Intrahepatic Cholangiocarcinoma in Hodgkin Lymphoma Survivor: Take it or Leave?

Advances in treatment for Hodgkin Lymphoma (HL) have dramatically improved long-term survival and life expectancy. Despite, survivors are prone to develop high-dose radiotherapy late-onset neoplastic complications: the 30 years cumulative incidence of a second malignancy is 30.7% (95% CI, 28.7-32.7).

Among them, solid tumors account for up to 75–80% of all second malignancies, typically located at the edges of prior radiation fields. Primary liver cancer secondary to HL is significantly increased after mixed-modality treatment, with a 2.6 folds Relative-Risk and 0.5 Absolute Excess Risk per 10,000 Person-Years.

When technically resectable, surgery is recognized to be the best curative treatment for primary liver tumors. The downside is that surgery on radiation tissues is highly dangerous leading to poor wound healing, fistula formation, skin necrosis and even death in relation with atrophic tissue inefficient to realize normal healing.

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Medico-legal Aspects of Delay in Diagnosis of Breast Cancer

As a capricious and heterogeneous disease breast cancer may be difficult to diagnose and despite being appropriately treated may relapse unexpectedly.

Governmental pressure to reduce waiting for women with breast cancer may lead some patients to suspect that very short delays may impact adversely on their prognosis.

In this supercharged atmosphere of anxiety, communicational skills of breast surgeons may be constantly tested so that minor solecisms may translate into major patient dissatisfaction.

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Huge Bilateral Mature Cystic Teratoma in Adolescence: A Case Report and Review of Literature

Mature cystic teratoma is a benign tumor of the ovary arising from germ cells. It can occur at any age but, commonly in patients between 20 and 40 years. It is usually unilateral. The size of the tumor is relatively small at the time of diagnosis.

An unusual presentation of mature cystic teratoma considering age of the patient, diagnosis and features of the tumor, is described, which to our knowledge has not been reported before in the literature.

The incidence of mature cystic teratoma is 10-20% of all ovarian tumor. It is usually unilateral, and bilateral in 10-15% of cases, commonly seen in patients between 20 and 40 of age. Size of this tumor rarely exceeds 10 cm. An unusual presentation of bilateral mature cystic teratoma in a young adolescent patient is described.

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The Utility of Mammi-Pet in Multifocal Breast Cancer

We present the case of a 65 year-old woman referred from the breast cancer prevention programme by the appearance of a suspicious lesion in the mammography.

There were not personal or familiar antecedents of breast cancer in the clinical history and was mother of two child. The patient was asymptomatic and the physical examination revealed a tumor of 4 cm in the upper outer quadrant of the left breast. She also presented a palpable lymph node in the left axilla.

The ultrasound image described a bad defined nodule of 25 × 24 × 20 mm with and adjacent nodule of 12 × 9 × 11 mm in the upper outer quadrant of left breast, one nodule of 7 × 7 × 7 mm in the axillary tail, and one of 4 × 3 × 4 mm near the nipple.

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Oncolytic Viral Therapy of Glioblastoma: Will this Soon become a Reality?

The first oncolytic virus therapy (talimogene laherparepvec or TVEC) in the U.S. was approved in October 2015 for the treatment of advanced melanoma patients.

Such novel and safer treatments are in active development but not yet available for brain tumors. Glioblastoma multiforme (GBM) is the most common and aggressive form of brain cancer in adults with median survival of less than 15 months.

Current radiotherapy and chemotherapy regimens not only have failed to significantly benefit high-grade tumor patients, but also are associated with severe long-term side effects that worsen the quality of life.

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Neuroimmunological Manifestations of Chemotherapy Exposure: Implications for Mucositis, Glia and Cognition

Chemotherapy drugs reduce quality of life often causing acute and delayed central side-effects, termed chemotherapy-induced cognitive impairment (CICI). Another dose-limiting chemotherapy-induced side-effect is oral and intestinal mucositis which results in significant gastrointestinal (GIT) damage and intestinal inflammation.

Recent interest has been paid to neurological complications arising in patients with gut disorders, yet little attention has been paid to the role GIT damage plays in CICI. Our current understanding of neuronal adaptations and behavioral consequences resulting from immune system dysregulation has paved the way for investigation into the neuroimmunological manifestations associated with chemotherapy.

In a clinical setting cancer patients experience a cluster of symptoms, similar to that manifested in cytokine-induced sickness responses.

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Review of Leakage from a Linear Accelerator and Its Side Effects on Cancer Patients

Radiation therapy using external beam radiation therapy (EBRT) is playing an important role for effective treatment of all kinds of tumors. Peripheral dose is the result of leakage and scatter from multileaf collimators devices (MLCs), counts for 2-10% of the maximum dose given to the patient, depending on the machine used and type of treatment.

The present review reveals that despite of the recent advancements in linear accelerators (LINAC) and MLC design and technology, the remaining small amount of leakage (peripheral dose) of these devices still has significant side effects on patient’s life span and quality of life after treatment.

Based on the findings in this review, it is suggested that introduction of additional effective and patient-specific shielding techniques would have great impact on reducing risk of radiating healthy cells and hence adversely side effects on cancer patients.

Current Understanding of Epidemiology, Genetic Etiology and Treatment of Gliomas from Indian Population

Tumors of the central nervous system (CNS) consist of 1-2% of the total cancer spectrum. Gliomas are the most common tumors within the CNS. These tumors originate from glial cells or glial precursor cells.

Tumors originates from astroglial cells are known as astrocytoma, oligodendroglioma originates from oligodendroglial cells, oligoastrocytoma are mixed tumor containing cellular property of both astrocytes and oligodendrocytes and ependymal cells gives rise to ependymoma.

The World Health Organization (WHO) classification of central nervous system tumors separates glioma into four grades, in which grade I and II are defined as low grade whereas grade III and IV are classified as high grade (also known as malignant glioma).

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Analysis of Set-up Parameters in Head and Neck Patients at the Charlotte Maxeke Johannesburg Academic Hospital

This study aimed to collect and analyze the recorded daily setup parameters of the bed as incidentally captured on an integrated record and verify system.

This was done on some radical head and neck patients treated from 2008 to 2010 at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa. Most of these patients had anterior neck fields that were set-up using fixed couch longitudinal movements (meaning more than one treatment isocentre).

It was hoped that the ideal absolute position of the patient on the bed relative to the isocentre of the treatment machine, for a course of head and neck radiotherapy at CMJAH, could be established. Knowledge of the set-up margin achievable could also assist in defining the tolerance assigned to couch parameters on the electronic record and verify system, such that setup is restricted accordingly.

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Caveats in Diagnosis of Helicobacter Pylori Infection can be Avoided by a Panel of Serum Biomarkers

The understanding on the important role played by Helicobacter Pylori (HP) infection in pathogenesis of gastric cancer (GC) and peptic ulcer disease has increased progressively since the discovery of the bacteria in 1984 by Marshall and Warren.

According to the current concepts, GC develops from HP-infection through precursor lesions of progressively increasing severity: mild, moderate and severe atrophic gastritis (AG), accompanied by intestinal metaplasia (IM) and dysplasia. This sequence of events is generally known as the “Correa cascade”, and estimated to be involved in around 50% of GC cases, particularly the intestinal type of GC.

In parallel with the increased understanding of the pathogenetic mechanisms, also the management of HP- infection has undergone substantial development during the past decade. In this context, the term management also covers the complex topics related to the diagnosis of HP-infections. Much of this favourable development can be attributed to the European Helicobacter Study Group that took its first initiative in 1996 in Maastricht to gather dedicated experts to review all relevant clinical data to draft the recommendations for the clinical management of HP-infection.

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Arsenic Trioxide Induces Apoptosis via Specific Signaling Pathways in HT- 29 Colon Cancer Cells

Arsenic trioxide (ATO) is highly effective in the treatment of patients with acute promyelocytic leukemia (APL). It is a chemotherapeutic agent that has been shown to induce apoptosis in several tumor cell lines. However, research into its effects on colon carcinoma cells is still very limited.

We previously reported that ATO is cytotoxic and causes DNA damage in HT-29 human colorectal adenocarcinoma cells. In the present study, we further evaluated its effect on oxidative stress (OS), and examined its apoptotic mechanisms of action on HT-29 cells. Methods: OS was assessed by spectrophotometric measurements of MDA levels while cell cycle analysis was evaluated by flow cytometry to determine whether ATO induces cell cycle arrest. Its effect on early apoptosis was also evaluated by flow cytometry using Annexin V-FITC/PI staining.

Fluorescence microscopy was used to detect the morphological changes, and Western blotting was carried out to determine the expression of apoptosis-related proteins. Results: The lipid peroxidation assay revealed a dose-dependent increase in MDA production. DAPI staining showed morphological changes in the cell’s nucleus due to apoptosis.

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