RESUMO
BACKGROUND: Osteosarcoma is a malignant mesenchymal bone tumor. Although it is a common tumor in the appendicular skeleton of dogs and cats, it is rarely reported in birds. Retroviruses are usually associated with solid tumor development in different avian species. CASE PRESENTATION: This report aims to describe a case of osteosarcoma associated with the avian leukosis virus in a captive bare-faced curassow (Crax fasciolata). A captive adult female bare-faced curassow presented with lameness, hyporexia, and a non-ulcerative and firm tumor in the right femur. The bird was euthanized due to the poor prognosis. Histopathology revealed an infiltrative mesenchymal neoplasm consisting of spindle cells with moderate cell pleomorphism, organized in bundles and interspersed by marked deposition of the osteoid matrix, which was compatible with osteosarcoma affecting both femur and tibiotarsus, with renal metastasis. Immunohistochemistry of the primary and metastatic tumor demonstrated vimentin expression by neoplastic cells. Samples of the neoplasm, bone marrow, and spleen were processed for PCR, which enabled the demonstration of proviral avian leukosis virus (ALV) DNA. CONCLUSIONS: To the best of our knowledge, this is the first report of an osteosarcoma in a bare-faced curassow with an unusual polyostotic manifestation and associated with ALV infection.
Assuntos
Leucose Aviária , Doenças das Aves/patologia , Neoplasias Ósseas/veterinária , Osteossarcoma/veterinária , Animais , Vírus da Leucose Aviária/isolamento & purificação , Doenças das Aves/virologia , Medula Óssea/virologia , Neoplasias Ósseas/virologia , Feminino , Galliformes/virologia , Neoplasias Renais/secundário , Neoplasias Renais/veterinária , Osteossarcoma/virologia , Baço/virologia , Vimentina/metabolismoRESUMO
A 10-year-old female American Pit Bull dog was diagnosed with metastatic undifferentiated carcinoma of the scapula. Immunohistochemistry showed positive immunoexpression for cytokeratins (AE1/AE3, 34BE12, CK7) and vimentin, confirming squamous cell carcinoma. No evidence of nodules was found in the complete physical examination and imaging procedures conducted. The patient was diagnosed with carcinoma of unknown primary origin. Amputation and adjuvant chemotherapy with doxorubicin and piroxicam were performed, but the patient died of respiratory failure after 737 days of diagnosis. Necropsy confirmed undifferentiated carcinoma infiltrating the lungs and kidneys, and showing the same immunoexpression as the tumor in the scapula. Amputation associated with chemotherapy extended the overall survival time of this patient.
Assuntos
Neoplasias Ósseas/secundário , Neoplasias Ósseas/veterinária , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/veterinária , Neoplasias Primárias Desconhecidas/veterinária , Amputação Cirúrgica/veterinária , Animais , Biomarcadores Tumorais , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/cirurgia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/cirurgia , Cães , Tratamento Farmacológico/veterinária , Feminino , Imuno-Histoquímica , Queratinas/metabolismo , Neoplasias Renais/secundário , Neoplasias Renais/veterinária , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/veterinária , Neoplasias Primárias Desconhecidas/tratamento farmacológico , Neoplasias Primárias Desconhecidas/cirurgia , Escápula/metabolismo , Escápula/patologia , Escápula/cirurgia , Vimentina/metabolismoRESUMO
PURPOSE: To study the detailed mechanisms of tumorigenesis and clinical outcomes of centrosomal protein 55 (CEP55) overexpression in renal cell carcinoma. MATERIALS AND METHODS: Microarray analysis was performed to explore differentially expressed genes in five pairs of RCC tissues. Data of CEP55 expression and corresponding clinical information for 532 RCC patients of TCGA database were downloaded from cBioPortal. The expression of CEP55 in RCC tissues and cells was determined by real-time quantitative reverse transcription PCR (qRT-PCR), Western blot analysis and immunohistochemistry (IHC). Cells were transfected with siRNAs or lentivirus to regulate the expression of CEP55. The effects of CEP55 on proliferation, migration, invasion and epithelial-to-mesenchymal transition (EMT) of RCC cells were determined by MTS, migration and invasion assay and Western blot analysis. RESULTS: CEP55, one of the most upregulated genes in microarray analysis, was overexpressed in RCC tissues and cells. CEP55 expression was significantly correlated with poor outcome including neoplasm disease stage, histologic grade and TNM status, as well as survival status of patients. In vitro experiments showed that downregulation of CEP55 could dramatically inhibit RCC cell proliferation, migration and invasion, while overexpression of CEP55 could promote these biological behaviors. We further demonstrated that CEP55 knockdown suppressed epithelial-mesenchymal transition (EMT), which was mediated via upregulation of E-cadherin and downregulation of N-cadherin and ZEB1, through PI3K/AKT/mTOR pathway. In contrast, overexpression of CEP55 could promote EMT in RCC cells via the activation of PI3K/AKT/mTOR pathway. Importantly, inhibition of PI3K/AKT/mTOR pathway reduced the effects of CEP55 on the migration, invasion and EMT of RCC cells. CONCLUSION: Our study showed that CEP55 could promote EMT through PI3K/AKT/mTOR pathway and might be an effective prognostic marker in RCC.
Assuntos
Carcinoma de Células Renais/patologia , Proteínas de Ciclo Celular/metabolismo , Transição Epitelial-Mesenquimal , Neoplasias Renais/secundário , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Renais/metabolismo , Carcinoma de Células Renais/cirurgia , Proteínas de Ciclo Celular/genética , Movimento Celular , Proliferação de Células , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Renais/metabolismo , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Fosfatidilinositol 3-Quinases/genética , Prognóstico , Proteínas Proto-Oncogênicas c-akt/genética , Taxa de Sobrevida , Serina-Treonina Quinases TOR/genética , Células Tumorais CultivadasRESUMO
Background: Neurological paraneoplastic syndromes are rare, occur in 0.01% of all cancer patients; like part of them, the Lambert-Eaton syndrome is an autoimmune presynaptic disorder of neuromuscular transmission characterized by muscle weakness and neurovegetative dysfunction, and often associated with small cell lung cancer. Case report: A 72 years old female with a family history of lung cancer and leukemia, with 7 months of dry cough and 3 months with waist and pelvic muscle weakness, oropharyngeal dysphagia, dry mouth, chronic constipation and weight loss of 10 kg. Physical examination: patient prostrated; clinical muscle examination: pelvic muscles waist -3/5 and -4/5 the rest; diminished reflexes. Laboratory normal parathormone and hypercalcemia. With electrophysiological study and positive anti-voltage-gated calcium channel antibodies, confirming Lambert-Eaton syndrome and imaging studies with neoplastic condition in brain, liver and kidney, with unspecified primary origin.
Antecedentes: Los síndromes paraneoplásicos neurológicos son poco frecuentes; se presentan en el 0.01% de todos los pacientes con cáncer. Uno de ellos es el síndrome de Lambert-Eaton, correspondiendo a un trastorno presináptico autoinmunitario de transmisión neuromuscular caracterizado por debilidad muscular y disfunción neurovegetativa, y asociado con frecuencia al carcinoma microcítico de pulmón. Caso clínico: Mujer de 72 años, con antecedentes heredofamiliares de cáncer de pulmón y leucemia, con tos seca de 7 meses, 3 meses con debilidad de los músculos de cintura pélvica, disfagia al inicio de la deglución, xerostomía, estreñimiento crónico y pérdida de peso de 10 kg. A la exploración física: paciente postrada; examen clínico muscular: músculos de cintura pélvica en −3/5, resto en −4/5; reflejos disminuidos. Pruebas de laboratorio indicando hipercalcemia y paratohormona normal. Estudio electrofisiológico y anticuerpos anticanales de calcio positivos, demostrando síndrome de Lamber-Eaton, y estudios de imagen con afectación neoplásica en cerebro, hígado y riñón, sin lograr especificar el origen primario.
Assuntos
Síndrome Miastênica de Lambert-Eaton/etiologia , Neoplasias Primárias Desconhecidas/complicações , Idoso , Autoanticorpos/sangue , Autoanticorpos/imunologia , Autoantígenos/imunologia , Encéfalo/patologia , Canais de Cálcio/imunologia , Neoplasias do Sistema Nervoso Central/secundário , Eletromiografia , Feminino , Gliose/patologia , Humanos , Neoplasias Renais/secundário , Síndrome Miastênica de Lambert-Eaton/diagnóstico , Síndrome Miastênica de Lambert-Eaton/patologia , Síndrome Miastênica de Lambert-Eaton/fisiopatologia , Neoplasias Hepáticas/secundário , Imageamento por Ressonância Magnética , Atrofia Muscular/etiologia , Tomografia Computadorizada por Raios X , Substância Branca/patologiaRESUMO
A 66-year-old woman with a history of papillary thyroid cancer status after total thyroidectomy underwent I radioiodine ablation therapy 3 months after surgery. Posttherapy whole body planar imaging revealed focal intense I uptake in the posterior right abdomen. SPECT/CT of this region localized the uptake to the medial lower pole of the right kidney. Further evaluation with MRI demonstrated a correlative suspicious right renal mass. The patient underwent right partial nephrectomy with pathology demonstrating that the renal mass was of thyroidal origin (papillary subtype).
Assuntos
Carcinoma Papilar/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Idoso , Carcinoma Papilar/secundário , Carcinoma Papilar/cirurgia , Feminino , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias Renais/secundário , Neoplasias Renais/cirurgia , Imageamento por Ressonância Magnética , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Neoplasias da Glândula Tireoide/terapia , TireoidectomiaRESUMO
INTRODUCCIÓN: Antecedentes: El presente dictamen expone la evaluación de tecnologia de la eficacia y seguridad de sunitinib para el tratamiento de pacientes adultos con cáncer renal de células no claras (cromófobo) con enfermedad metastásica irresecable. Aspectos Generales: El carcinoma de células renales (CCR) usualmente se origina en el revestimiento de los túbulos del riñon y contiene muchos vasos sanguíneos. El CCR es el tipo más común de cáncer de riño, representando el 90% de todos los cánceres de riños y aproximadamente el 3% de todos los cánceres en adultos en Europa. Tecnología Sanitaria de Interés: Sunitinib es un fármaco antineoplásico de administración oral, que inhibe múltiples receptores de tirosina quinasa (RTKs), algunos de los cuales están implicados en el crecimiento tumoral, la neoangiogénesis y la progresión a metástasis. Estos incluyen los receptores del factor de crecimiento derivado de plaquetas (PDGFR alfa y PDGFR beta), factor de crecimiento del endotelio vascular (VEGFR1, (VEGFR2 y (VEGFR3), factor de células madre (KIT), tirosin-kinasa 3tipo Fms (FLT3), factor estimulador de colonias (CSF-1R) y factor neurotrófico derivado de la línea celular glial (RET). La inhibición simultánea de estos receptores genera una fuerte disminución de la neovascularización tumoral, conllevando así a la reducción del tumor, y a su vez explica muchos de sus efectos adversos tales como el síndrome mano pie, estomatitis, y otra variedad de efectos dermatológicos. METODOLOGÍA: Estrategia de Búsqueda: Se realizó una búsqueda sistemática de la evidencia científica, especialmente la proveniente de ensayos clínicos, con respecto a la eficacia y seguridad de sunitinib en pacientes adultos con diagnóstico de carcinoma de células renales metastásico cromófobo en las bases de datos MEDLINE, TRIPDATABASE y LILACS. Una vez identificados los artículos que respondían a la preginta PICO, se pasó a revisar la bibliografia incluida en dichos artículos seleccionados, con la finalidad de identificar evidencia adicional. Asimismo, se realizó una búsqueda dentro de bases de datos pertenecientes a grupos que realizan revisiones sistemáticas, evaluación de tecnologías sanitarias y guías de práctica clínica tales como National Comprehensive Cancer Network (NCCN), The National Guideline for Clearinghouse (NGC), Scottish Intercollegiate Guidelines Network (SIGN), The National Institute for Health and Cares Excellence (NICE), The Canadian Agency for Drugs and Technologies in Health (CADTH), The Agency for Healthcarre Research and Quality (AHQR) y The Cochrane Collaboration. Se hizo una búsqueda adicional en clinicaltrials.gov y www.ensayosclinicos-repec.ins.gob.pe, para poder identificar ensayos clínicos en curso o que no hayan sido publicados. RESULTADOS: Sinopsis de la Evidencia: Se realizó una búsqueda de la literatura con respecto a la eficacia y seguridad de sunitinib, en comparación a la mejor terpia de soporte, como tratamiento del cáncer renal de céluas no claras de tipo cromófobo con enfermedad metastásica irresecable. Debido a que no se encontraron ensayos clínicos que respondieran a la preginta PICO, se incluyeron diseños de estudios del tipo ensayos clínicos de un solo brazo, ensayos clínicos comparativos versus otras terapias dirigidas y estudios retrospectivos. CONCLUSIONES: A la fecha, no existe evidencia suficiente sobre la eficacia de sunitinib, con respecto a la mejor terpia de soporte, en pacientes adultos con diagnóstico de cáncer renal cromófobo, en términos de mayor sobrevida global, calidad de vida, sobrevida libre de progresión y tasa respuesta objetiva. El Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI) no aprueba el uso de sunitinib para el tratamiento de pacientes adultos con cáncer de células no claras (cromófobo) con enfermedad metastásica irresecable.
Assuntos
Humanos , Carcinoma de Células Renais/tratamento farmacológico , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/secundário , Inibidores da Angiogênese/administração & dosagem , Avaliação da Tecnologia Biomédica , Resultado do TratamentoRESUMO
PURPOSES: To examine the factors related to the choice of cytoreductive nephrectomy (CN) for patients with metastatic clear cell renal cell carcinoma (mCCRCC), and compare the population-based survival rates of patients treated with or without surgery in the modern targeted therapy era. MATERIALS AND METHODS: From 2006 to 2009, patients with mCCRCC were identified from SEER database. The factors that affected patients to be submitted to CN were examined and propensity scores for each patient were calculated. Then patients were matched based upon propensity scores. Univariable and multivariable cox regression models were used to compare survival rates of patients treated with or without surgery. Finally, sensitivity analysis for the cox model on a hazard ratio scale was performed. RESULTS: Age, race, tumor size, T stage and N stage were associated with nephrectomy univariablely. After the match based upon propensity scores, the 1-, 2-, and 3-year cancer-specific survival rate estimates were 45.1%, 27.9%, and 21.7% for the no-surgery group vs 70.6%, 52.2%, and 41.7% for the surgery group, respectively (hazard ratio 0.42, 95%CI: 0.35-0.52, log-rank P<0.001). In multivariable Cox proportional hazard regression model, race, T stage, N stage and median household income were significantly associated with survival. Sensitivity analysis on a hazard ratio scale indicated that the hazard ratio might be above 1.00 only when the unknown factor had an opposite effect on survival which was 3-fold than CN. CONCLUSION: The results of our study showed that CN significantly improves the survival of patients with metastatic CCRCC even in the targeted therapy era.
Assuntos
Carcinoma de Células Renais/mortalidade , Carcinoma de Células Renais/cirurgia , Procedimentos Cirúrgicos de Citorredução/métodos , Neoplasias Renais/mortalidade , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Fatores Etários , Idoso , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/secundário , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/secundário , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pontuação de Propensão , Modelos de Riscos Proporcionais , Programa de SEER , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo , Resultado do Tratamento , Carga TumoralRESUMO
The most common sites of metastases in renal cell carcinoma (RCC) are lung and bone. However, unusual sites, including the stomach, are characteristic of RCC.This article presents a case of a metastatic RCC (lung and liver) with a symptomatic gastric metastasis treated by a laparoscopic wedge resection (LWR).A 66-year-old woman, diagnosed with RCC underwent a right nephrectomy. During her follow-up, an upper gastrointestinal (GI) endoscopy showed an ulcerated lesion at the stomach. A biopsy of the specimen revealed metastatic RCC. The patient underwent a palliative LWR and was discharged home 8 days after surgery.Therefore, LWR is a relatively simple technique with the advantages of minimal invasive access in the treatment of palliative cases.
Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Laparoscopia , Nefrectomia , Cuidados Paliativos , Neoplasias Gástricas/cirurgia , Idoso , Carcinoma de Células Renais/secundário , Feminino , Humanos , Neoplasias Renais/secundário , Prognóstico , Neoplasias Gástricas/patologiaRESUMO
OBJECTIVE: The aim of this study was to explore the clinical characteristics of renal metastatic cancer, the methods for its detection by radioiodine (131)I, and the response to (131)I treatment in fourteen patients with renal metastases from differentiated thyroid carcinoma (DTC). SUBJECTS AND METHODS: DTC patients (n = 2,955) that received treatment with (131)I were retrospectively analyzed. Scans ((131)I-WBS, (31)I-SPECT/CT and/or (18)F-FDG-PET/CT) were performed after an oral therapeutic dose of (131)I. Therapeutic efficacy was evaluated based on changes in Tg and anatomical imaging changes at renal lesions. RESULTS: Among these 14 patients, 11 had avidity for (131)I, but three patients did not accumulate (131)I after (131)I treatment. In the 11 (131)I-positive renal lesions, 10 cases were detected by (131)I-SPECT/CT combined with another imaging modality and one case by (131)I-WBS combined with ultrasonography (US). In the three (131)I-negative renal lesions, two cases were detected by 18F-FDG-PET/CT and one case by computed tomography (CT). In 11 patients with (131)I-avid renal metastases, Serum Tg levels in 81.82% (9/11) patients showed a gradual decline, and 18.18% (2/11) of the patients showed a significant elevation. There was no marked difference in serum Tg before the last (131)I treatment (Z = 0.157; p = 0.875). Only one patient presented partial response, eight patients exhibited stable disease, and renal metastases progressed in two patients showing progressive disease. No patients reached complete response. CONCLUSION: (131)I-SPECT/CT, combined with another imaging modality after (131)I-WBS, can contribute to the early detection of renal metastases of DTC. (131)I therapy is a feasible and effective treatment for most DTC renal metastases with avidity for (131)I.