Duodenal metastasis from male breast cancer: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Breast cancer is the most frequent type of tumor and the second leading cause of death in women. Metastases are present in nearly 60% of cases at the time of diagnosis with the lymph nodes, skeleton, lungs, brain and liver as the most frequent sites of metastases. Gastrointestinal involvement is rare, present in only 10% of all the cases. There is a very low risk of developing breast cancer in men.</p> <p>Case presentation</p> <p>A 68-year-old man, with a past history of ductal breast cancer, presented with duodenal obstruction. Medical treatment was attempted without success, so he underwent surgery with subtotal gastrectomy and resection of the first portion of the duodenum. Histological examination showed a duodenal metastasis originating from the previous carcinoma of the breast. Five months after surgery, the patient is alive and well.</p> <p>Conclusion</p> <p>Gastrointestinal metastases should be considered in patients with a past history of breast cancer. Surgical treatment should be performed in patients who are symptomatic and in good general condition. To our knowledge this is the only case of a gastrointestinal metastasis from breast carcinoma in a man.</p

Mapping quantitative trait loci affecting biochemical and morphological fruit properties in eggplant (Solanum melongena L.)

Eggplant berries are a source of health-promoting metabolites including antioxidant and nutraceutical compounds, mainly anthocyanins and chlorogenic acid; however, they also contain some anti-nutritional compounds such as steroidal glycoalkaloids (SGA) and saponins, which are responsible for the bitter taste of the flesh and with potential toxic effects on humans. Up to now, Quantitative Trait Loci (QTL) for the metabolic content are far from being characterized in eggplant, thus hampering the application of breeding programs aimed at improving its fruit quality. Here we report on the identification of some QTL for the fruit metabolic content in an F2 intraspecific mapping population of 156 individuals, obtained by crossing the eggplant breeding lines ‘305E40’ x ‘67/3’. The same population was previously employed for the development of a RAD-tag based linkage map and the identification of QTL associated to morphological and physiological traits. The mapping population was biochemically characterized for both fruit basic qualitative data, like dry matter, °Brix, sugars and organic acids, as well as for health-related compounds such chlorogenic acid, (the main flesh monomeric phenol), the two peel anthocyanins (i.e. delphinidin-3-rutinoside (D3R) and delphinidin-3-(p-coumaroylrutinoside)-5-glucoside (nasunin)) and the two main steroidal glycoalkaloids, solasonine and solamargine. For most of the traits, one major QTL (PVE ≥ 10%) was spotted and putative orthologies with other Solanaceae crops are discussed. The present results supply valuable information to eggplant breeders on the inheritance of key fruit quality traits, thus providing potential tools to assist future breeding programs

Metaeuristiche innovative per la risoluzione di problemi inversi non lineari nell’ambito dell’ingegneria industriale e dell’informazione

In the world of technology, many industrial operations such as design of efficient devices, or planning production in a big factory, require optimization approach and the solution of inverse problems[chapter 1]. In this contest, in the last 20 years, the heuristic methods had a primary role considering their capabilities to find out solutions in all those cases in which a lot of computation time is requested. The present thesis work is mainly based on swarm algorithms, and on their capabilities to achieve global optima without remain trapped into local minima. In particular, in this work we treat high hybridization and integration among the different capabilities in exploitation and exploration, expressed by 3 optimization algorithms which are: Particle Swarm Optimization (PSO), Flock of Starlings Optimization (FSO), Bacterial Chemotaxis Optimization (BCA). The research of high hybridization among different heuristics led to implement a new metaheuristic which has been called MeTEO (Metric Topological Evolutionary Optimization). MeTEO exploits the synergy among the three algorithms already mentioned above. Moreover, in MeTEO a further method called Fitness Modification (FM) has been used. As will be shown, the FM enhance the exploration properties of MeTEO together with benefits in the parallelization. The first problem encountered making a metaheuristics composed of three complex algorithms is the computation time required. For this reason, the thesis work has been focused also in the analysis and synthesis of a parallel structures for supporting calculus. In this context, two different approaches have been studied: 1)the algorithm-based and 2) the fitness-based. Moreover, in order to extend the exploration capability of FSO problems with discrete variable as well, a binary version of FSO has been implemented [chapter 2]. MeTEO has been validated on benchmarks and on inverse problems. The benchmarks used are called hard benchmarks, because they show a structure without preferential tendency towards a particular point, and local minima with depth value, some monomodal, with one global minimum, and multimodal, with many equivalent minima. Afterwards a list of real inverse and optimization problems are proposed: the parameters identifications of Jiles-Atherton parameters, the efficiency improvement of Travelling Wave Tube (TWT) device, taking in account the geometry, the magnetic focusing field, and the voltage of a Multistage Compressed Collector, the harmonic detection in distorted waveforms. The simulation has been made with MATLAB, and with the help of a FEM simulator called COLLGUN. All results have been compared with those from other algorithms such as random walk, and the also from the use of a single heuristics which MeTEO exploits [chapter 3]. In the Chapter 4 of this thesis the point of view changes toward the hardware, whereas all the discussion done in the previous three chapters were focused on the improvement of the optimization process preformed by numerical algorithms (Software). In fact, we present a method for translating a numerical swarm based algorithm into an electric circuit, that is able to reproduce by mean of voltages and currents the same trajectories shown by the numerical swarm-based algorithms. A circuit, called swarm circuit, has been implemented with Simulink after to have deduced the mathematical relations between the numerical algorithms and their translation into a dynamic system. The swarm circuit has been tested with hard benchmarks and with two inverse problems. The swarm circuit open the road towards a real time optimization, argument that is difficult to be addressed with software approaches

Trattamento chirurgico dei GIST gastrici non metastatici: due casi significativi e revisione della letteratura

I tumori stromali del tratto gastrointestinale (GIST) rappresentano un capitolo della chirurgia oncologica ancora in evoluzione e devono essere affrontati secondo criteri prognostici e terapeutici specifici. Nel sospetto di GIST il chirurgo deve vagliare tutte le opzioni terapeutiche, considerando tuttavia l’impossibilità frequente di predirne il comportamento biologico e quindi l’aggressività. La presenza di un GIST deve essere sempre sospettata nel caso di pazienti con emorragia del tratto gastroenterico, nei quali non emerga una diversa patologia causale. La strategia chirurgica deve considerare che, rispetto ai più comuni adenocarcinomi, una resezione conservativa in queste neoplasie ha un suo razionale anche per quanto riguarda la radicalità. L’estensione della resezione può variare, in relazione alle caratteristiche volumetriche e di sede, da interventi estremamente demolitivi condotti per via “aperta” tradizionale all’asportazione con accesso video-laparoscopico e demolizioni settoriali. La linfoadenectomia non è indicata di principio per la bassissima probabilità di diffusione linfatica di queste neoplasie. Vengono discussi di seguito due casi clinici giunti alla nostra osservazione per emorragia gastrointestinale. Nel sospetto di GIST gastrico le pazienti sono state sottoposte ad asportazione chirurgica della neoplasia: nel primo caso si è proceduto a una gastrectomia polare superiore, indicata per la contiguità della massa con il cardias; nel secondo caso è stata eseguita una resezione parziale del fondo gastrico a comprendere la neoformazion

A proposito di un caso di neuroma d'amputazione della via biliare dopo colecistectomia laparoscopica

Presentiamo un caso di neuroma del dotto epatico comune insorto 5 anni dopo colecistectomia (laparoscopica, convertita in laparotomica). Il paziente, di 73 anni, è stato ricoverato per ittero ostruttivo e sottoposto ad ecografia, TC e colangiografia retrograda endoscopica che evidenziavano una massa di 1 cm a livello del dotto epatico comune determinante una stenosi dello stesso. L?esame istologico sul pezzo operatorio ha dimostrato trattarsi di neuroma del dotto epatico comune. Basandoci sull?analisi di questo e di altri 42 casi descritti in letteratura, abbiamo potuto delineare le seguenti caratteristiche del neuroma delle vie biliari: 1) esiste un intervallo di tempo variabile tra la colecistectomia e l?insorgenza dell?ittero (da 2 mesi fino a 40 anni); 2) l?incidenza è simile dopo colecistectomia laparoscopica o laparotomica; 3) generalmente il decorso post-operatorio dell?intervento primitivo non è esente da complicanze; 4) la possibilità di variazioni nella localizzazione a livello dell?albero biliare (dotto cistico, via biliare principale, vie biliari intraepatiche); 5) l?ittero come primo segno di presentazione clinica; 6) la necessità di una diagnosi istologica; e 7) il trattamento di scelta è la resezione del tratto della via biliare interessata e la ricostruzione mediante epaticodigiunostomia. English version We report a case of neuroma of the common hepatic duct arising five years after cholecystectomy (laparoscopic then converted in laparotomic). A 73-years-old patient was admitted for obstructive jaundice. Ultrasonography, TC and cholangiography showed a nodular lesion of the common hepatic of 1 cm in diameter, causing a regular and important stenosis of the main bile duct. Histologic examination demonstrated neuroma. By the analysis of this and 42 other previously published cases, the following features of bile duct neuroma were outlined: 1) variable interval between cholecystectomy and the onset of jaundice (2 months to 40 years); 2) the same incidence after laparoscopic or laparotomic cholecystectomy; 3) the generally complicated postoperative course after first surgical approach; 4) the various localizations on the biliary tree (cystic, main bile duct, intrahepatic ducts); 5) the circumstances of onset are almost the same (obstructive jaundice); 6) the histologic examination is mandatory for a correct diagnosis; and 7) the best treatment is resection of the bile duct tract involved in neuroma and reconstruction of biliary tree with hepaticojejunostomy

An unusual case of a well-differentiated neuroendocrine tumour of the ileum with peritoneal carcinomatosis: A case report

Neuroendocrine tumours (NETs) are a family of neoplasms that come from neuroendocrine cells and express neural markers, such as synaptophysin or chromogranin A.The current classifications of these tumours are presented by the WHO 2000 classification, based on histological parameters, and the WHO 2010 classification, based on the proliferative index, that divides the NETs into a neuroendocrine tumour of a low grade, neuroendocrine tumour of a intermediate grade and neuroendocrine carcinoma (NEC) of a high grade.We are reporting a very rare case of a G1 low-grade neuroendocrine tumour (NET) of the ileum with a peritoneal carcinomatosis.This case is challenging because the tumour expresses low proliferative index as G1 tumours, but it has an aggressive clinical behaviour such as node metastasis and peritoneal carcinomatosis.The peritoneal carcinomatosis is not actually considered by the current classifications of NETs, so it is difficult to predict the prognosis of this patient