Suppression of tumor development by another tumor in primary immunodeficiency in experiment.

e21583 Background: Multiple primary malignant tumors (MPMTs) are characterized by the presence of several primary neoplasms in one patient. The purpose of the study was to create an experimental model of MPMTs with one dominating tumor. Methods: The study included 21 female BALB/c Nude mice. The main group included mice with simultaneous subcutaneous inoculation of tumors: Guerin's carcinoma (0.5 million tumor cells in 0.5 ml of saline solution) under the right scapula and B16/F10 melanoma (0.5 ml of suspension diluted 1:20 in saline solution) under the left scapula. Control groups included females with melanoma or carcinoma inoculated at the same dosage and volume as in the main group. Results: In a MPMT model, tumors appeared 3 times faster than in controls and demonstrated larger volumes: melanoma – by 7.5 times, carcinoma – by 2.2 times; the survival of mice with MPMTs decreased. Carcinoma in a MPMT model metastasized to melanoma and almost completely suppressed its growth. Melanoma was represented by a small “island” of tumor tissue 3-4 mm in diameter and was located just under the skin at the site of injection of melanoma cells. The light part of the same loose pasty consistency as the dark part, with a diameter of 6-7 mm, was located around the dark “center” of melanoma. The rest part of the tumor located under the left scapula looked like an elongated grayish-pink node of a dense elastic consistency - just like the tumor located under the right scapula, which was much larger in volume. The right and left tumors did not merge with each other; there was a small distance of about 2-3 mm between them. A small lesion of caseous necrosis, 6–7 mm in diameter, was recorded in the center of the right tumor node of Guerin's carcinoma; there was no necrosis in the left tumor. Smaller size, the absence of necrosis and visually more “young” carcinoma tissue on the left indicated its later appearance than that on the right, which, in combination with the remnants of melanoma fused to the left tumor and the absence of “contact” between the left tumor and the right one, indicated the metastatic nature of Guerin’s carcinoma on the left. B16/F10 melanoma did not metastasize. Conclusions: In simultaneous subcutaneous inoculation of murine B16/F10 melanoma and rat Guerin’s carcinoma to female BALB/c Nude mice, carcinoma cells metastasized to melanoma and suppressed its growth.

Germinal GLT8D1, GATAD2A and SLC25A39 mutations in a patient with a glomangiopericytal tumor and five different sarcomas over a 10-year period

Soft tissue sarcoma represents about 1% of all adult cancers. Occurrence of multiple sarcomas in a same individual cannot be fortuitous. A 72-year-old patient had between 2007 and 2016 a glomangiopericytal tumor of the right forearm and a succession of sarcomas of the extremities: a leiomyosarcoma of the left buttock, a myxofibrosarcoma (MFS) of the right forearm, a MFS of the left scapula, a left latero-thoracic MFS and two undifferentiated sarcomas on the left forearm. Pathological examination of the six locations was not in favor of disease with local/distant recurrences but could not confirm different diseases. An extensive molecular analysis including DNA-array, RNA-sequencing and DNA-Sanger-sequencing, was thus performed to determine the link between them. The genomic profile of the glomangiopericytal tumor and the six sarcomas revealed that five sarcomas were different diseases and one was the local recurrence of the glomangiopericytal tumor. While the chromosomal alterations in the six tumors were different, a common somatic CDKN2A/CDKN2B deletion was identified. RNA-sequencing of five tumors identified mutations in GLT8D1, GATAD2A and SLC25A39 in all samples. The germline origin of these mutations was confirmed by Sanger-sequencing. Innovative molecular analysis methods have made possible a better understanding of the complex tumorigenesis of multiple sarcomas.

Germinal GLT8D1, GATAD2A and SLC25A39 mutations in a patient with a glomangiopericytal tumor and five different sarcomas over a 10-year period

Soft tissue sarcoma represents about 1% of all adult cancers. Occurrence of multiple sarcomas in a same individual cannot be fortuitous. A 72-year-old patient had between 2007 and 2016 a glomangiopericytal tumor of the right forearm and a succession of sarcomas of the extremities: a leiomyosarcoma of the left buttock, a myxofibrosarcoma (MFS) of the right forearm, an MFS of the left scapula, a left latero-thoracic MFS and two undifferentiated sarcomas on the left forearm. Pathological examination of the six locations was not in favor of disease with local/distant recurrences but could not confirm different diseases. An extensive molecular analysis including DNA-array, RNA-sequencing and DNA-Sanger-sequencing, was thus performed to determine the link between them. The genomic profile of the glomangiopericytal tumor and the six sarcomas revealed that five sarcomas were different diseases and one was the local recurrence of the glomangiopericytal tumor. While the chromosomal alterations in the six tumors were different, a common somatic CDKN2A/CDKN2B deletion was identified. RNA-sequencing of five tumors identified mutations in GLT8D1, GATAD2A and SLC25A39 in all samples. The germline origin of these mutations was confirmed by Sanger-sequencing. Innovative molecular analysis methods have made possible a better understanding of the complex tumorigenesis of multiple sarcomas.

No Directional Scapular Asymmetry among Tamarines of the Genus Saguinus (Primates: Callitrichidae)

Bilateral asymmetry is defined as a deviation of a whole organism or a part of it from a perfect symmetry, and different categories can be recognized. One is the fluctuating asymmetry, defined as the random developmental variation of a trait (or character) that is expected to be perfectly symmetrical on average, and the other one is directional asymmetry, which occurs when one of the sides shows stronger morphological structures or marks than the other. The aim of this study was to determine the kind of scapula asymmetry in Saguinus scapulae. On lateral surface of each right and left scapula, a set of 5 landmarks and 3 curves with semi-landmarks along the margins, on a sample of 16 pairs from different Saguinus species, were considered. Asymmetries (fluctuating and directional) on size and shape of the scapulae were analysed by means of geometric morphometric methods. Directional asymmetry was not detected, demonstrating no side scapular shape bias. The absence of significant directional asymmetry may indicate a similar contralateral pattern of employment of the shoulder, at least for one-arm vertical suspension, as it needs stronger forces than those for terrestrial locomotion and thus would cause more asymmetry in case side loadings were different. To our knowledge, this is the first investigation on the symmetrical/asymmetrical nature of scapulae in Saguinus. Our findings increase knowledge and understanding of humeral joint and arboreal locomotion in primates.

Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence

Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injection-associated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.

A Case of Premature Closure

This case describes a young male who is brought to the emergency department of a major teaching hospital at night by friends. He has multiple stab wounds to the upper back, arms, and scalp. He is seen by the chief emergency resident. He has one laceration on his left scalp, two on the left arm, and one inferior to the left scapula. The resident’s main concern is the laceration to the patient’s posterior chest. Eventually, in consultation with the attending emergency physician, he is satisfied that the patient’s pleural cavity has not been entered and did not require a chest computed tomography scan. His lacerations are repaired, and he is discharged home with his mother. Several days later, the patient starts experiencing symptoms from a major missed diagnosis.

Neuroma of the Dorsal Rami in the Back and Its Surgical Treatment: A Case Report

A neuroma is a benign tumor caused by irregular or disorganized regeneration of nerve tissue after nerve injury. It sometimes causes severe symptoms and thus deteriorates the quality of life. There are few reports of truncal neuromas and its surgical treatment with the outcome. The authors report a case of a surgically improved traumatic neuroma in a 77-year-old man presented with dysesthesia of the back skin medial to the left scapula.