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Pediatric Oncology
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Stephen Lowis, Rachel Cox, John Moppett, Helen Rees
Anaplasia occurs in 5% of cases, typically in older children. High-risk WT include blastemal-predominant subtype (at least 66% viable tumor consisting of blastema after pre-operative chemotherapy) and those with diffuse anaplasia.
Endocrine Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What further investigations would you request?This is probably a multinodular goitre. However, if it has rapidly increased in size, anaplastic carcinoma needs to be ruled out.I would request thyroid function tests (T4 and TSH) and arrange an initial USS ± FNA of any dominant nodule.If the goitre is retrosternal, I would ask for a CT scan to assess the trachea and the degree of retrosternal extension and consider spirometry to assess the degree of airway compromise.
Thyroid cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Gitta Madani, Polly S Richards
Anaplastic carcinoma is a clinical diagnosis, presenting as a rapidly expanding neck mass, often associated with symptoms indicating local invasion and compression. US appearances are of a diffuse, ill-defined hypoechoic or heterogeneous mass which may involve part or the entire thyroid gland (83). Areas of necrosis and extracapsular spread are common, with invasion of adjacent structures such as overlying strap muscles and major neck vessels (Figure 4.17). The assessment of tracheal or oesophageal involvement requires cross-sectional imaging (Figure 4.18). Lymph node or distant metastases are present in the majority of patients (83).
LncRNA-IQCH-AS1 sensitizes thyroid cancer cells to doxorubicin via modulating the miR-196a-5p/PPP2R1B signalling pathway
Published in Journal of Chemotherapy, 2023
Thyroid cancer, which is located within the thyroid gland, is a prevalent human endocrine tumour, associating with poor diagnosis and survival rates in worldwide especially for the advanced and aggressive thyroid cancer [1]. Currently, surgery and radioiodine therapy (I-131 therapy) are the primarily therapeutic approaches for thyroid cancer [2]. In addition, chemotherapy with the combination of radiation therapy has been applied for anaplastic thyroid cancer [3]. Doxorubicin, which is an antibiotic derived from the Streptomyces peucetius bacterium, has been widely applied as an anti-cancer agent [4]. Doxorubicin functions through inhibiting the enzyme topoisomerase II to intercalate within DNA base pairs, leading to DNA strands breaking to inhibit both DNA and RNA synthesis [4,5]. Although doxorubicin has achieved improved survival rate for thyroid cancer patients, a large fraction of patients was aggravated by adverse effects and developed doxorubicin resistance, arising a severe challenge for its widely applications [6]. Thus, understanding the underlying molecular mechanisms and specific biotargets of the acquired doxorubicin resistance is an urgent task.
Gene expression analysis and the risk of relapse in favorable histology Wilms’ tumor
Published in Arab Journal of Urology, 2023
Mariam M. Abdel-Monem, Omali Y. El-Khawaga, Amira A. Awadalla, Ashraf T. Hafez, Asmaa E. Ahmed, Mohamed Abdelhameed, Ahmed Abdelhalim
Several of our study limitations should be acknowledged including, retrospective design and possible selection bias. However, the study was conducted at a single institution and has investigated a relatively uncommon disease with relapse occurring in only a sixth of treated patients according to the contemporary treatment protocols. The small sample size has certainly limited the ability to perform multivariable analysis to adjust the tested biological markers to the well-known prognostic variables such as disease stage and LOH for 1p and 16q. This is clearly supported by the modest accuracy of other predictive models of WT relapse risk studied on larger patient cohorts with even more rigorous genetic testing [5]. Additionally, since some of the tested biological pathways could overlap, multicollinearity could compromise the quality of multivariable analysis. Some patients included in this study received preoperative chemotherapy which could have altered gene expression in the examined specimens. This study has only included patients with unilateral, non-syndromic and favorable histology WT. Therefore, we do not know if our findings could be generalized to patients with bilateral, syndromic or anaplastic tumors. Despite these limitations, the examined markers have demonstrated strong associations with the risk of disease relapse and overall survival. Future studies should be directed to unravel the underlying mutations, understand the relationship of these markers to the clinical trajectory of WT and guide potential therapeutic interventions with the hope of refining WT treatment and lowering relapse risk.
Secondary enucleated retinoblastoma with MYCN amplification
Published in Ophthalmic Genetics, 2021
Alexandre P. Moulin, Christina Stathopoulos, Fabienne Marcelli, Jacqueline Schoumans Pouw, Maja Beck-Popovic, Francis L. Munier
Microscopically, the retina was diffusely infiltrated by a poorly differentiated retinoblastoma with extensive exophytic growth. The retinoblastoma cells contained enlarged angulated nuclei with occasional prominent nucleoli. Severe anaplasia was only focally observed. The retinoblastoma circumferentially extended from the superior ciliary body, with local invasion of the iris root and the angle, to the inferior equatorial choroid. The ciliochoroidal invasion measured 36 mm. Posteriorly, the tumor infiltrated the optic nerve, extending beyond the lamina cribosa (611 µm) with a total optic nerve involvement of 1.25 mm. Tumor cells also invaded the prehyaloid space, the vitreous, the posterior and anterior chambers. A superior scleral canal was also infiltrated, showing perineural invasion without extraocular spread. There was no Azzopardi phenomenon and no intratumoural endothelial cell proliferation. In the centre of the globe, partially preserved gliotic retina alternated with calcification foci and areas of necrosis. Anteriorly, there was rubeosis iridis with a closed angle.