Retrospective analysis of perianal Paget's disease with underlying anorectal carcinoma

AIM:To analyze clinical and pathological characteristics of an aggressive subtype of perianal Paget's disease(PPD) and explore its rational treatment modalities.METHODS:PPD patients were retrospectively collected in the institutional colorectal database of the Fudan University Shanghai Cancer Center.Detailed patient histories of past medical condition,diagnosis,treatment,and pathological findings were reviewed.Surgical specimen from diagnosis and surgery were reviewed by two independent pathologists for confirmation of diagnoses.Follow up was accomplished by clinical interview by cellphone.RESULTS:In total,eight cases of PPD were analyzed.All patients had underlying anorectal adenocarcinoma,including seven with synchronous lesions and one with metachronous lesions.Moreover,all anorectal lesions had a mucin-producing component.The median age at diagnosis was 65(range 29-81 years),and the male/female ratio was 7:1.The Median follow-up time of all patients was 61.5 mo(range 10-204 mo).One patient treated with abdominoperineal resection(APR) died from lung metastases 10 mo after the APR operation.The other patients are still free of disease at the time of this analysis.CONCLUSION:PPD is a rare malignancy and is easily misdiagnosed.Underlying anorectal cancer was not unusual and was a significant prognostic factor.Rational treatment of both anorectal cancer and PPD lesion is essential for long-term survival.

A single institution, retrospective study of treatment experience in primary mediastinal germ cell tumors： elucidating the significance of systemic chemotherapy

Background Primary malignant germ cell tumors （GCTs） of mediastinum are rare neoplasms.We introduce our institutional experience in managing patients with primary malignant GCTs of the mediastinum,focusing on the analysis of therapeutic modalities.Methods A retrospective review was done in 39 consecutive patients with mediastinal malignant GCTs treated in our institution between 1991 and 2007.Results A total of 39 patients were enrolled in this study with a median age of 27 years.The 5-year overall survival （OS） and progression-free survival （PFS） rates of the whole population were 60.2% and 57.7%,respectively.Stratified by the histology,18 patients （46.2%） had seminoma and 21 patients （53.8%） had nonseminomatous germ cell tumors （NSGCTs）.The 5-year OS rate of patients with seminoma was 87.4% as compared with 36.7% in patients with NSGCTs （P=-0.0004）.The 5-year PFS rate was also significantly higher in seminoma patients （87.4% vs.31.6%,P=-0.003）.For 19 patients with NSGCTs managed with multi-modality treatment,chemotherapy exposure appeared to impact the prognosis.The 5-year OS rate was 44.9% in patients with chemotherapy exposure as compared with 20.0% in patients without it （P=0.43）.Conclusion Our study confirmed the significance of systemic chemotherapy in the treatment of primary mediastinal GCTs.

Prognostic value of lymph node ratio in hypopharyngeal squamous cell carcinoma after chemoradiotherapy

Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution.

Isolated extramedullary ocular relapse of acute lymphoblastic leukemia after peripheral blood stem cell transplantation

Isolated extramedullary ocular relapse of acute lymphoblastic leukemia （ALL） after allogeneic peripheral blood-stem cell transplantation （allo-P-BSCT） without concomitant involvement of the bone marrow is very rare,while the common sites of extramedullary relapse are the central nervous system, skin, bone, and breasts.^1 This is the report of isolated ocular relapse without any extra- ocular involvement of ALL after allo-PBSCT confirmed by histopathology.

CT guidance ^(125)I seed implantation for pelvic recurrent rectal cancer assisted by 3D printing individual non-coplanar template

Objective To analyze the difference of dosimetric parameters between pre-plan and post-plan of 125I radioactive seed implantation assisted by 3D printing individual non-coplanar template（3D printing template）for locally recurrent rectal cancer（LRRC）.Methods From February 2016 to April 2016,a total of 10 patients with locally recurrent rectal cancer received 125I seeds implan-