An experience in treatment of neurologically silent clival chordoma mimicking a nasopharyngeal tumor

Cranial chordoma is a rare neoplasm that is challenging to both diagnose and manage. We present our experience in treating a case of clival chordoma mimicking a nasopharyngeal mass without any signs of cranial deficits or intracranial insult. Management was comprised of endoscopic transnasal debulking surgery followed by radiotherapy. However, we failed to achieve an oncologic outcome due to the development of lethal central nervous system and respiratory infections 1 month after the surgery.

Cadmium-Associated Molecular Signatures in Cancer Cell Models

The exposure of cancer cells to cadmium and its compounds is often associated with the development of more malignant phenotypes, thereby contributing to the acceleration of tumor progression. It is known that cadmium is a transcriptional regulator that induces molecular reprogramming, and therefore the study of differentially expressed genes has enabled the identification and classification of molecular signatures inherent in human neoplastic cells upon cadmium exposure as useful biomarkers that are potentially transferable to clinical research. This review recapitulates selected studies that report the detection of cadmium-associated signatures in breast, gastric, colon, liver, lung, and nasopharyngeal tumor cell models, as specifically demonstrated by individual gene or whole genome expression profiling. Where available, the molecular, biochemical, and/or physiological aspects associated with the targeted gene activation or silencing in the discussed cell models are also outlined.

Clinicopathological Factors and Prognosis of Massive Hemorrhage After Radiotherapy for Nasopharyngeal Carcinoma

Background: To investigate the clinicopathological factors and prognosis of nasopharyngeal hemorrhage after radiotherapy for nasopharyngeal carcinoma (NPC). Methods: The clinicopathological data of 539 NPC patients who received radiotherapy were analyzed retrospectively, including gender; age; T-stage; N-stage; pathological type; type of radiotherapy; synchronous chemotherapy; secondary-course radiotherapy; radioactive skull base osteonecrosis; diabetes, hypertension, or other systemic diseases; results of nasopharyngeal bacterial culture. Univariate and multivariate analyses were performed using the c2 test and logistic regression. The Kaplan-Meier method was applied to analyze the survival of patients with nasopharyngeal hemorrhage. Results: Among all patients, 64 (11.9%) had nasopharyngeal hemorrhage after radiotherapy. Results from the univariate analysis showed that T-stage (p<0.01), secondary-course radiotherapy (p<0.01), radioactive skull base osteonecrosis (p<0.01), nasopharyngeal bacterial culture results (p<0.01), and nasopharyngeal tumor recurrence (p<0.01) were associated with nasopharyngeal hemorrhage. Multivariate analysis showed that only radioactive skull base osteonecrosis was significantly associated with nasopharyngeal hemorrhage after radiotherapy (OR=41.83, p=0.0001). In patients with internal carotid artery hemorrhage, the survival rate was 60.9% in one year, 15.1% in3 years, and 0% in 5 years. In patients with external carotid artery bleeding, the 5-year survival rate was 50%. The main cause of death during follow-up was rebleeding. Conclusion: The rate of mortality in patients with nasopharyngeal hemorrhage after radiotherapy is high. The presence of radioactive skull base osteonecrosis is the decisive factor in patients with nasopharyngeal hemorrhage after radiotherapy. Influencing and synergistic factors include T-stage, secondary-course radiotherapy, results of nasopharyngeal bacterial culture, and nasopharyngeal tumor recurrence. After successful rescue,arterial embolization or stent implantation may prolong survival.