Primary intratesticular rhabdomyosarcoma: A case report and literature review.

Rhabdomyosarcoma (RMS) that primarily occurs in the testes is particularly rare, with only retrospective studies and sporadic cases reported in the literature. The present study describes the case of a large, primary intratesticular RMS (ITRMS) that was treated with a radical inguinal orchiectomy (RIO) and a regimen of chemotherapy. The study also presents a review of the literature regarding primary ITRMSs, aiming to elucidate the clinical characteristics and optimal treatment of the disease. A 14-year-old male presented with a 1-year history of a slow-growing, painless, left scrotal mass. Magnetic resonance imaging identified a mass in the left scrotum with mixed signal intensity; no abnormal signals were identified in the right testicle and retroperitoneal lymph node. An X-ray of the chest demonstrated no evidence of metastasis. Subsequent to this, a left RIO was performed. Histopathological and immunohistochemical examination confirmed the final diagnosis of embryonal ITRMS. At 21 days post-surgery, an 18F-fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) scan identified widespread metastatic lesions in the lungs, local lymph nodes and bones, presenting as increased glucose metabolism nodules. Subsequently, the patient received six sequential cycles of adjunct chemotherapy. The patient is alive with disease in October 2015. The case described is noteworthy as it is an example of ITRMS, in which the patient received successful treatment. However, multidisciplinary treatment may further improve the outcome of the disease.

Epidermal growth factor receptor mutation heterogeneity analysis of pulmonary sarcomatoid carcinoma successfully treated with erlotinib: A case report.

Pulmonary sarcomatoid carcinoma (PSC) is a rare histological subtype of non-small cell lung cancer, and the available studies on the response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) is limited. In the present study, a 73-year-old female presented with a large mass in the lower right lung, which was diagnosed as a PSC on biopsy. An amplification-refractory mutation system (ARMS) test revealed that the patient possessed the wild-type EGFR gene, and the patient subsequently underwent radiotherapy (60 Gy) and four 21-day cycles of chemoradiotherapy (1,600 mg gemcitabine, days 1 and 8; 30 mg, cisplatin, days 1-3). Following radiotherapy and chemotherapy treatment, a CT scan revealed complete remission of the mass in the lower right lung, however, metastases were identified in the paraaortic lymph node, bilateral iliac fossa and the right gluteal region. Notably, an EGFR exon 21 L858R gene mutation was identified in the mass of the right gluteal metastasis. Therefore, treatment with erlotinib was initiated. The patient continued to experience progression-free survival for six months following the initiation of erlotinib therapy. However, multiple metastases were then identified, and all lesions possessed the wild-type EGFR gene, as identified by the ARMS test. The findings suggest that erlotinib is a viable therapeutic option for the treatment of PSC patients that possess an EGFR mutation. The spatio-temporal evolution of EGFR mutational heterogeneity in PSC may result in drug-resistance, which challenges EGFR-TKI therapy and EGFR gene mutation diagnosis.

Downregulation of c-Met expression does not enhance the sensitivity of gastric cancer cell line MKN-45 to gefitinib.

The aim of the present study was to investigate the effect of downregulation of the c­Met gene on signal transduction and apoptosis in gastric cancer MKN­45 cells; furthermore, the study aimed to determine whether altered c­Met gene expression affected MKN­45 sensitivity to gefitinib. Three c­Met­specific small interfering RNAs (siRNAs) were synthesized and transfected into MKN­45 cells. Messenger RNA (mRNA) and protein levels of c­Met and its downstream signaling molecules [phosphoinositide 3­kinase (PI3K) and AKT] were examined using reverse transcription polymerase chain reaction and western blot analysis 48 h following transfection. Cell apoptosis was evaluated using Annexin­V/propidium iodide double staining and fluorescence­activated cell sorting analysis. An MTT assay was performed in order to measure the 50% inhibitory concentration (IC50) of gefitinib on MKN­45 cells. The results of the present study demonstrated that 48 h post­transfection with c­Met siRNA, MKN­45 cells showed significantly downregulated expression of c­Met mRNA and protein as well as an increased rate of apoptosis (P<0.05). In addition, following c­Met siRNA transfection mRNA and protein levels of PI3K and AKT were not significantly altered in MKN­45 cells (P>0.05); however, a marked decrease in the expression levels of phosphorylated (p)­PI3K and p­AKT was observed (P<0.05). Furthermore, the IC50 of gefitinib in MKN­45 cells was not significantly decreased. In conclusion, knockdown of the c­Met gene promoted gastric cancer cell apoptosis and inhibited downstream p­PI3K and p­AKT; however, the sensitivity of MKN­45 cells to gefitinib was not increased.

Primary giant mediastinal synovial sarcoma of the neck: A case report and review of the literature.

Synovial sarcomas commonly occur in the soft tissue of the extremities, while a primary occurrence in the mediastinum is quite rare. The current study reports the case of an 11-year-old male who presented with a neck mass, which computed tomography showed was due to a giant mediastinal mass involving the thyroid gland. The tumor was resected by thoracotomy and diagnosed as monophasic synovial sarcoma by histopathology. The patient received adjuvant combination chemotherapy and radiation therapy following surgery. At the 3-month follow-up, no local tumor recurrence was found. The present case report highlights the significance of recognizing the unusual presentation and clinical manifestation of synovial sarcoma to aid clinical management. Written informed consent was obtained from the patient's family.