Development of three different neoplasias in a patient in an 18-year period of time.

This study presents a rare case of a patient who developed three different types of neoplasia in an 18-year period of time. The case presents a 31-year-old man with a history of treated Hodgkin's lymphoma in the neck region at the age of 13 years. The patient was admitted at the General Hospital of Nafplio for differential diagnosis of pain in the right subcostal region initiated 1 month before his admission and normochromic, normocytic anaemia. The laboratory examinations lead to the diagnosis of a sarcoma in the cardioesophageal junction. The patient was subjected to total gastrectomy. Nine months later he is admitted with a palpable firm lump in the nipple of the right breast, which suggested a malignant neoplasia. The patient was subjected to modified radical mastectomy. The appearance of three different types of neoplasia in three different organ systems in the same patient and the infrequency of the specific neoplasias individually and in combination present a special interest considering the patient's genetic background and the uniqueness of the case in the international literature.

Efficacy of ibandronate for the treatment of skeletal events in patients with metastatic breast cancer.

Patients with breast carcinoma often develop bone metastases that carry a high risk of complications. A randomized, placebo-controlled trial was conducted to evaluate the efficacy and safety of ibandronate in patients with metastatic bone disease following breast cancer. The primary efficacy end point of the study was the proportion of patients who developed skeletal-related events (SREs, defined as pathologic fracture, spinal cord compression, radiation therapy to bone, change in anti-neoplastic therapy and surgery to bone). Secondary end points included time to first skeletal event, skeletal morbidity rate (events/year) and time to progression of bone lesions. In 150 patients (148 [female symbol] / 2 [male symbol]) with breast carcinoma and bone metastases, treatment with intravenous ibandronate 6 mg over 15 min every 4 weeks for 24 months significantly reduced the proportion of patients who experienced an SRE compared with placebo (36% vs. 48%; P = 0.027). Time to first SRE was also delayed significantly (median 457 vs. 304 days; P = 0.007). Multiple event analysis showed that ibandronate reduced the risk of developing an SRE by 32% (hazard ratio = 0.69; 95% confidence interval 0.42-0.79; P = 0.003). In general, ibandronate was well tolerated with very rare grade 3 or 4 toxicity. In this study, ibandronate was shown to be significantly more effective than placebo as a treatment for metastatic bone disease from breast cancer using multiple end points.