bluuebunny/crossref_metadata_2025 huggingface dataset:
FDG-PET in Thyroid Cancer
Authors: Crippa Flavio , Alessi Alessandra , Gerali Alberto , Bombardieri Emilio
Published: April 2018

The most widely used diagnostic nuclear medicine technique in well-differentiated thyroid cancer (DTC) is radioiodine scintigraphy, either diagnostic or post-therapeutic, together with serum thyroglobulin (Tg) measurement; this combination is usually able to determine the presence or absence of cancer. FDG-PET has shown less sensitivity in DTC that retains the ability to trap 131I. Several alternative procedures with single photon emitting radiopharmaceuticals have been evaluated including whole body scan with 201TI, 99mTc-sestamibi or tetrofosmin scan, with different sensitivity and specificity. The main advantage of these tests is that their results are not influenced by the levels of TSH, therefore they do not require a hypothyroid state in the patient. Recently positron emission tomography (PET) with FDG has been demonstrated to be highly useful in thyroid cancer patients with a negative 131l whole body scan but measurable Tg. According to reports in the literature FDG-PET in the follow-up of operated patients has a sensitivity ranging from 70% to 90% in identifying the source of Tg. The demonstration of lesions can lead to a change in treatment including surgery or external radiation instead of radioiodine treatment. In Europe, medullary thyroid cancer (MTC) is currently visualized by 99mTc pentavalent dimercaptosuccinic acid (DMSA) and 99mTc-sestamibi or tetrofosmin. Metaiodobenzylguanidine (MIBG) radiolabeled with 123I or 131I is another reliable radiopharmaceutical for medullary tumors. 111In-pentetreotide scan is positive in a high percentage of patients because MTC expresses somatostatin receptors. FDG-PET has an interesting role to play in calcitonin-positive patients, where PET has been shown to correctly identify lesions in cervical and mediastinal lymph nodes as well as at distant sites. Furthermore, calcitonin-guided PET has been found to be superior to CT and MRI in many patients. Recent reports indicated that 18F-DOPA scan in MTC seems to be more accurate than FDG-PET.
Prophylactic Thyroidectomy in Men 2A Syndrome
Authors: Mattavelli Franco , Seregni Ettore , Collini Paola , Pasini Barbara , Aiello Antonella , Barbaccia Carmen , Bimbi Gabriella , Riccio Stefano , Santamaria Sergio
Published: April 2018

Genetic testing is the appropriate procedure in MEN 2A syndrome for the early diagnosis of medullary carcinoma even at a preclinical stage. Prophylactic total thyroidectomy represents the standard preventive and therapeutic surgical approach in the treatment of medullary thyroid carcinoma in MEN 2A syndrome. Our experience has confirmed the presence of CCH and medullary thyroid carcinoma even in clinically negative patients, in agreement with reports in the literature.
Diagnostic Procedures in the Follow-Up of Patients Affected by Men Type 2
Authors: Seregni Ettore , Pallotti Federica , Mattavelli Franco , Ferrari Leonardo , Martinetti Antonia , Aliberti Gianluca , Villano Carlo , Castellani Maria Rita , Bombardieri Emilio
Published: April 2018

Multiple endocrine neoplasia type 2 (MEN 2) is an inherited disease caused by germline mutations in the RET proto-oncogene. The most distinctive MEN 2 variants are MEN 2A, MEN 2B and familial medullary thyroid cancer (FMTC). The hallmark of these syndromes is the development of medullary thyroid carcinoma (MTC), which occurs in almost all patients with MEN 2 syndromes. Other endocrinopathies are variably expressed. Pheochromocytoma and hyperparathyroidism occur in patients with MEN 2A with a frequency of about 50% and 30%, respectively. In this paper we summarize the most relevant diagnostic methods to detect and monitor MTC, pheochromocytoma and hyperparathyroidism.
Experimental Assessment of Chemotherapy-induced Early Intestinal Damage in Colon Cancer the Lactulose-mannitol Permeability Test
Authors: Sukkar Samir Giuseppe , Schenone Emanuela , Foppiani Luca , Nobile Maria Teresa
Published: April 2018

Aims and Background

Although chemotherapy plays an important role in the management and cure of cancer, it has undesiderable side effects mostly affecting the bone marrow and gastrointestinal tract, which greatly limit patient compliance and treatment efficacy.

Methods

The lactulose-mannitol test was used to assess intestinal mucosa damage 48 hours after the end of the first adjuvant chemotherapy cycle with 5-fluorouracil (5-FU) and levamisole in 12 patients with colon cancer. Fifteen age- and sex-matched subjects were studied as controls. The excreted amount of lactulose and mannitol was expressed as the percentage of the administered doses recovered in the urine as well as their ratio.

Results

The percent urinary recovery of lactulose was significantly (P <0.001) higher in colon cancer patients (1.1 ± 0.5%) than in the control group (0.3 ± 0.03%), whereas the mannitol recovery was only slightly reduced in the former. As a result, the lactulose/mannitol excretion ratio was significantly (P <0.001) higher in colon cancer patients (0.07 ± 0.03) than in the control group (0.01 ± 0.01).

Conclusions

As assessed by the lactulose-mannitol test, the combined chemotherapy regimen with 5-FU and levamisole affects mainly the barrier function of the intestinal mucosa rather than its absorption capacity. The toxic effect seems to be attributable to the 5-FU molecule rather than to levamisole. The lactulose-mannitol test is a simple, safe and reliable tool to evaluate chemotherapy-induced early damage to the intestinal epithelium, in particular when new kinds of substances are being administered. Its use in clinical practice seems appropriate to establish the correct timing of drug administration, thereby enhancing treatment efficacy and improving patient compliance.
Narrower Surgical Margins Might be Sufficient in Invasive Horizontal Growth Phase Melanoma
Authors: Bono Aldo , Bartoli Cesare , Baldi Marzia , Moglia Daniele , Santoro Nicola , Tomatis Stefano , Dorji Tshering , Cascinelli Natale , Santinami Mario
Published: April 2018

Background and Aims

The delineation of horizontal and vertical growth phases in primary cutaneous melanoma has contributed to our understanding of melanoma progression. Horizontal growth phase invasive melanomas are now believed to metastasize very rarely. Consequently, some of us have started to treat these lesions with very limited surgical margins, assuming that in terms of biological behavior this type of melanoma is more similar to an in situ than an invasive lesion.

Methods

Between January 1997 and December 2001 42 lesions of this type in 41 patients (24 women and 17 men) were treated in the outpatient clinic under local anesthesia. The excision margin was half a centimeter and the subcutaneous fat was cleared in most cases to the deep fascia, which was conserved. Loss was made good by direct tissue closure. All patients had undergone an excisional biopsy before definitive surgery. The size of the lesions ranged from 2 mm to 19 mm in maximum linear extent (median 7 mm). Lesion thickness ranged from 0.11 mm to 0.58 mm (median, 0.27 mm).

Results

The median follow-up was 47 months (range, 26-83). During this period none of the patients had locoregional or distant relapses.

Conclusions

This preliminary report seems to corroborate the assumption that horizontal growth phase melanoma is not an aggressive lesion and might therefore be cured by non-aggressive surgery. The proper treatment of such lesions might be a surgical excision at half a centimeter distance from the biopsy scar. This approach may produce very good cosmetic results, while keeping the costs and required resources to a minimum.
Unilateral Breast Edema in two Patients with Malignant Pleural Effusion
Authors: Toh Chee Keong , Leong Swan Swan , Thing Choon Hua , Tan Eng Huat
Published: April 2018

Unilateral breast edema usually signifies an underlying pathology of the breast and prompts extensive investigations for the purpose of an early treatment. Although breast edema has been reported with other systemic etiologies, it has not been described in patients with lung cancer. We report two cases of unilateral breast edema occurring in patients with non-small cell lung cancer and ipsilateral pleural effusion. Mammography and ultrasound of the breast both revealed increased interstitial density suggestive of fluid retention without any underlying masses. We performed a therapeutic pleurocentesis on one patient for symptomatic relief, and there was simultaneous improvement of the breast edema. We postulate a possible pathophysiology for the association between breast edema and malignant pleural effusion. The principle of management when one encounters similar cases would be to treat the underlying pleural effusion.
A Case of Bilateral Breast Cancer and Graves’ Disease
Authors: Benedetti Mario , Tinozzi Francesco Paolo , Albertario Simone , Bianchi Carlo , Niebel Thekla , Vailati Alberto , Danova Marco , Tinozzi Stefano
Published: April 2018

We report a case of bilateral breast cancer associated with Graves’ disease characterized by a large goiter and complicated by a severe ophthalmopathy. The hyperthyroidism was treated initially with methimazole and then with thyroidectomy, the ophthalmopathy with intravenous steroids combined with orbital radiotherapy. The breast tumors underwent surgical resection followed by chemotherapy. We describe this case because of the well-known association between breast cancer and thyroid disease, particularly of the autoimmune type, the causes of this being still unclear. Recent literature on this topic is reviewed, discussing the possible role of the Na+-I− symporter and anti-TPO antibodies.
Nephrotic Syndrome and Angiotropic Lymphoma Report of a Case
Authors: Cossu Antonio , Deiana Angelo , Lissia Amelia , Satta Andrea , Cossu Maria , Dedola Maria Filomena , Bella Michele A , Palmieri Giuseppe , Tanda Francesco
Published: April 2018

A case of angiotropic lymphoma involving renal glomeruli and interstitial vessels associated with nephrotic syndrome and with minor lesions in the glomerular basal membrane is reported. A 56-year-old woman had fever, weakness and clinical findings of a nephrotic syndrome with normal renal function. Renal biopsy revealed that the glomeruli were infiltrated by neoplastic lymphoid cells positive for CD20 and CD45; the glomerular basement membranes showed a pattern of minimal change disease. This case and our review of the literature suggest that the rare association of intravascular lymphoma and glomerular disease is more than coincidental.
Lymphangioleiomyomatosis: A Case Report and Review of the Literature
Authors: Bearz Alessandra , Rupolo Maurizio , Canzonieri Vincenzo , Balestreri Luca , La Mura Nicoletta , Berretta Massimiliano , Colussi Anna Maria , Frustaci Sergio
Published: April 2018

Lymphangioleiomyomatosis, a rare disease of unknown etiology that is seen almost exclusively in women of childbearing age, generally presents with features of pulmonary involvement. It may be associated with tuberous sclerosis. Its clinical pulmonary manifestations vary from simple cough to the development of recurrent pneumothorax, hemoptysis, and even complicated pleural effusions. Progressive dyspnea develops as the disease evolves. Most patients eventually require lung transplant. This wide array of symptoms and signs makes the differential diagnosis extensive, and the clinician must be familiar with this disorder to arrive promptly to the correct diagnosis. Here we report a case of a 35-year-old woman with a history of pleuritic effusion with associated dyspnea before being diagnosed with lymphangioleiomyomatosis. A review of the literature pertinent to this case is also provided.
Preradiation Chemotherapy with VM-26 and CCNU in Patients with Glioblastoma Multiforme
Authors: Mañé Joan M , Fernández Ricardo , Muñoz Alberto , Rubio Itziar , Ferreiro Josefa , López-Argumedo Gonzalo , Barceló Ramón , López-Vivanco Guillermo
Published: April 2018

Aims and Background

The objective of the study was to evaluate the efficacy of combined chemoradiation in patients with newly diagnosed glioblastoma multiforme. The main end points were time to progression and overall survival.

Methods

Thirty-one patients with glioblastoma multiforme underwent surgery whenever possible and then received intravenous VM26 (120 mg/m2) and oral CCNU (120 mg/m2) for three cycles followed by radiotherapy (60 Gy).

Results

Surgery consisted of a complete resection in 39% of patients, partial resection in 35% and a biopsy in 26%. Sixteen patients had clinical or radiological evidence of progression during or after chemotherapy. Hematologic toxicity was mild. Forty-five percent of patients received the scheduled dose of radiation. The outcome was disappointing, with a median time to progression of 18 weeks and median survival of 37.17 weeks.

Conclusions

The survival of patients with glioblastoma multiforme remains disappointing. Multimodal therapy does not seem to modify the evolution of the tumor. Stratification according to prognostic factors might detect a potential benefit of other therapeutic approaches.
Androgen Ablation Therapy Does not Increase the Risk of Late Morbidity following 3D-conformal Radiotherapy of Organ-confined Prostate Cancer: The Experience of the European Institute of Oncology
Authors: Greco Carlo , Castiglioni Simona , Fodor Andrei , Mazzetta Chiara , De Cobelli Ottavio , Orecchia Roberto
Published: April 2018

Aims and Background

Androgen ablation therapy in conjunction with radiotherapy-neoadjuvant and adjuvant – has consistently been shown to be associated with improved biochemical and local control, whereas controversy still remains as regards its benefit in terms of overall survival. The objective of this study is to determine the impact of androgen ablation in combination to 3D-conformal radiotherapy on late treatment-related toxicity.

Methods

236 patients were treated with 3D-conformal radiotherapy to a total dose ranging from 70 and 78.6 Gy. Fifty-six patients did not receive any form of androgen ablation whereas 176 were given at least 3 months of neoadjuvant androgen ablation. Of these, 64 stayed on androgen ablation for a median time of 6 months post-radiotherapy. Acute toxicity was evaluated weekly during the course of treatment. Late toxicity was assessed at 3-months intervals during the follow-up. Toxicity was scored according to the RTOG criteria.

Results

The median follow-up was 24.6 months (range, 12-62). The incidence of late genitourinary toxicity was: 3% G2, 3.5% G3, 0.5% G4. The incidence of late gastrointestinal toxicity was: 12% G2, 2% G3, 1% G4. No association was observed between the use of androgen ablation and late treatment-related toxicity. High-risk patients who continued on androgen ablation long-term were not found to have an increased risk of developing late toxicity with respect to those who never had any form of androgen ablation or those only treated neoadjuvantly.

Conclusions

In our experience, the use of androgen ablation does not impact on late toxicity following high dose 3D-conformal radiotherapy for prostate cancer.
Measures of Late Effects in Conservative Treatment of Breast Cancer with Standard or Hypofractionated Radiotherapy
Authors: Marcenaro Michela , Sacco Simona , Pentimalli Sara , Berretta Laura , Andretta Valeria , Grasso Rachele , Parodi Roberto Carlo , Guarrera Marcella , Scarpati Daniele
Published: April 2018

Aims and Background

To confirm the equivalence in terms of late effects between two fractionation schedules of radiotherapy in conservative treatment of breast cancer.

Methods

Fifty-eight patients treated at our institution from 1999 to 2002, with a median follow-up of 15 months (range, 7-46 months), were evaluated retrospectively. Twenty-nine patients (group A) were treated with standard fractionation: 5000 cGy/25fx/5 weeks, and 29 patients (group B) were treated with a hypofractionated schedule: 4500 cGy/15fx/5 weeks, three fractions per week. Late effects were evaluated using the LENT-SOMA scoring scale. The cosmetic results were assessed on a five-point scale. Skin elasticity was measured using a dedicated device (Cutometer SEM 575).

Results

There were no differences in breast volume, age at diagnosis and follow-up between groups. The LENT-SOMA toxicity observed in groups A and B, respectively, was as follows: grade 2-3 pain in five patients in each group; grade 2 breast edema in two and three patients; grade 2-3 and grade 2 fibrosis in six and eight patients; grade 2 and grade 2-3 telangiectasia in two and three patients; grade ≥2 and 2 arm edema in two and one patients; no ulceration or atrophy were observed. Two patients in group A and one patient in group B needed treatment for breast and arm edema and arm edema, respectively. Very good, good-acceptable, and poor cosmetic results were observed in seven and two, fifteen and nineteen, and six and eight patients, respectively. Median skin elasticity loss due to treatment was −4.19% in group A and −6.29% in group B. These results are not statistically different.

Conclusions

LENT-SOMA toxicities were minimal and no differences were observed between groups. Few patients in the hypofractionated group had very good cosmetic results, but it is debatable if radiotherapy was the only cause. Skin elasticity was not different between groups. Our results seem to suggest that it is possible to treat patients with both schedules, with similar late toxicity.
A Novel Image Probing System for Precise Quantification of Angiogenesis
Authors: Ejaz Sohail , Seok Kim Bum , Woong Lim Chae
Published: April 2018

The rapid development of clinical diagnostic imaging technology, in tandem with medical and angiogenesis research, has led to some major advances in healthcare. The chorioallantoic membrane assay is commonly used for studying normal angiogenesis as well as putative angiogenic and antiangiogenic substances. Despite the progress, it is generally recognized that a major problem is the lack of a suitable quantitative bioassay for angiogenesis. Image probing is a novel solution to this problem, which, together with its associated discipline of evaluating angiogenesis, is showing great potential not only for accurate measurement of even very small blood vessels but also for detailed three-dimensional quantification of blood vessels and surface characterization. This technique could be a helpful tool for quantification in angiogenesis research.
Two Cases of Secondary Sotf Tissue Sarcomas after Radiotherapy and Radiochemotherapy
Authors: Saggia Chiara , Forti Giorgio , Biaggi Gabriele , Lattuada Sara , Santagostino Alberto , Angeli Giovanni , Pollo Maria Cristina , Negru Maria Emanuela , Alabiso Oscar
Published: April 2018

Background

The development of secondary soft tissue sarcomas after chemo-radiotherapy is a rare and little known event, but its frequency is increasing.

Patients and Methods

We report two cases of secondary soft tissue sarcomas. The first is the case of a 51-year-old woman treated for Hodgkin's disease with chemotherapy and radiotherapy 15 years before she developed a high-grade malignant pleural sarcoma. The patient had no history of asbestos exposure. The second is the case of a 64-year-old woman with a giant cell malignant histiocytoma secondary to colorectal cancer treated with surgery and radiotherapy nine years before. The patients were not eligible for surgery or radiotherapy. Both were treated with chemotherapy (ifosfamide and epirubicin) without any relevant secondary effects; however, the response to therapy was poor.

Conclusions

The causes of secondary malignancies are multifactorial, but radiation therapy and chemotherapy are certainly implicated in the development of post-therapy neoplasms that are difficult to treat.
A Consensus Protocol: Image-improved Therapeutic Guidelines for Limited Adult Hodgkin's Disease
Authors: Busetto Mario , Sotti Guido , Zorat Pierluigi , Salvagno Luigi , Fior Sandro Dal , Gaion Fernando , Soraru Mariella
Published: April 2018

Hodgkin's disease (HD) has greatly benefited from new technologies in terms of less invasive and more accurate staging as well as improved overall and relapse-free survival. However, the likelihood of late adverse effects of treatment, including second tumors, has increased due to the longer survival of patients with HD. Today's trend is to aim at minimal therapeutic exposure while guaranteeing lower therapy-related morbidity. This encourages new research efforts but also leads to less uniformity in treatments, as observed in the Veneto Region in Italy. The Gruppo Veneto Linfomi, composed of representatives of Radiotherapy and Oncology Departments of the Veneto Region, has been analyzing this problem and proposing therapy guidelines since 1995. A set of 10 prognostic factors has been developed to identify three prognostic groups: highly favorable (HF) are patients up to 40 years of age presenting with stage I disease involving only one site of disease with a maximum tumor diameter (TD) of 5 cm and no adverse factors. In this group only mantle field irradiation is recommended if the disease is located in the neck or above, inverted-Y irradiation is recommended for distal subdiaphragmatic lesions, and subtotal nodal irradiation in all other cases. HF cases may also be treated like favorable cases with limited chemoradiation. Favorable (F) cases are patients in stage I with a TD greater than 5 cm and smaller than 10 cm or stage II, up to three sites of disease and negative prognostic factors for systemic disease. All other patients are included in the “not favorable” (NF) group at Ann Arbor stage I or II with any adverse prognostic factor. For the latter two groups, chemotherapy with the ABVD or Stanford V regimen precedes involved-field radiotherapy to sites with a TD of at least 5 cm. The total irradiation dose is determined by local disease extent and level of response to chemotherapy. Images on which the radiation fields are drawn serve as an important reference to improve the homogeneity of treatments. This protocol includes a list of adverse treatment effects (chemo- and/or radiotherapy) together with follow-up guidelines for the early detection of secondary cancers in previously irradiated patients.
A Long-term Follow-up Analysis in Adult Acute Myeloid Leukemia Patients after Hematopoietic Stem Cell Transplantation
Authors: Annaloro Claudio , Zilioli Vittorio Ruggero , Fracchiolla Nicola Stefano , Verier Claudia , Soligo Davide , Volpe Aldo Della , Deliliers Giorgio Lambertenghi
Published: April 2018

Aims and Background

Over the last 17 years, 119 adult acute myeloid leukemia patients have undergone hematopoietic stem cell transplantation at our Center.

Study Design

Seventy patients in first complete remission received hematopoietic stem cell transplantation (28 allogeneic and 42 autologous HSCT) as late intensification after conventional chemotherapy; 38 patients received allogeneic hematopoietic stem cell transplantation in a more advanced phase. A reference group was built up by collecting 40 acute myeloid leukemia patients who received high-dose cytosine arabinoside as late intensification and whose complete remission lasted more than 10 months.

Results

Results of the study led to conclude that an earlier timing of allogeneic hematopoietic stem cell transplantation can be recommended in order to treat patients who would otherwise suffer an early relapse.

Conclusions

The outcome of autologous hematopoietic stem cell transplantation in patients not in first complete remission supports the possibility of achieving good quality second complete remissions and suggests that autografting may be a life-saving strategy in selected acute myeloid leukemia patients with advanced disease.
Sampling of Internal Mammary Chain Lymph Nodes during Breast Reconstruction by Free Flaps from the Abdomen
Authors: Arnez Zoran M , Snoj Marko
Published: April 2018

The role of internal mammary chain lymph node removal in breast cancer is still not clarified. Although it has been proven that elective dissection of the internal mammary chain nodes does not improve survival, their selective treatment based on sentinel lymph node biopsy is under evaluation. There is another possibility to establish the status of internal mammary chain nodes - sampling of the nodes during the preparation of the site for microvascular anastomosis to the internal mammary artery and vein for free flap transfer. From August 2002 to December 2003, 54 free flaps were performed for breast reconstruction. In 11 cases, an internal mammary chain lymph node was harvested. A positive internal mammary chain node was found in only one case. In this case, the treatment policy was changed by adding irradiation to the internal mammary chain. The sampling of internal mammary chain nodes during preparation of the site for microvascular anastomosis to the internal mammary artery and vein should be a part of the reconstructive procedure after total mastectomy for invasive breast cancer because it could change the treatment plan.
Chemotherapy with Mitomycin C and Capecitabine in Patients with Advanced Colorectal Cancer Pretreated with Irinotecan and Oxaliplatin
Authors: Rimassa Lorenza , Gullo Giuseppe , Carnaghi Carlo , Abbadessa Giovanni , Zuradelli Monica , Tronconi Maria Chiara , Pressiani Tiziana , Santoro Armando
Published: April 2018

Aims and background

To assess the activity and tolerability of the combination of mitomycin C and capecitabine in patients with metastatic colorectal cancer after failure of irinotecan- and oxaliplatin-containing regimens.

Methods

We retrospectively reviewed 28 patients with pretreated advanced colorectal cancer who had been treated with mitomycin C, 6 mg/m2 on day 1, and capecitabine, 1,900 mg/m2 on days 1–14, every 3 weeks. Tumor assessment was performed every 3 cycles, toxicity assessed at each cycle.

Results

Main patient characteristics were median age, 61 years (range, 35–73); male/female ratio, 16/12; single metastatic site involvement, 5/28 (18%); ≥3 metastatic sites, 10/28 (36%). Ninety-six courses of therapy were given (median number, 3; range, 1–9). Twenty-six patients were assessable for response, and all were assessable for toxicity. There was 1 partial response (4%) and 12 had stable disease (43%). Median time to progression was 2 months (range, 1–9) and median overall survival was 6 months (range, 1–29+), with a 1-year overall survival rate of 25%. The regimen was very well tolerated without significant hematological toxicity.

Conclusions

Our results are disappointing. Despite the good safety profile, they do not support further investigation or the routine use of this regimen in this setting.
The Correlation between TTF-1 Immunoreactivity and the Occurrence of Lymph Node Metastases in Patients with Lung Cancer
Authors: Altaner Semsi , Yoruk Yener , Tokatli Fusun , Koçak Zafer , Tosun Birsen , Guresci Servet , Kutlu Kemal
Published: April 2018

Aims and background

Thyroid transcription factor (TTF-1) is a tissue-specific transcription factor expressed in the epithelial cells of thyroid and lung. The aim of this study was to evaluate the relationship between the expression of TTF-1 and clinicopathological parameters in pulmonary adenocarcinoma and adenosquamous carcinoma.

Methods

Resection material of pneumonectomies and lobectomies of 39 patients was retrospectively examined. Twenty-eight patients were diagnosed with adenocarcinoma and 11 with adenosquamous carcinoma. Tumors were classified into 3 groups: a strongly positive group (++) with ‡50% tumor cells positive for TTF-1; a weakly positive group (+) with 1–49% positive tumor cells; and a negative group (-) with less than 1% or no positive tumor cells. Analysis was performed with Kaplan-Meier estimates and log-rank tests.

Results

Staining for TTF-1 was negative in 10 cases. There was focal staining in 9 cases, while there was diffuse staining in 20 (51%) cases out of 39, and 15 (75%) of these were adenocarcinomas. There was a statistically significant association between TTF-1 and lymph node metastases (P = 0.029). No relationship was found between TTF-1 positivity and disease-free and overall survival.

Conclusions

TTF-1 expression may be a predictor of lymph node metastases. Additional work in a larger group of patients is needed to better assess the utility of this marker.
Combining Independent Studies of Diagnostic Fluorodeoxyglucose Positron-Emission Tomography and Computed Tomography in Mediastinal Lymph Node Staging for Non-Small Cell Lung Cancer
Authors: Alongi Filippo , Ragusa Pietro , Montemaggi Paolo , Bona Cristina Maria
Published: April 2018

Aims and background

A meta-analysis of diagnostic test performance was conducted to compare the results of relevant studies reporting diagnostic accuracy values for mediastinal staging in patients with non-small cell lung cancer (NSCLC). This paper deals with the two most accurate imaging techniques currently in use: positron emission tomography (PET) with FDG and computed tomography (CT). A statistical pooling method was used to perform a quantitative meta-analysis aimed at demonstrating the potential advantage of one of these two methods.

Methods

Studies in all languages published between 1998 and 2005 that examined the use of FDG-PET and CT for mediastinal staging in NSCLC patients, enrolled at least 18 participants, and provided enough data to allow calculation of sensitivity and specificity rates were considered eligible for the quantitative meta-analysis. Statistical methods to pool the overall estimates of sensitivity and specificity and to compare the discriminant power of PET and CT were discussed and used.

Results

Of the 13 studies included in the analysis, 12 reported greater accuracy of FDG-PET than CT in detecting mediastinal lymph node metastases. The sensitivity of FDG-PET ranged from 50% to 100%. The estimate of the overall sensitivity was 0.83% with 95% CI (0.749–0.913). Specificity ranged from 79% to 100%, with an overall estimated specificity of 0.87% with 95% CI (0.80–0.95). For CT, the sensitivity and specificity ranged from 50% to 97% and 58% to 94%, respectively; the overall estimate was 0.68% with 95% CI (0.582–0.788) and 0.76% with 95% CI (0.668–0.859). The summary receiver operating characteristic (SROC) approach was used to assess the superior diagnostic accuracy of one of the two methods. The areas under the two SROC curves were AUCPET = 0.909 vs AUCCT = 0.794.

Conclusions

Numerical and visual results of the meta-analysis of recent relevant reports agreed that FDG-PET is more accurate than CT in identifying mediastinal lymph node metastases in non-small cell lung cancer.
Cystic Hygroma of the Breast: A Rare Lesion
Authors: Torcasio Angelo , Veneroso Stefano , Amabile Maria Ida , Biffoni Marco , Martino Giovanni , Monti Massimo , Tintisona Orlando , Pasta Vittorio
Published: April 2018

Lymphangiomas are congenital malformations of lymphatic vessels. More than 50% of these lesions are present at birth; 90% are diagnosed by the age of 2. These lesions do not expand very rapidly but they tend to infiltrate surrounding tissues; their degeneration into malignant tumors is an extremely rare occurrence. They are mostly located in the neck region and the axilla; breast lymphangioma is very rare. Surgery is usually performed for aesthetic reasons and in order to make a differential diagnosis with other, more common lesions. The surgical procedure involves the excision of the mass; other methods, such as radiotherapy and sclerotherapy, have proved to be completely ineffective.
Metastasis of Giant Cell Tumor to the Breast: Case Report and Review of the Literature
Authors: Alacacıoğblu Ahmet , Bengi Göksel , Öztop İıhan , Canda Tülay , Baicı Pınar , Osma Emine , Yılmaz Uğbur
Published: April 2018

Breast cancer is the most common type of malignancy in women. Of all breast cancers, 0.5–3% involve metastasis of a non-breast malignancy to the breast. Metastasis of soft tissue tumors to the breast is rarely seen. In particular, metastasis of a giant cell tumor to the breast has never been reported in the literature. We present here a case of breast metastasis in a 44-year-old woman with a diagnosis of malignant giant cell tumor originating from the distal radius and metastatic to the lung, who had been treated with radiotherapy, surgery and chemotherapy.
Overprotective Caregivers of Elderly Cancer Patients: A Case Report
Authors: Basso Umberto , Brunello Antonella , Magro Cristina , Favaretto Adolfo , Monfardini Silvio
Published: April 2018

The essential role of the caregiver in the management of elderly cancer patients is still poorly documented. This case report concerns a woman with metastatic lung carcinoma who was sincerely informed and successfully treated with chemotherapy and gefitinib only after gaining the trust of her overprotective daughter. Devoting time to the relatives represents a key element to create a communicative and efficient relationship with older cancer patients.
OSSERVAZIONI SULL'AZIONE DEGLI AZOTOIPRITICI SUI LEUCOCITI CIRCOLANTI
Authors: Federico Pizzetti , Enrico Clerici , Sergio Di Pietro
Published: April 2018

The quantitative and qualitative alterations induced by nitrogen mustards in the leukocytes of circulating blood are studied. Slight but constant numerical modifications have been observed in the first 24 hours after a single therapeutical dose; they consist in a slight initial increase (which lasts 1 hour about) followed by a temporary decrease. These variations have no statistical value; on the contrary, a diminished osmotic resistance of the circulating leukocytes, especially of the polymorphonuclear leukocytes, has been statistically demonstrated; this phenomenon is most evident 2 hours after the administration of the drug and demonstrates that the leukopenia from nitrogen mustards is not be ascribed only to a medullar lesion but also to a peripheral distruction of leukocytes caused by a diminution of their osmotic resistance.
NOZIONI DI ONCOLOGIA APPLICATA AI PROCESSI LEUCEMICI E AI QUADRI LIMITE TRA FORME IPERPLASTICHE E NEOPLASTICHE DEL TESSUTO LINFATICO
Authors: Sirtori Carlo
Published: April 2018

Leukemiae, like all malignant tumours, can be more or less differentiated (also in the same subject), composed of more or less atyypical cells and accompanied by leukemoidal reactions. Lymphatic tumours too present precancerous stages and syndromes which are histologically difficult to recognize and can be diagnostically misunderstood.
SULLA DIAGNOSI CITOLOGICA ULTRAMICROSCOPICA DEI TUMORI DELLE VIE URINARIE
Authors: Clerici E.
Published: April 2018

The Papanicolau and ultramicroscopical methods for the early cytological diagnosis of malignancy in urinary sediments are compared. Papanicolau's method proved to be easier and more precise than the dark-field observation.
INFLUENZA DEL CORTISONE SULL'ATTECCHIMENTO DEI TRAPIANTI TUMORALI E SULLA RESISTENZA AI TUMORI
Authors: Bussolati Cesare
Published: April 2018

1) Scarcely receptive mice, injectd with cortisone (mg. 0,4 pro die for 15 days) develop a metylclolanthrene induced sarcoma in a hight percentage of cases. The oral administration of the same dose for the same period of time is scarcely effective on the percentage of induction. 3) A high resistance to methylcholanthrene-induced sarcoma in albino mice of a not-selected strain may be obtained by a previous graft of a methylcholantherene-sarcoma fragment or a fragment of a mous spontaneus tumor (ovarian follicoluma) when grafts are reabsorbed. Such a resistance has been hitherto verified for 5–6 months after the graft. 3) The oral administration of cortisone (mg. 0,4 pro die for 15 days) immediately after the graft, does not inhibit the tumor resistance due to the reabsorption of the transpanted fragments.
IL PARATIROIDOMA MALIGNO
Authors: Bissi A. , Gaetani M.
Published: April 2018

After a critical review of the malignant tumors of parathyroids published until now, an own case is presented which is characterised by the presence of bone metastases histologically ascertained. The anatomo-clinical picture of such tumors is summarized.
LA NOSTRA ESPERIENZA CLINICA CON UN ALCALOIDE DEL COLCHICUM AUTUNNALE
Authors: Gardini G. F. , Rizzente S.
Published: April 2018

Good results in the treatment of skin tumors have been obtained by an alkaloid of colchicum (colcemid).
L'EFFETTO DI ALCUNE SOSTANZE AD AZIONE ETILENIMINICA SUL TESSUTO LINFO-EPITELIALE DELLA TONSILLA PALATINA
Authors: Leonardelli Giambattista , Pizzetti Federico
Published: April 2018

The antimitotic and cytolytic action of triethylenmelamine and methyl-bis(β-chloroethyl)-oxyamine have been studied in the apithelial and lymphatic tissue of rabbits tonsils. Both substances exert their action especially in regard to the lymphatic tissue. Pratical considerations are briefly exposed and the possible damaging action of triethylenmelamine on spermatogenesis is mentioned.
TRATTAMENTO DELLE METASTASI LINFOGHIANDOLARI PERIFERICHE NEI TUMORI A SEDE PRIMITIVA IGNOTA
Authors: Catania V. C.
Published: April 2018

The relative frequency of peripheric lymphoglandular metastases from unknown primary malignant lesion is outlined. The survival date for untreated, radiologically and surgically treated patients are comparatively examined.

In these patients the clinical course of the disease is characterized more by the increasing of metastases than by the evolution of the primary tumor.

A radical surgery of the involved lymphatic ganglion is advised and supported by the exposition of a report of cases with late results.
E’ LECITO OPERARE IL CANCRO DELLA MAMMELLA METASTATIZZATO?
Authors: D'Alò Roberto
Published: April 2018

Radiotherapy is the choice treatment for mammary carcinomas of III° and IV° stages according to Steinthal. No favourable results were obtained by the combined surgical-radiotherapic treatment in cases which cannot undergo radical operation, owing to distant metastases or local conditions. The following survival percentages were obtained in cases treated by combined surgery-radiotherapy: 16 per cent after 3 years, 2,7 per cent after 5 years. The survival percentages obtained by radiotherapy alone are compared and underlined.
SULL'AZIONE IPERPLASEOGENA DI ALCUNE SOSTANZE ESTRATTE DAL CAFFÈ
Authors: Pizzetti Federico
Published: April 2018

Distypical verrucous proliferations of the epidermis were observed in mice painted with various substances extracted from coffee toasted at normal temperatures. More evident results were obtained by’ using products with high fat and especially wax contents.
VECCHIO E NUOVO IN TEMA DI LEUCEMIE SPERIMENTALI
Authors: Gallico Edoardo
Published: April 2018

The old and recent experimental contributions to the leukemia problem are discussed. Hereditary and hormonal factors, thymus influence and role of chemical and physical leukemogen agents are analyzed. The action of physical, chemical and hormonal therapies and of some viruses on the evolution of experimental leukemia is reported. Results obtained on a transplantable acute leukemia with some therapeutical trials are referred. The importance of Gross recent researches for the etiological problem of leukemia and tumours is emphasized.
IL CANCRO DELLO STOMACO CONSIDERAZIONI STATISTICHE E RISULTATI LONTANI
Authors: Umberto Ballarati
Published: April 2018

A series of 1 035 cases of gastric cancer observed in the Hospital of Busto Arsizio from 1921 to 1953 is presented. 727 patients (70,2 per cent) were operated: 438 of them (42,2 per cent) were submitted to resection, 110 to gastro-enterostomy or gastrotomy, 179 to exploratory laparotomy. The post-operative mortality is of the 18,2 per cent for the totality of operations; for the resections only (radical or sub-radical) a 21,6 per cent mortality is observed.

Percentages of 5 and 10 years survival were 18,3 and 13,8 respectively (for patients submitted to radical or palliative resection). For all the treated and untreated patients hospitalized for gastric cancer, the 5 years survival was of the 7,7 per cent.
LA POTASSIEMIA NEL TRATTAMENTO ATTINICO DEL CANCRO GENITALE
Authors: Samuel S.
Published: April 2018

The main notions about potassium and its importance, proved by recent researches, are shortly exposed. Data observed in the potassiemia during actinic treatment of genital cancer are reported. Notwithstanding the massive cell destruction, no significant modifications were observed in the plasmatic level of potassium.
CARATTERIZZAZIONE DEI COSTITUENTI PROTEICI DEL PERFUSATO DI SARCOMA DI ROUS
Authors: Caputo Antonio
Published: April 2018

The perfusion fluid, obtained from physiological salt solution circulating in the vascular district of Rous sarcoma, has been electrophoretically examined and ultracentrifuged.

The electrophoretic tracings give evidence to four distinct components: their characteristics of mobility and U.V. absorption show that the components 1 and 2 are of nucleoproteic nature, while the components 3 and 4 are of proteic nature (albumins and globulins). The sedimentation diagrams show the presence of two components: one of them represents the 39 per cent and has a S20 = 5,88 × 10−13, the other represents the 61 per cent and has a S20 = 3,84 × 10−13.
L'INFLUENZA DEGLI ORMONI IPOFISARI SULLA CRESCITA DEL CARCINOMA DI WALKER
Authors: Rabotti G. C.
Published: April 2018

Adult albino rats of the same weight and age were hypophisectomized and grafted with Walker carcinoma. The animals were divided in 8 groups, 4 of which submitted to hormonotherapy and 4 kept as controls. Non hypophisectomized grafted animals submitted to hormonotherapy were also considered as controls.

a) in the first group, treated with ACTH, a partial restoration of the tumour growth value was observed in comparison with hypophisectomized untreated animals.

b) The same result, though in a lesser degree, was obtained in animals treated with STH.

c) the administration of the folliculostimulating hormone (FSH) did not significantly increase the tumour weight.

d) the treatment with the interstitial cells stimulating hormone (ICSH) gave the same result of FSH administration.

e) animals treated with ACTH and STH showed a remarkable diminution in the ponderal value of the carcass (total weight minus tumour weight) at the end of the experiment.
TUMORI E PROTEINE EMATICHE
Authors: Antonini Francesco Mario , Sodi Amos
Published: April 2018

The main laboratory investigations for the diagnosis of malignancy are reviewed. None of them has demonstrated to have a sufficient sensibility and specificness. The results of electrophoretic separation of serum proteins of one hundred and twenty eight patients with malignant diseases and of ten patients with benign forms are reported.

From the examination of the results we may conclude:

a) Eighty five per cent of the patients with malignant diseases has presented alterations of the electrophoretic pattern while no alteration was evident in subjects with benign forms.

b) According to what has been already described by others the most frequent alteration seen in subjects with malignant tumors is the increase of alpha 2 globulins. Wo have seen the highest values of alpha 2 globulins in subjects with gastric and pulmonary cancer and in bone metastasis from prostate and breast cancer.

c) Hepatic metastasis from gastric cancer presented increase of beta globulins and alpha 2 globulins. In gastric cancer we have very often seen an increase of alpha 1 globulins too. In four cases of gastric cancer (two infiltrating forms and two old gastric ulcers degenerated) we had no modification of serum proteins.

d) We had increase of gamma globulins in pulmonary cancer, bone cancer and in the second stage of linphogranuloma.

e) The described alterations of the electrophoretic pattern are common to other pathological conditions, out they assume particular importance in tumors of some organs (stomach, lung, bone).

f) The insufficient specificness and sensibility of these modification makes them of no value when other pathological conditions are present in the same patient.

g) Electrophoretic pattern is very important in the post-operation course (after removal of tumor) as a token of local relapses or metastasis.
LA CONTRAZIONE PROVOCATA QUALE AUSILIO NELLA DIAGNOSI CITOLOGICA DEI TUMORI MALIGNI DEL CORPO DELL'UTERO
Authors: Morano Ettore
Published: April 2018

The described technique consists in a cytological examination of the material coming from the cervical canal after uterine contraction provoked by parenteral injection of ecbolic substances. By this method a certain number of endometrial cells is expelled from the uterus into the vagina and a rich cytological material is obtained especially in cancers of the uterus body, being the cells from malignant tumours more easily destroyable than those from normal tissues. In the four cases of cancers of the uterus body the cytological examination carried out after provoked contraction has always been evidently positive.
« PRIME OSSERVAZIONI CLINICHE ED EMATOLOGICHE SULL'IMPIEGO DELLA SARCOCLORINA NEL TRATTAMENTO DI ALCUNE EMOLINFOPATIE MALIGNE »
Authors: Consoli G. , Violante A.
Published: April 2018

8 cases of Hodgkin's disease, 1 case of chronic myeloid leukemia and 1 case of reticulosarcoma have been treated with sarcochlorine (DL-para-bis (β-chloroethyl) aminophenylalanine).

A marked cytostatic action of the compound, effectively influencing the general conditions, the febrile course and the zonal manifestations of the disease, was observed in all patients. Two negative aspects were demonstrated, i.e. a marked leukopenic influence of the cytostatic substance and a short duration of the clinical remissions.
IL SIGNIFICATO DELLA LUNGHEZZA DELLA VITA MESTRUALE NELL'INSORGENZA DEL CANCRO DELLA MAMMELLA MULIEBRE
Authors: Bucalossi P. , Catania V. C. , Pellegris G. , Veronesi U.
Published: April 2018

Menarche and menopause age and duration of menstrual life have been examined in a series of 4,000 consecutive cases of breast carcinoma, hospitalized in the Cancer Institute of Milan from 1928 to 1957. The same examination was performed on 2,788 patients hospitalized in the same period for non-tumour affections or for benign and malignant tumours in organs non dependent on endocrine stimulation. A good agreement was found in the age distribution of breast cancer patients and controls. In breast cancer patients the average age of menarche and menopause was observed to be 13.646 and 47.905 years respectively; in control patients, 13.831 and 47.220. 1 out of 4,000 cases of breast cancer (0.025 per cent) and 6 out of 2,788 controls (0.36 per cent) had never been menstruated. The duration of the menstrual life was 34.256 years for breast cancer patiens and 33.389 years for control patients (with a prolongation of 0.867 years for cancer patients).
ASPETTI DOTTRINARI E CLINICI DEL CARCINOMA DELLA MAMMELLA
Authors: Sartori A.
Published: April 2018

308 malignant tumours of the breast (303 in women and 5 in men) histologically proved, observed in the Surgical Department of the « Ospedale Fatebenefratelli-Sorelle-Ciceri-Agnesi » of Milano from 1941 to 1956 are reported.

Out of the 303 cases of the female sex, 301 were epithelial and 2 connectival malignomas. In women, the age distribution showed a highest frequency from 45 to 49 years; the left breast was found to be prevailingly affected (158 cases against 141 in the right breast); 3 cases of bilateral cancer were observed. The most involved quadrant was found to be the supero-external, followed by the supero-internal and the central one.

From a clinical point of view, 92 cases were of the I stage, 123 of the II, 78 of the III; in 8 cases the stage was undetermined.

Of the 227 cases operated upon, 191 underwent radical mastectomy according to Halsted, followed by postoperative roentgentherapy; 36 (all in the last five years) underwent simple mastectomy with roentgentherapy according to Mc Whirter. Out of the 191 radical cases, 117 showed axillary metastases.

A histological differentiation between solid and adeno-carcinoma is of very little practical value, owing to the frequent concomitance of both microscopical features in the same case.

Survival percentages in relation to clinical data, pathological findings and treatment could not be established because of the little number of long-term observations after the surgical procedure.