Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunoc...Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunocompromised or previously irradiated patients. These are part of a spectrum of more aggressive fibro-histiocytic neoplasms. In the older literature, these have been termed aggressive or metastatic AFX, but currently these have been reclassified as pleomorphic dermal sarcomas (PDS) and systemic undifferentiated pleomorphic sarcoma (UPS, formerly malignant fibrohistiocytic sarcoma, MFH). We present the case of a 64-year old woman who developed a deeply invasive PDS on the vertex of her scalp invading to the galea, with in-transit scalp metastases. Very little information is available about optimal treatment of metastatic PDS lesions. The patient was initially treated with 2 cycles of epirubicin/ifosfamide chemotherapy, resulting in life-threatening complications. A pretreatment peripheral blood sample was sent for CTC-derived colony assay. This sample grew 8 colonies from 10 ml blood. The tumor failed to respond to epirubicin and ifosfamide, and after several months of hospitalization, a second peripheral blood CTC-derived colony assay grew >376 colonies. The patient could not tolerate additional chemotherapy. She was therefore treated with the oral targeted agent pazopanib. The patient developed a dramatic biopsy-confirmed complete response. After 11 months of pazopanib treatment, a repeat CTC-derived culture sample grew only 8 colonies/10 ml blood. The complete response to pazopanib is still ongoing at over 41 months. To our knowledge, this is the first demonstration of clinical complete response of a PDS tumor following targeted therapy. An additional novel feature was the demonstration that CTC-derived colonies could be grown from the blood of a PDS patient. The number of colonies appeared to correlate with the clinical treatment response and seemed to function as a potential prognostic marker.展开更多
目的：研究丹参酮ⅡA磺酸钠对雌激素受体（ER）、表皮生长因子受体‐2（HER‐2）表达不同的人乳腺癌细胞株（MCF‐7、SKBR‐3、MDA‐MB‐231）的作用，并探讨其作用机制。方法：以0．025～0．8μg／ml不同浓度丹参酮ⅡA磺酸钠处理MCF‐7...目的：研究丹参酮ⅡA磺酸钠对雌激素受体（ER）、表皮生长因子受体‐2（HER‐2）表达不同的人乳腺癌细胞株（MCF‐7、SKBR‐3、MDA‐MB‐231）的作用，并探讨其作用机制。方法：以0．025～0．8μg／ml不同浓度丹参酮ⅡA磺酸钠处理MCF‐7、SKBR‐3、MDA‐MB‐231细胞，MTT法测定不同浓度丹参酮ⅡA磺酸钠对三种乳腺癌细胞株细胞增殖的抑制作用，流式细胞仪检测细胞凋亡及细胞周期。结果：丹参酮ⅡA磺酸钠处理后，MCF‐7细胞增殖活性降低，凋亡指数升高，细胞周期分布改变，G0／G1期细胞数增加，S期和G2／M期细胞数减少；SKBR‐3和MDA‐MB‐231细胞增殖活性、细胞凋亡及细胞周期无明显改变。结论：丹参酮ⅡA磺酸钠对ER阳性乳腺癌细胞具有生长抑制作用，其作用机制可能与凋亡诱导、细胞周期阻滞有关；丹参酮Ⅱ A 磺酸钠对ER阴性、HER‐2阳性和ER阴性、HER‐2阴性乳腺癌细胞无明显生长抑制作用。展开更多
文摘Atypical fibroxanthomas (AFX) are rare skin tumors. These generally are superficial tumors, usually <3 cm red, fleshy, ulcerated skin lesions, that characteristically occur on sun-damaged skin, sometimes in immunocompromised or previously irradiated patients. These are part of a spectrum of more aggressive fibro-histiocytic neoplasms. In the older literature, these have been termed aggressive or metastatic AFX, but currently these have been reclassified as pleomorphic dermal sarcomas (PDS) and systemic undifferentiated pleomorphic sarcoma (UPS, formerly malignant fibrohistiocytic sarcoma, MFH). We present the case of a 64-year old woman who developed a deeply invasive PDS on the vertex of her scalp invading to the galea, with in-transit scalp metastases. Very little information is available about optimal treatment of metastatic PDS lesions. The patient was initially treated with 2 cycles of epirubicin/ifosfamide chemotherapy, resulting in life-threatening complications. A pretreatment peripheral blood sample was sent for CTC-derived colony assay. This sample grew 8 colonies from 10 ml blood. The tumor failed to respond to epirubicin and ifosfamide, and after several months of hospitalization, a second peripheral blood CTC-derived colony assay grew >376 colonies. The patient could not tolerate additional chemotherapy. She was therefore treated with the oral targeted agent pazopanib. The patient developed a dramatic biopsy-confirmed complete response. After 11 months of pazopanib treatment, a repeat CTC-derived culture sample grew only 8 colonies/10 ml blood. The complete response to pazopanib is still ongoing at over 41 months. To our knowledge, this is the first demonstration of clinical complete response of a PDS tumor following targeted therapy. An additional novel feature was the demonstration that CTC-derived colonies could be grown from the blood of a PDS patient. The number of colonies appeared to correlate with the clinical treatment response and seemed to function as a potential prognostic marker.
文摘目的：研究丹参酮ⅡA磺酸钠对雌激素受体（ER）、表皮生长因子受体‐2（HER‐2）表达不同的人乳腺癌细胞株（MCF‐7、SKBR‐3、MDA‐MB‐231）的作用，并探讨其作用机制。方法：以0．025～0．8μg／ml不同浓度丹参酮ⅡA磺酸钠处理MCF‐7、SKBR‐3、MDA‐MB‐231细胞，MTT法测定不同浓度丹参酮ⅡA磺酸钠对三种乳腺癌细胞株细胞增殖的抑制作用，流式细胞仪检测细胞凋亡及细胞周期。结果：丹参酮ⅡA磺酸钠处理后，MCF‐7细胞增殖活性降低，凋亡指数升高，细胞周期分布改变，G0／G1期细胞数增加，S期和G2／M期细胞数减少；SKBR‐3和MDA‐MB‐231细胞增殖活性、细胞凋亡及细胞周期无明显改变。结论：丹参酮ⅡA磺酸钠对ER阳性乳腺癌细胞具有生长抑制作用，其作用机制可能与凋亡诱导、细胞周期阻滞有关；丹参酮Ⅱ A 磺酸钠对ER阴性、HER‐2阳性和ER阴性、HER‐2阴性乳腺癌细胞无明显生长抑制作用。
