Metastatic rectal adenocarcinoma within haemorrhoids: a case report

<p>Abstract</p> <p>Introduction</p> <p>Metastatic tumour involvement of the anal canal is rare. Routine pathological evaluation of haemorrhoidectomy specimens has been suggested to be unhelpful and expensive. Selective rather than routine pathological evaluation of haemorrhoidectomy specimens has been recommended.</p> <p>Case presentation</p> <p>We report the case of a 69-year-old woman with metastatic colorectal carcinoma who presented with metastatic carcinoma within thrombosed haemorrhoids.</p> <p>Conclusion</p> <p>We suggest that in patients with colorectal cancer, careful examination of haemorrhoids on colonoscopy as well as histological examination of suspected haemorrhoidal tissue after surgical resection be performed to evaluate for metastasis.</p

Germline genetic variation and predicting immune checkpoint inhibitor induced toxicity

Immune checkpoint inhibitor (ICI) therapy has revolutionised the treatment of various cancer types. ICIs reinstate T-cell function to elicit an anti-cancer immune response. The resulting immune response can however have off-target effects which manifest as autoimmune type serious immune-related adverse events (irAE) in ~10–55% of patients treated. It is currently challenging to predict both who will experience irAEs and to what severity. Identification of patients at high risk of serious irAE would revolutionise patient care. While the pathogenesis driving irAE development is still unclear, host genetic factors are proposed to be key determinants of these events. This review presents current evidence supporting the role of the host genome in determining risk of irAE. We summarise the spectrum and timing of irAEs following treatment with ICIs and describe currently reported germline genetic variation associated with expression of immuno-modulatory factors within the cancer immunity cycle, development of autoimmune disease and irAE occurrence. We propose that germline genetic determinants of host immune function and autoimmune diseases could also explain risk of irAE development. We also endorse genome-wide association studies of patients being treated with ICIs to identify genetic variants that can be used in polygenic risk scores to predict risk of irAE

X-ray-Absorption Spectral Study of the R₂Fe₁₇₋ₓMₓ Solid Solutions (R=Ce, Nd and M=Al, Si)

The x-ray-absorption near-edge structure (XANES) spectra obtained at the cerium LIII edge of the Ce2Fe17-xAlx solid solutions and Ce2Fe14Si3, show two absorption peaks characteristic of the 4f1 and 4f0 configurations of cerium, peaks which indicate that cerium is in a mixed valent state in these compounds. All the XANES spectra have been consistently and excellently fit with one sigmoidal function and two Gaussianbroadened Lorentzian functions. The cerium spectroscopic valence obtained from the relative areas of the two peaks decreases from 3.64 to 3.43 between x=0 and 9 in Ce2Fe17-x,Alx, and correlates linearly with the cerium site volume This correlation confirms that the cerium valence is strongly dependent upon steric effects. In contrast the cerium valence obtained from the XANES spectrum of Ce2Fe14Si3 is not determined by stenc effects and indicates, in agreement with other measurements and calculations, that silicon is more covalently bonded with its near-neighbor cerium atoms than is aluminum. The neodymium LIII,-edge XANES spectra of the Nd2Fe17-x Alx solid solutions, where x is 0, 3, and 8, reveal the presence of only trivalent neodymium and an increase of the empty 5d state density when aluminum is substituted in place of iron. XANES measurements at the iron K edee of the Ce2Fe17-xAlx, and Nd2Fe17-1Alx, solid solutions show changes m the relative intensity of the multiple scattering peaks, changes which are related to the changing composition of the first three neighbor shells with increasing aluminum content