Duct Ectasia Research Articles

The value of ultrasound to differentiate between benign and malignant duct ectasia

Background: Mammary duct ectasia is defined as dilated duct larger than 2 mm in diameter seen in fibrocystic changes, ductal epithelial hyperplasia, papiloma, DCIS. US has a significant role in diagnostic breast imaging. It is most commonly used as an adjunctive test in characterizing lesions detected by other imaging modalities or by clinical examination
 Objective: This study was designed to investigate differences in ultrasonographic findings between malignant and benign mammary duct ectasia.
 Patients and Methods: From November 2010 to July 2011, 100 womem with mammary duct ectasia lesions depicted on sonograms were included in this study. We evaluated the ultrasonographic (US) findings in terms of involved ductal location, size, margin, intraductal echogenicity, presence of an intraductal nodule, calcification, ductal wall thickening and echo changes of the surrounding breast parenchyma. The US findings were correlated with the pathological features.
 Results: Of the 100 lesions, 84 lesions were benign and 16 lesions were malignant. Benign lesions include: an inflammatory change (n=14), ductal epithelial hyperplasia (n=6), fibrocystic change (n=54), intraductal papilloma (n=10). Malignant lesions include: ductal carcinoma in situ (DCIS) (n=2), infiltrating ductal carcinoma (n=14). On US images, the peripheral ductal location, an ill-defined margin, ductal wall thickening and a hypoechoic change of the surrounding parenchyma were features significantly associated with malignant duct ectasia.
 Conclusion: For ill-defined peripheral duct ectasia with ductal wall thickening and surrounding hypoechogenicity as depicted on US, the possibility of malignancy should be considered and radiologists should not hesitate to recommend a prompt biopsy.

Duct Ectasia an Unusual Case Presentation and an Overview

Accessory breast is the presence of breast tissue at any part of the body except the normal breast region. Ectasia of the breast is a condition where the lactiferous ducts are blocked by secretions. Both accessory breast and duct ectasia are very common entities presenting separately but coexistence is rarity with a normal breast finding. In this case report, a 24-year-old female presented with bilateral painful axillary mass of 3 months duration which was excised is presented. Gross examination showed fibrofatty tissue with few areas of fibrosis while microscopic examination revealed breast tissue with duct ectasia. This case is reported for its rarity and to give clinicians a differential diagnosis of simultaneous coexistence of accessory breast with duct ectasia with a normal breast finding and a review of relevant aspects of duct ectasia is also included.

Pathological Nipple Discharge

Introduction: Pathological nipple discharge is usually of benign aetiology but cancer may be the underlying cause in up to 20% of the presentations. The diagnostic value of discharge cytology and significance of presence of blood remains a topic of interest. Our study sets out to review the distribution of histopathology and diagnostic application of blood-staining and cytology in pathological nipple discharge. Methods: We performed a retrospective analysis of those patients that had surgery for pathological nipple discharge. The hospital's electronic medical records and breast cancer information systems were used to identify our study cohort. Parameters evaluated included patient demographics, radiological assessment, if discharge was blood-stained and histological/cytological analysis. Results: Of 123 patients, intraductal papilloma was the leading diagnosis (�� = 62) followed by duct ectasia (�� = 34). Carcinoma in-situ and invasive carcinoma occurred in nine cases. Seventy-one patients presented with blood-stained nipple discharge of which 41 had a diagnosis of intraductal papilloma, 17 had duct ectasia, and seven cases were due to carcinoma. Two cases of cancer were negative for blood. Cytology was done only in 23 patients and was not diagnostic of carcinoma and identified intraductal papilloma in only 3 cases. Conclusion: This study supports the generally accepted view that cytology has very poor sensitivity for detecting breast cancer and has therefore very limited diagnostic value. Nipple discharge that is negative for blood is still associated with cancer. It also confirms that intraductal papilloma is the leading cause of pathological nipple discharge.

Çocukluk Çağı Meme Kitleleri

Objective: The overwhelming majority of breast masses in children are benign. In this paper we aimed to evaluate the breast masses in children. Methods: All children younger than 18, who were diagnosed with breast mass and were admitted to our center between March 2012 and March 2014 were analyzed for age, gender, complaint, the history of malignancy, the localization of breast mass, sonographic and pathological findings, and the diagnosis, retrospectively. Results: Twenty-nine girls and 8 boys (age ranges from 5 to 18) were admitted to our center with breast mass within the last two years. Except for mass, 5 patients had pain, and 8 patients had nipple discharge. Two patients had family history of breast cancer. Three patients had an operation of mass excision. Histopathological diagnosis of two patients were juvenile fibroadenoma, and pseudoangiomatous stromal hyperplasia. Other diagnoses according to clinical and sonographic features were: Fibroadenoma 11, gynecomastia 8, breast abscess 6, premature thelarche 3, mammary duct ectasia 2, accessory breast 1, fibrocystic change 1 and adenosis 1. Patients were followed up with ultrasound and none of them developed malignacy. Conclusion: The prevalence of breast cancer in the pediatric age group is extremely low, so a conservative approach of clinical and sonographic follow-up is more commonly adopted in children.

Cytological profile of breast lesions in females and males presenting to a Kenyan Hospital with breast complaints

Objectives This study aims to determine the types of breast lesions diagnosed by fine-needle aspiration cytology and nipple discharge cytology and assess the clinical adequacy of narrative format for reporting breast cytology results. Methods Medical records of 80 patients presenting to Kenyatta National Hospital between January 2014 and March 2014 with breast complaints were evaluated retrospectively. Results Of the 80 diagnosed breast lesions, 90% (n = 72) occurred in females, while 10% (n = 8) occurred in males, yielding a female-to-male ratio of 9:1. Neoplastic breast lesions (n = 60) comprised 75% while non-neoplastic breast lesions (n = 20) comprised 25% of all diagnosed breast lesions. The neoplastic lesions were identified as 85% (n = 51) benign and 15% (n = 9) malignant, yielding a benign-to-malignant ratio of 5.7:1. Fibroadenoma (n = 35) and gynecomastia (n = 6) were the most frequently diagnosed breast lesions for females and males, respectively. Conclusions Fine-needle aspiration cytology was useful in the diagnosis of fibroadenoma, ductal carcinoma, and fibrocystic changes. Nipple discharge cytology was useful in the diagnosis of intraductal papilloma, fibroadenoma and mammary duct ectasia. Based on these findings, a synoptic reporting format incorporating six cytological diagnostic categories (inadequate, atypia of undetermined significance, neoplastic: benign, neoplastic: malignant, non-neoplastic: inflammatory, and non-neoplastic: other) should undergo feasibility evaluation in this hospital.

Histopathologic diagnosis of chronic graft-versus-host disease of the oral mucosa according to the National Institutes of Health Consensus.

ABSTRACTObjectiveTo validate the minimal criteria of the histopathologic diagnosis of oral chronic graft-versus-host disease, based on the histopathologic classification of the National Institutes of Health and correlate them with clinical features.MethodsForty-one specimens containing both oral mucosa and salivary glands were analyzed in slides stained with hematoxylin-eosin. The histological specimens were blindly examined by two trained pathologists using criteria recommended for the histopathologic diagnosis of chronic graft-versus-host disease proposed by the National Institutes of Health Consensus. The clinical classification of chronic graft-versus-host disease was correlated with analysis of slides.ResultsOur data showed that the epithelium was involved in 39/41 specimens, presenting acanthosis (29/70.7%), exocytosis of lymphocytes (29/70.7%), thickening of basal lamina (29/70.7%), and apoptosis (15/36.6%). Connective tissue presented interstitial inflammatory infiltrate (38/92.7%). Minor salivary glands showed periductal fibrosis (38/92.7%), mixed periductal inflammatory infiltrate (32/78%), ductal ectasia (30/73.2%), lymphocytes around and into acinar units (30/73.2%), and interstitial fibrosis (29/70.7%). The most common clinical manifestations were lichenoid aspect (40/97.6%), complaints of sensitivity to oral feeding (38/92.7%), and dry mouth sensation (36/87.8%).ConclusionThis study validated the National Institutes of Health Consensus of minimal histologic criteria for diagnosis of oral chronic graft-versus-host disease and has not found an association between the severity of clinical manifestation and the histopathological stage.

Prevalence of benign proliferative breast lumps among females with benign breast diseases in Sohag governorate

Background: Benign breast diseaseis animportantrisk factor for a later breast cancer, which can develop in either breast. It includes a spectrum of histologic entities, usually subdivided into non-proliferative lesions, proliferative lesions without atypia, and atypical hyperplasia, with an increased risk of breast cancer associated with proliferative or atypical lesions. Aim: To estimate the prevalence of benign proliferative breast lumps that carry a risk of developing breast cancer in Sohag governorate. Patients and methods: This prospective study included 416 female patients presented to Breast Clinic with clinically palpable benign breast lump(s) at Sohag University Hospital; only 390 of them were enrolled in the study. All patients were subjected to thorough clinical examination, sana-mammography and fine needle aspiration cytology. Those who were pregnant or proved to be malignant were excluded. Data including use of contraceptives, Parity, menarche, menopausal status, family history of breast cancer were collected prospectively using a pre-test questionnaire in a face to face interview. All biopsies taken form the excised lumps were examined by three pathologists with experience in breast diseases. Results: Of 416 females with clinically benign breast lump(s), only 390 were recruited in the study. The prevalence of BPBD was 78/390 (20%)while non BPBD was 312/390 {80%). BPBD with atypia was 24/390 (6.1%), while BPBD without atypia was 54/390 (13.8%).The commonest breast lesions were fibroadenoma, fibrocystic disease and duct ectasia (54.1%), (25 6%) and (5.6%) respectively. Conclusion: Benign proliferative breast lumps are common among premenopausal women in Sohaggovernorateand a significant proportion ofBPBD had atypical proliferation

Affections of the salivary ducts in buffaloes

The aim of the present study was to determine different affections of the salivary ducts in buffaloes with special reference to diagnosis and treatment. The study was carried out on 39 buffaloes suffering from different affections of the salivary ducts. The recorded affections of the salivary ducts in buffaloes include; ectasia of the parotid duct (21 cases), parotid duct fistula (15 cases) and sialocele (3 cases). Each case was subjected to full study including case history, clinical examination, diagnosis, and treatment whenever possible. Exploratory puncture and radiography were used for confirmation of diagnosis. Intraoral marsupialization was performed for treatment of parotid duct ectasia. Salivary fistula was corrected by one of two successful techniques; the first by reconstruction of the parotid duct and the second by ligation of the parotid duct just caudal to the fistula opening. Sialoceles were corrected by removal of the mandibular salivary gland of the affected side.

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

To determine the pattern of disease in patients presenting with breast lumps and to determine the sensitivity and specificity of fine needle aspiration cytology of benign and malignant diseases as a diagnostic tool by correlating with histopathology findings. This retrospective study was carried out in the Department of Pathology, Maharaja Agrasen Medical College, Agroha, from Jan 2008 to April 2012. Fine needle aspiration cytology was performed on 370 cases and out of these 52 cases were received in the Department for histopathological examination. Fibroadenoma was the most common disease encountered, in 88 (24%), with a peak incidence in second and third decade of life. Fibrocystic disease was second, being common in the third and fourth decades of life. Peak incidences of duct ectasia, granulomatous and tubercular mastitis were seen in the third decade. Gynaecomastia showed two peak incidences in second and sixth decades of life . Out of total 370 cases undergoing fine needle aspiration, benign cases were 316 (85.4%), malignant and suspicious were 54 (14.6%) and 10 (2.70%) respectively. Out of total 22 histological confirmed malignant lesions 19 were interpreted as malignant cytologically while two as suspicious and one as benign. All thirty histologically confirmed benign cases were diagnosed as benign cytologically. The sensitivity, specificity, positive and negative predictive values were 98%, 100%, 100% and 96.4% respectively. FNA cytology is highly accurate for diagnosis of breast masses. However, the clinician should correlate FNA cytological results with physical examination and imaging findings to prevent false negative and false positive events and to obtain optimal management of their patients.

Telorragia en el lactante por ectasia ductal. Consideraciones acerca de dos casos

Bloody discharge from the nipple (thelorrhagia) is a rare symptom in childhood and is a cause of great concern due to the mistaken association with carcinoma in adults. However, in children thelorrhagia is due to benign mammary duct ectasia in the majority of cases. Up to date, only isolated case reports or case series have been published and, although different theories have been postulated, no definite etiology has been identified. We report two cases with similar clinical features and outcome, in whom bleeding resolved spontaneously 4 and 6 weeks after onset. We present a review of the literature. Based on the benign and self-limiting process and in the absence of other findings on physical examination, we suggest a watch-and-wait approach with minimally invasive studies and reassurance and support for the family as most cases resolve spontaneously.

Bloody nipple discharge in infancy

Objective – We present three infants with bloody nipple discharge (BND). This rare clinical entity is mostly related to benign conditions such as ductal ectasia and epithelial hyperplasia. However, BND may be the first symptom of breast carcinoma and for this reason, it causes anxiety in parents. Case reports – The infants were older than six-months with unilateral left-sided BND and had normal physical exams. Haematological and endocrinological test results were within normal limits in all but one infant, who had increased follicle stimulating hormone and prolactin. Ultrasonography of the breasts showed asymmetry in the quantity of mammary tissue and the discrete dilated ducts. Cytologic examination of the BND did not reveal any inflammatory signs or atypical cells. The BND resolved spontaneously within six months without any specific treatment. Conclusion – Our findings confirm previously reported observations that BND in infants is associated with ductal ectasia and epithelial hyperplasia. This condition is benign and disappears spontaneously so no specific management intervention is needed.

Granulomatous lobular mastitis associated with mammary duct ectasia: a clinicopathologic study of 32 cases with review of literature

To study the clinicopathologic features of granulomatous lobular mastitis and mammary duct ectasia. The clinicopathologic data from August 2005 to May 2013 of 32 cases of granulomatous lobular mastitis and mammary duct ectasia were retrospectively reviewed. The age of patients ranged from 26 to 45 years. Two patients had no history of delivery. Fourteen patients had no history of lactation or lactational disorder in the lesional side. Most of the remaining patients had history of breast feeding. Gross examination showed that the lesions were poorly circumscribed and varied from 3 to 12 cm in greatest dimension. Tiny abscess cavities, ranging from 0.1 to 0.5 cm in diameter and containing light yellowish to greyish secretion, were demonstrated. Histologic examination showed granuloma formation and ductal dilatation. Eleven patients had received antibiotic treatment. Twelve cases were complicated by sinus formation related to skin incision and drainage. The duration of follow-up ranged from 5 to 90 months. Three cases showed ipsilateral recurrence and 3 cases had similar pathology in the contralateral breast. Four patients defaulted follow-up. Granulomatous lobular mastitis is associated with mammary duct ectasia. Accurate pathologic diagnosis is prudent for clinical management and control of local recurrence.

Uncommon benign breast abnormalities in adolescents.

The authors discuss benign breast abnormalities in the adolescent breast other than fibroadenoma. Although fibroadenoma is the most common benign abnormality in the adolescent breast, other diagnoses are possible. The majority of adolescents who present with a palpable concern or lump have no discrete abnormality on ultrasound and are diagnosed with clinical fibrocystic change and followed up to ensure clinical stability. Intraductal papilloma and duct ectasia are two benign abnormalities associated with bloody nipple discharge, occurring more rarely in adolescents compared with adult women. Breast infections can occur in adolescents, including both mastitis and/or abscess, and are treated similarly to adults, with drainage and antibiotic coverage for Staphylococcus. When infections are due to nipple piercing, other organisms should be suspected. All surgical procedures in the developing breast should be performed cautiously, as trauma to the undeveloped breast can result in failure of breast development or asymmetry, and surgical disruption of subareolar ducts can impair or preclude future lactation.

Microdochectomy for pathologic nipple discharge.

e12032 Background: Nipple discharge has a known association with breast cancer, determing which cases to identify as being at high risk is a complex task for the clinician. The current policy at West Herfordshire hospital NHS Trust is to offer microdochectomy to all women who present with unilateral single duct nipple discharge, dominant duct discharge, or peristent duct discharge. The aim of this study was to determine if on basis of the pattern ofnipple discharge, patients could be subselected for microdochectomies, and to create a base line to allow future subselection of patients for survillience only. Methods: All patient with single duct unilateral spontaenous nipple discharge, who underwent microdochectomy, were assessed. Demongraphics, clincial presentation, radilogical assessment, cytology, core biopsy. This group of patients was anlysed and correlated with their final histological assessment. Results: 122 patients were analysed in this study. 7 ( 5.74%) were diagnosed with carcinomas. 4patients had ductal carcinoma in situ, three patients had dutcal carcinoma in situ and invasive ductal carcinoma, of these two patients had blood stained nipple discharge. two other patients had papillary carcinomas, one patient of these two had blood stained nipple discharge. 47 out of 122 patient presened with history of blood statined discharge,30 were negative for cytology, two patients had (ductal carcinoma in situ with Invasive ductal carcinoma and papillary ca) at final histololgy. 17 of the 47 showed cellular cytology.and one patient had intermediate grade DCIS confirmed on final histology, whereas in the remaining sixteen patients histological feaatures of papillomas, duct ectasia, and benign breast disease was noted. Of the 122 patient 42 patients had mammary duct ectasia (34%), 52 patients had papillomas (42%) at final hisotology. Conclusions: The negative predictive value (2/30), appears in this series appreas to be more valuable than, the positive predictive value (1/17) in cellular smears to predict ductal carcinoma or invasive ductal carcinoma. Cytological assessment of nipple discharge is equivocal at its best. Microdochectomy perford for nipple discharge results in a low rate of malignacy on excision and is comparable with other series.

Cystic lymphoid hyperplasia: an orofacial lesion strongly associated with HIV and AIDS

Cystic lymphoid hyperplasia (CLH) frequently affects the parotid gland in human immunodeficiency virus (HIV)-infected patients. This clinicopathological study, comprising 167 cases, aims to define the clinical-pathological parameters of CLH in order to elucidate the aetiopathogenesis. This retrospective study of 167 archival cases of CLH recorded patients' age, race and gender, and the nature, site and symptoms of CLH. A total of 109 cases were reviewed histologically and analyzed for HIV-1 p24 antigen immunopositivity using standard procedures. CLH of the parotid gland showed a male predominance, whereas submandibular gland (P = 0.27) and bilateral parotid involvement favoured females (2:1). CLH occurred at a younger mean age in females than males in the parotid gland (P = 0.0035) and in the submandibular gland (P = 0.0032). Intra-lymph nodal origin was favoured, with 76.1% of cases occurring within entrapped salivary gland remnants. P24 staining revealed ~90% sensitivity in HIV-associated CLH. CLH should be used preferentially to describe parotid enlargement in HIV-infected patients. This study strongly supports the hypothesis that CLH develops following ductal ectasia of entrapped salivary gland inclusions arising within lymph nodes. CLH should be classified as an orofacial lesion associated strongly with HIV and AIDS.

Pancreatic Cystic Neoplasms: Management and Unanswered Questions

Approximately 10% of persons 70 years old or older are now diagnosed with pancreatic cysts, but it is not clear which ones require additional analysis, interventions, or follow-up. Primary care doctors rely on gastroenterologists for direction because no one wants to miss a diagnosis of pancreatic cancer, but meanwhile there is pressure to limit use of diagnostic tests and limit costs. We review the different cystic neoplasms of the pancreas and diagnostic strategies based on clinical features and imaging data. We discuss surgical and nonsurgical management of the most common cystic neoplasms, based on the recently revised Sendai guidelines. Intraductal papillary mucinous neoplasm (particularly the branch duct variant) is the lesion most frequently identified incidentally. We report what is known about its pathology, its risk of developing into pancreatic ductal adenocarcinoma, the pros and cons of current guidelines for management, and the potential role of endoscopic ultrasound in determining cancer risk. We also review surgical treatment and strategies for surveillance of pancreatic cysts.

Aspectos Ultrassonográficos Do Tumor De Kuttner E Seu Diferencial Nas Patologias Cervicais

To describe the clinical and radiological aspects of Kuttner's tumor, emphasizing the discussion of the differential diagnosis of cervical pathologies. RM, 29 years old, male, complaining of pain and increase in volume of the left submandibular region 1 month ago, with reports of previous similar episodes. For diagnostic cervical ultrasonography was performed which revealed left submandibular gland with increased dimensions, lobulated, diffusely heterogeneous echotexture associated with images consistent with calculations in the region proximal to the duct of Wharton. A biopsy revealed lymphocytic infiltration periductal glandular, ductal ectasia and irregular sclerosis. Chronic sclerosing Sialoadenitis (Kuttner tumor). Chronic sclerosing sialadenitis, also called Kuttner tumor, is a unusual salivary gland chronic inflammatory fibrosing. It mainly affects the submandibular, with the highest incidence between 30 and 70 years, regardless of sex, predominantly unilateral. Clinically increase and hardening of the gland with or without pain, recurrent. This sialolithiasis ductal associated with the end portion by 30 to 85% of cases. The main differential diagnoses are Kimura disease, lymphoma, sarcoidosis and Sjogren's Syndrome. Definitive diagnosis is by histopathology. The prognosis is favorable and there are no reports of malignant transformation.

ATG proteins mediate efferocytosis and suppress inflammation in mammary involution

Involution is the process of post-lactational mammary gland regression to quiescence and it involves secretory epithelial cell death, stroma remodeling and gland repopulation by adipocytes. Though reportedly accompanying apoptosis, the role of autophagy in involution has not yet been determined. We now report that autophagy-related (ATG) proteins mediate dead cell clearance and suppress inflammation during mammary involution. In vivo, Becn1+/− and Atg7-deficient mammary epithelial cells (MECs) produced ‘competent’ apoptotic bodies, but were defective phagocytes in association with reduced expression of the MERTK and ITGB5 receptors, thus pointing to defective apoptotic body engulfment. Atg-deficient tissues exhibited higher levels of involution-associated inflammation, which could be indicative of a tumor-modulating microenvironment, and developed ductal ectasia, a manifestation of deregulated post-involution gland remodeling. In vitro, ATG (BECN1 or ATG7) knockdown compromised MEC-mediated apoptotic body clearance in association with decreased RAC1 activation, thus confirming that, in addition to the defective phagocytic processing reported by other studies, ATG protein defects also impair dead cell engulfment. Using two different mouse models with mammary gland-associated Atg deficiencies, our studies shed light on the essential role of ATG proteins in MEC-mediated efferocytosis during mammary involution and provide novel insights into this important developmental process. This work also raises the possibility that a regulatory feedback loop exists, by which the efficacy of phagocytic cargo processing in turn regulates the rate of engulfment and ultimately determines the kinetics of phagocytosis and dead cell clearance.

BREAST DISEASES;

Objective: To determine pattern of breast diseases presenting in the surgical OPD of a General hospital. Design: Aprospective observational study. Place & duration of study: The study was conducted at Railway hospital, Rawalpindi from September2008 to Feburary 2010. Patients & Methods: Female patients presenting with complaints regarding breast were recruited in the study. Allof them underwent clinical breast examination followed by necessary radiological and / or histopathological investigations to diagnosethe disease. Data regarding personal information, clinical examination findings and results of investigations done was collected on aproforma. Results mainly as frequencies were analyzed using software SPSS 16.0. Results: A total of 207 female patients presented inthe OPD with breast complaints. 15 patients were lost to follow up before a definitive diagnosis could be made; therefore they wereexcluded from the study. Out of 192 patients 21.9% had mastalgia followed by fibroadenoma (19.3%), breast abscess (15.6%),carcinoma breast (13.5%), fibrocystic disease (6.25%), duct ectasia (5.7%), acute mastitis (4.7%), no disease (4.2%), nipple eczyma(2.1%). Benign phylloides tumour, chronic mastitis, prominent axillary tail, cracked nipple were each 1% and 3 patients presented withmammary fistula (0.5%), accessory nipple (0.5%), and lipoma(0.5%). Conclusion: Breast diseases make a sizeable portion of thegeneral surgical practice. In our set up benign diseases are far more common than the malignant ones. Mastalgia is the commonestbreast problem. Malignancy of breast presents usually in late stages.

Decrease of survivin, p53 and Bcl-2 expression in chemorefractory colorectal liver metastases may be predictive of radiosensivity after radioembolization with yttrium-90 resin microspheres

In a prospective multicenter phase II trial of radioembolization with yttrium-90 (90Y-RE) in chemorefractory liver-dominant metastatic colorectal cancer (mCRC), we showed that median survival was 12.6 months (95% CI 7.0–18.3) with 48% of 50 patients achieving disease control. In this extension retrospective study, we analyzed whether a panel of biomarkers, known to be associated to an adverse clinical outcome, underwent variations in CRC liver metastases pre and post 90Y-RE.Of the 50 patients included in the study, 29 pre-90Y-RE therapy and 15 post-90Y-RE had liver biopsy specimens available. In these series we investigated survivin, p53, Bcl-2 and Ki-67 expression pre- and post-90Y-RE by immuhistochemistry (IHC). Our findings evidenced a decrease of survivin (77% vs 33%), p53 (93% vs 73%), Bcl-2 (37% vs 26%) expression as well as of Ki-67 proliferation index (62.5% vs 40%) on liver biopsies collected post-90Y-RE as compared to pre-90Y-RE. In the subset of 13 matched liver metastases we further confirmed the reduction of survivin (92.3% vs 53.8%; p = 0.06), p53 (100% vs 69.2%; p = 0.05) and Bcl-2 (69.2% vs 53.8%; p = 0.05) expression post-90Y-RE. This biomarker modulation was accompanied by morphological changes as steatohepatitis, hepatocyte necrosis, collagen deposition, proliferating and/or bile duct ectasia, focal sinusoidal dilatation and fibrosis.Although our analysis was conducted in a very limited number cases, these changes appear strictly related to the response to 90Y-RE therapy and may deserve further investigation on a larger series of patients.