Sebaceous carcinoma of the eyelid

Sebaceous carcinoma belongs to rare malignant tumors of the eyelids, is characterized by a variety of clinical manifestations and is often disguised as other tumors or inflammatory diseases of the eyelids. The purpose of the work is to analyze the clinical picture and features of the course of sebaceous carcinoma. Material and methods. From January 2015 to December 2020, 6 patients were diagnosed with cancer of the sebaceous gland (5 patients with adenocarcinoma of the meibomian glands, 1 with adenocarcinoma of the Zeiss sebaceous glands). 4 were women and 2 were men aged from 59 to 89 years. Results. From the moment the first symptoms appeared to adequate treatment, 6-12 months passed. According to the 8th revision of the T-classification of malignant tumors of the AJCC eyelids, two patients had T2b, three had T3b, and one patient had T3c stage. A painless thickening of the eyelid cartilage and the eyelid margin was accompanied by the growth of yellowish dense masses on the conjunctiva in two women; the tumor spread to the eyelid skin in one patient. By the time the primary tumor was diagnosed, none of the patients had metastases to regional lymph nodes and hematogenous metastases. Wide excision of the tumor with simultaneous plastic surgery of the eyelid was performed in 4 patients. After excisional biopsy, 3 patients underwent local external beam radiation therapy to the area of the affected eyelid (Total dose 60 Gy.). Orbital exenteration was performed in two patients. The observation period for the patients: 3 months – 49 months. One patient died of a cause unrelated to the tumor. One patient died of metastases of Zeiss glands adenocarcinoma. Relapse of the tumor developed and metastasis to the preauricular lymph node appeared in one patient. Conclusion. Diagnosis of the sebaceous gland cancer of the eyelids is difficult, it is detected late. Ki67 does not depend on the size of the tumor, however, the large size of the tumor is an unfavorable factor in the prognosis of the disease. All patients with cancer of the sebaceous gland after treatment need to be followed up for at least 5 years with whole body PET/CT once a year. Key words: sebaceous carcinoma of the eyelids, adenocarcinoma of the meibomian glands, adenocarcinoma of the Zeiss sebaceous glands.

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Safety and feasibility of rhenium-186 nanoliposome (186RNL) in recurrent glioma: The ReSPECT phase 1 trial.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.2061 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 2061-2061

Author(s):

Andrew J. Brenner ◽

Ande Bao ◽

William Phillips ◽

Gregory Stein ◽

Vibhudutta Awasthi ◽

...

Keyword(s):

Dose Escalation ◽

Tumor Volume ◽

Phase 1 ◽

Absorbed Dose ◽

External Beam Radiation ◽

Whole Body ◽

Recurrent Glioma ◽

Normal Brain ◽

Beam Radiation ◽

The Mean

2061 Background: While external beam radiation therapy (EBRT) remains a central component of the management of primary brain tumors, it is limited by tolerance of the surrounding normal brain tissue. Rhenium-186 NanoLiposome (186RNL) permits the delivery of beta-emitting radiation of high specific activity with excellent retention in the tumor. We report the results of the phase 1 study in recurrent glioma. Methods: A Phase 1 dose-escalation study of 186RNL in recurrent glioma utilizing a standard 3+3 design was undertaken to determine the maximum tolerated dose of 186RNL. 186RNL is administered by convection enhanced delivery (CED). Infusion is followed under whole body planar imaging and SPECT/CT. Repeat SPECT/CT imaging is performed immediately following, and at 1, 3, 5, and 8 days after 186RNL infusion to obtain dosimetry and distribution. Subjects were followed until disease progression by RANO criteria. Results: Eighteen subjects were treated across 6 cohorts. The mean tumor volume was 9.4 mL (range 1.1 – 23.4). The infused dose ranged from 1.0 mCi to 22.3 mCi and the volume of infusate ranged from 0.66 mL to 8.80 mL. From 1 – 4 CED catheters were used. The maximum catheter flow rate was 15 µl/min. The mean absorbed dose to the tumor volume was 239 Gy (CI 141 – 337; range 9 - 593), to normal brain was 0.72 Gy (CI 0.34 – 1.09; range 0.005 – 2.73), and to total body was 0.07 Gy (CI 0.04 – 0.10; range 0.001 – 0.23). The mean absorbed dose to the tumor volume when the percent tumor volume in the treatment volume was 75% or greater (n = 10) was 392 Gy (CI 306 – 478; range 143 – 593). Scalp discomfort and tenderness related to the surgical procedure did occur in 3 subjects. The therapy has been well tolerated, no dose-limiting toxicity has been observed, and no treatment-related serious adverse events have occurred despite markedly higher absorbed doses typically delivered by EBRT in patients with prior treatment. Responses have been observed supporting the clinical activity. Final results from the dose escalation will be presented. Conclusions: 186RNL administered by CED to patients with recurrent glioma results in a much higher absorbed dose of radiation to the tumor compared to EBRT without significant toxicity. The recommended Phase 2 dose is 22.3 mCi in 8.8 mL of infusate. Clinical trial information: NCT01906385. [Table: see text]

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SUN-LB77 Incidental Anaplastic Thyroid Carcinoma: An Uncommon Entity

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2034 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Preethi Padmanaban ◽

Eric Nylen

Keyword(s):

Thyroid Cancer ◽

Adjuvant Therapy ◽

Median Survival ◽

Anaplastic Thyroid Cancer ◽

Anaplastic Carcinoma ◽

External Beam Radiation ◽

Whole Body ◽

American Thyroid Association ◽

Beam Radiation ◽

Disease Free

Abstract Background: Anaplastic thyroid cancer is an aggressive thyroid malignancy with a median survival of 3 to 9 months. It is rare and represents 2-5% of all thyroid tumors. Even more uncommonly in about 2%–6% of all ATC cases, it is identified as a small, incidental finding after surgical resection of a predominantly non-anaplastic tumor. Clinical Case: We report a case of 67 year old Caucasian male who presented with history of hoarseness of voice for one month. Fine needle aspiration biopsy of right dominant thyroid nodule revealed papillary thyroid cancer. Pre-operative imaging was negative for involvement of surrounding structures or distant metastasis. He underwent total thyroidectomy and final pathology revealed Anaplastic carcinoma arising in papillary carcinoma measuring 3.6cm in greatest dimension. Undifferentiated (Anaplastic) Carcinoma comprised approximately 5% of the tumor. Areas from anaplastic and papillary tumor were dissected separately. DNA separated from these two specimens were analyzed by PCR amplification and both were positive for BRAF mutation. External beam radiation and radioactive iodine therapy were administered after surgery. Given absence of invasion or metastasis adjuvant therapy was not initiated. His positron emission tomography, computed tomography imaging and whole-body scan has been negative for residual/ recurrent or metastatic disease. He remains disease free at 18 months after diagnosis. Discussion: Anaplastic thyroid cancer is a rare but highly aggressive tumor. In most cases it develops from a pre-existing well differentiated thyroid cancer. ATC incidence typically peaks at the 6-7th decade of life, predominantly in women. The median survival is between 3 to 9 months with less than 10% of patients alive 3 years after the time of diagnosis. Because of its aggressive behavior, the American Joint Committee on Cancer Staging Manual classifies all Anaplastic thyroid cancer Stage IV tumors. Surgery, chemotherapy and radiotherapy are the conventional therapeutic strategies performed in the attempt to improve survival. However, incidental anaplastic thyroid cancer is rare variant with very few reported cases. American Thyroid Association (ATA) Guidelines for Management of Patients with ATC do not include specific recommendations for this form of ATC. There is no consensus to define best treatment approach as to whether intrathyroidal incidentally detected ATC is best treated with surgery alone, surgery followed by radiotherapy, or surgery followed by chemotherapy plus radiation therapy. Conclusion: Based on review of our case as well as outcomes of similar reported cases, prognosis is favorable for incidental anaplastic thyroid cancer. Hopefully, with more data from similar cases to demonstrate difference in disease free survival we should be able to define the role of chemotherapy and adjuvant therapy for incidental ATC better. The question remains open, as to whether incidental anaplastic thyroid cancer should be considered as a separate entity from aggressive form of ATC.

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Cutaneous sebaceous gland carcinoma in the postauricular region

The Journal of Laryngology & Otology ◽

10.1017/s0022215100117906 ◽

1991 ◽

Vol 105 (11) ◽

pp. 954-956 ◽

Cited By ~ 5

Author(s):

Ataman Guneri ◽

M. Ufuk Gunbay ◽

Ismail Deniz ◽

Kaplan Demirdoven

Keyword(s):

Poor Prognosis ◽

Sebaceous Gland ◽

Sebaceous Carcinoma ◽

Sebaceous Glands ◽

Sebaceous Gland Carcinoma ◽

Large Size ◽

Gland Carcinoma

AbstractCarcinomas of the sebaceous glands of the skin are uncommon. These tumours metastasize frequently. A case of cutaneous sebaceous carcinoma localized in the postauricular region is presented with its exceptional large size and very poor prognosis.

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Papillary Thyroid Carcinoma Presented with Huge Bone Metastases Right Ileum and Frontal Bones

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v17i1.22504 ◽

2015 ◽

Vol 17 (1) ◽

pp. 125-132

Author(s):

Fatima Begum ◽

Sadia Sultana ◽

Nabeel Fahmi Ali ◽

Mohshi Um Mokaddema ◽

Nurun Nahar

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Radioiodine Therapy ◽

Frontal Region ◽

External Beam Radiation ◽

Whole Body ◽

Surgical Removal ◽

Papillary Thyroid ◽

Beam Radiation ◽

History Of

Papillary thyroid carcinoma (PTC) without metastases is most curable cancer. However, it rarely metastasizes to bone and in those cases prognosis is poor. A 55 years old female has presented with history of painless swelling on frontal region of skull for one year and limping gait to National Institute of Nuclear Medicine and Allied Sciences (NINMAS) in September 2013. She also had total thyroidectomy for multinodular goiter in early 2013. She had history of excision of swelling on frontal region in July of same year. Histopathological report of excised mass confirmed metastatic PTC. The patient again developed visible swelling on frontal region of skull suggesting recurrence. Her serum TSH was low 0.89 mIU/L without levothyroxine supplement may be due to thyroid hormones produced from metastatic masses. Serum thyroglobulin level was 464 ng/ml. X-ray of pelvis and skull showed huge soft tissue masses arising from right ileum and a lytic lesion on posterior aspect of frontal region. Whole body bone scan with 99m Technetium methylene diphosphonate (MDP) revealed a doughnut lesion of frontal bone and a big lesion with hot and cold areas in right ileum and. On ultrasound scan, there was huge solid mass (about 10.0 cm× 7.0 cm) with some inhomogeneity and central cystic changes in medial aspect of right hip bone extending to pelvic cavity. Similar mass corresponded the visible swelling on skull. This mass was extended to intracranial region. Color Doppler study showed vascularity within and at margins of masses. To avoid risk of raised intracranial pressure following radioiodine therapy we sent the patient for external beam radiation therapy (EBRT) for reduction of the size of masses. Patient under went 5 cycles of EBRT (total 2000 c Gy in each lesion) but there were no reductions of sizes within one month follow up period. Small bony metastatic lesions from PTC in early stage are curable by surgical removal and repeated dose of radioiodine therapy. PTC with multiple advanced bony metastases shows poor prognosis. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22504 Bangladesh J. Nuclear Med. 17(1): 125-132, January 2014

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Primary Osseous Spine Tumors in Adults: A Review and Update on Diagnosis and Treatment

10.26420/austinjtraumatreat.2021.1015 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Emerson BD ◽

◽

Ameri BJ ◽

Downing MA ◽

Temple HT ◽

...

Keyword(s):

Malignant Tumors ◽

Correct Diagnosis ◽

Surgical Techniques ◽

External Beam Radiation ◽

Disease Stage ◽

Spinal Tumors ◽

Tumor Type ◽

Beam Radiation ◽

Diagnostic Strategies ◽

Spine Tumors

Objective: This article aims to provide a convenient and comprehensive review describing unique features of the most common primary osseous spine tumors, as well as current diagnostic and therapeutic modalities for each tumor. Background: Primary osseous spine tumors are a rare and diverse group of neoplasms with varying biologic behavior. Clinical, radiographic, and pathologic correlation is critical in making a correct diagnosis. Prompt treatment is necessary to optimize clinical outcomes, and is based on tumor type, location, and disease stage. Most patients with spinal tumors present with a history of pain often similar in quality and intensity as non-tumoral etiologies of back pain. Spinal neoplasms, especially malignant tumors, require a multidisciplinary approach and are best treated in dedicated cancer centers to mitigate incorrect diagnoses and inappropriate treatment. Methods: A literature review was conducted using PubMed and EBSCO. Multiple search queries for relevant articles between 2014 to present were included. Preference was given to recent articles with clinical evidence, current treatment, diagnostic modalities and/or future potential therapies and diagnostic strategies. Results: Numerous modalities including surgery, chemotherapy, evolving immunologic and targeted therapies as well as stereotactic external beam radiation therapy are utilized to optimize care. Still, current therapeutic strategies result in significant morbidity and mortality and local disease recurrence and systemic relapse are common despite chemotherapy and advanced surgical techniques. Conclusion: Because primary spinal tumors are uncommon, level I and II data are scarce though novel treatment strategies are emerging. Medical and orthopaedic oncologists and spine surgeons therefore should have a fundamental knowledge of the current state of literature pertaining to this topic.

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RADT-24. HIGH ABSORBED DOSES OF RHENIUM-186 NANOLIPOSOMES (RNL) IN RECURRENT GBM: A PHASE 1 STUDY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.777 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii186-ii186

Author(s):

Andrew Brenner ◽

John Floyd ◽

Ande Bao ◽

William Phillips ◽

Vibhudutta Awasthi ◽

...

Keyword(s):

Phase 1 ◽

High Specific Activity ◽

Absorbed Dose ◽

External Beam Radiation ◽

Whole Body ◽

Recurrent Glioma ◽

Normal Brain ◽

Beam Radiation ◽

Absorbed Doses ◽

The Mean

Abstract INTRODUCTION While external beam radiation therapy (EBRT) remains a central component of the management of primary brain tumors, it is limited by tolerance of the surrounding normal brain tissue. Nanoliposomal BMEDA-chelated-186Rhenium (RNL™) permits the delivery of beta-emitting radiation of high specific activity with excellent retention in the tumor. We report on the phase 1 results in recurrent glioma. METHODS A phase 1 dose-escalation study of RNL in recurrent glioma utilizing a standard 3 + 3 design was undertaken to determine the maximum tolerated dose of RNL following stereotactic biopsy. RNL is administered with the BrainLab Flexible Catheter by convection enhanced delivery (CED) with placement guided using iPlan Flow and the Varioguide system. Infusion is followed under whole body planar imaging and SPECT/CT. Repeat SPECT/CT imaging is performed immediately following, and at 1, 3, 5, and 8 days after RNL infustion to obtain dosimetry and distribution. RESULTS Thirteen patients have been treated to-date, 12 were recurrent glioblastoma, and 54% failed treatment with bevacizumab. The infused dose was progressively increased from 1.0 mCi to 13.4 mCi and the volume of infusate from 1.0 mL to 5.28 mL using 1 – 2 CED catheters. The mean absorbed dose to the distribution volume was 175 Gy (CI 97 – 254). The maximum absorbed dose to the tumor volume was 593 Gy. The mean retention of the administered dose at 24 hours was 61.4% (CI 45.4 – 77.5). The therapy has been well tolerated and no dose-limiting toxicity has been observed with no treatment related adverse effects despite markedly higher absorbed doses than EBRT in patients with prior treatment. The plan is to increase the dose to 22.3 mCi and the infusate volume to 8.8 mL. CONCLUSION Intratumoral RNL can deliver up to twenty times the absorbed dose of radiation administered by EBRT without significant toxicity.

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