Magnetic resonance imaging following treatment of advanced hepatocellular carcinoma with sorafenib

Hepatocellular carcinomas are highly vascular tumors, showing progressive hypervascularity by the process of neoangiogenesis. Tumor angiogenesis is critical for tumor growth as well as metastatic spread therefore, imaging and quantification of tumor neo-angiogenesis is essential for monitoring response to targeted therapies and predicting disease progression. Sorafenib is a molecular targeting agent used for treating hypervascular tumors. This drug is now the standard of care in treatment of patients with advanced hepatocellular carcinoma. Due to its anti-angiogenic and anti-proliferative actions, imaging findings following treatment with Sorafenib are quite distinct when compared to conventional chemotherapeutic agents. Liver MRI is a widely adopted imaging modality for assessing treatment response in hepatocellular carcinoma and imaging features may reflect pathophysiological changes within the tumor. In this mini-review, we will discuss MRI findings after Sorafenib treatment in hepatocellular carcinoma and review the feasibility of MRI as an early biomarker in differentiating responders from non-responders after treatment with molecular targeting agents.

A swelling of the maxilla: a case report and differential diagnosis

Ossifying fibromas are benign fibro-osseous tumors of mesenchymal origin. Although ossifying fibromas have principally been found in the jaw, they have also been reported in the frontal, ethmoid, sphenoid, and temporal bones, as well as the orbit and anterior cranial fossa. Ossifying fibromas affecting the jaw exhibit variable behaviors ranging from slow growth to occasionally aggressive local destruction. In the present article, we discuss a differential diagnosis considered for maxillary swellings and report a rare case of ossifying fibroma occurring in the maxilla.

Adenoid cystic carcinoma presenting as an ulcer on the floor of the mouth: a rare case report

Adenoid cystic carcinoma is a rare epithelial tumour, and comprises about 1% of all malignant tumours of the oral and maxillofacial region. It is a malignant tumour which may develop in the trachea, bronchus, lungs or mammary glands, in addition to the head and neck region. Occurrences in the head and neck are mostly detected in the major salivary gland, oral cavity, pharynx and paranasal sinus where it presents as a slow growing firm nodular swelling. The aim of the article is to highlight the unique presentation of adenoid cystic carcinoma as a solitary ulcer on the floor of the mouth.

Spontaneous regression of hepatocellular carcinoma in a cirrhotic patient: possible vascular hypothesis

Spontaneous regression of hepatocellular carcinoma is extremely rare, and the exact pathogenesis leading to this remarkable phenomenon remains unclear. We describe a case of spontaneous regression of an incidentally discovered hepatocellular carcinoma in a 63-year-old man with hepatitis C cirrhosis. The regression followed a series of events, in particular, an upper gastrointestinal haemorrhage. Ischaemic insult may be a major pathway leading to tumour regression. As limited data is available in the literature, knowledge and recognition of this rare event will have implications for patient management and may alter treatment. Further, data may be useful to assess if these patients have an altered prognosis with improved survival.