Adenoid basal carcinoma of the cervix in a 20-year-old female: a case report

BACKGROUND: Adenoid basal carcinoma of the cervix is a rare condition mostly occurring among postmenopausal women. Although it can be confused with adenoid cystic carcinoma of the cervix, adenoid basal carcinoma has several clinicopathologic features that will allow distinction from adenoid cystic carcinoma. CASE PRESENTATION: This is the case of a twenty-year old African-American female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear, with a subsequent cervical LEEP specimen revealing adenoid basal carcinoma. The lesion showed the characteristic histologic features of adenoid basal carcinoma and was positive for the immunohistochemical marker EMA and negative for collagen IV, further defining the tumor while helping to rule out the possibility of adenoid cystic carcinoma. As far as the authors are aware, this is the youngest reported case of adenoid basal carcinoma to date. CONCLUSION: This case shows that adenoid basal carcinoma can deviate markedly from its typical postmenopausal demographics to affect women as young as 20 years of age. In addition, adenoid basal carcinoma has several identifiable features that will differentiate it from adenoid cystic carcinoma including histologic and cellular morphologies, as well as immunohistochemistry. Treatment for most patients involves hysterectomy, LEEP, or a conization procedure which provides a favorable prognosis because of this lesion's low potential for recurrence and metastasis

Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report

We present the case of a 46 year old woman with a giant, 23-centimeter, atypical carcinoid of the liver. A primary site for this neoplasm could not be identified despite multiple radiographic imaging studies, including a somatostatin scan, and a thorough inspection of the bowel during surgical resection of the lesion. Histologically, the tumor displayed mild cytologic atypia, abundant necrosis, and intravascular metastases, the last feature of which was identified by immunohistochemical markers for chromogranin and synaptophysin. Also described is the unusual sinusoidal infiltration, or "spillage," of tumor cells into the surrounding liver parenchyma, a feature that has not been described as far as we are aware but may suggest an aggressive clinical course. Even though an exact definition of atypia for these lesions apparently does not exist at this point, the multiple atypical features in this case strongly suggest the diagnosis of atypical carcinoid of the liver, thus far an altogether rare and vaguely reported entity. As more cases arise in the medical literature, it may be worthwhile to establish a set of guidelines to define atypical hepatic carcinoids and other gastrointestinal carcinoids, although survivorship data thus far indicates no significant difference in the prognosis between typical versus atypical variants

(A) Multiple areas of intravascular invasion are found throughout the liver (H&E, 400×)

<p><b>Copyright information:</b></p><p>Taken from "Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report"</p><p>http://www.jmedicalcasereports.com/content/1/1/47</p><p>Journal of Medical Case Reports 2007;1():47-47.</p><p>Published online 12 Jul 2007</p><p>PMCID:PMC1950516.</p><p></p> (B) A stain for the neuroendocrine marker chromogranin reveals the tumor border at the left edge of the photomicrograph (H&E, 100×) with multiple scattered neoplastic cells spilling into the surrounding liver parenchyma (inset, H&E, 400×)

(A) The enormous tumor has all but replaced and distorted the right hepatic lobectomy specimen

<p><b>Copyright information:</b></p><p>Taken from "Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report"</p><p>http://www.jmedicalcasereports.com/content/1/1/47</p><p>Journal of Medical Case Reports 2007;1():47-47.</p><p>Published online 12 Jul 2007</p><p>PMCID:PMC1950516.</p><p></p> (B) Cut sections reveal diffuse areas of necrosis and a large, irregular central scar. (C) The tumor is composed mostly of a trabecular architecture but with some scattered acinar structures (H&E, 400×). The cells show mild atypia while displaying eccentric, "salt and pepper" nuclei and gritty pink cytoplasm (inset, H&E, 1000×)

Drug–Drug Interactions Involving Dexamethasone in Clinical Practice: Myth or Reality?

Concomitant administration of multiple drugs frequently causes severe pharmacokinetic or pharmacodynamic drug–drug interactions (DDIs) resulting in the possibility of enhanced toxicity and/or treatment failure. The activity of cytochrome P450 (CYP) 3A4 and P-glycoprotein (P-gp), a drug efflux pump sharing localization and substrate affinities with CYP3A4, is a critical determinant of drug clearance, interindividual variability in drug disposition and clinical efficacy, and appears to be involved in the mechanism of numerous clinically relevant DDIs, including those involving dexamethasone. The recent increase in the use of high doses of dexamethasone during the COVID-19 pandemic have emphasized the need for better knowledge of the clinical significance of drug–drug interactions involving dexamethasone in the clinical setting. We therefore aimed to review the already published evidence for various DDIs involving dexamethasone in vitro in cell culture systems and in vivo in animal models and humans