Oral Metastasis of Metaplastic Breast Carcinoma in a Patient with Neurofibromatosis 1

Neurofibromatosis type 1 (NF1) has been associated with an increased risk for development of malignancy, especially malignant peripheral nerve sheath tumors. In addition, recently, literature has demonstrated an increased risk of breast cancer in women with NF1. The present paper shows a 53-year-old woman with NF1 who presented with metaplastic breast carcinoma and developed multiple metastases, including mandible. Furthermore, we reviewed the English literature, found 63 cases showing the association between NF1 and breast cancer, and added one more case. The present study demonstrated an important association between NF1 and breast cancer. Until the present time, there has been only one case of metaplastic breast carcinoma associated with NF1. Curiously, in our case the oral metastasis corresponded to sarcomatous component of metaplastic breast carcinoma

Diffusion-Weighted MRI in the Assessment of Early Treatment Response in Patients with Squamous-Cell Carcinoma of the Head and Neck: Comparison with Morphological and PET/CT Findings.

To evaluate changes in apparent diffusion coefficients (ADC) as measured by magnetic resonance imaging (MRI) before and after the treatment of primary tumors and cervical metastases in patients with squamous-cell carcinoma (SCC) of the head and neck, and to compare these values to the results of widely used morphological criteria and [18F]-FDG PET/CT findings.This was a longitudinal, prospective, single-center nonrandomized trial involving patients with head and neck SCC treated with chemotherapy alone or in combination with radiotherapy. Imaging examinations ([18F]-FDG PET/CT and diffusion-weighted MRI) were performed on the same day, up to one day prior to the beginning of the first treatment cycle, and on the 14th day of the first chemotherapy cycle. Treatment response was evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) and World Health Organization (WHO) morphological criteria, as well as PET Response Criteria in Solid Tumors (PERCIST) metabolic criteria.Seventy-five lesions were examined in 23 patients. Pre- and post-treatment comparisons of data pertaining to all target lesions revealed reductions in tumor size and SUV, as well as increases in ADC values, all of which were statistically significant. The increase in ADC following treatment was significantly higher in patients classified as complete responders by both morphological criteria than that observed in any of the other patient groups of response. Patients with a complete metabolic response also showed greater increases in ADC values as compared to the remaining groups.The assessment of tumor response based on diffusion-weighted MRI showed an increase in the ADC of cervical lesions following treatment, which was corroborated by morphological and metabolic findings. Associations between changes in ADC values and treatment response categories using morphologic criteria and [18F]-FDG PET/CT were only identified in complete responders

Dispersion of ADC and SUV in target lesions as observed in staging examinations.

<p>ADC = apparent diffusion coefficient, SUV = standard uptake value.</p

(A-B), Correlation between changes in SUV and treatment response according to WHO and RECIST guidelines.

<p>ADC = apparent diffusion coefficient, SD = stable disease, CR = complete response, RECIST = Response Evaluation Criteria In Solid Tumors, PR = partial response, SUV = standard uptake value, WHO = World Health Organization.</p

Correlation between changes in ADC values and treatment response categories according to SUV (PERCIST), where 1 indicates complete metabolic response, 2 corresponds to partial metabolic response, 3 to stable metabolic disease and 4 to progressive metabolic disease.

<p>ADC = apparent diffusion coefficient, SUV = standard uptake value, PERCIST = PET Response Criteria in Solid Tumors.</p

Correlation between changes in ADC values and treatment response categories according to WHO and RECIST guidelines.

<p>ADC = apparent diffusion coefficient, SD = stable disease, CR = complete response, RECIST = Response Evaluation Criteria In Solid Tumors, PR = partial response, WHO = World Health Organization.</p

Age, gender, primary tumor site, clinical stage and location of affected lymph nodes in patients included in the study.

<p>Age, gender, primary tumor site, clinical stage and location of affected lymph nodes in patients included in the study.</p