18 research outputs found
Imaging findings of an epidermoid cyst undergoing malignant transformation
Malignant transformation of epidermoid cyst into squamous cell carcinoma (SCC) is rare. We report the case of a 39-year-old woman presenting with dizziness and cerebellar ataxia. MR scan revealed a mass in the left cerebropontine angle compressing the brainstem and the cerebellum, with two main components, a cystic and a solid one. The cystic component displayed imaging findings consistent with an epidermoid cyst. The solid component showed dense calcifications, low signal intensity on T1W, T2W and DW images and peripheral nodular enhancement. MR spectroscopy detected high lipid/lactate peaks and choline/creatine ratio. Imaging findings raised suspicion for malignant transformation, which was confirmed by histopathologic examination revealing an SCC. MR imaging with intravenous administration of gadolinium, DW images and MR spectroscopy can play a critical role in the diagnosis of malignant transformation of an epidermoid cyst
DARPP32, STAT5 and STAT3 mRNA Expression Ratios in Glioblastomas are Associated with Patient Outcome
Effects of tamoxifen and CV 205502 on the morphology and the evolution of the noncancerous mouse mammary gland
Tamoxifen (TAM, 0.01 mglanirnal,
three times a week) and the experimental prolactinlowering
CV 205502 (CV, 1 pglanimal, daily)
were administered prophylactically, alone or
combined, to virgin C3HISy mice during the
early period of promotion in this spontaneous
mammary carcinogenesis system (end of 2nd-
5th month of age), in order to study their influence
on the rnorphology and evolution of the noncancerous
mammary gland during therapy and
after treatment cessation. During TAM administration
the epithelial cells of the growing part of the
gland exhibited myoepithelial- and, late in the
treatrnent period, apoptotic-like features instead
of the secretory ones expected, accompanied by
intense basement rnembrane alterations, thickening
of the surrounding connective tissue and arrested
adipocyte maturation. These effects reversed
progressively after drug withdrawal. The epithelial
alterations were more intense and longer lasting in
the TAM+CV-group, while growth arrest of the glands was observed in both groups parallel to the
degree and the duration of these morphological changes.
In these groups, tumor incidence was diminished,
as expected, but the tumors that developed late
after treatment cessation were of low histological
differentiation. The above morphological obsemations
show that TAM inhibits noncancerous mammary gland
growth during the reproductive period by altering
stromal and epithelial differentiation, effects that reverse
progressively after treatrnent discontinuation and are
potentiated by a prolactin-lowering agent in this animal
study
Multiple Myeloma Presenting as MPO-ANCA Associated Microscopic Polyangiitis
Reports on the association of multiple myeloma with systemic vasculitis are rare and concern, vasculitis due to crystalglobulin deposition in vessels or to polyarteritis nodosa PAN-like type necrotizing vasculitis. The association of multiple myeloma with MPO-ANCA positive microscopic polyangiitis has not yet been described. We report a case of a 72 year old man, who was referred to our clinic for evaluation of recent onset renal failure (serum creatinine 8mg/dl), proteinuria 2g/day, severe anemia (hematocrit 16%) and fever accompanied by malaise, anorexia, weigh loss, myalgia and arthralgia. These symptoms appeared 20 days prior to his admission. There was no evidence of any infection. The renal biopsy showed necrotizing crescentic glomerulonephritis. The MPO-ANCA were positive. Bone marrow biopsy revealed infiltration with IgG-lambda neoplastic plasma cells. The patient was treated with hemodialysis, plasma exchange, corticosteroids and cyclophosphamide. Even though his clinical situation and renal function improved gradually, two months after his admission, he developed acute respiratory insufficiency accompanied by heavy hemoptysis, patchy infiltration on chest X-rays, due to lung vasculitis and died. Multiple myeloma should be considered in the differential diagnosis of hematological neoplasms capable of causing paraneoplastic ANCA positive microscopic polyangiitis
Post-operative combined radiation and chemotherapy with temozolomide and irinotecan in patients with high-grade astrocytic tumors. A phase II study with biomarker evaluation
Background: Clinical studies have shown that temozolomide (TMZ) and irinotecan demonstrate activity in high grade astrocytic tumors (HGAT). However, the optimal schedule of administration is unknown. Patients and Methods: In the present study, a total of 45 HGAT patients, 38 with glioblastoma multiforme (GBM) and 7 with anaplastic astrocytoma (AA), were treated with TMZ, 150 mg/m(2) on days 1-5, followed by irinotecan, 150 mg/m(2) on days 6 and 17, every 4 weeks,for 6 cycles or until the occurrence of unacceptable toxicity or disease progression. Radiation therapy (60 Gy) was initiated on the first day of treatment. Results: Twenty-two patients completed six cycles of treatment. Most frequently recorded side-effects included neutropenia (37%), nausea/vomiting (66%), diarrhea (31%) and infection (44%). Five episodes of vaso-occlusive disease, all of them fatal, were observed. After a median follow-up of 49.8 months, median progression-free survival for patients with GBM was 7.7 months, while median overall survival was 12.8 months. There were six long-term survivors, three of them with GBM. Two out of the five biomarkers studied, epidermal growth factor receptor (EGFR) and vascular endothelial growth factor-C (VEGF-C), were found to be overexpressed in 74% of the tumors, however they had no predictive value for progression-free or overall survival. Conclusion: The combination of TMZ and irinotecan, as administered in this study, was accompanied by high rates of toxicity, especially myelotoxicity and infection. Further development of this regimen in the treatment of HGAT is not recommended