Clinical efficacy and biomarker analysis of neoadjuvant camrelizumab plus chemotherapy for early-stage triple-negative breast cancer: a experimental single-arm phase II clinical trial pilot study.

BACKGROUND: Triple-negative breast cancer (TNBC) is associated with a dismal prognosis. Immune checkpoint inhibitors have shown promising antitumor activity in neoadjuvant settings. This single-arm, phase II trial aimed to evaluate the efficacy and safety of camrelizumab plus chemotherapy as the neoadjuvant therapy (NAT) in early TNBC. METHODS: Patients received eight cycles of camrelizumab plus nonplatinum-based chemotherapy. The primary endpoint was total pathological complete response (pCR). Secondary endpoints included the breast pathological complete response (bpCR), adverse events (AEs). Multiomics biomarkers were assessed as exploratory objective. RESULTS: Twenty of 23 TNBC patients receiving NAT underwent surgery, with the total pCR rate of 65% (13/20) and bpCR rate of 70% (14/20). Grade ≥3 treatment-related AEs were observed in 14 (60.9%) patients, with the most common AE being neutropenia (65.2%). Tumor immune microenvironment was analyzed between pCR and non-pCR samples before and after the NAT. Gene expression profiling showed a higher immune infiltration in pCR patients than non-pCR patients in pre-NAT samples. Through establishment of a predictive model for the NAT efficacy, TAP1 and IRF4 were identified as the potential predictive biomarkers for response to the NAT. Gene set enrichment analysis revealed the glycolysis and hypoxia pathways were significantly activated in non-pCR patients before the NAT, and this hypoxia was aggravated after the NAT. CONCLUSION: Camrelizumab plus nonplatinum-based chemotherapy shows a promising pCR rate in early-stage TNBC, with an acceptable safety profile. TAP1 and IRF4 may serve as potential predictive biomarkers for response to the NAT. Aggravated hypoxia and activated glycolysis after the NAT may be associated with the treatment resistance.

Comparative Efficacy and Safety of Neoadjuvant Immunotherapy with Chemotherapy versus Chemotherapy Alone in Non-Small Cell Lung Cancer: A Propensity Score and Inverse Probability Treatment Weighting Analysis.

Purpose: This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy (NCT) and neoadjuvant immunotherapy combined with chemotherapy (NICT) combined with radical lung cancer resection for the treatment of patients with resectable non-small cell lung cancer (NSCLC). To adjust for confounding factors, we innovatively adopted two matching methods: propensity score (PS) and inverse probability of treatment weighting (IPTW). Patients and Methods: We conducted a retrospective analysis of the clinicopathological features and prognosis of patients with resectable NSCLC treated with NCT or NICT combined with radical lung cancer resection using propensity score matching (PSM) at a ratio of 1:1 and IPTW to balance potential bias. Results: After PSM, 116 pairs of patients who had undergone NCT or NICT were selected for the final analysis. The pathological complete remission (pCR) and major pathological remission (MPR) rates were significantly better in the NICT group than in the NCT group (pCR rate of 44.8% vs 2.6%, P< 0.001; MPR rate of 66.4% vs 20.7%, P< 0.001). No significant difference was seen between the NICT and NCT groups in terms of postoperative complications (12.1% vs 9.5%, P=0.182). Patients in the NICT group had significantly better disease-free survival (DFS) and overall survival(OS) than those in the NCT group ([3-year DFS: 75.2% vs 43.3%, P< 0.001] and [3-year OS: 91.5% vs 58.0%, P< 0.001]). Among all patients, those with postoperative pathology of pCR had better DFS (P< 0.001) and OS (P= 0.009). Patients with postoperative pathology of MPR had better DFS (P< 0.001) and OS (P< 0.001). The IPTW method yielded similar pathologic and prognostic results. Conclusion: Patients with resectable NSCLC treated with NICT had better pathological responses and prognosis, than those treated with NCT, and the safety profiles of NICT and NCT were similar.

Risk, Obligation, and Public Noncompliance with Mobility Directives in China during the COVID-19 Pandemic.

Human mobility greatly increases the risk of epidemic transmission. This study examines the psychological mechanism of individuals' noncompliance with public health directives and their choice to travel amidst threats through two rounds of surveys (N = 1473 in total) in China at different stages of the COVID-19 pandemic. This research revealed the relative strength of the motivating and impeding factors that determined behavioral intention. In subtle internal conflicts, maladaptive responses (e.g., wishful thinking, denial, fatalism) were identified as a significant factor in negotiating risk-related constraints and encouraging risky travel behavior. Interestingly, both those who traveled amidst threats and those who did not travel agreed that they had social obligations for epidemic prevention. The results demonstrated that obligation could have an indirect negative impact on behavioral intention only via attitude. By unveiling the psychological mechanism of individuals' noncompliance with health directives and travel during the pandemic, this study can aid in the development of appropriate operational strategies to manage population mobility during crises.

Utilization of Waste Amine-Oxime (WAO) Resin to Generate Carbon by Microwave and Its Removal of Pb(II) in Water.

Utilising waste amine-oxime (WAO) resin through microwave semi-carbonization, a carbon adsorbent (CA) was obtained to remove Pb(II). After microwave treatment, the pore size of the skeleton structure, three-dimensional porous network, and lamellar pore structure of WAO was improved. The distribution coefficient (Kd) of Pb(II) onto CA is 620 mL/g, and the maximum adsorption capacity of Pb(II) is 82.67 mg/g after 20 min of WAO microwave treatment. The adsorption kinetics and adsorption isotherms conform to the quasi-second-order kinetic equation and Langmuir adsorption isotherm model, respectively. The surface of MT-WAO is negatively charged and the adsorption mechanism is mainly electrostatic interaction. Pb(II) elution in hydrochloric acid solution is more than 98%, and its recovery is high at 318 K and for 1 h.

Efficacy and analysis of modified "three-tube method" in the treatment of intrathoracic anastomotic leakage after esophagectomy.

BACKGROUND: This study aimed to retrospectively evaluate the clinical efficacy of the modified "three-tube method" for the treatment of intrathoracic anastomotic leakage (IAL) after esophagectomy, and to analyze the independent risk factors for prolonging the treatment time of the modified "three-tube method". METHODS: From January 2013 to December 2018, IAL was reported in 22 patients with esophageal cancer who underwent esophagectomy with intrathoracic anastomosis. By reviewing and analyzing the clinical data of the 22 patients, the efficacy of the modified "three-tube method" treatment and the independent risk factors associated with a longer treatment duration of the modified "three-tube method" were evaluated. RESULTS: Of the 22 patients, 19 were male (86.4%). The average age was 65.2 years old. A total of 4 patients (18.2%) underwent preoperative neoadjuvant chemotherapy; 6 patients (27.3%) had a Charlson comorbidity index (CCI) score of 1-3; the average diagnosis time of IAL was 9.5 days; the median intervention time was 4 days; and the average fistula length was 1.5 cm. The average albumin level after surgery was 30.5 g/L, and the average C-reactive protein (CRP) level was 139.4 mg/L. The modified "three-tube method" average treatment time was 19.5 days. One patient (4.5%) died of respiratory failure during treatment. Univariate analysis and multivariate analysis by establishing multiple linear regression model found that the date of intervention and the fistula size were significantly associated with a longer treatment duration of the modified "three-tube method". CONCLUSIONS: The modified "three-tube method" is a safe and effective means for non-surgical treatment of IAL after esophagectomy. The intervention time and the fistula size are independent risk factors for prolonging the treatment time of the modified "three-tube method".

Cerebral Air Embolism After Pigtail Catheter Drainage for Pneumothorax: A Case Report and Review of the Literature.

Objective: Cerebral air embolism (CAE) is an extremely rare but serious complication of pigtail catheter drainage. The aim of the case report is to review our experience in the diagnosis and treatment for CAE after pigtail catheter drainage. Case presentation: In our study, we report a case of CAE following pigtail catheter insertion for pneumothorax. A 50-year-old man was diagnosed with a pulmonary mass in the right lower lobe. He underwent a right lower lobectomy. Pneumothorax was present after the removal of the chest tube. Pigtail catheter drainage was used in order to treat the pneumothorax, which resulted in convulsions, limb stiffness, and unconsciousness. A brain CT scan was immediately performed and showed multiple low densities in the right occipital lobe, which was diagnosed as CAE. Assisted breathing, antibiotic treatment, and antiepileptic therapy were used and the patient gradually improved and was discharged at 27 days of treatment but the muscle strength of the left limb was weakened. Conclusion: We analyzed and summarized the possible causes of CAE in the literature, and the findings of the case could enhance the vigilance of clinicians.

Rapid metastasis of stage IA primary pulmonary high-grade mucoepidermoid carcinoma with a cystic airspace: a case report and reflection.

Primary pulmonary high-grade mucoepidermoid carcinoma (MEC) with a cystic airspace is uncommon, and early metastasis is extremely rare. In such cases, however, it is clinically important for clinicians to consider whether the tumor has spread to the lymph nodes through the cystic airspace. A 77-year-old man presented to our hospital with cough and hemoptysis. Chest computed tomography showed a 25-mm-diameter mass with a cystic airspace located in the upper lobe of the left lung. The possibility of malignancy was considered. Without a definitive preoperative diagnosis, left upper lobectomy and mediastinal lymphadenectomy were performed. Histopathological examination revealed the typical histological characteristics of high-grade MEC (stage IA) and no lymph node metastasis. However, lymph node metastasis was found 6 months after surgical resection, and radiochemotherapy was performed. The patient developed widespread metastatic disease 4 months following completion of radiochemotherapy and died 2 months later. Primary pulmonary MEC with a cystic airspace is a rare malignant disease with uncommon imaging findings. Complete surgical resection is the main treatment method for high-grade MEC. In this case, we hypothesize that early metastasis was caused by seeding of tumor cells through the cystic airspace.

Construction and Identification of New Molecular Markers of Triple-Negative Breast Cancer Stem Cells.

Objective: We screened the TNBC stem cells using phage display (PD) and acquired the specific binding clones; and then the positive phage DNAs were amplified and extracted, synthesized with specific polypeptides, and labeled with fluorescein isothiocyanate (FITC). Finally, we identified the specificity of the polypeptides in vitro and in vivo. Methods: Human breast cancer cell line MDA-MB-231 and human mammary gland cell line hs578bst were chosen in our study, and MDA-MB-231 breast cancer stem cells (BCSCs) were cultured and identified by flow cytometry. The phage peptide library was screened using MDA-MB-231 BCSCs, the positive phage clones were identified by ELISA, and the DNA of the positive phages was extracted and sent to a biotechnology company for sequencing. According to the sequencing results, a specific polypeptide was synthesized and labeled with FITC. In the end, the specificity of a polypeptide to BCSCs was identified in vivo and in vitro. Results: The MDA-MB-231 BCSCs were cultured and enriched with the "serum and serum-free alternate" method. The BCSCs were found to have characteristics of CD44+/CD24-/low epithelial surface antigen (ESA) and ALDH+ with flow cytometry. The phage was enriched to 200-fold after three rounds of screening for MDA-MB-231 BCSCs. The positive phages were sequenced; then a polypeptide named M58 was synthesized according to sequencing results. Polypeptide M58 has a specific affinity to MDA-MB-231 BCSCs in vivo and in vitro. Conclusion: Specific polypeptides binding to MDA-MB-231 BCSCs were screened out by PD screening method, which laid a theoretical foundation for the targeted therapy and further research of BCSCs.

Mutant Allele Frequency-Based Intra-Tumoral Genetic Heterogeneity Related to the Tumor Shrinkage Mode After Neoadjuvant Chemotherapy in Breast Cancer Patients.

The shrinkage mode of tumor extent after neoadjuvant chemotherapy (NAC) is an important index to evaluate the odds of breast-conserving surgery. However, there is no sufficient measurement to predict the shrinkage mode after NAC. In this study, we analyzed 24 patients' formalin-fixed, paraffin-embedded samples before and after treatment and analyzed 456 cancer-related genes panel by using target next-generation sequencing. Meanwhile, the pathological shrinkage mode was reconstructed in three dimensions after surgery, and the genetic heterogeneity level was estimated by mutant-allele tumor heterogeneity (MATH). We measured the genetic intra-tumor heterogeneity and explored its correlation with the shrinkage mode after NAC. A total of 17 matched pair samples of primary tumor tissue and residual tumor tissue were successfully accessed. It was found that the most common mutated genes were TP53 and PIK3CA in both samples before and after NAC, and no recurrent mutations were significantly associated with the shrinkage mode. Besides, the MATH value of formalin-fixed, paraffin-embedded samples before and after NAC was analyzed by the area under the curve of the receiver operating characteristic, and it is feasible to classify patients into concentric shrinkage mode and non-concentric shrinkage mode in NAC based on the MATH threshold of 58. Our findings indicate that the MATH value was associated with the shrinkage mode of breast cancer in a non-linear model. Patients with the MATH value below the threshold of 58 before and after NAC displayed a concentric shrinkage mode. The area under the curve was 0.89, with a sensitivity of 0.69 and specificity of 1. Our study might provide a promising application of intra-tumor heterogeneity that is measured by MATH to make a choice of surgery.

Meta-Analysis of Shrinkage Mode After Neoadjuvant Chemotherapy for Breast Cancers: Association With Hormonal Receptor.

Background: Patients with concentric shrinkage mode after neoadjuvant chemotherapy (NAC) is considered to be ideal candidates for breast conserving treatment (BCT). While, what proportion of patients would represent CSM have not been well defined. This study was conducted to pool the rates of concentric shrinkage mode (CSM) in patients undergoing NAC, determine the impact of hormonal receptor on the shrinkage mode after NAC and estimate the rates of the CSM in various subgroups. Methods: We conducted a systematic review following the guidelines for Meta-Analyses and Systematic reviews for the PRISMA guidelines. We systematically searched the literature about shrinkage mode after NAC from PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang database published from January 2002 to June 2020 on breast cancer shrinkage mode after NAC and carefully screened the literature by using eligibility criteria: (1) patients with primary breast cancer treated with NAC; (2) publications with available data of shrinkage mode measured by magnetic resonance imaging (MRI), or data of pathology and hormonal receptor. The association between shrinkage mode and hormonal receptor was estimated using Stata 15.1 software. Results: This analysis included a total of 2434 tumors from 23 papers. The included studies were heterogeneous (I2 = 89.4%, P<0.01). Random effects model was used to estimate the overall rates of CSM: 56.6% [95%CI (50.5%, 62.7%)]. According to the analysis of hormonal receptor, 10 of the paper was included for HR+ (hormone receptor positive) type analysis and the rate of CSM for HR+ type was 45.7% [95%CI (36.4%, 55.0%)]; 9 of the paper was used for HR- type (hormone receptor negative) analysis and the incidence of HR-CSM is 63.1% [95%CI (50.0%, 76.1%)]; with HR+ type as the control, the OR of the HR- CSM rate is 2.32 (1.32, 4.08) folds of HR+ type. From subgroup analyses, the CSM% of luminal A, luminal B, Her2+, and triple negative were 29.7% (16.5%, 42.8%); 47.2% (19.1%, 75.3%); 59.0% (39.7%, 78.3%); 66.2% (52.8%, 79.6%), respectively. Conclusions: Breast cancer patients undergoing NAC did not get an ideal odds ratio of CSM. The incidence of CSM in breast cancer after NAC is associated with hormonal receptor. Patients with triple-negative breast cancers have the highest rates of CSM after NAC. More care should be taken to select patients with the luminal subtypes for BCT throughout NAC.

Is Pathologic Complete Response the Surrogate in Primary Gastric Angiosarcoma Undergoing Doxorubicin-Based Neoadjuvant Chemotherapy? A Case Report.

INTRODUCTION: Angiosarcoma is a malignant tumor with low incidence. Especially in the advanced tumors, there is still a lack of knowledge of evidence-based medicine. CASE PRESENTATION: We report a case of a 55-year-old woman with abdominal pain of 2 months of duration, which had increased in severity for 2 weeks prior to the presentation. The diagnosis is primary gastric angiosarcoma. We performed multiple disciplinary team (MDT), and doxorubicin-based neoadjuvant chemotherapy (NAC) was proposed. After two cycles of NAC, a computed tomography (CT) scan showed complete regression compared with the previous scan. An open surgery was done, and surgical specimens were confirmed as a pathological complete response (PCR) by pathological and immunohistochemical examination, but unfortunately, the patient suffered a relapse after the surgery in 3 months. CONCLUSION: Repeated endoscopic biopsy and biopsy specimen examinations can improve accuracy in diagnosis. It seems that NAC could be a candidate for advanced primary gastric angiosarcomas. But after the rapid relapse, we are wondering whether pathologic complete response is the surrogate in primary gastric angiosarcoma undergoing NAC.

How important is community participation to eco-environmental conservation in protected areas? From the perspective of predicting locals' pro-environmental behaviours.

Community participation is considered an effective measure to protect the eco-environment and to improve people's livelihoods in protected areas. However, it has not received enough attention at the practical level in most developing countries, and it is unclear how important it is in stimulating locals' pro-environmental behaviours to achieve eco-environmental protection goals. This study focuses on the relationship among community participation, perception changes in livelihood capitals and place attachment, which are related to residents' production, livelihoods, and pro-environmental behaviours. The study uses a convenience sampling method in the Nanling National Nature Reserve, China. Regression analysis results show that community participation is the most powerful predictor of pro-environmental behaviours. Furthermore, community participation moderates the relationship between place attachment and pro-environmental behaviours. In addition, perception changes in livelihood capitals positively affect pro-environmental behaviours in the high-level community participation group while having negative or positive results in the low-level community participation group. The findings, which emphasize the importance of community participation in conservation, provide a better understanding of the differences in pro-environmental behaviours between high and low community participation groups and will aid future development and conservation planning of these initiatives.

Biotransformation of 5-hydroxymethylfurfural into 2,5-dihydroxymethylfuran by Ganoderma sessile and toxicological assessment of both compounds.

Biotransformation has the advantages of low cost and environmental protection and is a preferred method for production of compounds. At present, most 2,5-dihydroxymethylfuran (DHMF) is synthesized by chemical methods. In this study, 12.008 µg/mL DHMF was produced from 9.045 µg/mL 5-hydroxymethylfurfural (5-HMF) with a yield of 1.33 g/g using the crude enzymes from fungus Ganoderma sessile. To elucidate the toxic potential for both compounds, cytotoxicity tests and acute toxicity were evaluated respectively. 5-HMF induced weak cytotoxicity in HCT-8, A549 and SGC-7901 cells and DHMF exerted no cytotoxicity on HCT-8 while induced inhibition proliferation of A549 and SGC-7901 cells. The acute toxicity study showed no mortality happened in any group even at the single dose of 2000 mg/kg body weight. These results suggest it is feasible to convert 5-HMF to DHMF via crude enzymes from fungus G. sessile under mild condition, and that DHMF displays a potential effect of antitumor in vitro with little acute toxicity.

Screening and identification of novel specific markers of breast cancer stem cells.

Breast cancer is the leading cause of death among women worldwide. Until recent years, triple negative breast cancer could be divided into 6 types according to different biomarkers with the development of sequence and microarray technology. However, these results rarely have therapeutic impact and still lack validation with the string criteria of clinical studies. Therefore, the present study aimed to screen novel markers of breast cancer stem cells and to verify the specificity in vitro and in vivo. In the present study, screening for phages specifically binding to breast cancer stem cells was performed, positive phage DNAs were extracted, and polypeptides were synthesized and labeled with FITC. The specificity of the polypeptides was identified in vitro and in vivo. Breast cancer stem cells were cultured and identified by flow cytometry. A phage random-peptide library was amplified and screened by culturing with breast cancer cells and breast cancer stem cells. The positive phage was identified by ELISA, and positive phage DNA was extracted. The DNA pellet was isolated and sent for external sequencing with the primer -96 gIII. Based on the sequencing results, a polypeptide was synthesized and labeled with FITC. The specificity to breast cancer stem cells was identified in vivo and vitro. Following three rounds of screening, the phage was enriched ~200-fold. Immunofluorescence demonstrated that two randomly selected phage clones, B8 and A3, had specific affinity to breast cancer stem cells. The results of the present study indicated that phage polypeptides that specifically bind to breast cancer stem cells were successfully screened through stem cell enrichment and phage display technology, which may be beneficial for targeted therapy and further study of breast cancer stem cells.

Biocompatibility and cellular compatibility of decellularized tracheal matrix derived from rabbits.

OBJECTIVE: To study the different concentrations of Triton X-100 and nuclease needed to remove cells from the tracheal matrix of rabbits and analyse their biocompatibility and cellular compatibility. METHODS: Fifty tracheas were harvested from donor New Zealand rabbits. Thirty tracheas were randomly divided into five groups (n = 6 each). The tracheas in group A were untreated and served as a control group, and those in groups B, C, D and E were treated with different concentrations of Triton X-100 (1%, 2%, 3% and 4%), respectively. The tracheas of the five groups were assessed by histological observation, scanning electron microscopy and mechanical evaluation. The remaining 20 donor tracheas, which were divided into a control group and an optimally decellularized group, were used for xenogeneic transplantation and cell seeding. RESULTS: Many epithelial cells and cartilage cells were observed in the tracheas of group A. There were fewer cartilage cells in the tracheas of groups C, D and E than in the tracheas of groups A and B under histological observation. In scanning electron microscopy, there were many ciliated epithelial cells in the tracheas of group A; in groups B and C, the ciliated epithelial cells disappeared, but the basement membrane was intact. The basement membranes were broken in the tracheas of groups D and E. Implanted decellularized tracheas showed good biocompatibility. Bone marrow mesenchymal stem cells grown in the decellularized tracheal matrix grew well. CONCLUSION: Decellularized tracheal matrix obtained from rabbits by 2% Triton X-100 may be suitable for the construction of tissue-engineered trachea because of its favourable morphological and biomechanical properties as well as its biocompatibility and cellular compatibly.

Long noncoding RNA Z38 promotes cell proliferation and metastasis and inhibits cell apoptosis in human gastric cancer.

Gastric cancer is one of the leading causes of cancer-associated mortality and has a high tendency to metastasize, making it a priority to develop novel diagnostic and treatment methods at the early stages. The present study investigated the role of a newly-discovered long non-coding RNA, Z38, in gastric cancer cell proliferation, metastasis and apoptosis. It was observed that Z38 was upregulated in tissues from patients with gastric cancer as well as in cultured gastric cancer cells. Knockdown of Z38 decreased the cell proliferative rate, as evidenced by colony formation assays and cell proliferation assays. In addition, Transwell assays and wound-healing assays demonstrated that depletion of Z38 significantly inhibited cell migration and invasion in AGS and MKN74 cells. Furthermore, a cell apoptosis assay and measurement of relative activities of related caspases revealed that depletion of Z38 increased cell apoptosis by promoting the activities of caspase-3 and caspase-9, but not that of caspase-8. Finally, western blot analysis further demonstrated the role of Z38 in the apoptosis of AGS and MKN74 cells. These results suggested that Z38 promotes cell proliferation and metastasis, and inhibits cell apoptosis in gastric cancer. Z38 may represent a novel therapeutic target for the treatment of gastric cancer in clinic.

Inhibition of CXCR4 regulates epithelial mesenchymal transition of NSCLC via the Hippo-YAP signaling pathway.

CXCR4 has been shown to play a key role in the metastasis of non-small cell lung cancer (NSCLC). And CXCR may be associated with the Hippo-Yes kinase-associated protein (YAP) pathway, thus involving in the occurrence and progression of NSCLC. This study aims to investigate the effect of CXCR4 inhibition on epithelial-mesenchymal transition (EMT), invasion and migration of NSCLC cells via the Hippo-YAP pathway. QRT-PCR and Western blot were employed to detect CXCR4 expression in NSCLC cell lines. A549 and H1299 cells were treated with WZ811 (0, 10, 30, and 50 µM), and A549 cells were also divided into the Control, WZ811, YAP siRNA, and WZ811 + YAP groups. Wound-healing, Transwell assay, immunofluorescent staining, and a luciferase reporter gene assay were performed in this experiment. Compared with human bronchial epithelial (HBE) cells, CXCR4 expression was up-regulated in NSCLC cell lines. WZ811 increased E-cadherin; decreased expression of Twist, vimentin, Snail, p-YAP, CTGF, and BIRC5; blocked GTIIC reporter activity; and reduced migration and invasion of A549 cells, all in a dose-dependent manner. YAP siRNA had a similar effect to WZ811 by inhibiting EMT, invasion and migration of A549 cells. However, compared with A549 cells in the YAP siRNA and WZ811 groups, cells in the WZ811 + YAP group showed a dramatically enhanced EMT phenotype as well as invasion and migration abilities. Inhibition of CXCR4 may reduce EMT, invasion and migration of NSCLC cells, thereby providing a new therapeutic target for NSCLC.

Cavernous hemangioma of the thymus: A case report and review of the literature.

RATIONALE: Cavernous hemangioma is a congenital venous malformation with the potential to develop in all tissues of the body. However, cavernous hemangioma of the thymus is extremely rare. PATIENT CONCERNS: The present study describes the case of an asymptomatic, 30-year-old female who presented with a cavernous hemangioma in the thymus during a physical examination. Enhanced computed tomography of the chest revealed a 2.3 × 1.7 × 1.3 cm mass in the thymus. DIAGNOSES: Histopathological examination revealed that the tumor exhibited the typical histological findings of a cavernous hemangioma. INTERVENTIONS: The patient underwent surgical resection due to the uncertain diagnosis and the possibility that the mass was a thymoma or teratoma. OUTCOMES: One-year post surgery, the patient was alive with no evidence of tumor recurrence. LESSONS: Cavernous hemangioma of the thymus is a very rare disease. Complete surgical resection may be a critical therapeutic option.

Surgery combined with radio-chemotherapy for esophageal mucoepidermoid carcinoma: A case report.

RATIONALE: Primary mucoepidermoid carcinoma (MEC) of the esophagus is a rare type of malignant neoplasm. Its morphology resembles that of MEC of the salivary glands. It is characterized by a diffuse mixture of squamous and mucus-secreting glandular carcinoma cells. Due to the low incidence of esophageal MEC, the biological behavior and treatment of this tumor have not been well studied. PATIENT CONCERNS: In this case report, we describe a case of a 59-year-old man who presented with difficulty in swallowing. Iohexol swallowing revealed a malignant-appearing structure in the inferior-thoracic region. DIAGNOSES: Biopsy of the lesion under endoscopy demonstrated a mucoepidermoid carcinoma of the esophagus. INTERVENTIONS: We performed esophagectomy, esophagogastrostomy through the esophageal bed and 2-field lymphadenectomy. Histopathological analysis of the tumor revealed histological characteristics typical of an esophageal MEC. Radio-chemotherapy was administered to this patient. OUTCOMES: Seventeen months after surgery, an esophageal computed tomography (CT) scan revealed that the wall of esophagus was evenly thickened. However, endoscopic assessment revealed no evidence of recurrence. Further CT scans at 19 and 31 months after surgery also showed a thickened esophageal wall, although endoscopic assessment at 31 months still revealed no esophageal stricture and no evidence of recurrence. The patient is alive with no dysphagia and no evidence of recurrence for over 39 months. LESSONS: There is little evidence of effective treatment nor guidelines for treatment of esophageal MEC. Although the general prognosis of esophageal MEC is poor, comprehensive treatment of surgery and radio-chemotherapy appeared to be effective in this case. Radio-chemotherapy is a possible treatment option that was shown to have acceptable short-term effects.