Abscopal effect of radiation in metastatic esophageal carcinoma: fourth reported case.

Abscopal or bystander effect of radiotherapy is a rare and unpredictable outcome encountered during treatment of metastatic cancer where tumor regression is observed distant from irradiated volume. While it has been more frequently reported with malignancies like melanoma, lymphoma, and renal cell carcinoma, data regarding metastatic esophageal cancers are sparse. We describe a case of abscopal regression of distant mediastinal and upper abdominal lymph nodes in a 65-year-old gentleman whose primary esophageal tumor was irradiated with hypo-fractionated radiotherapy in an attempt to achieve local palliation. Our case study emphasizes the systemic benefit of local radiotherapy and the need for future research to investigate its utility as this clinical event poses widespread response in an otherwise dismal Stage-IV cancer with minimal treatment-related side effects.

Was it Ewing's? A Diagnostic and Therapeutic Dilemma.

We present an atypical case of histopathology suggesting hemangioendothelioma and immunohistochemistry-proven Ewing's sarcoma in a 39-year-old lady who presented with multiple stony hard swellings involving the occipital region of the scalp, right cervical lymph node, right scapular region, left infraclavicular region of the chest, right anterior abdominal wall swelling, and inner aspect of right thigh. She underwent left-sided below-knee amputation for parosteal osteosarcoma in the left distal tibia 3 years back. Palliative radiotherapy with dose of 30 Gy in 10 fractions over 2 weeks was administered to the right neck and right upper back following which she attained moderate pain relief but no reduction in swellings as was expected had it been a case of hemangioendothelioma or Ewing's sarcoma..

Treatment Outcome and Patterns of Failure in Patients with Maxillary Sinus Cancer: Clinical Experience from a Regional Cancer Centre in North India.

Treatment of maxillary sinus cancer poses several challenges because of its complex anatomy, close proximity to critical structures and majority of patients presenting at an advanced stage. Despite presence of several treatment approaches, the outcome in these cancers has remained dismal. This article examines its clinical behaviour and treatment outcome of these patients treated at our centre in past 7 years. In this retrospective study, 67 patients with carcinoma of maxillary sinus presented from January 2011 to December 2017 were analysed. All the patients reporting during this period were included except those who did not turn up after first visit. Of all the patients, 64.2% had squamous cell carcinoma. The majority of patients presented with advanced stage (IVA and IVB, 83.58%). Nodal disease at presentation was seen in seven patients (10.4%). Treatment to the primary site comprised of surgery and radiotherapy in 24 patients, radiotherapy alone in 22 patients and surgery alone in 12 patients. Statistical program for social sciences (SPSS) version 16 was used for all statistical analyses. The mean follow-up time was 25 months (range 3-72 months). Overall, 17 out of 41 patients who were treated with curative intent (41.5%) developed recurrence. Patients who underwent surgery followed by adjuvant radiotherapy did fairly better in terms of recurrence. Seven patients out of 17 (41.2%) could be salvaged by surgery or radiation. Only one patient developed distant metastasis to D8 vertebra. Patients who were treated with surgery and radiotherapy (either preoperative/adjuvant setting) had better disease-free survival. The results of the current study regarding the treatment of carcinoma of the maxillary sinus show feasibility and efficacy of multimodal therapy. Radical radiotherapy appears to be a feasible alternative in cases of inoperable tumours. Loco regional relapse remains a significant pattern of failure.

Inflammatory myofibroblastic tumor of maxillary sinus successfully treated with radiotherapy and corticosteroid: report of a rare case.

BACKGROUND: Inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor mainly found in lung or retroperitoneum and rarely affects head and neck region. Extensive English literature search reveals that less than fifty cases of head and neck IMT have been reported so far, maxillary sinus being fewer. CASE PRESENTATION: We present a case of IMT involving maxillary sinus in a 48-year-old gentleman who attained complete clinico-radiologic response after treatment with radiotherapy (RT) and concurrent oral prednisolone. CONCLUSIONS: This is the first report where such magnificent response was attained in primary setting treated with RT and steroids as opposed to surgery which used to be considered as standard of care till now.

Carcinoma buccal mucosa with left axillary lymph node metastasis: First reported case and review of the literature.

Head-and-neck squamous cell carcinomas are tumors with propensity mostly for locoregional spread. The most frequent sites of metastasis include lung, bone, liver, adrenal, heart, and kidney. Distant metastasis to axillary lymph nodes from buccal mucosa cancer is extremely rare. To the authors' knowledge, this is the first case reported where a gentleman who was treated for carcinoma right buccal mucosa developed left axillary lymph node metastasis at 6th year of follow-up.

Ewing's Sarcoma of Scapula: a Rare Case Report.

Neoplasms arising from scapula are rare. We herein, present a rare case of Ewing's sarcoma of scapula in a 9-year-old male child. Extensive literature search reveals that less than 20 similar cases have been reported so far. The index case had been treated with multimodal therapies-chemotherapy, surgery, and radiotherapy. This case is reported to highlight the rarity of the case and discuss the review of literature comprehensively.

A comparative study of treatment outcome in younger and older patients with locally advanced oral cavity and oropharyngeal cancers treated by chemoradiation.

BACKGROUND: Evidence suggests that older patients with oral cavity and oropharyngeal cancers may behave differently from their younger peers. AIM: The aim of this study is to determine if there is difference in responses, survival, and toxicities between young patients (≤40 years of age) with oral cavity and oropharyngeal cancers and older patients (>40 years of age) treated with concurrent chemoradiation. MATERIALS AND METHODS: Sixty-one patients with unresectable, locally advanced oral cavity and oropharyngeal cancers received concomitant chemoradiation to a dose of 70 Gray in 35 fractions over 7 weeks with concomitant weekly cisplatin (40 mg/m2). These patients were then distributed in two arms. Arm-A patients having age ≤40 years and Arm-B patients having age >40 years, and the two arms were assessed for treatment outcome. RESULTS: The overall response rate (complete responders + partial responders) evaluated using response evaluation criteria in solid tumors criteria version 1.1 was equivalent in both groups (80.76% in Arm-A and 74.28% in Arm-B; P = 0.93). Older patients (>40 years) experienced more acute mucositis and xerostomia (P < 0.5); although not statistically significant, more acute skin and pharynx toxicities were also observed in this group. Higher late salivary gland toxicity (P < 0.5) was also seen in older patients; however, disease-free survival and progression-free survival were found to be similar in both groups. CONCLUSIONS: Older patients with locally advanced oral cavity and oropharyngeal cancers have similar response rates and survival as compared to their younger counterparts but may experience higher treatment-related toxicities.

Giant cell glioblastoma with spinal and spinal leptomeningeal metastasis in a child: A rare presentation of a rare tumor.

Giant cell glioblastoma (GCG) is a rare subtype of classic glioblastoma multiforme with favorable prognosis and little is known about its metastatic potential. We hereby present a unique case of GCG in a 7-year-old child who developed spinal and spinal leptomeningeal metastasis during adjuvant therapy. She succumbed to it in spite of salvage therapy.

Synchronous endometrioid carcinoma of the endometrium and small cell neuroendocrine carcinoma of the cervix: a rare combination.

Synchronous multiple primaries of female genital tract are uncommon, with the most frequently encountered combination being of endometrium and ovary. Concurrent primary tumours of endometrium and cervix are rare. We report a case of coexistent endometrioid carcinoma of the endometrium and small cell neuroendocrine carcinoma of the cervix in 48-year-old woman who presented with menometrorrhagia and was detected to have metastases to distant sites on imaging. She underwent multimodality treatment which resulted in a significant reduction in the tumour bulk.

A Rare Case Report of Giant Cell Tumor of the Sphenoid Bone in a Patient Who Developed "Erythema Multiforme Associated with Phenytoin and Cranial Radiation Therapy Syndrome".

Giant cell tumors (GCTs) are rare, usually affecting the epiphyses in long bones of the extremities. GCTs may be locally aggressive with a high rate of local recurrence and exhibit the potential for distant metastasis. They seldom occur in the skull, where they preferentially affect the sphenoid and temporal bones. Several case reports with follow-up describe gross total resection of skull-base GCT to be curative. Radiation therapy, although controversial, is reserved for lesions that cannot be completely resected. Here, we describe the case of an 18-year-old female with GCT of sphenoid bone who underwent subtotal resection followed by adjuvant radiotherapy, although whose radiotherapy could not be completed because of her demise due to erythema multiforme associated with phenytoin and cranial radiation therapy syndrome.

Comparative study of concomitant chemoradiation versus concomitant chemoradiation followed by high-dose-rate intraluminal brachytherapy in locally advanced esophageal carcinoma: a single institutional study.

PURPOSE: The aim of this study is to compare efficacy and toxicity between concurrent chemoradiotherapy (CCRT) followed by high-dose-rate intraluminal brachytherapy (ILBT) and CCRT in inoperable, locally advanced esophageal carcinoma. MATERIAL AND METHODS: Thirty-four patients with inoperable, locally advanced esophageal carcinoma were randomized into two arms. In the CCRT + ILBT arm (arm A), eighteen patients received 50.4 Gy at 1.8 Gy per fraction over 5.6 weeks, along with concurrent cisplatin (75 mg/m2) intravenously on day 1, and 5-fluorouracil (1000 mg/m2) continuous intravenous infusion on days 1-5, starting on the first day of irradiation and repeated after 28 days. This was followed by ILBT boost with a dose of 10 Gy in 2 fractions, one week apart. In the CCRT arm (arm B), sixteen patients received two cycles of chemotherapy, using the same schedule, along with external beam radiotherapy fractionated in a similar manner without brachytherapy boost. The endpoints were tumor response, acute and late toxicities, disease and progression-free survival. RESULTS: With a median follow-up of 13 months, the complete response rate was 88.89% in arm A and 87.50% in arm B (p = 0.71). Acute esophageal toxicity was higher in CCRT followed by ILBT arm (p = 0.60). There was no significant difference between the Kaplan Meier survival plots of disease-free survival (p = 0.68) and progression-free survival (p = 0.55). CONCLUSIONS: In our study, addition of brachytherapy as a boost following concurrent chemoradiation failed to improve treatment outcomes without additional toxicity in locally advanced esophageal cancer.

Report of a unique case of myoepithelial carcinoma of left parotid gland with metachronous bilateral cavernous sinus metastasis.

Myoepithelial carcinoma (MC) is a rare, locally aggressive malignant neoplasm of the salivary glands. Only few evidences on its metastatic behavior are available in the literature. We herein present a unique case of MC of left parotid gland which metastasized to bilateral cavernous sinuses. The patient was successfully treated with palliative radiotherapy and chemotherapy.

Endolymphatic Sac Tumor in von Hippel-Lindau Disease: A Rare Case Report.

Endolymphatic sac tumor (ELST) is a rare papillary neoplasm with locally destructive behavior which can occur sporadically or in association with Von Hippel-Lindau (VHL) disease. We herein present a case of ELST associated with VHL disease in a 14-year-old girl and discuss clinico-radiological, immunohistopathologic findings, and management by staged surgery and postoperative radiotherapy to the residual lesion.

Malignant solitary fibrous tumor of thoracic spine with distant metastases: Second reported case and review of the literature.

Solitary fibrous tumor (SFT) usually originates from the pleura because of abnormal proliferation of fibroblast cells. It is extremely rare for the tumor to originate from the spine. Here, we report the second case of malignant SFT of thoracic spine with distant metastases in a 35-years-old female.

Triple-bridged ferromagnetic nickel(II) complexes: a combined experimental and theoretical DFT study on stabilization and magnetic coupling.

Two dinuclear [Ni2L2(o-(NO2)C6H4COO)2(H2O)] (1), [Ni2L2(p-(NO2)C6H4COO)2(H2O)]·0.5CH3OH (2) complexes and one trinuclear [Ni3L2(p-(NO2)C6H4COO)4]·C2H5OH (3) Ni(II) complex have been synthesized using a tridentate Schiff base ligand, 1-[(3-dimethylamino-propylimino)-methyl]-naphthalen-2-ol (HL) along with ortho- and para-nitro benzoate as co-ligands. All these three (1-3) complexes have been characterized by spectral analysis, X-ray crystallography and variable temperature magnetic susceptibility measurements. The structural analyses reveal that complexes 1 and 2 are dinuclear in which two µ2-phenoxido and a water molecule bridge the two Ni(ii) centers to make the complexes face sharing bioctahedra. Complex 3 is a linear triple bridged (phenoxido and carboxylato) trinuclear Ni(II) complex. Variable-temperature magnetic susceptibility studies indicate the presence of ferromagnetic exchange coupling in complexes 1-3 with J values of 25.4, 28.1 and 6.2 cm(-1) respectively. Theoretically obtained J values of 21.4 cm(-1) (for 1), 22.0 cm(-1) (for 2) and 9.3 cm(-1) (for 3) corroborate very well the experimental results. DFT calculation also shows that stronger H-bonding interactions present in the case of carboxylate based coligands stabilise the triple oxido-bridged complexes.

Synthesis, crystal structure, magnetic property and DFT calculations of an unusual dinuclear µ2-alkoxido bridged iron(III) complex.

A new dinuclear di(µ-alkoxido) bridged complex [Fe2L2] (1) (H3L = N,N'-bis{1-(2-hydroxyphenyl)-ethylidene}-2-hydroxy-1,3-propanediamine) has been synthesized and characterized. The structure of 1 consists of a centrosymmetric dimer where two crystallographically equivalent metal ions are asymmetrically bridged by two alkoxido oxygen atoms. In the structure, each ligand coordinates to one Fe(III) centre and consequently the imino nitrogen atoms are in cis positions, which is rather unusual for this ligand. Variable-temperature magnetic susceptibility measurements of the complex indicate that the two iron(III) centres are antiferromagnetically coupled (J = -17.46 cm(-1)). The exchange mechanism has been investigated by means of DFT calculations. In addition, the theoretical study has been also used to rationalize the unusual coordination mode of the Schiff base ligand. Moreover, the influence of the weak forces or solvent molecules present in the solid-state structure for the conformational change is also analysed theoretically. This theoretical calculation incorporates two more similar structures, [Fe2L]·CH2Cl2 (2) and [Fe2L'2]·2CH3CN (3) (H3L' = N,N'-bis(salicylidene)-1,3,-diaminopropan-2-ol), for a comparative study. Complex 2 has been reported previously in the literature with the usual binding mode of the ligands. We have repeated its synthesis and recrystallized it from another solvent (acetonitrile) to get complex 3 which is isostructural with 2 but has acetonitrile as solvent molecule.

A new family of trinuclear nickel(II) complexes as single-molecule magnets.

Three new trinuclear nickel (II) complexes with the general composition [Ni3 L3 (OH)(X)](ClO4 ) have been prepared in which X=Cl(-) (1), OCN(-) (2), or N3(-) (3) and HL is the tridentate N,N,O donor Schiff base ligand 2-[(3-dimethylaminopropylimino)methyl]phenol. Single-crystal structural analyses revealed that all three complexes have a similar Ni3 core motif with three different types of bridging, namely phenoxido (µ2 and µ3 ), hydroxido (µ3 ), and µ2 -Cl (1), µ1,1 -NCO (2), or µ1,1 -N3 (3). The nickel(II) ions adopt a compressed octahedron geometry. Single-crystal magnetization measurements on complex 1 revealed that the pseudo-three-fold axis of Ni3 corresponds to a magnetic easy axis, being consistent with the magnetic anisotropy expected from the coordination structure of each nickel ion. Temperature-dependent magnetic measurements indicated ferromagnetic coupling leading to an S=3 ground state with 2J/k=17, 17, and 28 K for 1, 2, and 3, respectively, with the nickel atoms in an approximate equilateral triangle. The high-frequency EPR spectra in combination with spin Hamiltonian simulations that include zero-field splitting parameters DNi /k=-5, -4, and -4 K for 1, 2, and 3, respectively, reproduced the EPR spectra well after a anisotropic exchange term was introduced. Anisotropic exchange was identified as Di,j /k=-0.9, -0.8, and -0.8 K for 1, 2, and 3, respectively, whereas no evidence of single-ion rhombic anisotropy was observed spectroscopically. Slow relaxation of the magnetization at low temperatures is evident from the frequency-dependence of the out-of-phase ac susceptibilities. Pulsed-field magnetization recorded at 0.5 K shows clear steps in the hysteresis loop at 0.5-1 T, which has been assigned to quantum tunneling, and is characteristic of single-molecule magnets.

A rare phenoxido/acetato/azido bridged trinuclear and an unprecedented phenoxido/azido bridged one-dimensional polynuclear nickel(II) complexes: synthesis, crystal structure, and magnetic properties with theoretical investigations on the exchange mechanism.

The reaction of a tridentate Schiff base ligand HL (2-[(3-dimethylaminopropylimino)-methyl]-phenol) with Ni(II) acetate or perchlorate salts in the presence of azide as coligand has led to two new Ni(II) complexes of formulas [Ni(3)L(2)(OAc)(2)(µ(1,1)-N(3))(2)(H(2)O)(2)]·2H(2)O (1) and [Ni(2)L(2)(µ(1,1)-N(3))(µ(1,3)-N(3))](n)(2). Single crystal X-ray structures show that complex 1 is a linear trinuclear Ni(II) compound containing a µ(2)-phenoxido, an end-on (EO) azido and a syn-syn acetato bridge between the terminal and the central Ni(II) ions. Complex 2 can be viewed as a one-dimensional (1D) chain in which the triply bridged (di-µ(2)-phenoxido and EO azido) dimeric Ni(2) units are linked to each other in a zigzag pattern by a single end-to-end (EE) azido bridge. Variable-temperature magnetic susceptibility studies indicate the presence of moderate ferromagnetic exchange coupling in complex 1 with J value of 16.51(6) cm(-1). The magnetic behavior of 2 can be fitted in an alternating ferro- and antiferromagnetic model [J(FM) = +34.2(2.8) cm(-1) and J(AF) = -21.6(1.1) cm(-1)] corresponding to the triple bridged dinuclear core and EE azido bridge respectively. Density functional theory (DFT) calculations were performed to corroborate the magnetic results of 1 and 2. The contributions of the different bridges toward magnetic interactions in both compounds have also been calculated.