Molecular classification of breast cancer: an overview with emphasis on ethnic variations and future perspectives

Morphologically identical breast cancers can display divergent clinical outcomes and responses to therapy. This can predominantly be attributed to molecular class differences that exist amongst histologically similar cancer types. Consequently, molecular classification can be more powerful than histopathology as a predictive factor for the different treatments. This article reviews the molecular classification of breast cancer and emphasizes that ethnic variations may exist in molecular class prevalence patterns. It also highlights key insights into the currently defined molecular classes as provided by ongoing research on primary breast cancers using recent state-of-the-art technology. Such research is revealing that significant molecular heterogeneity may exist within the molecular classes themselves. More diverse ethnic variations may also be unraveled. The results of ongoing and upcoming research may provide more precise prognostic and predictive information about breast cancer and perhaps a breakthrough step toward "personaliziation" of breast cancer treatment. Forty-one relevant articles [2000-2012] extracted through PubMed and Google advanced searches and at our institute's library were utilized to prepare the article, along with results of published and ongoing research hby the authors

Indeterminate cell tumor [histiocytosis]

Indeterminate cell tumor [ICT; histiocytosis] is a rare disorder characterized by accumulation of histiocytes that do not fulfill the phenotypic criteria designated for Langerhans cells [LC]. The cells classified as "indeterminate" exhibit overlapping features between dendritic cells and histiocytic cells by showing variable reactivity for CD1a and positivity for S-100 protein and CD68. Ultrastructurally, absence of Birbeck granules, a feature consistent with LC, epitomizes the lesional cells. Herein, we report a case of ICT in a new born emphasizing its histogenesis and clinical, morphologic, immunohistochemical, and ultrastructural features

Mixed vestibular schwannoma and meningioma without neurofibromatosis

The co-existence of meningioma and schwannoma as 2 distinct histologic components within the same tumor has been described in neurofibromatosis 2 [NF2], but the co-existence of both tumors without evidence of NF2 is much rarer. Here, we are reporting a case of mixed schwannoma with meningioma without clinical evidence of NF2. In an adult Saudi lady with progressive left-sided hearing loss, left cerebellopontine tumor was diagnosed by MRI, and the histopathological diagnosis revealed that this tumor was composed of vestibular schwannoma and meningioma. This case is discussed with literature review

Assessment of restricted orbital undercutting operation in the management of some psychiatric disorders

Forty-seven cases with different psychiatric disorders were collected for orbital undercutting. Preoperative and two years postoperative careful assessment of the personality and mental state was done for 70% of patients with varying degrees. Deterioration was not recorded in any patient after operation. The best results were obtained in patients with chronic anxiety states, obsessional neurosis and chronic depression, while poor results were obtained in patients with schizophrenic reaction. There was no mortality or major complications in patients subjected to this operation

Tumours of the spinal canal

"There can be few greater satisfactions either to patient or surgeon than for a bed ridden, incontinent patient to take up his bed and walk, to have once more control of his sphincters and remain well for many years without recurrence of the tumour". Rogers [1955] on removal of spinal tumours. This is a study of 72 cases of tumours in relation to the spinal cord, removed during the last 15 years. The incidence and pathological types are presented and the literature reviewed. Intradural angiomatous malformations and extradural haemangiomata were discussed at some length as their incidence was high in our series. Stress has also been laid on the potential malignant nature of some extradural meningiomata encountered in this series. Certain tumours presented with unusual clinical features and some rare tumours were reported and discussed

Diastematomyelia

The features of Diastematomyelia were presented, stress has been made on the radiological diagnosis. Two cases were presented and were accompanied by persistently low lying conus medullaris. The different theories advanced to explain this anomaly were presented. The literature was reviewed and suggestion is made for an additional step in the operative procedure, that is division of the filum terminal to help in the relaxation of the tethered and fixed conus medullaris

Anterior cingulecotomy its value in mental deficiency

Fifteen cases of destructive uneducable mentally deficient children were subjected to anterior cingulectomy. Reduction of aggressive tendency was noticed to a varying degree in ten out of fifteen cases. Five cases could be educated to perform simple tasks when they were releaved from their aggression. The rationale of the operation is discussed