Papillary tumor of the pineal region. Report of two cases and literature review

Papillary tumor of the pineal region (PTPR) was introduced to the WHO classification in 2007. This rare tumor of little known natural history and unpredictable behavior was described in fewer than 100 cases. Its optimal treatment is not established yet. We report another two cases of PTPR in whom tumors were totally removed via supracerebellar infratentorial approach and both were treated with radiotherapy. In a 37-year-old man the operation was delayed 6 years after the first tumor diagnosis and subsequent shunt placement. He has no complaints 10 years after the onset of the disease. A 45-year-old woman has no complaints 24 months after surgery. Our experience and the data from literature indicate that a total tumor removal is the major prognostic factor

The role of Tau protein in resistance to paclitaxel

Resistance to taxanes, related to limited efficacy of systemic therapy in cancer patients, is multifactorial. Among mechanisms of resistance to taxanes, those related to microtubule-associated proteins (MAP), including protein Tau, are of great importance. Protein Tau (50–64 kD) binds to beta-tubulin in the same place as paclitaxel. In preclinical studies, low expression of Tau in cancer cells was associated with increased sensitivity to paclitaxel. High expression of Tau protein in ER-positive breast cancers indicates resistance to taxane-containing chemotherapy and sensitivity to hormonal treatment. This article reviews current knowledge on predictive value of protein Tau in response to taxanes. Better understanding of its role may facilitate patients selection to this sort of treatment and lead to treatment optimization

New automated image analysis method for the assessment of Ki-67 labeling index in meningiomas.

Many studies have emphasised the importance of Ki-67 labeling index (LI) as the proliferation marker in meningiomas. Several authors confirmed, that Ki-67 LI has prognostic significance and correlates with likelihood of tumour recurrences. These observations were widely accepted by pathologists, but up till now no standard method for Ki-67 LI assessment was developed and introduced for the diagnostic pathology. In this paper we present a new computerised system for automated Ki-67 LI estimation in meningiomas as an aid for histological grading of meningiomas and potential standard method of Ki-67 LI assessment. We also discuss the concordance of Ki-67 LI results obtained by presented computerized system and expert pathologist, as well as possible pitfalls and mistakes in automated counting of immunopositive or negative cells. For the quantitative evaluation of digital images of meningiomas the designed software uses an algorithm based on mathematical description of cell morphology. This solution acts together with the Support Vector Machine (SVM) used in the classification mode for the recognition of immunoreactivity of cells. The applied sequential thresholding simulated well the human process of cell recognition. The same digital images of randomly selected tumour areas were parallelly analysed by computer and blindly by two expert pathologists. Ki-67 labeling indices were estimated and the results compared. The mean relative discrepancy between the levels of Ki-67 LI by our system and by the human expert did not exceed 14% in all investigated cases. These preliminary results suggest that the designed software could be an useful tool supporting the diagnostic digital pathology. However, more extended studies are needed for approval of this suggestion

Przypadek linijnej atrofodermii Moulina

Linijna atrofodermia została opisana po raz pierwszy w 1992 roku przez Moulina i wsp. Cechą zespołu Moulina (MS) jest linijne występowanie (wzdłuż linii Blaschko) zanikowych, miękkich, przebarwionych ognisk. Zmiany skórne lokalizują się jednostronnie i zazwyczaj na skórze tułowia. Podobne zmiany mogą być widoczne na kończynach tej samej strony ciała. Przebieg choroby jest wieloletni, a morfologia wykwitów nie ulega zmianie wraz z upływem czasu. W diagnostyce różnicowej zazwyczaj rozważa się występowanie: arofodermii Pasini-Pierini, linijnej postaci twardziny, whorled nevoid hypomelanosis. Do tej pory opisano nie więcej niż 30 przypadków tej choroby. Celem pracy jest przedstawienie przypadku zespołu Moulina u 24-letniego mężczyzny z 7-letnim wywiadem, który został przyjęty do Kliniki DIM w Warszawie w celu diagnostyki zmian skórnych. Zmiany skórne zlokalizowane były po stronie lewej w okolicy łopatki, ramiona, stawu barkowego oraz okolicy okołosutkowej i miały charakter miękkich, przebarwionych ognisk, układających się linijnie wzdłuż linii Blaschko. Zmiany skórne stopniowo postępowały i nie towarzyszyły im żadne objawy podmiotowe. W wynikach badań laboratoryjnych nie stwierdzono odchyleń od normy. Występujące w MS zmiany nie wymagają żadnego leczenia

Long-term remission after erlotinib therapy in an elderly patient with advanced non-small-cell lung cancer. Case report and conclusions for clinical practice

Drobnocząsteczkowe inhibitory kinazy tyrozynowej (TKI) receptora dla naskórkowego czynnika wzrostu (EGFR) - gefitynib i erlotynib - znalazły w ostatnich latach zastosowanie w leczeniu zaawansowanego niedrobnokomórkowego raka płuca (NDRP) po niepowodzeniu pierwszej lub drugiej linii chemioterapii. W pracy przedstawiono przypadek niepalącej chorej na zaawansowanego NDRP w podeszłym wieku, po niepowodzeniu wcześniejszej chemioterapii, u której na podstawie kryteriów demograficznych i klinicznych zastosowano erlotynib, uzyskując długotrwałą remisję. Posługując się tym przykładem i danymi z piśmiennictwa, omówiono zasadność wybiórczego doboru chorych do tej nowej formy leczenia.Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gefitinib and erlotinib - have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first- or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method

Accuracy of a remote quantitative image analysis in the whole slide images

The rationale for choosing a remote quantitative method supporting a diagnostic decision requires some empirical studies and knowledge on scenarios including valid telepathology standards. The tumours of the central nervous system [CNS] are graded on the base of the morphological features and the Ki-67 labelling Index [Ki-67 LI]. Various methods have been applied for Ki-67 LI estimation. Recently we have introduced the Computerized Analysis of Medical Images [CAMI] software for an automated Ki-67 LI counting in the digital images

Chromophobe renal cell cancer - review of the literature and potential methods of treating metastatic disease

Chromophobe renal cell carcinoma (ChRCC) is a subtype of renal cell carcinoma (RCC). ChRCC is diagnosed mainly in 6th decade of life. An incidence of ChRCC is similar in both men and woman. Eighty six percent of ChRCCs cases are diagnosed in stage 1 or 2. Prognosis of ChRCC is better than in other types of RCC. Five- and 10-year disease free survival (DFS) for ChRCC was 83.9% and 77.9%, respectively. Expression of immunohistological markers: cytokeratins (CK), vimentin, epithelial membrane antigen (EMA), CD10 could be potentially helpful in diagnosis of different subtypes of RCC. From all conventional RCC, CD 117 was detected (overexpression) in membrane of cells ChRCC

Sarcomatoid renal-cell carcinoma: treatment strategy, review of the literature and a case report

Introduction: Sarcomatoid renal-cell carcinoma is a very rare cancer characterised with aggressive course of disease and poor prognosis. At present there are no standards of care for this histologic subtype of renal cell carcinoma resistant to various forms of systemic treatment. Methods: The study describes a case of 58 year old woman after left nephrectomy for clear cell carcinoma with sarcomatoid component and after resection of right-kidney tumour for synchronous clear cell carcinoma who received first-line bevacizumab and temsirolimus under the clinical trial, and then second-line chemotherapy based on gemcitabine and doxorubicin and ifosfamide-based third-line chemotherapy. The patient underwent pulmonary metastasectomy twice, and once a metastasectomy for liver metastases. Conclusions: Surgery (including metastases treatment) followed by the systemic chemotherapy seems to be correct option of treatment in patients with renal cell carcinoma with sarcomatoid features. The development of optimum method of systemic treatment requires further prospective randomised trials

Semi-automatic and automatic Ki-67 index examination in whole slide images of meningiomas

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