Prednisolone-induced virginal mammary hypertrophy: Case report.

INTRODUCTION: Virginal mammary hypertrophy (VMH) is a rare benign disorder of the breast characterized by excessive enlargement of one or both breasts. It usually presents during adolescence. Drug-induced VMH has been scarcely reported in case reports. Review of the literature showed that prednisolone-induced gigantomastia was reported in a single study on a 47-year-old female. In this study, a case of VMH in a 17-year-old girl following prednisolone treatment will be described. Clinical presentation, clinical findings, diagnostic work-up, management and follow up are discussed. PRESENTATION OF CASE: A 17-year-old, single female presented to the plastic surgery department at our institute with progressive enlargement of both breasts, 2 months following treatment with prednisolone. Incisional biopsy excluded other breast differential diagnoses. The patient was managed surgically with bilateral mammaplasty with free nipple-areola graft. A total of 8.325 kg of breast tissue was resected. Follow-up 48 months postoperatively revealed good patient satisfaction with no recurrence of breast hypertrophy. DISCUSSION: Although the estrogen theory is regarded as the most credible explanation for VMH, several cases of drug-induced mammary hypertrophy have been reported. This study may be the first reported case of adolescent prednisolone-induced VMH. Mammaplasty is an accepted treatment despite its possible association with a higher recurrence rate. CONCLUSION: VMH may be a rare complication of prednisolone treatment. It should be considered in patients presenting with breast hypertrophy following steroid administration.

Heat Shock Protein Association with Clinico-Pathological Characteristics of Gastric Cancer in Jordan : HSP70 is Predictive of Poor Prognosis.

Gastric cancer (GC) is a major health problem worldwide and is one of the ten most commonly diagnosed cancers in Jordan. GC is usually diagnosed at late aggressive stages in which treatment options are limited. Recently, heat shock proteins (HSPs) found to be overexpressed in a wide range of malignancies have been considered as promising candidate biomarkers for GC. The aim of this study was to investigate pathogenic roles of a panel of cytosolic HSPs including HSP90, HSP70, HSP60 and HSP27 in GC. Immunohistochemistry was used to assess the level of expression of these proteins in archived tumor samples (N=87) representing various pathological characteristics of GC. HSP90, HSP60 and HSP27 were expressed abundantly in gastric tumors. On the other hand, HSP70 was reduced significantly and was also found to be associated with Helicobacter pylori infection in tissues collected from GC patients. Furthermore, HSP27 was found to be associated with the level of differentiation. Our findings indicate a role of HSP70 as a potential prognostic biomarker, patients harboring positive HSP70 expression displaying worse disease free survival than those with negative HSP70 expression. Differential expression of HSPs may play crucial roles in the initiation and progression of GC, and could be exploited as future therapeutic targets.

Asynchronous adenoid cystic carcinoma of the prostate and transitional cell carcinoma of the urinary bladder.

Histologic variants of prostatic carcinoma are readily recognized. In this report, we describe a rare variant, adenoid cystic carcinoma, in a 75-year-old man previously diagnosed to have transitional cell carcinoma of the urinary bladder. The diagnosis of adenoid cystic carcinoma was made by the characteristic microscopic features of the tumor morphologically and immunohistochemically. Two months later he was found to have metastatic disease. The patient's treatment consisted of chemotherapy in combination with prednisone and hormonal therapy. Five and a half months after diagnosis, he died with metastatic disease. Making this case unique is the asynchronous occurrence of this variant with transitional cell carcinoma of the urinary bladder, which has never been reported in the literature. We discussed the histopathologic and immunohistochemical features of adenoid cystic carcinoma of the prostate with review of literature.