Endometrioid ovarian carcinoma benefits from aromatase inhibitors: case report and literature review

Aromatase inhibitors have not been adequately assessed in treatment of ovarian cancer. The aromatase inhibitor letrozole (2.5 mg daily) was administered in 2 cases of advanced endometrioid ovarian cancer with positive estrogen receptor. CASE 1: A 52-year-old woman with a grade 2-3, stage iiic endometrioid ovarian cancer was optimally debulked and received 6 cycles of intravenous paclitaxel and intraperitoneal cisplatin-paclitaxel. Post chemotherapy, one of several biopsies showed residual disease during the second-look laparoscopy. This patient was treated with letrozole and remained disease-free during 30 months of follow-up. CASE 2: A 47-year-old woman with a grade 3, stage iiic endometrioid ovarian cancer was optimally debulked and treated with intravenous carboplatin-paclitaxel. After a 15-month remission, her first recurrent disease was treated with carboplatin-docetaxel. The second remission lasted only 11 months, after which the patient was treated with splenectomy and subsequent liposomal doxorubicin. Letrozole was administered after the chemotherapy. The patient had a 30-month remission before the next recurrence of her disease. CONCLUSIONS: Endometrioid ovarian carcinoma may benefit from aromatase inhibitors, especially when the tumour burden is low after primary chemotherapy or when the inhibitor is used as maintenance therapy between chemotherapies.     

Radiation recall pneumonitis induced by erlotinib after palliative thoracic radiotherapy for lung cancer: Case report and literature review

Radiation lung injury usually develops 1–6 months after cessation of radiation therapy to the lung. Acute change in the previously irradiated lung after administration of antineoplastic agent is known as radiation recall pneumonitis. Erlotinib is a reversible epidemal growth factor receptor tyrosine kinase inhibitor, which is effective for patients with advanced lung cancer with epidermal growth factor receptor mutations. Here we report a rare case of radiation recall pneumonitis following treatment with erlotinib 4 months after palliative radiotherapy to the lung. A 76‐year‐old man with non–small cell lung cancer was treated with polychemotherapy, palliative thoracic irradiation (30 Gy in 12 fractions) and erlotinib thereafter. Two months after administration of erlotinib he developed of severe dyspnea, cough, anorexia and lack of energy. CT chest revealed extensive radiation pneumonitis. Erlotinib was ceased and high‐dose steroids were started. The symptoms ultimately resolved and erlotinib was resumed cautiously after 11 weeks. On dosimetric analysis, lung V20 and the mean lung dose were 20.33% and 10.7 Gy, respectively, and hence, the risk of radiation pneumonitis is very low. These data indicate that systemic administration of erlotinib after low‐dose palliative radiation therapy can be associated with unexpected toxicity when visceral organs are within the radiation field.     

肺血管内大B细胞淋巴瘤一例分析并文献复习

为了探讨血管内大B细胞淋巴瘤(IVLBCL)的临床和病理特点,分析1例IVLBCL的临床特征和病理资料,用形态学方法和免疫组化染色进行研究。系统分析国内公开报道24例IVLBCL临床表现及诊断特点。本例临床表现以呼吸系统症状为主,肿瘤通过肺活检发现,镜下表现瘤细胞仅位于小血管腔内,瘤细胞大,核仁明显。瘤细胞表达淋巴细胞标记LCA(+),CD20(+),CD79a(+),CD3(-),CD45RO(-),血管内皮CD31(+),CD34(+)。初步研究结果提示,我国IVLBCL具有自身特点,该瘤是一种罕见的结外弥漫性大B细胞淋巴瘤,诊断只能依靠病理检查确诊,发热气喘等呼吸系统症状具有提示作用。该瘤具有高度恶性和高度侵袭性,预后很差,早期诊断具有重要意义。     

肺鳞癌前列腺转移1例并文献复习

目的:探讨肺鳞癌转移到前列腺的临床表现、诊断及治疗,以提高医师对此的认识。方法:总结1例肺鳞癌术后前列腺转移患者,表现为排尿困难,手术后确诊。术后行抗肿瘤综合治疗,观察其病情演变及转归,并进行文献复习。结果:预后良好。结论:肺鳞癌前列腺转移罕见,确诊依赖病理。寡转移者预后良好。     

Liver metastases from gastric carcinoma: A Case report and review of the literature

Gastric carcinoma (GC) is the fifth most common malignancy worldwide but the third leading cause of cancer death, and surgery remains the only curative treatment option. Prognosis of patients with liver metastases from gastric carcinoma (LMGC) is poor, and the optimal treatment of metastatic gastric cancer remains a matter of debate. In 2002, a 53-year-old male patient with GC and synchronous oligometastatic lesion in liver VIII segment underwent a total gastrectomy combined with metastasectomy. The pathologic diagnosis was stage IV gastric adenocarcinoma (pT3N2M1), which was treated with adjuvant chemotherapy (cisplatin, epirubicin, leucovorin, and 5-fluorouracil). In 2012, abdominal ultrasound and percutaneous liver biopsy revealed recurrence of the metastasis in the right liver lobe. Progression of the disease was observed after palliative chemotherapy (epirubicin, oxaliplatin, and capecitabine). Nevertheless, an extended right hemihepatectomy, with excision of segments 1, 4A, 5, 6, 7, and 8, was still performed. Pathologic examination confirmed large KRAS- and HER2-negative LMGC. The patient is alive and free of disease 47 months after the repeated hepatectomy and 13 years after removal of the primary GC and synchronous liver metastasis. Based on review of 27 articles, 5-year overall survival rate following gastrectomy and liver metastasectomy may reach 60%, with median survival time up to 74 months. Although the combination of aggressive surgical approach with systemic therapy for LMGC is controversial, it may allow favorable outcome. Careful selection of patients based on evaluable predictive factors for R0 surgical resection of both primary tumor and liver metastases can lead to cure, as shown in our case presentation, where a 10-year relapse-free survival was observed, followed by successful repeated hepatectomy due to liver metastases.     

Simultaneous multiple myeloma and non-small cell lung carcinoma: A case report and review of the literature

Multiple myeloma (MM) is the second commonest hematologic malignancy. Synchronous presentation of MM and lung cancer is a rare occurrence. The present study reports a case of MM combined with lung cancer and reviews previously reported cases of the co-existence of non-small cell lung carcinoma and MM. At Hebei General Hospital (Shijiazhuang, China), a 52-year-man was diagnosed with MM complicated by lung lesion. Lung computed tomography (CT) showed an increase in lesion density after the second cycle of chemotherapy. The lesion was surgically removed and the patient was diagnosed with non-small cell lung carcinoma by lung biopsy pathology. After the fifth cycle of VDT (bortezomib, dexamethasone and thalidomide), the patient received autologous stem cell transplantation. Immunohistochemical staining for CD38, CD138, CD39, CD203a and TNF-α were positive in both MM and lung cancer; CD73 was only positive in lung cancer. The present study described the rare event of the simultaneous occurrence of MM and lung adenocarcinoma and discussed the potential link between the two tumors. CD38 may play a role in MM and lung cancer by changing the bone marrow microenvironment through adenosine.     

Intramedullary spinal cord metastases from atypical small cell lung cancer: a case report and literature review

Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy. Lung cancer represents the most common solid tumor associated with the development of ISCM.

We describe a 47-year-old female with atypical small cell lung cancer (SCLC) developing ISCM. After a thoracoscopic biopsy she was treated with combination chemotherapy consolidated by mediastinal radiotherapy leading to complete remission. Three months later, she developed a Brown-Sequard syndrome and an MRI scan revealed ISCM at the T10-T12 levels, and secondary brain lesions. Despite treatment with steroids and thoracic spine/brain radiotherapy, no recovery of her motor function was seen and she died 4 months later due to progressive disease in the CNS.

The present case, adds to the existing list of ISCM cases reported so far for lung cancer, undermine the ominous prognosis and limited treatment options available, and an extensive literature overview and discussion of similar cases is provided.     

Small cell lung cancer transformation from EGFR-mutated lung adenocarcinoma: A case report and literatures review

Epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have markedly improved the response of non-small cell lung cancer (NSCLC) with EGFR-mutant patients. However, these patients inevitably come cross acquired resistance to EGFR-TKIs. The transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following treatment with EGFR-TKIs is rare, which leads to resistance to EGFR-TKIs.

The present case concerns a case of a 38-year-old man presenting with cough and dyspnea. Radical resection was performed and confirmed an EGFR exon 21 L858R lung adenocarcinoma. However, the patient suffered pleural metastasis after successful treatment with surgery and adjuvant treatment. So, erlotinib was administered with 18 months. Because of enlarged pleural nodule, repeat biopsy identified an SCLC and chemotherapy was started. However, despite the brief success of chemotherapy, our patient suffered brain metastasis.

Our case emaphsizes both the profile of transformation from NSCLC to SCLC and the importance of repeat biopsy dealing with drug resistance. We also summarize the clinical characteristics, mechanisms, predictors of SCLC transformation, treatment after transformation and other types of transformation to SCLC.     

Carcinoma of the anal gland: Case report and review of the literature

Anal gland cancer is often insidious in its presentation with no evidence of an intraluminal mass. It is frequently slow-growing and often thought to be a perirectal or ischiorectal abscess. Repeated incision and drainage is performed until a biopsy reveals the diagnosis. A very wide resection is then necessary to totally remove the tumor.     

Spontaneous regression of breast carcinoma: Follow-up report and literature review

A case of spontaneous complete regression of metastatic breast carcinoma (malignant pleural effusion and bone metastases) with previously reported from M. D. Anderson Hospital and Tumor Institute. The patient did not receive any form of hormonal manipulation or systemic chemotherapy. This patient has now relapsed after 72 months of spontaneous complete remission, and a follow-up of her clinical history is presented. A search of the literature for previously reported instances of spontaneous regression of breast carcinoma indicates that this event is exceedingly rare.     

Large adrenal metastasis in non-small cell lung carcinoma. Case report and literature review

Adrenal metastases are frequent in patients with non-small cell lung carcinoma (NSCLC). We present a case of a large adrenal metastasis from NSCLC and we discuss the relevant literature. In such cases, early surgical intervention is recommended to avoid spontaneous rupture of the tumor and improve patient survival.     

Basaloid carcinoma of the prostate: a case report and review of the literature

Malignant tumours arising from the basal cells of the prostate gland are extremely rare, and the majority of reports in the literature suggest a relatively indolent clinical course. We report a case of infiltrative basaloid carcinoma of the prostate in a 68-year old man that did not respond to systemic chemotherapy. It is essential that this aggressive disease is differentiated from more indolent basaloid proliferations, as metastatic spread can occur and outcome may be poor.     

Lipid-secreting carcinoma of the breast: A case report and review of the literature

A case of lipid-secreting carcinoma in the right breast of a 78-year-old Japanese woman is reported. Light microscopy revealed solid alveolar proliferation in the majority of tumor cells, which had abundant foamy cytoplasm. A variable amount of neutral lipid was identified in the cytoplasm of the tumor cells by Sudan III staining and electron microscopy. This case is reported along with a discussion of other cases of lipid-secreting or lipid-rich carcinoma that have been reported in the international literature.     

同时性卵巢癌合并非小细胞肺癌1例并文献复习

目的:探讨多原发癌的临床诊断、治疗和预后,提高对多原发癌的认识,从而延长患者生存期,改善预后。方法:报道1例卵巢癌同期并非小细胞肺癌的多原发癌病例,并通过文献复习,阐述其发病率、发病机制、临床诊治方法及预后。结果:1名54岁女性以卵巢癌收住入院,行胸部CT及病理穿刺活检诊断同时合并肺腺癌,遂采用紫杉醇联合卡铂3周方案化疗,并肺部病灶射频消融。6周期化疗后,持续口服埃克替尼靶向治疗近13个月,肺部病灶较前明显缩小,卵巢癌无复发及转移征象。结论:临床需提高多原发癌的诊断意识,掌握多原发癌发病特点、诊疗方法,以提高治疗水平。     

肺大细胞癌的CT征象分析与文献回顾

Objective： Large cell carcinoma of lung is a very rare tumor. The clinical characteristics and CT imaging feature of large cell carcinoma of lung were discussed in this article. Methods： Eight cases of large cell carcinoma of lung proven by post-operational pathology were retrospectively analyzed from 2000 to 2005 and the literature on it was reviewed. Results： All 8 cases were men. The average age of patients was 64.88 years. Seven cases were smokers. Six cases had obvious chest stuffy, short breath, thrill dry cough. Hereinto 3 cases had cardinal red blood sputum. CT images of large cell carcinoma of lung were represented as single and peripheral mass or nodule. The distribution of large cell carcinoma of lung was short of some rule. 75% focus had clear finitude. One case showed internal calcification and 2 cases showed cavity. They did not show internal fat density. Conclusion： Large cell carcinoma of lung is difficult to be diagnosed before operation. Its CT finding is nonspecific.     

Squamous cell carcinoma of the rectum: a case report and review of the literature

Squamous cell carcinoma of the colon and rectum are extremely rare neoplasms. Many questions regarding their histogenesis and biological behaviour remain unanswered. Surgery is the most effective therapy, and adjuvant chemotherapy and radiotherapy should be considered, especially for node-positive patients. We present a patient with squamous cell carcinoma of the middle rectum who underwent abdominoperineal resection and postoperative adjuvant chemotherapy. The pertinent literature is reviewed.     

晚期肺癌并双侧颈内静脉栓塞1例报告

2012年收治1例晚期非小细胞肺癌放化疗后并双侧颈内静脉血栓患者,现对此病例报告进行文献回顾。
　　1病例介绍
　　女性患者,65岁,因“左肺鳞癌并纵膈右锁骨上淋巴结、脑转移于放化疗3天后,右颈肿胀1天”入院。2012年2月15日无明显诱因出现咳嗽,干咳,无其它不适伴随症状。CT提示左肺上叶肿块34mm ×31mm,伴纵隔、右锁骨上淋巴结肿大。右锁骨上淋巴结病理提示转移性鳞癌。脑 MRI 提示左顶叶异常强化,直径1cm,考虑脑转移。骨、腹部影像检查
　　未见转移。诊断左肺鳞癌并多发转移。患者于2012年2月24日-2012年8月22日行5周期 GP 方案化疗及左肺肿瘤姑息性放疗（PTV DT 58Gy/2Gy/29f）,化疗2周期评价 CR,4周期评价 SD,化疗期间出现Ⅳ度骨髓抑制,输血及细胞因子治疗后缓解。既往体健,无遗传及肿瘤病史。查体：KPS 70分,右颈局部皮肤红肿3cm ×2cm,皮温升高,表浅静脉曲张,轻压痛,右侧锁骨上可见1.5cm 愈合良好瘢痕,浅表淋巴结无肿大。右上肢可见 PICC 置管,双肺呼吸音清,未闻及干湿啰音,余无异常。辅助检查：血常规正常,FIB 3.6g/ L, INR 1.5g/ L。彩超提示右侧颈内静脉血栓（见图1）。诊断：①左肺上叶鳞癌并多发转移（纵隔淋巴结4R、6、7区、右锁骨上淋巴结转移,脑转移）于放化疗后;②右锁骨上淋巴结转移性鳞癌于切除术后;③右颈内静脉血栓。分期：AJCC7版分期 T2 N3 M1b IV 期。     

宫颈癌下颌骨转移1例报告并文献复习

宫颈癌是女性最常见的恶性肿瘤之一,骨转移不常见,下颌骨转移尤为罕见。发生骨转移的宫颈癌患者预后极差。治疗以减轻临床症状和提高生活质量为目标。     

阿帕替尼治疗肺巨细胞癌1例并文献复习

目的:探讨肺巨细胞癌的临床特征、诊断和治疗方法。方法:报道1例肺巨细胞癌患者的临床资料并对相关文献进行复习。对肺巨细胞癌的临床特征、影像学表现、病理学特征和治疗方法进行分析。结果:1例肺巨细胞癌患者因刺激性呛咳、左侧胸部闷痛3个月入院。胸部CT检查及病理穿刺活检明确诊断为肺巨细胞癌。采取多西他赛联合顺铂3周方案化疗,化疗2个周期后临床症状轻微好转且疗效评价稳定（SD）,化疗4个周期后疗效评价进展（PD）,口服阿帕替尼抗肿瘤血管生成治疗后疗效评价亦是PD。结论:肺巨细胞癌临床罕见,生存期短,预后差,目前无标准的治疗方法,化疗可能短暂延缓肿瘤进展,阿帕替尼抗肿瘤血管生成治疗效果可能欠佳。