bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric Cancer Metastatic to the Pituitary Gland: A Case Report
Authors: Pozzessere Daniele , Zafarana Elena , Buccoliero Anna Maria , Pratesi Chiara , Fargnoli Rossana , Di Leo Angelo
Published: February 2018

Neoplasms from almost every tissue have been reported to metastasize to the pituitary. Gastric carcinoma is a rare cause of metastases in pituitary gland. Gastric carcinoma will be the primary tumor in less than 2% of patients with pituitary gland metastases. We report the case of a 60-years old white man with liver metastasis from gastric cancer with fair presentation symptoms of pituitary gland metastasis. Basal endocrinological work-up showed corticotroph, gonadotroph, somatotroph and thyrotroph cell insufficiency; serum PRL was elevated and no deficit of the ADH level was observed. Despite the hormonal deficits the patient did not report any specific symptom. After diagnosis the patient began thyroid and adrenal-replacement therapy and was referred to Radiotherapy Unit for treatment on the sellar and pituitary gland region.
Adult-Type Granulosa Cell Tumor of the Testis. Report of a Case
Authors: LÓPez José I
Published: February 2018

A new case of adult-type granulosa cell tumor of the testis in a 77-year-old man is reported. The patient was healthy and asymptomatic and only showed a discrete left hydrocele. The orchiectomy specimen showed the typical histology of this entity, with prominent nuclear grooving and Call-Exnerlike bodies as the main features. The literature on this exceedingly rare tumor in the testis is reviewed and briefly commented upon.
Colorectal Cancer: What has Changed in Diagnosis and Treatment over the Last 50 Years?
Authors: Gennari Leandro , Russo Antonio , Rossetti Carlo
Published: February 2018

Aims and background

This overview focuses on what has changed in the diagnosis and treatment of colorectal cancer over the last 50 years.

Methods

The most important international registers (SEER, European and Italian) as well as the literature have been consulted. Furthermore, many prognostic factors are analyzed with the aim to understand the reasons why 5-year survival has improved over the last two decades.

Results

Since the biologic characteristics of the tumor cannot be changed, improved survival must be supported by concomitant multiple factors, such as earlier diagnosis (as given by a more informed educational behavior and the advent of screening) as well as the wide use of colonoscopy and the technical improvement of surgical and medical treatment. However, it seems that the greatest improvement in survival is limited to 5-year controls, whereas long-term survival does not appear to show any significant improvement.

Conclusions

We can hypothesize that our efforts have just delayed the inevitable end: death. Nevertheless, further research should be done to confirm this hypothesis, perhaps in the field of molecular biology, which may also be the right approach to understanding the biologic aggressiveness of each tumor.
A Pilot Phase ii Study of Chemotherapy with Oxaliplatin, Folinic acid, 5-Fluorouracil and Irinotecan in Metastatic Gastric Cancer
Authors: Chiesa Matteo Dalla , Buti Sebastiano , Tomasello Gianluca , Negri Federica , Buononato Massimo , Brunelli Antonio , Lazzarelli Silvia , Brighenti Matteo , Donati Gianvito , Passalacqua Rodolfo
Published: February 2018

Aims and background

Previous phase II studies have reported that combinations of oxaliplatin, folinic acid and 5-fluorouracil or irinotecan, folinic acid and 5-fluorouracil are associated with good efficacy and an acceptable safety profile in metastatic gastric cancer. The aim of this study was to evaluate chemotherapy with oxaliplatin, folinic acid, 5-fluorouracil and irinotecan (COFFI regimen) in metastatic gastric cancer.

Methods

Patients received oxaliplatin (85 mg/m2 d 1), irinotecan (140 mg/m2 d 1), and L-folinic acid (200 mg/m2 d 1) followed by 5-fluorouracil bolus (400 mg/m2 d 1) and then 5-fluorouracil (2,400 mg/m2 48-h continuous infusion), every 14 days.

Results

Seventeen patients with metastatic gastric cancer were enrolled. Eight patients were pretreated for advanced disease. Of the 9 chemo-naïve patients, 8 were evaluated for response (1 patient was lost to follow-up): one complete response, 5 partial responses and 2 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 67%. Of the 8 pretreated patients, 6 were evaluated for response (2 patients had nonmeasurable disease): one partial response, 2 disease stabilizations and 3 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 12%. Median progression-free and overall survival in chemo-naïve patients were 8.2 and 10.2 months, respectively, and in pretreated patients 2.7 and 3 months. Grade 3-4 neutropenia occurred in 55% of chemo-naïve patients. Thrombocytopenia, and anemia were observed in 18% and 29%, respectively. Grade 3 nausea/vomiting occurred in 12% and grade 3 diarrhea in 6%.

Conclusions

The COFFI regimen is active and well tolerated, therefore phase III studies are warranted.
CO2 Laser in the Treatment of Laryngeal Synovial Sarcoma: A Clinical Case
Authors: Capelli Marco , Bertino Giulia , Morbini Patrizia , Proh Michele , Falco Carlo Emilio , Benazzo Marco
Published: February 2018

Synovial sarcoma is a rare mesenchymal neoplasm that is usually located in the limbs. Its occurrence in the head and neck region, and particularly in the larynx, is exceptional, with only 16 cases reported to date. Two histological variants have been described, a biphasic and a monophasic variant. Immunohistochemistry is determinant in the differential diagnosis between synovial sarcoma and other spindle and biphasic neoplasms. The treatment of choice is conservative surgery with tumor-free margins, while radiotherapy is effective in local control of the disease after recurrence. Chemotherapy is indicated for the treatment of distant metastases. We present a case of monophasic synovial sarcoma of the laryngeal ventricle that was successfully treated with CO2 laser excision and we briefly review the literature on the subject.
Glottic Tuberculosis Masquerading as Early Multifocal Carcinoma
Authors: Cantarella Giovanna , Pagani Davide , Fasano Valter , Scaramellini Gabriele
Published: February 2018

The incidence of tuberculosis has progressively decreased in developed countries after the advent of antituberculous chemotherapy, but has recently been increasing again mainly due to migratory flows. Although common in the past and considered to be a prelethal event, laryngeal involvement has become a rarity. We report the case of a 52-year-old female smoker who complained of persistent aphonia. Videostroboscopy showed bilateral vocal fold erythroleukoplakias. A chest X-ray and CT scan aroused the suspicion of lung tuberculosis, which was confirmed by Ziehl-Neelsen staining for acid-alcohol-fast bacilli on bronchoalveolar lavage. Antituberculous chemotherapy rapidly improved the quality of her voice and led to complete disappearance of the vocal fold lesions. In conclusion, laryngeal tuberculosis may mimic an early glottic multifocal carcinoma and should therefore, despite its rarity, always be considered in the differential diagnosis of erythroleukoplakia-like lesions in order to avoid improper surgical treatment and voice damage.
Positron Emission Tomography: False Positive Result Due to Splenic Uptake in an Extension Study in Bronchial Carcinoma. A Case Report
Authors: Giménez David Orts , Yáñez Rosa Jiménez , Galiana Gaspar Esquerdo , Dávila Antonia Galán , Martínez Eleuterio Llorca , Castellano Manuel Díaz , Ferrándiz Cristina Llorca
Published: February 2018

Lung cancer is one of the most common malignant diseases. Many tests and techniques are used in the staging of this disease, including positron emission tomography. This is probably the most recently introduced test and is capable of providing information on all the structures affected by malignancy. We present a case of a false positive result due to increased splenic uptake of the tracer.
Tumor vs Non-Tumor Origin of Occult and Obscure Gastrointestinal Bleeding Requiring Hospitalization
Authors: Costantini Raffaele , De Nicola Pierpaolo , Bianco Francesco , Cotroneo Antonio Raffaele , Iezzi Roberto , Di Bartolomeo Nicola , Innocenti Paolo
Published: February 2018

Aims and Background

Occult/obscure gastrointestinal bleeding is often problematic to diagnose. It often leads to delayed treatment, a particularly dangerous circumstance when tumor origins are involved. This study reports the six-year experience of an Italian Surgery Center in the identification of the nature (tumor versus non tumor) and site of origin (upper, middle, lower gastrointestinal tract) of occult/obscure bleeding requiring hospitalization, as well as in its treatment.

Methods

Diagnostic instrumental examinations employed were: esophagogastroduodenoscopy, rectocolonoscopy, computerized tomography small bowel follow-through examination, capsule endoscopy, biopsy, angiography, abdominal computerized tomography scans and ultrasound. Therapies included: interventional radiology and surgery.

Results

Thirty-five cases of obscure and 27 cases of occult bleeding were examined; all received a definite diagnosis during hospitalization. In the cases with obscure bleeding the diagnosis was inflammatory bowel disease (n = 7), angiodysplasia (5 gastric, 2 duodenal, 2 jejunal, 3 ileal, 4 right colon), small bowel tumors (4 non-Hodgkin lymphomas, 1 leiomyoma, 6 adenocarcinomas), and gastric metaplasia of Meckel's diverticulum (n = 1). There were significantly more nontumor lesions than tumors (P <0.005), and a middle tract source was significantly more frequent than upper/lower tract sources (P <0.0001). Intestinal resections were performed for all small bowel tumors (8 laparotomic, 3 laparoscopic), 5 angiodysplasias, all cases of inflammatory bowel disease and gastric metaplasia of Meckel's diverticulum; arterial embolization was performed for 11 angiodysplasias. In the cases with occult bleeding the diagnosis was sigmoid colon polyps in 6 (treatment, endoscopic polypectomy) and right colon cancer in 21 (treatment, right hemicolectomy). There were significantly more tumors than nontumor lesions (P <0.0001); all derived from the lower gastrointestinal tract. In all cases, the interventions resolved the bleeding completely.

Conclusions

The results show that more than 50% of cases with obscure/occult bleeding requiring hospitalization are motivated by malignant gastrointestinal tumors, 34% of which are located in the small bowel, usually a difficult tract to explore. Thanks to modern technology, however, their diagnosis and treatment can nowadays be promptly and successfully achieved.
When Should Trastuzumab be Stopped after Achieving Complete Response in Her2-Positive Metastatic Breast Cancer Patients?
Authors: Beda Manuela , Basso Umberto , Ghiotto Cristina , Monfardini Silvio
Published: February 2018

We report the case of a woman with HER2-positive metastatic breast cancer who achieved prolonged complete remission of multiple liver metastases after treatment with weekly trastuzumab plus paclitaxel but relapsed in the brain soon after stopping trastuzumab maintenance therapy which had been prosecuted for almost three years. In the absence of randomized trials, the optimal duration of trastuzumab administration after achieving complete remission of metastatic breast cancer remains questionable.
Malignant Fibrous Histiocytoma Associated with Coxofemoral Arthrodesis
Authors: Olmedo Daniel G , Michanié Ernesto , Olvi Liliana , Santini-Araujo Eduardo , Cabrini Rómulo L
Published: February 2018

The discovery of biomaterials led to their use in the manufacture of implants for biomedical applications. In vivo, no metal or alloy is completely inert. The potential toxicity of some of the metals most frequently employed in the manufacture of orthopedic implants has been reported. Their carcinogenic potential has been evaluated in experimental animal models. However, few reports have discussed the potential development of malignant tumors associated with prosthetic structures in humans. The present study documents a case of intraosseous sarcoma that developed in the vicinity of a metallic prosthesis 43 months after a coxofemoral arthrodesis with metallic pins and screws. With this report the authors seek to contribute to the understanding of the potential toxicity and risks of using metallic implants. Since metallic implants employed in the rehabilitation of osteo-muscular-articular disorders usually remain in the organism for long periods of time, the need to monitor the metallic structures and the adjacent tissues is extremely relevant.
Bone Marrow Metastasis of Desmoplastic Small round Cell Tumor
Authors: Deng Jing , Xu Nong , Shen Peng , Wang Zhaoming , Zhang Xiaochen , Lou Haiyan , Shi Genming
Published: February 2018

Desmoplastic small round cell tumor is an extremely rare and highly aggressive neoplasm. It usually arises as a single mass or multiple masses in the abdominal cavity, characterized by diffuse peritoneal implants, involvement of regional lymph nodes, and liver and lung metastases. However, bone marrow metastasis has rarely been reported in the literature. We present a case of clinically symptomatic bone marrow metastasis in a 25-year-old woman with a diagnosis of desmoplastic small round cell tumor originating from the pelvic cavity.
Nonsurgical Treatment of an Incompletely Excised Primary Adenocarcinoma of Nonpigmented Ciliary Epithelium
Authors: Lee Sei Won , Park Sung Hye , Kim Il Han , Chung Hum , Kim Tae Yoo , Heo Dae Seog
Published: February 2018

Primary adenocarcinoma of the nonpigmented ciliary epithelium (NPCE) is a very rare disease and the majority of acquired cases were treated by enucleation. We report the case of a 19-year-old man who had an adenocarcinoma arising from the NPCE. The tumor was found incidentally due to changed pupil shape. An excisional biopsy was performed and histopathological examination showed primary adenocarcinoma of the NPCE with a positive resection margin. Because of the positive resection margin and to save the eye, radiotherapy rather than enucleation was performed, followed by chemotherapy. Two years after the diagnosis, the patient continues to be followed up without evidence of relapse or cataract change.

Our case suggests that adjunctive radiotherapy should be considered as a sight-saving treatment modality for primary malignant tumors of the NPCE.
Primary Squamous Cell Carcinoma of the Thyroid: Immunohistochemical Profile and Literature Review
Authors: Fassan Matteo , Pennelli Gianmaria , Pelizzo Maria Rosa , Rugge Massimo
Published: February 2018

Background

Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome.

Case Presentation

A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histo-logically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7–19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5–6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10–20, thyroglobulin, TTF-1, CD5, galectin-3 or p53.

Conclusions

This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.
Aberrant Promoter Methylation Can be Useful as a Marker of Recurrent Disease in Patients with Cervical Intraepithelial Neoplasia Grade III
Authors: Terra Ana Paula Sarreta , Murta Eddie Fernando Candido , Maluf Paulo José , Caballero Otávia Luísa Silva Damas , Brait Mariana , Adad Sheila Jorge
Published: February 2018

Introduction

Although studies of risk factor profiles have been conducted to identify biological markers to predict the natural history of cervical intraepithelial neoplasia (CIN) grade III, there is not sufficient information to support the routine clinical use of any biomarker.

Objectives

The purpose of this study was to examine aberrant promoter methylation, which is implicated in cancer development and progression, in CIN III lesions in order to identify markers associated with more aggressive biological behavior that could be used to recognize women who are at higher risk of recurrence.

Patients and methods

We used methylation-specific polymerase chain reaction to analyze promoter hypermethylation of 8 genes ( p16, RARβ, GSTP1, MGMT, p14, TIMP3, E-cad and DAPk) in 33 uterine cervix cones with CIN III that were also submitted to human papillomavirus (HPV) genotyping. All 33 patients in this study had been clinically followed after conization with Papanicolaou smears, colposcopy, and biopsy when indicated, every 6 months during 5 years.

Results

Of the 33 patients, 12 (36%) underwent immediate hysterectomy after conization for having compromised cone margins, 14 (43%) have not relapsed, and 7 (21%) presented CIN relapse. The frequency of HPV infection in this group was 97% and no significant difference between the groups was observed. HPV of high oncogenic risk was present in 29 (87.9%) cases; HPV 16 was the most frequent (69.7%), while HPV 18 was found in 33.3%; however, it was associated with HPV 16 in 15.1%. Concomitant infection by HPV 6/11 was detected in 21.2% (15.1% with HPV 16 and 6.1 with HPV 18). 85.7% (6/7) of patients with recurrence had HPV 18 vs 0% (0/14) of patients without recurrence ( P = 0.0001). At least 1 of the 8 genes was found hypermethylated in all samples. Concomitant hypermethylation of several genes was frequently found. However, CIN relapse was only seen in the cases with hypermethylation of 3 or more of the 8 genes studied ( P = 0.0039).

Conclusion

We suggest that aberrant promoter methylation may play a role and may serve as a useful biomarker in the recurrence of CIN.
Investigation of Mutations and Expression of the FHIT Gene in Turkish Patients with Brain Metastases Derived from Non-Small Cell Lung Cancer
Authors: Bekar Ahmet , Çeçener Gülşah , Tunca Berrin , Guler Gulnur , Egeli Unal , Tolunay Sahsine
Published: February 2018

Aims and background

Brain metastases occur in 20–40% of patients with cancer, and their frequency has increased over time. Lung, breast and skin (melanoma) are the most common sources of brain metastases. Recent studies show that several genes such as CD44 and PTEN have roles in the suppression of metastatic growth. Although it has been determined that there is a relationship between the FHIT gene and several primary tumors, its role in the initiation and progression of brain tumors has not yet been entirely explained. Furthermore, it is not known whether the FHIT gene has a role in the formation of brain metastases.

Patients and methods

The present study investigated mutations of the FHIT gene in Turkish patients with brain metastases derived from non-small cell lung cancer (NSCLC). Single-strand conformational polymorphism and sequencing analysis of the coding exons (5–9) of the FHIT gene were performed on 26 tissues. Furthermore, the level of Fhit protein expression of 36 tumor tissues was identified by immunohistochemistry.

Results

Using single-strand conformational polymorphism and sequencing analyses, no point mutations of the FHIT gene were detected in brain metastases derived from NSCLC. However, it was observed that Fhit protein expression was reduced in 88.9% of subjects.

Conclusions

We suggest that the FHIT gene may be turned off in brain metastases via other genetic/epigenetic mechanisms rather than mutations.
18FDG-PET Evaluation Correlates Better than CT with Pathological Response in a Metastatic Colon Cancer Patient Treated with Bevacizumab-Based Therapy
Authors: Funaioli Chiara , Pinto Carmine , Di Fabio Francesca , Santini Donatella , Ceccarelli Claudio , De Raffaele Emilio , Fanti Stefano , Castellucci Paolo , Longobardi Ciro , Buggi Federico , Martoni Andrea Angelo
Published: February 2018

Around 20–30% of patients with hepatic metastasis from colorectal cancer can undergo liver resection, but the increased response rate obtained with the addition of monoclonal antibodies to chemotherapy regimens could result in a higher rate of liver surgery. In this report we describe the case of a patient who underwent a liver resection after neoadjuvant treatment with capecitabine, oxaliplatin and bevacizumab and who achieved a complete pathological response of the liver metastasis. A preoperative CT scan demonstrated a partial response to the treatment while 18FDG-PET scan correctly evaluated the complete pathological response in the liver and detected an active interaortocaval lymph node metastasis. New specific studies are required to evaluate the imaging response in metastatic colorectal cancer patients especially after treatment with new, targeted agents.
Primary Pulmonary High Grade Non-Hodgkin's Lymphoma in an Elderly Patient. A Case Report
Authors: Pagani Mauro , Antico Andrea , Bellarosa Sergio , Cavazzini Giovanna , Aitini Enrico
Published: February 2018

An 82-year-old non-smoker female was admitted with cough, fever and poor general health.

Radiological examination revealed a right parahilar mass and a transbronchial biopsy confirmed the presence of a tumor. Immunohistochemical analysis established the diagnosis of high-grade primary pulmonary lymphoma. The rare nature of this disease, its non-specific clinical presentation and particular prognosis, also in elderly patients, are discussed in this article.
A Case of Stevens-Johnson Syndrome Possibly Induced by Amifostine during Radiotherapy
Authors: Zollo Enrico , Cusano Francesco , Argenone Angela , Cusano Carlo Ivan , Pelosi Patrizia , Pironti Teresa , Spacagna Ettore , Viscusi Alfonso , Lioce Marco
Published: February 2018

Skin reactions to amifostine are considered to be rare. Here we describe the case of a patient who developed a severe skin eruption (Stevens-Johnson syndrome) during radiotherapy probably due to amifostine. As in most of the patients described so far, the worst lesions were located in the skin areas previously treated with radiotherapy.
Metachronous Malignancies in Men with Previous Prostate Cancer in Umbria, Italy, 1994–2003
Authors: Cassetti Tiziana , Stracci Fabrizio , Minelli Liliana , Scheibel Massimo , Sapia Ida Elena , La Rosa Francesco
Published: February 2018

Data about second primary tumors after prostate carcinoma are controversial. Some authors emphasize an increased incidence of some cancer sites, others an overall diminution. With the aim to provide further information to define the issue, we have analyzed the frequency of second metachronous primary malignancies in patients with diagnosed prostate cancer in the Umbria region of Italy. A total of 410 metachronous cancers among 4528 prostate cancer patients were abstracted from incident cases of the RTUP, over the period 1994–2003. This cohort was compared with all cases (except prostate cancers) recorded in the RTUP archive. The expected number of cases was obtained from indirect standardization with regional incidence rates of several sites. The significance of the observed/expected ratios and the corresponding 95% confidence intervals were based on the Poisson distribution. A significant standardized incidence ratio was found for all sites but prostate, with 410/351 observed/expected cases. The significance disappears considering all sites except prostate and skin non-melanomas. Among several sites, significant standardized incidence ratios were found for skin non-melanomas, for bladder, for rectum, but not for colon cancers. Kidney, ureter and urethra showed a nonsignificant standardized incidence ratio. Nasopharynx showed a significant standardized incidence ratio, but the result was based on a very small number of cases. In our data, the increase in urinary bladder and rectal cancers, after prostate cancer diagnosis, seems to be real: it is plausible that the number of second cancers may be due to increased urologist surveillance, which, in our Region, does not seem to be reduced in elderly men.
Thin-Walled Cysts as a Pathognomonic CT Finding in Cystic Mesothelioma
Authors: Sugarbaker Paul , Yan Tristan , Zappa Luis , Haveric Namik , Brun Erwin
Published: February 2018

Aim

Cystic mesothelioma is a rare disease that results in abdominal distention and poorly defined abdominal pain. Diagnosis has always been made by tissue biopsy rather than by radiologic studies.

Materials and methods

Our experience with 7 patients with cystic mesothelioma includes 4 patients who had not had prior surgery before the performance of a high resolution CT scan. A special review of the radiology of these cases was performed in order to identify any pathognomonic signs of this disease.

Results

In all patients who did not have a distortion of the radiologic images (as a result of surgical interventions) prior to the performance of a high resolution CT scan at our institution, a pathognomonic thin-wall cystic structure located within the gelatinous appearing mass was observed. These thin-walled cysts were of variable size and preferentially located within the greater omentum, pelvis and beneath the right hemidiaphragm.

Conclusion

Cystic mesothelioma can be diagnosed preoperatively by a high resolution abdominal and pelvic CT. The thin-walled cysts with great variation in size are located beneath the right hemidiaphragm, within the greater omentum and in the pelvis. No other disease with these radiologic findings has been identified.
Assessment of Treatment-Related Thyroid Dysfunction in Patients with Head and Neck Cancer
Authors: Cetinayak Oguz , Akman Fadime , Kentli Suleyman , Duzen Murat , Eyiler Ferhat , Sen Mehme , Kinay Munir
Published: February 2018

Objective

To assess thyroid dysfunction in head and neck cancer patients who have received external beam radiotherapy according to radiotherapy fields and dose, tumor site and other local or systemic treatments retrospectively and prospectively and propose a follow-up schedule.

Material and methods

A total of 378 patients was classified into two groups. Group I (n = 345) consisted of surgically treated 153 laryngeal, 80 nasopharyngeal and 112 oral cavity/oropharyngeal carcinoma patients; these patients were evaluated retrospectively for treatment-related thyroid dysfunction using their data files. Group II included 33 patients with head and neck cancer who were evaluated prospectively. Thyroid function tests were performed at the beginning of the radiotherapy and every three months after the radiotherapy course, and thyroid dysfunction regarding surgery, radiotherapy and chemotherapy was evaluated.

Results

In Group I, the median follow-up for 153 operated laryngeal carcinoma patients was 44 months. Four (2.6%) of them were found to have clinically apparent hypothyroidism. After a median follow-up of 36 months, none of the 80 nasopharyngeal carcinoma patients showed signs of hypothyroidism. Clinically apparent hypothyroidism was detected in only 1 (0.8%) of the oral cavity/oropharyngeal carcinoma patients after a median follow-up of 25 months. In Group II, 1 (3%) patient was found to have thyroid dysfunction postoperatively prior to radiotherapy. At the time of analysis, 29 (87.8%) patients were euthyroidic, 2 (6.1%) patients had subclinical and 2 (6.1%) patients had clinical hypothyroidism. All patients with thyroid dysfunction have had combined surgery and radiotherapy, and none of the patients treated with radical radiotherapy has experienced hypothyroidism.

Conclusions

Even after a short follow-up, the incidence of thyroid dysfunction was 12.2% in head and neck cancer patients treated with combined surgery and radiotherapy. We recommend thyroid function tests in these patients prior to and once every 3–6 months after the radiotherapy course.
Radiotherapy Resources for the Care of Head and Neck Patients in Italy. A Survey by the Head and Neck Group of the Italian Association for Radiation Oncology (AIRO)
Authors: Frata Paolo , Ponticelli Pietro , Cosentino Dorian , Buffoli Alberto , Di Pilla Angelo , Morrica Brunello , Palazzi Mauro
Published: February 2018

Aims and background

In 2006 a survey was performed to define the resources available in Italy for the provision of radiotherapy services to head and neck cancer patients. This was the first initiative of the newly founded Head and Neck Group of the Italian Association for Radiation Oncology.

Methods

A questionnaire was sent to all 138 radiotherapy centers active in the country. Items investigated included total numbers of head and neck cancer patients treated per year, waiting time before the start of treatment, general technical issues, and integration with surgery and chemotherapy.

Results

Sixty-nine questionnaires were returned (50% response rate). The total number of patients treated was 4,670, averaging 68 cases per center. The larynx was the primary site most frequently involved. Average waiting time was 30 days and 47 days for nonresected and postoperative cases, respectively. The combination of chemotherapy and radiotherapy was delivered to nonresected and resected patients in 96% and 54% of centers, respectively. Survey response rates, waiting time, and the use of organ preservation protocols were the issues showing more variations across the country.

Conclusions

This survey provides important data on radiotherapy resources available for head and neck cancer patients in Italy. The evidence of significant differences across the country concerning several relevant issues and the potential for cooperative clinical efforts in this relatively rare group of diseases urge the Group to plan further initiatives.
IGG* Practice Guidelines on Germ Cell Tumor in Adult Male Patients
Authors: De Giorgi Ugo , Nicolai Nicola , Tana Silvia , Tavolini Ivan Matteo , Palazzi Silvia , Bracarda Sergio , Tedeschi Lucilla , Palmieri Giovannella , Frassineti Luca , Da Pozzo Luigi , Pastorino Ugo , Emiliani Ermanno , Marangolo Maurizio , Pizzocaro Giorgio , Rosti Giovanni , Salvioni Roberto
Published: February 2018

Germ cell tumors are rare neoplasms that affect young males. Nearly 99% of patients with localized stage I disease and nearly 80% of patients with metastatic disease can be cured. Even patients who relapse following chemotherapy can achieve a long-term survival in approximately 30–40% of cases. The main objective in early stages and in good prognosis patients has changed in recent years, and it has become of major importance to reduce treatment-related morbidity without compromising the excellent long-term survival rate. In poor prognosis patients, there is a correlation between the experience of the treating institution and the long-term clinical outcome of the patients, particularly when the most sophisticated therapies are needed. So far, of utmost importance is the information from updated practice guidelines for the diagnosis and treatment of germ cell tumors. The Italian Germ cell cancer Group (IGG) has developed the following clinical recommendations, which identify the current standards in diagnosis and treatment of germ cell tumors in adult males.
Translational and Functional Oncogenomics. From Cancer-Oriented Genomic Screenings to New Diagnostic Tools and Improved Cancer Treatment
Authors: Medico Enzo ,   the TRANSFOG Consortium
Published: February 2018

We present here an experimental pipeline for the systematic identification and functional characterization of genes with high potential diagnostic and therapeutic value in human cancer. Complementary competences and resources have been brought together in the TRANSFOG Consortium to reach the following integrated research objectives: 1) execution of cancer-oriented genomic screenings on tumor tissues and experimental models and merging of the results to generate a prioritized panel of candidate genes involved in cancer progression and metastasis; 2) setup of systems for high-throughput delivery of full-length cDNAs, for gain-of-function analysis of the prioritized candidate genes; 3) collection of vectors and oligonucleotides for systematic, RNA interference-mediated down-regulation of the candidate genes; 4) adaptation of existing cell-based and model organism assays to a systematic analysis of gain and loss of function of the candidate genes, for identification and preliminary validation of novel potential therapeutic targets; 5) proteomic analysis of signal transduction and protein-protein interaction for better dissection of aberrant cancer signaling pathways; 6) validation of the diagnostic potential of the identified cancer genes towards the clinical use of diagnostic molecular signatures; 7) generation of a shared informatics platform for data handling and gene functional annotation. The results of the first three years of activity of the TRANSFOG Consortium are also briefly presented and discussed.
Biotherapy of Cancer: Break the Barriers to Foster Translation oF knowledge
Authors: Ferrantini Maria , Lombardo Claudio , Moretti Franca , Belardelli Filippo
Published: February 2018

Biotherapy of cancer holds great promise for its potential to lead to the identification of novel, selective, and effective treatments against cancer. However, the clinical development of biopharmaceuticals and biotherapy products is hampered by several and diverse barriers.

Herein, we will address some of the critical issues identified both at the national and European level as the major obstacles for the translation of knowledge into clinical applications in the field of biotherapy and immunotherapy of cancer. We will also illustrate specific initiatives undertaken both in Europe and in Italy in order to support the translational and clinical research and that are expected to have a favorable impact on the process of clinical development of novel and more effective therapeutic interventions against cancer.

The contents of this article are directly referred to the event “International Clinical Trials’ Day on Biotherapy of Cancer” organized in the context of the OECI Genoa 2008, with the sponsorship of Alliance Against Cancer (ACC) and the Istituto Superiore di Sanità (ISS, the Italian National Institute of Health), and under the auspices of the European Clinical Research Infrastructures Network (ECRIN). This event sees the active participation of representatives of the ISS and of the Italian Network for Tumor Biotherapy, both involved in a project recently funded by ACC and aimed at the promotion of clinical research in the field of cancer biotherapy and immunotherapy, through the creation of a national network of clinical cancer research centers and GMP facilities dedicated to the production of biological drugs and advanced medicinal products.
MR and Iron Magnetic Nanoparticles. Imaging Opportunities in Preclinical and Translational Research
Authors: Neumaier Carlo Emanuele , Baio Gabriella , Ferrini Silvano , Corte Giorgio , Daga Antonio
Published: February 2018

Ultrasmall superparamagnetic iron oxide nanoparticles and magnetic resonance imaging provide a non-invasive method to detect and label tumor cells. These nanoparticles exhibit unique properties of superparamagnetism and can be utilized as excellent probes for magnetic resonance imaging. Most work has been performed using a magnetic resonance scanner with high field strength up to 7 T. Ultrasmall superparamagnetic iron oxide nanoparticles may represent a suitable tool for labeling molecular probes that target specific tumor-associated markers for in vitro and in vivo detection by magnetic resonance imaging.

In our study, we demonstrated that magnetic resonance imaging at 1.5 T allows the detection of ultrasmall superparamagnetic iron oxide nanoparticle conjugated antibody specifically bound to human tumor cells in vitro and in vivo, and that the magnetic resonance signal intensity correlates with the concentration of ultrasmall superparamagnetic iron oxide nanoparticle antibody used and with the antigen density at the cell surface. The experiments were performed using two different means of targeting: direct and indirect magnetic tumor targeting. The imaging of tumor antigens using immunospecific contrast agents is a rapidly evolving field, which can potentially aid in early disease detection, monitoring of treatment efficacy, and drug development. Cell labeling by iron oxide nanoparticles has emerged as a potentially powerful tool to monitor trafficking of a large number of cells in the cell therapy field. We also studied the labeling of natural killer cells with iron nanoparticles to a level that would allow the detection of their signal intensity with a clinical magnetic resonance scanner at 1.5 T.

Magnetic resonance imaging and iron magnetic nanoparticles are able to increase the accuracy and the specificity of imaging and represent new imaging opportunities in preclinical and translational research.
Delivery of Small Interfering RNA. A Review and an Example of Application to a Junction Oncogene
Authors: Ramon Anne-Laure , Bertrand Jean-Rémi , Malvy Claude
Published: February 2018

RNA interference strategies using small interfering RNA is one of the most important discoveries in biology in recent years. This technology alongside antisense oligonucleotides is very promising and our group has focused its work on the targeting of junction oncogenes with these molecules. We have taken, as first example, papillary thyroid carcinoma. But there is a great need in delivery methods for these molecules in the treatment of cancers. Indeed, many studies have shown that small interfering RNA and antisense oligonucleotides are made efficient by various innovative delivery methods and, under these conditions, offer a powerful new therapeutic tool in cancer treatment.
Efficacy of Disease Management Profiles. The Mammographic Screening Program of Lazio
Authors: Rossi Paolo Giorgi , Chini Francesco , Barca Alessandra , Baiocchi Diego , Federici Antonio , Farchi Sara , Borgia Piero
Published: February 2018

Background

Screening programs are considered disease management profiles. The aim of the present study was to evaluate the efficacy of screening programs compared to regularly offered health care services, using early outcomes and process indicators.

Method

In the study period (1/7/99-30/6/01), six breast cancer screening programs were active in 12 health districts in the Lazio region of Italy. Screening histories of all the incident cases of women surgically treated for a breast neoplasm were reconstructed (not contacted, contacted, non-participants, participants). The subpopulations were then compared for the appropriateness of treatments received.

Results

We identified 3251 women who were treated for malignant neoplasms of the breast and 1562 treated for benign neoplasms. The incidence of malignant neoplasms was higher in the women contacted for screening (incidence rate ratio, 1.45; 95% CI, 1.32–1.60), and the incidence of treatment for non-malignancies was similar in the two populations (incidence rate ratio, 1.00: 95% CI, 0.86–1.16). The percentage of surgery for non-malignancies detected by screening was 16.7%, whereas among the cases diagnosed outside a screening program it was 33.8%. Of malignancies detected outside of screening, 16.6% had a surgical treatment that was too invasive, among the screen-detected malignancies the percentage fell to 11% (prevalence rate ratio, 0.66; 95% CI, 0.48–0.91). Women contacted for screening showed a higher incidence of localized and in situ tumors, whereas the incidence of non-localized and metastatic tumors was basically the same in the two groups.

Conclusions

The first round of screening programs led to more surgical interventions, a similar incidence of mastectomy and of interventions for benign neoplasm, but a lower incidence of unnecessary treatment.
Incidence and Radiographic Findings of Primary Central Nervous System Lymphoma in Immunocompetent Patients in Southern Thailand
Authors: Rujirojindakul Pairaya , Rohitoprakarn Montanan , Kongkabpan Daolada , Viboonjantra Pongthep , Lekhakula Arnuparp
Published: February 2018

Aims and Background

In the last two decades there have been conflicting reports concerninga rising incidence of primary central nervous system lymphoma (PCNSL) in immunocompetent patients. This study is being conducted to review the incidence and radiographic findings of PCNSL in a large tertiary care institution in southern Thailand.

Patients

A review was carried out in Songklanagarind University Hospital of the clinical records, CT and MRI images of immunocompetent patients who had histologically proven PCNSL diagnosed between January 1993 and December 2004.

Results

A total of 25 PCNSL patients were diagnosed over a 12-year period. The incidence trend was rising but not to a statistically significant extent. The median age at diagnosis was 57.4 years. Based on the Working Formulation classification, diffuse large cell was the most common subtype. All of the 20 patients with available immunohistochemical results had B-cell lymphomas. The radiographic findings in our series show that the majority of patients had a single lesion (60%) at a supratentorial location (50%). Most of the lesions were well circumscribed. Based on the density of the lesions before administration of a contrast medium, 56% of the lesions on CT images appeared hyperdense. On T1-weighted MRI images, the lesions of our patients were most frequently hypointense (67%) while the T2-weighted images were more commonly hyperintense (60%) and contrast enhancement was found in all lesions. There were 21 patients who received whole brain radiotherapy with doses ranging between 4.2 and 6.0 Gy. The median survival time was 14.4 months.

Conclusions

This study indicates that there has been no significant increase in PCNSL cases over the last 12 years. The recognition of characteristic imaging features of PCNSL may facilitate a stereotactic procedure before steroid administration. In addition, we provide evidence that radiotherapy alone is insufficient in PCNSL.
Increased Expression of Endonuclease G in Gastric and Colorectal Carcinomas
Authors: Yoo Nam Jin , Jeong Eun Goo , Kim Min Sung , Ahn Chang Hyeok , Kim Sung Soo , Lee Sug Hyung
Published: February 2018

Aims

Endonuclease G (EndoG) is a mitochondrial protein that plays a role in DNA fragmentation during apoptosis. In addition, EndoG plays a role in cell proliferation and survival. It may be important to identify EndoG protein expression to predict its function in human cancers. The aim of this study was to explore whether alteration of EndoG expression might be a characteristic of colorectal or gastric carcinoma.

Methods

We investigated EndoG protein expression in 103 colorectal and 60 gastric carcinoma tissues by immunohistochemistry using a tissue microarray approach.

Results

Expression of EndoG was detected in 72 (70%) of the colorectal carcinomas and 41 (68%) of the gastric carcinomas in cytoplasm. By contrast, normal mucosal cells of both stomach and colon tissues showed no or very weak expression of EndoG. There was no significant association of EndoG expression with clinocopathological characteristics, including invasion, metastasis and stage.

Conclusion

Our data indicate that EndoG inactivation by loss of expression may not occur in colorectal and gastric cancers. Rather, increased expression of EndoG in colorectal and gastric cancer cells compared to their normal mucosal epithelial counterparts suggests that neo-expression of EndoG may play a role in both colorectal and gastric tumorigenesis.
Lung Cancer Stage is an Independent Risk Factor for Surgical Mortality
Authors: Pastorino Ugo , Borasio Piero , Francese Massimo , Miceli Rosalba , Calabrò Elisa , Solli Piergiorgio , Leo Francesco , Novello Silvia , Scagliotti Giorgio , Mariani Luigi
Published: February 2018

Aims and Background

To study surgical mortality and evaluate major risk factors, with specific focus on the role of pathological stage in patients undergoing lung cancer resection.

Methods and Study Design

Age, gender, comorbidity, resection volume, experience of the hospital and surgical team have been reported as variables related to postoperative morbidity and mortality in lung cancer. The role of pathological tumor stage on postoperative mortality has never been fully evaluated. The study included 1418 consecutive lung cancer resections performed from 1998 to 2002 in two institutions. The effect of age, gender, comorbidity, resection volume, pathological stage and induction therapies on postoperative mortality was assessed by univariable and multivariable logistic regression analysis.

Results

Postoperative mortality was 1.8% overall, 3.7% (9/243) for pneumonectomy, 1.7% (17/1016) for lobectomy, and null (0/159) for sublobar resections (P = 0.020). At multivariable analysis, cardiovascular comorbidity (P = 0.008), resection volume (P = 0.036) and pathological stage (P = 0.027) emerged as significant predictors of surgical mortality.

Conclusions

Early stage lung cancer resection has a favorable effect on surgical mortality, not only by preventing the need for pneumonectomy, but also by reducing mortality after lobectomy.
Undifferentiated Carcinoma of the Esophagus with Rapid Growth of Lymph Node. A Case Report and Review of the Literature
Authors: Mori Shozo , Tagaya Nobumi , Hamada Kiyoshige , Nakagawa Aya , Sawada Tokihiko , Honma Koichi , Kubota Keiichi
Published: February 2018

We present a case of undifferentiated carcinoma of the esophagus (UCE) treated with chemotherapy consisting of 5-fluorouracil plus nedaplatin and radiotherapy. The patient developed rapid growth of lymph nodes and died of massive hematemesis 2 months after the diagnosis. UCE is rare but highly malignant. Since there is no established treatment for UCE, its clinical outcome is invariably poor. We also reviewed the effectiveness of chemotherapy against UCE.
Carcinosarcoma of the Esophagogastric Junction
Authors: Solerio Dino , Ruffini Enrico , Camandona Michele , Raggio Eleonora , Castellano Isabella , Dei Poli Marcello
Published: February 2018

Carcinosarcoma of the esophagus and the stomach are rare neoplasms characterized by the simultaneous presence of carcinomatous and sarcomatous elements. There is no report in the literature of carcinosarcoma of the esophagogastric junction. We present a case of carcinosarcoma of the esophagogastric junction whose unique clinical presentation, surgical issues, morphological and immunohistochemical features makes it quite distinctive from similar cases observed in the esophagus or in the stomach.