An atypical presentation of extensive centrofacial microcystic adnexal carcinoma responding to radiation: A case report and review of the literature

Microcystic adnexal carcinoma is a rare cutaneous neoplasm believed to arise from pluripotent keratinocytes capable of adnexal differentiation. Due to its insidious growth and appearance, diagnosis is often delayed. A deep incisional or excisional biopsy for histopathology is the gold standard for diagnosis. Different treatment modalities have been described in the literature, including the Mohs micrographic surgery, standard excision, radiation, chemotherapy, and observation. Currently, Mohs remains the treatment of choice. We present a unique case of a 12-month history of an extensive progressive centrofacial cutaneous induration diagnosed as microcystic adnexal carcinoma in an 83-year-old female. Due to the extensive nature of the tumor, she received radiation therapy and continues to receive ongoing assessment with no evidence of clinical recurrence at 2-year post-treatment including negative scouting biopsies. To date, there is no consensus on the optimal treatment for microcystic adnexal carcinoma.

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Stage IAE Follicular Lymphoma of the Breast: Case Report and Review of the Literature

Case Reports in Oncological Medicine ◽

10.1155/2013/597527 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

Raymon Patron ◽

Edward F. Miles

Keyword(s):

Breast Carcinoma ◽

Follicular Lymphoma ◽

Excisional Biopsy ◽

Treatment Modalities ◽

Caucasian Woman ◽

Primary Lymphoma ◽

Primary Breast Carcinoma ◽

Rare Entity ◽

Review Of The Literature ◽

Breast Malignancies

Primary lymphoma of the breast is a rare entity in the field of oncological medicine and represents <0.5% of all breast malignancies. A definitive diagnosis is obtained by excisional biopsy as the clinical and radiographical presentation is similar to the more common primary breast carcinoma. Unlike primary breast carcinoma, localized radiation therapy is the mainstay of treatment. We report on a case of primary follicular lymphoma of the breast in a 67-year-old Caucasian woman treated with localized radiation as well as coinciding literature review regarding outcomes of different treatment modalities.

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Comorbidities at time of diagnosis as a predictor of more or less aggressive treatment modalities in early-invasive breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12591 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12591-e12591

Author(s):

Sreejata Raychaudhuri ◽

Jaclyn M Kyko ◽

Julie J. Ruterbusch ◽

Jennifer Lynn Beebe-Dimmer ◽

Ann G. Schwartz ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Hormone Therapy ◽

Invasive Breast Cancer ◽

Advanced Age ◽

Treatment Modalities ◽

Comorbidity Burden ◽

History Of ◽

To Receive ◽

Localized Treatment

e12591 Background: Comorbidities and advanced age have been shown to play important roles in breast cancer treatment and outcomes. Reduced doses of chemotherapy, worse treatment-related side-effects, poor performance status in patients with significant comorbidities, and the biological interplay between other diseases and cancer may also play roles. We evaluated the relationship between age and pre-existing comorbidities and receipt of local and systemic therapy in a cohort of African American (AA) women with early invasive breast cancer. Methods: The study population included 1,169 AJCC stage I-III invasive breast cancer survivors from the Detroit Research on Cancer Survivors (ROCS) study, a large cohort of AA cancer survivors. Comorbidities (both individual diseases and a combined count that was categorized as low/medium/high comorbidity burden), age at diagnosis, and other demographic variables were obtained from self-reported standardized questionnaires. Cancer-related variables including treatment were obtained from the Metropolitan Detroit Cancer Surveillance System registry. Recommended treatment was subdivided into localized (surgery ± radiation; N = 1,156), hormonal (N = 848) and chemotherapy (N = 680). Logistic regression estimated the associations between age and pre-existing comorbid conditions and the receipt of recommended treatments. Adjusted models included variables that were selected a priori and were significant predictors in univariate analysis. Results: Most women received recommended localized treatment (82.6%), hormone treatment (73.7%), and chemotherapy (79.9%). There were no differences in receipt of localized treatment based on age or comorbidity burden in adjusted analyses. However, arthritis and depression were significantly associated with not receiving recommended localized treatment (Odds ratio (OR): 0.66, 95% CI: 0.47, 0.93 and OR: 0.53, 95% CI: 0.36, 0.78, respectively). Women with a history of obesity (BMI ≥30) were more likely to receive recommended hormone therapy (OR: 1.64, 95% CI: 1.19, 2.26), while women with congestive heart failure were less likely (OR: 0.46, 95% CI: 0.23, 0.90). Receipt of recommended chemotherapy was less likely for those with increasing age (Ptrend< 0.01) and increasing comorbidity burden (Ptrend= 0.02). Those with a history of arthritis (OR: 0.66, 95% CI: 0.44, 0.99) and hypercholesterolemia (OR: 0.62, 95% CI: 0.41, 0.95) were also less likely to receive recommended chemotherapy. Conclusions: Advanced age and presence of pre-existing co-morbid medical conditions appears to influence the receipt of chemotherapy, while individual conditions were associated with receipt of local treatment or hormone therapy in a cohort of AA survivors, suggesting the importance of providing comprehensive medical care for all women with early invasive breast cancer.

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Primary Chondroblastic Osteosarcoma of the Breast in a Teenager: What Is Changing?

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz117.009 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S88-S89

Author(s):

James Yahaya

Keyword(s):

Triple Negative ◽

Previous History ◽

Phyllodes Tumor ◽

Excisional Biopsy ◽

Left Breast ◽

Treatment Modalities ◽

Large Tumor ◽

Primary Osteosarcoma ◽

History Of ◽

Chondroblastic Osteosarcoma

Abstract Background Nonepithelial tumors of the breast are extremely rare and have an incidence of less than 1%. The most common nonepithelial breast tumor is phyllodes tumor (PT), which accounts for 61%. Primary osteosarcomas of the breast contribute up to only 12.5% of all the extraosseous osteosarcomas, and among young females, they are extremely rare, especially in those without a previous history of primary bone osteosarcoma. A case of a 16-year-old female with primary chondroblastic osteosarcoma of the left breast is herein presented. Case Description In this report, we describe and report a 16-year-old female with neither a previous history of bone osteosarcoma nor a family history of breast cancer who was diagnosed with a primary chondroblastic osteosarcoma of the left breast. The mass was shining, warm, firm, and slightly fixed. The excisional biopsy showed a large tumor measuring 11 × 9 × 7 cm, encapsulated, grayish-white, and nodular. The H&E-stained sections showed a tumor composed of atypical spindle cells, large pleomorphic epithelioid cells, and multinucleated cells of osteoclastic type with osteoid formation with abundant areas having malignant chondroid matrix. About 40 atypical mitoses/10 HPF were seen. A diagnosis of primary osteosarcoma was made. Immunohistochemically, the tumor was triple negative, vimentin was strongly positive, SMA was focally positive, and AE1/AE3 was negative. The patient was put under observation. Her postoperative course is generally promising without any complaint of pain. We present a case of a very young female with the rarest diagnosis of primary osteosarcoma involving the left breast. Conclusion Primary osteosarcomas of the breast carry poor prognosis by being triple negative, and because of being the rarest tumors, they pose a challenge in managing the patients due to lack of established treatment modalities.

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Rosai-Dorfman-Destombes disease: isolated intracranial without nodal involvement presentation. Illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case21238 ◽

2021 ◽

Vol 1 (24) ◽

Author(s):

César Chong ◽

Xavier Wong-Achi ◽

Cinthya Apolo

Keyword(s):

Clinical Course ◽

Excisional Biopsy ◽

Therapeutic Management ◽

Treatment Modalities ◽

Pathology Report ◽

Illustrative Case ◽

Resonance Imaging ◽

History Of ◽

The Brain

BACKGROUND Rosai-Dorfman-Destombes disease is a rare and heterogeneous entity that has been associated with autoimmune, hereditary, and malignant diseases. There is controversy about its etiopathogenesis, clinical course, and therapeutic management. OBSERVATIONS The authors report a case of a 61-year-old man with a history of progressive headache without any other symptoms. Magnetic resonance imaging of the brain revealed multiple irregular lesions with an initial diagnostic impression of meningiomatosis. An excisional biopsy was performed, and the pathology report stated the finding was Rosai-Dorfman-Destombes disease. LESSONS The uniqueness of this case is its rarity. The isolated intracranial location presents many diagnostic and therapeutic challenges, with radiological and clinical characteristics similar to those of other central nervous system tumors. There is currently no clear evidence of the pathogenesis and therapeutic management of this condition. Follow-up of these patients will help elucidate the natural history of this condition and the benefits of various treatment modalities.

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Unusual Clinical Presentation of Cutaneous Angiosarcoma Masquerading as Eczema: A Case Report and Review of the Literature

Case Reports in Dermatological Medicine ◽

10.1155/2013/906426 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Nhat Q. Trinh ◽

Issra Rashed ◽

Kelli A. Hutchens ◽

Aileen Go ◽

Edward Melian ◽

...

Keyword(s):

Case Report ◽

Clinical Manifestation ◽

Unusual Case ◽

Clinical Presentation ◽

Excisional Biopsy ◽

Topical Steroids ◽

Review Of The Literature ◽

Facial Erythema ◽

History Of ◽

Single Modality

An unusual case of cutaneous angiosarcoma clinically mimicking eczema is described. A 98-year-old Caucasian male presented with a 6-month history of a flesh-colored, subcutaneous nodule on his left forehead with contralateral facial erythema and scaling that had been previously diagnosed as eczema. Despite treatments with topical steroids and moisturizers, the condition did not resolve. At our clinic, excisional biopsy of the forehead lesion and scouting biopsies from the contralateral cheek were performed which revealed cutaneous angiosarcoma. The described case illustrates that dermatitis-like features should be considered as a rare clinical manifestation of cutaneous angiosarcoma. It also demonstrates that these lesions may respond well to radiotherapy as a single modality.

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Lumbar nerve root compression due to extramedullary hemopoiesis in a patient with thalassemia: complete clinical regression with radiation therapy

Journal of Neurosurgery Spine ◽

10.3171/spi.2007.6.2.156 ◽

2007 ◽

Vol 6 (2) ◽

pp. 156-160 ◽

Cited By ~ 3

Author(s):

Philippos Tsitsopoulos ◽

Dimitris Zevgaridis ◽

Parmenion Tsitsopoulos ◽

Christos Tsonidis ◽

Ioannis Anagnostopoulos ◽

...

Keyword(s):

Radiation Therapy ◽

Nerve Root ◽

Lesion Size ◽

Nerve Root Compression ◽

Review Of The Literature ◽

Unique Case ◽

Lumbar Nerve Root ◽

Hemopoietic Tissue ◽

History Of

✓The authors describe the case of a 24-year-old woman who had a history of β-thalassemia and presented with severe symptoms of lumbar nerve root compression due to extramedullary hemopoiesis in the intervertebral foramen. Radiation therapy (2000 cGy in six fractions) was delivered to the mass. The patient’s neurological symptoms completely resolved following treatment. Follow-up images showed a reduction in lesion size. The results of this unique case supported by a review of the literature suggest that radiation therapy alone is an effective modality in the treatment of patients with compression of neural structures due to extramedullary hemopoietic tissue.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

2020 ◽

Author(s):

Adam Lee ◽

Adam Bajinting ◽

Abby Lunneen ◽

Colleen M. Fitzpatrick ◽

Gustavo A. Villalona

Keyword(s):

Literature Review ◽

Retrospective Review ◽

Review Of The Literature ◽

Rare Presentation ◽

Spontaneous Pneumomediastinum ◽

Nonaccidental Trauma ◽

Comprehensive Literature Review ◽

Healthy Infants ◽

History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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Pseudo-Parkinson Disease Secondary to Ritonavir–Buspirone Interaction

Annals of Pharmacotherapy ◽

10.1177/106002800303700207 ◽

2003 ◽

Vol 37 (2) ◽

pp. 202-205 ◽

Cited By ~ 9

Author(s):

Patrick G Clay ◽

Molly M Adams

Keyword(s):

Drug Interaction ◽

Inhibitory Effect ◽

Hiv Positive ◽

High Dose ◽

Resting Tremor ◽

Case Summary ◽

History Of ◽

Drug Drug Interaction ◽

To Receive

OBJECTIVE: To report a case of Parkinson-like symptoms appearing in a patient after introduction of ritonavir to buspirone therapy. CASE SUMMARY: A 54-year-old HIV-positive white man presented to the clinic with a 2-week history of ataxia, shuffling gait, cogwheel rigidity, resting tremor, and sad affect with masked features. This patient had been receiving high-dose buspirone (40 mg every morning and 30 mg every evening) for 2 years prior to the introduction of ritonavir/indinavir combination therapy (400 mg/400 mg twice daily) 6 weeks prior to initiation of the above symptoms. Buspirone was decreased to 15 mg 3 times daily, ritonavir/indinavir was discontinued, and amprenavir 1200 mg twice daily was added. The patient's symptoms began to subside after 1 week, with complete resolution after about 2 weeks. The patient continued to receive buspirone for an additional 12 months without recurrence of symptoms. DISCUSSION: This is the first reported interaction of buspirone and antiretrovirals. Buspirone, extensively metabolized by CYP3A4, was likely at supratherapeutic levels due to the inhibitory effect of ritonavir and, secondarily, indinavir. The Parkinson-like symptoms developed rapidly and severely, impacted this patient's quality of life, and necessitated significant clinic expenditures to identify this drug–drug interaction. CONCLUSIONS: This case demonstrates a severe drug–drug interaction between buspirone and ritonavir and further demonstrates the need for awareness of the metabolic profile for all agents an HIV-infected patient is receiving.

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History of Extensive Disease Small Cell Lung Cancer Treatment: Time to Raise the Bar? A Review of the Literature

Cancers ◽

10.3390/cancers13050998 ◽

2021 ◽

Vol 13 (5) ◽

pp. 998

Author(s):

Chiara Lazzari ◽

Aurora Mirabile ◽

Alessandra Bulotta ◽

Maria Grazia Viganó ◽

Francesca Rita Ogliari ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Treatment Time ◽

Small Cell ◽

Review Of The Literature ◽

Small Cell Lung ◽

Extensive Disease ◽

History Of ◽

Line Standard

Several trials have tried for decades to improve the outcome of extensive disease small cell lung cancer (ED-SCLC) through attempts to modify the standard treatments. Nevertheless, platinum/etoposide combination and topotecan have remained respectively the first and the second line standard treatments for the last 40 years. With the advent of immunotherapy, this scenario has finally changed. Our review aims to provide an overview of the primary studies on the actual therapeutic strategies available for ED-SCLC patients, and to highlight emerging evidence supporting the use of immunotherapy in SCLC patients.

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Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents

Science Advances ◽

10.1126/sciadv.abf6780 ◽

2021 ◽

Vol 7 (15) ◽

pp. eabf6780

Author(s):

Corinde E. Wiers ◽

Leandro F. Vendruscolo ◽

Jan-Willem van der Veen ◽

Peter Manza ◽

Ehsan Shokri-Kojori ◽

...

Keyword(s):

Ketogenic Diet ◽

Alcohol Withdrawal ◽

Alcohol Use Disorder ◽

Alcohol Intake ◽

Anterior Cingulate ◽

Dorsal Anterior Cingulate Cortex ◽

Beneficial Effects ◽

Alcohol Cues ◽

History Of ◽

To Receive

Individuals with alcohol use disorder (AUD) show elevated brain metabolism of acetate at the expense of glucose. We hypothesized that a shift in energy substrates during withdrawal may contribute to withdrawal severity and neurotoxicity in AUD and that a ketogenic diet (KD) may mitigate these effects. We found that inpatients with AUD randomized to receive KD (n = 19) required fewer benzodiazepines during the first week of detoxification, in comparison to those receiving a standard American (SA) diet (n = 14). Over a 3-week treatment, KD compared to SA showed lower “wanting” and increased dorsal anterior cingulate cortex (dACC) reactivity to alcohol cues and altered dACC bioenergetics (i.e., elevated ketones and glutamate and lower neuroinflammatory markers). In a rat model of alcohol dependence, a history of KD reduced alcohol consumption. We provide clinical and preclinical evidence for beneficial effects of KD on managing alcohol withdrawal and on reducing alcohol drinking.

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