The Case of an Elderly Male Patient with Unknown Primary Mucinous Adenocarcinoma within Presacral Teratoma (Teratoma with Malignant Transformation)

Teratomas are rarely seen in adults, and presacral region is an area where they rarely settle in. Similarly, only about 1% of teratomas show malignant transformation. Malignant transformation is often associated with the area where teratoma settles in. Malignant transformation of mediastinal teratomas is more frequent than the ones located in retroperitoneal area and gonad. They most commonly show rhabdomyosarcoma, primitive neuroectodermal tumor, enteric adenocarcinoma, and leukemia transformation. In teratomas showing malignant transformation, the clinical course is aggressive; and survival of patients with metastatic disease is very low. The primary treatment of teratomas with malignant transformations is surgical. Effect of radiotherapy and chemotherapy is not clear in patients, to whom surgical operation cannot be applied, or those who are with residual tumor, even if surgical operation can be applied to them, or those who are at metastatic stage. In this paper, we presented a 76-year-old male patient due to the histologic diagnosis of mucinous adenocarcinoma within teratoma, in whom approximately 7 cm presacral mass was found during the radiographic examination made by the reason of low back pain and pelvic pain

Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation

Lung cancer in smokers and non-smokers demonstrates distinct genetic profiles, and cigarette smoking affects epidermal growth factor receptor (EGFR) function and causes secondary EGFR tyrosine kinase resistance. We evaluated the effect of active smoking in patients with metastatic lung adenocarcinoma. A total of 132 metastatic lung adenocarcinoma patients, diagnosed between 2008 and 2013, with known EGFR mutation status, were evaluated retrospectively. Among these patients, 40 had an activating EGFR mutation. Patients who continued smoking during the treatment were defined as active smokers. Former smokers and never smokers were together defined as non-smokers. The outcomes of the treatment in relation to the EGFR mutation and smoking status were evaluated. The median follow-up time was 10.5 months. The overall response rate for the first-line therapy was significantly higher among the EGFR-mutant patients (p = 0.01), however, smoking status had no impact on the response rate (p = 0.1). The EGFR-mutant active smokers progressed earlier than the non-smokers (p < 0.01). The overall survival (OS) of the non-smokers and patients treated with erlotinib was significantly longer (p = 0.02 and p = 0.01, respectively). Smoking status did not affect the OS in EGFR wild type tumors (p = 0.49) but EGFR-mutant non-smokers had a longer OS than the active smokers (p = 0.01).The active smokers treated with erlotinib had poorer survival than the non-smokers (p = 0.03). Multivariate analysis of EGFR-mutant patients showed that erlotinib treatment at any line and non-smoking were independent prognostic factors for the OS (p = 0.04 and p = 0.01, respectively). Smoking during treatment is a negative prognostic factor in metastatic lung adenocarcinoma with an EGFR mutation

Why do some patients with stage 1A and 1B endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors

Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC. Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files. Results: The median age of the patients was 60 years (range 31–89). The median follow-up time of the patients was 63.6 months (range 3.3–185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients. Conclusions: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms

Male breast cancer exhibiting features of basal-like subtype female breast cancer

The molecular subtypes of male breast cancer are not well-known, but luminal A is generally regarded as the predominant subtype. We present the clinical and histopathological features in a man with triple-negative breast carcinoma

Demographic features of patients submitted for smoking cessation and the success rate of pharmacological therapy

WOS: 00020937040063

Success Rates of Pharmacological Therapies Used for Smoking Cessation and Factors that Affect Smoking Cessation Rates

WOS: 000367541400006Smoking is still the most important cause of preventable diseases and premature deaths. Thus, smoking cessation interventions should include pharmacological therapies and/or counseling either alone or in combination. To analyze the demographic data of patients who presented to the smoking cessation polyclinic and received pharmacological therapies and determine the success rate of given therapies, and the factors that affect smoking cessation rates retrospectively. This retrospective study included patients who presented to the smoking cessation polyclinic and received pharmacological therapy (varenicline, bupropion or nicotine replacement therapy). Demographic data of patients, exhaled carbonmonoxide levels, and Fagerstrom test for nicotine addiction results were derived. Patients were reached by telephone survey in February 2013, and asked for their current smoking status and duration of therapy at the end of therapy. Patients were grouped into quitters and non-quitters. Differences between groups were assessed, and success rates of pharmacological therapies were compared. The study included 240 women and 509 men. Fagerstrom test for nicotine addiction results and exhaled carbonmonoxide levels were statistically higher in the non-quitter group than the quitter group. We did not find any significant difference between the groups in variables such as profession, age, gender, marital status and education levels. Varenicline had the highest smoking cessation rates at the end of therapy, and the rates were significantly different from others. Smoking cessation rates for varenicline, bupropion and nicotine replacement therapy were 50.9%, 35.9%, and 35.2%, respectively (p<0,05). However, long-term success rates (3-12 months) were similar for all pharmacotherapies. Long-term success rates of pharmacological interventions used for smoking cessation were not significantly different among groups. To prevent relapses, patients should be monitorized closely and new interventions should be developed to keep patients' motivation high for long-term abstinence