1/53. Synchronous primary cancers of the breast and cervix: planning multidisciplinary primary treatment [clinico-pathological conference]Multiple metachronous primary malignancies are becoming increasingly frequent; however, multiple synchronous primary malignancies are still unusual. We report the case of a 61-year-old woman with synchronous stage IIIB ductal carcinoma of the left breast and FIGO stage IB2 squamous cell carcinoma of the cervix. The patient was treated initially every 4 weeks with a 24-h intravenous infusion of paclitaxel (175 mg/m2) followed by a 1-h infusion of carboplatin (area under the curve of 5 mg/ml x min) with concurrent irradiation of the pelvis. Significant toxic reactions including nausea, vomiting, and diarrhea required hospitalization or outpatient intravenous fluids and antiemetics. After four cycles of chemotherapy, the breast cancer was in complete clinical remission, and the patient underwent a modified radical mastectomy with axillary lymph node dissection. Pathologic findings revealed a few microscopic foci of residual infiltrating ductal carcinoma exhibiting a marked treatment effect; none of the 14 axillary lymph nodes removed showed evidence of metastatic tumor. A near-complete pathologic response of the breast cancer and a complete clinical response of the cervical cancer were obtained. Adjuvant chemotherapy for the breast cancer was then initiated, followed by radiation and hormonal therapy.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/53. Primary lymphoepithelioma-like carcinoma of the lung.Lymphoepithelioma is an undifferentiated carcinoma with prominent lymphoid stroma in the nasopharynx. Tumors with similar histology have been reported with other localizations, including the lungs, and are designated as lymphoepithelioma-like carcinomas (LELC). Primary LELC of the lung is very rare, and scant information is available in the scientific literature. This paper details the case of a 25-year-old Caucasian male patient with the diagnosis (determined by thoracotomy) of primary LELC of the lung. Immunohistochemical analysis was negative for Epstein-Barr virus, as was the in situ hybridization of the tumor cells. observation of the nasopharynx and a magnetic resonance image of the cavum were normal. Because the tumor (T4N2M0) could not be resected, the patient was treated with chemotherapy, carboplatin/5-fluorouracil, completing two cycles. The patient's condition worsened when he developed contralateral pneumonia, which was then followed by pericardial effusion. The patient died 36 h later from cardiac tamponade. Presented here is a revision of this rare pathology, not often reported in the literature.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
3/53. A case of inoperable esophageal carcinoma with hepatic and nodal metastases which showed a long-term survival after chemoradiotherapy including nedaplatin.We report a case of metastatic esophageal carcinoma successfully treated with chemoradiotherapy. A 61-year-old man, diagnosed as suffering from advanced esophageal carcinoma with liver and lymph node metastases, was treated with a combination of nedaplatin (90 mg/m2/day, 1 h drip infusion, day 1), 5-fluorouracil (800 mg/m2/day, continuous infusion, days 1-5), and radiotherapy (2 Gy/day, days 1-5, 8-12 and 15-19). The cycle was repeated twice every 5 weeks from July 2, 1997. He achieved a complete response 1 month after finishing two courses of chemoradiotherapy followed by an additional three courses of chemotherapy without radiation. Seven months after the completion of radiotherapy, pericardial effusion with negative cytology was recognized. The effusion was treated by pericardiocentesis and drainage for several days. After drainage, the effusion could be easily managed with diuretics. This patient is still alive with no evidence of disease more than 2.5 years after the initiation of the treatment.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
4/53. cell cycle proteins as molecular markers of malignant change in vulvar lichen sclerosus.Lichen sclerosus (LS) has a known association with the development of squamous cell carcinoma of the vulva. The purpose of this study was to investigate molecular markers, which could indicate premalignant changes. Multiple sequential vulvar biopsies were taken over a period of 11 years from a patient with longstanding LS. Immunohistochemical staining was used to demonstrate a range of molecular markers. Increased expression of p53 and Ki67 was found in areas of squamous hyperplasia (SH) and differentiated vulvar intraepithelial neoplasia (dVIN) which correlated with the subsequent development of invasive squamous cell carcinoma (SCC). Molecular changes have been found to accompany histologic changes in the progression of vulvar LS to malignancy. Such markers may prove a useful addition in the clinical management of these conditions.- - - - - - - - - - ranking = 4keywords = cycle (Clic here for more details about this article) |
5/53. Glassy cell carcinoma of the uterine cervix: combination chemotherapy with paclitaxel and carboplatin in recurrent tumor.Combination chemotherapy with paclitaxel and carboplatin every 4 weeks for 3 cycles was administered for recurrent glassy cell carcinoma of the uterine cervix in a 67-year-old Japanese female. The response rate was 56% under computed tomography (partial response). However, the effect was transient even with follow-up radiotherapy, and further cases need to be accumulated to determine a successful treatment modality.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
6/53. Squamous cell carcinoma in situ of the penis successfully treated with imiquimod 5% cream.BACKGROUND: Multiple treatments for squamous cell carcinoma in situ (SCCIS) of the penis have been used with variable success and morbidity. Surgery and destructive treatment modalities have significant risk of scarring, deformity, and impaired function. OBJECTIVE: The purpose of this study was to determine whether topical imiquimod 5% cream is a potentially effective treatment for SCCIS of the penis and to qualify treatment associated morbidity. methods: The case of a patient with extensive penile SCCIS is reported. The patient was treated with topical imiquimod 5%, administered daily until blistering occurred (2 cycles). Biopsy specimens were obtained to confirm tumor clearance. RESULTS: One month after therapy was completed, no clinical or histologic evidence of residual tumor was found. Adverse effects of imiquimod included localized tenderness and erythema. No evidence of scarring, deformity, loss of function, or tumor recurrence was noted 18 months after treatment. CONCLUSION: Imiquimod 5% cream may represent an alternative treatment option for SCCIS of the penis.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
7/53. Multiple cutaneous metastases from carcinoma of the penis.A 65-year-old male patient with carcinoma of the penis in association with bilateral inguinal lymphadenopathy and widespread cutaneous dissemination is described. Histopathological examination of the primary tumor and metastatic sites was suggestive of undifferentiated squamous cell carcinoma. The patient was administered combination chemothrapy using cisplatin, methotrexate, and bleomycin with a good response after three cycles. The case is unique because of the rapid onset and widespread nature of skin metastasis and rare presentation.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
8/53. anaphylaxis to cisplatin following nine previous uncomplicated cycles.anaphylaxis to cisplatin is an infrequent life-threatening complication which may occur even in patients who have received prior treatment with cisplatin. We report here a patient with carcinoma of the cervix with recurrent abdominal and thoracic disease who was previously treated with concurrent cisplatin and radiation for local control of pelvic disease. After nine previous uncomplicated cycles she developed severe anaphylaxis to cisplatin. The anaphylactic reaction was managed successfully with corticosteroids, nebulization with beta(2) agonists, and isotonic fluid support. With the extensive use of platinum-based chemotherapy regimens, either alone or in combination with radiation therapy in the management of gynecological malignancies, this uncommon complication should be kept in mind for early detection and successful management.- - - - - - - - - - ranking = 5keywords = cycle (Clic here for more details about this article) |
9/53. Metastatic cutaneous squamous cell carcinoma arising from a previous area of chronic hypertrophic lichen planus.Malignant transformation of cutaneous lichen planus is a rare event. We report a 34 year old Caucasian male who presented with an exophytic tumor on the right foreleg. The tumor gradually developed within previous areas of histologically proven hypertrophic lichen planus that had existed for about 10 years. However, the current histological examination of the excised tumor revealed highly differentiated squamous cell carcinoma with a depth of tumor invasion of 10 mm. At that time, neither sentinel lymph node biopsy nor further imaging diagnostics revealed evidence for metastatic spreading. Nevertheless, five months after surgery inguinal lymph node metastases were detected. Initial chemotherapy and inguinal lymph node dissection were unable to stop the spread of the tumor. One year later, parailiacal lymph node metastases were detected by computed tomography. Further cycles of chemotherapy resulted in significant reduction of the parailiacal tumor masses. This report indicates that the long-standing hypertrophic form of lichen planus seems to have a considerable propensity for malignant transformation, even in young patients.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
10/53. Malignant conversion of florid oral and labial papillomatosis during topical immunotherapy with imiquimod.We report a case of a 61-year-old woman suffering from florid oral papillomatosis with a squamous-cell cancer of the floor of the mouth, which was removed by scalpel surgery combined with a radical neck dissection in 1996. Between 1996 and 2000 several histologically benign papillomatous lesions of mouth and lips were removed with laser and electrosurgery. However, the lesions recurred. In July 2000 hyperkeratotic, wart-like lesions were present at the lower and upper lips and at the right angle of the mouth and the adjacent oral mucosa. Overnight treatment with a topical 5% imiquimod cream on a Monday-Wednesday-Friday schedule was initiated. However, due to severe irritation and pain the application had to be reduced to 4 h per night, three times a week, followed by a therapy-free interval of 2 weeks. Despite this treatment consisting of four cycles of 3 weeks (1 week treatment and 2 weeks pause), the lesions increased markedly in size. A biopsy taken from the tumorous lesion from the right angle of the mouth proved to be a squamous-cell carcinoma. The tumors of the labial and oral mucosal sites as well as the right submandibular lymph nodes were removed by wide scalpel excision. The lips were reconstructed by plastic surgery. 24 months after surgical intervention no recurrence nor metastasis to lymph nodes or distal sites were observed.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
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