Thoracic dumbbell spinal chordoma mimicking a schwannoma

Background: Epidural dumbbell-shaped chordomas are localized slow growing, and malignant/aggressive neoplasms. Here, we present a 62-year-old male with a T3-T4 dumbbell-shaped chordoma and reviewed the appropriate literature. Case Description: A 62-year-old male presented with a three-month history of thoracic pain. When the thoracolumbar magnetic resonance (MR) showed a T3-T4 dumbbell-shaped intracanalicular/extradural tumor, he underwent tumor removal. After the histological examination proved the lesion was a spinal chordoma, he underwent a secondary radical transthoracic tumor resection. Postoperatively, the patient was able to walk without assistance, and at 6-month follow-up, was neurologically intact with only residual paresthesias. Conclusion: Malignant spinal chordomas may mimic benign neurinomas on MR scans. Here, biopsy of the lesion to confirm the diagnosis of chordoma was critical and directed subsequent definitive transthoracic tumor resection.

Clinical outcome of recurrent endometrial cancer: analysis of post-relapse survival by pattern of recurrence and secondary treatment

IntroductionRecurrence of endometrial cancer is an important clinical challenge, with median survival rarely exceeding 12 months. The aim of this study was to analyze patterns of endometrial cancer recurrence and associations of these patterns with clinical outcome.MethodsThe study included patients with endometrial cancer who underwent primary surgical treatment with or without adjuvant treatment between July 2004 and June 2017 at the Gynaecologic Oncology Unit of one of three tertiary hospitals of the Catholic University Network in Italy with complete follow-up data available. Information on the date and pattern of recurrence was retrieved for each relapse. Post-relapse survival was recorded as the time from the date of recurrence to the date of death or last follow-up. Survival probabilities were compared using log rank tests, and associations of clinico-pathological characteristics with post-relapse survival were tested using Cox’s regression models.ResultsA total of 1503 patients were included in the analysis. We identified 210 recurrences (14.0%) and 105 deaths (7.0%) at a median follow-up of 34 months (range 1–162). One hundred and fifty-eight recurrences (78.1%) occurred during the first two years of follow-up. Most recurrences were multifocal (n=121, 57.6%) and involved extrapelvic sites (n=38, 65.7%). Parameters associated with post-relapse survival in the univariate analysis included histotype, grade, time to recurrence, pattern of recurrence, number of relapsing lesions, and secondary radical surgery. Only the pattern of recurrence and secondary radical surgery were independent predictors of post-relapse survival in the multivariate analysis (p=0.025 and p=0.0001, respectively).ConclusionLymph node recurrence and the feasibility of secondary radical surgery were independent predictors of post-relapse survival in patients with recurrent endometrial cancer.

Critically evaluated propagation rate coefficients for radical polymerizations: acrylates and vinyl acetate in bulk (IUPAC Technical Report)

Arrhenius parameters capturing the temperature dependence of radical polymerization propagation rate coefficients, kp, for methyl acrylate, butyl acrylate, and vinyl acetate in bulk are reported, based on the fitting of benchmark data sets compiled from independent laboratories using the pulsed-laser polymerization/size exclusion chromatography method. The reported kp values for acrylates hold for secondary-radical propagation and are needed to calculate effective propagation rate coefficients in situations where there is a significant population of mid-chain acrylate radicals resulting from backbiting, as will be the case at technically relevant temperatures. The results are compared to those previously reported for styrene and methacrylates to highlight the large differences in kp values seen between the major monomer families.

Stress-induced colouration and crosslinking of polymeric materials by mechanochemical formation of triphenylimidazolyl radicals

Subjecting hexaarylbiimidazole in polymer architectures to stress generates coloured triphenylimidazolyl radicals that initiate secondary radical reactions unifying stress-sensing and damage-repair.