Following commencement of the UK Bowel Cancer Screening Pilot, there has been a significant decline in emergency CRC workload with a marked improvement in 30-day mortality and decreased stoma formation, in Coventry and North Warwickshire. It is postulated that the witnessed and notable positive impact over such a short time period is the result of increased detection of asymptomatic malignancies within the screening programme, increased public awareness of the symptoms of CRC, together with a change in attitudes and referral patterns of general practitioners within Coventry and North Warwickshire.
Malignant eccrine spiradenomas are exceedingly rare tumours. They are aggressive tumours normally arising in long-standing benign eccrine spiradenomas. We present a case of malignant eccrine spiradenoma of the right side of the face with direct intracranial extension without distant metastasis. A 48 years old woman presented with a large exophytic tumour on the right side of her face. Radiological imaging of the head and neck region revealed extensive invasion of the facial tissues around right orbit, maxilla and extension into the middle cranial fossa involving the right temporal lobe. She underwent craniotomy and debulking of the right temporal lobe and biopsy of the facial tumour. Histopathological findings were consistent with malignant eccrine spiradenoma. This is a rare case of facial malignant eccrine spiradenoma with direct intracranial extension with no distant metastasis. A literature search revealed that it is first case to be reported of this kind.KeywordsEccrine carcinoma; Spiradenoma; Adnexal carcinoma; Malignant eccrine spiradenoma
There is currently an ongoing debate regarding the time to surgery (TS) following neoadjuvant chemotherapy in patients with breast cancer and its effect on survival outcomes. There are three retrospective studies suggesting that the ideal interval is as low as 21 days, 40 days and up to 8 weeks. To date, to the best of our knowledge, there is no consensus available on the ideal time interval to surgery following neoadjuvant chemotherapy in breast cancer patients in the published literature. The present study aimed to evaluate the influence of TS of ≥28 days and its effect on survival outcomes. For this purpose, patients with breast cancer (n=61), during the time period between January, 2012 and December, 2016, were categorised into two cohorts based on the TS following the completion of neoadjuvant chemotherapy. Patients in group 1 (n=8) had a TS of ≤28 days, and those in group 2 had a TS of ≥29 days (n=53). Overall survival and locoregional recurrence-free survival were compared between both groups. A total of 61 patients with breast cancer who had received neoadjuvant chemotherapy followed by surgery and fulfilled the inclusion criteria were included in the study. The median follow-up time was 29 months. There was no observed association between age, tumour biology, the chemotherapy regimen, type of surgery, pathological response and the TS. The mortality rates were zero in group 1 and 18.9% in group 2. Locoregional recurrence rates were zero in group 1 and 9.4% in group 2. On the whole, the findings of the present study support a shorter duration (≤28 days) of TS following neoadjuvant chemotherapy for optimal survival outcomes.
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