scholarly journals Synchronous breast and colon cancer in a young female: a single stage surgery

2021 ◽  
Vol 8 (4) ◽  
pp. 1309
Author(s):  
Mohammed Ayed Abushwemeh ◽  
Nusrat Jabeen ◽  
Asma Al Qaseer ◽  
Mohamed Isa ◽  
Amal Al Rayes ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Family History ◽  
Multidisciplinary Team ◽  
Young Female ◽  
Single Stage ◽  
Synchronous Tumors ◽  
Primary Malignancy ◽  
Colon Cancers ◽  
First Case ◽  
Tumour Board

Synchronous breast and colon cancers are rare, particularly in the absence of family history. Synchronous tumors should always be kept in mind during the staging workup for the primary malignancy. There are no definitive guidelines for the management of synchronous tumors, thus the involvement of tumour board multidisciplinary team is essential. We present a case of a young female patient who was diagnosed with synchronous breast and colon cancer. A handful of synchronous breast and colon cancer cases have been reported and operated at intervals, but up to our knowledge this is the first case operated simultaneously in a single stage surgery.   

Complete distal deltoid muscle detachment: a case report

2020 ◽  
Author(s):  
Naji S. Madi ◽  
Rayane Issa ◽  
Youssef Koaik ◽  
Muhyeddine Al-Taki
Keyword(s):  
Traumatic Injury ◽  
Deltoid Muscle ◽  
Shoulder Function ◽  
Young Female ◽  
Surgical Reconstruction ◽  
Conservative Approach ◽  
Successful Management ◽  
First Case ◽  
Basic Functions ◽  
Musculoskeletal Examination

Abstract Background The deltoid is a large triangular muscle at the shoulder. It attaches proximally to the clavicle, acromion and scapula, while distally it attaches to the lateral deltoid tuberosity. Ruptures are rare, and the literature only reports cases of proximal detachment. In this article, we report the first case of distal traumatic deltoid muscle detachment and its successful management. Case A young female sustained a traumatic injury following a Jet Ski accident with loss of consciousness. A complete distal rupture of the deltoid muscle was diagnosed after the basic functions were regained and a thorough musculoskeletal examination could be conducted. A conservative approach helped her to regain an acceptable shoulder function, but there was persistent pain upon activity and cosmetic scarring. The patient underwent surgical reconstruction. Postoperatively, she recovered satisfactorily. Discussion Distal detachment of the deltoid muscle is rare. The choice for surgical treatment may be undertaken based on several factors including functional status and patient-based assessment.

scholarly journals Activation of the GPR35 pathway drives angiogenesis in the tumour microenvironment

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323363
Author(s):  
Ester Pagano ◽  
Joshua E Elias ◽  
Georg Schneditz ◽  
Svetlana Saveljeva ◽  
Lorraine M Holland ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Tumour Growth ◽  
Tumour Microenvironment ◽  
Tube Formation ◽  
Tissue Remodelling ◽  
Colon Cancers ◽  
Inflammatory Bowel ◽  
Ion Pumping ◽  
G Protein Coupled

ObjectivePrimary sclerosing cholangitis (PSC) is in 70% of cases associated with inflammatory bowel disease. The hypermorphic T108M variant of the orphan G protein-coupled receptor GPR35 increases risk for PSC and ulcerative colitis (UC), conditions strongly predisposing for inflammation-associated liver and colon cancer. Lack of GPR35 reduces tumour numbers in mouse models of spontaneous and colitis associated cancer. The tumour microenvironment substantially determines tumour growth, and tumour-associated macrophages are crucial for neovascularisation. We aim to understand the role of the GPR35 pathway in the tumour microenvironment of spontaneous and colitis-associated colon cancers.DesignMice lacking GPR35 on their macrophages underwent models of spontaneous colon cancer or colitis-associated cancer. The role of tumour-associated macrophages was then assessed in biochemical and functional assays.ResultsHere, we show that GPR35 on macrophages is a potent amplifier of tumour growth by stimulating neoangiogenesis and tumour tissue remodelling. Deletion of Gpr35 in macrophages profoundly reduces tumour growth in inflammation-associated and spontaneous tumour models caused by mutant tumour suppressor adenomatous polyposis coli. Neoangiogenesis and matrix metalloproteinase activity is promoted by GPR35 via Na/K-ATPase-dependent ion pumping and Src activation, and is selectively inhibited by a GPR35-specific pepducin. Supernatants from human inducible-pluripotent-stem-cell derived macrophages carrying the UC and PSC risk variant stimulate tube formation by enhancing the release of angiogenic factors.ConclusionsActivation of the GPR35 pathway promotes tumour growth via two separate routes, by directly augmenting proliferation in epithelial cells that express the receptor, and by coordinating macrophages’ ability to create a tumour-permissive environment.

scholarly journals Enhancing the performance of gastrointestinal tumour board by improving documentation

2018 ◽  
Vol 7 (1) ◽  
pp. e000168 ◽  
Author(s):  
Roaa Saleh Alsuhaibani ◽  
Hajer Alzahrani ◽  
Ghada Algwaiz ◽  
Haneen Alfarhan ◽  
Ashwaq Alolayan ◽  
...  
Keyword(s):  
Performance Measures ◽  
Multidisciplinary Team ◽  
Positive Impact ◽  
Team Approach ◽  
Rapid Improvement ◽  
Past Performance ◽  
Pdsa Cycle ◽  
Tumour Board ◽  
Medical Records System ◽  
Documentation Tool

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan–Do–Study–Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts’ input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and outcomes.

scholarly journals Synchronous NET and colorectal cancer development: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shinsei Yumoto ◽  
Yuji Miyamoto ◽  
Takahiko Akiyama ◽  
Yuki Kiyozumi ◽  
Kojiro Eto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Systemic Therapy ◽  
Multiple Organ ◽  
Cancer Development ◽  
Sigmoid Colon Cancer ◽  
Synchronous Tumors ◽  
Case Presentation ◽  
The Difference ◽  
Rectal Neuroendocrine Tumor

Abstract Background The incidence of synchronous gastrointestinal neuroendocrine tumors (GI-NETs) and colorectal cancer is very low. Case presentation We present a 72-year-old man diagnosed with a rectal neuroendocrine tumor (NET) with multiple organ metastases and simultaneous sigmoid colon cancer. Although the NET was his prognostic factor, he underwent a laparoscopic sigmoidectomy at first because it was expected that the colon cancer would cause obstruction or bleeding during NET treatment. Subsequently, he started taking everolimus. Conclusions We should consider surgical resection of the synchronous cancer before systemic therapy for a GI-NET regardless of the difference in prognosis between synchronous tumors, if the cancer may impair the continuation of systemic therapy.

Non-syndromic oligodontia in siblings: A spectrum of experience

Dental Update ◽  
2021 ◽  
Vol 48 (2) ◽  
pp. 135-139
Author(s):  
Claudia Heggie ◽  
L Gartshore
Keyword(s):  
Family History ◽  
Preventive Care ◽  
Dental Care ◽  
Multidisciplinary Team ◽  
Dental Students ◽  
Permanent Teeth ◽  
Tooth Surface ◽  
Affect Expression ◽  
Relevant Family History

Non-syndromic oligodontia, the agenesis of six or more teeth, has a prevalence of 0.14–0.25%. Genetic, epigenetic and environmental influences affect expression. Three brothers presented with agenesis of 14, 21 and 23 permanent teeth, respectively. They were medically well, with no relevant family history. Each case presented with caries, microdontia and attritive tooth surface loss. Comprehensive care was delivered in each case by undergraduate dental students. Individualized prevention and stabilization were completed before referral for multidisciplinary long-term planning. Primary dental care practitioners are instrumental in delivering preventive care and stabilizing the dentition in cases of dental anomaly, while sharing care with specialist teams. CPD/Clinical Relevance: An unusual presentation of non-syndromic oligodontia relevant to primary dental care practitioners who are likely to provide the first clinical contact and referral to the wider multidisciplinary team.

Solitary Peutz-Jeghers Type Polyp of Jejunum with Gastric Fundic and Antral Gland Lining Mucosa: A Case Report and Review of Literature

2021 ◽  
pp. 106689692110677
Author(s):  
Bella Lingjia Liu ◽  
Huifang Zhou ◽  
Martina Risech ◽  
Alex Ky ◽  
Jane Houldsworth ◽  
...  
Keyword(s):  
Family History ◽  
Small Bowel ◽  
Smooth Muscles ◽  
Fundic Gland ◽  
Muscularis Mucosa ◽  
Hamartomatous Polyp ◽  
Gi Tract ◽  
First Case ◽  
Mucocutaneous Pigmentation ◽  
Peutz Jeghers Syndrome

Solitary Peutz-Jeghers type polyps are characterized by a hamartomatous polyp of the gastrointestinal (GI) tract in a patient without mucocutaneous pigmentation, family history of Peutz-Jeghers syndrome, or STK11/LKB1 mutations. Histologically identical to the polyps in Peutz-Jeghers syndrome, these sporadic polyps can arise anywhere along the GI tract, with typical arborizing smooth muscles extending from the muscularis mucosa. While the lining mucosa is generally the same as the organ in which it arises, gastric pyloric and osseous metaplasia have been reported in intestinal polyps in Peutz-Jeghers syndrome. Herein, the authors report the first case of a small intestinal solitary Peutz-Jeghers type polyp with gastric antral and fundic gland lining mucosa. A 43-year-old male was admitted for small bowel obstruction. Diagnostic laparoscopy revealed jejuno-jejunal intussusception with an associated polyp measuring 7.2 cm. Histological examination showed a hamartomatous polyp with arborizing smooth muscle bundles extending from the muscularis mucosae. The polyp was lined by non-dysplastic gastric antral and fundic gland mucosa, and was sharply demarcated from the adjacent non-polypoid intestinal mucosa. Colonoscopy, esophagogastroduodenoscopy and small bowel enteroscopy revealed no additional polyps or masses. Thorough investigation of the patient's family history was negative for Peutz-Jeghers syndrome or mucocutaneous pigmentation. Molecular analysis of the lesion was negative for STK11/LKB1 mutations. A diagnosis of solitary Peutz-Jeghers type polyp of the small bowel with gastric antral and fundic gland mucosal lining was rendered.

scholarly journals Age-related inequalities in colon cancer treatment persist over time: a population-based analysis

2018 ◽  
Vol 73 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Louise Hayes ◽  
Lynne Forrest ◽  
Jean Adams ◽  
Mira Hidajat ◽  
Yoav Ben-Shlomo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Treatment ◽  
Treatment Decision ◽  
Population Based ◽  
Surgical Patients ◽  
Area Deprivation ◽  
Treatment Decision Making ◽  
Colon Cancers ◽  
Age Related ◽  
Over Time

BackgroundOlder people experience poorer outcomes from colon cancer. We examined if treatment for colon cancer was related to age and if inequalities changed over time.MethodsData from the UK population-based Northern and Yorkshire Cancer Registry on 31 910 incident colon cancers (ICD10 C18) diagnosed between 1999–2010 were obtained. Likelihood of receipt of: (1) cancer-directed surgery, (2) chemotherapy in surgical patients, (3) chemotherapy in non-surgical patients by age, adjusting for sex, area deprivation, cancer stage, comorbidity and period of diagnosis, was examined.ResultsAge-related inequalities in treatment exist after adjustment for confounding factors. Patients aged 60– 69, 70–79 and 80+ years were significantly less likely to receive surgery than those aged <60 years (multivariable ORs (95% CI) 0.84(0.74 to 0.95), 0.54(0.48 to 0.61) and 0.19(0.17 to 0.21), respectively). Age-related differences in receipt of surgery and adjuvant chemotherapy (but not chemotherapy in non-surgical patients) narrowed over time for the ’younger old’ (aged <80 years) but did not diminish for the oldest patients.ConclusionsAge inequality in treatment of colon cancer remains after adjustment for confounders, suggesting age remains a major factor in treatment decisions. Research is needed to better understand the cancer treatment decision-making process, and how to influence this, for older patients.

scholarly journals Alteration in the immune microenvironment based on APC status in MSS/pMMR colon cancer data retrieved from TCGA

2020 ◽  
Author(s):  
Haishan Lin ◽  
Hongchao Zhen ◽  
Kun Shan ◽  
Xiaoting Ma ◽  
Bangwei Cao
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Enrichment Analysis ◽  
Tumor Immunotherapy ◽  
Immune Checkpoints ◽  
Immune Microenvironment ◽  
Cancer Data ◽  
T Cell Infiltration ◽  
Colon Cancers ◽  
Tumor Immune Microenvironment

Abstract Immunotherapy is currently the most advanced anti-tumor treatment approach. The efficacy of anti-tumor immunotherapy is closely related to the tumor immune microenvironment, including immune cells, infiltration of immune factors, and expression of immune checkpoints. At present, the biomarkers for predicting the efficacy of colon cancer immunotherapy do not cover all colon cancer patients suitable for immunotherapy. In this study, TCGA database was used to identify tumor genotypes suitable for anti-tumor immunotherapy. We found that some of the MSS/pMMR populations, that were initially considered unsuitable for immunotherapy, might actually be suitable. In APC-wt/MSS colon cancer, the expression of PD-1, PD-L1, CTLA4 and CYT（GZMA and PRF1）were increased. Based on calculations done by ESTIMATE and CIBERSORT algorithms, the ImmunoScore and the proportion of CT8+ T cell infiltration is increased in these patients. Enrichment analysis was done to screen signaling pathways involved in immune response, extracellular matrix, and cell adhesion. Tumors from 42 colon cancer patients, including 22 APC-mt/MSS and 20 APC-wt/MSS, were immunohistochemically evaluated for expression of CD8 and PD-L1. And APC-wt/MSS tumors showed significantly higher expression of CD8 and PD-L1 than APC-mt/MSS tumor. Based on the results, we found that some colon cancers of APC-wt/MSS are classified by Tumor Immune Microenvironment types (TIMTs) TMIT I. So that we speculate that APC-wt/MSS colon cancer patients could benefit from anti-tumor immunotherapy.

scholarly journals A Rare Case of Left Ventricular Non-Compaction with Coronary Artery Anomaly Complicated by ST-Elevation Myocardial Infarction and Subcutaneous Defibrillator Implantation

2022 ◽  
Vol 19 (2) ◽  
pp. 791
Author(s):  
Francesca Romana Prandi ◽  
Federica Illuminato ◽  
Chiara Galluccio ◽  
Marialucia Milite ◽  
Massimiliano Macrini ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Family History ◽  
Lateral Wall ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Congenital Defects ◽  
Circumflex Artery ◽  
First Case ◽  
The Right

Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis and characterized by the persistence of ventricular hypertrabeculation, isolated or associated to other congenital defects. A 33-year-old male, with family history of sudden cardiac death (SCD), presented to our ER with typical chest pain and was diagnosed with anterior STEMI. Coronary angiography showed an anomalous origin of the circumflex artery from the right coronary artery and a critical stenosis on the proximal left anterior descending artery, treated with primary percutaneous coronary intervention. The echocardiogram documented left ventricular severe dysfunction with lateral wall hypertrabeculation, strongly suggestive for non-compaction, confirmed by cardiac MRI. At 3 months follow up, for the persistence of the severely depressed EF (30%) and the family history for SCD, the patient underwent subcutaneous ICD (sICD) implantation for primary prevention. To the best of our knowledge, this is the first case of LVNC associated with anomalous coronary artery origin and STEMI reported in the literature. Arrhythmias are common in LVNC due to endocardial hypoperfusion and fibrosis. sICD overcomes the risks of transvenous ICD, and it is a valuable option when there is no need for pacing therapy for bradycardia, cardiac resynchronization therapy and anti-tachycardia pacing.

Sign in / Sign up

Export Citation Format

Share Document