Successful Lumpectomy in a Patient With Multicentric Breast Cancer.

When there is extensive breast cancer, patients typically undergo mastectomy. However, lumpectomy may still be performed for patients who are motivated to avoid a mastectomy and understand the risk for positive margins requiring second surgery in unique cases. This report details the surgical management and clinical reasoning behind lumpectomy for a multicentric breast cancer spanning 5 cm. The lumpectomy was a success with negative margins on final pathology.

Malignant Phyllodes Tumor of the Breast in a 26-year-old Woman.

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in women. Early detection, accurate diagnosis and proper treatment are important prognostic factors due to the wide variety of breast cancer subtypes. This becomes of particular importance with rare breast tumors, which are difficult to diagnose due to their varying presentations. Malignant phyllodes tumor (PT) is one of the rare breast tumors that is difficult to diagnose. First reported in 1838, PT of the breast accounts for less than 1% of all breast masses. Based on histological features, PT is categorized on a spectrum of benign to malignant tumors. High-grade PTs are commonly seen in older patients but can also occur in young patients, as reported in this case of a 26-year-old female. Failure to detect the malignancy early and initiate appropriate treatment can lead to widespread metastasis and poor outcomes.

Diagnosis and Management of Metastatic Breast Cancer in a 33-year-old Pregnant Female: A Case Report.

Despite the rarity, breast cancer diagnosed during pregnancy implies multiple therapeutic dilemmas. The initial diagnostic process can be complicated by the physiological changes that occur in the breast during pregnancy, which can further lead to a delayed diagnosis. Moreover, treatment methods, as well as treatment onset and time of pregnancy termination, remain controversial. This case report highlights some of the inherent difficulties associated with breast cancer diagnosis and treatment in a pregnant patient. It also discusses how to optimize a multidisciplinary approach to improve health outcomes for both the mother and the infant.

Pseudoangiomatous Stromal Hyperplasia of the Breast: A Rare Finding in a Male Patient.

Pseudoangiomatous stromal hyperplasia (PASH) in male patients is a rare condition that represents a hormonally-induced proliferation of mesenchymal tissue of the breast. This benign pathology is often undiagnosed due to many reasons. When PASH presents as a breast mass, it appears innocent, developing as a smooth and well-circumscribed tumor. Furthermore, it does not elicit suspicious findings on imaging. These points often halt further investigation of many breast abnormalities. Breast masses are statistically most likely to be gynecomastia when they arise in men. However, they are important to investigate because, although rare, breast cancer can occur in men. Furthermore, the benign conditions of the breast that commonly affect women can also impact male patients. It is oftentimes overlooked that men too can experience hormonal stimulation of the breast tissue. The following case describes this rare but important instance of a male patient diagnosed with PASH following a previous diagnosis of infiltrative ductal carcinoma in situ of the contralateral breast.

Detection of a Mammographically Occult Breast Cancer with a Challenging Clinical History.

Screening mammography has helped to identify countless incidences of breast cancer since its adoption in the 1960s. Over time, the screening guidelines and techniques have been refined to better detect malignancies and to avoid false positive results. However, weaknesses remain in mammography and represent an opportunity for improvement. The interference of natural breast tissue and glands can obscure the presence of occult breast malignancies. Additionally, the inability to differentiate breast tissue on the basis of depth, and the compounding of breast densities that occurs as a consequence of two-dimensional imaging, are setbacks when it comes to relying on mammography. User error and bias can also misguide the proper detection of underlying cancers during the radiological interpretation process. The following case represents a combination of these factors and others that culminated in a missed diagnosis of invasive ductal carcinoma in a young woman suffering from mastitis of the contralateral breast.

Primary T-cell lymphoblastic lymphoma of the cavernous sinus.

The rare occurrence of T-cell lymphoblastic lymphoma as a primary tumor in the cavernous sinus is described. The patient, a 17-year-old girl, presented with right-sided ophthalmic and maxillary neuropathy and diplopia due to neuropathies of cranial nerves III and VI. An enhancing mass in the cavernous sinus was identified on MR imaging. Dexamethasone was prescribed but did not provide symptomatic relief. Rapid progression of symptoms led to open biopsy, and a diagnosis of T-cell lymphoblastic lymphoma was made. The patient promptly underwent aggressive chemotherapy in which a modified hyper-cyclophosphamide, vincristine, and dexamethasone without doxorubicin regimen with concurrent radiotherapy was used. The patient achieved complete remission and is currently completing the 2-year maintenance phase of chemotherapy.

Resveratrol: biologic and therapeutic implications.

Resveratrol (3,4',5 trihydroxystilbene), a naturally-occurring molecule known as a phytoalexin, is synthesized by plants in response to attacks by fungi, bacteria, or other injurious substances; it is also known to possess an array of cardioprotective effects. Recently, studies have shown resveratrol to protect against the metabolic changes associated with hypercaloric diets in mice with induced insulin resistance, hyperglycemia, and dyslipidemia. Despite impressive gains in diagnosis and treatment, cardiovascular disease (CVD) remains a serious clinical problem and threat to public health. The metabolic syndrome, which identifies persons at higher risk for diabetes mellitus and CVD, is approaching a prevalence of nearly 25% of the western world. If the metabolic syndrome can be considered a polar opposite to caloric restriction, then agents that mimic caloric restriction may offer a new therapeutic approach to preventing CVD. The authors discuss the cardioprotective effects of resveratrol and highlight its role in glucose homeostasis and lipid metabolism in mice. Armed with the ability to prevent the deleterious effects of excess caloric intake and prevent detrimental cardiovascular events, resveratrol merits proper clinical investigations for its efficacy in treating metabolic diseases and CVD.