http://www.wjso.com The latest research articles published by World Journal of Surgical Oncology 2010-03-21T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Backround:Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall.Case presentationA 72-year-old female underwent sigmoidectomy for stage I (T2N0M0) sigmoid colon cancer in May 2008. In June 2009, an abdominal computed tomography scan revealed a tumor 2 cm in size at the lower anterior mesorectum and a second mass 2cm in size at the anterior abdominal wall midline. Total colonoscopy showed no mucosal lesion. The serum carcinoembryonic antigen level was normal. A biopsy of the mesorectum tumor showed similar histologic characteristics with the primary tumor. Since no other site of recurrence was identified, an abdominoperineal resection was attempted. During the operation and after the removal of the incision recurrence, sinus bradycardia and signs of myocardial ischemia were noticed. A loop transverse colostomy was immediately perfomed and the operation was terminated. Postoperative cardiologic examination revealed an acute myocardium infract. Chemo-radiation of the mesorectum tumor and re-evaluation for surgical excision was decided. Conclusion: Metachronous metastasis of the mesorectum from sigmoid colon cancer is extremely rare. Although patterns of lymphatic spread from rectal cancer to sigmoid colon have recently been demonstrated, there is no evidence of metachronous mesorectum invasion from sigmoid colon cancer. This could be the issue for future trials. http://www.wjso.com/content/8/1/17 John Kalaitzis George Filippou Adamantia Zizi-Sermpetzoglou Athanasios Marinis Andreas Hadjimarcou Nikolaos Paschalidis Spyros Rizos World Journal of Surgical Oncology 2010, 8:17 2010-03-21T00:00:00Z doi:10.1186/1477-7819-8-17 World Journal of Surgical Oncology 1477-7819 8 17 2010-03-21T00:00:00Z PDF Mesenchymal tumors represent a small number of bladder cancer cases. Leiomyosarcoma is the most common histology with over 100 cases reported in the whole literature. This tumor is been historically considered as highly aggressive and showing a poor prognosis. Despite very low survival rates showed in older reports, some authors indicate that some patients could have a better outcome. We report a review of the literature and a case of high-grade LMS of the bladder in a 68 years old woman. Diagnosis was delayed and disease was locally advanced. Symptoms and imaging of our case first oriented to a gynecologic condition with an adnexal or uterine origin of the mass, and, a genitourinary origin could be unveiled only intra-operatively. http://www.wjso.com/content/8/1/16 Enzo Ricciardi Paolo Maniglio Mauro Schimberni Massimo Moscarini World Journal of Surgical Oncology 2010, 8:16 2010-03-19T00:00:00Z doi:10.1186/1477-7819-8-16 World Journal of Surgical Oncology 1477-7819 8 16 2010-03-19T00:00:00Z PDF The primary staging of an oesophageal cancer can be difficult, if accompanied by sarcoidosis. In these patients endosonography, CT and PET may not be sufficient for staging purposes concerning lymph node and distant metastases. In these special cases operative biopsies of enlarged lymph nodes and unclear pulmonary nodules have to be obtained. In connection with the radiographic examinations the histopathological results of the biopsies contribute to further precise staging and help to decide on a curative versus a palliative therapy concept. http://www.wjso.com/content/8/1/15 Matthias Schauer Joerg Theisen World Journal of Surgical Oncology 2010, 8:15 2010-03-12T00:00:00Z doi:10.1186/1477-7819-8-15 World Journal of Surgical Oncology 1477-7819 8 15 2010-03-12T00:00:00Z PDF Background: Neurofibromatosis Type 1(NF-1) has autosomal dominant inheritance with complete penetrance, variable expression and a high rate of new mutation. Pheochromocytoma occurs in 0.1%-5.7% of patients with NF-1.Case presentationWe present the case of a 37-year-old patient with laparoscopically resected pheochromocytoma. He was investigated for hypertension, flushing and ectopic heart beat. Abdominal CT and MRI revealed a mass measuring 8x4 cm in the right adrenal gland. The diagnosis of pheochromocytoma was confirmed by elevated 24-hour urine levels of VMA, metanephrines and catecholamines as well as positive MIBG scan. The patient presented with classic clinical features of NF-1, which was confirmed by pathologic evaluation of an excised skin nodule. The patient underwent laparoscopic right adrenalectomy through a transabdominal approach and was discharged on the second postoperative day, being normotensive. The patient is normotensive without antihypertensive therapy 11 years after the procedure. Conclusion: Nowadays in the era of laparoscopy, patients with pheochromocytoma reach the operating theatre easier than in the past. Despite, the feasibility and oncological efficacy of the laparoscopic approach to the adrenals, continued long term follow-up is needed to establish the minimally invasive technique as the preferred approach. Furthermore, these patients should be further investigated for other neoplasias and stigmata of other neurocutaneous syndromes, taking into account the association of the familial pheochromo-cytoma with other familial basis inherited diseases. http://www.wjso.com/content/8/1/14 George Zografos George Vasiliadis Flora Zagouri Chrysanthi Aggeli Dimitris Korkolis Sophia Vogiaki Matina Pagoni Gregory Kaltsas George Piaditis World Journal of Surgical Oncology 2010, 8:14 2010-03-10T00:00:00Z doi:10.1186/1477-7819-8-14 World Journal of Surgical Oncology 1477-7819 8 14 2010-03-10T00:00:00Z PDF We describe the complete resection of a giant, well-differentiated mediastinal liposarcoma extending retropharynx to envelop the aortic arch, trachea and esophagus following preoperative radiotherapy. http://www.wjso.com/content/8/1/13 Thomas Gethin-Jones Nathaniel Evans Christopher Morse World Journal of Surgical Oncology 2010, 8:13 2010-03-02T00:00:00Z doi:10.1186/1477-7819-8-13 World Journal of Surgical Oncology 1477-7819 8 13 2010-03-02T00:00:00Z XML Background: Primary carcinoid tumor of the gallbladder is rare and comprises less than 1% of all carcinoid tumors. Preoperative diagnosis of carcinoid tumor of the gallbladder is difficult. The imageology findings are similar to those in other gallbladder cancers.Case presentationA 46-year-old woman was hospitalized with a preoperative diagnosis of gallbladder carcinoma, The patient was referred for surgical opinion and laparotomy was subsequently performed. A 4 × 5 cm mass was found within the gallbladder, located on the free surface of the body and fundus of the gallbladder. Neither metastases nor direct invasion to the liver was found. The entire mass and gallbladder were excised and intact. Histologically, the tumor consisted of small oval cells with round-to-oval neclei and tumor cells formed small nodular, trabeculare and acinar structures. The tumor showed moderate pleomorphism with scattered mitotic figures, but no definite evidence of vascular permeation, perineural invasion or lymphatic permeation was seen. The tumor cells invaded the mucosa extensively, and some penetrated the muscular layer but not through the serosa of the gallbladder into the liver. Immunohistochemical studies revealed strong positive reaction for chromogranin A and NSE. This lesion was proved to be a primary carcinoid tumor of the gallbladder. A brief review of literature, clinical feature, pathology and treatment of this rare disease was discussed. Conclusion: Primary carcinoid tumor of the gallbladder is uncommon. The definite diagnosis is often made on histopathological results after surgery. http://www.wjso.com/content/8/1/12 Yi-Ping Zou Wei-Min Li Hao-Run Liu Ning Li World Journal of Surgical Oncology 2010, 8:12 2010-02-23T00:00:00Z doi:10.1186/1477-7819-8-12 World Journal of Surgical Oncology 1477-7819 8 12 2010-02-23T00:00:00Z XML IntroductionPrediction of optimal cytoreduction in patients with advanced epithelial ovarian caner preoperatively. Methods: Patients with advanced epithelial ovarian cancer who underwent surgery for the first time from Jan. to June 2008 at gynecologic oncology ward of TUMS (Tehran University of Medical Sciences) were eligible for this study. The possibility of predicting primary optimal cytoreduction considering multiple variables was evaluated. Variables were peritoneal carcinomatosis, serum CA125, ascites, pleural effusion, physical status and imaging findings.Univariate comparisons of patients underwent suboptimal cytoreduction carried out using Fisher's exact test for each of the potential predictors. The wilcoxon rank sum test was used to compare variables between patients with optimal versus suboptimal cytoreduction. Results: 41 patients met study inclusion criteria. Statistically significant association was noted between peritoneal carcinomatosis and suboptimal cytoreduction. There were no statistically significant differences between physical status, pleural effusion, imaging findings,serum CA125 and ascites of individuals with optimal cytoreduction compared to those with suboptimal cytoreduction. Conclusions: Because of small populations in our study the results are not reproducible in alternate populations. Only the patient who is most unlikely to undergo optimal cytoreduction should be offered neoadjuvant chemotherapy, unless her medical condition renders her unsuitable for primary surgery. http://www.wjso.com/content/8/1/11 Azam-Sadat Mousavi Marjan Moradi Mazhari Mitra Modares Guilani Fatemeh Ghaemmaghami Nadereh Behtash Setareh Akhavan World Journal of Surgical Oncology 2010, 8:11 2010-02-19T00:00:00Z doi:10.1186/1477-7819-8-11 World Journal of Surgical Oncology 1477-7819 8 11 2010-02-19T00:00:00Z PDF IntroductionMale breast cancer (MBC) is a rare, yet potentially aggressive disease. Although literature regarding female breast cancer (FBC) is extensive, little is known about the etiopathogenesis of male breast cancer. Studies from our laboratory show that MBCs have a distinct immunophenotypic profile, suggesting that the etiopathogenesis of MBC is different from FBCs. The aim of this study was to evaluate and correlate the immunohistochemical expression of cell cycle proteins in male breast carcinoma to significant clinico-biological endpoints. Methods: 75 cases of MBC were identified using the records of the Saskatchewan Cancer Agency over 26 years (1970-1996). Cases were reviewed and analyzed for the immunohistochemical expression of PCNA, Ki67, p27, p16, p57, p21, cyclin-D1 and c-myc and correlated to clinico-biological endpoints of tumor size, node status, stage of the disease, and disease free survival (DFS). Results: Decreased DFS was observed in the majority of tumors that overexpressed PCNA (98%, p = 0.004). The overexpression of PCNA was inversely correlated to the expression of Ki67 which was predominantly negative (78.3%). Cyclin D1 was overexpressed in 83.7% of cases. Cyclin D1 positive tumors were smaller than 2 cm (55.6%, p = 0.005), had a low incidence of lymph node metastasis (38.2%, p = 0.04) and were associated with increased DFS of >150 months (p = 0.04). Overexpression of c-myc (90%) was linked with a higher incidence of node negativity (58.3%, p = 0.006) and increased DFS (p = 0.04). p27 over expression was associated with decreased lymph node metastasis (p = 0.04). P21 and p57 positive tumors were related to decreased DFS (p = 0.04). Though p16 was overexpressed in 76.6%, this did not reach statistical significance with DFS (p = 0.06) or nodal status (p = 0.07). Conclusion: Aberrant cell cycle protein expression supports our view that these are important pathways involved in the etiopathogenesis of MBC. Tumors with overexpression of Cyclin D1 and c-myc had better outcomes, in contrast to tumors with overexpression of p21, p57, and PCNA with significantly worse outcomes. P27 appears to be a predictive marker for lymph nodal status. Such observation strongly suggests that dysregulation of cell cycle proteins may play a unique role in the initiation and progression of disease in male breast cancer. Such findings open up new avenues for the treatment of MBC as a suitable candidate for novel CDK-based anticancer therapies in the future. http://www.wjso.com/content/8/1/10 Rani Kanthan Isabella Fried Theresa Rueckl Jenna-Lynn Senger Selliah Kanthan World Journal of Surgical Oncology 2010, 8:10 2010-02-12T00:00:00Z doi:10.1186/1477-7819-8-10 World Journal of Surgical Oncology 1477-7819 8 10 2010-02-12T00:00:00Z XML Background: Human oesophageal carcinoma is considered to be one of the most aggressive malignancies and has a very poor prognosis. The incidence of oesophageal cancer shows a gender bias and is higher in males compared with females, the ratio between males and females varying from 3:1 to 7:1. This sex ratio is not entirely attributable to differences in the prevalence of known risk factors between the sexes. The potential role of oestrogen receptors (ER) in oesophageal cancer has been debated for several years but the significance of the receptors in this cancer remains unknown. Most of the work has been based on immunohistochemistry and has not been validated with other available techniques. The inconsistencies in the published literature on the link between ER expression and oesophageal cancer warrant a thorough evaluation of the potential role of ERs in this malignancy. Even the expression of the two ER isoforms, ERα and ERβ, and its implications for outcome of treatments in histological subtypes of oesophageal tumours is ill defined. The aim of this article is to provide updated information from the available literature on the current status of ER expression in oesophageal cancer and to discuss its potential therapeutic role.Methods and ResultsWe performed a comprehensive literature search and analysed the results regarding ER expression in oesophageal tumours with special emphasis on expression of different oestrogen receptors and the role of sex hormones in oesophageal cancer. This article also focuses on the significance of the two main ER subtypes and mechanisms underlying the presumed male predominance of this disease. Conclusion: We postulate that differential oestrogen receptor status may be considered a biomarker of poor clinical outcome based on tissue dedifferentiation or advanced stage of the disease. Further, if we can establish the importance of oestrogen and its receptors in the context of oesophageal cancer, then this may lead to a new future direction in the management of this malignancy. http://www.wjso.com/content/8/1/9 Farhan Rashid Raheela Khan Syed Iftikhar World Journal of Surgical Oncology 2010, 8:9 2010-02-10T00:00:00Z doi:10.1186/1477-7819-8-9 World Journal of Surgical Oncology 1477-7819 8 9 2010-02-10T00:00:00Z XML Background: Defining the optimal treatment for patients with inoperable non small cell lung cancer (NSCLC), presenting with metastatic mediastinal lymph nodes, is challenging. Nevertheless, preoperative chemotherapy or radiotherapy might offer a chance for these patients for radical surgical resection and, possibly, complete recovery.Case PresentationA 62-year old man with IIIA-N2 inoperable NSCLC was treated with first-line single agent docetaxel. A platinum-based treatment, though considered more active, was ruled out because of renal impairment. The patient tolerated the treatment very well and, although his initial response was not impressive, after 14 cycles he obtained a complete clinical response, which was confirmed pathologically after he underwent surgical lobectomy. Conclusion: In non-operable NSCLC patients not eligible for a platinum-based treatment, single-agent docetaxel can provide complete pathologic responses. Failure to obtain a response after the first few cycles should not automatically discourage to continue treatment. http://www.wjso.com/content/8/1/8 Ferdinando Riccardi Giuseppe Di Lorenzo Carlo Buonerba Guglielmo Monaco Roberto Monaco Mimma Rizzo Sarah Scagliarini Florinda Scognamiglio Marilena Di Napoli Giacomo Carteni' World Journal of Surgical Oncology 2010, 8:8 2010-02-05T00:00:00Z doi:10.1186/1477-7819-8-8 World Journal of Surgical Oncology 1477-7819 8 8 2010-02-05T00:00:00Z XML