[Differentiation between a thoracic spinal intramedullary lipoma and an intramedulary hematoma on fast spin-echo MRI scans: a case report].

We describe differentiation of a spinal intramedullary lipoma from an intramedullary hematoma on magnetic resonance images (MRI) with fast spin-echo (FSE) sequences. A 60-year-old man with dysesthesia in the legs and gait disturbance, was suspected of having myelopathy at a middle thoracic lesion. MRI with FSE sequences revealed an intramedullary lesion at T7 to T8. On the basis of hyperintensity on both T1-and T2-weighted images and a perilesional hypointense rim on T2-weighted images we made a diagnosis of subacute hematoma and planned observation. However, computed tomography for associated vertebral degeneration revealed a hypodense area (-97 Hounsfield units) in the region corresponding to the lesion depicted by MRI. We revised our diagnosis to an intramedullary lipoma and debulked the lesion. The lipoma was surrounded by a thick whitish capsule. Histopathologically, the capsule contained mature fat tissue and abundant collagen. The initial diagnosis was mainly attributable to specific FSE characteristics, i. e., the depiction of fat tissue as hyperintense on both T1-and T2-weighted images. Conventional spin-echo MRI depicts fat tissue as hyperintense on T1-and as hypointense on T2-weighted images. Other factors contributing to our initial diagnosis were MRI findings suggestive of an intramedullary hematoma, i. e., the intrinsic location of the lesion and the perilesional hypointense rim on T2-weighted images ascribable to collagen present in the capsule. The accurate diagnosis of an intramedullary lipoma on FSE requires correct interpretation of the signal, which is different from the signal on conventional spin-echo MRI.

Etodolac improves 5-FU sensitivity of head and neck cancer cells through inhibition of thymidylate synthase.

BACKGROUND: 5-Fluorouracil (5-FU) is widely used in the treatment of head and neck squamous cell carcinoma (HNSCC). However, development of drug resistance is one of the major causes of HNSCC treatment failure. The goal of this study was to investigate the mechanism of 5-FU resistance and to develop a novel combination therapy with another agent which sensitizes cells to 5-FU. MATERIALS AND METHODS: A 5-FU-resistant cell line, UM-SCC-23F/R, was developed from UM-SCC-23 cells. We determined sensitivities to 5-FU, etodolac and a combination treatment and also analyzed the expressions of cyclooxygenase-2 (COX-2) and thymidylate synthase (TS). RESULTS: Selective COX-2 inhibitor, etodolac, sensitized UM-SCC-23F/R cells to 5-FU. Expression of COX-2 decreased after etodolac treatment in both cell lines. While overexpression of TS was observed in UM-SCC-23F/R cells, etodolac inhibited TS expression, suggesting that the sensitizing effect induced by etodolac depends on TS suppression. CONCLUSION: We demonstrate for the first time an important inhibitory effect of etodolac on TS expression leading to sensitization to 5-FU in 5-FU-resistant cells. Our data suggest that TS inhibition can be accomplished by this routinely used nonsteroidal anti-inflammatory drug, and this may have a role as novel effective cancer treatment for 5-FU-resistant cancer.

Pre-radiation enhances the cytotoxicity of docetaxel in head and neck squamous cell carcinoma cells.

This study was designed to determine the effect of the treatment schedule on the interaction between docetaxel and irradiation. Human head and neck squamous cell carcinoma (HNSCC) cells with different p53 status, and HSC4 (p53 wild-type) and CAL27 (p53 mutant type) cells were treated with docetaxel and irradiation using three schedules: i) concurrent treatment, ii) docetaxel pretreatment and iii) pre-radiation. Docetaxel and radiation inhibited the proliferation of HSC4 and CAL27 cells in a dose-dependent manner. However, irradiation pretreatment was more effective than the other treatment regimens in all cells. Our data suggest that pre-radiation in HNSCC cells significantly enhances docetaxel cytotoxity by arresting S-phase, and this provides the most effective treatment sequence of docetaxel and radiation combination therapy. Therefore, radiation followed by docetaxel may be the most effective sequence for head and neck cancer therapy.

Cancer screening of healthy volunteers using whole-body 18F-FDG-PET scans: The Nishidai clinic study.

In order to evaluate the diagnostic performance of cancer screening using whole-body (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning for asymptomatic subjects, we conducted a historical cohort study. The study group comprised 5807 individuals who underwent PET scanning from 2002 to 2003. Each subject had carried out a procedure with whole-body (18)F-FDG-PET scan with some other diagnostic tests. Out of 5807 participants, data from 4881 subjects were analysed. Among them, PET screening revealed abnormal FDG uptake in 562 subjects, and possible or probable malignancy in 324 subjects, and histological diagnosis of cancer in 36 subjects (16 thyroid, seven colon, four lung, five breast, two prostate, and two others) out of them. The overall cancer detection rate was 0.7%, and PET scanning had a sensitivity of 70.6% and a specificity of 94.0%. This result warrants further prospective cohort studies to evaluate the usefulness of PET cancer screening for cancer prevention.