Locally Advanced Adenoid Cystic Carcinoma of the Breast-A Case Report with a Review of the Literature.

Breast cancer (BC) is a heterogeneous disease distinguished by four main subtypes based on the expression of estrogen, progesterone receptors, and human epidermal growth factor-2 on the cancer cells. Triple-negative breast cancer (TNBC) consists of approximately 10-20% of all BCs and is characterized by a poor prognosis. Adenoid cystic carcinoma (ACC) of the breast is a rare, special type of TNBC with low metastatic potential and usually favorable prognosis. There are no established recommendations concerning systemic therapy in advanced ACC. We present a case of a 70-year-old woman with locally advanced ACC with progression after radical mastectomy, and review the literature concerning the treatment of metastatic disease focused on systemic therapy.

Limitations of Systemic Oncological Therapy in Breast Cancer Patients with Chronic Kidney Disease.

Breast cancer is the most common malignancy, affecting middle-age and older women frequently suffering from other chronic diseases, including chronic kidney disease. The risk of breast cancer development in women on renal replacement therapy (peritoneal dialysis and haemodialysis) is higher than in the general population. Chronic kidney disease does not limit surgical treatment or radiotherapy; however, it affects the pharmacokinetics of drugs used in the systematic treatment to a different extent, increasing their toxicity and the risk of adverse drug reactions. This article summarizes the current knowledge (published studies accessed through PUBMED) on drugs used in chemotherapy, hormone therapy, anti-HER2 drugs, CDK4/6 inhibitors, PARP inhibitors, and immune therapy in breast cancer patients undergoing dialysis. We discuss the data, the optimal choice of the chemotherapeutic protocol, and the administration of drugs in a specific time relation to the haemodialysis session to ensure the most effective and safe treatment to breast cancer patients.

Acanthosis nigricans as a paraneoplastic syndrome. Case reports and review of literature.

Acanthosis nigricans (AN) is a skin disorder characterized by focal or diffuse hyperkeratosis symmetric hyperpigmentation of the skin and oral cavity mucosa. Various neoplasms, especially gastrointestinal adenocarcinomas are associated with acanthosis nigricans (AN malignant). Chemotherapy may cause regression of skin lesions. The etiology of AN is not clear. A role of growth factors such as melanocyte stimulating hormone alpha, transforming growth factor alpha, and insulin-like growth factor 1 has been discussed. Two cases of AN have been reported in this paper. Both have been associated with gastric adenocarcinoma. In the first case skin lesions were sensitive to chemotherapy (until cancer progression), while in the second case treatment had to be discontinued because of cardiotoxity without regression of skin lesions.

[Diagnostic difficulties in diagnosis of splenic abscesses]. / Trudnosci diagnostyczne w rozpoznawaniu. ropni sledziony.

We report an 18-year old patient with hypochromic anaemia and subfebriles states and long-persisting despite symptomatic treatment. On admission he presented body proportions similar to Marfan syndrome. Hypochromic anaemia and positive inflammatory markers were present along with negative results of serologic and microbiological assays. Hormonal parameters, as well as karyotype were normal. Among several imagining procedures, ultrasound and CT of the abdomen revealed areas in the spleen suggestive of proliferative disease or abscesses. Bone marrow examination was normal. Because of high probability of the disease limited to the spleen and deteriorating clinical state of the patient, splenectomy was performed. After the operation significant improvement of the health state of the patient was observed. Histopathological evaluation showed splenic abscesses. However, anamnesis and accessory examinations did not reveal their etiology. This report is an example of possible difficulties in diagnosing splenic abscesses, as well as supports grounds for surgical intervention in chosen cases.

Focal lesions in the ultrasonographic examination of the spleen as a symptom of various disease statuses: literature survey and case descriptions.

BACKGROUND: Ultrasonography (US) is an easy and non-invasive technique of visualizing spleen. Thanks to its repeatability, it plays an important role in the diagnostics of, among others, developmental anomalies, such as supernumerary or lobated spleens, as well as focal lesions. It is also used in monitoring the size of the spleen and it considerably facilitates diagnosis after certain injuries. Thanks to the application of the Doppler method, it also facilitates the diagnostics of pathologies within the spleen's vessels. CASE REPORT: This paper presents six different cases of focal lesions in the spleen, including lesions in the course of histiocytosis, in the course of sarcoidosis, as well as isolated abscesses of the spleen. The authors also present the case of a spleen with numerous metastatic lesions, the case of a near-splenic cyst, and the case of asymptomatic focal lesions of unknown origin. In all the presented cases, the lesions were accidentally revealed during ultrasonographic examination, which was the starting point for further diagnostics. CONCLUSIONS: Though rare, morphologic lesions in the spleen should always be taken into consideration when performing a routine ultrasonographic examination of the abdominal cavity, and the organ itself should not be ignored. US is a widely available, noninvasive, and useful method for diagnosing splenic abnormalities, including focal changes.

[CD20 antigen of Hodgkin and Reed-Sternberg cells as possible prognostic factor in patients with Hodgkin's lymphoma--preliminary reports]. / Antygen CD20 komórek Hodgkina i Reed-Sternberga jako potencjalny czynnik prognostyczny u chorych na chloniaka Hodgkina--doniesienia wstepne.

UNLABELLED: THE AIM of the study was to asses the validity of CD20 expression on H-RS cells as independent prognostic factor in patients with Hodgkin's lymphoma. METHODS: 72 patients (44 men and 28 women) between 15 and 73 y.o. (av. 36,5 y.o) treated in the Department of Oncological Chemotherapy of Silesian Medical Academy (1992-2002) were included in the study. Tissue specimens were immunohistochemically stained with monoclonal antibodies for CD20. RESULTS: Analyzed group was classified according to histological subtype as follows: LP - n = 3, NS - n = 26, MC - n = 23, LR - n = 7 and LD - n = 13. Overall survival (OS) for the group was from 3 to 169 months (av. 64,5), disease free survival (DFS) - 4 to 167 months (av. 44,8) respectively. CD20 expression on H-RS cells was found in 13,9% subjects. Statistically significant difference (p = 0,0001) in DFS has been found between groups with and without CD20 expression. Results of this study are preliminary and should be confirmed in larger prospective studies.

[Primary lymphoma of the thyroid--diagnostic and treatment problems. The case report]. / Pierwotny chloniak tarczycy--trudnosci diagnostyczne i terapeutyczne. Opis przypadku.

The authors present the case of primary malignant thyroid lymphoma and problems with distinguishing between Hashimoto's thyroiditis and primary thyroid lymphoma. Primary malignant thyroid lymphoma (PMTL) is a rare disease and difficult to diagnose. The appearance of PMTL may be preceded by Hashimoto's thyroiditis. The biopsy is useful but often only surgical treatment allows to establish diagnosis. The treatment of PMTL includes surgical treatment, chemo- and radiotherapy. The prognosis depends on the disease period.

[Malignant neoplasms of the small intestines]. / Nowotwory zlosliwe jelita cienkiego.

The paper contains a retrospective study of 12 cases of malignant small bowel tumors observed and treated in the Department of Oncological Chemotherapy of Medical University of Silesia. The authors presented the most common symptoms, typical diagnostic procedures and the difficulties in the diagnostics of small bowel neoplasms.

Expression of TGF beta1 genes and their receptor types I, II, and III in low- and high-grade malignancy non-Hodgkin's lymphomas.

BACKGROUND: Transforming growth factor beta (TGF ) is involved in a variety of important cellular functions. The lack of TGF -dependent cell-growth control might be related to oncogenesis, as it has been shown in lung, breast, and colon carcinomas. Current observations have revealed that TGF is rather an inhibiting, not a stimulating, factor as far as malignant tumor development is concerned. Recently, however, there has been a growing number of reports on increased expression of TGF genes in certain tumors. In patients with a diagnosis of non-small-cell lung carcinoma, the tumors expressing high levels of TGF were the ones that had a higher proliferation and metastasis capability, whereas more promising were the cases with lower levels of TGF expression. MATERIAL/METHODS: A pilot study of 14 patients was conducted comprising 8 patients with a low-grade lymphoma and 6 patients with a high-grade lymphoma. The QRT-PCR method was employed to assess the activity of TGF 1 and of its receptor types I, II, and III. RESULTS: The expression values for TGF 1 and its receptors I, II, and III were twice as high in the group of patients with a diagnosis of high-grade lymphomas as in the group of patients diagnosed with low-grade lymphomas. CONCLUSIONS: Results showed a clear difference in TGF 1 expression in patients with NHL depending on the subtype of the lymphoma, suggesting its significant role in the pathomechanism of this group of malignant diseases as well as its potential value as a prognostic factor.

[Current principles of Wilson's disease--diagnosis and treatment]. / Aktualne zasady diagnostyki i leczenia choroby Wilsona.

Wilson's disease defined also as hepatolenticular degeneration is an important clinical problem of young adults still causing diagnostic difficulties. In the course of the last decade, genetic background of the disease has been definitely established and elucidated, confirming the variety of genetic mutations, responsible for its origin. The current scheme of the disease treatment has been elaborated and established. It aims to eliminate the excess of toxic copper ions from the organism as fast as possible. In the initial phase of the treatment, traditional and recently introduced chelating agents administration usually results in prompt tissue copper deposits excretion and copper metabolism balance maintenance. In the chronic therapy, zinc compounds, inducing intestinal and hepatic metallothionein synthesis, have been gaining more common application. Life-long, constant, pharmacological Wilson's disease therapy, administered after its early diagnosis, allows for long periods of patients survival, frequently comparable to the normal population.