Current Issue : January - March Volume : 2016 Issue Number : 1 Articles : 7 Articles
A 26-year-old male without any significant past medical history presented to the hospital with shortness of breath, cough, pleuritic\nchest pain, and weight loss for the past 3 months. On chest CT, he was found to have extensive mediastinal and hilar lymphadenopathy\nand multiple pulmonary nodules. On physical examination, a right groin mass was noted which had been slowly growing\nfor the past 2 years. Ultrasound of the groin showed complex solid mass with internal vascular channels. CT guided biopsy of the\nmass showed desmoplastic small round cell tumour. His hospital course was complicated by hypoxic respiratory failure requiring\nemergent intubation and ICU admission where he completed one cycle of vincristine, cyclophosphamide, and doxorubicin with\nsubsequent improvement, followed by extubation. His condition continued to improve after second cycle of chemotherapy and he\nwas ultimately discharged in a stable condition to continue outpatient chemotherapy after a 2-month inpatient stay....
Oral squamous cell carcinoma (OSCC) is usually preceded by detectable mucosal changes, as leukoplakias and erythroplakia.\nHistologically, these lesions can range from hyperkeratosis and acanthosis to epithelial dysplasia and even OSCC. The aim of\nthis study was to investigate the proliferative activity, using AgNORs quantification proteins, in low- and high-risk oral epithelial\ndysplasia, OSCC, and nondysplastic epithelium (inflammatory fibrous hyperplasia). The sample was divided into 4 groups: G1:\n10 cases of inflammatory fibrous hyperplasia (IFH), G2: 11 cases of low-risk epithelial dysplasia (LD), G3: 10 cases of high-risk\nepithelial dysplasia (HD), and G4: 11 cases of OSCC. The quantitative analysis was performed using an image processing software in\nphotomicrographs at 1000x magnification.The one-way ANOVA was used for comparison of the mean AgNORs counts between\nthe study groups. The mean AgNORs count was significantly higher (...
Gallbladder cancer (GBC) is an uncommon disease in the majority of the world despite being the most common and aggressive\nmalignancy of the biliary tree. Early diagnosis is essential for improved prognosis; however, indolent and nonspecific clinical\npresentations with a paucity of pathognomonic/predictive radiological features often preclude accurate identification of GBC at\nan early stage. As such, GBC remains a highly lethal disease, with only 10% of all patients presenting at a stage amenable to surgical\nresection. Among this select population, continued improvements in survival during the 21st century are attributable to aggressive\nradical surgery with improved surgical techniques. This paper reviews the current available literature of the 21st century on PubMed\nand Medline to provide a detailed summary of the epidemiology and risk factors, pathogenesis, clinical presentation, radiology,\npathology, management, and prognosis of GBC....
Although signet-ring cell (SRC) adenocarcinoma is commonly seen in the stomach, it is a very rarely seen histologic entity in the\nbladder. It is difficult to distinguish primary SRC adenocarcinoma of the bladder from bladder metastasis of SRC carcinoma of the\nstomach only based on histological findings. In such cases, clinical findings and immunohistochemical studies may be helpful.We\npresent here a 48-year-old male patient presenting with hematuria and abdominal pain. Computerised tomography of the patient\nrevealed a gastric mass, peritoneal involvement, and thickening of the bladder wall, and histopathological analysis revealed SRC\nadenocarcinoma in both of the endoscopic biopsies taken fromthe stomach and bladder. Immunohistochemical analyses confirmed\nthe diagnosis of SRC adenocarcinoma of the bladder secondary to gastric cancer....
On the basis of remarkable antitumor activity, programmed death receptor-1 (PD-1) inhibitors pembrolizumab and nivolumab were\napproved for the treatment of advanced melanoma in the second-line setting following progression on either CTLA-4 inhibitor\nipilimumab or BRAF/MEK inhibitors (for BRAF mutated melanoma). Given hypothesized risk of triggering exacerbations of\nautoimmune diseases and/or chronic viral infections, clinical trials (including regulatory studies) evaluating checkpoint blocking\nantibodies PD-1 and CTLA-4 have excluded patients with autoimmune diseases, chronic hepatitis B/C virus (HBV/HCV), and/or\nhuman immunodeficiency virus (HIV) infections. Herein, we describe two patients with advanced melanoma and concomitant\nHCV/HIV infections treated with PD-1 inhibitor pembrolizumab. Patient 2 with HIV/HCV coinfection progressed after 2 doses\nof pembrolizumab. Patient 1 who had HCV alone was treated with pembrolizumab with initial partial response. HCV viral load\nremained stable after 9 cycles of pembrolizumab following which 12-week course of HCV-directed therapy was commenced,\nresulting in prompt reduction of HCV viral load below detectable levels. Response is ongoing and HCV viral load remains\nundetectable. In both patients, no significant toxicities were observed when pembrolizumab was initiated.We argue for the further\ninvestigation of checkpoint inhibition in cancer patients with underlying chronic viral infections in the context of carefully designed\nclinical trials....
Primary CNS melanomas are rare and they constitute about 1% of all cases of melanomas and 0.07% of all brain tumors. These\ntumors are aggressive in nature and may metastasise to other organs. Till date less than 25 cases have been reported in the literature.\nThe primary treatment for local intraparenchymal tumours is complete resection and/or radiotherapy and it is associated with good\nsurvival. However once there is disease spread to leptomeninges the overall median survival is around 10 weeks. In this case report\nwe describe a primary intracranial melanoma without any dural attachment in 16-year-old boy who had radical excision of the\ntumor followed by radiotherapy who eventually had rapidly developed leptomeningeal disease and review the literature with a\nfocus on the clinic pathological, radiological, and treatment options....
Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods.\nWe conducted a prospective cohort study to characterize the syndrome that we term ââ?¬Å?pulmonary vein obstruction syndromeââ?¬Â\n(PVOS) between January 2005 and March 2014. The criteria for inclusion were (1) episodes of shortness of breath; (2) chest\nX-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3)\nCT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and\ntwenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28\n(13%), and medical/surgical procedures in 21 (9%) and showed diurnal change in intensity in 32 (14%). Chest X-rays all revealed\nabnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87%) and pleural effusion in 192 (86%). CT scans all\nshowed pulmonary vein thrombosis/tumor (100%) and surrounding the pulmonary veins by tumor lesions in 140 patients (63%).\nPVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image\nimprovement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal\npulmonary hilum shadows....
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