Search

This multicenter prospective trial assessed the outcome in 63 patients, 40 years of age or younger, with high-risk early breast cancer (HREBC), included in an ovarian protection study. The patients were treated with a luteinizing hormone-releasing hormone (LH-RH) analogue administered for 5 years, tailored chemotherapy and an aromatase inhibitor, in estrogen receptor-positive (ER(+)) patients. T-regulatory cells (T-regs) and vascular endothelial growth factor (VEGF) were measured at baseline and yearly. The mean age of the patients was 36 years (range 26-40). Sixty-five percent had ER(+) tumors, 24% had negative axillary nodes with tumors >1 cm and high histological grade with lymphovascular invasion, while 76% had a mean of 3.6 positive axillary nodes (range 1-21). Serum estradiol was maintained at values <40 pg/ml in all of the patients. A statistically significant decrease in VEGF (P<0.0001) and T-regs (P<0.0001), with respect to baseline values, was observed after LH-RH administration. After a median follow-up of 110 months, the 10-year progression-free and overall survival rates were 86.1 and 89.7%, respectively. These data revealed that the administration of an LH-RH analogue to HREBC patients, followed by chemotherapy and hormonal therapy, decreased VEGF and T-regs and improved the expected clinical outcome.

The Goseki grading system, based on intracellular mucin content and tubular differentiation, was originally created to study the influence of histologic type on the mode of extension of gastric carcinoma. The prognostic value of this grading system was subsequently proposed and even recently supported, but controversies still remain about this topic. We applied the Goseki system on 114 cases of node-negative primary gastric cancer and compared Goseki groups with the other clinicopathologic features of the patients. Statistical analysis showed a significant correlation between Goseki grading and Laurèn classification, but failed to reveal any prognostic significance for this grading system. We believe that Goseki classification should not be routinely used for prognostic purposes.

The management of cystectomy specimens represents the first and most important step in the study of bladder cancer and related lesions. We carried out a study on 110 patients, applying an original mapping protocol which allowed to determine the exact topography of lesions, recognizing even the smallest ones and putting in evidence some rare histotype. A prevalence of high-grade, high-stage tumors was noted, as well as a remarkable frequency of precancerous lesions, mostly found in Brunn's nests. This latter finding could mean that in many cases a flat carcinoma becomes invasive within a Brunn's nest rather than in surface urothelium. We were also able to accurately evaluate prostatic pathology, finding incidental malignant lesions of this gland in 24.2% of the cystectomized males. The apparently worst prognosis of the patients who underwent chemotherapy depends on the fact that they had grades and stages higher than the untreated subjects. In conclusion, we believe that a more extensive sampling of cystectomy specimens gives highly reliable prognostic data and represents an unreplaceable tool in understanding bladder neoplasms.

Based on the additive or synergistic antiproliferative effect of interferon and tamoxifen on breast cancer cell lines and on preclinical and clinical data on retinoids alone and in combination with antiestrogen or interferon, we designed a pilot phase II study to test the toxicity of simultaneous administration of interferon-beta (IFN-beta), retinoids (R), and tamoxifen (TAM) and the efficacy of this combination as salvage therapy in a group of patients with metastatic breast cancer (MBC). A total of 49 stage IV breast cancer patients, 11 pretreated with hormones, 26 with chemotherapy, and 12 with both, received 30 mg TAM and two dose levels of IFN-beta and retinyl palmitate. Among 49 evaluable patients, 27 achieved a clinical response (55%; 95% CI 41-69%), 10 had stable disease (20%), and in 12 (25%) the disease progressed. Toxicity with both dose levels was moderate and mainly hepatic. Median response duration, not statistically different in estrogen receptor-positive and negative patients, was 31.4 months (range 4.9-67). Median overall survival was 19.2 months (range 2-69). We have shown that long-term administration of TAM, IFN-beta, and retinyl palmitate is feasible with moderate toxicity. We have also demonstrated that this regimen is active in pretreated MBC patients and that responses are not influenced by receptor status.

During 712 consecutive autopsies on liveborn infants, body weight and the weight of single organs were systematically recorded. These data have provided the material for a statistical investigation. Tables and graphs have been prepared to allow a statistical estimate of the normal value of the weight of organs in the first year of life, as a function of body weight and/or the subject's age. It has been shown that in this period, the weight of an organ varies as a linear function of these two independent variables, whose action is sometimes synergic and, more rarely, in conflict in determing the weight of the organ.

A case of testicular specialized gonadal stroma tumor was evaluated by histologic, ultrastructural and immunohistochemical techniques in a young adult male patient. The neoplastic cells were organized in cords or tubular structures delimited by a basement membrane. The ultrastructural findings suggested a diagnosis of a partially differentiated Sertoli cell tumor. This was also supported by the presence of a vimentin rich cytoskeleton, which is normally present in Sertoli and Leydig cells. The tumor cells did not secrete steroid hormones, as suggested by clinical findings, as well as by hormonal, immunohistochemical, and ultrastructural observations.

Two cases of lipoma of the tuber cinereum, unexpectedly discovered in the course of autopsy examination, are reported. Each case was thoroughly investigated by serial sectioning of both the diencephalic floor and the tumor. Some peculiar findings observed and a complete survey of the literature revealed that such a growth may be considered an incomplete benign mesenchymoma, i.e., a mixed tumor of mesenchymal derivates, according to Stout (14). The error in development, consisting in the inclusion of embryonal germs of primitive meninx into the nervous system, may occur early during the third month of intrauterine life, at the time of the formation of the primitive septa.

Pericentric inversion of chromosome 19 has been found in several members of three unrelated families from a restricted geographical region. In one of the families, an additional pericentric inversion of chromosome 9 was observed. Reproductive problems, multiple abortions in two families and a neonatal death in the third, were present. A review of previously described cases is included, and the genetic risk connected with this type of rearrangement is also discussed.