Correlation between onco-suppressors PTEN and NM23 and clinical outcome in patients with T1 breast cancer

The aim of the present work was to evaluate the prognostic significance in patients with T1 breast cancer of tissue expression of the two oncosuppressors phosphatase and tensin homolog (PTEN) and non-metastatic clone 23 (NM23) as detected by immunohistochemistry

Clinical predictive factors of pathologic complete response in locally advanced rectal cancer

Background: Predictive factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) are still not identified. The purpose of this study was to define them. Materials and Methods: Data from consecutive LARC patients treated between January 2008 and June 2014 at our Institution were included in the analysis. All patients were treated with a long course of nCRT. Demographics, initial diagnosis and tumor extension details, as well as treatment modalities characteristics were included in the univariate and logistic regression analysis. Results: In total 99 patients received nCRT, of whom 23 patients (23.2%) achieved pCR. Patients with and without pCR were similar in term of age, sex, comobidities, BMI and tumor characteristics. Multivariate logistic regression indicated that pre-treatment tumor size <= 5 cm was a significant predictor for pCR (p = 0.035), whereas clinical N stage only showed a positive trend (p = 0.084). Conclusions: Tumor size at diagnosis could be used to predict pCR, and thus to individualize therapy in LARC patients management. Validation in other studies is needed

Pancreas divisum. Correlation between anatomical abnormalities and bile precipitation in the gallbladder in seven patients

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder. Cholecystectomy can be considered curative in patients with PD in the absence of indications for major surgery

Linfoadenopatie ascellari monolaterali da granulomi di tipo sarcoidosico: malattia granulomatosa idiopatica o sarcoidosi? Caso clinico

La presenza di granulomi di tipo sarcoidosico nei linfonodi periferici, in assenza di altre alterazioni cliniche e/o radiologiche suggestive, non è di per sé sufficiente a porre diagnosi di sarcoidosi. Per definizione, infatti, la sarcoidosi è una malattia sistemica e per una diagnosi certa è pertanto necessario dimostrare il coinvolgimento di due o più organi che però può rendersi evidente a distanza di anni dall’esordio della malattia, ponendo così il medico di fronte a un difficile quesito diagnostico. In assenza di altre localizzazioni di malattia, viene posta diagnosi di “malattia granulomatosa idiopatica” dei linfonodi periferici. I pazienti vanno comunque sottoposti ad un accurato follow-up a lungo termine per evidenziare eventuali variazioni del quadro clinico-strumentale, che rendano certa la diagnosi. Prendendo spunto da un caso di malattia granulomatosa idiopatica a localizzazione ascellare monolaterale, gli Autori effettuano una revisione della letteratura sulla sarcoidosi e sulla presentazione extrapolmonare della malattia, evidenziando come questa vada tenuta presente nella diagnostica differenziale delle linfoadenopati

Sinonasal adenocarcinoma in a patient without exposure to risk factors Case report and review of the literature

OBJECTIVE: Sinonasal adenocarcinoma is a tumor typically associated with exposure to occupational carcinogens. The International Agency for Research on Cancer (IARC) published several data in order to classify carcinogenic power of physical-chemical agents as far as sinonasal cancer is concerned. MATERIALS AND METHODS: We report a clinical case of sinonasal adenocarcinoma observed in an 84 years old patient, without clinical history of past exposure to carcinogens, smoke and alcohol. RESULTS AND CONCLUSIONS: A sinonasal adenocarcinoma in a patient without risk factors is extremely rare. It is very important to recognize this cancer at an early stage in order to give better survival rates to the patients. Carcinogens, Intestinal-type adenocarcinoma, Sinonasal cancer

Malignant Peripheral Nerve Sheath Tumour: CT and MRI Findings

Malignant peripheral nerve sheath tumour (MPNST) is extremely rare malignancy in the general population, occurring more frequently in patients with Neurofibromatosis type 1 (NF1). In the literature five cases of MPNST arising from the parapharyngeal space (PPS) in patients without neurofibromatosis have been reported. We report imaging techniques in a patient with MPNST in the PPS, who had neither a family history nor sign of NF1. Computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed for a correct therapeutic planning. CT and MRI findings were correlated with hystopathological diagnosis

Postoperative septic complications in Crohn’s patients in relation to immune status

Postoperative complications in Crhon’s patients kn relation to immune status — The authors report on their experience of 96 Crohn’s disease patients observed between 1985 and 1990 and undergoing surgery and immunologically monitored. The result obtained was better in those patients in whom the immune response was most active

Unusual presentation of metastatic thyroid cancer without a primary. Role of diagnostic imaging in a daily clinical setting

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland. In 21-90% of the patients occult lymph node metastases may occur. The case reported here in describes a women who underwent a complete thyroidectomy for multinodular goiter and who presented an enlarged lymph node on the left side of the neck, which was demonstrated a metastasis from PTC. The patient underwent radiological investigations with CT and FNAB. The pathological examination diagnosed a papillary thyroid cancer metastases. The pT underwent a I131 total body scan, negative for secondary localization

Role of Leptin in Neoplastic and Biliary Tree Disease

Background/Aim: Leptin is a small hormone of protein nature, it is strongly involved in the regulation of lipid metabolism and its functioning mechanism is not yet well known or whether or not it is actually secreted by cholangiocytes, nor if the biliary tree expresses its receptors. In the past, various studies have tried to correlate leptin levels with certain neoplasms. The aim of this study was to demonstrate that serum leptin values can become a new sensitive and specific serum marker for cholangiocarcinoma. Materials and Methods: Seventy-two patients with gallbladder stones, hepatolithiasis with benign biliary stenosis, cholangiocarcinoma, and a group of patients without epatobiliary diseases were enrolled in the study. In all cases blood and bile samples were collected for evaluation of leptin levels and liver biopsies were performed to confirm diagnosis. In all patients, both ultrasound and cholangio-magnetic resonance imaging (MRI) were performed to complete the diagnostic procedure. Results: Twenty-two patients were affected by cholangiocarcinoma, 50 by benign biliary disease (35 cholelithiasis and 6 hepatolithiasis and 9 by inflammatory biliary stenosis). The mean values of serum leptin in patients with cholangiocarcinoma were 19.28±8.76 ng/ml, significantly higher than those observed in non-neoplastic biliary diseases. Conclusion: Serum leptin levels might be a useful marker to differentiate patients with cholangiocarcinoma from those with biliary lithiasis and inflammatory stenosis

Un caso di faringocele bilaterale recidivato come mediano e rioperato con successo

l faringocele, nelle sue varianti congenita ed acquisita, rappresenta una patologia di raro riscontro. È caratterizzato da un’erniazione della mucosa faringea, in genere attraverso un “locus minoris resistentiae” localizzato a livello della parete laterale del faringe. I segni e i sintomi del faringocele sono generalmente scarsi e aspecifici per cui molto spesso la diagnosi è radiologica. La particolarità del caso di faringocele riportato è dovuta sia alla bilateralità sia alla recidiva unica e paramediana dopo otto anni. Il trattamento è stato chirurgico, con totale scomparsa della sintomatologia e delle formazioni previamente dimostrate dalle indagini strumentali