Jundishapur Journal of Oncology

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Intestinal lymphoma presenting as intermittent bloody diarrhea and abdominal pain
(Brieflands, 2015-12-31) Ali Akbar Shayesteh; Pezhman Alavinejad; Elena Lak
Primary lymphoma of the colon is a rare tumor of the GI tract that comprises only 0.2-1.2% of all colonic malignancies and most commonly involve the cecum followed by the right colon and sigmoid. They can mimic features of ulcerative colitis and in this article we reporting a colonic lymphoma, which misdiagnosed as a refractory IBD. This is a middle- aged man presenting with abdominal pain and bloody diarrhea, which is diagnosed as ulcerative colitis, but due to the refractory symptoms and non-responsiveness, he has undergone further evaluation, which revealed the primary diffuse large B -cell lymphoma of the colon as the main culprit of patients’ symptoms and referred for systemic chemotherapy. Colonic lymphomas can be presented as a mucosal type and characterized by small superficial erosive and hyperemic changes within a mucosal layer that can mimic the features of ulcerative colitis, so in any refractory IBD, their possibility should keep in mind.
Inflammatory Myofibroblastic Tumor of Pelvic Cavity in a 17- Year- Old Girl with Previous History of Wilms’ Tumor: A Case Report
(Brieflands, 2015-12-31) Abdolhassan Talaiezadeh; Nematollah Jazayeri; Esamaeel Naderi; Amir Mardani; Iman Ahrari
Existence of Synchronous or metachronous tumors in one patient is a rare phenomenon. However, some genetically controlled processes can lead to multiple tumors in one patient. Inflammatory myofibroblastic tumor(IMT) is a rare neoplasm that usually happens in the lung and the usual location for extra pulmonary presentation is kidney. In following article we report a 17- year old girl presented with hypo gastric abdominal pain fever and malaise which CT scan showed a huge mass in the pelvic cavity. The patient previously underwent left nephrectomy due to Wilms’ tumor in childhood. The pathology report of the resected pelvic mass showed the spindle cell tumor and inflammatory myofibroblastic neoplasm. Despite improvement in diagnostic procedures, the precise diagnosis of myofibroblastic tumor remains highly dependent on surgery and following pathologic assessments.
Fibroadenoma of axillary ectopic breast tissue: A rare clinical entity
(Brieflands, 2015-12-31) Faramarz Paziar; Sara Zaheri; Iran Rashidi; Soraya Mollaii
Ectopic breast tissues may be affected by the same physiological and pathological alterations seen in the normal breast, including fibroadenoma. Since valid studies describing this anomaly are rare, we decided to report a case of fibroadenoma in axillary breast tissue. We report a 28-year-old nulliparous woman presented with a left axillary lump, for which clinical impression of axillary lymphadenopathy was made for two months. After surgical resection of the nodule, the histology was identical to the fibroadenoma seen in the ectopic breast tissue.The histopathology was identical to the fibroadenomas seen in the ectopic breast tissue and those observed along the milk line. Therefore, fibroadenoma in an ectopic breast tissue must be kept in mind in the differential diagnosis of axillary mass.
Port Implantation and Its Side Effects in Cancer Patients: An Oncology Center Experience
(Brieflands, 2016-12-31) Sasan Razmjoo; Sholeh Arvandi; Seyyed Mohammad Hosseini; Zahra Mazloumi Jalali
Objectives: Port placement is a helpful tool in cancer patients requiring long-term intravenous therapy. However, the tool is used in a small number of patients in Iran due to various reasons, such as no facilities and time, limited access, and poor patient cooperation. This study aims to examine the frequency of port placement and its complications in cancer patients.Methods: In this prospective study, the data of cancer patients who underwent port placement and received chemotherapy were collected from October 2019 to September 2020. Then, we reviewed and analyzed their demographic characteristics, method and frequency of port placement, and the associated complications.Results: Of 2634 patients who received chemotherapy, 50 underwent port placement (1.9%). Of whom, 15 were excluded due to missing data or no access to the patients or their files. In the remaining 35 patients, the most common method of port placement was surgical (91%), and the most common methods of flushing and locking were using distilled water (88%) and heparin (100%), respectively. The frequency of main complications was 20% which included infection (11.4%) and mechanical catheter dysfunction (8.5%). Six patients (17.1%) underwent catheter removal.Discussion: The number of patients who underwent port placement was very low, possibly due to the above reasons. The frequency of complications was low, but it can be further reduced by using better materials and techniques and following port maintenance instructions.
The Association Between H. pylori Antibodies as a Risk of Gastric Cancer and Vitamin D Levels
(Brieflands, 2016-12-31) Mehrdad Haghighi; Amir Mohammad Alborzi; Reza Ghanbari
Objectives: Helicobacter pylori (H. pylori) infection is a significant cause of chronic gastritis. Various studies have reported a link between H. pylori and vitamin D levels. Most showed the effect of serum levels of 25 hydroxy vitamin D (25[OH]D) on the eradication of H. pylori infection. In the present study, we aimed to assess the association between vitamin D serum levels and various types of antibodies against H. pylori infection. It is well recognized that H. pylori infection is the most important risk factor for gastric adenocarcinoma. Furthermore, vitamin D deficiency may be associated with a poor prognosis in gastric cancer.Methods: In the present laboratory-based retrospective study, the medical records of random individuals referred for screening to the Negaresh Pathobiology Laboratory in Tehran, Iran, from 2019 to 2021 were retrospectively reviewed. A total of 196 subjects were eligible for evaluation and were enrolled. The serum concentration of Vitamin D was determined quantitatively via a fully automated enzyme-linked immunosorbent assay (ELISA), and H. pylori IgG, IgM, and IgA antibodies were analyzed quantitatively by using the ELISA microplate reader.Results: According to our results, the serum levels of 25(OH)D did not change significantly in different groups of patients with different levels of H. pylori IgG, IgM, and IgA antibodies.Discussion: The relationship between vitamin D and H. pylori remains to be determined. In conclusion, no significant relationship was identified between the level of vitamin D and the amount of different anti-H pylori antibodies, including IgG, IgM, and IgA.
Effect of Right-to-Left (Isoperistaltic Anastomosis) or Left-to-Right (Antiperistaltic Anastomosis) Gastrojejunostomy Technique on the Delayed Gastric Emptying After the Whipple Surgery
(Brieflands, 2016-12-31) Milad Arabi; Behruz Shayestezadeh; Amin Bahreini
Objectives: Delayed Gastric Emptying (DGE) after the Whipple surgery is a common problem. This study aimed to compare the efficacy of Right to Left (R-to-L) (isoperistaltic anastomosis) gastrojejunostomy versus Left to Right (L-to-R) (antiperistaltic anastomosis) in DGE after the Whipple surgery.Methods: In this clinical trial, 60 patients referred to Golestan and Arvand Hospital in Ahvaz City, Iran, who needed Pancreaticoduodenectomy (PD) or the Whipple procedure were recruited in our study and divided into two groups. The first group underwent gastrojejunostomy with isoperistaltic as R-to-L anastomosis and the second group antiperistaltic as L-to-R anastomosis. The two groups were compared one month after surgery for DGE severity, NPO (Nothing by mouth) duration, hospital stay duration, TPN (total parenteral nutrition) requirement, and rehospitalization requirement.Results: DGE intensity in R-to-L decreased significantly compared to L-to-R (intensity: 5 [16.7%] vs 13 [43.5%]; P
Frequency of histological subtypes and patients’ survival with tumors originating from thymus
(Brieflands, 2015-12-31) Seyed Mohammad Hosseini; Ali Reza Nezami; Puya Nezami; Sasan Razmjoo; Sholeh Arvandi; Hodjatollah Shahbazian
Background: Thymoma is a rare tumor in the mediastinum. Due to the fact that a complete study has not been conducted on thymoma in Khuzestan region, this study was designed as part of a comprehensive study on thymoma in Ahvaz Golestan Hospital.Materials and Methods: This retrospective study was conducted on patients’ medical records with Thymoma attending Department of Radiotherapy and Oncology, Ahvaz Golestan Hospital, in a 10-year period from 2001 to 2011. The study also aimed to investigate the epidemiological data; diagnosis and treatment of patients for the duration of the same time.Results: Among the 26 patients with a mean age of 45.38±SE, ratio of male to female was 5.5 to 1. The majority of the patients were in the range of 30-50 years old which jointly was at 61.8±SE. However, the minimum rate of tumor was seen in decades of 51-60 and 71-80 (7.7 %). In total, 72.7% (n=19) patients had invasive thymoma, while 27.3% (n=8) hadnoninvasive tumor. In addition, there was a significant relationship between invasive thymoma rate and developingmyasthenia gravis. The 3-year survival rate for all patients was equivalent to 83.3%. However; 5-year survival was equal to 71%.Conclusion: According to the study, most patients with invasive thymoma had a 5-year survival rate and also most of them were with myasthenia gravis.
Neoadjuvant Chemotherapy in Local Advanced Gastric Cancer
(Brieflands, 2015-03-31) Abdolhassan Talaiezadeh; Amir Jafar Modirgolestan; Hodjatollah Shahbazian
Background: Gastric cancer remains a major cause of cancer death in Iran despite a significant decreasing inci-dence in western countries. Surgery alone has not been effective for treatment of locoregional gastric cancer be-cause of the low rate of curative resection and high incidence of local recurrence and distant metastases. Our aim was to determine the resectability of tumor after neoadjuvant chemotherapy.
Evaluation of correlation between the expression of p53 as a immunohistochemical marker&prognosis of gastric cancer
(Brieflands, 2015-03-31) Nastaran Ranjbari; Neda Hojatpanah
Background: Gastric cancer is the most common form of gastro intestinal malignancy in certain part of the word and the most common type is Adenocarcinoma. The tumor suppressor gene p53 is a nuclear protein which plays a key role in tumor progression. Therefore in this study, we investigate p53 expression in gastric cancer specimens and possible relationship between this marker and clinical-pathological factors of disease.Materials and methods: This study included 54 patients with primary Adenocarcinoma of stomach whom under- went gastrectomy at the Ahvazs Emam Khomeini hospital. Tumor specimens examined by immuno-histochemical staining with monoclonal antibody against p53. For evaluate value of p53, A stain was considered positive, when %20 of cancer cells showed a positive nuclear staining.Result: P53 marker was positive in 40 cases (%74). Stronger expression of p53 was related with higher grade (p=0/035) and lymph node metastasis (p=0/033). No significant differences were seen between value of p53 marker with age, sex, tumor size, depth of invasion and tumor type. Expression of p53 was not correlated with vascular and neural invasion or involvement of margins (p≥0.05).Conclusion: In gastric cancer, the expression of p53provides significant information about prognosis and evalua- tion of p53 level could be a useful tool in identification of patients with more aggressive disease.
Evaluation of 2 and 5 years survival rate of breast cancer in patients raffered to radiothrapy ward of Ahvaz Golestan hospital in 2001-2007
(Brieflands, 2015-03-31) Seyed Mohammad Hosseini; Hodjatollah Shahbazian; Akram Jalili; Sholeh Arvandi; Sasan Razmjoo
Background: Cancers are in to accounted as chronic diseases that in many countries for recent decades have high rates of mortality. One of the most common cancers is breast cancer which is the second leading cause of cancer death in women after lung cancer. This study was performed to examine the 2-year and 5-year survival rate in pa- tients with metastatic breast cancer referring to Ahvaz Golestan Hospital Radiotherapy and oncology Department for the period of 2001-2007.Materials and methods: This study was a retrospective investigation and the studied population was the patients who had been hospitalized with breast cancer in Ahvaz Golestan Hospital Radiotherapy and oncology Department. The duration of patients’ survival rate was evaluated by obtaining the data from the archives, records and tele- phone calls.Results: In this study, a total number of 352 patients were studied for breast cancer. The most patients were in the age range of 40-49 years with the prevalence percentage of 38.6. The less than 2 year survival rate was 47%, 2-year survival rate of 41.5% and 5-year survival rate of 11.5%, respectively. The frequency percentage of bone metastasis only was 40.3% however; the 59.7% was recorded for visceral metastasis.Conclusion: Given the study results the survival rate of patients with over time was fewer so that, with 2-fold time, the survival rate was decreased to about one third to one quarter. In addition, the incidence of bone metastasis was associated with a better prognosis.
Histological Subtype and Stage Study of Lung Cancers in Patients Referred to Radiotherapy and Oncology Department from Ahvaz Golestan Hospital for the duration of 2001-2011
(Brieflands, 2015-03-31) Seyed Mohammad Hosseini; Sasan Razmjoo; Nasibeh Noshadi; Sholeh Arvandi; Hodjatolah Shahbazian
Background: Lung cancer is the main leading cause of cancer deaths in men and the second leading cause of cancer death for women in worldwide. This study, explains the subtypes histological study of lung cancers in patients admitted to Ahvaz Golestan Hospital.Materials and methods: Data from the records of all patients with primary lung cancer that their disease was diag- nosed during the years of 2001 to 2011 were collected and coded to be analyzed by SPSS software version 20. Result: Over the 11-year of study a total number of 483 lung cancer cases were identified. Of which, 13% were SCLC and 64.4% NSCLC. A total number of 141 of the patients were female and 372 male. The most common subtype among men was SCC while adenocarcinoma was the most frequent subtype among women. The mean age of patients with SCLC, 63.16 years and in the case of NSCLC was 63 years.Conclusion: The obtained results from this study showed that there was not a significant relationship for the pro- cess of changing in the subtype’s frequency, the male and female sex ratio as well as the mean age of patients.
A Gastric Volvulus After the Whipple Procedure in a Pancreatic Cancer: A Case Report
(Brieflands, 2016-12-31) Amin Bahreini; Mohsen Yousefzadeh; Behruz Shayestaezadeh; Khalil Kazemnia
Vomiting and delayed gastric emptying are common complications after the Whipple surgery. In our patient, this complaint was related to gastric volvulus. Gastric volvulus is a life-threatening condition characterized by an abnormal rotation of the stomach around an axis. The first line of treatment for this disorder is surgical. We present a 67 years old male patient with a history of pancreatic cancer status after the pylorus-preserving Whipple procedure. The patient presented with nausea and vomiting after surgery. Computed tomography revealed a normal anatomic structure without any abscess or hematoma. In the barium swallow study, partial stenosis in the anastomosis site and delayed stomach emptying was diagnosed. On the 23rd day after the first surgery, we performed a detorsion of the stomach with a gastric volvulus diagnosis. Gastric volvulus could be a complication of pancreatoduodenectomy, and performing gastropexy during the Whipple surgery may prevent this complication. For evaluating treatments, best diagnostic studies, and risk factors, more studies are needed.
Different Features of the Regulatory T Cells in Gastrointestinal Tract Cancers and Disorders
(Brieflands, 2016-06-30) Marziye Norozian; Abbas Ghaderi
Regulatory T cells (Treg) located in tissues have a critical role in controllinghomeostasis and immune responses also modulate nonimmunological processes.The T cell receptor repertoires of non-lymphoid tissue Tregs are distinct from Tregs in lymphoid organs.Less information is available about various ways to change the program of transcription in tissue-resident subsets of Treg cellsfor adapting to very different fields. However, recent progress in our understanding of Treg cells that reside in two important sites, the gut and adipose tissue, may provide some clues. Gastrointestinal is the largest reservoir for tissue-resident Treg cells in the body. Adequate number and performance of intestinal Treg cells are essential for maintaining normal intestinal immune homeostasis.Treg in the GI tract have shown conflicting features. Therefore, in this study, phenotypic and functional characteristics of Treg cells are discussed in normal conditions, chronic inflammatory bowel disease (IBD) and colorectal cancer (CRC), as well as Treg cell therapeutic strategies in the treatment of these diseases.
Neoadjuvant Chemoradiotherapy for Advanced Rectal Cancer
(Brieflands, 2016-06-30) Abdolhassan Talaiezadeh; Hodjatollah Shahbazian; Mohammad Hosein Sarmast Shushtari; Seyyed Mohammad Hoseini; Seyyed Saheb Hoseininejad
Background: There is some evidence that neoadjuvant chemoradiation for stages II and III rectal tumors associated with significant greater rate of complete pathologic response and sphincter preservation. The aim of this study was to determine the outcome of neoadjuvant chemoradiation in patients with advanced rectal cancer.Materials and Methods: In this retrospective investigation, the medical records of all patients with stage II or III that underwent neoadjuvant chemoradiation (during 2005-2010) were studied. Radiotherapy was delivered by 4500-5000cGy/25-28f for 25-28 sessions, and oral 5-FU and weekly injected Eloxatin were administered. Then, all patients underwent surgery by one expert oncologist surgeon. Data include demographic data, the kind of operation, the rate of pathologic complete response and clear surgical margins and sphincter preservation were collected. Data were analyzed with SPSS software version 14.Results: Among70 patients, the mean age was 46±13 years and 71.5% of them were male.Ten percent had the pathologic complete response, 60% had clear surgical margins. Sphincter preservation rate in cases which the distance of the tumor from anal verge was five cm or more and in cases which it was less than five cm were 51.4% and 5.6%, respectively.Conclusion: Our results indicated that neoadjuvant chemoradiation recommended for patients with the stages II and III rectal cancers. The advantages of this modality are relatively higher chance of complete response and anal sphincter saving procedure.
Dermoid cyst of the cecum: case report
(Brieflands, 2016-06-30) Abdolrahim Nahidi; Seyed Nematollah Jazayeri; Payman Fathizadeh
Dermoid cyst, also known as mature teratoma is a benign neoplasia of germ cells and usually is seen in female or male gonads (ovary or testis). Beside gonads, dermoid cysts sometimes are seen in midline of the body such as sacrocoxygeal area in children or mediastinum, but it is very rare in gastrointestinal tract. The origin of all teratom (either mature as benign or immature as malignant) is germ cells which are derived from the primary yolk sac in 3rd week of gestation and migrate to primitive sex cord via primary GI tract and dorsal mesentery. Gastrointestinal tract is an unusual site for dermoid cyst to occur. To the best of our knowledge only five cecal dermoid cysts have been reported in the English medical literature since now. We report a dermoid cyst in the cecum of 41 years-old female, causing diagnostic confusion with ovarian tumor.
Unusual Metastatic Malignant Gastric Glomus Tumor (Glomangiosarcoma): A Case Report and Literature Review
(Brieflands, 2016-12-31) Abdolhassan Talaiezadeh; Mohammad Nejaty; Nematollah Jazayeri
Glomangiosarcoma is a pericytic neoplasm derived from glomus cells. It is a rare tumor, especially within the gastrointestinal tract. We report a female patient around 67 years old with a history of gastrectomy surgery due to a submucosal glomus tumor. After 4 years of surveillance, the patient came with thigh and hepatic metastases with the same histology (metastatic glomangiosarcoma).
Relationship between the ABO blood groups and Breast cancers
(Brieflands, 2015-12-31) Faramarz Paziar; Sara Zaheri; Iran Rashidi; Neda Shirkhani; Hamid Reza Aslani; Mehrdad Dargahi Malamiri
Background: Breast cancer is the most common cancer among women. However, the mortality rates are falling slightly for some subpopulations; it is still a potentially lethal adversary. The relationship between ABO/Rh blood group and breast cancer has been assessed previously, but background information is few and the role of blood group as a prog- nostic factor remains controversial.Materials and Methods: In this retrospective study, a self-administered questionnaire was used to collect the infor- mation from patients with breast cancer during 2008-2010.Results: Totally 59 women with breast cancer were enrolled in this study. Mean age was 48.5±11.8 (25-80) years old. The distribution of ABO blood-grouping blood- were as follows: blood group type O: 19; A: 25; B: 8; and AB: 7.56. Anumber of patients had positive Rh. Lymph node involvement and distant metastasis were found in 26 of them; there- fore, there was a positive correlation between regional lymph node metastasis and ABO (p>0.05). The mean of the long-est diameter of the tumor was 1.5-6. The distribution of ABO and Rh blood-grouping did differ according to age of pa- tients.Conclusion: We conclude that the role of blood groups as risk factors for breast cancer should be considered togetherwith other risk factors. However, based on our results, there are significant associations between Rh blood group and the breast cancer and lymph node metastasis.
Small intestine gastro-intestinal stromal tumor mimicking an ovarian mass
(Brieflands, 2016-06-30) Maryam Esfehani; Azar Ahmadzadeh; Masoud Hedayat
Gastrointestinal stromal tumors (GISTs) are rare tumors affecting the gastro-intestinal tract. These tumors tend to grow large and may elicit clinical symptoms due to their mass effect. On occasions, due to their propensity toward the pelvis, they may mimic genitourinary lesions. In this article, we present a young lady diagnosed pre-operatively to have an ovarian neoplasm which turned intra-operatively to originate from small intestine and proved histo-pathologically to be GIST. Pertinent literature and tricks to diagnose such lesions are discussed in detail.
Screening for thyroid cancer
(Brieflands, 2015-12-31) Abdolhassan Talaiezadeh
Outcome and Complications of Crush Clamp and Ultrasonic Dissection Techniques in Hepatectomy of Patients With Hepatic Mass
(Brieflands, 2016-12-31) Amin Bahreini; Parisa Naviafar; Khalil Kazemnia
Objectives: Perioperative hemorrhage and postoperative bile leakage are important complications of hepatectomy. Various methods have been reported to reduce intraoperative bleeding during liver transection. We designed a randomized clinical trial to compare the outcomes and complications between Crush Clamp (CC) and ultrasound dissection methods (the Cavitron Ultrasonic Surgical Aspirator, CUSA) in liver transection.Methods: Twenty patients underwent hepatectomy with the crush clamp method, and 20 underwent ultrasonic dissection. The surgical outcome and complications, including duration of the surgery, bleeding, packed cells requirement after the operation, bile leakage, hospital stay, and hepatic failure, were evaluated and compared.Results: Mean blood loss during the operation in the CUSA group was less than CC group, but this loss was not significant (247±77.1 in CC vs 232.2±84.3 mL in CUSA, P=0.769). The operation time in the CC group was longer than in the CUSA group, but this difference was not significant (171.3±55.1 min in CC vs 163.1±74.2 min in CUSA; P=0.72). The duration of transection in patients of the CC group was significantly less than that in the CUSA group (47.5±21.1 min for CC vs 77.6±30.4 min for CUSA, P=0.06), and the length of hospitalization in the CC group was significantly less than CUSA group (1.9±0.7 day for CC vs 2.8±1.1 day for CUSA, P=0.016). There were no cases of infection and bile leakage in the two groups.Discussion: Postoperative complications did not differ in the two groups, but the duration of transection in crush clamp was shorter than the ultrasonic dissection method, and blood loss was almost identical. Because ultrasonic dissection is an equipmentdependent procedure and more expensive, we tend to perform liver transection with the crush clamp method.

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