Combined administration of ethodolac, ascorbic acid and radiotherapy as adjuvant therapies in an extrathoracic desmoid tumor with gross postoperative residual disease; case report and review of the literature

A 37-year-old man was admitted with an extrathoracic desmoid tumor invading the brachial plexus. Magnetic resonance imaging (MRI) of the thorax demonstrated a 20 x 9 x 14 cm mass in the supraclavicular fossa, axillary fossa and the right side of the chest. It invaded the brachial plexus and circumscribed the subclavian and axillary arteries concentrically. Biopsy revealed desmoid tumor which was resected subtotally with the brachial plexus. The gross residual mass was treated postoperatively with radiotherapy (60 Gy) which resulted in major regression of the mass. Following radiotherapy, ethodolac with ascorbic acid were administered. The tumor was clinically indiscernible 35 months post-radiotherapy. This case shows the high effectiveness of radiotherapy along with less toxic medical treatment modalities in instances where local control is hard to achieve with surgery and highlights the importance of using multidisciplinary treatments to maintain good functional results.

Isolated inguinal lymph node metastasis from breast carcinoma--case report and review of the literature

We report on a case of a premenopausal woman with breast cancer and unusual dissemination with isolated inguinal and iliac lymph node metastasis. The primary tumor was T2N0M0. After mastectomy the patient received adjuvant chemotherpy, hormonotherapy and radiotherapy (RT). Painful edema developed at the right leg 69 months after the operation. Diagnostic investigations revealed isolated right inguinal and iliac lymphadenopathy (LAP). Tru-cut aspiration biopsy was reported as negative. Four months later, abdominal magnetic resonance imaging (MRI) disclosed paraaortic and bilateral iliac and inguinal LAP. Pathological assessment of the right inguinal LAP confirmed a metastasis from breast cancer. After unsuccesful chemotherapy, palliative RT was performed to the inguinal, iliac and paraaortic lymph nodes, resulting in partial response. The patient ultimately died because of disease progression. Clinicians should maintain a high degree of suspicion when coming across with unusual complaints and findings in patients with breast cancer.