Branchioma is an uncommon benign neoplasm with an adult male predominance, typically occurring in the lower neck region. Different names have been used for this entity in the past (ectopic hamartomatous thymoma, branchial anlage mixed tumor, thymic anlage tumor, biphenotypic branchioma), but currently, the term branchioma has been widely accepted. Branchioma is composed of endodermal and mesodermal lineage derivatives, in particular epithelial islands, spindle cells, and mature adipose tissue without preexistent thymic tissue or evidence of thymic differentiation. Twenty-three branchiomas were evaluated morphologically. Eighteen cases with sufficient tissue were assessed by immunohistochemistry, next-generation sequencing (NGS) using the Illumina Oncology TS500 panel, and fluorescence in situ hybridization (FISH) using an RB1 dual-color probe. All cases showed a biphasic morphology of epithelial and spindle cells with intermingled fatty tissue. Carcinoma arising in branchioma was detected in three cases. The neoplastic cells showed strong AE1/3 immunolabeling (100%), while the spindle cells expressed CD34, p63, and SMA (100%); AR was detected in 40-100% of nuclei (mean, 47%) in 14 cases. Rb1 showed nuclear loss in ≥ 95% of neoplastic cells in 16 cases (89%), while two cases revealed retained expression in 10-20% of tumor cell nuclei. NGS revealed a variable spectrum of likely pathogenic variants (n = 5) or variants of unknown clinical significance (n = 6). Loss of Rb1 was detected by FISH in two cases. Recent developments support branchioma as a true neoplasm, most likely derived from the rudimental embryological structures of endoderm and mesoderm. Frequent Rb1 loss by immunohistochemistry and heterozygous deletion by FISH is a real pitfall and potential confusion with other Rb1-deficient head and neck neoplasms (i.e., spindle cell lipoma), especially in small biopsy specimens.
- MeSH
- branchiom * patologie MeSH
- dospělí MeSH
- hybridizace in situ fluorescenční MeSH
- lidé MeSH
- molekulární biologie MeSH
- nádory brzlíku * MeSH
- nádory glandulární a epitelové * MeSH
- nádory měkkých tkání * patologie MeSH
- nádory sítnice * MeSH
- retinoblastom * genetika patologie MeSH
- thymom * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Branchioma (previously called ectopic hamartomatous thymoma, branchial anlage mixed tumor, or thymic anlage tumor) is a rare lower neck lesion with an adult male predominance and an uncertain histogenesis. Except for 4 cases, all branchiomas described in the literature were benign. Recently, HRAS mutation was detected in one case, but still little is known about the molecular genetic background of this rare entity. We herein report the histological, immunohistochemical, and molecular genetic analysis of a branchioma with a nested/organoid (neuroendocrine-like) morphology in a 78-year-old man. Histology revealed classical branchioma areas merging with nested/organoid cellular component lacking conventional features of malignancy. Immunohistochemistry was positive for high-molecular-weight cytokeratins. CD34 was expressed in the spindle cell component. Moreover, the tumor cells showed near-complete loss of retinoblastoma (RB1) expression (<1% of cells positive). All neuroendocrine markers (synaptophysin, chromogranin, and INSM1) were negative. Next-generation sequencing (TSO500 Panel) revealed 5 pathogenic/likely pathogenic mutations including 1 mutation in KRAS and 2 different mutations in each of MSH6 and PTEN. FISH and DNA sequencing were negative for RB1 gene alterations. To our knowledge, this is the first report of a branchioma showing misleading nested/organoid morphology and the first report on Rb1 immunodeficiency in this entity, in addition to multiple gene mutations revealed by NGS.
- MeSH
- branchiom * patologie MeSH
- lidé MeSH
- nádory měkkých tkání * MeSH
- nádory sítnice * MeSH
- organoidy patologie MeSH
- represorové proteiny MeSH
- retinoblastom * genetika patologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- enukleace oka metody MeSH
- geny retinoblastomu genetika MeSH
- lidé MeSH
- nádory oka diagnostické zobrazování diagnóza klasifikace patologie MeSH
- oční paraneoplastické syndromy diagnóza klasifikace MeSH
- oftalmoskopie metody MeSH
- retinoblastom * chirurgie diagnóza klasifikace patologie MeSH
- uveitida diagnóza MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Cieľ: Kazuistika záchytu choroidálnej neovaskularizácie (CNV) u pacienta v ranom detstve liečeného pre obojstranný retinoblastóm. Materiál a metodika: Pacient v 1,5 roku života liečený na endofytický retinoblastóm 4. štádia (podľa Reese-Ellsworthovej klasifikácie) obojstranne, s pozitívnou mutáciou v Rb1 géne. Po 3-násobnom absolvovaní obojstranného laserového ošetrenia sietnice a 6-tich cykloch systémovej chemoterapie zostal tumor bez aktivity a iných komplikácii. V 14-tich rokoch sa u chlapca objavilo zhoršenie videnia na ľavom oku s prítomnými metamorfopsiami. Na základe lokálneho nálezu a ďalších pomocných vyšetrení mu bola diagnostikovaná CNV v makulárnej oblasti na rozhraní jazvy po tumore a zdravej sietnice ľavého oka. Výsledky: Po troch podaniach anti-VEGF(antibodies blocking vascular endothelial growth factor) preparátu intravitreálne (bevacizumab 1,2 mg) došlo k redukcii CNV a tiež k zlepšeniu zrakových funkcii. Záver: Vitreoretinálne komplikácie po liečbe retinoblastómu nie sú časté, avšak môžu sa vyskytnúť ako dôsledok lokálnej a celkovej liečby tumoru. U nášho pacienta sa jednalo o raritnú komplikáciu so vznikom CNV v dlhšom časovom odstupe od liečby s dobrou reakciou na intravitreálne podanie anti-VEGF preparátu.
Aim: Case report of choroidal neovascularization (CNV) detection in patient who was treated for bilateral retinoblastoma in early childhood. Material and methods: Patient at 1.5 years of age treated for endophytic retinoblastoma stage 4 (according to the Reese-Ellsworth classification) bilaterally, with a positive mutation in the Rb1 gene. After undergoing bilateral retinal laser treatment and 6 cycles of systemic chemotherapy, the tumor remained inactive without other complications. At the age of 14, the boy developed visual impairment in his left eye with metamorphosis. Based on a local finding and other auxiliary examinations, he was diagnosed with CNV in the macular area at the interface of the tumor scar and the healthy retina of the left eye. Results: After three applications of anti-VEGF (antibodies blocking vascular endothelial growth factor) substance intravitreally (bevacizumab 1.2 mg), there was a reduction in CNV and also an improvement in visual function.
- MeSH
- injekce intravitreální MeSH
- lidé MeSH
- mladiství MeSH
- neovaskularizace choroidey diagnóza farmakoterapie komplikace MeSH
- retinoblastom * komplikace terapie MeSH
- vaskulární endoteliální růstový faktor A terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Aim: This study aimed to determine the effects of a single intravitreal ranibizumab injection in rabbits induced with retinoblastoma (RB). Material and Methods: RB was induced in six New Zealand white rabbits by subretinal injection of a cultured WERI-RBb-1 cell line into the right eye. After six weeks, Group A (n = 3) was given intravitreal ranibizumab injection (0.3mg in 0.03ml) and Group B (n = 3) was the control. Baseline and serial clinical examinations were performed on days 1, 3, 6, 12, 15, 18 and 21. The right eyes were enucleated for both groups on day 21 for histopathological examination. Results: The rabbits in both groups developed intraocular lesions which was detectable clinically at one-week post-tumor inoculation. The tumor grew slowly without spontaneous regression. After the animals in Group A were given an intravitreal ranibizumab injection, regression of the tumor was detected clinically, while the tumor in Group B continued to grow slowly. Histopathological findings confirmed the presence of a tumor that closely resembled features of poorly differentiated human RB cells. At the end of 21 days, the size of the tumor was larger in Group B in comparison to Group A. However, the treated group also developed a focal area of retinal hyperplasia. There was no significant side effect of ranibizumab injection except temporary high intraocular pressure immediately post-injection, which was relieved after paracentesis. Conclusions: Intravitreal ranibizumab is a potential treatment for RB. It is an effective therapy with a tolerable safety profile in this animal experimental study.
- MeSH
- inhibitory angiogeneze farmakologie MeSH
- injekce intravitreální MeSH
- králíci MeSH
- modely nemocí na zvířatech MeSH
- nádory sítnice chemicky indukované farmakoterapie MeSH
- ranibizumab * terapeutické užití MeSH
- retinoblastom * chemicky indukované farmakoterapie MeSH
- vaskulární endoteliální růstový faktor A MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- zvířata MeSH
- MeSH
- dítě MeSH
- hemangiom klasifikace patologie MeSH
- lidé MeSH
- melanom klasifikace patologie MeSH
- nádory oka * chirurgie klasifikace patologie radioterapie terapie MeSH
- oftalmologické chirurgické výkony klasifikace MeSH
- radioterapie klasifikace MeSH
- retinoblastom dějiny diagnóza farmakoterapie klasifikace patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- anestetika lokální klasifikace škodlivé účinky terapeutické užití MeSH
- anestezie * metody škodlivé účinky MeSH
- celková anestezie metody škodlivé účinky MeSH
- dítě MeSH
- lidé MeSH
- lokální anestezie klasifikace škodlivé účinky MeSH
- nitrooční tlak účinky léků MeSH
- oční nemoci * chirurgie MeSH
- poranění oka chirurgie MeSH
- předoperační péče MeSH
- premedikace anestezie metody MeSH
- retinoblastom terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- chromozomální aberace klasifikace MeSH
- chromozomální poruchy genetika klasifikace patologie MeSH
- dědičné nemoci očí * genetika klasifikace patologie MeSH
- genetická terapie MeSH
- genetické nemoci vázané na chromozom X genetika MeSH
- genetické poradenství etika metody MeSH
- glaukom genetika MeSH
- lidé MeSH
- multifaktoriální dědičnost MeSH
- oční nemoci genetika klasifikace vrozené MeSH
- repetitivní sekvence nukleových kyselin MeSH
- retinoblastom genetika patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
- MeSH
- lidé MeSH
- nádory sítnice * diagnóza epidemiologie MeSH
- průřezové studie MeSH
- retinoblastom * diagnóza epidemiologie MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Afrika MeSH
Treatment of retinoblastoma (Rb) has greatly improved in recent years in terms of survival and eye salvage rates, using mainly intra-arterial or intravitreal chemotherapy. However, the treatment of vitreous tumor seeding still represents a challenge and it is of great interest to develop new strategies to deliver pharmacologically sufficient drug amounts to the vitreous humor. In the present work, we present a lens-shaped bi-layered hydrogel implant for delivery of topotecan (TPT) via transscleral diffusion. The implant consists of an inner TPT-loaded poly(2-hydroxyethyl methacrylate) (pHEMA) layer adjacent to the sclera and an outer covering poly(2-ethoxyethyl methacrylate) (pEOEMA) layer impermeable to TPT. TPT-loaded pHEMA samples exhibit long-lasting in vitro cytotoxicity against the Rb cell line Y79. In an in vivo experiment, pHEMA/pEOEMA implants are successfully surgically administered to the posterior segment of rabbit eyes. The determination of TPT pharmacokinetics demonstrates the attainment of promising levels of TPT (10 ng/ml) in vitreous humor 8 h after implant placement. The results from the pilot experiment constitute the proof of principle for the use of the proposed implants as a drug delivery system for the local treatment of intraocular diseases.
