Malignant Cell Tumors Research Articles

Electroporation-Based Treatments in Small Animal Veterinary Oral and Maxillofacial Oncology.

Electroporation is a method of inducing an increase in permeability of the cell membrane through the application of an electric field and can be used as a delivery method for introducing molecules of interest (e.g., chemotherapeutics or plasmid DNA) into cells. Electroporation-based treatments (i.e., electrochemotherapy, gene electrotransfer, and their combinations) have been shown to be safe and effective in veterinary oncology, but they are currently mostly recommended for the treatment of those solid tumors for which clients have declined surgery and/or radiotherapy. Published data show that electroporation-based treatments are also safe, simple, fast and cost-effective treatment alternatives for selected oral and maxillofacial tumors, especially small squamous cell carcinoma and malignant melanoma tumors not involving the bone in dogs. In these patients, a good local response to treatment is expected to result in increased survival time with good quality of life. Despite emerging evidence of the clinical efficacy of electroporation-based treatments for oral and maxillofacial tumors, further investigation is needed to optimize treatment protocols, improve clinical data reporting and better understand the mechanisms of patients' response to the treatment.

PRIMARY ORAL LEIOMYOSARCOMA: A DETAILED CASE REPORT AND IMMUNOHISTOCHEMICAL ANALYSIS

Leiomyosarcoma is a malignant neoplasm characterized by proliferation of cells with smooth muscle differentiation. It is extremely rare in the oral cavity; to date, only well-documented 29 cases of primary oral leiomyosarcoma have been reported. A 35-year-old man was referred complaining of a painful tumor mass on the right mandibular body, lasting for 45 days. During anamnesis, the patient reported previous dental examination, being diagnosed as pericoronitis, followed by antibiotic prescription, but the lesion continued to increase. Extra-oral examination showed prominent facial asymmetry on the right side. Intra-oral examination revealed an extensive tumor mass measuring 8 × 5 × 2 cm on the right mandibular region. Panoramic radiography showed an ill-defined radiolucent area. After incisional biopsy, microscopy revealed a spindle cell malignant neoplasm. Immunohistochemistry showed positivity for vimentin, alpha-smooth muscle actin, and focally for desmin. Ki-67 was 50%. A diagnosis of primary oral leiomyosarcoma was established. The patient was referred for oncological treatment.

Primary round cell sarcomas of the urinary bladder with EWSR1 rearrangement: a multi-institutional study of thirteen cases with a review of the literature

Primary Ewingsarcoma (ES) of the urinary bladder is a rare and aggressive small blue round cell malignant neoplasm associated primarily with translocation involving EWSR1 and FLI1 genes located in the 22nd and 11th chromosomes, respectively. To date, 18 cases have been published in the literature as single-case reports, based chiefly on CD99 positivity (17 patients). Molecular confirmation by fluorescence in situ hybridization was performed in 9 patients, and FLI1 immunohistochemical (IHC) analysis was not performed in any of these published cases. Herein, we present thirteen patients of more comprehensive primary round cell sarcomas of the urinary bladder with EWSR1 rearrangement. Clinicopathologic parameters including demographics; clinical presentation; histopathologic, IHC, and molecular profiles; and management and follow-up data of 13 patients with primary round cell sarcomas with EWSR1 rearrangement (Ewingfamily of tumor) of the urinary bladder were analyzed. The studied patients (n = 13) included 6 females and 7 males; their age ranged from 4 years to 81 years (median=30 years). The most common clinical presentation was hematuria (n=7), followed by hydronephrosis (n=2, one with renal failure). The tumor size ranged from 2.9cm to 15cm in maximum dimension. Conventional ES architecture and histology was observed in 6 cases, and diverse histology was observed in 7 cases (adamantinomatous pattern [n=1], alveolar pattern [n=1], ganglioneuroblastoma-like pattern [n=2], and small cell carcinoma-likepattern [n=3]). All the tumors were muscle invasive (invasion into the muscularis propria). IHC analysis showed that all tumors expressed FLI1, CD99, and at least one neuroendocrine marker. Focal cytokeratin staining was positive in 2 patients, and RB1 was retained in all patients. EWSR1 rearrangement was seen in 12 of 12 tumors (in 12 patients) tested. A combined multimodal approach that included surgery with chemotherapy was instituted in all patients. Follow-up was available for 11 patients (ranging from 5 to 24 months). Six patients either died of disease (n=3) or other causes (n=3). Five patients were alive with metastases to the liver (n=1), liver and lung (n=2), liver and abdominal wall (n=1), and kidney (n=1). Based on our experience with the largest series to date and aggregate of the published data, ES/round cell sarcomas with EWSR1 rearrangement occurring in the bladder have bimodal age distribution with poor prognosis despite aggressive therapy. Owing to its rarity and age distribution, the differential diagnosis is wide and requires a systematic approach for ruling out key age-dependent differential diagnoses aided with molecular confirmation.

Anal extraskeletal osteosarcoma in a man: a case report and review of the literature

BackgroundOsteosarcoma is a common malignancy of bone that usually occurs in individuals in the age range of 0–24 years. Extraskeletal osteosarcoma is a rare tumor presentation which originates in non-bony tissues. Extraskeletal osteosarcoma comprises 2–5% of all osteosarcomas and less than 1% of all soft tissue sarcomas. As compared to bone-derived osteosarcoma, extraskeletal osteosarcoma occurs in older age groups. Extraskeletal osteosarcoma has a poorer prognosis than bone osteosarcoma. To the best of our knowledge, this is the first case of extraskeletal osteosarcoma in the anal region.Case presentationA 70-year-old Hazara man presented to a private hospital with the chief complaints of constipation, bloody defecation, and pain during defecation of 1.5 months’ duration. His past history was unremarkable. A digital rectal examination showed a solid growth in the middle part of his anus. A colonoscopic examination was done and showed a solid mass in his anal region. A computed tomography scan revealed an irregular mural thickening in the anal canal with heterogeneous enhancement. The maximum length of the involved segment was measured to be 4.5 cm. No suspicious lesions were noted in other organs. An abdominoperineal resection was performed on our patient. A 22 cm in length resected segment of his colon, consisting of the lower sigmoid, rectum, and anus was sent to us for histopathological examination. Gross examination revealed a polypoid dark-gray tumor measuring 5 × 3 × 2 cm. The cut section revealed gray and white appearance with firm-to-hard consistency and foci of ossification. Microscopic examination revealed normal anorectal mucosa and a spindle cell malignant neoplasm with osteoid formations. No evidence of epithelial carcinoma was noted. Immunohistochemical stains were positive for stabilin-2 and negative for cytokeratin, which confirmed the diagnosis of osteosarcoma.ConclusionExtraskeletal osteosarcoma of the colon is rare and presence of the tumor in the rectum and anal region is extremely rare. Radiology, colonoscopy, and histopathology with immunostaining are required for the diagnosis. The accurate diagnosis of extraskeletal osteosarcoma is important as it has a different regimen of treatment with poorer prognosis compared to primary osteosarcoma of the bone.

Ewing’s sarcoma of sinonasal tract: a rare case

<p class="abstract">Extra skeletal Ewing’s sarcoma (EES) is a rare, rapidly growing, round cell malignant tumour that can develop in the soft tissue at any location. Involvement of the paranasal sinus is a very rare entity. Nearly 80% of patients are younger than 20 years. Diagnosis is made after histopathological examination, immunohistochemical studies and cytogenetic studies. Treatment includes a multidisciplinary approach with surgery as the first line followed by chemotherapy and radiotherapy.</p><p class="abstract"> </p>

Cytopathology of Xp11 translocation renal cell carcinoma: a report of 5 cases

Xp11.2 translocation-associated RCC (Xp11RCC) defined by molecular alterations involving TFE3 genetic rearrangements constitutes a large percentage of primary renal neoplasms in children, but less than 4% of adult cases. Fewer than 10 single case reports constitute the English cytopathology literature regarding this neoplasm. Our objective is to describe and illustrate the cytopathology of this uncommon renal neoplasm from a series of 5 cases using cytologic imprints, effusion specimens, and fine-needle aspiration (FNA) cytology. Review was made of our cytopathology and surgical pathology databases. FNA biopsy smears and imprint smears were performed using a standard technique. Effusion samples were processed using liquid-based slides. Five cytologic specimens from 4 patients with histopathologically confirmed Xp11RCC were identified (mean age: 36 years) over a period of 7 years. All cases contained large cells with voluminous amounts of vacuolated cytoplasm arranged in non-descript clusters and as single forms. A "tigroid" pattern consisting of linear strips of detached cytoplasm was seen in both imprint smear cases and the single FNA case. Psammomatous calcifications, true papillary structures, and hyaline globules were absent in all cases. Four examples were diagnosed as Xp11RCC, but 3 represented metastatic disease, and 1 was diagnosed using both cytology and core needle tissue histopathology. The remaining case was diagnosed nonspecifically as a clear cell malignant neoplasm. The cytopathologic features of Xp1RCC are relatively nonspecific, and overlap with other renal cell carcinoma subtypes. A definitive diagnosis is only possible with ancillary immunohistochemistry with or without additional TFE3 fluorescence in situ hybridization.

Diagnosis and treatment of supratentorial tumors with small round cell malignancies diagnosed by intraoperative rapid pathology

Objective To explore the diagnosis and treatment of supratentorial tumors with small round cell malignancies diagnosed by intraoperative rapid pathology. Methods A retrospective analysis was conducted on the clinical data of 36 patients with supratentorial tumors diagnosed as small round cell malignant tumors by intraoperative frozen pathology at Department of Neurosurgery, Nanfang Hospital, Southern Medical University from January 2011 to December 2017. All patients were treated with complete tumor resection according to the principle of glioma operation. After the operation, the MRI of the head was reexamined, and the volume quantitative analysis was used to determine the degree of tumor resection, which was divided into complete resection, subtotal resection and partial resection. All patients were followed up regularly in outpatient department, and MRI was reexamined to explore the recurrence of tumor. Results MRI of 36 patients after operation showed that 31 patients (86.1%) had complete resection and 5 patients (13.9%) had subtotal resection. The results of pathological diagnosis were as follows: primary central nervous system lymphoma (10 cases), glioblastoma (6 cases), central neurocytoma (5 cases), primitive neuroectodermal tumors (3 cases), brain metastasis tumor (2 cases), pineal cell tumors(2 cases), ependymoblastoma (2 cases), World Health Organization (WHO) grade Ⅱ glioma (2 cases), pituitary adenoma (1 case), periangioblastoma (1 case), olfactory neuroblastoma(1 case) and desmoplastic small round cell tumor (1 case). Among the 33 patients diagnosed by MRI before operation, 8 (24.2%) had the same pathological results with preoperative diagnosis, including 4 cases of lymphoma, 1 case of central neurocytoma, 1 case of primitive neuroectodermal tumor, 1 case of hemangioblastoma and 1 case of metastasis. The follow-up duration of 36 patients was 28.9±8.1 months and ranged from 6 to 70 months . During the follow-up period, 26 out of 36 patients (72.2%) relapsed. Conclusions The supratentorial tumors with small round cell malignant tumor diagnosed by rapid pathology during operation should be resected in the maximal range under the premise of safety, the pathological results are various and its therapeutic effect seems relatively good. Key words: Supratentorial tumor; Pathology; Treatment outcome; In operation; Small round cell tumor

Bortezomib, Thalidomide and Dexamethasone Compared to Cyclophosphamide, Bortezomib and Dexamethasone As Induction Therapy for the Treatment of Transplant Eligible Multiple Myeloma: Real World Experience with Multiple Myeloma Patients in Colombia

<h3>Background and objectives</h3> Multiple Myeloma (MM) is a clonal plasma cell malignant neoplasm that accounts for approximately 10% of hematologic malignant disorders. ¹ Transplant-eligible patients typically receive approximately 4-6 cycles of initial therapy followed by stem cell collection and ASCT (autologous stem cell transplantation).2 In this study, we aimed to compared the effect of VTD and CyBorD for the treatment of transplant eligible MM patients in 1 center in Bogota, Colombia <h3>Patients and methods</h3> we included 146 patients with MM that performed an ASCT between January 2013 and August 2019 in a single institution. The median age (range) was 58.4 (24-73) years. During the procedure all patients received melphalan as conditioning chemotherapy. The primary objective was to assess ORR, CR, nCR, >=VGPR and PR rates after induction and at day 100 post-ASCT. <h3>Results</h3> 87 patients have received VTD and 59 have received CyBorD. Clinical characteristics are shown in table N1. At time of analysis, 20 patients in VTD group and 15 patients in CyBorD have had progressed. CR/nCR and VGPR rates after a median of 4 cycles of induction were 47.1% and 66.6% for patients treated with VTD and 50.8% and 62.7 for CyBorD group (P=0.29). At day 100 post Ð ASCT CR/nCR and VGPR rates improved in both groups, 60.9% and 74.7% in patients treated with VTD and 62.7% and 72.8 in patients with CyBorD (P=0.31). Median Overall Survival (P=0.8) and Progression Free Survival (P=0.1) did no differ among both groups (figure 1). Median time from ASCT to relapse was 15.2 months (CI 2.57- 29.2) for VTD group compared with 6.8 months (CI 12.73 Ð 27.9) for CyBorD group with a tendency towards statistical significance favoring VTD combination(P=0.06). <h3>Conclusions</h3> VTD and CyBorD are effective treatment options for transplant multiple myeloma patients, this study showing higher rates of >= VGPR after induction and day- 100 post ASCT in the VTD group.

Intraspinal metastasis of alveolar rhabdomyosarcoma: A case report

This paper reported a case of cervical intraspinal metastasis of alveolar rhabdomyosarcoma (ARMS). The clinicopathological features, surgical treatment, chemotherapy and prognosis were introduced and the current literature was reviewed. The diagnosis, differential diagnosis, treatment, molecular features and prognosis of the disease were comprehensively analyzed to improve clinicians' knowledge of this rare disease. The primary lesion appeared about 1 year ago which was painless mass of left hand whose size was about 2 cm×2 cm. After conservative treatment, the mass gradually enlarged and the mass was resected. Postoperative pathology revealed embryonic rhabdomyosarcoma. Postoperative chemotherapy with recombinant human endostatin, liposomal doxorubicin and ifosfamide was performed. The left neck mass was found about 3 months ago, and then the left neck mass was resected under general anesthesia. Postoperative pathological examination showed small round cell malignant tumors. Severe left upper extremity pain began about 2 weeks ago with nocturnal pain and supine pain. Non-steroidal anti-inflammatory drugs were needed to relieve pain which was accompanied by numbness and weakness of the left upper extremity. MRI showed a intraspinal tumor at C5. The left thumb and index finger were absent. Hypoesthesia, muscle atrophy and hypotonia of the left upper limb were confirmed. The muscle strength of biceps brachii and deltoid muscle of the left upper limb was grade 0, the muscle strength of extensor carpus and interphalangeal muscle was grade II, the muscle strength of intrinsic muscles of hands was grade I. The tendon reflex of the left upper limb disappeared. Intraspinal mass was removed and the pain was relieved. But there was no significant change in the muscle strength of the left upper limb. Pathological examination revealed small cell malignancies which were poorly differentiated with diffuse patchy distribution and disordered arrangement. The tumor cells had round, oval or irregular nuclei, and few cytoplasms were positive for Myogenin and MyoD1. FISH test of FOXO1 gene was positive. More than 50% of nuclei showed redgreen signal separation, and the distance between redgreen signals was larger than double diameter of the signal points, which supported ARMS. Total resection of intraspinal tumors was achieved and postoperative chemotherapy was admitted. But intraspinal disseminated metastasis occurred rapidly. ARMS was rare, aggressive tumor with poor prognosis. Subdural metastasis was rare. Correct diagnosis and classification can be made only with help of modern molecular diagnostic methods, which is effective to guide the treatment.

DIFFUSE LARGE B-CELL LYMPHOMA IN THE UPPER LIP: CASE REPORT

Diffuse large B-cell lymphomas (DLBCLs) are uncommon in the mouth; however, they are the commonest type of non-Hodgkin lymphomas at this site. Preferentially, they affect tonsils and their occurrence in the upper lip is rare. This work reports a case of DLBCL arising in the left upper lip of a 73-year-old white woman that was recently diagnosed as having advanced breast cancer besides being a carrier of Parkinson and Alzheimer diseases. The mucosal surface of the upper lip displayed a solitary, fast-growing, painful, ulcerated, reddish, and sessile 4-cm-sized swelling without cervical lymph node involvement at presentation. After incisional biopsy, the microscopic analysis showed a lymphoid cell malignant neoplasm presenting great amounts of large-to-medium–sized cells resembling centroblasts losing cell cohesion. Immunohistochemical profile was intensely positive for CD20 and Ki-67, diffusely positive for CD3, and negative for pan-cytokeratins. Unfortunately, the patient died 2 weeks after our clinical care before receiving her final diagnosis. Diffuse large B-cell lymphomas (DLBCLs) are uncommon in the mouth; however, they are the commonest type of non-Hodgkin lymphomas at this site. Preferentially, they affect tonsils and their occurrence in the upper lip is rare. This work reports a case of DLBCL arising in the left upper lip of a 73-year-old white woman that was recently diagnosed as having advanced breast cancer besides being a carrier of Parkinson and Alzheimer diseases. The mucosal surface of the upper lip displayed a solitary, fast-growing, painful, ulcerated, reddish, and sessile 4-cm-sized swelling without cervical lymph node involvement at presentation. After incisional biopsy, the microscopic analysis showed a lymphoid cell malignant neoplasm presenting great amounts of large-to-medium–sized cells resembling centroblasts losing cell cohesion. Immunohistochemical profile was intensely positive for CD20 and Ki-67, diffusely positive for CD3, and negative for pan-cytokeratins. Unfortunately, the patient died 2 weeks after our clinical care before receiving her final diagnosis.

The Syk Kinase Promotes Mammary Epithelial Integrity and Inhibits Breast Cancer Invasion by Stabilizing the E-Cadherin/Catenin Complex.

While first discovered in immunoreceptor signaling, the Syk protein kinase behaves as a tumor and metastasis suppressor in epithelial cells. Its reduced expression in breast and other carcinomas is correlated with decreased survival and increased metastasis risk, but its action mechanism remains largely unknown. Using phosphoproteomics we found that Syk phosphorylated E-cadherin and α-, β-, and p120-catenins on multiple tyrosine residues that concentrate at intercellular junctions. Increased Syk expression and activation enhanced E-cadherin/catenin phosphorylation, promoting their association and complex stability. In human breast cancer cells, Syk stimulated intercellular aggregation, E-cadherin recruitment and retention at adherens junctions, and promoted epithelial integrity, whereas it inhibited cell migration and invasion. Opposite effects were obtained with Syk knockdown or non-phosphorylatable mutant E-cadherin expression. Mechanistically, Syk stimulated the interaction of the E-cadherin/catenin complex with zonula occludens proteins and the actin cytoskeleton. Conditional Syk knockout in the lactating mouse mammary gland perturbed alveologenesis and disrupted E-cadherin localization at adherens junctions, corroborating the observations in cells. Hence, Syk is involved in the maintenance of the epithelial integrity of the mammary gland via the phosphorylation and stabilization of the E-cadherin/catenin adherens junction complex, thereby inhibiting cell migration and malignant tumor invasion.

Current management and emerging treatment strategies for multiple myeloma.

Multiple myeloma is a malignant plasma cell neoplasm that is incurable despite significant progress in treatment over the past several decades. The incorporation of novel agents and combinations into the MM treatment paradigm has resulted in improved survival and tolerability, as well as deeper responses including achieving a minimal residual disease negative state. The addition of new treatment options and combinations has added complexity in treatment selection for myeloma patients. The current strategy for newly diagnosed myeloma involves induction, consolidation, and maintenance therapy. However, nearly all myeloma patients will develop refractory disease. This highlights the need for more effective therapies targeting the myeloma cells and their microenvironment. In this article, we summarize current management of transplant eligible and ineligible newly diagnosed patients in both the upfront and relapsed refractory setting, highlighting risk adapted strategies. We also summarize emerging therapies, such as immune and targeted approaches, as well as drugs with novel mechanisms of action. Emerging strategies offer individualized treatment options and may ultimately offer the possibility of a cure for myeloma patients.

Diuretics and skin cancer

Diuretics and skin cancer

The Effect of PET/CT Deauville Criteria on Progression Free Survival and Overall Survival in Multiple Myeloma Patients Following Autologous Stem Cell Transplantation

Multiple myeloma (MM) is a clonal plasma cell malignant neoplasm that accounts for approximately 10% of hematologic malignant disorders. PET/CT is increasingly used as an imaging modality in MM. However, data about the role of PET/CT on prognosis are scarce. The aim of our study was to evaluate the role of Deauville score on PET/CT performed at day 100 after autologous stem cell transplantation, in terms of its guidance on treatment response, overall survival and progression free survival. Materials and

Efficacy of a Modified Scoring System to Facilitate Surgical Decision‐making for Diaphyseal Malignancies: When is Devitalized Tumor‐bearing Autograft of Value?

ObjectivesTo evaluate the validity of a modified scoring system (MSS) for inferring the bony quality of tumor‐bearing diaphyses and predicting the risk of reconstructive failure after devitalized bone replantation (DBR).MethodsIn this retrospective cohort study, we reviewed the records of 30 patients surgically treated for diaphyseal malignancies between 1996 and 2015. There were 18 male and 12 female subjects; the average age was 34.0 ± 24.5 years (8–82 years). Tumor locations comprised the femur (21), the humerus (4), the tibia (3), the radius (1), and the fibula (1). Histological diagnoses included osteosarcoma (13), metastases (4), Ewing sarcoma (3), chondrosarcoma (3), malignant fibrohistiocytoma (2), periosteal osteosarcoma (1), Langerhans cell sarcoma (1), lymphoma (1), rhabdomyosarcoma (1), and malignant giant cell tumor (1). All primary tumors were rated as stage IIB. Twenty patients underwent DBR. Prosthetic procedures and segmental autografting/allografting were performed in 7 and 3 cases, respectively. MSS (comprising 5 elements: pain, tumor location, bone destruction, localized dimension, and longitudinal dimension) for each patient was calculated in accordance with their preoperative presentations. Outcome measurements included oncological results, outcomes of reconstructions, complications, and functional preservation, presented using the musculoskeletal tumor society (MSTS) scale.ResultsFollow up was available in 29 cases for an average duration of 61.0 ± 49.9 months (12–152 months). Infection occurred in 2 patients (6.9%), primary nonunion in 6 (27.3%), metastases in 9 (31.9%), recurrences in 4 (13.8%), and deaths in 7 (24.1%); 1 subject underwent amputation due to recurrence following endoprosthetic replacement (3.4%). In the DBR group, fractures occurred in 4 cases (21.1%) and nonunion in 5 (25%); internal fixation was related to nonunion (nails, 44.4% vs plates, 9.1%, P = 0.02). MSS was associated with fractures of devitalized autografts (11.0 ± 1.2 vs 8.3 ± 1.8, P = 0.01); the system was efficacious in predicting chances of fractures of these grafts (P = 0.02). MSS ≥ 10 (with false positive rate ≤ 6.7%) suggested increased fracture probability (≥22.7%) after DBR; therefore, 10 was considered a cutoff value.ConclusionsDiaphyseal malignancies with MSS ≥10 may contraindicate DBR for increased chances of reconstructive failure. In this situation, alternative procedures are advisable. Further investigations are warranted to assess the efficacy of MSS in implying the validity of DBR for diaphyseal malignancies.

Ischiorectal fossa: benign and malignant neoplasms of this "ignored" radiological anatomical space.

To review the pertinent anatomy and the imaging features of common and uncommon benign and malignant neoplasms and masses of the ischiorectal fossa. The ischiorectal or ischioanal fossa is the largest space in the anorectal region. The benign neoplasms that develop in the ischiorectal originate from the different components that forms the fossa including vascular tumors such as aggressive angiomyxoma or hemangioma; neural tumors as plexiform neurofibroma or schwannoma; fat tumors as lipoma; skin/skin appendages tumors as hidradenoma papilliferum; smooth or skeletal muscle tumors as solitary fibrous tumor. The malignant neoplasms that develop in the ischiorectal fossa also originate from different components that forms the fossa including vascular tumors such as angiosarcoma, neural tumors as malignant granular cell tumor and malignant peripheral nerve sheath tumor; fat tumors as liposarcoma; smooth or skeletal muscle tumors as leiomyosarcoma, rhabdomyosarcoma, malignant PEComa, or undifferentiated pleomorphic sarcoma. Additionally, the ischiorectal fossa can also harbor secondary hematogenous metastases and be affected by direct invasion from neoplasms of adjacent pelvic organs and structures. Furthermore, other miscellaneous masses can occur in the ischiorectal fossa including congenital and developmental lesions, and inflammatory and infectious processes. Knowledge of the anatomy, and the spectrum of imaging findings of common and uncommon benign and malignant neoplasms of the ischiorectal fossa is crucial for the radiologists during interpretation of images allowing them to make contributions to the diagnosis and better patient management.

Rare Breast Malignancy Subtypes: A Cytological, Histological, and Immunohistochemical Correlation.

Background:Breast malignancies encompass various subtypes which differ in their clinical presentations, outcomes, and response to the treatment regimens. Thus, a proper histological diagnosis and a special mention of the rare histologic subtypes are required to formulate clear recommendations of their treatment protocols.Materials and Methods:This is a 1-year retrospective study highlighting the rarely encountered subtypes on the mastectomy specimens received.Results:We encountered only 11 rare cases out of the total 153 mastectomy specimens received. The rare subtypes were as follows mucinous cystadenocarcinoma (0.6%), mucinous carcinoma (0.6%), dermatofibrosarcoma protuberans (0.6%), Squamous cell carcinoma (0.6%), papillary carcinoma (2.6%), medullary carcinoma (0.6%), and malignant mesenchymal tumor (1.3%).Conclusion:Our data suggest that these variants are distinct clinicopathological entities with a unique hormonal receptor status. Scant information is available on the rare breast tumor subtypes.

Penectomia parcial em equino com carcinoma espinocelular: relato de caso

O carcinoma espinocelular, ou carcinoma epidermóide, é uma neoplasia maligna de células escamosas. Possui crescimento rápido nas células epidérmicas, sendo comumente encontrado na espécie equina, em regiões como pênis e prepúcio, tendo maior predileção por animais de idade avançada e não castrados. O diagnóstico diferencial é baseado em fatores como sintomatologia clínica e citologia, assim como no exame histopatológico da lesão. Dentre as possibilidades para acometimento em pênis, a remoção cirúrgica da lesão, ou seja, a penectomia, é o tratamento de eleição para o carcinoma espinocelular, pontuando que, nessa neoplasia, é comum haver casos de recidiva . Este trabalho relata um caso de carcinoma epidermóide em um equino sem raça definida (SRD) atendido no hospital veterinário (HV) da Faculdade Dr. Francisco Maeda e descreve a técnica cirúrgica utilizada para o tratamento.

A multi-institutional retrospective study of carbon-ion radiotherapy for non-squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon-Ion Radiation Oncology Study Group study 1402 HN.

BackgroundThis multi‐institutional retrospective study focused on the clinical outcome of carbon‐ion radiotherapy (C‐ion RT) for non‐squamous cell malignant tumors of the nasopharynx.MethodsThe Japan Carbon‐ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non‐squamous cell malignant tumors of the nasopharynx treated with C‐ion RT at four institutions in Japan.ResultsTwenty‐nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty‐six of the 43 patients (61%) had T4 tumors. The most common dose‐fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow‐up period was 30 months. The 2‐year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation.ConclusionsC‐ion RT provided good LC and OS rates with acceptable toxicity for treatment of non‐squamous cell malignant tumors of the nasopharynx.

Programmed death ligand 1 and CD8+ immune cell infiltrates in resected primary tracheal malignant neoplasms.

Many patients with primary malignant tracheal neoplasms are not surgical candidates nor do they experience residual or recurrent disease after surgery and may benefit from alternative therapies. This study explores the expression of programmed death ligand 1 (PD-L1) in patients with primary tracheal malignancy as a biomarker for candidacy for treatment with immune checkpoint inhibitors. We conducted a retrospective review of the medical records of 23 patients with resected primary tracheal malignant tumours from 2010 to 2016. Paraffin-embedded blocks of tumour tissue were evaluated immunohistochemically to determine the expression of PD-L1 and infiltration by CD8+ immune cells. We identified 14 (61%) adenoid cystic carcinomas, 4 (17%) squamous cell carcinomas (SCC), 4 (17%) mucoepidermoid carcinomas and 1 adenosquamous carcinoma. PD-L1 expression was observed in 3 (75%) cases of SCC and 1 (100%) case of adenosquamous carcinoma, but it was absent in cases of adenoid cystic carcinomas and mucoepidermoid carcinomas. PD-L1 expression was significantly higher in tumours with a SCC component than in salivary-type tumours (P = 0.001). The presence of CD8+ immune cells in the tumour or peritumoural stroma was significantly higher in cases of tracheal tumours with a SCC component than in salivary-type tumours. Salivary-type primary malignant tracheal tumours do not significantly express PD-L1. In contrast, most primary tracheal tumours with a SCC component show membranous expression of PD-L1 and larger numbers of infiltrating CD8+ immune cells. PD-L1 expression may serve as a biomarker in patients with primary tracheal squamous cell malignant neoplasms when the patients are being considered for alternative treatments and inclusion in clinical trials. Protocol No. 2017P000415 (22 March 2017).