A Rare Case of Glioblastoma With Extensive Liver Metastases.

Glioblastoma (GBM), the most common primary brain tumor, is a highly aggressive malignancy for which the median survival is about 13 months, and 5-year survival is well under 5%. These tumors usually occur in the brain and enlarge and infiltrate through white matter, including crossing through the corpus callosum to the opposite cerebral hemisphere. They may spread to distant parts of the central nervous system (CNS) via cerebrospinal fluid pathways. Extraneural metastases from primary brain tumors are quite rare, for 2 probable reasons: because most patients survive less than 2 years, and because of the absence of true lymphatics in the CNS. Typical sites for distant extraneural metastasis of GBM are lungs and pleura, followed by lymph nodes and bones; spread to the liver is exceptional. Most of the reported cases with liver metastases had either single or only a few such metastatic lesions. We report a probably unique case of GBM with extensive liver metastases along with a review of previous cases of liver metastasis from GBM, and we discuss the possible mechanisms of metastasis.

Metastatic Basal Cell Carcinoma Arising From a Primary Cutaneous Carcinosarcoma.

Primary cutaneous carcinosarcoma is a rare malignant tumor composed of both an epithelial and mesenchymal cell population. We present a case of a man, aged 56 years, found to have a 26-mm exophytic lesion on the vertex scalp identified to contain a distinct population of basal cell carcinoma (BCC) as well as another population of spindled cells representing a poorly differentiated sarcomatous component. Five years after the removal of the primary lesion, the patient presented with metastatic BCC to the right scalp, right cervical nodes, lung, and rib. Next-generation sequencing of the lung metastasis was performed, revealing mutation of the patched gene (PTCH1) and prompting treatment with vismodegib (Erivedge). Cases of primary cutaneous carcinosarcoma with a basal cell epithelial component are rare and not much is known about their pathogenesis or clinical course. This case is unique in that metastatic BCC arose from a primary carcinosarcoma in which the carcinomatous component was basal cell. Furthermore, it has clinical significance in the successful use of a selective hedgehog pathway inhibitor.

Enhancing medical research efficiency by using concept maps.

Even with today's advances in technology, the processes involved in medical research continue to be both time consuming and labor intensive. We have built an experimental integrated tool to convert the textual information available to the researchers into a concept map using the Web Ontology Language as an intermediate source of information. This tool is based on building semantic models using concept maps. The labor-intensive sequence of processes involved in medical research is suitably replaced by using this tool built by a suitable integration of concept maps and Web Ontology Language. We analyzed this tool by considering the example of linking vitamin D deficiency with prostate cancer. This tool is intended to provide a faster solution in building relations and concepts based on the existing facts.