RESUMEN
El cáncer de mama en hombres es una entidad poco frecuente y muy poco estudiada. Su pronóstico y manejo aun distan de lo ideal y de lo que se ha logrado en cáncer mamario en mujeres. Los tumores neuroendocrinos de la mama son aún más raros. Su comportamiento tiende en la mayoría de los casos a ser incierto y su manejo controversial. El reporte de caso se trata de un paciente masculino de 67 años, con historia de aparición de masa en mama derecha, con diagnóstico inicial de tumor mal diferenciado, con posterior inmunohistoquimica que informa tumor neuroendocrino primario de la mama. El diagnóstico temprano de cáncer de mama en hombres implica un verdadero reto para los sistemas de salud. Debemos conocer más sobre su fisiopatología y factores de riesgo(AU)
The early diagnosis of breast cancer in men represents a real challenge for the health systems. Therefore, our knowledge about its physiopathology and risk factors must be expandedBreast cancer in men is a rare and poorly studied malady. The prognosis and management is far from being ideal and from the achievements of the female breast cancer treatment. Even rare are neuroendocine breast tumors. In most of cases, its behavior is uncertain and its management is controversial. This was the report of a male patient aged 67 years, with history of right breast mass, initially diagnosed as a poorly differentiated tumor with later immunohistochemical test that reported the existence of a primary neuroendocrine breast tumor(AU)
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de la Mama Masculina/diagnóstico por imagen , Mastectomía Radical Modificada/efectos adversos , Tumores Neuroendocrinos/cirugía , Neoplasias de Mama Unilaterales/radioterapiaRESUMEN
Purpose To explore the immunohistochemical features of neuroendocrine markers, CKpan and TTF-1 and their relationship to TNM stage and prognosis in small cell lung cancer (SCLC). Methods The expression of NSE, CgA, Syn, CD56, TTF-1 and CK-pan in SCLC tissue specimens were detected using immunohistochemical EnVision indirect method. Clinical data and TNM stage of 90 patients were collected and the overall survival ( OS) was followed up by telephone. Results Of 90 cases of SCLC, the vast majority were occured in the elderly men. The ratio of man to woman was 5 to 1. The median age was 64 years old. The stageⅠ+Ⅱ was 21 cases, 30 in stageⅢand 39 cases in stage IV. The positive rate of immunohistochemical staining of neuroendocrine markers for NSE, CgA, Syn and CD56 were 83. 3%, 70%, 65. 5% and 86%, respectively. The positive rate of CKpan, TTF-1 were 92. 2% and 81. 1%. Kaplan-Meier analysis indicated that the expression of TTF-1 and NSE were significantly correlated with the TNM stage and over-all survival of patients with SCLC (P<0. 05). The median OS was 8 months in positive expression of TTF-1, which was higher than those in negative expression of TTF1 (5. 5 months)(P=0. 000). The median OS was 7 months in NSE positive expression which was lower than those in negative expression of NSE (11 months)(P=0. 009). The median OS of stageⅠ+Ⅱ,ⅢandⅣwere 16 months, 9 months and 4 months with significant difference ( P=0. 000 ) . Cox multivariate analysis indicated the TTF-1 expression and TNM were independent prognostic factors for the OS of the SCLC patients. Conclusion Most of SCLC has neuroendocrine differentiation, expression CKpan and TTF-1. The expression of TTF-1 may be negative correlation but NSE positive correlation with the prognosis of SCLC patients. And the TTF-1 expression and TNM may be independent prognostic factors for the OS of the SCLC patients.
RESUMEN
BACKGROUND: Insular thyroid carcinoma (ITC) is a relatively infrequent thyroid carcinoma that has distinctive histologic features. ITC shows an aggressive clinical course and the predominant presence of an insular component, which has been reported to be an independent factor of a poor prognosis. We retrospectively examined clinical details of the nine ITC patients, which represented 9 years of experience with ITC, and investigated the expressions of variable neuroendocrine and other immunohistochemical markers associated with well-differentiated thyroid carcinomas. METHODS: We adopted an immunohistochemical approach and studied the expressions of synaptophysin, chromogranin A, CD56, NSE, S-100, RET, PPARgamma, calcitonin, galectin-3, and thyroglobulin in formalin-fixed, paraffin embedded tissue array slides of the 9 ITC patients, and investigated clinical features. Seven cases of follicular carcinoma and 4 cases of medullary carcinoma were also included as controls. RESULTS: ITCs were positive for synaptophysin (44%, 4/9), CD56 (11%, 1/9), NSE (89%, 8/9), S100 (67%, 6/9), calcitonin (22%, 2/9), galectin-3 (78%, 7/9), and thyroglobulin (100%, 9/9), but completely negative for chromogranin A, RET, and PPARgamma. CONCLUSION: ITCs express neuroendocrine markers in variable proportions and appear not to be associated with the oncoproteins of conventional thyroid carcinomas. Notably, its differential diagnosis from medullary carcinoma is required in cases showing focal calcitonin positivity.