Immunohistochemical expression of nestin in rhabdomyosarcoma: implications for clinicopathology and patient outcome

Rhabdomyosarcoma (RMS) is a highly malignant cancer. Over the last two decades, prognosis for RMS patients has significantly improved, with the exception of those in the high-risk group. In order to identify new prognostic factors, we investigated the expression of nestin in RMS cells and its correlation with clinicopathological features and patient outcome. The analysis of overall survival for all patients (N = 30) revealed 1-, 2-, 3-, 4-, and 5-year survival rates of 93.3, 83.3, 66.7, 63.3, and 63.3%, respectively. Nestin overexpression significantly correlated with survival (P = 0.044). Survival of patients with = 50% nestin-positive cells was 90, 70, and 40% after 1, 2, and 3 years, respectively, and remained unchanged until the end of the investigation period. The study group composed of patients exhibiting nestin expression in GT 50% of cells showed 1-, 2-, 3-, and 4-year survival rates of 95, 90, 80, and 75%, respectively, remaining stable at 75% for the fifth year of observation. A nestin-positive expression rate lower than 50% was observed more frequently in older patients (43.60 +/- 27.58 years; P = 0.028). In addition, higher rates of nestin expression were observed in most embryonal RMS specimens and low-grade tumors, in early stages of the disease, and among younger patients. Our results lead us to propose nestin as possible positive prognostic factor in RMS

Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature

Background: Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal ‑resistance. It is able to cause localized cutaneous or subcutaneous infections in both immu‑ nocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation. Case report: We report the case of a 70 ‑year ‑old immunocompromised man, who developed a fungal mycetoma‑ tous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Sce - dosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed. Conclusions: Corticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure ‑enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voricona‑ zole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections

Mast cells in periapical lesions: potential role in their pathogenesis

Objective: The aim of this study was to qualitatively and semi-quantitatively analyze mast cells in periapical lesions. Materials and methods: Biopsy specimens of 96 periapical lesions were stained with hematoxylin-eosin, histochemical Giemsa and immunohistochemical CD 117 (C kit) antibody. Mast cell count below 100 mast cells on 1000 fields of high power magnification was noted as 'negative', 101-400 as 'mild', 401-800 cells as 'moderate', and over 800 cells as 'severe'. Results: Mast cells are found in 68 (70.8%) lesions. The presence of mast cells was greater in cysts than in granulomas (P lt 0.0028). There was no difference in semi-quantitative expression of CD 117 in granulomas and cysts (P > 0.05). Mast cells were placed in both: inflammatory infiltrate and in fibroblastic areas of periapical lesions, and their presence was most frequently mild to moderate. Conclusions: The findings of present study could suggest a role of mast cells in regulation of cellular immune mechanisms in periapical lesions, balancing between alterative and reparatory processes in inflamed periapical tissue

Case report of ewing sarcoma of the chest wall

© 2017, Serbian Medical Society. All rights reserved. Ewing Sarcoma, a highly malignant and poorly differentiated tumor, is composed of small round cells. Being the second most frequent tumor, it most commonly occurs in children and adolescents, with the gender ratio being 1.5:1 in favor of males. Location-wise, it most often occurs in the area of pelvis, knee, femur and humerus, whereas it is considerably less common in other bones, bones of the head, clavicle or ribs. According to EICESS studies, the forecast, along with adequate treatment, depends on the occurrence of distant metastases. Three-year survival rate of 66% was reported in patients in whom there were no secondary diseases. The emergence of a large volume tumor, which is primarily localized in the pelvis or the chest, has a poor prognosis. In 2013, a boy born in 2005 presented with a pain in the chest. Upon performed biopsy and verified diagnosis, the case was presented to the Sarcoma Conference, and preoperative chemotherapy was conducted in accordance with the Euro Ewing 2008 protocol. As decided by the Sarcoma Conference, the resection was performed in 2013. The patient is regularly controlled and still without metastatic disease; fully rehabilitated. The abovementioned case report can lead us to conclude that a serious approach to all symptoms suffered by patients, some of which are often non-specific, is essential. All types of pain should be taken seriously and all necessary diagnostic testing should be immediately performed: to X-ray the affected area, and then, in case of suspected findings, to do a CT of the affected region, as well as skeletal scintigraphy. Tumors of the chest wall are rarely seen in children. Consistent application of the diagnostic system is not less important than the subsequent approach to complete treatment. Surgical therapy must be aggressive to healthy resection surfaces, especially in relapses. Recurrence is not rare, and therefore surgical technique requires special attention. Ewing’s sarcoma serves as an example proving that only a multidisciplinary approach can result in an adequate diagnosis and treatment, as well as in providing patients with higher possibilities of final recovery

Intracranial Arteriovenous Malformations as a Possible Cause of Endocranial Bone Lesions and Associated Neurological Disorder

Endocranial bone lesions have attracted intensive scientific debate on their aetiology. In recent literature, the lesions were almost exclusively interpreted as of infectious origin. In this paper, we give new insight into the aetiology of endocranial lesions, distinguishing the lesions of vascular origin from those caused by tuberculosis or other conditions. The analysis is based on a rare case of a young female individual who displayed multiple endocranial lesions with serpens endocrania symmetrica' morphology. The lesions were associated with an uncommon branching pattern of the middle meningeal artery and marked side differences in teeth pathology. Postcranial skeleton showed signs of the left upper limb weakness. The macroscopic finding of the endocranial lesions along with the skeletal evidence of neurological damage, together with characteristic radiological and histological features, can lead to diagnosis of arteriovenous malformations. This study aims to improve understanding of the aetiology of endocranial bone lesions