Recurrent Liver Abscess in a Non-toxic Patient.

Liver abscesses range in presentation from asymptomatic infection to sepsis. Recurrence is rare. We describe a case of an asymptomatic liver abscess that recurred 10 years after a previous abscess. The patient presented with flu-like symptoms and dark urine. Laboratory evaluation showed an elevation of aminotransferases and bilirubin. Triple-phase CT showed a 2.8 cm mass in the right liver lobe with linear enhancement. The abscess was aspirated, with cultures growing Escherichia coli. The patient was started on ceftriaxone and metronidazole and then discharged with outpatient follow-up. We describe an unusual case of asymptomatic pyogenic liver abscess growing E. coli, with the same location and causative organism as an abscess that occurred 10 years prior.

Pathological responses and survival outcomes in patients with locally advanced breast cancer after neoadjuvant chemotherapy: a single-institute experience.

BACKGROUND: Pathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). We analyzed the predictive clinical factors for pathological responses and survival outcomes in a cohort of Egyptian patients. METHODS: We evaluated the medical records of patients with breast cancer who received NCT in our academic institute. Survival curves were estimated with the Kaplan-Meier method. Cox proportional models were used for multiple regression analysis. RESULTS: Our cohort included 368 patients with a median age of 48 years (range 21-70). The median follow-up time was 3 years. The clinical tumor stage (T3-4) represented 58%, with 80% having positive axillary nodes. The luminal subgroup prevailed by 68%. The objective response rate (ORR) reached 78%, and 16% of patients achieved pCR. The clinical node stage and optimal chemotherapy were associated with higher ORR (p = 0.035 and p = 0.001, respectively). Predictors of pCR were clinical T-stage (p = 0.026), high Ki-67 index > 20 (p = 0.05), and receiving optimal chemotherapy (p = 0.014). The estimated 3-year disease free-survival (DFS) was 53%. Receptor status, achieving ORR, and pCR were associated with better DFS with hazard ratios of 0.56, p = 0.008; 0.38, p = 0.04; and 0.28, p = 0.007, respectively. CONCLUSIONS: Luminal tumors still draw benefit from neoadjuvant chemotherapy in terms of clinical response and breast conservative surgery. Treatment escalation to those who did not achieve pCR requires more investigation, given a higher recurrence rate in real-world experience.