Evaluation of cleaved caspase-3 and Ki-67 index on diagnostic biopsy in response to neoadjuvant chemotherapy in the context of post-treatment tumour ypT stage, ypN stage, grade, and molecular subtype.

Introduction: Breast carcinoma is a heterogeneous disease, characterised by diverse clinical behaviour. The aim of this study was to assess how cleaved caspase-3 and Ki-67 index, evaluated on diagnostic biopsy, are related to response to neoadjuvant chemotherapy in the context of molecular subtype, post-treatment tumour, N category, and grade. Material and methods: A retrospective analysis was carried out among 110 breast cancer patients. Ki-67 levels and caspase-3 expression on diagnostic biopsy were explored regarding their relation to tumour grade and molecular subtype, ypT, ypN categories, and T and N categories according to Sataloff tumour response evaluation. Results: A statistically significant relationship was found between Ki-67 levels and tumour grade K-W = 24.2932, p < 0.0001; molecular subtype K-W = 28.5439, p < 0.00000967538; size and invasion of the primary tumour after neoadjuvant chemotherapy K-W = 11.7944, p < 0.0377169; caspase-3 expression after neoadjuvant therapy, evaluated according to the Sataloff classification χ2 = 5.97, df = 1, p = 0.0145. Discussion: No significant difference was found between Ki-67 expression in patients with pathological complete response, compared to those with partial and no response, a statistically significant difference in cases with different molecular subtype, histology grade, and tumour stage after neoadjuvant therapy. Cleaved caspase-3-positive breast cancer cases are often better responders to neoadjuvant therapy, but with no significant correlation to molecular subtype, high-grade categories, or tumour stage. Conclusions: The caspase-3 and Ki-67 index on diagnostic biopsy are related to post-neoadjuvant treatment prognostic factors (ypT stage, grade), proving them useful for prediction of treatment response to neoadjuvant therapy and further patient management.

Lymphoepithelioma-like Carcinoma of the Breast Synchronous with a High-Grade Invasive Ductal Carcinoma and Ductal Carcinoma in Situ in a Different Quadrant of the Same Breast: A Case Report.

Lymphoepithelioma-like breast carcinoma (LELC) is a rare type of malignant breast tumor that is not included in the current edition of the World Health Organization (WHO) classification of breast tumors. Currently, there are no clearly defined therapeutic strategies, and the general information on breast LELC is based on sporadic clinical cases described in the medical literature. We present a clinical case that describes a 49-year-old woman with a tumor formation in the right breast, histologically verified as LELC, together with a non-palpable, synchronous high-grade invasive ductal carcinoma and ductal carcinoma in situ Grade 2 (DCIS G2) in a different quadrant of the same breast. To our knowledge, this is the first case described in the literature that combines a LELC with a synchronous carcinoma in the same breast.

Post-radiation soft tissue damage in endometrial carcinoma: a case report.

INTRODUCTION: Radiotherapy (RT) is a widely used treatment modality of malignant tumours of the uterine cervix and body. There are different techniques to deliver RT to the tumour lesions, including external beam radiation and brachytherapy. All international guidelines recommend RT as treatment modality for many stages of uterine cervical and body cancers because it improves a number of oncological outcomes, such as disease-free and overall survival. However, it may also lead to a number of complications, which can be roughly divided into early or late, depending on the time of their manifestation. The most frequent RT-induced early complications involve the skin and the soft subcutaneous tissues. They typically present as inflammatory conditions of all abdominal wall layers: dermatitis, cellulitis, and necroses of subcutaneous fatty tissue, muscles, or fasciae. CASE REPORT: This paper presents a case report of a 38-year-old woman diagnosed with endometrial cancer (EC). She was initially treated with open abdominal surgery, and subsequently the treatment was continued with external beam adjuvant RT. DISCUSSION: While RT was ongoing, a necrosis of the anterior abdominal wall in the surgical scar developed. It manifested at the end of the RT treatment and is thus regarded as an early complication of the RT for EC. It was successfully managed with surgery, and there was no compromise in the treatment of the oncological condition. CONCLUSIONS: RT-induced necrosis of the surgical scar of the anterior abdominal wall is a very rare complication. Surgical treatment is the main method of treatment of this condition.

Appendiceal mucocele presenting as a right adnexal mass: a case report.

A 68-year-old female presented to the Gynecologic Oncology Clinic with a right-lower quadrant abdominal mass 3 × 4 cm in diameter palpable on pelvic examination. Her routine laboratory tests were normal. Transvaginal ultrasonography revealed a cystic mass in the right adnexa 3.9 cm in diameter, which was thought to arise in the ovary. At the time of laparoscopy, a 3 × 4 cm tumor arising from the distal end of the appendix was noted. A laparoscopic appendectomy with tumor removal was performed. Histologic examination of the surgical specimen revealed a mucocele of the appendix (AM). Although rare, this tumor should be considered in the differential diagnosis of a right adnexal mass. These tumors can be identified laparoscopically and removed by minimally invasive surgery.