Cronkhite-Canada Syndrome Associated with Metastatic Colon Cancer

Cronkhite-Canada syndrome is characterized by gastrointestinal and ectodermal manifestations. In this paper, we describe a 64-year-old Iranian male, presenting with Cronkhite-Canada syndrome with metastatic colon cancer. The patient was suffering from hair loss, which occurred on the scalp at first and then, during 5 months, extended to the whole body. After that, his sense of taste was impaired, and 2 months later, gastrointestinal symptoms gradually started, with weight loss of 20 kg over 2 months with an initial weight of 100 kg. Finally, he was admitted to our center 10 months after the onset of symptoms. On skin examination, generalized hair loss and hyperpigmentation and dysmorphic nail changes were observed. Multiple polyps within the colon and sigmoid were observed on colonoscopy. According to biopsies, a serrated adenoma and an invasive adenocarcinoma were reported in the ascending colon and sigmoid, respectively. Other polyps were pseudopolyps, and their characteristics were not significant. Computed tomography of the lungs and abdomen showed multiple adenopathies. On biopsy, metastatic adenocarcinoma was reported. The patient underwent chemotherapy with FOLFIRI and ERBITUX. Finally, after 5 courses of chemotherapy, his regimen was changed to FOLFOX and Avastin because of evidence of progression on computed tomography. The etiology of Cronkhite-Canada syndrome is currently unknown, and the optimal therapy has not been reported so far. This syndrome has many complications; the major of them is malignancy, and the prognosis is poor with a mortality rate of 50%. Therefore, annual monitoring is necessary in these patients

Efficacy of Taxotere, Thalidomide, and Prednisolone in Patients with Hormone-Resistant Metastatic Prostate Cancer

Purpose: To evaluate the efficacy and safety of combination treatment with thalidomide and taxotere in patients with hormone-resistant prostate cancer.Materials and Methods: This clinical trial was performed on 16 patients with hormone-resistant prostate cancer. Results: Mean age of the participants was 72.7 ± 5.39 years (range, 65 to 85 years). In 94% of patients who received the drug combination, prostate-specific antigen level decreased more than 50%. The mean time to progression was 15 months and mean survival time was 23 months. This combination therapy has some adverse events.Conclusion: Addition of anti-angiogenic agents, such as thalidomide, can improve therapeutic outcome in this group of patients

Determination of Antibiotic Resistance Pattern of Bacteria Isolated from Blood, Cerebrospinal Fluid, and Urine Samples in Neonatal Intensive Care Unit of Ali Asghar Hospital, Iran during 2013-15

Background: Infections are one of the most important causes of death in infants, especially in developing countries. Inappropriate use and administration of antibiotics can contribute to the resistance and spread of infection. In this study, we determined the antibiotic resistance pattern of the bacteria isolated from clinical samples of blood, cerebrospinal fluid, and urine in the neonatal intensive care unit (NICU) of Ali Asghar Hospital, Iran during 2013-2015.Methods: For the purposes of the study, clinical samples of blood, cerebrospinal fluid, and urine were collected from the NICU of Ali Asghar Hospital during 2013-15. The type of bacterial strain and antibiotic susceptibility pattern was determined by routine microbiological tests. The collected data were analysed in SPSS software (version 19), using χ2, Student’s t-test, and ANOVA test for comparison.Results: In total, 240 positive culture samples (118 blood, 117 urine, and 5 cerebrospinal fluid samples) were collected for this research. The most common isolates in the blood, urine, and cerebrospinal fluid samples were Staphylococcus epidermidis (63.6%), Klebsiella (35%), and Acinetobacter Baumannii (40%), respectively. The highest antibiotic resistance in S. epidermidis isolated from blood samples was found against amikacin and cefotaxime, while linezolid and vancomycin were the most effective antibiotics against S. epidermidis. Moreover, ciprofloxacin and nitrofurantoin were the most effective antibiotics against Klebsiella isolated from urine samples, while this bacterial strain had the highest resistance to imipenem and ampicillin. Despite the fact that A. Baumannii strains were resistant to most studied antibiotics, ceftazidime and ceftriaxone had an acceptable antibacterial effect against these isolates.Conclusion: Continuous surveillance for antibiotic susceptibility, rational use of antibiotics, and the strategy of antibiotic cycling can provide some answers to the emerging problem of antibiotic resistance

A Patient with Chronic Hepatitis C and a Pancreatic Mass in Endoscopic Ultrasound

We report a rare case of pancreas tumor (lymphoma) in a patient with a history of chronic hepatitis C virus (HCV) infection without treatment, with a high viral load (20,199,805 IU/ml). He presented with abdominal pain, jaundice, weight loss and sweating. Computed tomography showed a hypodense mass located in the head of the pancreas, and immunohistochemistry of a specimen obtained by endoscopic ultrasound-guided fine needle aspiration revealed non-Hodgkin’s lymphoma of the pancreas, B cell type. An association of HCV infection with pancreatic lymphoma has only been reported rarely in the literature and its clinical significance is uncertain

RET/PTC rearrangement in papillary thyroid carcinoma arising in malignant struma ovarii with abdominal wall metastasis and cervical thyroid gland: a case report and review of the literature

Abstract Background Struma ovarii refers to rare mature cystic teratomas containing at least 50% of thyroid tissue, and malignant transformation is known to be even rarer. The synchronous development of malignant struma ovarii and cervical thyroid carcinoma are also scarce and poorly understood due to limited data about molecular features. Here, we present the first report of RET/PTC 1 rearrangement in synchronous metastatic malignant struma ovarii to the abdominal wall and cervical thyroid cancer. Case presentation We described a 47-year-old multigravida woman with bilateral adnexal and lower abdominal wall masses detected during the evaluation of abnormal uterine bleeding. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, and surgical removal of abdominal wall mass. Then, the pathological evaluation revealed papillary thyroid carcinoma (PTC) within struma ovarii and metastatic PTC in the abdominal wall fibro adipose tissue. Further, cervical thyroid gland physical examination and ultrasound illustrated a nodule within the left lobe. Subsequently, a total thyroidectomy was performed, and a histological examination revealed PTC. Furthermore, all affected tissue, i.e., struma ovarii, abdominal wall metastasis, and cervical thyroid gland tested for BRAF and RAS mutations and RET/PTC 1 rearrangement. RET/PTC 1 rearrangement was identified among all three different sites. Finally, after six years of follow-up, the patient had no evidence of recurrence or distant metastasis. Conclusions In light of these findings, malignant struma ovarii might yield a clue to cervical thyroid carcinoma, and the molecular analysis could provide valuable information for understanding the underlying mechanism, tumor clinicopathological behaviors, and prognosis