[ long-term results of transsternal thymectomy and its related factors in patients with myasthenia gravis presenting at Loghman Hakim hospital in Tehran during 1993-2007: a descriptive study]

Myasthenia gravis is an autoimmune disease characterized by production of autoantibody directly against acetylcholine receptors on postjunctional membranes. The complete removal of the thymus has been the logical goal of operation, but there has been controversy on its relation to long term results. In this study, we try to describe the efficacy of long term result of transsternal thymectomy, and the rate of improvement in patients with myasthenia gravis that presented to Loghman Hakim Hospital, in Tehran, between 1993 and 2007. The study descriptively analyzed all patients with general myasthenia gravis with transsternal thymectomy. At first all patients with myasthenia gravis on the study year's period were found and invited. Efficacy of surgery was studied with dosage of used drug, signs, age, sex, thymus pathology, etc. and was statistically expressed. A maximum of 15 years of postsurgery followup was studied [Mean= 9 yrs]. In study years, 63 patients underwent thymectomy, 48 of whom met the criteria to enroll in our study [76.2%]. Overall, surgical benefit after thymectomy was 77% and 31.2% of the patients were completely cured. In 45.8% of the patients, drug doses were reduced. In 18.7% of the patients drug dose had not changed. In 4.2% of patients, the disease had progressed. Most of the improvement was seen in the first 2 years postthymectomy. Thymectomy is a beneficial treatment modality in patients with generalized myasthenia gravis. The efficacy of transsternal thymectomy for myasthenia gravis had satisfactory results by examining and long-term follow-up of patients. But further investigation in mass population in clinical trials is needed

Gastrointestinal stromal tumors: epidemiology and treatment outcomes

Numerous studies have investigated the prevalence, incidence and clinical manifestations of gastrointestinal stromal tumors [GISTs]. However, little is known about GISTs in Iran. This pioneer study focuses on description of 36 patients with GISTs in Iran. A database was created for 36 patients suffering from GIST who were treated in Loghman Medical Center and Tehran Cancer Institute in Tehran, Iran. Information on age, sex, clinical manifestations, treatment and outcomes were recorded and analyzed using SPSS version 13. Patients had an average age of 60 years; and 16 of them were males. The disease was most commonly manifested by abdominal mass, weight loss, and anemia. Twenty one patients had a mass smaller than 10cm; and in 33 patients KIT test was positive. In the follow-up, 5 patients experienced relapse and 3 succumbed due to advanced cancer. Primary results showed that GISTs might have different manifestations and incidence in Iran compared to other parts of the world. We hope that this study could serve as a starting point for the better understanding and classification of this disease in Iran and for development of improved management strategies

Rare peripheral nerve schwannoma

Schwannoma, a benign tumor of nerve sheath origin, is commonly found in the head and neck, as well as flexor surfaces of the extremities. It can rarely occur in the breast and stomach with only a few cases being reported. The cases are: 1- a 57-year- old man with breast mass, 2- a 58 -year -old man with gastrointestinal complaints who were finally diagnosed as peripheral nerve schwannomas. Clinical suspicion and histopathological confirmation are the keys to schwannomas diagnosis. Surgical excision is the treatment of choice for such patients

Acromegaly and breast cancer in a man: a case report

Acromegaly is due to excess of growth hormone production and imbalance of cell growth which leads to somatic manifestations and organ dysfunction. With increasing life span an increasing incidence of colorectal, breast, and blood cancers is seen. In this paper we report a 57 year old male with acromegaly; he had developed a swelling in the right breast for the last 2 years which had increased in size. On examination, the swelling was in the sub aereolar region, firm in consistency, about 5 cm in size and fixed to the chest wall which was ulcerated plus axillary lymphadenopthy on the same side. Radical mastectomy was done; histology revealed invasive ductal carcinoma. Acromegaly is a risk factor for breast cancer