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Coppola Bottazzi E, Gambardella C, Mongardini FM, Vanella S, Noviello A, Palma T, Murano R, De Chiara G, Conzo G, Docimo L, Crafa F. Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient. J Clin Med 2023; 12:6925. [PMID: 37959390 PMCID: PMC10649738 DOI: 10.3390/jcm12216925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION The adrenocortical oncocytic neoplasms (AONs) are rare tumors of the adrenal gland, classified as oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP) and oncocytic carcinoma (AOC). The aim of this study was to perform a review of the literature, in order to evaluate the prognosis of these rare cancers. We also reported the oldest patient with AON. METHODS A comprehensive literature review using as key words "adrenal oncocytoma", "adrenal oncocytic neoplasm", and "adrenal oncocytic carcinoma" was performed. REPORT OF THE CASE We report the case of an 88-year-old woman receiving a left open adrenalectomy for an AON (15 × 10 × 8 cm). The considerable size and weight together with the presence of necrosis were indicative for a lesion with an uncertain potential for malignancy, according to Weiss modified criteria. After two years, the patient was free from any sign of recurrence. RESULTS Only 287 AONs were detected in the scientific literature, exploring OVID, MEDLINE, PubMed and SCOPUS as dataset. These tumors are usually incidentalomas with an unpredictable malignant potential. Surgical resection remains the mainstay of treatment for AON. CONCLUSION AO and AONUMP have an excellent prognosis and a low mortality rate, with only three cases of recurrence reported in the literature and one metastatic case four years after first adrenal surgery. In contrast, AOC carries a high risk of local relapses, distant metastasis, and a significantly higher mortality rate (30%). Surgical resection remains the primary treatment for adrenal oncocytic neoplasms.
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Affiliation(s)
- Enrico Coppola Bottazzi
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
| | - Claudio Gambardella
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.M.M.); (G.C.)
| | - Federico Maria Mongardini
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.M.M.); (G.C.)
| | - Serafino Vanella
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
| | - Adele Noviello
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
| | - Tommaso Palma
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
| | - Rosa Murano
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
| | - Giovanni De Chiara
- Pathological Anatomy and Histology Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy;
| | - Giovanni Conzo
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.M.M.); (G.C.)
| | - Ludovico Docimo
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.M.M.); (G.C.)
| | - Francesco Crafa
- Oncological and General Surgery Unit, “St. Giuseppe Moscati” Hospital of National Relevance and High Specialty, 83100 Avellino, Italy; (E.C.B.); (S.V.); (A.N.); (R.M.)
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Iacomino G, Rotondi Aufiero V, Iannaccone N, Melina R, Giardullo N, De Chiara G, Venezia A, Taccone FS, Iaquinto G, Mazzarella G. IBD: Role of intestinal compartments in the mucosal immune response. Immunobiology 2020; 225:151849. [PMID: 31563276 DOI: 10.1016/j.imbio.2019.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Laser capture microdissection (LCM) is a powerful tool for the isolation of specific tissue compartments. We aimed to investigate the mucosal immune response that takes place in different intestinal compartments of IBD patients, dissected by LCM, analyzing cytokines expression profile and endoplasmic reticulum (ER) stress markers. METHODS Frozen sections of gut were obtained from patients with Crohn's disease (CD), ulcerative colitis (UC) and from controls. Using LCM, surface epithelium (SE) and lamina propria (LP) compartments were isolated and total RNA extracted. The relative expression of Th1, Th17 and Treg cytokines was evaluated by quantitative reverse transcriptase real-time PCR (qRT-PCR), in addition to the assessment of mRNA splicing of the transcription factor X-box binding protein-1 (XBP1). Human neutrophil elastase (HNE) and the transcription factor forkhead box P3 (Foxp3) were also analyzed by immunohistochemistry. RESULTS The increased expression of IL-17 was observed in both intestinal compartments of IBD patients when compared to controls. IFN- γ, TNF-α , IL-10, HNE and Foxp3 were overexpressed in the LP compartment of both IBD patients as compared to controls. An upregulation of IFN-γ and an infiltration of HNE+ cells was found in the SE of patients with UC. Splicing of XBP1 mRNA was recognized in both intestinal compartments of IBD patients when compared to controls. CONCLUSIONS In IBD patients, both intestinal compartments are involved in Th17 response, whereas, LP compartment plays a prominent role in Th1 and Treg immune responses. Nevertheless, high level of IFN- γ was found in the SE of UC patients, suggesting that this compartment is involved in the Th1 immune response. Our data also suggested that ER stress signalling is active in both LP and SE compartment of IBD patients, thus advocating that ER stress and immunity are intertwined.
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Affiliation(s)
| | | | | | - Raffaele Melina
- Department of Gastroenterology, San G. Moscati Hospital, Avellino, Italy
| | - Nicola Giardullo
- Department of Gastroenterology, San G. Moscati Hospital, Avellino, Italy
| | - Giovanni De Chiara
- Department of AnatomicPathology, San G. Moscati Hospital, Avellino, Italy
| | | | - Fabio Silvio Taccone
- Department of Intensive Care, Erasme Hospital, Universit e Libre de Bruxelles, Brussels, Belgium
| | - Gaetano Iaquinto
- Division of Gastroenterology, Santa Rita Hospital, Atripalda, Av, Italy
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Bellevicine C, Migliatico I, Sgariglia R, Nacchio M, Vigliar E, Pisapia P, Iaccarino A, Bruzzese D, Fonderico F, Salvatore D, Biondi B, Masone S, Novizio V, Scavuzzo F, Serino D, De Palma M, Chiofalo MG, Botti G, Pezzullo L, Nuzzo V, Spiezia S, De Chiara G, Iorio S, Conzo G, Docimo G, Faggiano A, Bongiovanni M, Malapelle U, Colao A, Triassi M, Troncone G. Evaluation of
BRAF
,
RAS
,
RET/PTC
, and
PAX8/PPARg
alterations in different Bethesda diagnostic categories: A multicentric prospective study on the validity of the 7‐gene panel test in 1172 thyroid FNAs deriving from different hospitals in South Italy. Cancer Cytopathol 2019; 128:107-118. [DOI: 10.1002/cncy.22217] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 12/21/2022]
Affiliation(s)
| | - Ilaria Migliatico
- Department of Public Health University of Naples Federico II Naples Italy
| | - Roberta Sgariglia
- Department of Public Health University of Naples Federico II Naples Italy
| | | | - Elena Vigliar
- Department of Public Health University of Naples Federico II Naples Italy
| | - Pasquale Pisapia
- Department of Public Health University of Naples Federico II Naples Italy
| | - Antonino Iaccarino
- Department of Public Health University of Naples Federico II Naples Italy
| | - Dario Bruzzese
- Department of Public Health University of Naples Federico II Naples Italy
| | - Francesco Fonderico
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Domenico Salvatore
- Department of Public Health University of Naples Federico II Naples Italy
| | - Bernadette Biondi
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Stefania Masone
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Vincenzo Novizio
- Department of Endocrinology Aziena Ospedaliera di Rilievo Nazionale A. Cardarelli Naples Italy
| | - Francesco Scavuzzo
- Department of Endocrinology Aziena Ospedaliera di Rilievo Nazionale A. Cardarelli Naples Italy
| | - Domenico Serino
- Department of Endocrinology Aziena Ospedaliera di Rilievo Nazionale A. Cardarelli Naples Italy
| | - Maurizio De Palma
- Department of Surgery Aziena Ospedaliera di Rilievo Nazionale A. Cardarelli Naples Italy
| | | | | | - Luciano Pezzullo
- Thyroid and Parathyroid Surgery Unit IRCCS G. Pascale Naples Italy
| | - Vincenzo Nuzzo
- Department of Endocrinology Hospital of the Sea‐Azienda Sanitaria Locale Naples 1 Center Naples Italy
| | - Stefano Spiezia
- Department of Endocrine Surgery Hospital of the Sea‐Azienda Sanitaria Locale Naples 1 Center Naples Italy
| | - Giovanni De Chiara
- Department of Pathology Aziena Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino Italy
| | - Sergio Iorio
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences University of Campania Luigi Vanvitelli Caserta Italy
| | - Giovanni Conzo
- Department of Cardiothoracic and Respiratory Sciences University of Campania Luigi Vanvitelli Caserta Italy
| | - Giovanni Docimo
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences University of Campania Luigi Vanvitelli Caserta Italy
| | | | | | - Umberto Malapelle
- Department of Public Health University of Naples Federico II Naples Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Maria Triassi
- Department of Public Health University of Naples Federico II Naples Italy
| | - Giancarlo Troncone
- Department of Public Health University of Naples Federico II Naples Italy
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Rossi E, Sgambato A, De Chiara G, Casaluce F, Losanno T, Sacco PC, Santabarbara G, Gridelli C. Endocrinopathies induced by immune-checkpoint inhibitors in advanced non-small cell lung cancer. Expert Rev Clin Pharmacol 2016; 9:419-28. [PMID: 26681547 DOI: 10.1586/17512433.2016.1133289] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The advent of immunotherapy has recently expanded the therapeutic options in advanced non-small cell lung cancer (NSCLC). In these patients, the recent efficacy demonstration of antibodies against immune checkpoints: the anti-programmed death-1 (PD-1) and anti-programmed death ligand-1 (PD-L1), has led to approval of nivolumab and pembrolizumab (anti-PD-1) in the treatment of advanced NSCLC. The mechanism of action of checkpoint inhibitors explains the development of autoimmune diseases as a side-effect of these medications. Among these, a spectrum of endocrine disorders has been also reported. This manuscript focuses particularly on endocrine disorders induced by immuno-checkpoint inhibitors employed in NSCLC, in order to suggest the strategies for their diagnosis and effective management.
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Affiliation(s)
- Emanuela Rossi
- a Division of Medical Oncology , "S. G. Moscati" Hospital , Avellino , Italy
| | - Assunta Sgambato
- b Department of Clinical and Experimental Medicine , Second University of Naples , Naples , Italy
| | - Giovanni De Chiara
- c Division of Pathologic Anatomy , "S. G. Moscati" Hospital , Avellino , Italy
| | - Francesca Casaluce
- b Department of Clinical and Experimental Medicine , Second University of Naples , Naples , Italy
| | - Tania Losanno
- d Department of Experimental Medicine , "Sapienza" University , Rome , Italy
| | - Paola Claudia Sacco
- a Division of Medical Oncology , "S. G. Moscati" Hospital , Avellino , Italy
| | | | - Cesare Gridelli
- a Division of Medical Oncology , "S. G. Moscati" Hospital , Avellino , Italy
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Gridelli C, Rossi A, Airoma G, Bianco R, Costanzo R, Daniele B, Chiara GD, Grimaldi G, Irtelli L, Maione P, Morabito A, Piantedosi FV, Riccardi F. Treatment of pulmonary neuroendocrine tumours: state of the art and future developments. Cancer Treat Rev 2012; 39:466-72. [PMID: 22818212 DOI: 10.1016/j.ctrv.2012.06.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 06/24/2012] [Accepted: 06/25/2012] [Indexed: 10/28/2022]
Abstract
The current classification of pulmonary neuroendocrine tumours includes four subtypes: low-grade typical carcinoid tumour (TC), intermediate-grade atypical carcinoid tumour (AC), and two high-grade malignancies: large cell neuroendocrine carcinoma and small cell lung cancer (SCLC). Unfortunately, with the exclusion of SCLC, no large phase II and III trials for pulmonary neuroendocrine tumours have been published. Thus, several treatment approaches are available for their treatment but none of them has been validated in appropriately designed and adequately sized clinical trials. The main problem of the published studies is that they include neuroendocrine tumours from various sites of origin with different clinical behaviour. It is important that future studies consider these tumours separately. In this regard, increased awareness and referral of these patients to tertiary centres, in which a multidisciplinary management is available, may be of value. The aim of this review is to evaluate the state of the art and discuss future developments in the management of pulmonary neuroendocrine tumours excluding SCLC which we consider should be addressed in a different issue.
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Affiliation(s)
- Cesare Gridelli
- Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
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Sorrentino P, Tarantino L, D'Angelo S, Terracciano L, Ferbo U, Bracigliano A, Panico L, De Chiara G, Lepore M, De Stefano N, Fiorentino F, Vecchione R. Validation of an extension of the international non-invasive criteria for the diagnosis of hepatocellular carcinoma to the characterization of macroscopic portal vein thrombosis. J Gastroenterol Hepatol 2011; 26:669-77. [PMID: 21054520 DOI: 10.1111/j.1440-1746.2010.06564.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM We aimed to validate the non-invasive criteria for the characterization of portal vein thrombosis (PVT) in patients with cirrhosis and hepatocellular carcinoma (HCC). In a prospective study, we examined the impact of arterial hypervascularity, as established by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases recommendations for the non-invasive diagnosis of HCC, as a criterion for characterizing macroscopic PVT (EASL/AASLD extension criteria). METHODS A total of 96 cases of PVT detected using ultrasonography in patients with cirrhosis and HCC were included in the study. When coincidental arterial hypervascularity was detected by contrast perfusional ultrasonography and helical computed tomography, the thrombus was considered malignant according to our EASL/AASLD extension criteria. In all cases, an ultrasound-guided biopsy examination of the thrombus was performed. RESULTS Coincidental hypervascularity was found in 54 of 96 nodules (56.2%), and all were malignant upon biopsy (100% positive predictive value). Twenty-four (25%) had negative results with both techniques (non-vascular thrombus). Biopsies showed HCC in five non-vascular thrombi (5.3% of all thrombi) and in 13 of 18 thrombi with a hypervascularity result from only one technique. CONCLUSIONS The EASL/AASLD extension criteria for non-invasive diagnosis of malignant thrombosis were satisfied in 75.2% of malignant thrombi; thus, a biopsy is frequently required in this setting. However, in the presence of coincidental hypervascularity of a thrombus with both techniques, a biopsy is not required (absolute positive predictive value for malignancy). Relying on imaging techniques in thrombi could miss the diagnosis of malignant portal invasion in up to 24.9% of cases.
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Affiliation(s)
- Paolo Sorrentino
- Liver Unit, Clinical and Experimental Hepatology, Department of Internal Medicine, S.G. Moscati Hospital, Avellino, Italy.
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Sorrentino P, Terracciano L, D'Angelo S, Ferbo U, Bracigliano A, Tarantino L, Perrella A, Perrella O, De Chiara G, Panico L, De Stefano N, Lepore M, Mariolina, Vecchione R. Oxidative stress and steatosis are cofactors of liver injury in primary biliary cirrhosis. J Gastroenterol 2010; 45:1053-62. [PMID: 20393861 DOI: 10.1007/s00535-010-0249-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 03/29/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND Factors responsible for the progression of primary biliary cirrhosis (PBC) are still poorly understood. In the present study, we investigated the associations between the stage of PBC and the immune reaction triggered by oxidative stress; the presence of obesity, steatosis,steatohepatitis; and other toxic, metabolic, or steatogenic factors. METHODS We studied clinical, laboratory, and histological data for 274 untreated patients with serum antimitochondrial antibody (AMA)-positive PBC. Circulating IgG against human serum albumin adducted with malondialdeyde, the major product of lipid peroxidation, was measured in these patients and in a group of 98 sex-, age and body mass index (BMI)-matched controls. RESULTS Steatosis was present in 40.5% of all patients. Steatohepatitis was present in 14.9% of all patients. There was a significant association between the frequencies of steatosis and steatohepatitis and the worsening of PBC. Circulating IgG against lipid peroxidation products was significantly higher in the PBC patients than in the controls. Titers of lipid peroxidation-related antibodies were significantly increased in patients with steatosis and inpatients at more advanced stages. Bivariate analysis revealed a significant association between indirect evidence of oxidative stress, steatosis, steatohepatitis, age, BMI, frequency of diabetes, alcohol intake, iron grade after Perl's stain, and PBC stage. Logistic regression analysis confirmed that the titers of antibodies against lipid peroxidation products (odds ratio 4.5, p< .001, 95% confidence interval 3.9–14.4), the presence of steatosis (odds ratio 4.1, 95% confidence interval 2.5–15.4, p< .001), higher BMI (odds ratio 3.9, p< .021, 95%confidence interval 1.4–9.5), and alcohol intake (males ≥ 30 g/day, females ≥ 20 g/day, odds ratio 4.5,95% confidence interval 1.3–19.8, p< .029) were independently associated with more advanced stages of the disease. CONCLUSIONS The immune reactions triggered by oxidative stress, steatosis, obesity, and alcohol intake are independent predictors of PBC stage progression.
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Affiliation(s)
- Paolo Sorrentino
- Liver Unit, Clinical and Experimental Hepatology, Department of Internal Medicine, S.G. Moscati Hospital, Via Pennini, Avellino, Italy.
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Amabile G, Rotondi M, De Chiara G, Silvestri A, Di Filippo B, Bellastella A, Chiovato L. Low-energy interstitial laser photocoagulation for treatment of nonfunctioning thyroid nodules: therapeutic outcome in relation to pretreatment and treatment parameters. Thyroid 2006; 16:749-55. [PMID: 16910876 DOI: 10.1089/thy.2006.16.749] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Interstitial laser photocoagulation (ILP) is a recently proposed therapeutic procedure for the ablation of benign thyroid nodules, which has already proven to be safe and effective. However, results supporting the routine use of ILP are still limited. DESIGN The aim of the study was to evaluate the efficacy and safety of ILP treatment in benign nonfunctioning thyroid nodules and to establish whether the therapeutic outcome may be predicted by any clinical parameter at baseline. Twenty-three patients with either a solitary nodule or a dominant nodule within a multinodular goiter underwent ILP and were evaluated 1 and 3 months later. In order to assess the efficacy of low-energy ILP, the procedure was performed with an output power of 3 W, delivering a mean energy of 33.4 +/- 12.7 Joule/mL of nodule volume, which is much lower than previously reported. MAIN OUTCOME Nodule volume significantly decreased after ILP as assessed after 1 and 3 months (analysis of variance; F = 5.37; p = 0.007). Patients with multinodular goiter showed a greater reduction at 3 months compared with patients bearing a solitary thyroid nodule (38.6 +/- 5.3 vs. 30.9 +/- 6.5%; p < 0.01). Age, sex, ultrasound pattern (isoechogenous/hypoechogenous), pretreatment volume, number of ILP treatments, and total energy delivered did not show any significant correlation with treatment outcome. CONCLUSIONS Our results demonstrate that ILP can produce a significant reduction of thyroid nodule volume even when a much lower energy than previously reported is delivered. ILP constitutes a minimally invasive technique, which can be carried out on an outpatient basis and could represent a valid nonsurgical alternative for thyroid nodule management. Dominant nodules within a multinodular goiter appear to be more responsive to ILP compared with solitary thyroid nodules.
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Rossi A, Colantuoni G, Cantore N, Panico L, De Chiara G, Ferbo U, Gridelli C. Complete response of severe symptomatic bone marrow metastases from heavily pretreated breast cancer with a 3-weekly trastuzumab schedule. A clinical case. Anticancer Res 2004; 24:317-9. [PMID: 15015614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Overexpression of HER-2/neu in breast cancer has been associated with more aggressive disease and poor overall survival. Trastuzumab, a recombinant humanized monoclonal antibody with high affinity for the HER-2 protein, inhibits the growth of breast cancer cells overexpressing HER-2. Trastuzumab showed, as second-line treatment, 15% of objective response in metastatic breast cancer. Bone marrow metastases are detectable in 23% of the patients with advanced breast cancer at first relapse and this rate increases in patients with metastatic disease. We report a case of a complete response of bone marrow metastases from breast cancer using a 3-weekly trastuzumab schedule, in a heavily pretreated patient with severe symptomatic pancytopenia.
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Affiliation(s)
- Antonio Rossi
- U.O. Oncologia Medica, Azienda Ospedaliera S.G. Moscati, Avellino, Italy
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