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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 6 | Issue 2
Page Nos. 25-47

Online since Friday, August 21, 2020

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ORIGINAL ARTICLES  

Characteristics and outcome of patients with pheochromocytoma p. 25
Nadeema Rafiq, Tauseef Nabi, Sajad Ahmad Dar, Shahnawaz Rasool
DOI:10.4103/ctm.ctm_5_20  
Aim: Pheochromocytomas are rare neuroendocrine tumors with variable clinical presentation, including hypertension, and usually arise from the adrenal medulla. The aim of the current study was to evaluate the clinical characteristics and therapeutic outcomes of patients with pheochromocytoma. Methods: This was a single-center retrospective observational study designed to study the clinical, laboratory, radiological, and surgical outcomes of 14 patients diagnosed with pheochromocytoma. Results: Of 14 patients, 10 were females and 4 males, with a mean age of 38 ± 16 years at diagnosis. Headache (96.6%), palpitation (64.3%), abdominal pain (64.3%), and sweating (57.1%) were the most common presenting symptoms, while triad was present in 42.8%. Hypertension was the predominant clinical finding (92.8%) followed by orthostasis in 35.7% and hyperglycemia in 35.7%. Most pheochromocytomas were sporadic (85.7%), adrenal gland tumors (78.6%), and benign (92.8%); two were familial (each due to neurofibromatosis type and von Hippel–Lindau). Metanephrine and nor-metanephrine secretory pattern was seen in 58.3% of the patients, while metanephrine only was seen in 41.7% of the patients. More than half of the tumors (54.5%) were located on the left side, with 36.4% on the right side, and one patient had bilateral presentation of a tumor. Postsurgical remission of hypertension was found in 35.7% of the hypertensive patients. Biochemical cure was obtained in 85.7% and surgical cure rate in 78.5% of the patients. Patient survival ranged from 2 months to 9 years. Conclusions: The present study confirms that the clinical presentation of pheochromocytoma is variable and nonspecific. Although pheochromocytoma is a rare tumor, proper evaluation, preoperative preparation, and complete surgical excision are important for its management.
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Comparison of histopathological grading and staging of breast cancer with p53-positive and transforming growth factor-beta receptor 2-negative immunohistochemical marker expression cases p. 30
Palash Kumar Mandal, Anindya Adhikari, Subir Biswas, Amita Giri, Arnab Gupta, Arindam Bhattacharya
DOI:10.4103/ctm.ctm_4_20  
Background: Immunohistochemical analysis of biomarkers is essential to understand the nature of breast cancer (BC) and predict its prognosis. A noticeable correlation is found between p53-positive and transforming growth factor-beta receptor 2 (TGFBR-2)-negative immunomarker expression in BC cases. Materials and Methods: Between January 2018 and December 2018, immunohistochemical analysis of p53 and TGFBR-2 biomarkers was done in biopsy samples from 50 BC cases (49 females and 1 male). Results: p53 expression was positive in 24 (48%) and negative in 26 (52%) cases. Similarly, TGFBR-2 expression was positive in 26 (52%) and negative in 24 (48%) cases. Among p53-positive cases, 8 (16%), 15 (30%), and 1 (2%) cases correlated with histologic Grade 1, Grade 2, and Grade 3 cases, respectively. Among TGFBR-2-negative cases, 9 (18%), 13 (26%), and 2 (4%) cases correlated with histologic Grade 1, Grade 2, and Grade 3 cases, respectively. Further, Grade 2 cancer cases were found mostly associated with both p53-positive and TGFBR-2-negative cases. Maximum p53positive cases was in T2N1Mx stage while maximum TGFBR-2-negative cases were in T2N0Mx stage. Conclusion: p53-positive and TGFBR-2-negative cases are mostly associated with Grade 2 and T2 stage of BC.
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Chemical compositions and antiproliferative effect of essential oil of asafoetida on MCF7 human breast cancer cell line and female wistar rats p. 34
Seyyed Majid Bagheri, Davood Javidmehr, Mohammad Ghaffari, Ehsan Ghoderti-Shatori
DOI:10.4103/ctm.ctm_36_19  
Background: Breast cancer is a leading cause of cancer-associated mortality in women, and the incidence is on the rise worldwide. Asafoetida has shown a good anti-cancer activity against breast cancer in both in vivo and in vitro studies. Materials and Methods: For the evaluation of the cytotoxic effect of essential oil of asafoetida (EOA), MCF7 cells, a highly invasive variant of human breast cancer cell line, were exposed to different concentrations of EOA (2, 4, 6, 8, and 10 μl/ml) over different periods (24, 48, and 72 h), followed by cell viability analysis using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. For determining thein vivo toxicity of EOA, the oil was administered orally at doses of 0.1, 1, 10, and 100 μl/kg for 28 days in female Wistar rats. After completion of the experiment, hematological and serum biochemical parameters were evaluated and compared to the untreated group. Results: MTT assay results showed that EOA significantly decreased the viability of MCF7 cells in a time- and concentration-dependent manner, demonstrating a strong cytotoxic effect of EOA on breast cancer cells. In chronic toxicity study, the female Wistar rats showed no change in hematological and biochemical parameters at any of the administered dose. Conclusions: The cytotoxic effect of EOA on breast cancer cells, without general toxicity, makes it a promising compound as adjuvant therapy for breast cancer.
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HYPOTHESIS Top

Cyclooxygenase-2 contributes to mutant epidermal growth factor receptor lung tumorigenesis by promoting an immunosuppressive environment p. 40
Mun Kyoung Kim, Aidin Iravani, Matthew K Topham
DOI:10.4103/ctm.ctm_7_20  
Targeted therapies reduce growth of mutant epidermal growth factor receptor (EGFR) non-small cell lung cancers, but most patients develop drug resistance. This has led to efforts to develop additional therapies. We found abundant activation of the cyclooxygenase-2 (COX-2) axis in a mouse model of mutant EGFR lung cancer. Inhibiting COX-2 in the mice significantly reduced lung tumor growth, and dual targeting of COX-2 and EGFR had more pronounced effects. Collectively, our data and published data have led us to hypothesize that COX-2 contributes to mutant EGFR lung tumorigenesis, in part, by promoting an immunosuppressive environment that facilitates tumor progression.
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