Topoisomerase 2α status in invasive breast carcinoma - comparison of its clinical value according to immunohistochemical and fluorescence in situ hybridization methods of evaluation.

The main purpose of the study was to compare topoisomerase 2α (TOP2A) status in invasive breast carcinomas to the outcome of a therapy containing neoadjuvant treatment with anthracyclines (a combination chemotherapy treatment for breast cancer, namely AC [cyclophosphamide, doxorubicin]). To achieve these goals we created a method of evaluation with criteria based on two methods used in the present study (immunohistochemical [IHC] and fluorescence in situ hybridization [FISH]). The threshold for positive immunohistochemically evaluated status was set for all cases with: nuclear stain intensity score 3+ in 10% or more nuclei and nuclear stain intensity score 2+ in 50% or more nuclei. Our results suggest that TOP2A status may be used as a predictive factor for patient selection for protocols which include anthracyclines as one of the chemotherapeutics. Both methods, IHC and FISH, are suitable for implementation for diagnostic purposes, but IHC positive status measured according to the criteria presented above is the best predictor of longer disease-free survival (DFS) according to our study. Immunohistochemical also gave satisfactory results in all analyzed cases in comparison to only 60% of cases analyzed by FISH.

[Orbital tumours in children and adolescents. Differential diagnostics and clinical symptoms]. / Orbitale Raumforderungen im Wachstumsalter. Differenzialdiagnostik und Krankheitsbilder.

BACKGROUND: The aim of this retrospective study was to determine the incidence of and surgical strategies used for treating orbital tumours in children and adolescents. PATIENTS AND METHODS: A retrospective chart review was carried out for 22 patients between the ages of 2 weeks and 18 years who were treated in the years 1997-2007 for suspected space-occupying orbital lesions. The specific investigation methods, therapy, and treatment results were described. RESULTS: The most frequent orbital lesions in the children in this study were mesenchymal tumours; the second most common were dermoids. Nineteen patients were surgically treated. Three children with malignant tumours underwent radiochemotherapy after surgery, and two died in the first year after diagnosis. Two other children with benign tumours suffered recurrence of their disease. CONCLUSION: The variety of orbital diseases in paediatric patients includes benign and malignant tumours as well as nonneoplastic lesions. The treatment of orbital disease is a diagnostic and therapeutic challenge for the attending physician.

[Tumour-like lesions of the orbit - clinical symptoms, difficulties in differentiation and options for therapy]. / Klinische Symptomatik, differenzialdiagnostische Schwierigkeiten und Therapieoptionen bei tumorartigen Läsionen der Orbita.

Tumour-like lesions are very rare entity among orbital diseases. Between 1996 and 2007, 83 patients with orbital disorders were treated and three of them complained about different tumour-like lesions: giant cell granuloma, eosinophilic granuloma and fibrous dysplasia. Because of the considerable increase of functional disorders and tumour growth, all of the patients underwent surgical treatment. In this paper we describe the clinical symptoms, diagnostics and the methods of therapy for each of the lesions. The results shows that the preoperative neuro-ophthalmological examination as well as radiological imaging are necessary to assess the motility, visual field, vision, eye ball dislocation and to plan the surgical strategy. In terms of this descriptive character of the paper, we hope to submit some relevant information in order to improve the diagnostics and therapeutic procedures for tumour-like lesions of the orbit.

[Intraorbital tumours of the peripheral nervous system]. / Intraorbitale Tumoren des peripheren Nervensystems.

In neoplastic processes in the orbital area, a not significant part of these new entities is caused by tumours of the peripheral nervous system. Due to a clinically similar behaviour and radiological features also being similar, these tumours sometimes cause differential diagnostic difficulties. Our experience with these tumours shows that they do not have a uniform symptom complex. Exophthalmus and displacement of the globe are the most visible symptoms besides pain, motility disturbances, reduced visus and double images. Clinical imaging allows the exact localisation of the tumour and makes it easier to choose the best surgical method. However, imaging does not allow the exact assessment of the entity or enable a decision to be made about the possible malignancy of the tumour. Therefore, a representative biopsy and a histopathological examination are essential. Then, a complete tumour resection should be performed using the most careful incision possible to avoid postoperative complications.