Lymphangioma of the pancreas is a rare benign neoplasm. A survey of the literature shows that only thirty cases have been reported previously. We report an additional case which concerns a 34-year-old male who presented with epigastralgia radiating to the back for three days. Examinations including abdominal sonography, computer tomography and duodenoscopy all pointed to the diagnosis of pancreatic head tumor. During exploratory laparotomy, a large mass 6x6x3 cm^3 was found to be arising from the Pancreatic head and invading the second portion of duodenum. Pyloric preserving Whipple's procedure was performed. Histological features of the tumor met the diagnosis of cavernous lymphangioma of pancreas.
Background/Objectives: Breast cancer remains the leading malignancy affecting women worldwide, with significant mortality rates. This study aimed to evaluate the prognostic significance of FOXM1 expression specifically in hormone receptor-positive, HER2-negative (HR+HER2-) breast cancer patients with high KPNA2 expression, and to identify potential FOXM1-targeted therapeutic strategies for this patient subgroup. Methods: We analyzed RNA sequencing and microarray data from three independent cohorts: Mackay Memorial Hospital patient samples, The Cancer Genome Atlas, and Gene Expression Omnibus databases. The expression levels of KPNA2, FOXM1, CCNB1, and CCNB2 were evaluated, with particular emphasis on stratifying patients based on KPNA2 expression levels. Their associations with clinical outcomes were assessed using Gene Set Enrichment Analysis and survival analyses. Results: While KPNA2 expression showed strong positive correlations with FOXM1, CCNB1, and CCNB2 across all datasets, our analysis revealed a distinct prognostic pattern in HR+HER2- breast cancer patients with high KPNA2 expressions. In this specific subgroup, low FOXM1 expression emerged as a favorable prognostic indicator, despite the generally poor prognosis associated with high KPNA2 levels. Gene Set Enrichment Analysis demonstrated significant enrichment of the G2/M checkpoint pathway in high KPNA2-expressing patients, suggesting potential therapeutic vulnerability to FOXM1 inhibition in this subgroup. Conclusions: This study establishes FOXM1 expression as a critical prognostic marker, specifically in KPNA2-high HR+HER2- breast cancer patients, where low FOXM1 levels correlate with improved survival outcomes. These findings suggest that FOXM1 inhibition could be particularly effective in patients with high KPNA2 expression, offering a novel therapeutic strategy for this specific molecular subtype. Several FOXM1 inhibitors, including thiostrepton and FDI-6, warrant investigation as potential targeted treatments for KPNA2-high HR+HER2- breast cancer patients.
The most common tracers used for lymphatic mapping in sentinel lymph node dissection (SLND) are blue dye and radio-colloid. The former is associated with hypersensitivity, and the latter is not available in some institutions. It is still unclear as to which subsets of patients benefit most from SLND. In this study, we tried to evaluate the usefulness of activated carbon in SLND in the early stages of breast cancer.Patients with palpable lesions diagnosed as ductal carcinoma in situ (DCIS) or intraductal carcinoma with micro-invasion (DCMI) from their core-needle biopsy specimens were eligible for the study. A 0.4-0.6 cc emulsion of activated carbon particles (ACP) was injected peri-lesionally or subdermally, 5 minutes before modified radical mastectomy. When the axillary compartment was entered, the black-stained sentinel nodes (SLNs) were dissected and examined with H&E stain by frozen section. The extension of subsequent axillary lymph node dissection (ALND) was determined by the status of the sentinel nodes.Twenty-eight patients were diagnosed as DCIS and 10 as DCMI initially. The SLNs were successfully localized in 33 patients (86.8%), with an average of 2.4 SLNs dissected. The SLNs were positive for metastasis in three patients, and the non-sentinel axillary lymph nodes (ALNs) were also positive in one of them. The final diagnosis of these patients turned out to be infiltrating ductal carcinoma. The SLNs were negative for metastasis in 30 patients, and all the ALNs of these patients were also negative. Among these 33 patients, the final diagnosis was up-graded in nine (27.3%), including the three patients with positive SLNs. The SLNs were not identified in five patients, and the ALNs were positive for metastasis in one of them.ACP is an acceptable tracer for lymphatic mapping in SLND. For patients with palpable, biopsy-proven DCIS or DCMI, SLND can be used to select patients for ALND.
Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion, characterized by chronic infiltration of inflammatory cells and areas of necrosis mimicking a malignant tumor. Few cases have been reported, and the precise etiology is still unknown. Patients usually present with abdominal pain, fever, and jaundice. Herein, we report the case of a 78-year-old male with a history of diabetes mellitus who had abdominal fullness and body weight loss for 4 months. A computed tomography scan showed a 15-cm liver tumor in segment 2 and 3 and suspected hepatocellular carcinoma. Left hepatectomy was performed, and the pathology showed IPT. After surgery, the symptom of abdominal fullness subsided.
Introduction: The purpose of this study was to determine safety and feasibility of breast surgery under local anesthesia (LA) combined with adequate sedation.
Patients and Methods: Based on extensive satisfaction surveys, an anesthetic technique was developed that decreased nausea and pain, and reduced perioperative narcotic use. Using this new algorithm, patients treated by a single surgeon were given the choice of local anesthesia with adequate sedation.
Results: From August 1, 2006 to December 31, 2007, 50 mastectomies or lumpectomy/axillary dissections were performed in 50 patients. Less postoperative nausea and vomiting (PONV) and less pain were noted in the LA group.
Conclusions: Local block mastectomy can be safely performed. It can result in markedly improved postoperative outcome without incurring additional morbidity or mortality. Less nausea/vomiting and less pain infer better quality of cancer care and higher overall patient satisfaction.
This report described a patient who presented with biliary tract obstruction caused by ampullary hamartoma. Duodenoscopy showed a large mass on the ampulla of Vater. Endoscopic biopsy revealed no evidence of malignancy. Frozen section biopsies of the tumor performed during operation disclosed hamartoma without evidence of malignancy. Therefore, simple local excision and sphincteroplasly were performed. The serial histological sections of the resected specimen confirmed a hamartoma of the ampulla of Vater. Hamartomas are unusual tumors in the duodenum; we, therefore, present this very rare case.
'/%3e%3cuse xlink:href='%23a' transform='rotate(60)'/%3e%3ccircle r='17' fill='%23000095'/%3e%3ccircle r='15' fill='%23fff'/%3e%3c/svg%3e)