Male breast cancer: 6-year experience.

AIM: Breast cancer in men is a very rare neoplasm accounting 1% of all breast cancer with an incidence ratio of 1:100 of men to women and about 1% of all malignancies in men. On the basis of the literature review the authors tried to determine the main characteristics of this rare neoplasm in terms of epidemiology, diagnosis, prognosis, treatment and survival. METHODS: The authors report the experience of the Breast Unit of the San Giovanni Addolorata Hospital in Rome, where 4 cases of male breast cancer were observed and treated over 784 breast cancers. RESULTS: All tumours were ductal carcinomas. The extent of disease was as follows: 3 cases with stage I and 1 case with Stage IIIB; in two cases estrogen and progesterone receptors expression was 100% and in the other two cases it was 20-80%. Median follow up was 57.5 months. At present, after 6-year follow up the three patients with stage I are in good conditions; the patient with stage III died after 27 months with metastatic disease. CONCLUSIONS: Surgical treatment remains the gold standard in male breast cancer. The prognosis for males with breast cancer is similar to female patients on equal terms of stage of disease. Adjuvant therapy is based on retrospective studies of male breast cancer conducted over the past 20 years using the guidelines for breast cancer in women.

Effects of fluconazole in the prophylaxis of oropharyngeal candidiasis in patients undergoing radiotherapy for head and neck tumour: results from a double-blind placebo-controlled trial.

Fluconazole is recommended in the prophylaxis of oropharyngeal candidiasis (OPC) in patients undergoing radiotherapy for head-neck tumours; however, the actual effectiveness of fluconazole in this setting remains unclear. Adult patients with cervico-cephalic carcinoma submitted to radical or adjuvant radiotherapy were randomized to 100 mg fluconazole (n = 138) or matched placebo (n = 132) oral suspension once daily from the sixth session of radiotherapy up to the end of treatment. The final analysis of the investigation showed a higher rate of the OPC outbreak-free survival in the fluconazole compared with placebo (P = 0.008 in the log-rank test). The mean time (95% CI) to OPC outbreak was 56 (53-59) days in the fluconazole group and 47 (43-51) days with placebo. The mean duration of radiotherapy was 43.5 and 39.9 days, respectively in the two groups (P = 0.027). Adverse effects were reported in 70.3% of patients in the fluconazole group and in 67.4% with placebo. The results showed prophylaxis with fluconazole given in irradiated patients with head-neck tumours significantly reduces the rate and the time to development of OPC compared with placebo.

[Primary breast lymphoma: case report and review of literature]. / Linfoma primitivo della mammella: descrizione di un caso clinico e revisione della letteratura.

Primary non-Hodgkin's lymphoma of the breast is a rare entity representing 0.04-0.5% of all malignant female breast tumors, less than 1% of all patients with non-Hodgkin lymphoma and approximately 1.7-2.2% of all patients with extranodal non-Hodgkin lymphomas. A 75 years old patient presented with masses in the lateral part of the left breast for 6 weeks. Ultrasound detected 3 masses suggesting fibroadenomas while mammography set the suspicion of breast multicentric carcinoma. Fine needle aspiration cytology of one mass showed low grade lymphoma subsequently confirmed with histopathology which diagnosed extranodal non-Hodgkin lymphoma MALT type CD 20+/CD 79a+/CD 3-/Bcl 2- and index of proliferation Ki 67=30% (stage IE). Primary non-Hodgkin lymphomas of the breast, though rare, should be considered in the differential diagnosis of breast malignancies. At present, a standard treatment doesn't exist yet; low grade lymphomas should be managed with excision biopsy and/or local radiation therapy, while high grade lymphomas should be managed with chemotherapy in association with radiation therapy.

Malignant peripheral neuroectodermal tumor (MPNET) of the kidney.

BACKGROUND: Malignant peripheral neuroectodermal tumors (MPNETs) are primitive neuroblastic tumors that arise, unlike neuroblastomas, outside the autonomic nervous system. A renal origin has been described in very few cases. CASE REPORT: We report the case of a young male patient with a large MPNET of the right kidney, studied with ultrasound and computed tomography before surgical resection. The main radiologic features, the microscopic appearance and the typical immunohistochemical findings, are described and discussed.

[Optimization of dosage and exam technique in the use of oral contrast media in magnetic resonance]. / Ottimizzazione della dose e della tecnica di esame nell'utilizzazione di un mezzo di contrasto orale nella risonanza magnetica.

PURPOSE: Aim of our study was to optimize the dose, scan delay and sequences for use in MR studies with an oral contrast agent (FerriSeltz, Bracco, Milan, Italy) to obtain positive or negative contrast enhancement in the bowel lumen. MATERIAL AND METHODS: In vitro: 10 mL vials with increasing concentrations (10-100 mg/mL) of the agent, containing 200 mg ferric ammonium citrate/g, were studied with a 1.5 T magnet (Philips NT, The Netherlands), by acquiring T2-weighted STIR and TSE and T1-weighted TFE sequences. Signal intensity was compared by using a ROI. In vivo: 16 volunteers were examined with the same sequences at 20 minutes and 2 hours after the oral administration of 6-27 g of the product diluted in 600 mL water. Images were analyzed by two radiologists and scored on a 4-point scale based on signal intensity; results were compared with Student's "t"-test. RESULTS: In vitro: MR signal was always hyperintense on T1-weighted images, as well as on T2-weighted TSE and SPIR images at concentrations lower than 45 mg/mL. Hypointense signal was seen on T2-weighted TSE and SPIR images at higher concentrations and on STIR sequences at 10-20 mg/mL concentrations. In vivo: the bowel exhibited positive enhancement on T1-weighted TFE and T2-weighted TSE and SPIR images 20 minutes after contrast agent administration at concentrations lower than 45 mg/mL. At 2 hours, bowel loops were hypointense on T2-weighted TSE and SPIR images at 15-20 mg/mL concentrations. STIR images showed hypointense bowel loops at both 20 minutes and 2 hours after 10-20 mg/mL contrast agent administration. Quantitative analysis showed a statistically significant superiority (p < .05) of T2-weighted STIR images in providing negative opacification of the bowel lumen. CONCLUSIONS: Ferric ammonium citrate, being a positive or negative contrast agent according to its dilution, permits to tailor the dose to optimize bowel lumen opacification.

[Role of ultrasonography in the study of patients with acute pancreatitis]. / II ruolo dell'ecografia nello studio dei pazienti con pancreatite acuta.

The aim of the present study is to establish the role of ultrasound examination (US) in the diagnosis of acute pancreatitis and its ability in differentiating mild or edematous acute pancreatitis (EAP) from severe or necrotizing acute pancreatitis (NAP) in order to indicate further diagnostic procedures and appropriate therapy. Forty patients with clinical suspect of acute pancreatitis were examined with US. All of them were followed-up clinically and with laboratory tests. Nineteen patients underwent a CT examination with contrast media and one without. In 28 cases US diagnosed acute pancreatitis in agreement with clinical and laboratory data. US identified 19 patients with EAP and 9 with NAP. CT, performed in 20 cases on the basis of clinical and US findings, confirmed US diagnosis in 19 cases while in 1 patient CT identified a NAP instead of the EAP suggested by US. According to our results, US is an easy-to-perform and accurate method for the diagnosis of acute pancreatitis and effective in differentiating EAP from NAP; it is also useful in suggesting further diagnostic procedures such as contrast-enhanced CT required in patients with NAP to assess the extension of peripancreatic fluid-collections and possible complications.

Effect of ethionine on the rough endoplasmic reticulum from male and female rat liver.

Ethionine causes a decrease in the amount of rough endoplasmic reticulum in rat liver, the effect being greater in female than in male rats. Rough endoplasmic reticulum isolated from rat liver 24 hr after ethionine injection and stripped of its ribosomes partially lost its in vitro ribosome binding capacity. However, no differences were detected between the binding affinities of ribosomes, isolated from either untreated animals or intoxicated rats, to stripped rough membranes derived from normal rats. Structural changes occur in the rough endoplasmic reticulum of the ethionine treated rats, while the ribosomes are still bound to the membrane.