Primary breast cancer in a patient with Wilson disease: A case report
Rationale: Wilson disease (WD) is an autosomal recessive hereditary disease in which the patient usually has a reduced risk of developing cancer. In particular, with the exception of hepatocellular carcinoma and cholangiocarcinoma, the incidence of cancer is significantly lower in WD patients compared with the general population. This case study presents a rare case of WD complicated with primary breast cancer. Patient concerns: A 40-year-old woman who was diagnosed with WD at 25 years of age found a lump in her left breast. She has a family history of cancer. Diagnoses: Ultrasound and mammography results were highly suggestive of a malignant lesion. After core needle biopsy, it was confirmed that she had invasive breast cancer. Interventions: A modified radical mastectomy was performed for the left breast. As the tumor was defined as a stage IIa triple negative breast cancer, the patient would have been recommended epirubicin/cyclophosphamide + docetaxel for 8 cycles if WD was not a comorbidity. As the patient had cirrhosis and abnormal liver function, she was given paclitaxel weekly for 6 cycles instead. Outcomes: The patient showed good tolerance, and has not had a recurrence in 2 years. Lessons: We reviewed the literature for studies of patients with WD complicated with cancers, and to our knowledge, this is the first report on WD complicated with breast cancer. The patient received chemotherapy even with liver dysfunction, which suggests that patient...
Irreversible T cell exhaustion limits the efficacy of programmed cell death 1 (PD-1) blockade. We observed that dual CD40-TLR4 stimulation within a single tumor restored PD-1 sensitivity and that this regimen triggered a systemic tumor-specific CD8+ T cell response. This approach effectively treated established tumors in diverse syngeneic cancer models, and the systemic effect was dependent on the injected tumor, indicating that treated tumors were converted into necessary components of this therapy. Strikingly, this approach was associated with the absence of exhausted PD-1hi T cells in treated and distant tumors, while s...
Active surveillance (AS) has been widely accepted as a first-line management approach in men with low-risk prostate cancer. While AS provides an avenue to reduce risk of overtreatment without compromising oncological safety, there remains a lack of consensus on the optimal approach to monitoring. An ideal surveillance strategy would be one that minimizes invasive testing such as prostate biopsy without conceding adverse oncologic outcomes. Thus, several studies have sought to identify men at higher risk of reclassification so as to more carefully select when biopsy is truly necessary.
In “National trends in the utilization of androgen deprivation therapy for very low risk prostate cancer,” the authors demonstrate a significant decline in the use of primary androgen deprivation (pADT), for very low risk prostate cancer. By 2015, only 1.7% of men in this population received pADT, representing a furthering of trends witnessed in the early 21st century, and which have been previously described.1,2
Obtaining a Post-void Residual (PVR) is one of the most common procedures performed in Urology. In a subspecialty replete with uncomfortable and potentially embarrassing tests, measuring PVR using ultrasound is arguably unique in its minimally-invasive nature, reproducibility, and ability to deliver objective data. It is a technique which has been universally adopted and employed, albeit with little data to guide the user in interpreting its results. Indeed, several guideline statements deemed obtaining a PVR a Clinical Principle, a statement for which there may or may not be evidence in the medical literature that is wide...
ConclusionReal-time indocyanine green fluorescence imaging may be particularly helpful for delineating the anatomical surgical plane and determining the appropriate division point of the hepatic duct during laparoscopic living donor hepatectomy.
ConclusionThe novel approach for transthoracic hepatectomy was safe and feasible for lesions of segment VIII in selected patients with cirrhosis,8 which was associated with reduced blood loss and a safe surgical margin.
Hi everyone I failed a course by a single question (0.2%) and as a result I have to take a Remediation Exam. The exam is on our Fundamentals Course which is all of the basics sciences. It is 2 days away and I am starting to panic. It is on all of Immuno, all of BioChem, all Anatomy, all Micro, Anti-biotics, Anti-cancers, Anti-fungals, Fundamentals of Pathology, Infectious Disease and pretty much anything you can think of. I have been studying for a month but I feel like I just cant... Remediation Exam
You've done a bowel case for a perfed DU in an otherwise young healthy guy who took too much naproxen... At the end of the case, you put in a triple lumen with ultrasound, but still manage to get a little hole in the pleura... Patient extubated and in PACU, develops shortness of breath... can anyone walk me through the physiology of how this patient could develop a tension PTX if he's spontaneously breathing and not positive pressure ventilated... ? [URL... Tension PTX
We present a series of three cases in which the suprascapular nerve was affected by hourglass-like constrictions, which were visualized by high-solution MRN, including a nerve-selective morphological MR pulse sequence with strong fat- and water-signal suppression.
AbstractPathology of the fascia lata attachment at the iliac crest (FLAIC) is an under-recognized and often misdiagnosed cause of lateral hip pain. The fascia lata has a broad attachment at the lateral iliac crest with contributions from the tensor fascia lata muscle, the iliotibial band, and the gluteal aponeurosis. The FLAIC is susceptible to overuse injuries, acute traumatic injuries, and degeneration. There is a paucity of literature regarding imaging and image-guided treatment of the FLAIC. We review anatomy and pathology of the FLAIC, presenting novel high-resolution (18 –24 MHz) ultrasound images includin...
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