ABSTRACT
Background: renal cell carcinoma [RCC] represent 2-3% of all malignant tumors in adults. Clear cell carcinoma is the most frequent histological type, and 25-30% of renal carcinoma have metastasis at the time of diagnosis. RCC very rarely metastasize to the colon. The objective of the present study is to report synchronous haematogenous solitary colonic metastasis that presented as severe recurrent lower gastrointestinal haemorrhage which required right hemicoloectomy and right nephrectomy plus chemotherapy
Clinical Case: we report the case of a 46-year old male patient who presented with multiple episodes of severe haemotochezia and anemia. He had a right flank mass. CT scan of the abdomen showed a large right kidney mass together with a lesion in the ascending colon, not connected to the renal mass. It also showed hepatic metastasis, lung metastasis and ascites. Colonoscopy revealed an ascending colonic mass. The patient was managed by right nephrectomy and right hemicolectomy. The pathology report of the colonic mass showed clear cell carcinoma with involvement of the colon from serosa to mucosa. It indicated the presence of haematogenous spread of the RCC as the mechanism of metastasis. The colonic haemorrhage did not recur. the patient survived close to a year after surgery
Conclusion: RCC metastasis to the colon is very rare and can be synchronous with the primary renal tumor and can be metachronous after nephrectomy. Also, it can be the result of direct invasion, haematogenous spread or after local recurrence following nephrectomy. Metastatic RCC requires surgery, immunotherapy, tyrosine kinase inhibitors, and mammalian target rapamycin inhibitors. Surgery is the first step for disease control and control bleeding from colonic metastasis. Metastectomy is indicated in localized disease and when surgically accessible
ABSTRACT
To compare the clinicopathological features of breast cancer in two distinct patient populations below and above age of 40 and to investigate whether it is associated with a more aggressive tumor biology and disease progression in young female patients. A retrospective study conducted at the oncology clinic at King Hussein Medical Center. A total of 90 females with histopathology proven invasive breast cancer aged less than 40 years [group A] were matched with a group of 160 female patients whose age was 40 years or older [group B] during the period of 2007 to 2014. Demographic variables collected included age, mode of presentation, details of radiological imaging. Data reviewed from the histopathology report included tumor histology, site, size, grade, lymphovascular invasion, perineural invasion, number of lymph nodes involved by the tumor, hormonal status of tumors. Recurrence and site of distant metastasis were obtained during regular follow-up. The median age was 35 years [range 24-39 years] in Group A and 55 years [range 40-75 years] in Group B, The median duration of symptoms was longer among patients in group A. Patients in group A had larger tumors, more lymph nodes involved by tumor, higher stage at presentation, more estrogen negative tumor, and more patients developed distant metastasis or local recurrence during follow up. Breast cancer in young patients is associated with more advanced disease, more aggressive histopatholgy and biological characteristics, higher rate of recurrence and distant metastasis
ABSTRACT
The aim of the study was to assess the frequency of cutaneous manifestations in patients with chronic kidney disease on hemodialysis. A retrospective study, including 75 patients with chronic kidney disease at Prince Hashem Hospital in Al-Zarqa-Jordan, were seen and properly evaluated for their current skin problems. Their files were reviewed. Patients' age, sex, associated medical illnesses, underlying causes of renal failure, the duration of renal failure and the duration of hemodialysis were included. Descriptive statistical analysis was used. There were 31 female [41.3%] and 44 male [58.7%] patients, the mean age of the study group was 53.9 years, 66 patients [88%] complained of skin problems. The most common problem was xerosis in 61 patients [82.3%], pallor in 60 patients [80%], pruritus in 45 patients [60%], pigmentary changes in 45 patients [60%], oral mucosal changes were seen in 48 patients [64%], hair changes in 34 patients [45%], nail changes in 29 patients [39%] and other cutaneous changes such as purpura in 14 patients [18.6%], acquired perforating folliculitis in six patients [8%] and nephrogenic fibrosing dermopathy in two patients [2.7%].Cutaneous manifestations are very common in patients with chronic kidney disease undergoing hemodialysis. Pruritus was the most troublesome symptom and xerosis was the commonest finding. More attention to cutaneous changes may help to relieve some of patient's co-morbid symptoms and improve their quality of life
ABSTRACT
We report the case of a 59 year old woman who presented with a 17 year history of acral keratoses, facial trichilemmomas, skin fibromas and a benign tongue fibrous polyp. Cowden disease was suspected and after appropriate investigations the patient was found to have Hashimoto's thyroiditis. She also presented to our clinic five years after her first visit, where her clinical examination and investigations showed that she developed cancer in her right breast