ABSTRACT
HER-2 overexpression, a predictive marker of tumour aggressiveness and responsiveness to therapy, occurs in 20-30% of breast cancer. Although breast cancer is a heterogeneous disease, HER-2 measurement is carried out in primary tumour. This study aims to evaluate HER-2 overexpression in primary and metastases and its effect on treatment decisions. Biopsies from primary breast cancer and corresponding metastases from 58 patients were studied. HER-2 overexpression was evaluated immunohistochemically in all primary and metastatic sites. Positive overexpression in primary and/or metastases was confirmed by fluorescence in situ hybridisation (FISH). Discordance in HER-2 overexpression between primary and metastatic sites was 14% (eight of 58 patients). Concordance was found in 50 (86%) of patients (95% CI: 77-95). In one patient (2%), HER-2 was negative in metastasis but positive in primary. In seven (12%) patients, HER-2 was positive in metastases and negative in primary (95% CI: 3.7-20), and three of them responded to trastuzumab. Gene amplification by FISH was found in all cases with HER-2 positive (+2 and +3) by immunohistochemistry. Our data suggest that a possible discordance of HER-2 overexpression between primary and metastases should be considered when making treatment decisions in patients with primary HER-2-negative tumours.
Subject(s)
Breast Neoplasms/genetics , Carcinoma, Ductal, Breast/genetics , Carcinoma, Lobular/genetics , Neoplasm Metastasis/pathology , Receptor, ErbB-2/metabolism , Adult , Aged , Aged, 80 and over , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/metabolism , Carcinoma, Ductal, Breast/pathology , Carcinoma, Lobular/metabolism , Carcinoma, Lobular/pathology , Female , Humans , Immunoenzyme Techniques , In Situ Hybridization, Fluorescence , Male , Middle Aged , Neoplasm Staging , PrognosisSubject(s)
Dirofilariasis/complications , Penile Diseases/parasitology , Penis/parasitology , Adult , Animals , Humans , Male , Penile Diseases/surgery , Penis/surgeryABSTRACT
OBJECTIVE: To present clinical and pathological findings of extremely rare vaginal glomus tumor. METHODS: Clinical details were obtained from patient records. Histopathological examination included immunohistochemistry. RESULTS: A 45-year-old menopausal woman had a 4-year history of painless cystic mass, 1.0 cm in diameter, on the anterior vaginal wall. Surgical excision of mass was uneventful. Histological examination revealed glomus tumor, primarily solid but also containing a clearly identifiable angiomatous component. Tumor cells showed prominent cytoplasmic immunostaining for vimentin and actin and negative staining for desmin, epithelial membrane antigen, pancytokeratin, Factor VIII, S-100, HMB-45, chromogranin, and estrogen, progesterone, and androgen receptors. CONCLUSION: Vaginal glomus tumor may be painless and, when the angiomatous component is evident, may appear as cystic mass.
Subject(s)
Glomus Tumor/diagnosis , Vaginal Neoplasms/diagnosis , Diagnosis, Differential , Female , Glomus Tumor/pathology , Humans , Middle Aged , Vaginal Neoplasms/pathologyABSTRACT
Secondary malignancy is a well-recognized complication of radiation therapy. The risk of postirradiation sarcoma in long-term follow-up is 0.03-0.8%. We report a case of radiation-induced perisacral angiosarcoma 6 years after pelvic irradiation for sigmoid cancer in a 77-year-old man. The tumor was diagnosed postmortem and was locally advanced and metastatic. He died 6 months after onset of symptoms. This case demonstrates the importance of long-term follow-up in those given radiotherapy.
