Recurrence Developing 21 Years after Treatment of Breast Cancer

Background: Breast cancer is a very common cancer among females. In which most recurrence (around 75%) occurs within the initial 5 years after diagnosis, especially within 3 years. Recurrence after 20 years is very less reported in the last few decades. Case Information: We are presenting a case of a 67-year old female patient presented with pleural based nodules suggestive of lung metastasis followed by brain metastasis. After reviewing history we came to know that the patient was a previously treated case of breast carcinoma treated 22 years back with mastectomy. Conclusion: We report late recurrence of breast cancer occurring 21 years after mastectomy suggesting that possibility of recurrence in carcinoma breast with 21-years latency period although rare should be taken into consideration when making decisions regarding patients who may need long term follow up.

Research Progress of Early Recurrence and Cut-off Time of Hepatocellular Carcinoma after Radical Hepatectomy / 肿瘤防治研究

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Surgery is the most important way to treat HCC currently. The high recurrence rate after hepatectomy is the most important reason to affect its prognosis, and it is also the key clinical problem to be solved. According to the recurrence time, the recurrence can be divided into early recurrence and late recurrence. The prognosis of patients with early recurrence is worse than that of patients with late recurrence. Therefore, it is very important for surgical decision-making to identify the two kinds of recurrence. This article reviews the research progress of early recurrence cut-off time of hepatocellular carcinoma after radical hepatectomy.

Very Late Recurrent Maxillary Sinus Squamous Cell Carcinoma on the Skin Graft Site 16 years after the Treatment

Maxillary sinus cancer is anatomically located adjacent to the orbit and the skull base. Local recurrence is by far the most common cause of treatment failure and the long-term survival rates is low. Local recurrence is usually happened within 2 years after initial treatment. Late recurrence is generally defined as a recurrence 5 years after initial treatment. But, late recurrence cases of maxillary sinus cancer is very rare, especially 10 years after treatment. We report a case of late recurrence on the previous skin graft site 16 years after the treatment of maxillary sinus squamous cell carcinoma in a 66-yr-old man. The patient was treated with surgical wide excision and skin graft. No recurrence was developed after one and a half year and we discussed the pathogenesis of this very late recurrent case.

Wilms' Tumor with Long-delayed Recurrence: 25 Years after Initial Treatment

Wilms' tumor is one of the most frequent malignant neoplasms in childhood. Advances in treatment modalities such as the combination of chemoradiation therapy with surgery have enhanced overall survival. However, recurrence of Wilms' tumor is still a problem. In this case, a 28-year-old female had experienced intermittent abdominal pain, and the computed tomography scan showed a huge pelvic mass. The patient had a history of radical nephrectomy for Wilms' tumor with concurrent chemotherapy at the age of three. The pelvic mass was resected in February 2010 and was confirmed to be a recurrent Wilms' tumor. The recurrent tumor showed a classic triphasic Wilms' tumor growth pattern with frequent mitoses and tumor necrosis. Our case is an extraordinary case of a long-delayed recurrent Wilms' tumor after 25 years, which is the longest disease-free interval ever reported. The possible effects of chemotherapy as well as some other mechanisms of this late relapse are discussed.

Metastatic Melanoma of the Right Axilla Developing 22 Years after the Treatment of Primary Cutaneous Melanoma of the Right Thumb: Probability of "Ultra-late Recurrence" / 대한피부과학회지

The recurrence of late onset cutaneous melanoma is not a common phenomenon. Ultra-late recurrence, which is defined as recurrence more than 15 years after initial treatment, is especially rare. A patient presented with a 2-month history of firm subcutaneous tumors in his right axilla. He had been diagnosed with melanoma of his right thumb 22 years ago, treated with amputation of the right thumb and partial ipsilateral axillary node dissection; there had been no previous recurrences. The present biopsy of the right axilla revealed lymph nodes occupied by melanoma cells. Distant metastasis was revealed on PET-CT and included the lung, pancreas and abdominal lymph nodes. Three possible explanations were proposed: (i) ultra-late recurrence of primary melanoma; (ii) axillary metastases from primary malignant melanoma of internal organ(s); (iii) axillary metastases of another unknown primary cutaneous melanoma which had completely regressed. After careful consideration, we concluded the most probable diagnosis to be "ultra-late recurrence" and report this case with reviews of late and ultra-late recurrence of melanoma.

Late Recurrence of Retinal Detachment after Successful Surgery

The purpose of this work is to study the prevalence, causes and prognosis of late recurrences of retinal detachment after successful surgery.We reviewed 986 cases in 926 patients who had undergone surgery for primary retinal detachment.Late recurrence was defined as the reappearance of subretinal fluid 6 months or longer after complete retinal reattachment.We performed scleral buckling, cryopexy, or vitrectomy as the first operation. Twenty seven eyes in 25 patients (2.7%)had a late recurrence.New breaks were definitely identified in 11 eyes (40.8%), and 9 eyes had proliferative vitreoretinopathy.In 3 eyes, previous breaks were reopened.The causes of redetachment were not identified in 4 eyes.Most common cause of late recurrence of rhegmatogenous retinal detachment was the newly developed retinal breaks.So, It may be helpful in reducing the incidence of late recurrence to perform long-term careful fundus examination after successful first operation.

Effect of Intravitreal Gas Injection in Retinal Detachment Assiciated with Macular Hole: Long Term Follow-up

In 11(64.7%) of 17 eyes treated by intravitreal gas injection, the retinas were successfully attached during follow-up period that ranged from 12 to 39 months. Group I(detachment limited to the perimaculararea) patients need more frequent gas injection than group II(detachment extending to equator), but success rate of group I(83.3%) is higher than group II(66.7%). Group III(detachment with peripheral retinal break) patients are not successful by gas injection only. In the succesful eyes, macular holes are not visible, but "window defects" are present on FAG. The relative scotomas improve. Recurrent detachment cases(31.3%) are associated with posterior staphyloma, peripheral retinal break and trauma. Time of late recurrences ranged from 4 to 13 months postoperatively(mean: 7 months).