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El Hanbuli HM, Sarie MAA, Ibrahium GA, Al-Amaragy A, Elsonbaty M. Adenosquamous carcinoma of the vulva: Rare tumor with unusual clinical presentation. J Cutan Pathol 2024; 51:329-331. [PMID: 38228312 DOI: 10.1111/cup.14587] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/15/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024]
Abstract
A 52-year-old female presented with labial ulcer of 4-month duration. Examination showed 1 cm × 1 cm single superficial ulcer in the right labium majus. Excision was done, and histopathologic examination revealed surface ulceration and dermal invasion by epithelial neoplasm formed of biphasic proliferation of squamoid and gland-forming cells. Immunohistochemical staining with p63 showed nuclear staining of the squamoid nests and was negative in areas with glandular differentiation, while epithelial membrane antigen and carcinoembryonic antigen highlighted the glandular elements. The case was diagnosed as primary cutaneous adenosquamous carcinoma (ASC). ASC is an uncommon malignant cutaneous neoplasm that is more aggressive than conventional squamous cell carcinoma. There are a few reports of ASC that presented as an erythematous papule or plaque with a preference for the head, neck, or upper extremities. We report a novel case of vulval ASC presented as a superficial ulcer, which is considered a unique site, and its clinical presentation.
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Affiliation(s)
- Hala M El Hanbuli
- Pathology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
| | | | | | | | - Mostafa Elsonbaty
- Obstetrics and Gynecology Department, Faculty of Medicine, Assiut University, Asyut, Egypt
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Potterveld SK, Williamson SR, Al-Obaidy KI, Akgul M, Chan E, Giannico GA, Sangoi AR. GATA3 Expression in Prostatic Adenosquamous Carcinoma: A Potential Diagnostic Pitfall. Int J Surg Pathol 2024:10668969241241640. [PMID: 38562047 DOI: 10.1177/10668969241241640] [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] [Indexed: 04/04/2024]
Abstract
Urothelial carcinoma and prostatic adenocarcinoma can have overlapping histologic features and in some instances pose challenges to pathologists. GATA binding protein 3 (GATA3) immunohistochemistry (IHC) is a well-established tool to aid in this specific diagnostic dilemma as it has been shown to be a sensitive marker for urothelial carcinoma and a putatively specific marker in excluding prostatic adenocarcinoma. However, in encountering an index tumor of prostatic adenosquamous carcinoma positive for GATA3, herein we sought to investigate this potential diagnostic pitfall in a larger series of tumors. In this study, we retrospectively reviewed prostatic adenosquamous carcinomas diagnosed in 17 patients across the authors' institutions and personal consult collections in the past 10 years. GATA3 IHC was either reviewed or performed on tumors not previously tested. We also recorded other immunostains that were performed at initial diagnosis. Positivity for GATA3 was found in 9 of 17 (53%) tumors, all within squamous regions (2 tumors also showed concomitant moderate GATA3 positivity within glandular elements). The GATA3 positive tumors were all positive for p63 in the 7 tumors where p63 was also performed. Of all tumors tested, NKX3.1 was positive in 100% (13/13) of the glandular elements (3 tumors also showed NKX3.1 concomitant positivity within squamous regions). In summary, when encountering a carcinoma with mixed glandular/squamous features in which prostatic origin is being considered, awareness of GATA3 immunoreactivity in a subset of prostatic adenosquamous carcinoma is critical to avoid diagnostic pitfalls.
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Affiliation(s)
| | | | | | - Mahmut Akgul
- Department of Pathology, Albany Medical Center, Albany, NY, USA
| | - Emily Chan
- Department of Pathology, Stanford Medical Center, Stanford, CA, USA
| | | | - Ankur R Sangoi
- Department of Pathology, Stanford Medical Center, Stanford, CA, USA
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Tantum J, Schneider R, Gallagher S, Leroy K, Lander J, Wong P. A Rare Case of Squamous Cell Carcinoma of the Bile Duct. ACG Case Rep J 2023; 10:e01119. [PMID: 37547480 PMCID: PMC10400063 DOI: 10.14309/crj.0000000000001119] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/10/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Squamous cell carcinoma of the biliary tract is a rare disease, comprising just 2% of all biliary malignancies. The exact etiology is poorly understood but believed to be secondary to chronic inflammation. We present a case of a patient with recurrent cholecystitis and cholangitis who developed invasive biliary squamous cell carcinoma.
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Affiliation(s)
- Julianna Tantum
- Department of Internal Medicine, Lankenau Medical Center, Wynnewood, PA
| | - Rachael Schneider
- Department of Internal Medicine, Lankenau Medical Center, Wynnewood, PA
| | | | - Kyley Leroy
- Department of Gastroenterology, Lankenau Medical Center, Wynnewood, PA
| | - Jared Lander
- Department of Gastroenterology, Lankenau Medical Center, Wynnewood, PA
| | - Patricia Wong
- Department of Gastroenterology, Lankenau Medical Center, Wynnewood, PA
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Fang S, Wang X, Wu X, Li H. Therapeutic response analysis for patients with adenosquamous carcinoma of the gallbladder: data analysis based on the Surveillance, Epidemiology, and End Results (SEER) database. J Gastrointest Oncol 2023; 14:405-419. [PMID: 36915441 PMCID: PMC10007914 DOI: 10.21037/jgo-22-1292] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
Background Adenosquamous carcinoma of the gallbladder (GBASC) is a rare histological variant without defined appropriate clinical measures. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, data on a cohort of patients with GBASC were collected from 21 cancer registries between 1975 and 2018. We used Kaplan-Meier analysis to evaluate the effectiveness of different treatment regimens on patients with GBASC. Then we used Cox proportional hazards regression method to determine the prognostic factors for cancer-specific survival (CSS) of GBASC patients. Results A total of 388 patients with GBASC were identified: 80 patients diagnosed as early stage and 308 patients diagnosed as advanced stage. For early-stage GBASC, radical lymph node dissection improved the CSS significantly; for advanced-stage GBASC, radical surgery, nonradical surgery, lymph node dissection, chemotherapy, and radiotherapy improved the CSS significantly. Surgery, lymph node dissection, radiation, chemotherapy, age, race, and the American Joint Committee on Cancer (AJCC) stage were the independent risk factors for the CSS of GBASC patients. Conclusions Radical intraoperative lymph node dissection provided a survival benefit for patients with early-stage GBASC, whereas chemotherapy and radiotherapy provided no significant benefit; surgical treatment, more complete lymph node dissection, radiotherapy, and chemotherapy provided survival benefits for patients with advanced GBASC. The prognosis for GBASC patients is affected by the factors of surgery, lymph node dissection, radiation, chemotherapy, age, race, and the AJCC stage.
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Affiliation(s)
- Shenzhe Fang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Xinxue Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Xiang Wu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Hong Li
- Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
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Li Q, Li X, Liu W, Yu J, Chen Y, Zhu M, Li N, Liu F, Wang T, Fang X, Li J, Lu J, Shao C, Bian Y. Non-enhanced magnetic resonance imaging-based radiomics model for the differentiation of pancreatic adenosquamous carcinoma from pancreatic ductal adenocarcinoma. Front Oncol 2023; 13:1108545. [PMID: 36756153 PMCID: PMC9900003 DOI: 10.3389/fonc.2023.1108545] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023] Open
Abstract
Purpose To evaluate the diagnostic performance of radiomics model based on fully automatic segmentation of pancreatic tumors from non-enhanced magnetic resonance imaging (MRI) for differentiating pancreatic adenosquamous carcinoma (PASC) from pancreatic ductal adenocarcinoma (PDAC). Materials and methods In this retrospective study, patients with surgically resected histopathologically confirmed PASC and PDAC who underwent MRI scans between January 2011 and December 2020 were included in the study. Multivariable logistic regression analysis was conducted to develop a clinical and radiomics model based on non-enhanced T1-weighted and T2-weighted images. The model performances were determined based on their discrimination and clinical utility. Kaplan-Meier and log-rank tests were used for survival analysis. Results A total of 510 consecutive patients including 387 patients (age: 61 ± 9 years; range: 28-86 years; 250 males) with PDAC and 123 patients (age: 62 ± 10 years; range: 36-84 years; 78 males) with PASC were included in the study. All patients were split into training (n=382) and validation (n=128) sets according to time. The radiomics model showed good discrimination in the validation (AUC, 0.87) set and outperformed the MRI model (validation set AUC, 0.80) and the ring-enhancement (validation set AUC, 0.74). Conclusions The radiomics model based on non-enhanced MRI outperformed the MRI model and ring-enhancement to differentiate PASC from PDAC; it can, thus, provide important information for decision-making towards precise management and treatment of PASC.
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Affiliation(s)
- Qi Li
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China,Department of Radiology, 96601 Military Hospital of PLA, Huangshan, Anhui, China
| | - Xuezhou Li
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Wenbin Liu
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Jieyu Yu
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Yukun Chen
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Mengmeng Zhu
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Na Li
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Fang Liu
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Tiegong Wang
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Xu Fang
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Jing Li
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Chengwei Shao
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China,*Correspondence: Yun Bian, ; Chengwei Shao,
| | - Yun Bian
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China,*Correspondence: Yun Bian, ; Chengwei Shao,
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Vial I, Kausar A. A rare case of concomittant pancreatic adenosquamous and neuroendocrine tumours. J Surg Case Rep 2022; 2022:rjac377. [PMID: 35991843 PMCID: PMC9386458 DOI: 10.1093/jscr/rjac377] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/27/2022] [Indexed: 11/25/2022] Open
Abstract
Only two cases of concomitantly occurring adenosquamous and neuroendocrine tumours (NET) have been reported in the literature. We report a case where both NET and adenosquamous are simultaneously occurring. A 42-year-old lady was hospitalized following painless jaundice and loss of weight. Computer tomography scan showed 3.0 x 2.9 cm hypo enhancing and hypovascular mass in the uncinate/head process. Another hypervascular mass was seen in the body of the pancreas. Pathological examination showed that the lesion in the uncinate process/neck of pancreas was an adenosquamous in the main pancreatic duct intraductal papillary mucinous neoplasm. The second tumour was a NET measuring 36 mm with no metastatic involvement. These findings suggested concurrently occurring but separated adenocarcinoma and NET tumours. This is the third case in the literature where both NET and adenosquamous are happening concomitantly, and the previous two other cases are also reviewed in the article.
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Affiliation(s)
- Izziddine Vial
- Correspondence address. Department of General Surgery, East Lancashire NHS Trust, Royal Blackburn Hospital, Haslingden Rd, Blackburn BB2 3HH, UK. Tel: +44 7709770702; E-mail:
| | - Ambareen Kausar
- Department of General Surgery, East Lancashire NHS Trust, Royal Blackburn Hospital, Blackburn, UK
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Thierauf JC, Farahani AA, Indave BI, Bard AZ, White VA, Smith CR, Marble H, Hyrcza MD, Chan JKC, Bishop J, Shi Q, Ely K, Agaimy A, Martinez-Lage M, Nose V, Rivera M, Nardi V, Dias-Santagata D, Garg S, Sadow P, Le LP, Faquin W, Ritterhouse LL, Cree IA, Iafrate AJ, Lennerz JK. Diagnostic Value of MAML2 Rearrangements in Mucoepidermoid Carcinoma. Int J Mol Sci 2022; 23:4322. [PMID: 35457138 PMCID: PMC9026998 DOI: 10.3390/ijms23084322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is often seen in salivary glands and can harbor MAML2 translocations (MAML2+). The translocation status has diagnostic utility as an objective confirmation of the MEC diagnosis, for example, when distinction from the more aggressive adenosquamous carcinoma (ASC) is not straightforward. To assess the diagnostic relevance of MAML2, we examined our 5-year experience in prospective testing of 8106 solid tumors using RNA-seq panel testing in combinations with a two-round Delphi-based scenario survey. The prevalence of MAML2+ across all tumors was 0.28% (n = 23/8106) and the majority of MAML2+ cases were found in head and neck tumors (78.3%), where the overall prevalence was 5.9% (n = 18/307). The sensitivity of MAML2 for MEC was 60% and most cases (80%) were submitted for diagnostic confirmation; in 24% of cases, the MAML2 results changed the working diagnosis. An independent survey of 15 experts showed relative importance indexes of 0.8 and 0.65 for "confirmatory MAML2 testing" in suspected MEC and ASC, respectively. Real-world evidence confirmed that the added value of MAML2 is a composite of an imperfect confirmation test for MEC and a highly specific exclusion tool for the diagnosis of ASC. Real-world evidence can help move a rare molecular-genetic biomarker from an emerging tool to the clinic.
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Affiliation(s)
- Julia C. Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital and Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alex A. Farahani
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - B. Iciar Indave
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Adam Z. Bard
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Valerie A. White
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Cameron R. Smith
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Hetal Marble
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB 2500, Canada;
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China;
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital, Atlanta, GA 30322, USA;
| | - Kim Ely
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany;
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Vania Nose
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Miguel Rivera
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Salil Garg
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Peter Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Long P. Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Lauren L. Ritterhouse
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Ian A. Cree
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - A. John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Jochen K. Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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Patil T, Nie Y, Aisner DL, Camidge DR. Case Report: Significant Clinical Benefit From Pemetrexed-Based Therapy in ROS1- and ALK-rearranged Lung Cancer With Adenosquamous Histology. Front Oncol 2022; 11:788245. [PMID: 35070994 PMCID: PMC8777186 DOI: 10.3389/fonc.2021.788245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Pemetrexed (used as a platinum doublet or as a maintenance regimen) is an established therapy for patients with advanced non-squamous non-small-cell lung cancer (NSCLC). In addition, certain gene rearrangements (e.g., ALK, ROS1, RET) appear to especially benefit from the use of pemetrexed. Inferior outcomes with pemetrexed compared to other chemotherapies in patients with NSCLC demonstrating squamous histology removed these patients from the labeled indication for the drug. While most squamous cases do not harbor driver oncogenes, rare exceptions exist. Whether the poor outcomes with pemetrexed extend to NSCLC with squamous component harboring driver oncogenes remains unexplored. In this case series, we describe two patients with adenosquamous histology harboring an ROS1 and ALK gene arrangement, respectively, who derived significant benefit from pemetrexed-based therapy. These cases suggest that the value of pemetrexed may need to be re-explored in adenosquamous NSCLC harboring such alterations.
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Affiliation(s)
- Tejas Patil
- Division of Medical Oncology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Yunan Nie
- Division of Medical Oncology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Dara L. Aisner
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - David Ross Camidge
- Division of Medical Oncology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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9
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Ramia-Angel JM, Jaén-Torrejimeno I, Serrablo-Requejo A, Rodriguez-Laiz GP, López-Guerra D, Abadía-Forcen T, Alenda C, Serradilla-Martín M, Blanco-Fernandez G. Adenosquamous cancer of the pancreas: A multicenter retrospective study. Gastroenterol Hepatol 2021; 45:543-551. [PMID: 34952130 DOI: 10.1016/j.gastrohep.2021.12.006] [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] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Adenosquamous cancer of the pancreas (ASCP) is an aggressive, infrequent subtype of pancreatic cancer that combines a glandular and squamous component and is associated with poor survival. METHODS Multicenter retrospective observational study carried out at three Spanish hospitals. The study period was: January 2010- August 2020. A descriptive analysis of the data was performed, as well as an analysis of global and disease-free survival using the Kaplan-Meier statistic. RESULTS Of a total of 668 pancreatic cancers treated surgically, twelve were ASCP (1.8%). Patient mean age was 69.2±7.4 years. Male/female ratio was 1:1. The main symptom was jaundice (seven patients). Correct preoperative diagnosis was obtained in only two patients. Nine pancreatoduodenectomies and three distal pancreatectosplenectomies were performed. 25% had major complications. Mean tumor size was 48.6±19.4 mm. Nine patients received adjuvant chemotherapy. Median survival time was 5.9 months, and median disease-free survival was 4.6 months. 90% of patients presented recurrence. Ten of the twelve patients in the study (83.3%) died, with disease progression being the cause in eight. Of the two surviving patients, one is disease-free and the other has liver metastases. CONCLUSION ASCP is a very rare pancreatic tumor with aggressive behavior. It is rarely diagnosed preoperatively. The best treatment, if feasible, is surgery followed by the standard chemotherapy regimens for pancreatic adenocarcinoma.
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Affiliation(s)
- Jose Manuel Ramia-Angel
- Servicio de Cirugía General. Hospital General Universitario, Alicante, España; ISABIAL: Instituto de Investigación Sanitaria y Biomédica, Alicante, España
| | | | - Alejandro Serrablo-Requejo
- Servicio de Cirugía General. Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
| | - Gonzalo P Rodriguez-Laiz
- Servicio de Cirugía General. Hospital General Universitario, Alicante, España; ISABIAL: Instituto de Investigación Sanitaria y Biomédica, Alicante, España
| | - Diego López-Guerra
- Servicio de Cirugía General. Complejo Hospitalario de Badajoz, Badajoz, España
| | - Teresa Abadía-Forcen
- Servicio de Cirugía General. Hospital Universitario Miguel Servet, Zaragoza, España
| | - Cristina Alenda
- Servicio de Cirugía General. Hospital General Universitario, Alicante, España; Servicio de Anatomía Patológica. Hospital General Universitario, Alicante, España
| | - Mario Serradilla-Martín
- Servicio de Cirugía General. Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
| | - Gerardo Blanco-Fernandez
- Servicio de Cirugía General. Complejo Hospitalario de Badajoz, Badajoz, España; Universidad de Extremadura, Badajoz, España
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10
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Abstract
Uterine cervical adenosquamous carcinoma in situ was originally defined as having either a uniform population of cells with features intermediate in appearance between glandular and squamous cells, or a mixture of distinct glandular and squamous components within a single lesion. The former type would likely be reclassified today as stratified mucin-producing intraepithelial lesion, while the latter type is vanishingly rare. Here, we report a novel case of bona fide adenosquamous carcinoma in situ, which exhibits 2 morphologically and immunophenotypically distinct components: (1) an inner glandular component composed of a single layer of p40-negative, ciliated, mucin-producing dysplastic columnar cells and (2) an outer p40-positive, stratified dysplastic squamous component otherwise identical to cervical intraepithelial neoplasia-3. Both components show block-positive staining for p16 and are positive for high-risk human papillomavirus RNA by in situ hybridization. Our finding expands the histological spectrum of human papillomavirus-associated preinvasive cervical lesions while also providing further evidence that human papillomavirus-driven processes can exhibit ciliated morphology.
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Affiliation(s)
- Jin Xu
- Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI
| | - Kay J. Park
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul Weisman
- Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI
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11
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Takigawa K, Takaya M, Ishii K, Saigoh K, Shirakawa O. Lung carcinoma-associated cognitive impairment in a patient with Alzheimer's disease pathology: A case report. Clin Case Rep 2021; 9:e04482. [PMID: 34257988 PMCID: PMC8259927 DOI: 10.1002/ccr3.4482] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/01/2021] [Accepted: 05/17/2021] [Indexed: 12/01/2022] Open
Abstract
A patient with Alzheimer's disease (AD) pathology when cognitive impairment is detected tends to be diagnosed with AD. However, before diagnosing, we make an effort to exclude other diseases, for example, carcinoma.
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Affiliation(s)
- Kiyoto Takigawa
- Department of NeuropsychiatryFaculty of MedicineKindai UniversityOsakaJapan
| | - Masahiko Takaya
- Department of NeuropsychiatryFaculty of MedicineKindai UniversityOsakaJapan
| | - Kazunari Ishii
- Department of RadiologyFaculty of MedicineKindai UniversityOsakaJapan
| | - Kazumasa Saigoh
- Department of NeurologyFaculty of Medicine and Department of Clinical GeneticsFaculty of MedicineKindai UniversityOsakaJapan
| | - Osamu Shirakawa
- Department of NeuropsychiatryFaculty of MedicineKindai UniversityOsakaJapan
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12
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Mandal S, Ponnekanti SK, Dadeboyina C, Tipparthi A, Kasireddy V. A Case Report on Adenosquamous Carcinoma of Gallbladder: A Very Rare Malignancy. Cureus 2021; 13:e15791. [PMID: 34306862 PMCID: PMC8294016 DOI: 10.7759/cureus.15791] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/09/2022] Open
Abstract
Gallbladder (GB) carcinoma is a rare carcinoma with a poor prognosis. The prevalence is 0.7-21/100,000 worldwide and 1-2/100,000 in the United States. Adenosquamous cell carcinoma is composed of glandular and squamous components. The overall five-year survival rate is less than 5%, with a median survival of fewer than six months. We are presenting a case of adenosquamous carcinoma of the GB in a 76-year-old female who presented with right upper quadrant abdominal pain and was found to have an enlarged GB, with thickened irregular wall likely inflammatory or malignant and mildly dilated common bile duct on ultrasound imaging of the abdomen. Core needle biopsy of GB showed findings compatible with adenosquamous carcinoma and immunohistochemistry was positive for P40, CK5,6. She was diagnosed with stage T4 N0 M0. She was started on chemotherapy with cisplatin and gemcitabine (25 mg/m2 and 1000 mg/m2), respectively, every three weeks but her condition worsened after the fifth cycle of chemotherapy and she decided to move forward with hospice care given her bad prognosis. Unfortunately, she passed away one week after being discharged home.
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Affiliation(s)
- Shobha Mandal
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA
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13
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Yoshimatsu Y, Ebi N, Ooi R, Sueyasu T, Nishizawa S, Munechika M, Yoshimine K, Ko Y, Ide H, Tsuruno K, Tobino K. Osimertinib for Lung Squamous Cell Carcinoma: A Case Report and Literature Review. Intern Med 2021; 60:1067-1071. [PMID: 33132329 PMCID: PMC8079920 DOI: 10.2169/internalmedicine.5463-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in lung squamous cell carcinoma is said to be low. Thus far, only four cases of osimertinib in lung squamous cell carcinoma have been published. We experienced a case of EGFR mutant lung squamous cell carcinoma in which fifth-line treatment with osimertinib was effective after T790M EGFR mutation turned positive. Osimertinib was resumed after sixth-line chemotherapy was ineffective, showing efficacy again. Osimertinib may be a promising treatment option for EGFR mutant lung squamous cell carcinoma. This is the first report to show its effect in a case of rechallenge after intervening chemotherapy. It may therefore be important to evaluate EGFR in never-smoker lung squamous cell carcinoma patients.
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Affiliation(s)
- Yuki Yoshimatsu
- Department of Respiratory Medicine, Iizuka Hospital, Japan
- Department of Physiology, Hyogo College of Medicine, Japan
| | - Noriyuki Ebi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Ryunosuke Ooi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Takuto Sueyasu
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | | | | | | | - Yuki Ko
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Hiromi Ide
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Kosuke Tsuruno
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Japan
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
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14
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Hester CA, Augustine MM, Choti MA, Mansour JC, Minter RM, Polanco PM, Porembka MR, Wang SC, Yopp AC. Comparative outcomes of adenosquamous carcinoma of the pancreas: An analysis of the National Cancer Database. J Surg Oncol 2018; 118:21-30. [PMID: 29878370 DOI: 10.1002/jso.25112] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 01/04/2018] [Accepted: 04/30/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND A paucity of data exists regarding the natural history and outcome measures of adenosquamous carcinoma of the pancreas (ASCP), a histology distinct from pancreatic adenocarcinoma (PDAC). The aim of this study is to characterize the clinicopathological features of ASCP in a large cohort of patients comparing outcome measures of surgically resected patients to PDAC. METHODS We identified patients diagnosed with ASCP or PDAC from the National Cancer Database from 2004 to 2012. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. RESULTS We identified 207 073 patients: 205 328 (99%) in the PDAC group and 1745 (1%) in the ASCP group. ASCP tumors were larger, located more frequently in a body/tail location (36% vs 24%, P < 0.001), undifferentiated/anaplastic histology (41% vs 17%, P < 0.001), and early stage presentation, (39% vs 32%, P < 0.001). There was no significant difference in OS when comparing all patients with PDAC and ASCP (6.2 months and 5.7 months, P = 0.601). In surgical patients ASCP histology was associated with worse OS (14.8 months vs 20.5 months, P < 0.001) but had lower nodal involvement (55% vs 61%, P < 0.001). ASCP histology was independently associated with worse OS, after adjusting for tumor characteristics, treatment, and patient demographics. In patients with only resected ASCP histology, negative lymph node status, R0 surgical resection, and receipt of chemotherapy was independently associated with improved overall survival following surgical resection. CONCLUSION Although patients with ASCP and PDAC tumors have similar survival when non-surgical and surgical patients are combined, ASCP is associated with worse survival in stage I/II resected patients.
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Affiliation(s)
- Caitlin A Hester
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mathew M Augustine
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael A Choti
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - John C Mansour
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca M Minter
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Patricio M Polanco
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Matthew R Porembka
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sam C Wang
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Adam C Yopp
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
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15
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Nagaraj AS, Lahtela J, Hemmes A, Pellinen T, Blom S, Devlin JR, Salmenkivi K, Kallioniemi O, Mäyränpää MI, Närhi K, Verschuren EW. Cell of Origin Links Histotype Spectrum to Immune Microenvironment Diversity in Non-small-Cell Lung Cancer Driven by Mutant Kras and Loss of Lkb1. Cell Rep 2017; 18:673-684. [PMID: 28099846 DOI: 10.1016/j.celrep.2016.12.059] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 07/09/2015] [Revised: 10/11/2016] [Accepted: 12/19/2016] [Indexed: 12/21/2022] Open
Abstract
Lung cancers exhibit pronounced functional heterogeneity, confounding precision medicine. We studied how the cell of origin contributes to phenotypic heterogeneity following conditional expression of KrasG12D and loss of Lkb1 (Kras;Lkb1). Using progenitor cell-type-restricted adenoviral Cre to target cells expressing surfactant protein C (SPC) or club cell antigen 10 (CC10), we show that Ad5-CC10-Cre-infected mice exhibit a shorter latency compared with Ad5-SPC-Cre cohorts. We further demonstrate that CC10+ cells are the predominant progenitors of adenosquamous carcinoma (ASC) tumors and give rise to a wider spectrum of histotypes that includes mucinous and acinar adenocarcinomas. Transcriptome analysis shows ASC histotype-specific upregulation of pro-inflammatory and immunomodulatory genes. This is accompanied by an ASC-specific immunosuppressive environment, consisting of downregulated MHC genes, recruitment of CD11b+ Gr-1+ tumor-associated neutrophils (TANs), and decreased T cell numbers. We conclude that progenitor cell-specific etiology influences the Kras;Lkb1-driven tumor histopathology spectrum and histotype-specific immune microenvironment.
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Affiliation(s)
- Ashwini S Nagaraj
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Jenni Lahtela
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Annabrita Hemmes
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Sami Blom
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Jennifer R Devlin
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Kaisa Salmenkivi
- HUSLAB, Division of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki 00029, Finland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland; Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 17165 Solna, Sweden
| | - Mikko I Mäyränpää
- HUSLAB, Division of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki 00029, Finland; Department of Pathology, University of Helsinki, Helsinki 00014, Finland
| | - Katja Närhi
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland
| | - Emmy W Verschuren
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki 00014, Finland.
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16
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Abstract
BACKGROUND Current published information of adenosquamous carcinoma (ASC) of the esophagus in the United States is limited to isolated case reports. We sought to study the clinical characteristics of this tumor using the Surveillance, Epidemiology and End Results (SEER) database. METHODS Relevant data of all patients with esophageal cancer in the SEER database diagnosed from 1998-2010 was obtained. Demographic, grade, stage, treatment and survival characteristics of patients with ASC were summarized and compared to those patients with adenocarcinoma (ACA) and squamous cell carcinoma (SqCC). Univariate analyses across comparison groups were performed using Wilcoxon rank sum test for continuous covariates and the Pearson Chi-square test for categorical covariates. To evaluate the association of selected covariates to survival by histology, unadjusted and adjusted proportional hazards models were generated for the entire study population. To further control for the difference in covariates among the histology groups, propensity weighted Cox regression modeling was performed using the inverse propensity to treat weighting (IPTW) approach. RESULTS Of 29,890 patients with the histological subgroups, only 284 patients had ASC (1%). Patients with ACA had a higher grade (72.9% with grade III/IV) and presented with advanced stage (48.2% distant disease) than their comparison group. Patients with ASC had worse overall survival compared to ACA but not SqCC in both univariate and multivariate analyses (OR =0.76; P<0.05 and OR =0.86; P<0.05 respectively). These results were further confirmed by the propensity weighted Cox regression analysis. Analysis of the ASC population alone demonstrated that decreasing stage, radiation therapy (OR =0.59; P<0.001) and surgery (OR =0.86; P<0.001) were associated with better overall survival, but grade was not. CONCLUSIONS ASC of the esophagus is a rare histological variant comprising 1% of esophageal ACA in the Unites States. This histological subtype presents in later stages, at a higher grade and portends a poorer survival than the more common ACA. Radiation therapy and surgical resection of appropriate stage patients provide the best chance of survival.
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Affiliation(s)
- Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Usha Malhotra
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Mark Hennon
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Austin Miller
- Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Adrienne Groman
- Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Alaa Halloon
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Mary E Reid
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
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17
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Castanon A, Landy R, Sasieni PD. Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix? Int J Cancer 2016; 139:1040-5. [PMID: 27096255 PMCID: PMC4915496 DOI: 10.1002/ijc.30152] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 04/12/2016] [Indexed: 11/17/2022]
Abstract
While the incidence of squamous carcinoma of the cervix has declined in countries with organised screening, adenocarcinoma has become more common. Cervical screening by cytology often fails to prevent adenocarcinoma. Using prospectively recorded cervical screening data in England and Wales, we conducted a population-based case-control study to examine whether cervical screening leads to early diagnosis and down-staging of adenocarcinoma. Conditional logistic regression modelling was carried out to provide odds ratios (ORs) and 95% confidence intervals (CIs) on 12,418 women with cervical cancer diagnosed between ages 30 and 69 and 24,453 age-matched controls. Of women with adenocarcinoma of the cervix, 44.3% were up to date with screening and 14.6% were non-attenders. The overall OR comparing women up to date with screening with non-attenders was 0.46 (95% CI: 0.39-0.55) for adenocarcinoma. The odds were significantly decreased (OR: 0.22, 95% CI: 0.15-0.33) in up to date women with Stage 2 or worse adenocarcinoma, but not for women with Stage1A adenocarcinoma 0.71 (95% CI: 0.46-1.09). The odds of Stage 1A adenocarcinoma was double among lapsed attenders (OR: 2.35, 95% CI: 1.52-3.62) compared to non-attenders. Relative to women with no negative cytology within 7 years of diagnosis, women with Stage1A adenocarcinoma were very unlikely to be detected within 3 years of a negative cytology test (OR: 0.08, 95% CI: 0.05-0.13); however, the odds doubled 3-5 years after a negative test (OR: 2.30, 95% CI: 1.67-3.18). ORs associated with up to date screening were smaller for squamous and adenosquamous cervical carcinoma. Although cytology screening is inefficient at preventing adenocarcinomas, invasive adenocarcinomas are detected earlier than they would be in the absence of screening, substantially preventing Stage 2 and worse adenocarcinomas.
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Affiliation(s)
- Alejandra Castanon
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Bart's and the London School of MedicineQueen Mary University of LondonCharterhouse SquareLondonUnited Kingdom
| | - Rebecca Landy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Bart's and the London School of MedicineQueen Mary University of LondonCharterhouse SquareLondonUnited Kingdom
| | - Peter D. Sasieni
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Bart's and the London School of MedicineQueen Mary University of LondonCharterhouse SquareLondonUnited Kingdom
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18
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Yeung V, Palmer JD, Williams N, Weinstein JC, Fortuna D, Sama A, Winter J, Bar-Ad V. Adenosquamous Carcinoma of the Pancreas in a Patient with BRCA2 Mutation: A Case Report. Case Rep Pancreat Cancer 2015; 1:22-25. [PMID: 30631805 PMCID: PMC6319674 DOI: 10.1089/crpc.2015.29003.vye] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Pancreatic adenosquamous carcinoma (ASC) is an uncommon subtype of pancreatic neoplasm, representing 1–4% of all pancreatic cancers. Given the rarity of this tumor, there is no well-established standard of care regarding treatment. We present the case of a BRCA2-deficient patient who responded tremendously well to a combination of gemcitabine and cisplatin therapy. Case presentation: A 66-year-old Caucasian man presented with a 2-week duration of progressively worsening clay-colored stools, tea-colored urine, and jaundice. Computed tomography scan of the abdomen revealed a 4-cm mass at the head of the pancreas. Preoperative carbohydrate antigen (CA) 19-9 was 255 U/mL (normal <37 U/mL). The patient underwent an uncomplicated pylorus-preserving pancreaticoduodenectomy with pathology revealing 11/12 positive lymph nodes, positive resection margins, perineural invasion, lymphovascular invasion, and positive disease in two distant perihepatic lymph nodes. The patient received one cycle of combination of gemcitabine and abraxane, was subsequently found to be BRCA2 deficient, and completed five cycles of gemcitabine and cisplatin thereafter. CA 19-9 before chemotherapy was 203 U/mL. Postchemotherapy CA 19-9 was 13 U/mL. As of today, the patient continues to do well 22 months postresection without radiographical or gross evidence of disease. Conclusion: Gemcitabine in combination with a platinum agent shows promise in the treatment of pancreatic ASC, particularly in setting of BRCA2 deficiency.
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Affiliation(s)
- Vincent Yeung
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joshua D Palmer
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Noelle Williams
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jonathan C Weinstein
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Danielle Fortuna
- Department of Pathology Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Ashwin Sama
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Jordan Winter
- Department of Surgery, The Jefferson Pancreas, Biliary, and Related Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Voichita Bar-Ad
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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19
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Abstract
We describe a case of pleomorphic carcinoma showing a recurrent tumor with massive hemorrhage and myxoid change in the chest wall 2 months after complete resection. Whereas specimens from the initial surgery revealed both adenosquamous carcinoma and sarcomatous elements, the recurrent tumor predominantly consisted of a sarcomatous element. The recurrent tumor had stronger immunoreactivity for mesenchymal markers than the primary tumor, indicating that the sarcomatous element had more malignant potential than the epithelial element.
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Affiliation(s)
- Yasushi Shintani
- Department of Thoracic Surgery, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
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20
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Chuthapisith S, Warnnissorn M, Amornpinyokiat N, Pradniwat K, Angsusinha T. Metaplastic carcinoma of the breast with transformation from adenosquamous carcinoma to osteosarcomatoid and spindle cell morphology. Oncol Lett 2013; 6:728-732. [PMID: 24137400 PMCID: PMC3789018 DOI: 10.3892/ol.2013.1464] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 06/18/2013] [Indexed: 11/06/2022] Open
Abstract
Metaplastic carcinoma of the breast refers to a heterogenous group of mammary carcinomas that contain a mixture of various cell types, including squamous cells, spindle cells and/or a mesenchymal component, such as bone or cartilage. To the best of our knowledge, the clinical course of a tumour that has undergone a transformation from one type of metaplastic carcinoma to another subtype has not previously been reported. The present study reports the five-year clinical and pathological course of a metaplastic breast carcinoma in a 55-year-old female, who was diagnosed with a sclerosing fibroadenomatous nodule with osseous metaplasia and focal atypia. A recurrent tumour was documented four years later, showing a predominant component of osteosarcoma with adenosquamous carcinoma. Upon pathological review of the initial mass, the diagnosis was changed to low-grade adenosquamous carcinoma. The patient was treated with breast conserving therapy. However, one year later, a recurrent metaplastic carcinoma with spindle cell morphology was documented and surgically removed by mastectomy. Subsequently, pulmonary invasion of the chest wall occurred and the patient eventually succumbed due to the invasive nature of the disease.
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Affiliation(s)
- Suebwong Chuthapisith
- Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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21
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Kwon OS, Lee HS, Koh DW, Cho YJ, Park YH, Park DK, Oh YL, Seo JH, Chun HJ, Um SH, Lee SW, Choi JH, Kim CD, Ryu HS, Hyun JH, Kim AR, Kim YS. A case of primary adenosquamous carcinoma of the liver presented with liver abscess. Korean J Intern Med 2001; 16:270-3. [PMID: 11855159 PMCID: PMC4578056 DOI: 10.3904/kjim.2001.16.4.270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6 x 5 x 5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.
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Affiliation(s)
- O S Kwon
- Department of Internal Medicine, Korea University, Ansan Hospital, 516 Kojan-Dong, Ansan City, Kyungki-Do, 425-020, Korea
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