Atorvastatin treatment is effective when used in combination with mefloquine in an experimental cerebral malaria murine model.

BACKGROUND: One of the major complications of Plasmodium falciparum infection is cerebral malaria (CM), which causes one million deaths worldwide each year, results in long-term neurological sequelae and the treatment for which is only partially effective. Statins are recognized to have an immunomodulatory action, attenuate sepsis and have a neuroprotective effect. Atorvastatin (AVA) has shown in vitro anti-malarial activity and has improved the activity of mefloquine (MQ) and quinine. METHODS: The efficiency of 40 mg/kg intraperitoneal AVA, alone or in association with MQ, was assessed in an experimental Plasmodium berghei ANKA rodent parasite model of CM and performed according to different therapeutic schemes. The effects on experimental CM were assessed through the evaluation of brain histopathological changes and neuronal apoptosis by TUNEL staining. RESULTS: AVA alone in the therapeutic scheme show no effect on survival, but the prophylactic scheme employing AVA associated with MQ, rather than MQ alone, led to a significant delay in mouse death and had an effect on the onset of CM symptoms and on the level of parasitaemia. Histopathological findings show a correlation between brain lesions and CM onset. A neuronal anti-apoptotic effect of AVA in the AVA + MQ combination was not shown. CONCLUSIONS: The combination of AVA and MQ therapy led to a significant delay in mouse mortality. There were differences in the incidence, time to cerebral malaria and the level of parasitaemia when the drug combination was administered to mice. When used in combination with MQ, AVA had a relevant effect on the in vivo growth inhibition and clinical outcome of P. berghei ANKA-infected mice.

[Peripheral ameloblastic fibrosarcoma]. / Fibrosarcome améloblastique périphérique.

We describe the clinicopathological features of a peripheral ameloblastic fibrosarcoma (PAFS) diagnosed in a 89-years-old man with a past history of recurrent peripheral ameloblastoma. Like other peripheral odontogenic tumors, PAFS shows histological features comparable to those of the central intraosseous form, with (fibro)sarcomatous proliferation associated to benign-appearing ameloblastomatous areas. The differential diagnosis must be made with a low-grade spindle ameloblastic carcinoma and with a collision tumor (a non odontogenic sarcoma associated with a recurrent ameloblastoma). Almost any odontogenic tumor has been observed in the peripheral soft tissues, but our case seems to be, to our best knowledge, the first case of PAFS reported in the literature. This fact can only reflect the rarity of its central counterpart. A particular feature is the old age of our patient (ameloblastic fibrosarcoma usually occurs in adolescent or young adult). Another particular feature is that this PAFS appeared in the contiguity of a recurrent peripheral ameloblastoma. As proposed by many authors, this finding suggests that peripheral odontogenic tumors should require a long-term follow-up and, maybe, a more aggressive initial surgical management.

Osteochondrolipoma of the submandibular region: a case report and review of the literature.

Lipoma is an extremely common and ubiquitous benign soft tissue tumor composed of mature adipose tissue, with frequent differentiation towards other mesenchymal elements such as blood vessels, fibrous tissue, or muscle. They are typically slow-growing, encapsulated, superficial or deep, and have a wide range in size depending on their location. The presence of cartilage or bone is very rare, with most reported cases in the head and neck area. We report the case of an osteochondrolipoma of the submandibular region with associated benign bone marrow elements, with a review of the literature and discussion of the differential diagnosis.

Primitive neuroectodermal tumor of the stomach.

Ewing sarcoma/primitive neuroectodermal tumor is classically a tumor of the soft tissue or bone in children and young adults, but several cases have been described in patients of all ages. Within the last decade, the clinicopathologic spectrum of Ewing sarcoma/primitive neuroectodermal tumor has been markedly expanded by recognition that the tumor may also have a visceral origin. We describe a case of primitive neuroectodermal tumor arising in the stomach of a 66-year-old woman. The neoplasm was excised using a radical surgical procedure. Microscopically, the tumor was made up of solid nests and sheets of round cells. Immunohistochemically, the tumor cells showed immunoreactivity for CD99, S100, neuron-specific enolase, and vimentin. A multiplex real-time polymerase chain reaction assay detected an EWS-ERG fusion. To our knowledge, this is the first description of a primitive neuroectodermal tumor arising in the stomach.