Lower fluorodeoxyglucose positron emission tomography maximum standardized uptake value may show a better response to stereotactic body radiotherapy of adrenals in oligometastatic disease.

Introduction: Stereotactic body radiotherapy (SBRT) is well established for oligometastatic disease, and it is increasingly used to treat adrenal metastases. Material and methods: In this retrospective study we performed an analysis of 75 metastatic adrenal lesions in 64 patients with oligometastatic disease. According to the fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) maximum standardized uptake value (SUVmax) of adrenal metastases, patients were categorized into three groups: low, intermediate, and high SUVmax. Results: For all clinicopathological characteristics we found significant relationships for levels of SUVmax and objective response rate (Kendall Tau-c = 0.290; p = 0.017). Patients who responded to SBRT had a significantly lower SUVmax value than those who did not respond (7.6 ±2.4 vs. 9.7 ±3.8; p = 0.015). At the appropriate SUVmax cut-off values, the biomarker distinguished between patients with and without a response significantly and moderately (area under the curve = 0.670, 95% confidence intervals: 0.540-0.790; p = 0.015). Conclusions: Lower SUVmax is associated with a better response to SBRT in patients whose disease progressed mainly in the adrenal glands.

Heteroatomic deltahedral zintl ions of group 14 and their alkenylation.

Reported is the synthesis of Ge(9-x)Sn(x) heteroatomic deltahedral Zintl ions and their alkenylation by reactions with alkynes. The nine-atom clusters are made either by extraction from mixed Ge/Sn precursors with nominal composition K(4)Ge(9-x)Sn(x) or by dissolution of mixtures of the corresponding binary precursors K(4)Ge(9) and K(4)Sn(9) in solvents with high dielectric constants such as DMF, DMSO, and acetonitrile. Reactions of the heteroatomic clusters with alkynes such as Me(3)SiC[triple bond]CSiMe(3), HC[triple bond]CCpr (Cpr = cyclopropyl), and HC[triple bond]CPh in ethylenediamine resulted in the following structurally characterized compounds with alkenylated heteroatomic clusters: [K-(2,2,2-crypt)](3)[GeSn(8)-CH=CH(2)].en.tol (1), triclinic, P1, a = 13.9220(3) A, b = 14.9788(3) A, and c = 21.5892(5) A, alpha = 94.2580(10) degrees , beta = 98.5210(10) degrees , and gamma = 98.4890(10) degrees , V = 4382.31(16) A(3), Z = 2; [K-(2,2,2-crypt)](4)[Ge(2)Sn(7)(CH=CH(2))(2)](2).en (2), monoclinic, P2(1)/c, a = 48.1883(15) A, b = 12.1551(4) A, and c = 21.4824(7) A, beta = 90.052(2) degrees , V = 12583.0(7) A(3), Z = 4; [K-(2,2,2-crypt)](3)[GeSn(8)-CH=CHCpr].en (3), monoclinic, P2(1)/c, a = 17.9132(9) A, b = 22.7967(11) A, and c = 21.6922(12) A, beta = 98.409(2) degrees , V = 8763.0(8) A(3), Z = 4; [K-(2,2,2-crypt)](3)[Ge(2)Sn(7)-CH=CHPh].2en (4), monoclinic, P2(1)/n, a = 13.2583(5) A, b = 47.0565(17) A, and c = 15.9978(6) A, beta = 111.536(2) degrees , V = 9284.1(6) A(3), Z = 4. The potassium countercations of the divinyl-substituted cluster in 2 were exchanged for tetrapropylammonium cations, and the resulting compound was also crystallized and structurally characterized: [Pr(4)N](4)[Ge(2)Sn(7)(CH=CH(2))(2)](2) (5), triclinic, P1, a = 11.6757(8) A, b = 18.8150(16) A, and c = 21.0608(17) A, alpha = 112.327(3) degrees , beta = 91.550(3) degrees , and gamma = 91.892(3) degrees , V = 4273.5(6) A(3), Z = 2. All clusters were also characterized in solution by electrospray mass spectrometry.

Progression of cutaneous squamous cell carcinoma in immunosuppressed patients is associated with reduced CD123+ and FOXP3+ cells in the perineoplastic inflammatory infiltrate.

AIMS: Squamous cell carcinoma of the skin (SCC) increases dramatically in organ transplant recipients (OTRs). The aim was to determine whether qualitative and quantitative differences in perineoplastic inflammation in OTRs contribute to the increased carcinogenesis. METHODS AND RESULTS: We studied the perineoplastic inflammatory infiltrate in SCC, assessing depth, density and phenotype (CD3, 4, 8, FOXP3, CD123 and STAT1) by immunohistochemistry in paired biopsy specimens of intraepithelial and invasive SCC in immunocompetent patients and OTRs. Considerable inflammation was observed in all intraepithelial SCC (inflammatory infiltrate depth 2.80 +/- 2.21 mm immunocompetent patients, 2.15 +/- 2.95 mm OTRs). Inflammation was more pronounced in invasive SCC of immunocompetent patients (4.60 +/- 4.67 mm) and OTRs (3.30 +/- 5.90 mm) (P < 0.005). The density of perineoplastic inflammatory infiltrates increased from intraepithelial to invasive SCC (P = 0.005). OTRs showed a lower density of perineoplastic inflammatory infiltrate (P = 0.041). OTRs also showed reduced CD3+ T-lymphocyte and CD8+ cytotoxic T-lymphocyte proportions in intraepithelial SCC (P = 0.025 and 0.027, respectively). FOXP3+ regulatory T-lymphocyte proportions in OTRs' invasive SCC were markedly diminished (P = 0.048). CD123+ plasmacytoid dendritic cells increased in the progression from intraepithelial to invasive SCC in immunocompetent patients (P = 0.040). CD123+ cells were reduced in all SCC of OTRs (P = 0.036). CONCLUSIONS: Perineoplastic inflammation in intraepithelial SCC is pronounced both in immunocompetent patients and OTRs. Inflammation increases further in invasive SCC. OTRs show reduced proportions of FOXP3+ regulatory T cells and CD123+ plasmacytoid dendritic cells. This distinct inflammatory infiltrate may result in increased cutaneous carcinogenesis and more aggressive behaviour of SCC in OTRs.

Lower lip squamous cell carcinoma in disabling pansclerotic morphea of childhood.

Disabling pansclerotic morphea of childhood (DPMC) is an aggressive form of cutaneous scleroderma that involves all layers of the skin, extending through the dermis and subcutaneous tissues to involve muscle, tendon, and even bone. As DPMC is extremely rare, its association with skin squamous cell carcinoma (SCC) is rarer still. To our knowledge there are only two cases of SCC in patients with DPMC that developed within areas of chronic skin ulceration. We report the first case of lower lip squamous cell carcinoma arising in a young woman with DPMC and discuss the carcinogenic pathway that may have led to its occurrence.

Pronounced allelic imbalance at D9S162 in skin squamous cell carcinoma of organ transplant recipients.

OBJECTIVE: To evaluate chromosomal instability at 9p21-22 with p16 protein expression in organ transplant recipients (OTRs) compared with immunocompetent patients with squamous cell carcinoma (SCC). DESIGN: In a select population of intraepithelial and subsequent invasive SCC from the same anatomic region of the same patient at different times, we assessed loss of heterozygosity at 3 microsatellites­IFNA, D9S162, and D9S925­in the course of carcinogenesis in OTRs and immunocompetent patients. SETTING: Department of Dermatology, University Hospital Zurich. PATIENTS: Immunocompetent patients and OTRs with SCC on sun-damaged skin. MAIN OUTCOME MEASURE: Chromosomal allelic balance in SCC of OTRs and immunocompetent patients. RESULTS: Reduced allelic balance at IFNA, D9S162, and D9S925 in intraepithelial forms of SCC and similar allelic imbalance in invasive forms of SCC were found. Allelic balance at D9S162 was reduced for SCC in OTRs compared with SCC in immunocompetent patients. The study revealed broadly reduced allelic balance at 9p21-22 in all cutaneous SCCs, and OTRs presented a further reduced allelic balance for D9S162, suggesting a common trait for SCC in OTRs. Actinic keratosis and Bowen disease differed in allelic balance at D9S162, suggesting substantial differences in their carcinogenesis. CONCLUSION: Reduced allelic balance around locus D9S162 is a genomic correlate for enhanced carcinogenesis in OTRs.

Alkylation of Deltahedral Zintl clusters: synthesis of [R-Ge9-Ge9-R]4- (R = tBu, sBu, nBu, tAm and structure of [tBu-Ge9-Ge9-tBu]4-.

Reactions of nine-atom deltahedral clusters (Zintl ions) of germanium, Ge9n- (n = 2, 3, 4), with alkyl chlorides, RCl (R = tBu, nBu, sBu, tAm), yielded the corresponding dialkylated dimers of Ge9 clusters [R-Ge9-Ge9-R]4-. The tBu derivative with [K(2,2,2-crypt)]+ countercations was characterized in the solid state by single-crystal X-ray diffraction as [K(2,2,2-crypt)]4[tBu-Ge9-Ge9-tBu].7en (monoclinic, C2/c, a = 35.0914(10) A, b = 24.8161(6) A, and c = 16.8782(5) A, beta = 94.0136(17) degrees , V = 14662.0(7) A3, and Z = 4) and in solution by 1H and 13C NMR. All species were also characterized in solution by electrospray mass spectrometry in the negative-ion mode. These are the first main group deltahedral clusters functionalized with purely organic substituents.