Pancreatic panniculitis as the first manifestation of the pancreatic involvement during the course of a gastric adenocarcinoma.

Pancreatic panniculitis (PP) is a rare disease presenting during the course of pancreatic diseases such as acute and chronic pancreatitis, pancreatic carcinoma. There are also a few reports of PP associated with other carcinomas. We present a 69-year-old male patient of gastric carcinoma with PP. The literature is reviewed, clinical and histological features of the case are discussed. This is the first case of PP in a gastric carcinoma patient reported in literature. As a conclusion, PP can be the first manifestation of a pancreatic metastasis of any carcinoma.

The impact of treatment interruptions on locoregional control during postoperative breast irradiation.

PURPOSE: Patients treated in the years 1990-2003 with breast conserving surgery and postoperative adjuvant radiotherapy were retrospectively analyzed in order to determine the impact of radiotherapy interruptions on the treatment outcome. PATIENTS AND METHODS: 470 patients received breast irradiation with (60)Co or with 4MV photon linear accelerator (total dose 50 Gy, range 46-54). Four hundred and sixty-two (98%) patients had boost dose of 10-20 Gy to the tumor bed either with photon or electron irradiation. Irradiation of the lymphatic fields was carried out according to the number of involved nodes. Even one day of treatment break was accepted as treatment interruption. Unplanned treatment interruptions occurred in 423 (90%) patients. A total of 196 (41%) patients had no treatment breaks or had interruptions of 7 days or less and 274 (59%) patients had treatment interruptions longer than 7 days. Locoregional control (LC) and overall survival (OS) rates were estimated by Kaplan-Meier method. The groups were compared with log-rank x(2) and Pearson x(2) tests. RESULTS: For all patients 5-year LC and OS rates were 91% and 85%, and 10-year rates were 86% and 75%, respectively. LC rates for the group of patients without interruptions or with an interruption of less than a week were 95% for 5 years and 90% for 10 years. Five- and 10-year LC rates for the patients with interruptions of 8 days or more were 87% and 83%, respectively (p=0.02). CONCLUSION: This retrospective study shows that postoperative irradiation interruptions of more than a week negatively impact LC.