Indian journal of cancer最新文献

Abstract: Embryonal sarcoma of the liver (ESL) is an aggressive tumor of childhood and rare in adults. Herein, we report an ESL in a 37-year-old female patient, who presented with liver rupture and acute abdomen. ESL was not considered in preoperative clinical differential diagnoses due to its rarity and the diagnosis was not established in the preoperative liver aspirate. This study highlights the fact that ESL should be considered as an uncommon malignant tumor in adults affecting commonly the right lobe of the liver, especially when the serum alpha-fetoprotein level is within normal ranges. Histological examination is essential to establish the diagnosis with ancillary tests. Due to its rarity, although a definitive mode of therapy is not known, postoperative adjuvant chemotherapy is effective in achieving symptom-free recovery. The index patient developed omental metastasis after 9 months of diagnosis and such a presentation is possibly an indicator of aggressive tumor behavior.

Abstract: Myofibroblastic sarcoma (MFS) is a rare malignant tumor of the myofibroblasts (mammary MFS being even rarer but more aggressive). Only 12 cases of mammary MFS have been reported before this. We report a rare case of a 32-year-old lady who had been operated on twice for phyllodes tumor and who came with another recurrence at the same site. Preoperative work-up was suggestive of recurrent phyllodes tumor. Wide local excision with 1 cm margin with type 1 oncoplastic reconstruction was done, considering her age and marital status. Final histology was suggestive of MFS, and margins were clear. Immunostaining was positive for vimentin and weakly positive for smooth muscle actin (SMA). In the existing literature, there exists no clarity on the underlying lesion or cell origin of MFS. One case report highlighted old fibroadenoma and another attributed radiation preceding the MFS. We report a rare case of MFS in a setting of recurrent breast phyllodes in a young unmarried woman.

Background: The aim of this study was to investigate the association between serum C-reactive protein-to-albumin ratio (CAR) and the prognosis of multiple myeloma (MM).

Methods: In this single-center retrospective cohort study, a total of 321 patients diagnosed with MM were enrolled between February 2008 and December 2020. All patients were divided into two groups according to the optimal cutoff value of CAR. Cox proportional hazard regression model and receiver operating characteristic (ROC) curve analysis were conducted to assess the prognostic predictive value of CAR.

Results: Higher CAR was significantly associated with shorter overall survival (OS), cause-specific survival (CSS), and progression-free survival (PFS) (HR = 1.864, 95%CI = 1.287-2.699, P < 0.001 for OS; HR = 1.916, 95%CI = 1.052-2.546, P < 0.001 for CSS; HR = 1.748, 95%CI = 1.291-2.367, P < 0.001 for PFS). The significance remained after multivariable logistic regression analysis (HR = 1.628, 95%CI = 1.066-2.485, P = 0.024 for OS; HR = 1.636, 95%CI = 1.052-2.546, P = 0.029 for CSS; HR = 1.666, 95%CI = 1.185-2.343, P = 0.003 for PFS). CAR demonstrated significantly higher predictive power compared to both albumin (P < 0.05) and C-reactive protein (P < 0.05) in terms of OS, CSS, and PFS. The composite variable exhibited the highest predictive value (P < 0.001).

Conclusions: Higher CAR was found to be an independent predictor for the poor prognosis of MM.

Introduction: Rectal cancer is a significant health problem. The study was conducted to analyze the overall survival (OS) and disease-free survival (DFS) and their relation to multiple patient-related clinicodemographic factors.

Materials and methods: This ambispective study was conducted at a tertiary care referral and university teaching hospital. The data from the patient records were collected for the year 2014-2016 and followed till June 2021. OS and DFS and their relation with multiple clinicodemographic factors like smoking habits, marital status, stage of the disease, circumferential resection margin (CRM), and the treatment received were assessed.

Results: The overall 5-year mean DFS and OS for all stages were 59.13 and 56.81 months, respectively. The mean DFS and OS were significantly better for stage I disease at 83.96 and 84.16 months and least for stage IV at 27.72 and 32.61 months, respectively, (P = 0.001). The mean 5-year DFS and OS in patients undergoing upfront surgery were significantly higher at 59.93 and 62.70 months compared with patients who received other treatment options at 51.11 and 49.85 months (P = 0.002 and P = 0.001), respectively. The association of CRM and 5-year DFS was statistically significant (P = 0.001) with improved survival in CRM-negative at 62.91 months compared with 43.68 months in CRM-positive patients. Similarly, there was a significant 5-year OS benefit in CRM-negative patients (P = 0.001). The 5-year DFS and OS were statistically significant (P = 0.028 and P = 0.053) among married patients, respectively.

Conclusions: The study revealed the impact of stage, CRM, upfront surgery as well as marital status on the OS and DFS. This study reveals that survival patterns can be improved if cancer is detected early and receive proper treatment at proper time.

Abstract: Primary renal well-differentiated neuroendocrine tumors (WDNETs) are uncommon tumors that differ in histological pattern, biological behavior, and response to treatment. There is a considerable correlation between WDNETs and congenital or acquired renal anomalies. We report a WDNET in a horseshoe kidney with lymph nodal metastasis in a 35-year-old male. This rare occurrence is discussed, especially the grading of these tumors and the value and vagaries of Mib-1 labeling index.

Abstract: Malignant fibrous histiocytoma-currently known as undifferentiated pleomorphic sarcoma-is the most common soft tissue sarcoma of mesenchymal origin. Undifferentiated pleomorphic sarcoma is commonly located in the extremities, trunk, head, and neck in decreasing order of frequency. We report a case of primary undifferentiated pleomorphic sarcoma of the biceps femoris muscle in a 50-year-old man complicated by hemorrhage. Diagnostic workup included imaging, histopathology, and positive results on immunohistochemistry, especially CD68. High-grade liposarcoma and rhabdomyosarcoma were regarded as differential diagnosis of undifferentiated pleomorphic sarcoma. Demonstration of spontaneous hemorrhage within the lesion on follow-up ultrasonography done at one month from the time of diagnosis deserves special mention in this report. Radical excision with tumor-free margins of the biceps femoris and tendon reconstruction were undertaken. MRI at six-month follow-up did not reveal tumor recurrence at the site of surgery and CT chest did not reveal metastases.

Abstract: Castleman disease is a rare lymphoproliferative disorder. It presents with localized or generalized lymph node enlargement with a multitude of inflammatory symptoms. The etiology is largely unknown; however, human herpes virus 8 and Interleukin 6 have been found to be associated with some of these cases. We hereby report a case of a 60-year male, with no known comorbidities, who presented with complaints of dry cough and breathlessness for 25 days and low-grade fever for 15 days. The patient also had anemia, thrombocytopenia, and anasarca. Infective work-up was negative, and imaging revealed generalized lymphadenopathy. An excisional biopsy from the lymph node helped in clinching the diagnosis.

Abstract: Here, we present a rare case of a 74-year-old woman with intermittent haematuria for 6 months. Computed tomography urography showed an ill-defined heterogeneously enhancing soft tissue lesion near the neck of the bladder. The patient was advised of radical cystectomy with an ileal conduit for which the patient was unwilling. Hence, transurethral resection of bladder tumor was performed. Histopathological evaluation of surgical specimen revealed it to be primary osteosarcoma of the urinary bladder. The patient was given radiotherapy. Regular follow-up revealed no abnormality, and the patient showed excellent response with normal urinary tract function. Primary urinary bladder sarcomas are extremely rare clinical entities. To date, in scientific literature, fewer than 50 primary bladder osteosarcomas have been reported.

Background: Myeloid sarcoma (MS) refers to extramedullary proliferation of blasts of myeloid lineages that disrupts the normal architecture of the tissue in which it is found. Due to its rarity, prognostic factors and optimal management are yet unknown.

Materials and methods: Medical records of patients diagnosed with MS without marrow involvement and with no history of previous acute myeloid leukemia (AML) were retrieved. Diagnosis was made by immunohistochemical analysis of fixed paraffin tissue. Clinical features and treatment outcomes were recorded. Our aim was to study the clinical features and outcomes of cases of isolated MS diagnosed at our institute from 2010 to 2018.

Results: Ten cases of isolated MS were diagnosed between 2010 and 2018. Median age was 29 years. Common sites of disease were soft tissues (40%) and lymph nodes (30%). Two patients refused treatment, one patient was treated with surgery followed by radiotherapy, and seven patients were treated with intensive chemotherapy. Also, 57.1% had complete response and 28.6% had partial response. The median survival for the entire cohort was 6.5 months. The median progression-free survival (PFS) and overall survival (OS) of patients treated with chemotherapy were 7 and 8 months, respectively.

Conclusion: Isolated MS is a rare presentation of AML. It has a better prognosis than MS with concomitant marrow involvement. Systemic chemotherapy is an essential component of treatment, but the optimal timing is debatable, that is, at diagnosis or if it can be safely deferred until relapse.