Bilateral symmetrical lymphangiomas of the gingiva: case report

BACKGROUND: Lymphangioma is a benign lesion that is related to proliferation of lymphatic vessels. Lymphangioma of the gingiva is a rare lesion that manifest as a pebbly hyperplasia on gingiva. The purpose of this study is to report a case of bilateral symmetrical lymphangioma of the gingiva. CASE PRESENTATION: A 32-year-old man was presented with bilateral hyperplasia of gingiva in upper canine regions. The lesions were resected completely and evaluated histologically. The microscopic evaluation revealed lymphangioma. CONCLUSION: Bilateral lymphangioma of the gingiva is a very rare lesion which its origin is controversial

HER2 Overexpression in Borderline and Malignant Ovarian Tumors: A Cross-sectional Study in an Iranian Population and Literature Review

Background: Different studies have investigated the overexpression of human epidermal growth factor receptor 2 in ovarian cancers, in addition to the association between the level of its overexpression and tumor characteristics (tumor grade, subtype, stage, and prognosis). However, the prognostic significance of human epidermal growth factor receptor 2/neu dysregulation in epithelial ovarian tumors is controversial. The current study aims to assess human epidermal growth factor receptor 2 overexpression in different types and stages of epithelial borderline and malignant ovarian tumors in a population of Iranian patients. Methods: We conducted this cross-sectional study on 100 patients diagnosed with epithelial borderline and malignant ovarian tumors who referred to the Cancer Institute of Imam Khomeini Hospital at Tehran between 2012 and 2014. After selection of the appropriate tissue block, we prepared slides for immunohistochemical staining with the human epidermal growth factor receptor 2 marker. Human epidermal growth factor receptor 2 positivity was evaluated and scored according to Ellis and Wolff recommendations. Cases with equivocal immunohistochemical results (score 2) also underwent chromogenic in situ hybridization. Results: The most prevalent tumor in our study was serous carcinoma (54%). Human epidermal growth factor receptor 2 scores were: 0 in 69%, 1+ in 26%, 2+ in 4%, and 3+ in 1% of tumors. Chromogenic in situ hybridization examination of cases with human epidermal growth factor receptor 2 score of 2 showed negative results for human epidermal growth factor receptor 2 gene amplification. We observed no association between human epidermal growth factor receptor 2 and the level of tumor differentiation, histologic subtype, clinical stage, tumor size, and patient’s age. Conclusion: Controversial results and wide range of prevalence in human epidermal growth factor receptor 2 overexpression in different studies could be due to several causes. Technical considerations, tumor heterogeneity, and lack of standard guidelines for interpretation could influence the results. We did not find any relationship between human epidermal growth factor receptor 2 overexpression and prognostic indices of grade, clinical stage or histologic subtype as many other reports. Future studies should be conducted on larger numbers of patients with different disease stages and adequate numbers of different histologic subtypes

Epstein-Barr virus associated gastric carcinoma: a report from Iran in the last four decades

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Static telepathology in cancer institute of Tehran university: report of the first academic experience in Iran

<p>Abstract</p> <p>Telepathology is the practice of pathology, which allows quick and timely access to an expert opinion at a distance. We analyzed our new experience in cancer Institute of Tehran University of Medical Sciences with the iPath telepathology server of Basel University. One hundred sixty one cases in a period of 32 months were consulted. These cases received for second evaluation but the definite diagnosis could not be made in this centre. The number of images per case ranged from 3 to 32 (mean: 8). Except one case all cases were evaluated by consultants. Definite final diagnosis was achieved in 88/160 (54.7%). Recommendations for further evaluation were offered in 42/160 cases (26%). Major discrepancies were encountered in 30/160 cases (19%). Thirty-nine of the cases (24.3%) were reported within 1 day. The rate of achieving final diagnosis was higher in histological group rather than cytological ones. Increase in number of H&E images had no significant effect on achieving a definite final diagnosis. The rate of achieving final diagnosis in this study is much lower than other similar studies, which could be due to inappropriate sampling images, a potential cause of misdiagnosis in static telepathology. The other possible reason is that all of the cases in this study were problematic cases that a definite diagnosis could not be made for them even in primary consultation. The mean time for achieving a final diagnosis was also more than other studies, which could be for the reasons mentioned above.</p

Comparison of Serum Leptin Levels among Patients with Benign or Malignant Breast Lesions

Background: Studies have shown that obese individuals are at increased risk of breast cancer development and poorer prognosis. Leptin, an adipose tissue-derived hormone, has pro-inflammatory and proliferative effects and a well-established association with several comorbidities of obesity. This study was designed and conducted to compare the serum levels of leptin in patients with malignant and benign breast lesions. Methods: A cross-sectional study was conducted in Research Center of Cancer Institute, Tehran, Iran between 2010 and 2011. Sixty-five patients with breast cancer and 65 BMI-matched patients with benign breast lesions were enrolled in this study. The serum leptin level was measured by the ELISA method and compared between the two groups. Results: A total of 130 patients were collected. The mean BMI in benign and malignant groups was 25.2±3.2 and 25.8±3.8 (kg/m2), respectively. Circulating levels of leptin were 20.05±14.69 vs. 14.74±10.16 mL in malignant and benign groups, respectively (P=0.011). A positive correlation was observed between BMI and leptin concentration (r = 0.431, P < 0.001). Leptins levels were not associated with the patients’ age (P = 0.108), menstrual status (P = 0.214), and history of OCP use (P = 0.269). Conclusions: Our findings suggest that patients with breast cancer have significantly higher levels of leptin compared to those with benign lesions

CD44 and CD74: The promising candidates for molecular targeted therapy in oral squamous cell carcinoma

Background: Considering molecular target therapy concept in the treatment of oral squamous cell carcinoma (OSCC), many attempts have been performed to introduce an effective molecular marker during recent years. Several investigations have emphasized on the role of CD44 in various cancers and few studies have mentioned CD24 and CD74. The purpose of this study was to investigate the relationship between CD44, CD24 and CD74 expressions and several clinical or histopathological factors in OSCC patients. Materials and Methods: In our analytical cross-sectional study, forty primary OSCC specimens were immunohistochemically stained for CD44, CD24, and CD74 proteins. Then, the relationship between their expressions and age, sex, lymph node metastasis, and histopathologic grading was statistically analyzed using Mann-Whitney nonparametric and t-test. Furthermore, P < 0.05 was considered as significant. Results: CD44 and CD74 proteins were significantly over-expressed in OSCC patients with high grade (P = 0.001 and P = 0.001) as compared to those with low grade. Furthermore, CD74 immunoreactivity showed significantly higher expression in patients with lower age (P = 0.039). Considering lymph node metastasis, we observed significant overexpression of CD74 in patients with no lymph node involvement (P = 0.033). Conclusion: Our observations support the significant role of membranous CD44 protein in progression of OSCC and also introduce CD74 protein as a probable interfering factor in different aspects of OSCC

Prognostic significance of matrix metalloproteinase-7 in gastric cancer survival: a meta-analysis.

The prognostic role of matrix metalloproteinase-7 in gastric cancer survival has been widely evaluated. However, the results are controversial. We aimed to set up a meta-analysis to reach a conclusion on the prognostic significance of metalloproteinase-7 in gastric cancer survival as well as its association with clinicopathological parameters. We searched popular databases from 1988 until October 2014 to gather eligible peer-reviewed papers addressing the prognostic effect of matrix metalloproteinase-7 in gastric cancer patients' survival. The CASP check list was used for quality appraisal. Pooled hazard ratio (HR) for survival and odds ratio (OR) for association with their 95% confidence interval (CI) were considered as summary measurements. Finally, 1208 gastric cancer patients from nine studies were included in the meta-analysis. Pooled HR estimate for survival was 2.01 (95% CI = 1.62 - 2.50, P < 0.001), which indicated a significant poor prognostic effect for matrix metalloproteinase-7. Sensitivity analysis detected no dominancy for any study. No publication bias was detected according to Egger's and Begg's tests. Clinicopathological assessment revealed that higher matrix metalloproteinase-7 expression is associated with deeper invasion (pooled OR = 3.20; 95% CI = 1.14 - 8.96; P = 0.026), higher TNM stage (pooled OR = 3.67; 95% CI = 2.281-5.99; P<0.001), lymph node metastasis (pooled OR = 2.84; 95% CI = 1.89 - 4.25; P<0.001), and distant metastasis (pooled OR = 3.68; 95% CI = 1.85 - 7.29; P<0.001), but not with histological grade. This meta-analysis indicated a significant poor prognostic effect of matrix metalloproteinase-7 in gastric cancer survival. Additionally it was associated with aggressive tumor phenotype

Gastrointestinal Tumor Board: An Evolving Experience in Tehran Cancer Institute

Gastrointestinal (GI) cancers are a significant source of morbidity and mortality in Iran, with stomach adenocarcinoma as the most common cancer in men and the second common cancer in women. Also, some parts of Northern Iran have one of the highest incidences of esophageal cancer in the world. Multi-disciplinary organ-based joint clinics and tumor boards are a well-recognized necessity for modern treatment of cancer and are routinely utilized in developed countries, especially in major academic centres. But this concept is relatively new in developing countries, where cancer treatment centres are burdened by huge loads of patients and have to cope with a suboptimum availability of resources and facilities. Cancer Institute of Tehran University of Medical Sciences is the oldest and the only comprehensive cancer treatment centre in Iran, with a long tradition of a general tumor board for all cancers. But with the requirements of modern oncology, there has been a very welcome attention to sub-specialized organ-based tumor boards and joint clinics here in the past few years. Considering this, we started a multi-disciplinary tumor board for GI cancers in our institute in early 2010 as the first such endeavor here. We hereby review this 2-year evolving experience. The process of establishment of a GI tumor board, participations from different oncology disciplines and related specialties, the cancers presented and discussed in the 2 years of this tumor board, the general intents of treatment for the decisions made and the development of interest in this tumor board among the Tehran oncology community will be reviewed. The GI tumor board of Tehran Cancer Institute started its work in January 2010, with routine weekly sessions. A core group of 2 physicians from each surgical, radiation and medical oncology departments plus one gastroenterologist, GI pathologist and radiologist was formed, but participation from all interested physicians was encouraged. An electronic database was kept from the beginning. The number of patients presented in the tumor board increased from 4 in January 2010 to 16 in December 2011. Most patients were presented by radiation oncology department (38%) and then surgical (36%) and medical oncology (20%) departments. Physicians’ participation also grew from an average of 8 each session to 12 in the same months, with a number of cancer specialists taking part from other university hospitals in Tehran. A total number of 225 patients were presented with a treatment decision made in this 2-year period. The majority of cases were colorectal (32%), stomach (23%), and esophageal (17%) cancers. The number of pancreatic (7%) and hepatobiliary (6%) cancers were much smaller. Most decisions were for a primary treatment (surgery or radiochemotherapy) and then a neoadjuvant approach. Tehran Cancer Institute's GI tumor board is one of the first multi-disciplinary organ-based tumor boards in Iran, and as such has made a successful start, establishing itself as a recognized body for clinical decisions and consultations in GI oncology. This experience is growing and evolving, with newer presentation and discussion formats and adapted guidelines for treatment of GI cancers in Iran sought

Forrest plot of overall hazard ratio estimate for MMP7 impact on GC survival.

<p>The middle point of the diamond represents the pooled HR and its left and right corners represent 95% CI. Horizontal lines belong to individual studies; the middle point and line length represent the corresponding study`s extracted HR and 95% CI. The area of box tagged with each line represents the individual study`s weight of contribution to the meta-analysis.</p