An unusual non­metastatic, mismatch repair­deficient primary gastric squamous cell carcinoma presenting as a large, exophytic, bleeding tumor: A case report.

Primary gastric squamous cell carcinoma (GSCC) is an extremely rare malignancy with a poor prognosis. Despite the improved knowledge regarding its pathogenesis and biology, the treatment options remain limited. The present study reported on the unique case of a mismatch repair-deficient (dMMR) primary GSCC in a 79-year-old woman reporting fatigue and symptoms of upper gastrointestinal tract bleeding. Physical examination revealed abdominal pain at palpation. Gastroscopy revealed a large, exophytic, bleeding tumor. Medical imaging confirmed a mushroom-like polyp in the lumen of the stomach, with no signs of disease spread. Total gastrectomy and D2 lymphadenectomy were performed. Pathological examination of the post-operational material confirmed a well-differentiated SCC invading the mucosa, submucosa and muscle layer. There were no signs of dissemination observed in any of the 32 excised lymph nodes. Notably, according to the last follow-up, the patient remains well, supporting the 5-year GSCC survival rate statistics. To the best of our knowledge, this is the first such GSCC case reported in the Surgical Oncology Outpatient Clinic (Copernicus Memorial Hospital, Lodz, Poland) and these findings add to the limited data on GSCC. Although this is a very rare condition, it should always be considered during the process of diagnosis of gastric tumors.

A preliminary evaluation of oxidative stress in patients with gastric cancer before chemotherapy.

Introduction: Due to an imbalanced redox status, cancer cells generate intrinsically higher levels of reactive oxygen species (ROS) compared to normal cells. Targeting ROS is an important therapeutic strategy for cancer as exemplified by cancer drugs, which induce ROS-dependent synergistic cytotoxicity in gastric cancer cells. The present study was designed to assess the level of selected oxidative stress biomarkers in blood plasma derived from gastric cancer patients. Material and methods: The study assessed the oxidative/nitrative biomarkers in blood plasma isolated from 51 gastric (adenocarcinoma) cancer patients, compared to a control group of 32 healthy volunteers. Oxidative stress was evaluated using a panel of biomarkers such as plasma protein thiol groups and 3-nitrotyrosine levels as well as indicators of plasma lipid peroxidation, i.e. lipid hydroperoxides (LOOH) and thiobarbituric acid-reactive substances (TBARS). Additionally, the total antioxidant capacity of blood plasma (non-enzymatic capacity of blood plasma, NEAC) was also estimated. Results: Our results showed that patients with gastric cancer had significantly different levels of thiol groups (lower, p < 0.001) and 3-nitrotyrosine (higher, p < 0.0001), LOOH (higher, p < 0.05), TBARS (higher, p < 0.05), NEAC (lower, p < 0.0001), compared to the control group. Conclusions: The present study indicates considerable oxidative/nitrative stress in gastric cancer patients. Our pilot study shows that not a single marker, but a biomarker panel, may be a more reliable representation of oxidative stress in patients with gastric cancer.

Increased H2O2 level in exhaled breath condensate in primary breast cancer patients.

PURPOSE: This study was designed to assess exhaled hydrogen peroxide (H(2)O(2)), blood serum antioxidant capacity, and tumor necrosis factor-alpha (TNFalpha) in primary breast cancer (PBC). METHODS: The study included 34 consecutive, non-smoking PBC patients (aged 62.5 +/- 13.5 at surgery) prior to the treatments, qualified for modified radical mastectomy and not undergoing any adjuvant systemic therapy, and 33 healthy controls. The post surgery pathological assessment included tissue expression of estrogen (ER) and progesterone (PR) receptors, and epidermal growth factor receptor type 2 (HER-2/neu). Exhaled H(2)O(2) was determined fluorometrically in the exhaled breath condensate (EBC). Blood serum antioxidant capacity and TNFalpha levels were assessed with ferric reducing ability of plasma (FRAP) and ELISA immunoassay, respectively. RESULTS: In PBC patients, 10 ER, 11 PR, and 9 HER-2/neu positive tumors were identified and HER-2/neu score was 2+ in 20% of all tumors. Median (Me) H(2)O(2) was increased up to 0.44 microM (interquartile range IR: 0.20-1.25 microM) compared with healthy control of 0.36 microM (IR: 0.12-0.48 microM; p < 0.05). The H(2)O(2) concentration in EBC was significantly correlated (tau = 0.27; p = 0.03) and increased in cases with nodal metastases (n = 12; p = 0.04). Serum TNFalpha was increased up to 51.7 +/- 21.0 pg/ml compared with controls 17.2 +/- 3.65 pg/ml (p < 0.05). FRAP was increased to 1.41 +/- 0.37 mM Fe(2+) compared with control 1.19 +/- 0.17 mM Fe(2+); (p = 0.006). CONCLUSIONS: This is the first study to demonstrate increased H(2)O(2) in exhaled breath condensate in patients with localized breast malignancy and its relation with clinical severity.

[Krukenberg tumor - common problem of gynecologists, surgeons oncologists and pathologists. Report of three cases and review of the literature]. / Guz krukenberga--problem interdyscyplinarny. Opis trzech przypadków klinicznych i przeglad pismiennictwa.

Ovarian cancer constitutes one of the most frequent malignant tumours in the female population not only in Poland. The screening of this tumour type is unsolved. The tumours are usually diagnosed in the advanced stage, thus the survival rate are usually poor. Their histopathological appearance has a wide variety, with the occurrence of numerous metastatic forms. Among the metastatic tumours, the primary tumours of the digestive tract occur the most frequently. They are known as the Krukenberg tumours. In these cases the choice of treatment is more difficult and prognosis is also worse in most cases with fatal outcome in one year. Early diagnosis and complete resection is the only possible hope. In this paper authors present three cases of Krukenberg tumour with nonspecific symptoms, difficulties during diagnostics, late beginning of treatment and poor prognosis.