Intraconal tumor-like mass as first manifestation of IgG4-related disease

A great variety of tumors and tumor-like lesions can involve the orbit. Benign and malignant neoplasms, inflammatory diseases, vascular and congenital lesions take part of this heterogeneous group that creates many challenges for diagnosis, management, and treatment. Obviously, symptoms and clinical history are fundamental to establish a differential diagnosis, and imaging is mandatory to distinguish between lesions that have similar clinical presentations in most cases. With this report, the authors highlight the diagnostic difficulties and the importance to include not only tumors but also vascular inflammatory process into the differential diagnosis of this unilateral orbital lesion type

Onset of suspected ulcerative colitis after treatment with tocilizumab in patient with celiac disease and juvenile idiopathic arthritis

To the Editors, Celiac disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), although their etiopathogenesis appear to be different and there are conflicting data about their association. The humanized anti- interleukin (IL)-6 receptor antibody tocilizumab is used for rheumatoid ar- thritis and sometimes for patients with UC refractory to conventional ther- apies. A few studies have reported that tocilizumab can aggravate pre-existing UC or cause de novo drug-induced IBD, probably because of failure to suppress intestinal IL-6 production. We report the case of a female pa- tient with a family history of CD and UC

Severe rectal prolapse and solitary rectal ulcer in a young anorectic woman with myxoid degeneration of visceral adipose tissue

Rectal prolapse is a disorder in which the rectum protrudes from the anal canal. Solitary rectal ulcer may coexist. Both conditions have been associated with chronic constipation and excessive straining during defecation. Rectal prolapse has been rarely reported in women suffering from anorexia nervosa. Lack of rectal support because of loss of ischiorectal fat has been proposed as one of the possible mechanisms in this condition, together with chronic constipation and abuse of laxative. We report the case of an anorexic woman with a severe rectal prolapse and bleeding requiring urgent Altmeier's procedure. Surgery was complicated by dehiscence of the anastomosis and volvulus, requiring ileostomy and laciniae debridement. Pathological analysis of all the surgical samples taken from different abdominal sites highlighted changes in the visceral adipose tissue consisting in nodular aggregates of small adipocytes dispersed in a myxoid matrix surrounding blood vessels within abundant fibrosis. The morphologic features resemble those observed in primordial fetal fat and are comparable to those observed in cancer associated cachexia. The diffuse myxoid degeneration of visceral adipose tissue may play a role in the pathogenesis of rectal prolapse in patients with anorexia nervosa. Besides starvation, the mechanism sustaining myxoid degeneration of the adipose tissue is not entirely clear. Whenever possible improving nutritional and clinical conditions should be ideal before any surgical approach

Additional file 1 of Combined TP53 status in tumor-free resection margins and circulating microRNA profiling predicts the risk of locoregional recurrence in head and neck cancer

Supplementary Figure 1. Study design and patient features. (a) Two groups of HNSCC patients (n=69 in total), referred to our Institute for surgical resection of their primitives, were consecutively enrolled between 2013 and 2017. Clinical characteristics of our cohort is detailed in Suppl. Tables, sheets 1-3. Analysis of mutational and/or microRNA profiles were performed on selected cohorts. Numbers of patients included in each of them are indicated together with the specific figures describing molecular results. (b) Patient characteristics of the intersection cases (n=28) between group 1 and 2. RMs: resection margins; pts: patients