Calcification of vestibular schwannoma: a case report and literature review

Calcification rarely occurs in vestibular schwannoma (VS), and only seven cases of calcified VS have been reported in the literature. Here, we report a 48-year-old man with VS, who had a history of progressive left-sided hearing loss for 3 years. Neurological examination revealed that he had left-sided hearing loss and left cerebellar ataxia. Magnetic resonance imaging and computerized tomography angiography showed a mass with calcification in the left cerebellopontine angle (CPA). The tumor was successfully removed via suboccipital craniotomy, and postoperative histopathology showed that the tumor was a schwannoma. We reviewed seven cases of calcified VS that were previously reported in the literature, and we analyzed and summarized the characteristics of these tumors, including the calcification, texture, and blood supply. We conclude that calcification in VS is associated with its texture and blood supply, and these characteristics affect the surgical removal of the tumor.

via World Journal of Surgical Oncology

Overwhelming response to Dabrafenib in a patient with double BRAF mutation (V600E; V600M) metastatic malignant melanoma

The recent findings brought the necessity of testing the mutational status of a series of geneswhich had been already identified as responsible for melanomas development andprogression, such as BRAF, CKIT and PTEN: the consequent results are, in fact, essential toguide the assessment of the novel treatment protocols based on tailored targeted therapies.We present here the case of a 66 year-old male patient, diagnosed with an advancedmelanoma in June 2011, and treated with Dabrafenib for double mutant metastatic disease.The patient was referred to our attention for a large exophytic malignant melanoma on theleft shoulder. After complete surgical excision and elective lymph node dissection forpresence of metastatic sentinel lymph node, the patient has started high-dose interferon alfa-2b injections as adjuvant therapy for a complete negative staging. The treatment wasinterrupted in August 2011 due to the appearance of metastatic lymph nodes. Tumor burdenwas rapidly growing reaching in few months the size of a tennis ball for the tumor masslocated in the shoulder. Mutational study of the tumor revealed a double BRAF mutation onV-600E and V600M. This finding incited us to enroll the patient in compassionateDabrafenib clinical trial. The therapy was started on may 2012 at 150 mg bid dosage. Almostsurprisingly for the rapidity of the effect, one week later the lesion on the shoulder hasreduced its size by 60% and one month later it has completely disappeared from sight. CTscan of June 2012 documented the astonishing clinical response.

via Journal of Hematology & Oncology

Effect of autoimmune diseases on incidence and survival in subsequent multiple myeloma

Background: Patients with many types of autoimmune diseases (AIDs) are at an increased risk of cancer,which may depend on underlying dysregulation of the immune system or treatment. Wesystematically analyzed myeloma risk and survival in patients diagnosed with 33 differentAIDs. Methods: Data on patients with AIDs were retrieved from the Swedish Hospital Discharge Register andwere linked to myeloma diagnoses from the Cancer Registry. Standardized incidence ratios(SIR) and hazard ratios (HRs) were calculated for subsequent myeloma between 1964 and2008. Results: Among patients with the 33 AIDs analyzed, 457 cases of myeloma were diagnosed. Theoverall SIR for myeloma was 1.12 and the overall HR was 0.92 and non-significant. SIRs formyeloma were significantly increased after ankylosing spondylitis (2.02) and systemicsclerosis (2.63). Only the HR for myeloma after rheumatic fever (5.27) was significantlyincreased. The SIR for myeloma before age 60 years was 1.45; the SIR for myeloma wasonly increased in the period 1964-1990 (1.31) and not later (1.04). Only the SIR for myelomaafter ankylosing spondylitis was increased in the period 1991-2008 (2.09); the HRs formyeloma were increased after polymyositis/dermatomyositis (6.44) and rheumatic fever(4.43) but there were only three cases of myeloma after these AIDs. Conclusions: The present data showed an increase in myeloma SIR after two AIDs, ankylosing spondylitisand systemic sclerosis, and in HR after rheumatic fever. The overall myeloma risk after anyAID was no longer increased in the latter follow-up period of 1991 through 2008.

via Journal of Hematology & Oncology

Nuclear BMI-1 expression in laryngeal carcinoma correlates with lymph node pathological status

Background: The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment. Methods: Sixty-four previously untreated patients who underwent surgical excision of laryngeal squamous cell carcinoma with neck dissection were included in this study. The expression of B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) was examined immunohistochemically on formalin-fixed paraffin-embedded primary tissue specimens. Results: Nuclear expression of BMI-1 (nBMI-1) was detected in 32 of the 64 tumors (50%), cytoplasmic expression of BMI-1 (cBMI-1) was detected in 22 (34.4%), and 10 tumors (15.6%) showed no BMI-1 immunoreactivity. High nBMI-1 expression levels (>=10) were detected in 28 of the 32 (87.5%) nBMI-1-positive patients. Multivariate analysis including age at diagnosis, grade, tumor location, TNM status, and nBMI-1 expression showed that a high nBMI-1 expression level was an independent prognostic factor for lymph node metastasis. Conclusion: The expression of BMI-1 in patients with laryngeal carcinoma seems to correlate with lymph node metastasis.

via World Journal of Surgical Oncology

Adjuvants underused initially, follow up needed for cancer patients in pain

Italian study results indicate that physicians underuse adjuvant therapies for treatment of pain in cancer in the first instance, and that close follow up of oncology patients is needed to improve the efficacy of analgesic therapy in this setting.

via Med Wire News

Incidence of esophageal, stomach cancers increased in AIDS

The risk for esophageal and stomach carcinomas, as well as non-Hodgkin lymphomas, is significantly increased in people with AIDS, although the incidence of lymphomas has decreased, the results of a US and UK study reveal.

via Med Wire News

GnRH agonist may protect breast cancer patient fertility

Treatment with a gonadotropin-releasing hormone agonist may reduce the risk for chemotherapy-induced amenorrhea, research shows.

via Med Wire News