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Axillary chest wall solid-papillary carcinoma: A case report on presentation and management. 腋窝胸壁实体乳头状癌1例表现及处理。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231155957
Harper E Niver, Priscilla Strom

Papillary breast carcinomas comprise <1% of all breast cancers. They are notorious among surgical pathologists for posing diagnostic difficulty, especially with small sample sizes, such as a core-needle biopsy and carry potential for overtreatment. Solid-papillary carcinoma is a subtype of papillary breast carcinomas that affects elderly females and generally has a favorable diagnosis in its in-situ form. This report focuses on the unique and clinically aggressive presentation and treatment of invasive solid-papillary carcinoma that was discovered along the axillary chest wall after an ipsilateral mastectomy for multifocal ductal carcinoma in situ.

乳头状乳腺癌包括
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引用次数: 0
Epithelioid hemangioendothelioma of the distal lower extremity and the role of radiotherapy: A report of two cases. 下肢远端上皮样血管内皮瘤及放疗的作用:附2例报告。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231172611
Robin Go, Linus Lee, Gayathri Vijayakumar, Sarah Tepper, Steven Gitelis, Alan Blank

We report two cases of epithelioid hemangioendothelioma (EHE) in the distal lower extremity. Our first patient had unicentric EHE of the left os calcis initially treated with an intralesional procedure; however, later developed two recurrences which were managed with radiation therapy. Our second patient had multicentric EHE of the distal tibia and fibula managed with primary radiation therapy. Although EHE is typically treated with wide resection or an intralesional procedure, we present two cases of EHE in the distal lower extremity to discuss the therapeutic role of radiation therapy in the management of distal EHE.

我们报告两例上皮样血管内皮瘤(EHE)在远端下肢。我们的第一位患者患有左肾钙单中心EHE,最初采用局内手术治疗;然而,后来出现了两次复发,用放射治疗进行了治疗。我们的第二例患者在胫骨和腓骨远端有多中心EHE,采用初级放射治疗。虽然EHE通常采用广泛切除或病灶内手术治疗,但我们提出了两例下肢远端EHE病例,以讨论放射治疗在远端EHE治疗中的治疗作用。
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引用次数: 0
Unusual cause of mediastinal tumor: A case of calcified pericardial cyst. 纵隔肿瘤的不寻常病因:钙化心包囊肿1例。
IF 0.9 Q4 ONCOLOGY Pub Date : 2023-01-01 DOI: 10.1177/20363613231177539
S M Tajdit Rahman, Mofizur Rhaman Mia, Mohammad Anamul Hoque, Sanghita Banik Proma

Pericardial cysts are rare benign intrathoracic lesions, and calcified pericardial cysts are even more uncommon. Most pericardial cysts are asymptomatic, but patients may present with chest pain, dyspnea and any complications of pericardial effusion. We present a case of a left-sided calcified pericardial cyst, highlighting its rarity and symptoms in relation to its location.

心包囊肿是少见的胸部良性病变,钙化的心包囊肿更是罕见。大多数心包囊肿是无症状的,但患者可能出现胸痛、呼吸困难和任何心包积液的并发症。我们报告一个左侧钙化心包囊肿的病例,强调其罕见性和症状与其位置的关系。
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引用次数: 0
A qualitative study to assess the psychological experiences and coping strategies of families affected with Li-Fraumeni syndrome in the Indian population. 一项定性研究评估心理经验和应对策略的家庭与李-弗劳梅尼综合征在印度人口。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231186300
Poonam Joshi, Sunidhi Bhandari, Ajesh Tk, Simran Kaur, Rachna Bhargava, Ghazal Tansir, Sameer Rastogi

Background: Li-Fraumeni syndrome (LFS) is a rare autosomal dominant hereditary cancer syndrome. Due to the high risk of occurrence of multiple cancers, families with LFS may have an overwhelming psychosocial burden. Methods: This cross-sectional study was conducted at a tertiary care center using face-to-face interviews through a grounded theory approach. Statistical analysis was done using Smith's Interpretative Phenomenological Approach. Themes and sub-themes were extracted, and a thematic schema was developed. Results: A total of five themes were identified. The extracted themes were psychological experiences, behavioural responses, stressors, coping strategies and perceived needs. The interlay of the themes deepened the impact of LFS on the affected ones and brought into light the turmoil of emotions and difficulties that these individuals were going through in the face of the disease. Conclusions: LFS-affected individuals had a range of experiences with this rare and little-known disease. The lack of information seems to be a precursor to the denial of diagnosis. Their experience with the illness sheds light on the grey areas like guilt and helplessness that demand immediate attention. Future policies need to be developed in accordance with the identified perceived needs to potentially guide the treatment and rising needs of LFS-affected individuals.

背景:Li-Fraumeni综合征(LFS)是一种罕见的常染色体显性遗传性癌症综合征。由于多种癌症发生的高风险,患有LFS的家庭可能会有巨大的社会心理负担。方法:本横断面研究采用面对面访谈的方式,通过扎根理论的方法在三级保健中心进行。统计分析使用史密斯的解释性现象学方法。提取主题和子主题,形成主题图式。结果:共确定了五个主题。提取的主题是心理体验、行为反应、压力源、应对策略和感知需求。这些主题的相互作用加深了LFS对受影响者的影响,并揭示了这些人在面对疾病时所经历的情绪动荡和困难。结论:lfs患者有一系列罕见且鲜为人知的疾病经历。缺乏信息似乎是否认诊断的前兆。他们的患病经历揭示了需要立即关注的内疚和无助等灰色地带。未来的政策需要根据已确定的感知需求来制定,以潜在地指导治疗和受慢性疲劳综合症影响的个人日益增长的需求。
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引用次数: 0
Posterior fossa giant adenoid cystic carcinoma with skull base invasion mimicking glomus jugulare: A case report and review of literature. 后窝巨大腺样囊性癌伴颅底侵犯模拟颈静脉球:1例报告及文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613221150218
Anand Kumar Das, Saraj Kumar Singh, Kranti Bhavana, Subhash Kumar

The author describes a rare case of giant adenoid cystic carcinoma (ACC) mimicking large paraganglioma with lower cranial nerve palsy. A 60-year-old female presented with a progressive increase in postauricular swelling with unilateral hearing loss, facial deviation, difficulty in swallowing, and hoarseness of voice. MRI brain showed highly vascular infiltrating and osteolytic mass suggestive of large glomus jugulare versus sarcoma. It was completely engulfing the jugular foramen and lower cranial nerves with bony erosion of the jugular foramen and occipital condyle. The whole mastoid was filled with the tumor. On digital subtraction angiography the majority of blood supply was from the occipital branch of the external carotid artery and vertebral artery. The patient underwent percutaneous embolization followed by external carotid ligation and resection of the mass. The postoperative course was uneventful. Histopathology was suggestive of mixed ACCs. The patient received radiotherapy. After 1 year of follow up no recurrence or distant metastasis was noted.

作者报告一例罕见的巨大腺样囊性癌(ACC),类似于大副神经节瘤合并下颅神经麻痹。一位60岁女性,表现为耳后肿胀进行性增加,伴有单侧听力丧失、面部偏斜、吞咽困难和声音嘶哑。脑MRI显示高度血管浸润和溶骨肿块提示颈内血管球与肉瘤。它完全吞没了颈静脉孔和下颅神经颈静脉孔和枕髁的骨质侵蚀。整个乳突充满了肿瘤。数字减影血管造影显示颈外动脉枕支和椎动脉供血最多。患者接受了经皮栓塞,随后进行了颈外动脉结扎和肿块切除。术后过程平淡无奇。组织病理学提示混合性acc。病人接受放射治疗。随访1年,无复发及远处转移。
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引用次数: 0
Nirogacestat and its potential impact on desmoid tumor. 硝加司他及其对硬纤维瘤的潜在影响。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231182485
Samia Rohail, Areeba Fareed, Muskaan Asim Taimuri, Alishba Adnan
Desmoid tumors (DT) are rare, benign, and invasive soft tissue tumors affecting 3–5 people in one million each year. Also known as desmoid fibromatosis, they present usually in the second and fourth decade of life, with an unpredictable prognosis and a risk of significant impairment in quality of life. According to estimates there are 1000 to 1650 new diagnoses in the United States each year. Habitually, these tumors are found in the abdomen, arms, and legs, however, they can affect vital organs as well. Desmoid tumors do not metastasize but painful disfigurement and problems in functioning due to local, aggressive growth can occur. Since desmoid tumors lack the ability to metastasize, local control using surgery and radiation has traditionally been the mainstay of therapy for these tumors. However, recurrence rate is very high, especially after surgery and in rare cases, it can be fatal. Therefore, the need for effective treatment is undeniable. The Food and Drug Administration (FDA) recently awarded Nirogacestat’s new drug application (NDA) for the treatment of adult patients with desmoid tumours a priority evaluation. The FDA has also given desmoid tumours in adult patients Fast Track and Breakthrough Therapy classifications. Nirogacestat is an oral, specific, small-molecule gamma secretase inhibitor that works by cleaving a variety of transmembrane protein complexes, including Notch, which may be involved in pathways that support the development of desmoid tumours. Inhibition of γ-secretase preserves membrane-bound B-cell maturation antigen (BCMA) and increases target density by reducing the levels of soluble BCMA, thus serving as a decoy receptor for BCMA-targeted therapy. The ability of Nirogacestat to potentiate the activity of BCMA-targeted therapy has been observed in preclinical models of multiple myeloma. A DeFi study, the largest and most rigorous randomized controlled trial was conducted in which 142 patients with advanced desmoid tumors were recruited. Patients were randomized to receive either Nirogacestat 150 mg or placebo twice daily in cycles of 28 days until they developed symptoms on radiologic imaging. The results showed a statistically significant improvement in progression of survival in patients randomized to Nirogacestat compared to placebo, with an average 71% reduction in risk of disease advancement. Participants taking Nirogacestat improved by 41% in their response within 5.6 months, compared to 8% in a longer period of 11.1 months by the placebo group. However, treatment was stopped due to ovarian dysfunction, which is defined by investigator-reported events of amenorrhea, premature menopause, menopause, and ovarian failure and was seen in 75% of women of childbearing potential receiving Nirogacestat. Nirogacestat demonstrated a manageable safety profile in DeFi studies, with 95% of all treatment-emergent adverse events. Therefore, treatment should be individualized for each patient to optimize tumor control and impro
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引用次数: 0
PARP inhibition utilized in combination therapy with Olaparib-Temozolomide to achieve disease stabilization in a rare case of BRCA1-mutant, metastatic myxopapillary ependymoma. 在罕见的brca1突变、转移性黏液乳头状室管膜瘤病例中,利用PARP抑制与奥拉帕尼-替莫唑胺联合治疗实现疾病稳定。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231152333
Preethika Mahalingam, Sam Smith, Juanita Lopez, Rajaei K Sharma, Thomas Millard, Khin Thway, Cyril Fisher, David A Reardon, Robin Jones, Andrew G Nicholson, David Cunningham, Liam Welsh, Bhupinder Sharma

Myxopapillary ependymoma (MPE) is a primary tumor of the central nervous system (CNS), characteristically an indolent malignancy involving the spinal conus medullaris, Filum terminale or cauda equina. We present a rare case of MPE, recurrent in the pelvic soft tissue with eventual pleural and intra-pulmonary metastasis. Refractory to repeated gross resection, adjuvant radiotherapy, platinum-based chemotherapy and temozolomide exploitation of mutant somatic BRCA1 status with the addition of a poly (ADP-ribose); polymerase inhibitor (PARPi) in a novel combination regimen with olaparib-temozolomide (OT) has achieved stable radiological disease after 10 cycles.

黏液乳头状室管膜瘤(MPE)是一种中枢神经系统(CNS)的原发性肿瘤,以累及脊髓圆锥、终丝或马尾的惰性恶性肿瘤为特征。我们报告一个罕见的MPE病例,在盆腔软组织复发,最终胸膜和肺内转移。反复大体切除、辅助放疗、铂基化疗和替莫唑胺难以耐受的突变体BRCA1状态,并添加聚adp核糖;聚合酶抑制剂(PARPi)与奥拉帕尼-替莫唑胺(OT)联合使用的新方案在10个周期后获得了稳定的放射学疾病。
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引用次数: 2
A staghorn kidney stone or extraskeletal osteosarcoma of the kidney? A case report and literature review. 是鹿角肾结石还是肾脏骨外骨肉瘤?病例报告及文献复习。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231176719
Ali Emadi Torghabeh, Masoumeh Gharib, Siavash Zahed Anaraki, Parisa Rabiei

Extraskeletal osteosarcoma (ESOS) is a very rare entity among renal malignancies. There are few reports of renal ESOS in the database. Renal ESOS was found to have a high rate of local recurrence and distant metastasis. In most reports, the overall survival of patients was less than 1 year. We present a 51-year-old man who presented with gross hematuria and a clinical diagnosis of a staghorn stone in the left kidney. He underwent radical nephrectomy. The pathologic diagnosis of osteosarcoma was evident.

摘要骨骼外骨肉瘤(ESOS)是一种非常罕见的肾脏恶性肿瘤。数据库中关于肾脏ESOS的报道很少。肾脏ESOS有很高的局部复发和远处转移率。在大多数报告中,患者的总生存期小于1年。我们提出一个51岁的男子谁提出肉眼血尿和临床诊断鹿角石在左肾。他接受了根治性肾切除术。骨肉瘤的病理诊断是明确的。
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引用次数: 0
Vorasidenib: A promising therapeutic breakthrough for diffuse isocitrate dehydrogenase mutant gliomas. Vorasidenib:弥漫性异柠檬酸脱氢酶突变型胶质瘤的有希望的治疗突破。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231197991
Abdul Wahid, Amna Tariq, Faiza Ahsan, Fatima Asif
The most common type of major malignant tumor of the brain includes gliomas, which are marked by diffuse invasion of malignant cells in the brain. Grade II and grade III diffuse gliomas classi fi ed by the World health organization (WHO) are also known as lower-grade gliomas LLG. These tumors are seen more frequently in younger people, show a slower growth rate, and mostly does not appear on contrast enhancement on T1-weighted brain MRI in the beginning. Current treatment includes chemotherapy, radiation, and maximally safe tumor resection. However, there is a high chance of recurrence and transformation of LLG into a more aggressive tumor. The advanced treatment outlook is to attack mutant genetic changes that are causing gliomas in the initial stage to minimize the use of harmful therapies and to hinder its progression to a higher tumor grade. 1 Isocitrate dehydrogenase (IDH), is an important enzyme having a major role in the tricarboxylic cycle as well as controlling the redox cofactor in between mitochondria and cytosol. IDH1, IDH2, and IDH3 are the three existing isoforms. 2 Mutations in isoforms of IDH1 and IDH2, that are heterozygous lead to the formation of oncogenic d-2-hy-droxyglutarate (2-HG), 3 causing different malignant growth counting
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引用次数: 0
Breakthrough treatment choice for Acute Myeloid Leukemia in pediatric and adult patients: Revumenib, an oral selective inhibitor of KMTA2Ar. 小儿和成人急性髓系白血病突破性治疗选择:Revumenib,一种口服选择性KMTA2Ar抑制剂。
IF 0.9 Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1177/20363613231183785
Areeba Fareed, Nimrah Inam, Fatima Faraz
Acute myeloid leukemia (AML) represents the predominant manifestation of acute leukemia in the adult population, whereas in children, it ranks second in terms of frequency. It is characterized by genetic mutations and epigenetic dysregulation resulting in a heterogeneous population of malignant cells with blocked differentiation resulting in increased proliferation and self-renewal activity . Every year 20,000 new cases of AML are diagnosed in the United States, whereas the global burden of the disease is believed to range between 119,000 to 352,000 cases per annum. NPM1 gene mutations are the most encountered genetic aberrations in acute myeloid leukemia (AML), being detectable in about one-third of adult AML and 50– 60% of AML patients with normal karyotype. The mutant NPM1 is directly involved in promoting increased expression of homeobox (HOX) genes, which are necessary for maintaining the leukemic cells in undifferentiated state. Recent studies have shown the importance of MLL1Menin interaction in AML with mutated nucleophosmin 1 (NPM1c). MLL1 (also known as lysine methyltransferase 2A [KMT2A]) is located on chromosome 11q23, but chromosomal translocation (MLL1-rearrangement [MLL1-r]) is observed in 5%–10% of acute leukemia cases (AML and ALL) in adults and children. This leads to the expression of chimeric MLL1 fusion proteins (ML-FP) that drive leukemic gene expression and proliferation and prevent hematopoietic differentiation, consequently giving rise to a particularly aggressive subtype of leukemia with an unfavorable outcome. Chromosomal rearrangements involving KMT2A gene are prevalent in neonates with acute leukemia, and affects 75% of newborns with ALL. Research findings suggest that this crucial molecular alternation takes place antenatally, leading to leukemia during the infantile period. Although induction therapy achieves complete remission (CR) in 60–80% cases, no targeted therapies have specifically been approved for acute leukemia with KMT2A rearrangement (KMT2Ar) or mutated NPM1currently. Unfortunately, the median survival is relatively brief at 8.5 months with 2-year and 5-year Overall Survival (OS) rates just 32% and 24%, respectively. Furthermore, existing research has suggested that circRNAs are capable of playing a role in the post-transcriptional regulation of AML by binding miRNAs, activating downstream signaling cascades, and regulating the expression of related genes, closely correlated with a wide variety of processes of AML. AML has a poor prognosis and a considerable tendency to relapse therefore, the need for effective treatment is undeniable.
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引用次数: 1
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Rare Tumors
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