Triple-negative breast cancer with ACTH-dependent Cushing's syndrome : case report

Introduction: Endocrine and metabolic paraneoplastic syndromes in the course of malignant tumors result from ectopic production of hormones or hormone precursors in tumor cells. Production of hormones by endocrine tumors is relatively frequent, while such production by adenocarcinoma cells is definitely rare. The study presents a case of triple-negative invasive breast cancer, with the ectopic secretion of ACTH (adrenocorticotropic hormone), which provokes serious metabolic disorders. Materials and methods: The patient was admitted to hospital with symptoms of Cushing`s syndrome. Diagnostic tests revealed that the cause of metabolic disorders was breast cancer. After proper preparation, the patient was qualified for surgery. Results: After the mastectomy, the patient’s metabolism stabilized. The patient underwent adjuvant chemotherapy and radiotherapy. Four months after the last cycle of systemic treatment, cancer dissemination was found. The patient was treated with second-line chemotherapy, however, control CT revealed progression. The patient died 20 months after surgery and two months after the last cycle of chemotherapy. Conclusions: The case reported in this study – triple-negative invasive breast cancer, responsible for ectopic production of ACTH and causing Cushing’s syndrome – is a rare phenomenon. Treatment of patients with breast cancer showing hormonal activity should not differ from general rules applied for breast cancer. However, due to accompanying metabolic disturbances, the patients need individualized oncological approach, precise diagnostic tests, and adequate preoperative preparation

Intraductal papilloma of the breast — management

In light of the growing availability of ultrasound testing and invasive diagnostic methods of the breast in everyday gyneco- logic practice, lesions of uncertain malignant potential, classified histologically as B3, have become a significant health issue. Intraductal papillomas (IPs) are the most common pathology in that group of lesions. Despite their benign histologic appearance, IPs may accompany malignant growths and the diagnosis made on the basis of biopsy material carries the risk of breast cancer (BC) underestimation. The article presents a review of the available literature on the management of patients diagnosed with intraductal papilloma at a standard core needle biopsy or vacuum-assisted core needle biopsy. The management is not uniform and depends not only on the verification technique or the accompanying pathological growths, but also on the result of clinical-pathological correlations. As it turns out, open surgical biopsy should not necessarily be recommended to every affected woman, and a growing number of sources have recently suggested that a control program would be sufficient in many cases. Thus, it is vital for gynecologists to be able to differentiate between those women who may be included in the annual ultrasound control program and those who require further surgical management.

Karyometric comparison of splenic and gastric marginal zone lymphomas

Background: Marginal zone lymphomas are indolent B-cell lymphomas associated with autoimmunity and chronic inflammation. The two most frequent variants are mucosa associated lymphoid tissues marginal zone lymphomas and splenic marginal zone lymphomas. The aim of the study was to determine if it is possible to classify splenic and gastric lymphomas according to karyometric features

Enterocolic lymphocytic phlebitis : an unusual cause of abdominal complaints

Enterocolic lymphocytic phlebitis (ELP) is a rare disease of unknown etiology involving most often the intramural and mesenteric small and medium-sized veins of the gastrointestinal tract. The diagnosis of the disorder is based on the histopathological examination of a surgical specimen as endoscopically obtained diagnostic material is usually too superficial. Clinical manifestation of ELP most frequently is characterized by acute symptoms, such as acute abdomen, signs suggesting acute appendicitis, gastrointestinal hemorrhage, sometimes it manifests as chronic gastrointestinal complaints. We report, to our knowledge for the first time in Poland, a case of ELP with clinical symptoms pointing to acute appendicitis, on laparoscopy manifesting as a tumorous mass in the colonic wall with an unchanged appendix

Application of tissue microarrays for receptor immunohistochemistry in breast carcinoma

Abstract: The current treatment of breast cancer, the most frequent malignancy found in females, requires the study of biomarkers. The standard set of these includes at least an estrogen receptor, a progesterone receptor and a HER2 receptor, although many other factors have been shown to contribute to the prognosis. Tissue microarrays have been introduced to decrease costs and workload of immunohistochemistry applied to large collections of samples. The aim of the study was to test the performance of this technology on three basic biomarkers of breast carcinoma in 106 cases of invasive breast carcinoma. Tissue microarrays composed of 3 cores sized 0.6 mm per case were constructed and stained by standard immunohistochemistry. The results were assessed on virtual slides created with an Aperio scanner. A sensitivity and specificity of 0.83 and 0.88 was obtained for the estrogen receptor, 0.76 and 0.88 for the progesterone receptor, 0.69 and 0.96 for HER2. In conclusion, TMA technology may give results comparable to the diagnosis based on whole sections, and the clinicopathologic correlations for the immunohistochemistry performed by both methods are fairy similar