(s)
- Ana M Gonzalez-Angulo
- Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Sengoku N, Kuranami M, Handa K, Hayashi K, Enomoto T, Watanabe M. [A case of local advanced breast cancer with multiple lung metastases successfully treated with multimodal therapy]. Gan To Kagaku Ryoho 2004; 31:1927-9. [PMID: 15553762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We report a case of local advanced breast cancer with multiple lung metastases (T4bN2M1) achieving a significant improvement of QOL by multimodal therapy with chemotherapy, antibody therapy, radiation therapy and surgery. The patient was a 47-year-old woman with mental deterioration who had an ulcerative breast cancer with multiple lung metastases. Breast biopsy led to a diagnosis of an invasive ductal carcinoma positive for erbB2 protein expression. She received 6 cycles of tri-weekly docetaxel (60 mg/m2) and weekly trastuzumab. Although metastases in the lung disappeared after chemotherapy, the response of breast ulceration was less satisfactory. Simple mastectomy followed by radiation therapy (50 Gy) to the axilla was performed as a palliative treatment. No signs of recurrence were observed for more than 14 months of treatment by trastuzumab. Multimodal therapy can improve patient QOL and the clinical outcomes in Stage IV local advanced breast cancer.
Collapse
|
48
|
Zoul Z, Filip S, Melichar B, Dvorák J, Odrázka K, Petera J. Weekly Paclitaxel Combined with Local Hyperthermia in the Therapy of Breast Cancer Locally Recurrent after Mastectomy – a Pilot Experience. Oncol Res Treat 2004; 27:385-8. [PMID: 15347895 DOI: 10.1159/000079093] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The combination of chemotherapy and hyperthermia (HT) is a promising approach in the treatment of malignant tumors. In the present report we evaluate the efficacy and toxicity of a combination of weekly paclitaxel combined with local hyperthermia in breast cancer. PATIENTS AND METHODS 7 patients were treated for inoperable local recurrence of breast cancer after mastectomy, irradiation, and chemotherapy or hormonal therapy. They weekly received paclitaxel (60-80 mg/m(2)) in 3-h infusions followed by local HT 41-44 degrees C for 45 min for 6-18 cycles. RESULTS Objective local response was observed in all treated patients (complete response in 4 patients and partial response in 3 patients). There were no grade 3 or 4 toxicities, neurologic toxicity or hypersensitivity reactions. Local tolerance to this regimen was also good, with only 4 patients developing mild transient erythema. CONCLUSION Our experience indicates that the combination of weekly paclitaxel and HT may be effective in the treatment of locally recurrent breast cancer after mastectomy.
Collapse
Affiliation(s)
- Z Zoul
- Department of Oncology and Radiotherapy, Charles University Medical School Teaching Hospital, Hradec Králové, Czech Republic.
| | | | | | | | | | | |
Collapse
|
49
|
Ushida H, Koizumi S, Okada Y. [A prostatic duct carcinoma difficult to distinguish from transitional cell carcinoma: a case report]. Hinyokika Kiyo 2004; 50:535-8. [PMID: 15471072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A 77-year-old male with a complaint of dysuria and gross hematuria for 3 months visited our hospital. Abdominal ultrasonography, computed tomographic scan and magnetic resonance imaging revealed a prominent tumor from the bladder neck. Serum prostate specific antigen (PSA) level was high (1,130 ng/ml) suggesting prostate cancer, but transitional cell carcinoma (TCC) was detected by transurethral biopsy. Bone scintigraphy revealed multiple bone metastasis. Since gross hematuria requiring bladder tamponade continued, simple cystoprostatectomy and cutaneous ureterostomy were performed. Pathological findings showed prostatic acinar carcinoma and prostatic duct carcinoma mimicking TCC, and PSA immunohistochemically weak positive. The final diagnosis was prostate cancer consisting of acinar and ductal component. Adjuvant hormonal therapy was performed, but was ineffective. The patient died 2.5 months after operation. We reviewed and discussed 66 cases of prostatic duct carcinoma, including our case, in the Japanese literature.
Collapse
MESH Headings
- Aged
- Biomarkers, Tumor/blood
- Bone Neoplasms/diagnosis
- Bone Neoplasms/secondary
- Carcinoma, Acinar Cell/diagnosis
- Carcinoma, Acinar Cell/pathology
- Carcinoma, Acinar Cell/therapy
- Carcinoma, Ductal/diagnosis
- Carcinoma, Ductal/pathology
- Carcinoma, Ductal/secondary
- Carcinoma, Ductal/therapy
- Carcinoma, Transitional Cell
- Cystectomy
- Diagnosis, Differential
- Diagnostic Imaging
- Fatal Outcome
- Humans
- Male
- Neoplasms, Multiple Primary
- Prostate-Specific Antigen/blood
- Prostatectomy
- Prostatic Neoplasms/diagnosis
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/therapy
- Ureterostomy
- Urinary Bladder Neoplasms
Collapse
|
50
|
Dixon JM, Gregory K, Johnston S, Rodger A. Breast cancer (non-metastatic). Clin Evid 2004:2300-33. [PMID: 15652112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
|