Is sentinel node mapping possible in surgically removed ectopic axillary breast cancer? A case report

We reported a 24-year-old female patient with the history of ectopic axillary breast cancer which was removed surgically. Sentinel node mapping was performed for lymphatic axillary staging of this patient with two injections of the 99m-Tc-phytate in both ends of the surgical scar. Lymphoscintigraphy showed an axillary sentinel node which was harvested during surgery and was not pathologically involved. Our case showed that sentinel node mapping is possible for ectopic axillary breast cancer patients even after excisional biopsy of the index lesion

Leiomyosarcoma with Unusual Macroscopic Features: A Case Report

Uterine sarcoma is a rare tumor of mesodermal origin, accounting for 2-6% of uterine malignancies. Leiomyosarcoma (LMS) has been reported in only 1% of all uterine malignancies and is regarded as the most common primary uterine sarcoma. Herein, we present a case of LMS with unusual macroscopic features. The patient was a 61-year-old woman with LMS, which consisted of a large cystic mass (88×136 mm), containing six liters of brownish fluid on the right side of the pelvis and abdomen. The fundus of the uterus was ruptured by the solid part of the tumor. For treatment, total hysterectomy, salpingo-oophorectomy and the optimal resection of tumoral parts were carried out. Overall, the distinctive biological behavior and poor overall survival of uterine sarcoma challenge the post-operative management of this tumor. According to the one-year follow-up, the patient was disease-free. Unfortunately, no further information is at hand beyond this period

Ki-67 protein: a proliferation index in breast cancer

Various clinicopathological factors are evaluated in different studies on carcinomas to demonstrate their prognostic and predictive significance during the diagnosis and therapeutic procedures of the malignancy. Ki-67 is a biomarker that was proposed as a cell proliferation related nuclear antigen, and it only expresses in growing and proliferating cells. This unique feature of Ki-67 makes it a subject of interest in different investigations. Evaluating the Ki-67 expression has been demonstrated to be beneficial in determining the tumor behavior including tumor size, stage, grading and patient survival. Moreover, it might be helpful in selecting the preferred subsequent treatment strategy. Due to the importance of Ki-67 index, we aim to briefly review its properties and the importance of its expression during various types of malignancies. At last, the prognostic and predictive value of Ki-67 would be overviewed regarding the efficacy of neoadjuvant and adjuvant therapies in breast cancer patients

Long term follow up of recurrent uterine cervical cancer: A Case Report

Background and Aim: Carcinoma of the uterine cervix is a significant cause of mortality because of malignancy in women. Radiotherapy is a major treatment modality for invasive cervical cancer with good treatment outcome in early-stage patients. However, substantial treatment failures still occur in the advanced-stage patients. In this case report a long term follow up of a 58 years old woman with stage II cervical squamous cell carcinoma (SCC), who was considered inoperable due to her general condition, cardiac poor function and ischemic heart disease (IHD) has been reported. After full dose external radiotherapy the patient became disease free till 6 years and after local recurrence, she was treated successfully with total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) as well as adjuvant chemotherapy with favorable results during a long term follow up of 14 years. It is concluded that long term favorable outcome may be achieved by intensive radiotherapy of uterine cervix SCC and probable recurrence could be managed successfully by surgical excision

Evaluation of Risk Factors of Non Epithelial Ovarian Cancer

Introduction: Non-epithelial ovarian cancers consist of tumors with germ cell and stroma basis and metastatic ovarian tumors. These tumors consist 10% of ovarian cancers but are more common in our region. In this study our purpose was to have a look at risk factor of these tumors. Methods: We studied 28 patients with non-epithelial ovarian and 84 control cases were also collected from those who came to genecology’s clinic. We evaluated past reproductive history and individual characteristic. Results: In our study age of marriage, the age of first gestational pregnancy, age of last gestational pregnancy, gravidity, parity, rate of abortion, age of menarche, age of menopause and use of contraception tablets and history of cancer in patient and her family between two group of cases and controls were not significant but body mass index showed statistically significant differences (p=0.017) Conclusion: body mass index was a risk factor for this type of cancer

Surgeons’ Errors in the Management of Patients with Cervical Cancer

Background and Aim: Generally, in patients with cervical cancer, careful preliminary evaluation is necessary for avoiding improper surgical procedures and making effective clinical decisions for treatment. The aim of this study was to determine surgeons’ errors, which necessitate a combination of surgery and radiotherapy for cervical cancer patients.    Methods: In this retrospective study, medical records of all cervical cancer patients, undergoing hysterectomy at tumor clinics of Ghaem and Omid hospitals, were collected from 1988 to 2008. In total, the medical records of 93 subjects with postoperative radiotherapy were examined. All records were assessed in terms of surgeons’ errors, patients’ follow-up after radiotherapy, rate of disease recurrence, and mortality rate. In addition, survival factors were recorded and assessed, and cumulative 3- and 5-year disease-free survival (DFS) rates as well as overall survival (OS) rate were determined by Kaplan–Meier test. Results: The overall rate of surgeons’ errors was 41%. The most common surgical error was improper surgical care due to surgeon’s lack of knowledge about the cervical cancer treatment. The 3-year DFS rates were 86% and 64% in cases without surgeon’s error and those affected by surgeon's error, respectively. In addition, the 5-year DFS rate was 53% in the non-affected group and 47% in cases affected by surgeon's error (P=0.05).      Conclusion: Pre-treatment evaluation as well as proper treatment is necessary for the prevention of adverse effects, caused by inappropriate surgical interventions. It is suggested that more time and attention be allocated to the improvement of surgical outcomes

Clinicopathologic aspects and treatment results in malignant sex cord-stromal tumor of ovary

Background: Ovarian sex cord-stromal tumors (SCST) account for rare ovarian malignancy. These tumors are 5-8% of all ovarian neoplasms. The most common type of sex cord ovarian tumors is granulosa cell tumor (GCT). In this study our purpose was to have a look at some of clinicopathologic aspects and treatment results of these tumors. Methods: In a retrospective study, all documents of patients with SCST was referred to tumor clinics of Ghaem and Omid Hospitals, from 1998 to 2008. The data of patients were collected and analyzed. Results: In 39 (5.9) of the 398 cases, ovarian malignancies was present in SCST. Eight Patients omitted from the study because there were not enough data for them. The commonest pathology was adult granulosa cell tumor in 25 patients (80.6%). Two patients (8.33%) had juvenile granulosa cell tumor, they were 25 and 38 years old. At time of diagnosis, 27 cases (87.1%) were in early stages (stage I). Mean age of patients was 41 years (range 16-76 years) at time of diagnosis of disease. Surgical staging of cancer was performed in 14 patients (46.7%). We did fertility sparing surgery in 12 patients (40%). Two patients were pregnant after surgery. 17 patients (54.80%) did not receive chemotherapy. Three patients (9.7%) received radiotherapy. Overall survival rates were 95% at both 2 years and 5 years. Longer survival had correlation with early stages of disease (P= 0.002). Age, conservative surgery and chemotherapy had no correlations with survival. Conclusion: The prognosis of SCST is almost good. Most of the patients were diagnosed in early stage of disease. In sex cord ovarian tumor, the only factor that have a full effect on survival, is stage of the disease. If the patients desire to preserve fertility, we can do fertility sparing surgery with minimal effect on survival

A New Integrated Approach for Municipal Landfill Siting Based on Urban Physical Growth Prediction: A Case Study Mashhad Metropolis in Iran

Due to irregular and uncontrolled expansion of cities in developing countries, currently operational landfill sites cannot be used in the long-term, as people will be living in proximity to these sites and be exposed to unhygienic circumstances. Hence, this study aims at proposing an integrated approach for determining suitable locations for landfills while considering their physical expansion. The proposed approach utilizes the fuzzy analytical hierarchy process (FAHP) to weigh the sets of identified landfill location criteria. Furthermore, the weighted linear combination (WLC) approach was applied for the elicitation of the proper primary locations. Finally, the support vector machine (SVM) and cellular automation-based Markov chain method were used to predict urban growth. To demonstrate the applicability of the developed approach, it was applied to a case study, namely the city of Mashhad in Iran, where suitable sites for landfills were identified considering the urban growth in different geographical directions for this city by 2048. The proposed approach could be of use for policymakers, urban planners, and other decision-makers to minimize uncertainty arising from long-term resource allocation.Peer Reviewe

Comparison of Adiponectin Level in Women with Breast Cancer with Healthy Women

Introduction: Adiponectin is one of the plasma protein derived from adipose tissue which has a positive effect on metabolism of fat and lipid, resulting from its own receptors. Increase in body mass index (BMI) has a direct relationship with life length. Obesity has effects on secretion of some hormons related to adipokines. Adiponectin is an adipokine having an opposite relationship with insulin resistance and breast cancer. It is also the connection between breast cancer incidence and obesity. Adiponectin level decreases in women affected by breast cancer and knowing this fact can help treat and prevent the cancer by giving adiponectin supplements. The present study compared the adiponectin levels in women affected by breast cancer and healthy females as control group Method: in this study, 80 women with breast cancer and 80 healthy females as controls were selected and adiponectin level was compared between them. Result: the group with breast cancer, having a higher BMI mean (28.77 ± 6.05), showed a lower adiponectin level in comparison to control group .(p= 0.0001) Conclusion: Considering the fact that the risk is higher in women with bigger BMI value, informing women in this regard could have a great effect on preventing this wide-spread disease. Taking adiponectin supplements as pills or injection could be a preventing step for breast cancer, which needs to be considered as targets for future studies