Rapid onset lung squamous cell carcinoma with prominent peritoneal carcinomatosis and an eosinophilic leukemoid reaction, with coexistence of the BRAF V600E and oncogenic KRAS G12A mutations: A case report.

Peritoneal carcinomatosis from lung cancer is rare, particularly from lung squamous cell carcinoma (LSCC). Concurrent somatic BRAF and KRAS mutations within the same tumor specimen have not been reported. The present study describes the case of a treatment-naïve LSCC patient with coexisting BRAF V600E and oncogenic KRAS G12A mutations in the primary lung lesion and the peritoneal metastases. The patient presented with prominent peritoneal carcinomatosis and an eosinophilic leukemoid reaction, but no respiratory symptoms. The patient succumbed 8 days after the onset of the condition due to rapid aggravation of the peritoneal carcinomatosis. To the best of our knowledge, this is the first study concerning the coexistence of BRAF and KRAS mutations in LSCC. Intensive activation of ERK was also observed in the primary lung lesion and the peritoneal metastases. Although the exact pathogenesis was unclear, the observations indicated that in the present study, the BRAF V600E and KRAS G12A mutations may have cooperate in inducing the malignant phenotype of LSCC. This case also highlighted the potential aggressive course and unusual pattern of spread of this specific dual-mutated tumor.

[Early intervention for children with language developmental delay].

OBJECTIVE: To explore the mode of intervention for children with language developmental delay under the current condition of China. METHOD: The study population consisted of a cross-sectional convenience sample of 206 children, ages 13 - 24 months, from six communities of Qingpu in Shanghai. Parents were asked to complete detailed questionnaires about their child's spontaneous use of vocabularies. Fourteen children with vocabularies less than 5 percentile of every age group were identified as having language developmental delay. During the 12-month intervention, developmental pediatricians did the developmental assessment for every child and set goals of intervention for everybody according to their language abilities and family situation. Then kindergarten teachers who got the training in language therapy carried out the intervention. Gesell development scale was used for developmental assessment before and after the intervention. RESULTS: The developmental quotient (DQ) in areas of language and personal-social behavior was elevated significantly after 12 months of intervention (P < 0.01). The developmental quotient (DQ) in the area of adaptive behavior was also elevated (P < 0.05). There was an obvious catching up effect in both areas of language and personal-social behavior. Increased developmental age in both areas was (18.0 +/- 5.3) months and (16.2 +/- 5.9) months, respectively. The language ability of 71.4% samples was in the normal range at the end. CONCLUSIONS: The mode of medical and educational cooperation to give early intervention for children with language developmental delay is feasible. It can significantly improve the abilities in language and communication of children 1 - 2 years of age.