A Case of Post-Radiotherapy Gastritis: Radiation Does Not Explain Everything

Hemorrhagic gastritis is a possible late toxicity outcome after radical radiotherapy but it is nowadays a very rare condition and most likely depends on other clinical factors. We report the case of a 77-year-old woman with a symptomatic solitary extramedullary intra-abdominal plasmacytoma and multiple gastric comorbidities, treated with external beam radiotherapy. Despite the good response to radiotherapy, the patient experienced multiple gastric bleeding a few months later, with the need of multiple treatments for its control. In this paper we will discuss in detail all aspects related to the different causes of hemorrhagic gastritis

Carcinoma adenóide quístico recorrente: Revisão a propósito de um caso clínico Recurrent adenoid cystic carcinoma: Review based on a case report

O carcinoma adenóide quístico é uma neoplasia epitelial maligna de origem glandular, ocorrendo nas glândulas mamárias, salivares e raramente no pulmão, onde é responsável por 0,2% dos tumores. Embora raro, é o tumor de “tipo glândula salivar” mais comum ao nível do tracto respiratório. Estes tumores apresentam um crescimento lento e curso clínico prolongado, caracterizando-se pela natureza infiltrativa, com tendência para a recorrência local tardia. Os autores apresentam o caso de uma mulher com carcinoma adenóide quístico do pulmão diagnosticado na sequência de investigação de nódulo do pulmão submetida a ressecção cirúrgica com intuito curativo, cujo follow-up documentou recidiva local tardia 9 anos após a ressecção. O presente caso vem realçar a necessidade de vigilância prolongada, dado o potencial de recidiva local tardia deste tipo de tumor. O artigo revê aspectos clínicos e patológicos do carcinoma adenóide quístico do pulmão e discute opções terapêuticas, nomeadamente de prevenção da recidiva, à luz dos conhecimentos actuais.The adenoid cystic carcinoma is a malignant epithelial glandular type neoplasia, occurring frequently in the salivary and mammary glands, and rarely in the lung, and is responsible for 0.2% of lung tumours. These tumours present a slow growth and prolonged clinical course, and are characterised by their infiltrative nature and tendency towards late local recurrence. The authors present a case of a woman with adenoid cystic lung carcinoma diagnosed after investigation of a lung nodule, submitted to surgical resection with curative intention, whose follow -up identified late recurrence, 9 years after surgery. The present case emphasises the need for a prolonged surveillance, due to the potential late recurrence of this kind of tumour. The article reviews clinical and pathological features of lung adenoid cystic carcinoma, as well as therapeutic options, namely for prevention of recurrence

Signet Ring Cell Carcinoma, Ileal Crohn Disease or Both - A Case of Diagnostic Challenge

Signet ring cell carcinoma is a rare form of adenocarcinoma that predominantly affects the stomach. Signet ring cell carcinoma originated from the ileum is extremely rare and the prognosis is poor. We present a case of small bowel obstruction with features suggesting Crohn disease of the ileum. The symptoms were chronic diarrhea and abdominal pain with a family history of inflammatory bowel disease. The patient underwent surgery and histopathology revealed both aspects of signet ring cell carcinoma and Crohn disease of the ileum. An association between long-standing inflammation and the development of this subtype of tumor has been proposed but there are no established surveillance guidelines for small bowel neoplasm in inflammatory bowel disease

Low doses of ionizing radiation activate endothelial cells and induce angiogenesis in peritumoral tissues

© 2020 Published by Elsevier B.V.Purpose: During radiotherapy the peritumoral tissues are daily exposed to subtherapeutic doses of ionizing radiation. Herein, the biological and molecular effects of doses lower than 0.8 Gy per fraction (LDIR), previously described as angiogenesis inducers, were assessed in human peritumoral tissues. Material and methods: Paired biopsies of preperitoneal adipose tissue were surgically collected from 16 patients diagnosed with locally advanced rectal cancer who underwent neo-adjuvant radiotherapy. One of the biopsies is located in the vicinity of the region where the tumor received the prescribed dose of radiation, and thus exposed to LDIR; the other specimen, outside all beam apertures, was used as an internal calibrator (IC). Microvessel density (MDV) was quantified by immunohistochemistry and the expression of angiogenic, pro-inflammatory, adhesion and oxidative stress genes was assessed by quantitative RT-PCR using exclusively endothelial cells (ECs) isolated by laser capture microdissection microscopy. Results: LDIR activated peritumoral ECs by significantly up-regulating the expression of several pro-angiogenic genes such as VEGFR1, VEGFR2, ANGPT2, TGFB2, VWF, FGF2, HGF and PDGFC and down-regulating the pro-inflammatory IL8 marker. Accordingly, the MVD was significantly increased in peritumoral tissues exposed to LDIR, compared to the IC. The patients that yielded a larger pro-angiogenic response, also showed the highest MVD. Conclusions: LDIR activate ECs in peritumoral tissues that are associated with increased MVD. Although the technological advances in radiotherapy have contributed to reduce the damage to healthy tissues over the past years, the anatomical regions receiving LDIR should be taken into account in the treatment plan report for patient follow-up and in future studies to correlate these doses with tumor dissemination.info:eu-repo/semantics/publishedVersio