Carcinoma en Cuirasse as the heralding sign of underlying HER-2 positive male breast cancer.

Carcinoma en cuirasse (CeC) is an uncommon presentation of metastatic cutaneous carcinoma, most often originating from breast carcinoma. We present a case study of a man in his 30s exhibiting progressive skin thickening over the left chest, alongside appetite and weight loss. On examination, the patient had painless skin induration and palpable, matted, hard, immobile and non-tender axillary, cervical and inguinal lymphadenopathy. Imaging revealed metabolically active left cervical, retro pectoral, inguinal and bilateral axillary lymph nodes with muscle involvement, likely neoplastic. Histopathology demonstrated metastatic carcinoma, morphologically originating from the breast. CeC most often presents after therapy, but our case reveals that it may be a presenting sign of an occult malignancy. CeC should be differentiated from non-oncological causes of skin thickening. Detailed history, physical examination and appropriate radiological investigations are essential. Although rare in young individuals, neoplastic aetiology should be considered if the history and physical examination suggest it.

Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults: A Multicenter Study From India.

PURPOSE: Colorectal cancer (CRC) in young adults is a rising concern in developing countries such as India. This study investigates clinicopathologic profiles, treatment patterns, and outcomes of CRC in young adults, focusing on adolescent and young adult (AYA) CRC in a low- and middle-income country (LMIC). METHODS: A retrospective registry study from January 2018 to December 2020 involved 126 young adults (age 40 years and younger) with CRC. Patient demographics, clinical features, tumor characteristics, treatment modalities, and survival outcomes were analyzed after obtaining institutional ethics committees' approval. RESULTS: Among 126 AYA patients, 62.70% had colon cancer and 37.30% had rectal cancer. Most patients (67%) were age 30-39 years, with no significant gender predisposition. Females had higher metastatic burden. Abdominal pain with obstruction features was common. Adenocarcinoma (65%) with signet ring differentiation (26%) suggested aggressive behavior. Limited access to molecular testing hindered mutation identification. Capecitabine-based chemotherapy was favored because of logistical constraints. Adjuvant therapy showed comparable recurrence-free survival in young adults and older patients. For localized colon cancer, the 2-year median progression-free survival was 74%, and for localized rectal cancer, it was 18 months. Palliative therapy resulted in a median overall survival of 33 months (95% CI, 18 to 47). Limited access to targeted agents affected treatment options, with only 27.5% of patients with metastatic disease receiving them. Chemotherapy was generally well tolerated, with hematologic side effect being most common. CONCLUSION: This collaborative study in an LMIC offers crucial insights into CRC in AYA patients in India. Differences in disease characteristics, treatment patterns, and limited access to targeted agents highlight the need for further research and resource allocation to improve outcomes in this population.