Primary Ductal Adenocarcinoma Research Articles

PD04-02 USING GENOMIC AND TRANSCRIPTOMIC PROPERTIES TO DETERMINE ANDROGEN RESPONSE IN DUCTAL PROSTATE CANCERS AND DETERMINE EFFICACY OF POLY(ADP-RIBOSE) POLYMERASE INHIBITORS WITH ANDROGEN SIGNALLING INHIBITORS THERAPY IN VITRO

You have accessJournal of UrologyCME1 Apr 2023PD04-02 USING GENOMIC AND TRANSCRIPTOMIC PROPERTIES TO DETERMINE ANDROGEN RESPONSE IN DUCTAL PROSTATE CANCERS AND DETERMINE EFFICACY OF POLY(ADP-RIBOSE) POLYMERASE INHIBITORS WITH ANDROGEN SIGNALLING INHIBITORS THERAPY IN VITRO Weranja Ranasinghe, Melbourne, Australia Patricia Troncoso, Mitchell Lawrence, Nicholas Choo, Birunthi Niranjan, Melissa Papargiris, Hong Wang, Andrew Ryan, Peter Shepherd, Bradley Broom, Ganiraju Manyam, Renea Taylor, Timothy Thompson, Nora Navone, Gail Risbridger, and Brian Chapin Weranja RanasingheWeranja Ranasinghe More articles by this author , Melbourne, Australia Patricia TroncosoMelbourne, Australia Patricia Troncoso More articles by this author , Mitchell LawrenceMitchell Lawrence More articles by this author , Nicholas ChooNicholas Choo More articles by this author , Birunthi NiranjanBirunthi Niranjan More articles by this author , Melissa PapargirisMelissa Papargiris More articles by this author , Hong WangHong Wang More articles by this author , Andrew RyanAndrew Ryan More articles by this author , Peter ShepherdPeter Shepherd More articles by this author , Bradley BroomBradley Broom More articles by this author , Ganiraju ManyamGaniraju Manyam More articles by this author , Renea TaylorRenea Taylor More articles by this author , Timothy ThompsonTimothy Thompson More articles by this author , Nora NavoneNora Navone More articles by this author , Gail RisbridgerGail Risbridger More articles by this author , and Brian ChapinBrian Chapin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003228.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The histologic variant prostatic ductal adenocarcinoma (DAC) has an aggressive biology with predisposition to metastasize early to visceral organs at low PSA levels. In contrast to acinar adenocarcinoma of the prostate (PAC), DACs have no effective systemic therapies, responding poorly to androgen deprivation therapy and chemotherapy. Poly(ADP-ribose) polymerase inhibitors (PARPi) may synergize with androgen signaling inhibitors (ARSI) inducing a “BRCAness” phenotype in castrate resistant prostate cancer (CRPC). A recent clinical trial demonstrated the efficacy of this combination therapy in CRPC, regardless of HR status. We aimed to characterize the genomic and transcriptomic properties of DAC to determine the androgen response and assess efficacy of PARPi+ARSI therapy in vivo. METHODS: 20 DAC and 10 PAC tumors, matched for stage, grade and volume, were micro-dissected from radical prostatectomy samples. Whole exome sequencing, RNA sequencing and Hallmark pathway analyses were performed. Validated BRCA2 heterozygous mutant (201.1A-Cx) and HR-proficient (287R) patient-derived DAC organoid models were treated with PARPi, enzalutamide and the combination of PARPi+enzalutamide. RESULTS: DACs had higher rates of mutations compared to matched PAC tumors (Figure 1). Unsupervised hierarchical clustering of RNA expression identified a distinct DAC cluster, with downregulation of AR pathways and enrichment of HR pathways, compared to PAC. Niraparib+Enzalutamide significantly reduced organoid viability of BRCA2 heterozygous mutant (201.1A-Cx) and HR proficient (287R) cells compared to control, Niraparib or Enzalutamide alone. Moreover, PARPi and ARSI were synergistic in these DAC models. Similarly, Talazoparib + Enzalutamide reduced the viability of the HR proficient 287R organoid compared to control, Talazoparib or Enzalutamide (65% vs 100% vs 91% vs 78%, p<0.01). CONCLUSIONS: In contrast to PACs, primary DACs have a unique genomic and transcriptomic landscape with high rates of mutations associated with intrinsic androgen resistance. PARPi+ARSI were more effective at decreasing DAC organoid viability than either treatment alone, regardless of the HR status. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e142 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Weranja Ranasinghe More articles by this author Melbourne, Australia Patricia Troncoso More articles by this author Mitchell Lawrence More articles by this author Nicholas Choo More articles by this author Birunthi Niranjan More articles by this author Melissa Papargiris More articles by this author Hong Wang More articles by this author Andrew Ryan More articles by this author Peter Shepherd More articles by this author Bradley Broom More articles by this author Ganiraju Manyam More articles by this author Renea Taylor More articles by this author Timothy Thompson More articles by this author Nora Navone More articles by this author Gail Risbridger More articles by this author Brian Chapin More articles by this author Expand All Advertisement PDF downloadLoading ...

Androgen receptor increases and negative expression of GCDFP-15 in primary ductal adenocarcinoma of the lacrimal gland: a case description.

Androgen receptor increases and negative expression of GCDFP-15 in primary ductal adenocarcinoma of the lacrimal gland: a case description.

Multiple Cranial Neuropathies as the Initial Presentation of Primary Ductal Adenocarcinoma of the Lacrimal Gland.

Primary ductal adenocarcinoma of the lacrimal gland is a rare, aggressive malignancy that clinically and histologically resembles salivary duct carcinoma. Similar to other malignant epithelial lacrimal gland tumors, ductal adenocarcinoma typically presents with unilateral proptosis, pain, upper eyelid swelling, palpable mass, diplopia, ptosis, and blurred or decreased vision. Rarely, primary malignant epithelial lacrimal gland tumors may first present with multiple cranial neuropathies due to occult spread to the cavernous sinus, as in this case. With such a vast differential diagnosis, a practical yet systematic approach to multiple cranial neuropathies, as guided by clinical history, exam, and neuroimaging, allows for a more targeted diagnostic evaluation, especially when multiple diagnostic tests and interventions return unrevealing. A repeat biopsy or complete excision of the lacrimal gland may be necessary to yield the correct diagnosis.

Primary De novo ductal adenocarcinoma of the lacrimal gland

BackgroundPrimary ductal adenocarcinoma of the lacrimal gland is a rare and aggressive malignant epithelial lacrimal gland neoplasm, morphologically and phenotypically resembles salivary duct carcinoma, and both strongly resemble infiltrating ductal carcinoma of breast. MethodRetrospective Chart review of cases of malignant lacrimal gland tumors from 2013 July to 2020 July. Authors describe the clinico radiological, morphological and immunohistochemical features of primary ductal adenocarcinoma (PDA) of lacrimal gland. Extensive review of literature of PDA of lacrimal gland and salivary gland ductal carcinoma has been performed. ResultsRetrospective chart review of the last 7 years yielded 22 malignant lacrimal gland neoplasms of which 4 cases demonstrated features of primary ductal adenocarcinoma of lacrimal gland, 2/4 cases showed an evidence of a pre existing pleomorphic adenoma and 2 were found to be de novo ductal adenocarcinomas. PDA of lacrimal gland showed expression of CK7, CK19, AR, HER2, cyclin D1 and were negative for CK5/14, CK 20, ER, PR, PSA, TTF-1, S-100 and SMA. Expression of GCDFP-15 was noted in one case. The presence of multiple events of loco-regional recurrences and/or distant metastasis necessitated a multidisciplinary approach. ConclusionsAuthors have expressed the need of clinical correlation; thorough tissue sampling and extensive immunohistochemical work up in identification of de novo PDA's and their molecular subtypes. A multi-institutional study might help in formulating the diagnostic criteria, identification of actionable targets, and thus study the role of targeted therapy in this rare and aggressive tumor which may result in better patient outcomes.

A case of skin metastasis presenting with an extensive dark reddish macule on the neck from primary ductal adenocarcinoma of the orbital region

A case of skin metastasis presenting with an extensive dark reddish macule on the neck from primary ductal adenocarcinoma of the orbital region

A case report of synchronous triple pancreatic tumors: Pancreatic metastasis of renal cell carcinoma combined with primary ductal adenocarcinoma and neuroendocrine tumor

A case report of synchronous triple pancreatic tumors: Pancreatic metastasis of renal cell carcinoma combined with primary ductal adenocarcinoma and neuroendocrine tumor

GCDFP-15, AR, and Her-2 as biomarkers for primary ductal adenocarcinoma of the lacrimal gland: a Chinese case and literature review.

PurposePrimary ductal adenocarcinoma (PDA) of the lacrimal gland is a rare malignant epithelial tumor, and its clinicopathological characteristics are still unclear. This study aimed to report a novel case of PDA of the lacrimal gland in the People’s Republic of China, as well as to determine its histopathological and immunohistochemical characteristics to support early diagnosis and direct further therapy.Patient and methodsClinical data (including ocular examination, computed tomography, magnetic resonance imaging, positron emission tomography, mammography, and serum tumor marker examination) and treatment of a 49-year-old woman with a left lacrimal gland mass, which was diagnosed as PDA of the lacrimal gland, were reported. Histopathological and immunohistochemical studies were performed. Eleven papers regarding this uncommon neoplasm were reviewed.ResultsHistopathologically, most of the tumor cells featured abundant granular eosinophilic cytoplasm, while few of them had a frothy appearance. The mass showed breast ductal carcinoma-like structural features, which most commonly demonstrated central necrosis, while less of these features showed cord-like infiltration. Immunohistochemically, the tumor cells were positive for GCDFP-15, CK 18 (++), AR (90%), Her-2 (+++), P53 (100%), and Ki-67 (with a proliferation index approximately 60%), while they were negative for ER, PR, P63, calponin, and CD 117.ConclusionThis was the first Chinese case of PDA of the lacrimal gland that had been reported. We suggested that GCDFP-15, AR, and Her-2 should be tested as biomarkers for ductal adenocarcinoma of lacrimal gland to confirm diagnosis, guide therapy, and further predict prognosis.

Primary Ductal Adenocarcinoma of the Lacrimal Gland: Report of a Case and Review of Literature

Primary ductal adenocarcinoma is a rare subtype of adenocarcinoma. Literature review showed 13 cases of primary ductal adenocarcinoma of the lacrimal gland. We report a case of primary ductal adenocarcinoma of the lacrimal gland and review of literature highlighting its clinical presentation, histopathology including immunochemistry and overall outcome.

Prognostic impact of a compartment-specific angiogenic marker profile in patients with pancreatic cancer.

Pancreatic cancer consists of a heterogenous bulk of tumor cells and stroma cells which contribute to tumor progression by releasing angiogenic factors. Those factors can be detected as circulating serum factors. We performed a compartment-specific analysis of tumor-derived and stroma-derived angiogenic factors to identify biomarkers and molecular targets for the treatment of pancreatic cancer. Kryo-frozen tissue from primary ductal adenocarcinomas (n = 51) was laser-microdissected to isolate tumor and stroma tissue. Expression of 17 angiogenic factors (angiopoietin-2, follistatin, GCSF, HGF, interleukin-8, leptin, PDGF-BB, PECAM-1, VEGF, matrix metalloproteinase -1, -2, -3, -7, -9, -10, -12, and -13) was analyzed using a multiplex elisa assay for tissue-derived proteins and corresponding serum. Our study reveals a compartment-specific expression profile for several angiogenic factors and matrix metalloproteinases. ROC analysis of corresponding serum samples reveals MMP-7 and MMP-12 as strong classifiers for the diagnosis of patients with pancreatic cancer vs. healthy control donors. High expression of tumor-derived PDGF-BB and MMP-1 correlates with prolonged survival in univariate and multivariate analysis. In conclusion, a distinct expression patterns for angiogenic cytokines and MMPs in pancreatic cancer and surrounding stroma may implicate them as novel targets for cancer treatment. Tumor-derived PDGF-BB and MMP-1 are significant and independent prognostic markers for poor survival.

Abstract 3836: TNFAIP8 protein expression in normal, inflammatory and neoplastic pancreatic tissues: Correlation with endocrine phenotype and advanced stage in ductal adenocarcinomas

Abstract Background: Tumor necrosis factor alpha induced protein 8 (TNFAIP8) is a transcription factor NF-kB inducible antiapoptotic and oncogenic molecule. This gene was initially discovered by comparison of expression profiles of primary and metastatic head and neck squamous cell carcinoma (hence earlier referred to as SCC-S2). Positive correlation between TNFAIP8 expression and cancer progression/poor prognosis has been suggested in a few human solid cancers including pancreatic and esophageal primaries. We were the first to publish the adverse prognostic implication of TNFAIP8 expression in prostatic adenocarcinomas. In this study, we evaluated the significance of this protein in normal, inflamed and neoplastic pancreatic tissues. Design: A total of 184 formalin-fixed, paraffin-embedded pancreatic tissues were analyzed; 151 samples in tissue microarray format [79 primary ductal carcinomas (PDC), 5 ductal adenocarcinomas from distant metastatic sites not matched to primary tumors (MDAC), 9 islet cell tumors (ICT) (one carcinoma), 2 chronic pancreatitis (CP), 29 normal adjacent to cancer, 8 normal adjacent to inflammation, and 19 normal pancreatic tissues] and 19 primary tumor resections [19 primary ductal adenocarcinomas (PDAC), 14 of these with normal tissue adjacent to the cancer]. All samples were immunostained by a manual method using a custom made anti-TNFAIP8 antibody as described earlier (Zhang et al., Int J Cancer, 133: 31-42, 2013). The staining pattern was semiquantitatively assessed based on staining intensity and distribution and the results were correlated with clinicopathologic variables. Results: Immunoreactivity for TNFAIP8 was predominantly cytoplasmic. TNFAIP8 protein overexpression was noted in 44/184 (24%) samples and correlated with tumor type [9/98 (9%) PDC/PDAC 2/5 (40%) unmatched distant MDAC, 5/9 (56%) (ICT) (1/1 carcinoma), 1/2 (50%) (CP), 15/43 (35%) normal adjacent to cancer, 5/8 (63%) normal adjacent to inflammation, and 7/19 (37%) normal pancreatic tissues, p&amp;lt;0.0001], with advanced tumor stage within PDC/PDAC [0/24 (0%) Stage I vs 3/44 (7%) Stage II vs 6/23 (26%) Stage III vs 0/7 (0%) Stage IV, p=0.010], and overall with gender [34/107 (32%) male vs 10/77 (13%) female, p=0.003]. Islets were present in 63 cases, all (100%) showing TNFAIP8 protein overexpression. Conclusion: TNFAIP8 immunohistochemical expression correlates with endocrine phenotype and portends poor prognosis in pancreatic ductal carcinomas. This protein may represent both a novel pathway in endocrine differentiation and a therapeutic target in the management of aggressive PDC, warranting further study. Citation Format: Jeffrey S. Ross, Bhaskar VS Kallakury, Hwa Jeong Lee, David M. Jones, Sanaz Ainechi, Gregory M. Sheehan, Christine E. Sheehan, Usha N. Kasid. TNFAIP8 protein expression in normal, inflammatory and neoplastic pancreatic tissues: Correlation with endocrine phenotype and advanced stage in ductal adenocarcinomas. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3836. doi:10.1158/1538-7445.AM2014-3836

Abstract 195: CD44v9 expression in clinical pancreatic cancer and the gemcitabine plus sulfasalazine therapy against chemoresistant pancreatic cancer murine model

Abstract Objective: Chemoresistance associating CD44-positive cancer stem cells may presents a crucial problem in treating pancreatic cancer. Among the various isoforms of CD44, valiant 9 (CD44v9) have revealed especially implicated in tumor growth, invasion, and metastasis. Interaction of CD44v9 with the cystine transporter subunit xCT provide the ability of cancer cells to defend themselves against reactive oxygen species, mediating chemoresistance. Sulfasalazine (SSZ), which is a specific inhibitor of xCT-mediated cystine transport,could be a new therapeutic weapon fight against cancer stem cells. However, the extent of this remains unclear, suggesting the need for a histological evaluation of CD44v9 expression in clinical pancreatic cancer and the anti-tumor effect on pancreatic cancer of SSZ. Therefore, In this study, we analyze the expression of CD44v9 in a pancreatic cancer surgical specimen and examine the anti-tumor effect of SSZ and altered expression of CD44v9 by administration of GEM (GEM) with tumorgrafts. Methods: Experiment 1: A total of 70 clinical primary ductal adenocarcinoma of the pancreas were applied for immunohistochemical evaluation of CD44v9 expression. Randomly picked up 10 fields for each cases were analyzed for intensity of membrane staining and the percentage of stained cancer cells per field, followed by summing the scores using our own scoring system. Experiment 2: Three lines of created tumorgrafts from clinical pancreatic cancer. We administered GEM to the tumorgrafts and also scored the clinical specimens’ immunohistochemical evaluation by CD44v9. In addition, using one line, we divided the mice into two groups, a GEM group and a GEM + SSZ group, and repeated as above to determine the effect on GEM of SSZ. Results: Experiment 1: There was no correlation for prognosis. It was found that CD44v9-positive cells are present in high numbers. Experiment 2: In 1 line, which increased CD44v9-positive cell after GEM treatment,the GEM group showed tumor regression of 85% and the GEM+SSZ group showed tumor regression of 90%. Discussion: Result in Experiment 1 is reasonable, therefore, to consider the significance of the treatment target CD44vv9 as likely to be very high. Further, there was one line of tumorgrafts used, but not all percentages of CD44v9-positive cells increased markedly by GEM administration. This suggests the possibility that CD44v9 may be regarded as a marker of GEM resistance. In addition, a small but insignificant tumor regression effect on GEM of SSZ was found. We present evidence that for pancreatic cancer as well as other carcinomas, CD44v9-positive cells may be regarded as one of the markers of chemo resistance. Furthermore, since SSZ shows the antitumor effects of plus for GEM, we suggest that SSZ treatment is a possibility for a new treatment option. Citation Format: Tomohiro Kurokawa, Tatsuya Oda, Yuki Inagaki, Ryoichi Miyamoto, Yoshimasa Akashi, Nobuhiro Ohkohchi. CD44v9 expression in clinical pancreatic cancer and the gemcitabine plus sulfasalazine therapy against chemoresistant pancreatic cancer murine model. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 195. doi:10.1158/1538-7445.AM2014-195

Mitochondrial Changes in Adenocarcinoma of the Pancreas

The aim of our study was to analyse the mitochondrial ultrastructure in primary ductal adenocarcinomas of the pancreas and to compare it with normal pancreatic cells. 52 samples of adenocarcinoma of the pancreas obtained by surgical resection or by endosonographic biopsy were examined. Compared to normal mitochondrial ultrastructure in non-tumorous cells, the mitochondria in cancer cells had a dense matrix and condensed configuration or with lucent-swelling matrix associated with disarrangement and distortion of cristae and partial or total cristolysis. Functionally, these structural alterations presume the presence of hypoxia-tolerant and hypoxia-sensitive cancer cells.

Clinicopathologic and immunohistochemical features of primary ductal adenocarcinoma of lacrimal gland: five new cases and review of literature

A primary ductal adenocarcinoma of the lacrimal gland is a rare epithelial malignant tumor, and its clinicopathological and immunohistochemical features have not been well determined. The purpose of this study was to determine the clinicopathological characteristics of lacrimal duct carcinomas and to determine their long-term prognosis. We performed immunohistochemical studies of biological and proliferative markers of primary ductal adenocarcinomas of the lacrimal gland in five patients, and followed their long term prognosis. We also reviewed nine published cases of primary ductal adenocarcinomas of the lacrimal gland. All specimens were positive for the androgen receptor, and three of five specimens overexpressed the HER-2/neu protein. Nuclear immunostaining for p53 ranged from 10% to 95% and that of Ki-67 from 20% to 70% in the tumor cells. Four of five patients had distant metastases and three patients died from the disease during the 5-year follow-up. Our findings indicate that primary ductal adenocarcinomas of the lacrimal gland express androgen receptors and a wide range of proliferative markers. Their long-term prognosis is poor.

A Rare Case of Direct Tumor Extension to the Right Ventricle

We report the case of a 72-year-old woman with signs of pulmonary embolism and right heart failure. Echocardiographic imaging and computed tomography revealed a mass within the inferior vena cava reaching from the head of the pancreas to the right ventricle. From standard imaging procedures and clinical findings alone, differentiation of a cardiac thrombus from a metastatic tumor mass was difficult. After resection of the intravascular tumor, histopathologic analysis confirmed a metastasis of primary ductal pancreatic adenocarcinoma. This is a report of a case of mucinous adenocarcinoma of the pancreas reaching the heart by continuous intravascular spreading.

Primary ductal adenocarcinoma of the lacrimal gland: case report

A 78-year-old male patient presented with double vision, painless palpable mass under the right superolateral orbital rim, downward displacement and restricted adduction of the right eye. His visual acuity was 20/50 OD and 20/20 OS. Hertel exophthalmometry was 21 mm OD and 17 mm OS. Computed tomographic scans showed an infiltrative orbital mass with ill-defined, irregular margins, involving the lacrimal gland and the lateral rectus muscle. The patient underwent an anterior transcutaneous transseptal orbitotomy with incisional biopsy and surgical debulking. Histopathologic evaluation revealed primary ductal adenocarcinoma of the lacrimal gland. Following the metastatic work up, he underwent an eyelid-sparing orbital exenteration. Microscopically, the tumor elements were characterized by large polygonal cells with vesicular nuclei, prominent nucleoli and amphophilic cytoplasm. The tumor components comprised duct-type structures with papillary and cribriform patterns, surrounded by prominent basement membrane. The tumor cells were positive for cytokeratin-7, matrix metalloproteinase (MMP)-2, MMP-9, MMP-13 and proto-oncogene Her-2/neu, but negative for cytokeratin-5, cytokeratin-20, p63, prostate-specific antigen, S-100 protein and thyroid transcription factor. These histopathologic findings were compatible with poorly differentiated ductal adenocarcinoma of the lacrimal gland, T3N0M0. Twenty-four months after orbital exenteration, the patient was diagnosed with ipsilateral parotid gland and cervical lymph node metastases and died of disease.

Solid Serous Adenoma of the Pancreas

We discuss the clinical, radiologic, and pathologic features, as well as the differential diagnosis, of pancreatic solid serous adenomas. Solid serous adenoma is a rare variant of the serous cystic neoplasms of the pancreas, with only 11 cases reported in the literature. Preoperatively, this lesion is frequently misclassified as a well-differentiated pancreatic endocrine neoplasm because of its well-circumscribed, solid, and vascular appearance on imaging studies. The primary diagnostic challenge for the surgical pathologist is to distinguish solid serous adenoma from other neoplasms with clear cytoplasm, including primary ductal adenocarcinoma with clear cell or foamy gland change, well-differentiated pancreatic endocrine neoplasm with clear cell features, metastatic clear cell renal cell carcinoma, PEComa, and solid-pseudopapillary neoplasm with clear cell change. A periodic acid-Schiff with and without diastase digestion demonstrates cytoplasmic glycogen, and immunohistochemical labeling for markers such as CD10, CD56, synaptophysin, chromogranin, renal cell carcinoma-Ma, and β-catenin can be useful in excluding other entities in the differential diagnosis. Establishing the correct diagnosis is particularly important because the solid serous adenoma is a benign lesion with much better prognosis than the other lesions in the differential diagnosis.

Primary ductal adenocarcinoma of the lacrimal gland

This patient noticed a progressive change in her lower eyelid beginning 7 months earlier. From old photographs, we confi rmed that the eyelid retraction was recent. She also had severe conjunctival injection, especially in the inferior half of the globe. Therefore, we concluded that the infl ammation had spread from the maxillary sinus to the orbit and lower eyelid, and that this was the main cause of the eyelid retraction. One of the objectives of surgical repair of a blowout fracture is complete reconstruction of the fractured orbital walls that separate the orbital tissue from adjacent cavities. The reconstructed orbital walls serve as a barrier preventing adhesion. Moreover, whereas the normal orbital fl oor serves as a barrier against the spread of infection to the orbit, an incompletely reconstructed orbital fl oor might not. Although very rare, incomplete reduction may lead to eyelid retraction when maxillary sinusitis occurs in patients treated with open reduction. Therefore, surgeons should try to reconstruct the orbital fl oor completely when they reduce blowout fractures and take care not to disturb the normal physiology of the maxillary sinus. The cause of maxillary sinusitis is uncertain. It may occur as a result of blockage of the ostium during previous surgery or accidentally. Although we could not verify the cause of the maxillary sinusitis, this case shows that eyelid retraction can occur after maxillary sinusitis. To our knowledge, no case of lower eyelid retraction as a complication of maxillary sinusitis has been reported. In this case, we achieved a satisfying result in correcting the eyelid retraction after removing the source of infection in the maxillary sinus.

Interleukin-13 exerts autocrine growth-promoting effects on human pancreatic cancer, and its expression correlates with a propensity for lymph node metastases

Interleukin-13 (IL-13) is an anti-inflammatory cytokine produced in cells of hematopoetic origin. It is not known whether pancreatic cancer cells produce IL-13 or whether IL-13 can modulate pancreatic cancer cell growth and influence the frequency of lymph node metastases. Cell growth and signaling were analyzed by cell counting, colorimetric proliferation assays, fluorescent-activated cell sorting, and in vitro kinase activity assays. IL-13 expression and secretion were determined by Northern blot analysis and enzyme-linked immunosorbent assay, respectively. Localization of IL-13 and its transmembrane receptor (IL-4R) in primary pancreatic ductal adenocarcinoma (PDAC) was characterized by immunohistochemistry. IL-13 enhanced the growth of ASPC-1, CAPAN-1, and COLO-357 cells. This was associated with enhanced p44/42 mitogen-activated protein kinase (MAPK) phoshorylation. In contrast to p44/42 MAPK, phosphatidylinositol 3-kinase activity was also induced in IL-13-unresponsive MIA PaCa-2, PANC-1, and T3M4 cells. All cells expressed and secreted IL-13. Neutralizing IL-13 antibodies inhibited the growth of ASPC-1 and CAPAN-1 cells. Immunohistochemical analysis of resected primary ductal adenocarcinoma specimens revealed high levels of IL-13 in 30 of 70 cases and its transmembrane receptor (IL-4R) in 28 of 70 cases, respectively. Fifteen of 16 specimens (94%) exhibiting high IL-13 and IL-4R coexpression had lymph node metastases, while only 30 of the remaining 54 samples (56%) had positive lymph nodes (p = 0.0134). IL-13 can act as an autocrine growth factor in PDAC. Endogenous expression of IL-13 in conjunction with IL-4R in the cancer cells seems to facilitate lymph node metastasis.

Novel management and unique metastatic pattern of primary ductal adenocarcinoma of the lacrimal gland

Clinical & Experimental OphthalmologyVolume 36, Issue 2 p. 194-196 Novel management and unique metastatic pattern of primary ductal adenocarcinoma of the lacrimal gland Michael JJ Kim MD, Michael JJ Kim MD Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this authorSharyu Hanmantgad, Sharyu Hanmantgad Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this authorAndrei I Holodny MD, Andrei I Holodny MD Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this author Michael JJ Kim MD, Michael JJ Kim MD Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this authorSharyu Hanmantgad, Sharyu Hanmantgad Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this authorAndrei I Holodny MD, Andrei I Holodny MD Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USASearch for more papers by this author First published: 19 March 2008 https://doi.org/10.1111/j.1442-9071.2008.01704.xCitations: 14Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume36, Issue2March 2008Pages 194-196 RelatedInformation

Invasive primary ductal apocrine adenocarcinoma of axilla: A case report with immunohistochemical profiling and a review of literature

Primary cutaneous ductal apocrine adenocarcinoma (PCDAA) is a rare malignant cutaneous neoplasm usually arising in areas of high apocrine gland density. There have been a total of 40 cases of primary apocrine adenocarcinoma reported in the literature; many are indolent and slowly- developing, but some are rapidly progressive. Primary cutaneous ductal apocrine adenocarcinoma has distinctive histologic and immunohistochemical characteristics and the treatment of choice for PCDAA is wide local excision with clear margins. Sentinel lymph node biopsy (SLNB) has also been used to determine prognosis and management. We present a case of a 92-year-old female with a 1-year history of a subcutaneous tumor of the right axilla, histologically consistent with a diagnosis of PCDAA arising in an accessory nipple. To our knowledge this is the first reported case of apocrine adenocarcinoma to develop in an accessory nipple.