Soft-tissue metastasis revealing a pancreatic adenocarcinoma: One case report and a review of literature

Soft tissue metastases from pancreatic adenocarcinoma are rare lesions and can be the source of diagnostic confusion both clinically and pathologically. To our knowledge, one patient has been reported on with soft tissue lesions that ultimately disclose a pancreatic adenocarcinoma. We report here on a patient who presented with a metastatic soft tissue lesion in the trochanter, and the buttocks, as the initial manifestation of pancreatic adenocarcinoma. Soft tissue metastasis from pancreatic carcinoma is a rare finding. Clinicians should be aware that metastatic soft tissue lesions could be the initial presenting sign for pancreatic cancer. Also, the immunohistochemical staining for CK 7 and 19 may be helpful for the diagnosis of metastatic pancreatic adenocarcinoma

Pathological complete response in advanced gastric stromal tumor after imatinib mesylate therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastrointestinal stromal tumors are a rare neoplasm exhibiting, in most cases, mutations of <it>c-kit</it>. Imatinib mesylate is the standard treatment for patients who have advanced gastrointestinal stromal tumors. Although the response rate in patients treated with imatinib mesylate in prospective clinical studies is above 50%, a complete response is very rare. We report the case of a patient with a gastric gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Case presentation</p> <p>We report the case of a 54-year-old Arab woman with a gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Conclusion</p> <p>The pathological examination of our patient documented a complete pathological response after imatinib therapy. Recently, it has been confirmed that the kinase genotype of <it>KIT </it>and <it>platelet-derived growth factor receptor α </it>can accurately predict a good response to imatinib mesylate therapy. We propose that this patient had a mutation conferring high sensitivity to imatinib mesylate.</p

Research NoteVolume–biomass functions reveal the effect of browsing on three Moroccan dwarf shrubs

We studied the effects of browsing on the plant architecture and volume-biomass relationships of three dominant dwarf shrubs &#8211; Artemisia herba-alba, A. mesatlantica and Teucrium mideltense &#8211; in a sagebrush steppe in the Central High Atlas Mountains, southern Morocco. For this purpose, we developed power-law volume-biomass functions based on nonlinear regressions for each of these species, under both browsed and unbrowsed conditions. These functions were then applied to individual-based annual monitoring data from inside and outside a browsing exclosure to calculate standing biomass for each of the years from 2004 to 2009. The biomass of the three species was well predicted by the allometric functions, and different functions for the browsed and unbrowsed conditions reflected changes in plant architecture. Browsing had a significant negative impact on biomass for A. herba-alba but not for A. mesatlantica, whereas its effects on T. mideltense were inconsistent between years. The fact that the latter two species hardly benefited from browsing exclusion might be because of increased competition from the more dominant A. herba-alba. During the study period, the standing biomass increased whether or not there was browsing, which might be because of the recovery of the shrubs after a preceding severe drought. Further studies are needed in order to investigate the generality of the findings.Keywords: allometric function, Atlas Mountains, nonlinear regression, permanent plot, plant architecture, standing biomassAfrican Journal of Range &amp; Forage Science 2012, 29(1): 31&#8211;3

How are we treating our systemic patients with primary Sjögren syndrome? Analysis of 1120 patients

Objective: To describe how systemic disease is treated in a large cohort of Spanish patients with primary Sjögren syndrome (pSS) in daily practice, focusing on the adequacy of therapies for the level of systemic activity measured by ESSDAI score. Patients and methods: By December 2014, our database included 1120 consecutive patients who fulfilled the 2002 classification criteria for SS. Therapeutic schedules were classified into 4 categories: no systemic therapies, hydroxychloroquine (HCQ) and/or low dose glucocorticoids (GCS) (20mg/day) and use of second-line therapies (immunosuppressive agents, intravenous immunoglobulins [IVIG] and/or rituximab [RTX]). Results: There were 1048 (94%) women and 72 (6%) men , with a mean age at diagnosis of 54 years. The main drug-based therapeutic approaches for systemic pSS during follow-up were HCQ in 282 (25%) patients, GCS in 475 (42%, at doses >20mg/day in 255-23%), immunosuppressive agents in 148 (13%), IVIG in 25 (2%) and RTX in 35 (3%) patients. HCQ was associated with a lower risk of death (adjusted HR of 0.57, 95% 0.34-0.95). We classified 16 (7%) of the 255 patients treated with >20mg GCS and 21/148 (14%) treated with immunosuppressive agents as patients inadequately treated, mainly associated with articular involvement of low/moderate activity. Conclusion: The management of pSS should be organ-specific, using low dose GCS in patients with moderate systemic activity, limiting the use of high dose GCS and second-line therapies to refractory or potentially severe scenarios. The use of systemic therapies for dryness, chronic pain or fatigue is not warranted