The heel amelanotic melanoma, a rare subtype of skin cancer misdiagnosed as foot ulcer: A case report.

Amelanotic melanoma (AM) of the heel is a very rare subtype of malignant melanoma in which the tumour cells, unlike other types of melanoma, are characterised by little or no melanin pigmentation. AM resembles many benign dermatological complications that often lead to late diagnosis of lesions, poor prognosis, and occasionally misdiagnosis at an early stage of the disease. We report a case of a 73-year-old man with a heel ulcer who was admitted to Al-Zahra Hospital (Isfahan, Iran). Chronic osteomyelitis was considered the primary diagnosis, and several courses of antibiotics were prescribed for the patient. The ulcer failed to improve after 9 months' of therapy, and because of an increase in the size of the ulcer and the growth of two tumours in the right heel, a biopsy of the lesion was conducted. The pathology report confirmed invasive AM. The present report emphasises the necessity to biopsy all skin lesions, even with low clinical significance, to avoid wrong subsequent treatments, prevent a delay in diagnosis, reduce misdiagnosis, and improve the survival rate of patients.

The prognostic value of lymph node ratio in survival of head-and-neck squamous cell carcinoma.

BACKGROUND: Head-and-neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancers in the world. Due to its relatively high rate of recurrence, the prognosis of patients is poor and the survival rate is low; therefore, identifying the prognostic factors is considered necessary for better treatment. MATERIALS AND METHODS: This historical cohort study was conducted on 201 patients diagnosed with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio (LNR) on overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival (LFFS). We noticed an association between LNR and survival by Kaplan-Meier analysis. Hazard ratio (HR) of LNR was determined by Cox's regression model. RESULTS: Two hundred and one patients entered this study after their medical histories were evaluated. The mean of lymph node count and LNR was 14.30 (±9.50) and 0.12 (±0.23), respectively. Eighty patients (39.80%) experienced recurrence of SCC. Five-year OS, DFS, and LFFS were 32%, 21%, and 64%, respectively. The median of OS was 40.70 months and 30.11 months in patients with LNR of ≤0.06 and >0.06, respectively (P < 0.01). The LNR >0.06 was found to be a significant prognostic factor for lower OS of patients with HNSCC (HR = 2.11 [1.10, 4.40]; P = 0.04). DFS was not significantly different among patients with LNR ≤0.06 and patients with LNR >0.06 (P = 0.9). However, LFFS was slightly different among two groups (HR = 2.04 [0.90-4.80]; P < 0.1). CONCLUSION: We recommend more intensive adjuvant therapies such as chemotherapy with radiotherapy and short interval follow-up for patients with LNR >0.06. Further investigations with larger sample sizes are recommended.

In silico identification and in vitro evaluation of MRPS30-DT lncRNA and MRPS30 gene expression in breast cancer.

BACKGROUND: It has been reported that long non-coding RNAs (lncRNAs) can play important roles in a variety of biological processes and cancer regulatory networks, including breast cancer. AIMS: This study aimed to identify a novel upregulated lncRNA in breast cancer and its associated gene using bioinformatics analysis, and then evaluate their potential roles in breast cancer. METHODS AND RESULTS: Extensive in silico studies were performed using various bioinformatics databases and tools to identify a potential upregulated breast cancer-associated lncRNA and its co-expressed gene, and to predict their potential roles, functions, and interactions. The expression level of MRPS30-DT lncRNA and MRPS30 was assessed in both BC tissues and cell lines using qRT-PCR technology. MRPS30-DT lncRNA and MRPS30 were selected as target genes using bioinformatics analysis. We found that MRPS30-DT and MRPS30 were significantly overexpressed in BC tissues compared with normal tissues. Also, MRPS30 showed upregulation in all three BC cell lines compared with HDF. On the other hand, MRPS30-DT significantly increased in MDA-MB-231 compared with HDF. While the expression of MRPS30-DT was significantly dropped in the resistance cell line MCF/MX compared to HDF and MCF7. Moreover, bioinformatics analysis suggested that MRPS30-DT and MRPS30 may play a potential role in BC through their involvement in some cancer signaling pathways and processes, as well as through their interaction with TFs, genes, miRNAs, and proteins related to carcinogenesis. CONCLUSIONS: Overall, our findings showed the dysregulation of MRPS30-DT lncRNA and MRPS30 may provide clues for exploring new therapeutic targets or molecular biomarkers in BC.

Deregulation of miR-1245b-5p and miR-92a-3p and their potential target gene, GATA3, in epithelial-mesenchymal transition pathway in breast cancer.

BACKGROUND: MicroRNAs (miRNAs) are small molecules that have prominent roles in tumor development and metastasis and can be used for diagnostic and therapeutic purposes. This study evaluated the expression of miR-92a-3p and miR-1245b-5p and their potential target gene, GATA3 in patients with breast cancer (BC). MATERIALS AND METHODS: In the search for BC-related microRNAs, miR-124b-5p and miR-92a-3p were selected using Medline through PubMed, miR2disease, miRcancer and miRTarBase. Moreover, target gene GATA3 and their possible interaction in the regulating epithelial-mesenchymal transition (EMT) and invasion was evaluated using in silico tools including miRTarBase, TargetScan, STRING-db, and Cytoscape. The expression level of miR-92a-3p, miR1245b-5p, and GATA3 were assessed on extracted RNAs of tumor and nontumor tissues from 36 patients with BC using qPCR. Additionally, clinical-pathologic characteristics, such as tumor grade, tumor stage, lymph node were taken into consideration and the diagnostic power of these miRNAs and GATA3 was evaluated using the ROC curve analysis. RESULTS: In silico evaluation of miR-92a-3p and miR-1245b-5p supports their potential association with EMT and invasion signaling pathways in BC pathogenesis. Comparing tumor tissues to nontumor tissues, we found a significant downregulation of miR-1245b-5p and miR-92a-3p and upregulation of GATA3. Patients with BC who had decreased miR-92a-3p expression also had higher rates of advanced stage/grade and ER expression, whereas decreased miR-1245b-5p expression was only linked to ER expression and was not associated with lymph node metastasis. The AUC of miR-1245b-5p, miR-92a-3p, and GATA3 using ROC curve was determined 0.6449 (p = .0239), 0.5980 (p = .1526), and 0.7415 (p < .0001), respectively, which showed a significant diagnostic accuracy of miR-1245b-5p and GATA3 between the BC patients and healthy individuals. CONCLUSION: MiR-1245b-5p, miR-92a-3p, and GATA3 gene contribute to BC pathogenesis and they may be having potential regulatory roles in signaling pathways involved in invasion and EMT pathways in BC pathogenesis, as a result of these findings. More research is needed to determine the regulatory mechanisms that they control.

Evaluation of the Relative Frequency of Epstein-Barr Virus Infection in Patients with Recurrent Breast Cancer Compared with Patients with Nonrecurrent Breast Cancer.

Background: The roles of Epstein-Barr virus (EBV) in breast cancer and breast lymphoma by transfecting EBV DNA have been indicated in different studies, but few investigations have been conducted on its roles in recurrence of breast cancer. Here, we aimed to evaluate the roles of EBV in recurrent breast cancer tissue. Materials and Methods: This is a cross-sectional retrospective study that was performed in 2020-2021 in Isfahan on patients with breast cancer. The study population consisted of 30 tissue samples from recurrent breast cancer and 30 samples from nonrecurrent breast cancer. We collected demographic data of patients including age using a checklist. Other collected data were type of cancer, stages of cancer, tumor size in greatest dimension, lymph node involvements, and presence of metastasis. Furthermore, we evaluated all of the pathology samples from both groups for the presence of DNA of EBV and compared the data of both groups. Results: The DNA of EBV was positive in 8 patients of the relapsed group (26.6%) and 7 patients in the nonrelapsed patients (23.3%). There was no significant difference between two groups regarding positive DNA of EBV (P = 0.39). There were no significant differences between two groups of positive DNA of EBV with and without recurrent breast cancer regarding type of cancer (P = 0.63), stage of cancer (P = 0.19), tumor size in greatest dimension (P = 0.31), mean lymph node involvement (P = 0.27), number of lymph node involvement (P = 0.43), and metastasis (P = 0.69). Conclusion: EBV might have no significant role in recurrence of breast cancer.

Colocolic Intussusception Because of Lipoma in a 44-year-Old Adult.

Lipoma is an uncommon mesenchymal tumor of the colon. They are typically symptom free, the large lipomas within the colon are rare, and can cause obstruction, bleeding, or intussusception. Intussusception is comparatively common in pediatrics and in adults, it could be a rare entity. Pathologic lesions are usually found with a major percentage of malignancy. This is a retrospective evaluation of an adult with an intestinal intussusception who underwent oncosurgical treatment. He was diagnosed with surgically proven intussusception. Using ultrasound and colonoscopy as diagnostic studies, colocolic intussusception was discovered. The patient underwent oncosurgical exploration. Intestinal resection with abrupt anastomosis was the procedure of choice for the patient. The etiology was benign lipoma. Adult intussusception should be evaluated in any patient with subacute abdominal discomfort with bearing in mind the high rate of malignancy and a lower rate of benign tumors. intestinal resection without reducing is highly recommended for colonic intussusceptions.

Evaluation of Relative Abundance of Lymphedema after Reverse Axillary Mapping in Patients with Breast Cancer.

Background: The axillary reverse mapping (ARM) technique identifies and preserves arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Here, we aimed to investigate the prevalence of lymphedema following ARM. Materials and Methods: This is a clinical trial that was performed in 2019-2020 in Isfahan on patients with breast cancer in the early stages. Demographic and initial information of all cases including age and body mass index (BMI) was collected. Patients were then underwent SLNB ± ALND associated with ARM and were followed up for lymphedema every 6 months to a year. The occurrence of lymphedema was assessed. Results: By evaluating data of 102 patients, we found that 10 patients (9.8%) had lymphedema and patients with lymphedema had significantly higher age (P = 0.004), higher BMI (P = 0.001), larger tumor size (P = 0.018), and longer surgery duration (P < 0.001). The frequency of menopausal women was higher in patients with lymphedema compared to other cases (P = 0.001). Conclusion: The prevalence of lymphedema was high among patients undergoing ARM that was associated with factors including higher age, higher BMI, prolonged surgery duration, larger tumor size, and menopause. We believe that further comparative studies should be conducted on this issue.