Daniel Motola-Kuba, Ileana Mackinney-Novelo*, and Ricardo Fernandez-Ferreira
Rhabdomyosarcoma is extremely rare in adults, but is the most common extra cranial solid tumor in children. Rhabdomyosarcoma in adults is a heterogeneous disease, with different form of presentation, histology, and prognosis and with difficulty in its treatment due to the rarity of the disease.
Here we briefly review the literature on adult rhabdomyosarcoma and present the case of a 39-year-old man clinical presentation of dyspnea, chest pain and weight loss, with initial approach with imaging studies and a mediastinal biopsy in which malignant neoplasia poorly differentiated with mesenchymal and epithelial immunophenotype is reported. He started chemotherapy with Paclitaxel/Carboplatin in a three-week regimen. After 2 cycles of chemotherapy a re-evaluation computed axial tomography showed progressive disease and the biopsy reported Embrionary Rhabdomyosarcoma with immunochemistry positive for myo D-1 and myogenine. Metastasis was confirmed at the diaphragm, retroperitoneal and central nervous system levels. 2nd line chemotherapy regimen with Vincristine, Doxorubicin and cyclophosphamide were initiated.
Sunila Hussain*, Rakia Sahaf, Muhammad Rashid Siraj, Fakeha Rehman, Sameer Anjum, Nida Ali, Ayesha Saeed, Ihtesham-ud-Din Qureshi, and Nadia Naseem
Extracellular matrix metalloproteinase inducer expression has been focus of research for variety of neoplasm's owing to its potential role played in invasion, angiogenesis and metastasis through interactions with other molecules.
This study was designed to determine the immunohistochemical expression of EMMPRIN in benign and malignant salivary glands tumors in local population.
This descriptive study was conducted at the Department of Morbid Anatomy and Histopathology/ Oral Pathology, University of Health Sciences Lahore, Pakistan. Biopsies and detailed clinical data of 85 cases of salivary gland neoplasm's (25 pleomorphic adenoma, 06 Warthin tumour, 25 adenoid cystic carcinoma, 25 mucoepidermoid carcinoma and 02 each basal cell adenocarcinoma and carcinoma ex pleomorphic adenoma) were obtained from different local tertiary care hospitals in Lahore from Jan. 2014 to Sep 2015. After confirming the histologic diagnosis on hematoxylin and eosin stained sections, immunohistochemical expression of EMMPRIN was determined. SPSS version 21.0 was used to determine the association between expression of EMMPRIN in benign, malignant and individual tumors. Chi-square and Fischer Exact tests were applied and p<0.05 was considered to be statistically significant.
Expression of EMMPRIN in malignant tumors was significantly higher than benign tumors (p< 0.0001). The staining pattern of cells was also significantly associated with type of tumour (p<0.0001). Significant EMMPRIN expression was noted with grades in AdCC (p <0.0001) & MEC (p=0.016).
The current study concludes that EMMPRIN expression is significantly higher in malignant salivary gland neoplasm's and may help the pathologists for assessing tumor differentiation and malignant potential if added in a panel of other conventional markers.
Amit Sengupta*, Sanjay Gupta, Arvind Ingle, and Jayant Goda
HBO has been used as an adjuvant to chemo (CT) or radiotherapy (RT) in cancer; however, in our previous work on survival study in small animal mice model, we reported cancer enhancing effect after cessation of the HBO therapy. The present study was designed to understand the underlying molecular mechanism that may be linked to cancer enhancing phenomenon. Tumor bearing C3H mice were subjected to hyperbaric hyperoxia (1.1 bar & 1.2 bar) therapy consequently for 6 days with a day off in between for 3 weeks. Each session comprised of daily 120 minutes of HBO exposure prior to and after being subjected to RT or CT. Another group was subjected to one, two and three weeks of HBO therapy to observe graded response and severity of DNA damage. We observed proportionate increase in the severity of DNA damage and histone modification in the tumor samples when subjected to longer duration of HBO therapy as compared to tumor control. Thus, we suggest that HBO therapy should be given under highly dose controlled condition and with caution, else dual effect of oxygen toxicity and molecular effects may lead to tumor enhancement or recurrence and/or metastasis.
Baena-Villamarin C, Beardo P*, Payares JL, and Extramiana J
Sunitinib is an anti angiogenic agent used in the first line treatment of metastatic renal cell carcinoma (mRCC), which is associated to a high incidence of adverse effects, although neurological adverse effects are uncommon. We describe the case of 76-year-old male with mRRC and severe aortic and mitral valve disease treated with sunitinib, who presented acute confusional syndrome (ACS) during sunitinib treatment without organic condition that, explains his status. After 24 months of sunitinib discontinuation, the patient remains completely recovered from the ACS and showed complete radiological response.
Khoi Anh Nguyen*, Tu Anh Thai, and Cuong Tri Giang
Warthin’s tumor is a salivary gland tumor consisting of epithelial and lymphoid components. The majority of Warthin’s tumors are benign and malignant transformation is extremely rare. We report a case of malignant transformation of a Warthin’s tumor of the right parotid gland. The patient had a right parotid tumor and underwent tumor excision. Histopathology after surgery showed malignant transformation of Warthin’s tumor. On examination, we found a cervical lymph node group VB and Fine Needle Aspiration (FNA) showed metastasis. We decided to perform a total parotidectomy and modified radical right neck dissection for the patient. Then the patient underwent adjuvant radiotherapy. Close follow-up was carried out and 3 months after surgery there was no evidence of recurrence or metastatic neoplasm. Therefore, if there is a parotid tumor which is suspected malignant, we should thoroughly investigate the cervical lymph nodes and consider prophylactic neck dissection although we do not find the susceptive nodes.