Solitary Adrenal Metastasis from Esophageal Adenocarcinoma: A Case Report and Review of the Literature

Introduction. In patients with extra-adrenal malignancy, an adrenal mass necessitates investigating the possibility of metastatic tumor. Curable adrenal metastasis are considered as a rare event. Case report. A 52-year-old male suffering from lower esophageal adenocarcinoma with a solitary left adrenal metastasis is presented herein, who underwent concomitant transhiatal esophagectomy and left adrenalectomy. The patient remains disease-free 18 months later. Discussion. Adrenal metastases mostly occur in patients with lung, kidney, breast, and gastrointestinal carcinomas. Primary esophageal adenocarcinoma gives adrenal metastatic deposits according to autopsy series with an incidence of about 3%–12%. When no other evidence of metastatic disease in cancer patients exists, several authors advocate adrenalectomy with curative intent. Isolated cases of long-term survival after resection of solitary adrenal metastasis from esophageal adenocarcinoma, like in our case, have been reported only as case reports. Conclusion. This study concludes that surgical resection may result in survival benefit in selected patients with solitary adrenal metastasis from esophageal adenocarcinoma

Primary retroperitoneal mullerian adenocarcinoma

Mullerian tumors are extremely rare malignancies in the retroperitoneum. We report a case of a 46-year old woman who presented with an eight year history of lower abdominal mass. Ultrasonography (US) and computed tomography (CT) demonstrated a 15×10 cm cystic mass in the left lower retroperitoneum. As serial percutaneous needle aspiration cytology was negative for malignancy, she was observed for seven years. Eleven months ago, the mass was excised. The histopathology was reported as mucinous adenocarcinoma of the retroperitoneum. Six cycles of intraperitoneal (IP) chemotherapy was administered during the last six months after diagnosis of recurrence by aspiration cytology and high serum tumor markers (CEA, CA19-9). A few days ago, positron emission tomographic (PET) scanning showed evidence of local recurrence and single vertebral metastasis, so she was admitted again for systemic chemotherapy. Meticulous revision of additional sections of the tumor revealed papillary, serous, mucinous, and endometrioid subtypes of the mullerian adenocarcinoma. To our knowledge, there has been no similar case described in the literature

Quasi-Bezier curves integrating localised information

Bezier curves (BC) have become fundamental tools in many challenging and varied applications, ranging from computer-aided geometric design to generic object shape descriptors. A major limitation of the classical Bezier curve, however, is that only global information about its control points (CP) is considered, so there can often be a large gap between the curve and its control polygon, leading to large distortion in shape representation. While strategies such as degree elevation, composite BC, refinement and subdivision reduce this gap, they also increase the number of CP and hence bit-rate, and computational complexity. This paper presents novel contributions to BC theory, with the introduction of quasi-Bezier curves (QBC), which seamlessly integrate localised CP information into the inherent global Bezier framework, with no increase in either the number of CP or order of computational complexity. QBC crucially retains the core properties of the classical BC, such as geometric continuity and affine invariance, and can be embedded into the vertex-based shape coding and shape descriptor framework to enhance rate-distortion performance. The performance of QBC has been empirically tested upon a number of natural and synthetically shaped objects, with both qualitative and quantitative results confirming its consistently superior approximation performance in comparison with both the classical BC and other established BC-based shape descriptor methods

Power-Aware QoS Enhancement in Multihop DS-CDMA Visual Sensor Networks

Abstract-We propose a quality-driven method for network resource allocation with transmission power control in a multihop Direct Sequence Code Division Multiple Access (DS-CDMA) Wireless Visual Sensor Network (WVSN). A multihop WVSN typically consists of source nodes that monitor different areas and relay nodes that retransmit recorded scenes. In order to achieve the best possible video quality at the receiver while consuming the least possible transmission power, we propose a joint optimization scheme that allocates the available resources among the nodes with respect to the imposed constraints. Moreover, we formulate a weighted bi-objective optimization problem and study the tradeoff between video quality and consumed transmission power. The simulation demonstrate that excessive transmission power is used when power control is omitted for a rather small quality gain for certain nodes

Dynamic Bezier curves for variable rate-distortion

Bezier curves (BC) are important tools in a wide range of diverse and challenging applications, from computer-aided design to generic object shape descriptors. A major constraint of the classical BC is that only global information concerning control points (CP) is considered, consequently there may be a sizeable gap between the BC and its control polygon (CtrlPoly), leading to a large distortion in shape representation. While BC variants like degree elevation, composite BC and refinement and subdivision narrow this gap, they increase the number of CP and thereby both the required bit-rate and computational complexity. In addition, while quasi-Bezier curves (QBC) close the gap without increasing the number of CP, they reduce the underlying distortion by only a fixed amount. This paper presents a novel contribution to BC theory, with the introduction of a dynamic Bezier curve (DBC) model, which embeds variable localised CP information into the inherently global Bezier framework, by strategically moving BC points towards the CtrlPoly. A shifting parameter (SP) is defined that enables curves lying within the region between the BC and CtrlPoly to be generated, with no commensurate increase in CP. DBC provides a flexible rate-distortion (RD) criterion for shape coding applications, with a theoretical model for determining the optimal SP value for any admissible distortion being formulated. Crucially DBC retains core properties of the classical BC, including the convex hull and affine invariance, and can be seamlessly integrated into both the vertex-based shape coding and shape descriptor frameworks to improve their RD performance. DBC has been empirically tested upon a number of natural and synthetically shaped objects, with qualitative and quantitative results confirming its consistently superior shape approximation performance, compared with the classical BC, QBC and other established BC-based shape descriptor techniques

Case Report Solitary Adrenal Metastasis from Esophageal Adenocarcinoma: A Case Report and Review of the Literature

Introduction. In patients with extra-adrenal malignancy, an adrenal mass necessitates investigating the possibility of metastatic tumor. Curable adrenal metastasis are considered as a rare event. Case report. A 52-year-old male suffering from lower esophageal adenocarcinoma with a solitary left adrenal metastasis is presented herein, who underwent concomitant transhiatal esophagectomy and left adrenalectomy. The patient remains disease-free 18 months later. Discussion. Adrenal metastases mostly occur in patients with lung, kidney, breast, and gastrointestinal carcinomas. Primary esophageal adenocarcinoma gives adrenal metastatic deposits according to autopsy series with an incidence of about 3%-12%. When no other evidence of metastatic disease in cancer patients exists, several authors advocate adrenalectomy with curative intent. Isolated cases of long-term survival after resection of solitary adrenal metastasis from esophageal adenocarcinoma, like in our case, have been reported only as case reports. Conclusion. This study concludes that surgical resection may result in survival benefit in selected patients with solitary adrenal metastasis from esophageal adenocarcinoma

Primary retroperitoneal mucinous cystadenocarcinoma: report of two cases

BACKGROUND: Retroperitoneal cystadenocarcinomas are rare lesions, the majority of cases presented as one-patient reports. METHODS: We present two cases of retroperitoneal cystadenocarcinoma, both in women of reproductive age: one with aggressive behavior, and the remaining case, with a more indolent clinical evolution. RESULTS: One case presented as pelvic tumor, was treated with surgical resection of the disease, but manifested with recurrent disease a few months later despite use of chemotherapy. The second case involved a patient with diagnosis of abdominal tumor; during laparotomy, a retroperitoneal tumor was found and was totally removed. At follow-up, the patient is disease-free with no other treatment. CONCLUSION: The behavior and treatment of retroperitoneal cystadenocarcinoma are controversial. We suggest aggressive surgery including radical hysterectomy and bilateral salpingoopherectomy with adjuvant chemotherapy in these cases

Reduced expression of the polymeric immunoglobulin receptor in pancreatic and periampullary adenocarcinoma signifies tumour progression and poor prognosis

The polymeric immunoglobulin receptor (pIgR) is a key component of the mucosal immune system that mediates epithelial transcytosis of immunoglobulins. High pIgR expression has been reported to correlate with a less aggressive tumour phenotype and an improved prognosis in several human cancer types. Here, we examined the expression and prognostic significance of pIgR in pancreatic and periampullary adenocarcinoma. The study cohort encompasses a consecutive series of 175 patients surgically treated with pancreaticoduodenectomy for pancreatic and periampullary adenocarcinoma in Malmö and Lund University Hospitals, Sweden, between 2001-2011. Tissue microarrays were constructed from primary tumours (n = 175) and paired lymph node metastases (n = 105). A multiplied score was calculated from the fraction and intensity of pIgR staining. Classification and regression tree analysis was used to select the prognostic cut-off. Unadjusted and adjusted hazard ratios (HR) for death and recurrence within 5 years were calculated. pIgR expression could be evaluated in 172/175 (98.3%) primary tumours and in 96/105 (91.4%) lymph node metastases. pIgR expression was significantly down-regulated in lymph node metastases as compared with primary tumours (p = 0.018). Low pIgR expression was significantly associated with poor differentiation grade (p < 0.001), perineural growth (p = 0.027), lymphatic invasion (p = 0.016), vascular invasion (p = 0.033) and infiltration of the peripancreatic fat (p = 0.039). In the entire cohort, low pIgR expression was significantly associated with an impaired 5-year survival (HR = 2.99, 95% confidence interval (CI) 1.71-5.25) and early recurrence (HR = 2.89, 95% CI 1.67-4.98). This association remained significant for survival after adjustment for conventional clinicopathological factors, tumour origin and adjuvant treatment (HR = 1.98, 95% CI 1.10-3.57). These results demonstrate, for the first time, that high tumour-specific pIgR expression signifies a more favourable tumour phenotype and that low expression independently predicts a shorter survival in patients with pancreatic and periampullary cancer. The mechanistic basis for the putative tumour suppressing properties of pIgR in these cancers merits further study

Floating tablets of hydralazine hydrochloride: optimization and evaluation

Hydralazine hydrochloride has a half-life of 2 to 4 hours with an oral bioavailability of 26-50%. Since hydralazine has a demethylating effect on various suppressor genes, it can be used in various types of cancer to support chemotherapy. The purpose of this study was to optimize and evaluate floating tablets of hydralazine hydrochloride designed to prolong the gastric residence time and to provide controlled release of the drug for 14 h. The floating tablets of hydralazine hydrochloride were prepared by the wet granulation method. Semi-synthetic polymers of hydroxy propyl methyl cellulose (HPMC K100M) and ethyl cellulose were used as the release retarding agents. A 2² factorial design was applied to systematically optimize the drug release profile. The concentrations of HPMC K100M and ethyl cellulose were optimized to provide controlled release of hydralazine for 14h. Non-Fickian diffusion release transport was confirmed as the release mechanism for the optimized formulation and the predicted values agreed well with the experimental values. Drug excipient compatibility studies were investigated by FTIR, DSC and XRD. These data indicate that there were no chemical interactions between the drug and the polymer. In vivo X-ray imaging showed floating tablet performance in rabbits