http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Thu, 16 May 2013 09:18:50 +0000 http://www.hindawi.com/crim/oncmed/2013/954346/ A 72-year-old woman underwent a mastectomy with one-stage breast reconstruction using silicone implant for right breast cancer. Postoperatively, she had received adjuvant chemotherapy with fluorouracil, epirubicin, and cyclophosphamide (FEC regimen). She was admitted for febrile neutropenia after the third course of chemotherapy. She remained febrile for a week, and she complained of dyspnea on hospital day 8. Computed tomography scan demonstrated widespread patchy ground glass changes in both lungs and serum (13)--D-glucan was elevated to 20 pg/mL. Oral trimethoprim-sulfamethoxazole was started on the strong clinical suspicion of PCP, and the patient subsequently made a rapid recovery from fever and dyspnea. Tsuyoshi Shinohara, Makito Yasui, Hiroyuki Yamada, Yoshiro Fujimori, and Kiyofumi Yamagishi Copyright © 2013 Tsuyoshi Shinohara et al. All rights reserved. Thu, 16 May 2013 09:16:41 +0000 http://www.hindawi.com/crim/oncmed/2013/610280/ Primary retroperitoneal teratomas involving adrenal glands are exceedingly uncommon accounting for only 4% of all primary teratomas. They are more common in childhood and rarely occur in adults. Only a very few case reports have been documented in literature so far. Herein, we report a mature (benign) cystic retroperitoneal teratoma in the region of left adrenal gland in a 22-year-old otherwise healthy male patient who presented with a 1-month history of left flank pain. In addition, a literature review on teratomas is included. Adnan Bhatti, Hindi Al-Hindi, Ayman Azzam, Tarek Amin, and Ahmed Abu-Zaid Copyright © 2013 Adnan Bhatti et al. All rights reserved. Tue, 14 May 2013 17:33:08 +0000 http://www.hindawi.com/crim/oncmed/2013/871292/ Introduction. Phyllodes tumors are rare fibroepithelial tumors which constitute less than 1% of all known breast neoplasms. The importance of recognizing these tumors lies in the need to differentiate them from fibroadenomas and other benign breast lesions to avoid inappropriate surgical management. We report a case of large phyllodes tumor which caused rupture of the breast and presented as an external fungating breast mass, a presentation which is exceedingly rare. Case Presentation. A 32-year-old female presented with a 1-year history of a mass in her right breast and eruption of the mass through the skin for the last 3 months. On physical examination, an ulcerated, irregular, and nodular mass measuring  cms was found hanging in the lower and outer quadrant of the right breast. Ultrasonography revealed an exophytic mass with heterogeneous echotexture and vascularity. Under general anesthesia, the tumor was excised. The resected specimen was  cm in size and the tumor was not invasive to the surrounding tissues. Histological examination confirmed a benign case of Phyllodes tumor. Conclusion. Clinicians should be aware of the myriad ways in which Phyllodes can present. A rapidly growing breast mass in a female should raise strong suspicion for Phyllodes. It is necessary to differentiate it from fibroadenomas to avoid inappropriate surgical management which may lead to local recurrence. Junaid Nabi, S. M. Quamrul Akhter, and Fatema N. Authoy Copyright © 2013 Junaid Nabi et al. All rights reserved. Sun, 12 May 2013 15:03:24 +0000 http://www.hindawi.com/crim/oncmed/2013/259326/ We present a patient with malignant melanoma on his heel. Wide local excision was performed, along with sentinel lymph node biopsy of the inguinal and popliteal lesions. The primary site was clear of tumor at all margins; the inguinal nodes were negative, but the popliteal node was positive for metastatic melanoma. Only radical popliteal lymph node dissection was performed. The patient went on to receive adjuvant chemoimmunotherapy. There was no recurrence or complication until the long-term followup. Popliteal drainage from below the knee is uncommon, and the rate of popliteal-positive and inguinal-negative cases is estimated to be less than 1% of all melanomas. There is no established evidence about how to treat lymph nodes in these cases. Because we considered popliteal nodes as a regional, not interval, lymph node basin, only popliteal lymph node dissection was performed, and good postoperative course was achieved. The first site of drainage is the sentinel node, and the popliteal node can be a sentinel node. The inguinal node is not a sentinel node in all lower extremity melanomas. This case illustrates the importance of individual detailed investigation of lymphatic drainage patterns from foot to inguinal and popliteal nodes. Kentaro Tanaka, Hiroki Mori, Mutsumi Okazaki, Aya Nishizawa, and Hiroo Yokozeki Copyright © 2013 Kentaro Tanaka et al. All rights reserved. Sun, 12 May 2013 14:15:19 +0000 http://www.hindawi.com/crim/oncmed/2013/780493/ Isolated muscle and bone metastases are rarely encountered in patients with testicular seminomas. In the present study, a patient who was admitted with pain, loss of motion, and swelling in the right leg 20 months following surgery for stage I seminoma was presented. Hypermetabolic lesion was detected in the right femoral muscle and bone via positron emission tomography. After the presence of metastasis from seminoma was confirmed by biopsy, bleomycin, cisplatin, and etoposide, combination chemotherapy was administered to the patient. Serkan Degirmencioglu and Burcu Degirmencioglu Copyright © 2013 Serkan Degirmencioglu and Burcu Degirmencioglu. All rights reserved. Sun, 12 May 2013 10:52:37 +0000 http://www.hindawi.com/crim/oncmed/2013/370179/ Burkitt's lymphoma (BL) is an aggressive B-cell malignancy with very high proliferation rate, more common in males than females. Here, we describe a case of Burkitt's lymphoma in a 24-week pregnant woman with cervical and abdominal involvement. The common genetic event of virtually all BL is a reciprocal chromosomal translocation involving the proto-oncogene MYC and one of the Ig gene heavy or light chain loci. Supportive treatment was administered until early delivery, after which the patient was treated according to protocol LMB96. Pregnancy and tumorogenesis share some important events such as immunologic tolerance, angiogenesis, and editing the host immune response. Little is known about the relationship between these events in pregnancy and in tumorogenesis. Carlos Zagalo, Francesca Pierdomenico, José Cabeçadas, and Pedro David Santos Copyright © 2013 Carlos Zagalo et al. All rights reserved. Wed, 08 May 2013 14:07:18 +0000 http://www.hindawi.com/crim/oncmed/2013/597527/ Primary lymphoma of the breast is a rare entity in the field of oncological medicine and represents <0.5% of all breast malignancies. A definitive diagnosis is obtained by excisional biopsy as the clinical and radiographical presentation is similar to the more common primary breast carcinoma. Unlike primary breast carcinoma, localized radiation therapy is the mainstay of treatment. We report on a case of primary follicular lymphoma of the breast in a 67-year-old Caucasian woman treated with localized radiation as well as coinciding literature review regarding outcomes of different treatment modalities. Raymon Patron and Edward F. Miles Copyright © 2013 Raymon Patron and Edward F. Miles. All rights reserved. Sun, 28 Apr 2013 16:05:17 +0000 http://www.hindawi.com/crim/oncmed/2013/167585/ Background. Sweat gland carcinoma is a rare malignancy with a high metastatic potential seen more commonly in elderly patients. The scalp is the most common site of occurrence and it usually spreads to regional lymph nodes. Liver, lungs, and bones are the most common sites of distant metastasis. Late lung metastasis of sweat gland adenocarcinoma after a time span of 5 years is extremely rare. Aim. We report a patient with late lung metastasis of a primary sweat gland carcinoma 10 years after initial surgical resection. Conclusion. Sweat gland carcinomas are rare cancers with a poor prognosis. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Late pulmonary metastases with a latency of 10 years have never been reported in the literature. This is the first clinical documentation of late lung metastasis from sweat gland carcinoma with a latency period of 10 years. R. F. Falkenstern-Ge, S. Bode-Erdmann, G. Ott, M. Wohlleber, and M. Kohlhäufl Copyright © 2013 R. F. Falkenstern-Ge et al. All rights reserved. Thu, 18 Apr 2013 15:13:06 +0000 http://www.hindawi.com/crim/oncmed/2013/198729/ Introduction. Pleural mesothelioma with metastasis to the subcutaneous tissue of the abdominal wall at first diagnosis and without penetration into the peritoneum is an extremely rare clinical presentation. Methods. Patients with pleural mesothelioma have low survival rate. Usually, the disease at presentation is confined to its site of origin (most often the pleural cavity). A 55-year-old man was referred to our center due to increasing dyspnea and a painful periumbilical mass in the anterior abdominal wall. CT scan revealed both advanced mesothelioma of the pleura and a tumor mass confined to the subcutaneous fatty tissue without penetration through the peritoneum. Results. Video-assisted thoracoscopy confirmed the diagnosis of epithelioid pleural mesothelioma, which was also confirmed by a biopsy of the periumbilical mass. Systemic chemotherapy with cisplatin and pemetrexed was initiated. Under the ongoing systemic chemotherapy, the evaluation revealed partial remission of pleura mesothelioma and its subcutaneous manifestation of the abdominal wall. Conclusion. Mesothelioma of the pleura with a simultaneous metastasis to the subcutaneous fatty tissue of the abdominal wall at presentation without penetration of peritoneum is a rare clinical presentation of mesothelioma disease. The knowledge of its natural history is very limited. This is the first ever clinical documentation of a patient with pleura mesothelioma and simultaneous subcutaneous manifestation of abdominal wall. R. F. Falkenstern-Ge, M. Kimmich, S. Bode-Erdmann, G. Friedel, G. Ott, and M. Kohlhäufl Copyright © 2013 R. F. Falkenstern-Ge et al. All rights reserved. Thu, 11 Apr 2013 11:25:57 +0000 http://www.hindawi.com/crim/oncmed/2013/485025/ Clear cell renal cell carcinoma (CCRCC) is the most common origin for metastasis in the thyroid. A 51-year-old woman was referred to our hospital for a subcarinal lesion. Ten years before, the patient had undergone a nephrectomy for CCRCC. Whole-body fluorodeoxyglucose positron emission tomography revealed elevated values in the thyroid gland, while the mediastinum was normal. An endoscopic ultrasonography-guided fine-needle aspiration biopsy of the mediastinal mass was consistent with CCRCC, and this was confirmed after resection. The thyroidectomy specimen also revealed lymphocytic thyroiditis, nodular hyperplasia, one follicular adenoma, two papillary microcarcinomas, and six foci of metastatic CCRCC involving both thyroid lobes. Curiously two of the six metastatic foci were located inside two adenomatoid nodules (tumor-in-tumor). The metastatic cells were positive for cytokeratins, CD10, epidermal growth factor receptor, and vascular endothelial growth factor receptor 2. No BRAF gene mutations were found in any of the primary and metastatic lesions. The patient was treated with sunitinib and finally died due to CCRCC distant metastases 6 years after the thyroidectomy. In CCRCC patients, a particularly prolonged survival rate may be achieved with the appropriate therapy, in contrast to the ominous prognosis typically found in patients with thyroid metastases from other origins. Carlos Zamarrón, Ihab Abdulkader, María C. Areses, Vanesa García-Paz, Luís León, and José Cameselle-Teijeiro Copyright © 2013 Carlos Zamarrón et al. All rights reserved. Tue, 09 Apr 2013 09:17:12 +0000 http://www.hindawi.com/crim/oncmed/2013/135307/ Verrucous carcinoma of the foot often affects deep structures such as tendons, muscles, or bones. A 74-year-old man presented with a foot lesion that had been diagnosed as a skin infection 7 years earlier. He was treated with multiple excisions and superficial biopsies associated with antibiotic therapy without success. In our department he underwent an aggressive and accurate debridement with marginal excision harvesting multiple biopsies. Pathological evaluation of tissue at the time of operation confirmed the diagnosis of verrucous carcinoma of the foot. Therefore, the patient underwent an amputation below knee, and there were no postoperative complications; the patient was able to walk with the aid of a prosthesis with no signs of recurrence. The lesion follows a chronic course evolving from a discrete focal lesion to a large fungating deeply penetrating mass often compromised by local infection. The slow growth and confusing early-stage appearances can lead to delays in diagnosis of 8 to 15 years causing the extracutaneous involvement that requires a leg amputation. Many patients are initially treated with many topical medications without success, and most tumors have been treated as recalcitrant warts or corns for some time, whereas the basic approach is surgical. C. Pempinello, A. Bova, R. Pempinello, R. Luise, and G. Iannaci Copyright © 2013 C. Pempinello et al. All rights reserved. Mon, 08 Apr 2013 10:32:11 +0000 http://www.hindawi.com/crim/oncmed/2013/683948/ Combined chemotherapeutic regimens in conjunction with oxaliplatin are considered safe and effective treatment options in the clinical management of metastatic colorectal cancer. A 62-year-old male patient with a metastatic rectal carcinoma developed a pulmonary reaction after the first application of the combined standard chemotherapy regimen (5-fluorouracil and sodium folinic acid as a 24 h infusion and oxaliplatin). Following the first dose of chemotherapy, the patient developed acute dyspnoea and fever. A computerised scan of the chest revealed bilateral pulmonary patchy consolidation. Despite high-dose empiric antibiotic and antimycotic treatment, no clinical improvement was seen. The patient's condition deteriorated, and he required invasive mechanical ventilation. Diagnostic thoracoscopic wedge resections were performed for further diagnosis. The histological workup revealed distinct granulomatous inflammation, but no microbial pathogens were to be found. Thereupon, a drug-induced reaction to chemotherapy was suspected and high-dose steroid treatment initiated. Subsequently, the patient's respiratory condition improved and he was extubated. The present case exemplifies the rare course of a bilateral pneumonia-like, drug-induced granulomatous reaction following a single application of oxaliplatin. In addition to the known side effects of oxaliplatin-containing combination chemotherapy, unexpected serious adverse events in the form of pulmonary toxicities should also be taken into account. Dane Wildner, Frank Boxberger, Axel Wein, Kerstin Wolff, Heinz Albrecht, Gudrun Männlein, Rolf Janka, Kerstin Amann, Jürgen Siebler, Werner Hohenberger, Markus F. Neurath, and Richard Strauß Copyright © 2013 Dane Wildner et al. All rights reserved. Mon, 08 Apr 2013 10:00:45 +0000 http://www.hindawi.com/crim/oncmed/2013/458378/ Introduction. Paraneoplastic syndromes represent rare symptom complexes resulting from the ability of tumour cells to disrupt the homeostatic processes of various bodily systems. Here we present two cases to demonstrate how such tumours may evade detection even after extensive investigation and how even relatively benign tumours can produce severe neurological symptoms. Case 1. A 69-year-old female was admitted with a subacute onset of dysarthria, ataxia, and cerebellar signs. Workup revealed a relatively benign Non-Hodgkin’s Lymphoma. Case 2. A 64-year-old female was admitted with acute leg weakness, which progressed to quadriplegia and was eventually fatal over the ensuing months. Her Ca-125 was elevated, though three different CT views of her pelvis and surgical exploration failed to demonstrate any malignancy. Discussion. These cases highlight how even relatively benign or very small tumours may result in severe neurological symptoms. Suspecting and investigating paraneoplastic syndromes (PNSs) are crucial as up to 80% of patients present with PNS before there is any other indication of malignancy. A PET scan and regular surveillance may reveal occult malignancies better than CT or MRI. Neuromodulatory therapies and treatment of the underlying malignancy remain the best management options in these patients. M. Ghadiri-Sani, Mueez Waqar, Dave Smith, and Mark Doran Copyright © 2013 M. Ghadiri-Sani et al. All rights reserved. Sun, 07 Apr 2013 15:35:11 +0000 http://www.hindawi.com/crim/oncmed/2013/903094/ Radiotherapy is the primary form of treatment in patients with locally advanced cervical carcinoma. However for residual disease in the form of the persistent lymph nodes, surgery or chemotherapy is recommended. As surgery is not acceptable by every patient and chemotherapy has associated side effects, we hereby report the positive outcome of in vitro expanded natural killer cell and activated T lymphocyte based autologous immune enhancement therapy (AIET) for the residual lymphadenopathy in a patient with locally advanced cervical cancer after radiation. After six transfusions of AIET, there was complete resolution of residual lymph nodes and there was no evidence of local lesion. The patient also reported improvement in quality of life. As AIET has been reported as the least toxic among the available therapies for cancer, combining AIET with conventional forms of therapy in similar patients might not only improve the outcome but may also help the patients achieve a good quality of life. Sumana Premkumar, Vidyasagar Devaprasad Dedeepiya, Hiroshi Terunuma, Rajappa Senthilkumar, Thangavelu Srinivasan, Helen C. Reena, Senthilkumar Preethy, and Samuel J. K. Abraham Copyright © 2013 Sumana Premkumar et al. All rights reserved. Sun, 07 Apr 2013 15:13:38 +0000 http://www.hindawi.com/crim/oncmed/2013/858705/ Introduction. Primary osteosarcoma of the breast is a rare soft-tissue form of osteosarcoma without involvement of the skeletal system. Due to the rarity of the disease, its clinical features and optimal treatment remain unclear. Case Presentation. This case report deals with a 62-year-old woman with pure osteosarcoma of the breast. Conclusions. The prognosis of primary osteosarcoma of the breast is poor. Recurrence is frequent, and it is often associated with haematogenous spread of the disease to the lung. Treatment follows the model of sarcomas affecting other locations and must be planned in a multidisciplinary fashion. Adjuvant chemotherapy should be considered for patients with tumors showing aggressive features. Anna Rizzi, Alberto Soregaroli, Claudia Zambelli, Fausto Zorzi, Stefano Mutti, Claudio Codignola, Paola Bertocchi, and Alberto Zaniboni Copyright © 2013 Anna Rizzi et al. All rights reserved. Thu, 04 Apr 2013 15:01:27 +0000 http://www.hindawi.com/crim/oncmed/2013/475961/ Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC) most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC) are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC. Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT) of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD) revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation. Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible. Natassja Frances, Simon B. Zeichner, Michael Francavilla, and Mike Cusnir Copyright © 2013 Natassja Frances et al. All rights reserved. Wed, 03 Apr 2013 15:51:59 +0000 http://www.hindawi.com/crim/oncmed/2013/270362/ We describe the presentation, management, and clinical outcome of a massive acinic cell carcinoma of the parotid gland. The primary tumor and blood underwent exome sequencing which revealed deletions in CDKN2A as well as PPP1R13B, which induces p53. A damaging nonsynonymous mutation was noted in EP300, a histone acetylase which plays a role in cellular proliferation. This study provides the first insights into the genetic underpinnings of this cancer. Future large-scale efforts will be necessary to define the mutational landscape of salivary gland malignancies to identify therapeutic targets and biomarkers of treatment failure. Anthony C. Nichols, Michelle Chan-Seng-Yue, John Yoo, Sumit K. Agrawal, Maud H. W. Starmans, Daryl Waggott, Nicholas J. Harding, Samuel A. Dowthwaite, David A. Palma, Kevin Fung, Bret Wehrli, S. Danielle MacNeil, Philippe Lambin, Eric Winquist, James Koropatnick, Joe S. Mymryk, Paul C. Boutros, and John W. Barrett Copyright © 2013 Anthony C. Nichols et al. All rights reserved. Thu, 28 Mar 2013 13:41:33 +0000 http://www.hindawi.com/crim/oncmed/2013/614658/ Primary central nervous lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin's lymphoma with a especially poor prognosis. The diagnosis is usually encountered in immunodeficient patients but is also encountered, albeit uncommonly, in the immunocompetent. We present a 50-year-old male who developed signs and symptoms of increased intracranial pressure. Imaging revealed the presence of a fourth ventricle mass with obstructive hydrocephalus. First, the patient underwent emergency endoscopic third ventriculostomy followed, few days later, by complete tumor resection via a posterior fossa craniotomy. Postoperative histopathology revealed the lesion to be a PCNSL. He received adjuvant chemotherapy and radiation and remained with no recurrence on regular imaging studies for 18-month followup. We report herein the fourth case of isolated PCNSL lesion to the fourth ventricle in the literature and provide the rationale for our belief that craniotomy and tumor resection, if feasible, should be the initial line of management in similar cases to relieve hydrocephalus and achieve the diagnosis. Rakan Bokhari, Ahmad Ghanem, Mahmoud Alahwal, and Saleh Baeesa Copyright © 2013 Rakan Bokhari et al. All rights reserved. Tue, 19 Mar 2013 16:19:40 +0000 http://www.hindawi.com/crim/oncmed/2013/328108/ Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal benign tumor which is generally seen in children and in young adults. It is especially located in the lungs. In histopathological examination, neoplastic fusiform cells originating from a subtype of accessory immune system cells which are called fibroblastic reticulum cells are seen (Kouichi and Youichirou, 2008). Although IMT is histopathologically benign, imaging methods show its tendency for local recurrence and invasion. In most of the cases, it may not be possible to make a distinction whether it is malign or benign. Complete surgical resection is the most important treatment method. In this study, we have discussed the findings of our case having a gastric submucosal located IMT in light of the current literatures. Deniz Arslan, Şeyda Gündüz, Deniz Tural, Mükremin Uysal, Ali Murat Tatlı, Cumhur İbrahim Başsorgun, Gülsüm Özlem Elpek, Hasan Şenol Coşkun, Hakan Şat Bozcuk, and Burhan Savaş Copyright © 2013 Deniz Arslan et al. All rights reserved. Thu, 14 Mar 2013 10:18:12 +0000 http://www.hindawi.com/crim/oncmed/2013/793418/ Introduction. Most common metastasis sites of breast cancer are the lungs, bones, liver, and brain, whereas uterine involvement by metastatic breast disease is rare. Metastatic carcinoma of the uterus usually originates from other genital sites, most commonly being from the ovaries. Invasive lobular carcinoma spreads to gynecologic organs more frequently than invasive ductal carcinoma. Case Report. A 57-year-old postmenopausal woman was diagnosed with breast carcinoma 2 years ago and modified radical mastectomy was performed. Pathological examination of tumor revealed invasive ductal carcinoma, stage IIIc. She presented with abdominal pain and distension. Diagnostic workup and gynecologic examination revealed lesions that caused diffuse thickening of the uterus wall. Endometrial sampling was performed for confirmation of the diagnosis. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Breast carcinoma metastases in endometrium and myometrium were confirmed histopathologically and immunohistochemically. Conclusion. We herein report the first case of isolated uterine patient who had invasive ductal carcinoma of breast. Deniz Arslan, Deniz Tural, Ali Murat Tatlı, Emre Akar, Mükremin Uysal, and Gülgün Erdoğan Copyright © 2013 Deniz Arslan et al. All rights reserved. Thu, 14 Mar 2013 10:17:16 +0000 http://www.hindawi.com/crim/oncmed/2013/524305/ Malignant Fibrous Histiocytoma (MFH) is a fairly common tumor in the deep soft tissues: the most frequent primary sites are the lower (49%) and upper (19%) limbs, but it has been reported even in the retroperitoneum and abdomen (16%), while localization in the breast is extremely rare (1-2). Breast cancer is rarely seen in males, accounts for approximately 1% of all breast cancer, and the breast sarcomas constitute less than 1% of breast tumors in both sexes. In the review of the literature, this is the third male and first young male with MFH. Here, we present a 37-years-old male patient who is diagnosed to have malignant fibrous histiocytoma in a variant of pleomorphic fusiform cell localized in the left breast. Following the wide local excision, the patient was given an adjuvant 50 Gy of external radiotherapy. He remained alive and well after 42 months of followup. We believe that reporting such few cases would contribute to forming treatment algorithms of rare tumors. Esengul Kocak Uzel, Metin Figen, Tuba Tulin Bek, Kubilay Inanc, Senem Onder, and Hazim orhan Kizilkaya Copyright © 2013 Esengul Kocak Uzel et al. All rights reserved. Wed, 13 Mar 2013 17:35:14 +0000 http://www.hindawi.com/crim/oncmed/2013/507504/ Benign lymphoreticulosis (cat scratch disease, CSD) may have a clinical course that varies from the most common lymphadenitis localized in the site of inoculation, preceded by the typical “primary lesion,” to a context of severe systemic involvement. Among these uncommon clinical aspects, there is mammarian granulomatous lymphadenitis which may appear as a mastitis or a solitary intraparenchymal mass, giving the impression of a breast tumor. In these cases, intensive clinical, instrumental, and laboratory investigations are necessary to exclude malignancy. Because of its rarity, in equivocal cases, it is reasonable to use surgical excision for accurate histological examination. We report a case of CSD of the breast in a 59-year-old woman, analyzing the clinical, histopathological, and instrumental appearance and also performing a literature review. Carlo Iannace, Domenico Lo Conte, Lorenzo Di Libero, Antonio Varricchio, Antonio Testa, Raffaella Vigorito, Giuliano Gagliardi, Maria Lepore, and Francesco Caracciolo Copyright © 2013 Carlo Iannace et al. All rights reserved. Thu, 28 Feb 2013 14:54:40 +0000 http://www.hindawi.com/crim/oncmed/2013/420393/ A 72-year-old man presented with weight loss, fever, and malaise. Chest radiograph and CT revealed two large ill-defined masses in middle and left lower lobes. CT-guided biopsy of left lower lobe mass disclosed bronchus-associated lymphoid tissue (BALT) lymphoma. Middle lobe mass was considered second deposit in contralateral lung. The patient received chemotherapy for BALT. Followup CT disclosed regression of left lower lobe mass and stability of middle-lobe mass and of right paratracheal lymph nodes. CT-guided biopsy of middle-lobe mass revealed squamous cell lung carcinoma. Surgical biopsy of right paratracheal lymph nodes revealed malignancy. Disease was staged T3, N2, and M0. Combined chemotherapy for lung cancer and BALT lymphoma was initiated. Anastasia Oikonomou, Emanuelle Astrinakis, Ioannis Kotsianidis, Vassiliki Kaloutsi, Vassileios Didilis, Konstantinos Tsatalas, and Panos Prassopoulos Copyright © 2013 Anastasia Oikonomou et al. All rights reserved. Thu, 28 Feb 2013 14:37:23 +0000 http://www.hindawi.com/crim/oncmed/2013/243939/ Malignant hepatic epithelioid hemangioendothelioma (HEHE) is a rare malignant tumor of vascular origin. Nonspecific symptoms and the absence of experience of surgeons, radiologists, and histopathologists due to the rarity of HEHE make the diagnosis of this entity very challenging. Misdiagnosis is not a rare event, and the consequences of such an event are catastrophic. We report a case of a patient suffering from HEHE in which the initial diagnosis was hepatocellular carcinoma (HCC). The presence of normal laboratory values, liver function tests, tumor markers along with the absence of a chronic liver disease, or any other predisposing factors for HCC, was in contrast with the diagnosis of HCC. Clinical suspicion drove us to the repetition of a liver biopsy and the reevaluation of the sample by a more experience histopathology department in liver tumors. The last biopsy confirmed the diagnosis of HEHE, and the patient escaped any unnecessary treatment for a nonexisting HCC. Kyriakos Neofytou, Andreas Chrysochos, Nikolas Charalambous, Menelaos Dietis, Christos Petridis, Charalampos Andreou, and Athanasios Petrou Copyright © 2013 Kyriakos Neofytou et al. All rights reserved. Wed, 27 Feb 2013 18:05:50 +0000 http://www.hindawi.com/crim/oncmed/2013/865032/ 18F-FDG PET/CT is a diagnostic three-dimensional non-invasive device, routinely employed in neurology, cardiology, and oncology, and which contributes to patient care giving functional informations about glucose metabolism. In particular, staging, restaging, follow-up and response to treatment of tumors are the most common applications in oncologic field. Many neoplasms show increased glucose metabolism and consequent 18F-FDG uptake. Nevertheless, some relative differentiated cancers, such as clear cell carcinoma of the kidney and bronchioloalveolar adenocarcinoma, show tipically faintly/no uptake resulting in a consequent negative PET/CT scan. This case report represents an extreme case in which three relative well-differentiated cancer forms, all characterized by low glucose metabolism, affect the same patient at the same time while 18F-FDG PET/CT scan is negative. M. Casali, A. Froio, C. Carbonelli, and A. Versari Copyright © 2013 M. Casali et al. All rights reserved. Wed, 27 Feb 2013 16:06:37 +0000 http://www.hindawi.com/crim/oncmed/2013/306983/ Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, visual loss, and characteristic imaging pattern in brain MRI. The cause of PRES is not yet understood. We report a case of a 27-year-old woman that developed PRES after the use of FOLFOX 5 (oxaliplatin/5-Fluoracil/Leucovorin) chemotherapy for a colorectal cancer. Luiz Carlos Porcello Marrone, Bianca Fontana Marrone, Tharick Ali Pascoal, Lucas Porcello Schilling, Ricardo Bernardi Soder, Sheila Schuch Ferreira, Giovani Gadonski, and Jaderson Costa da Costa Copyright © 2013 Luiz Carlos Porcello Marrone et al. All rights reserved. Wed, 27 Feb 2013 15:53:15 +0000 http://www.hindawi.com/crim/oncmed/2013/783862/ Anaplastic thyroid cancer (ATC) comprises 1-2% of all thyroid cancers and is one of the most aggressive cancers with a median survival rate of around four months. The average 5-year survival rate has been reported to be around 3.6%. In this paper, we have discussed management and prognostic variables of a patient with ATC who has survived for more than 5 years. A 59-year-old female was referred to our facility for an elective thyroid and parathyroidectomy for concerns of thyroid papillary cancer and hyperparathyroidism. At the time of surgery, the tumor mass had invaded the muscular layer of esophagus; radicle thyroidectomy parathyroidectomy along with removal of muscle layer of esophagus was performed, and diagnosis of ATC was made. The patient was treated with chemoradiation with a good treatment response and no recurrence of tumor for two and a half years until PET/CT followed by wedge biopsy of lung confirmed ATC recurrence. The patient was treated with another course of radiation treatment with a good treatment response. Since then, the patient has been following in our outpatient oncology clinic and has no evidence of tumor recurrence. Aggressive multimodal approach of combining radicle surgery with chemoradiation treatment in select patients of ATC with no distant metastasis helps improve prognosis. Nasir Hussain, Usman Mustafa, Su Hyeon Jung, and Alan D. Gilman Copyright © 2013 Nasir Hussain et al. All rights reserved. Tue, 26 Feb 2013 13:31:18 +0000 http://www.hindawi.com/crim/oncmed/2013/420565/ Hypercalcemia is a common medical problem with an estimated prevalence of 15% among hospitalized patients. Multiple myeloma (MM) and primary hyperparathyroidism (PHPT) are among the most common causes of hypercalcemia but coexistence of both pathologic processes in a patient is an extremely rare phenomenon. In this paper we have discussed a patient presenting with this rare phenomenon. We have also provided a comprehensive review of the scientific literature published on codiagnosis of MM and PHPT. Nasir Hussain, Moona Khan, Aparna Natarajan, Mubeenkhan Mohammedabdul, Usman Mustafa, Kalpana Yedulla, and Aibek E. Mirrakhimov Copyright © 2013 Nasir Hussain et al. All rights reserved. Tue, 19 Feb 2013 16:18:33 +0000 http://www.hindawi.com/crim/oncmed/2013/695450/ Signet cell carcinoma, which is a subtype of adenocarcinoma, usually originates from the stomach. However, it can also originate from the colon, rectum, gallbladder, pancreas, urinary bladder, and breast. We represent a 19-year-old boy diagnosed with signet cell tumour while he was being evaluated for an initial diagnosis of inflammatory bowel disease. Özgül Pamukçu, Fatih Selcukbiricik, Ahmet Bilici, Damlanur Sakız, Osman Özdoğan, and Fatih Borlu Copyright © 2013 Özgül Pamukçu et al. All rights reserved. Thu, 14 Feb 2013 14:53:05 +0000 http://www.hindawi.com/crim/oncmed/2013/728479/ Neuroendocrine neoplasms are defined as epithelial neoplasms with predominant neuroendocrine differentiation. They can arise in almost every organ of the body although they are most commonly found in the gastrointestinal tract and respiratory system. Nasal cavity and paranasal sinuses are a rare site for neuroendocrine carcinoma. In contrast to the other regions, neuroendocrine tumours of the sinuses have been reported to be recurrent and locally destructive. Very few cases of paranasal sinus neuroendocrine carcinoma have been reported till date. Difficulty in pathologic diagnosis and rarity of this malignancy have hindered the progress in understanding the clinical course and improving outcomes. We herein report a case of poorly differentiated neuroendocrine tumour of ethmoid and sphenoid sinus with invasion of orbit and intracranial extension. The patient had complete response at the end of chemoradiation and he was disease-free for 9 months duration after which he developed bone metastasis without regional recurrence. Nagesh T. Sirsath, K. Govind Babu, Umesh Das, and C. S. Premlatha Copyright © 2013 Nagesh T. Sirsath et al. All rights reserved.