A case of long surviving metastatic retroperitoneal epithelioid sarcoma in a 20 year old male.

This is the case of a 20 year-old male who came to our observation with a neoplastic lesion of the retroperitoneum. At diagnosis it had already spread to the lung, the liver and to the retroperitoneal para aortic lymph nodes. The patient was treated only with chemotherapy, first 4 cycles of PEI schedules and the second option were 3 cycles of EI schedule. After the first treatment the disease showed the enlargement of a liver lesion, in the VII segment and the vascular component of it was increased. This same lesion, after the EI administration, colliquated and didn't modify its size. Since the end of the therapy the patient has been followed up every 3 months for the first 3 years and every 6 months from the third year onward; he is now at 5 years from the last treatment with a stable disease.

Myoepithelial carcinoma of parotid gland: a case report.

Myoepithelial carcinoma or malignant myoepithelioma are considered extremely rare malignant salivary gland neoplasms. Their clinical behaviour by literature seems variable: most studies reported good prognosis for low-grade malignancy and vice versa. Nevertheless long term survival has been described in patients with high-grade tumours, while patients with low-grade have been reported to develop metastases. We report a case of myoepithelial carcinoma of the parotid gland arising in pleomorphic adenoma in a 52-year-old woman with favourable course in long term follow-up.

Unique pineal gland metastasis of clear cell renal carcinoma: case report and review of the literature.

The metastatic involvement of the pineal gland is an extremely unusual event; it has a 4% incidence in patients with disseminated neoplasias. Most metastatic pineal lesions are asymptomatic. Only in a small number of cases the symptoms produced by metastatic involvement of this organ precede those of the primary tumor or those of another metastatic site. To our knowledge the herein reported case is the first in which the pineal gland was apparently the unique metastatic site of a primitive kidney carcinoma and where the symptoms produced by metastasis in the pineal region were the first sign of the disease.

Solitary splenic recurrence of epithelial ovarian cancer: a case report and review.

The metastatic involvement of the spleen in epithelial ovarian cancer is rare and usually reflects late disseminated disease. Isolated parenchymal metastasis in the spleen is an extremely unusual event, in fact in most cases in medical literature, the spleen was involved as part of diffuse peritoneal carcinomatosis. We report a rare case of epithelial ovarian carcinoma, which recurred in the splenic parenchyma 15 years after initial treatment. The patient underwent a splenectomy followed by six cycles of platinum-based poly-chemotherapy. Currently, 8 years after splenectomy, the patient has no evidence of relapsed disease. In the solitary splenic recurrence of epithelial ovarian cancer our case suggests that accurate surgical resection of the spleen, followed by platinum-based chemotherapy, is correlated with a prolonged survival.

Malignant bronchial Abrikossoff's tumor and small cell lung cancer: a case report and review.

A 61-year-old male Caucasian smoker patient underwent chest radiography and CT scan for persistent non-inflammatory cough, which showed a left bronchial unresectable mass. Bronchoscopy showed an endobronchial mass; washing cytology was negative and histology findings suggested diagnosis of granular cell tumor (GCT), also called Abrikossoff's tumor. After 3 weeks a new washing cytology test revealed the presence of small cell lung cancer (SCLC). A CT-scan and chest radiography showed a 30% increase in the maximum diameter of the lesion, clinically defining the primary neoplasm as malignant. The patient was referred to our institution and started chemotherapy with cisplatin and etoposide. After 6 cycles of treatment, the CT scan showed complete, disappearance of the neoplasm and bronchoscopy examination showed no endobronchial lesion, defining the mucosal surface as normal. We have reviewed and summarized the international literature with regard to bronchial localization of malignant granular cell tumor and its association with SCLC, therefore concluding that our case is the first malignant endobronchial GCT linked to SCLC.

Antiblastic chemotherapy in the presence of abdominal aorta aneurysm (AAA): guidelines.

Concomitant neoplasm and abdominal aortic aneurysm (AAA) is not a rare clinical association and can pose problems if antiblastic treatment is required. The literature shows lack of consensus owing to the fact that AAA can modify the liquid load and the hemodynamic setting so that chemotherapy toxicity profile becomes important and hydration overload increases the AAA-breakage risk. We have analyzed the possibility of treatment with a non-critical water load related chemotherapy in these patients, and if it can offer benefit it terms of overall survival (OS) and quality of life (QL). We concluded that in chemotherapy the presence of AAA does not have to be excluded first, if such critical parameters such as response to chemotherapy AAA-breakage risk vascular and extravascular toxicity do not compromise the OS and QL of the patients.

Comparison of CEA, MCA, CA 15-3 and CA 27-29 in follow-up and monitoring therapeutic response in breast cancer patients.

In order to define the most useful tumor marker panel in breast cancer patients' follow-up and in monitoring treatment response, serological levels of CEA, MCA, Ca 15-3 and Ca 27-29 were evaluated in 220 patients. 180 patients had no evidence of disease (NED) after primary treatment, and 40 had metastases at first diagnosis time; in a 4 years follow-up, 30 of the NED patients relapsed, and were then included in the group of metastatic patients subjected to anticancer treatment. Overall sensitivity in metastatic patients was: CEA 40%, MCA 35%, Ca 15-3 79%, Ca 27-29 70%, with the highest percentages and mean values in liver and bone localizations. Combination of Ca 15-3 and Ca 27-29 improved sensitivity in bone lesion (85% vs 80%), in locoregional relapses only association with CEA increased sensitivity (60% vs 40%). Ca 15-3 and Ca 27-29 values increased on average 3 months before clinical diagnosis. In treated patients there was a better correlation with a clinical course of disease for Ca 15-3 and Ca 27-29 (both 81%) as compared to the other determined markers.

Concurrent chemoimmunotherapy in metastatic clear cell sarcoma: a case report.

Clear cell sarcoma is a rare tumor with a poor prognosis. The therapeutic approach in the metastatic disease stage is controversial: to the authors' knowledge the use of concurrent chemoimmunotherapy has not been previously reported. We present a case of a 57-year-old male with metastatic clear cell sarcoma treated simultaneously with subcutaneous interferon-a 2b and six courses of chemotherapy according to the CyVEDIC regimen. Disease stabilization lasting 17 months was achieved.

Contralateral solitary testis metastasis antedating renal cell carcinoma: a case-report and review.

A 56-year-old Caucasian smoker male patient underwent right orchiectomy and spermatic cord resection for intrascrotal transilluminating mass. Histology findings suggested diagnosis of metastasis from Renal Cell Carcinoma (RCC). After positive CT-scan for primary neoplasm, total left nephrectomy was accomplished. Patient referred to our institution and started interferon immunotherapy; nowadays, after 21 months is disease free and in good health. We have reviewed and summarized the international literature regarding testicular metastasis from renal cell carcinoma; this is the first case of histology-proved-RCC ("clear cell" type)-solitary-contralateral-testicular-recurrence antedating clinical evidence of the primary neoplasm, which underwent orchiectomy before nephrectomy.

[Clinical evaluation of the efficacy of the combined determination of serum markers CEA, CA 19.9, CA 72.4 as indexes of gastro-intestinal tract neoplasms]. / Valutazione clinica dell'efficacia dell'associazione dei markers sierici CEA, CA 19.9, CA 72.4 come indici di neoplasia del tratto gastro-intestinale.

The aim of our study was to evaluate the usefulness of the tumor markers CA 72.4, CEA and CA 19.9 in the monitoring of gastrointestinal carcinomas. Our experience demonstrated the usefulness of the determination of CA 72.4 in the follow up of patients with gastrointestinal neoplasms.