BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported. CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison, including age, clinical manifestations, and diagnostic process. This patient had no history of neoplasms of the salivary gland. CONCLUSION Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma. Long-term follow-up was necessary for further prognosis analysis.
L e t t e r s t o t h e e d i t o r 1641 GlioblastomaTo The ediTor: We are very interested in the laboratory investigation by Ju et al. 1 (Ju H, Li X, Li H, et al: Mediation of multiple pathways regulating cell proliferation, migration, and apoptosis in the human malignant glioma cell line U87MG via unphosphorylated STAT1. Laboratory investigation. J Neurosurg 118: 1239 -1247 , June 2013.Glioblastomas multiforme are characterized by high invasiveness, rapid proliferation, and resistance to apoptosis. Therefore, the investigation of a novel therapy is very important. Ju et al.1 explored the effect of overexpression of the signal transducer and activator of transcription 1 (STAT1) protein on apoptosis, migration, and proliferation of the U87 glioma cell line. They concluded that STAT1-transfected U87 glioma cells decreased proliferation, suppressed migration, and increased apoptosis.First, they did not show a fundamental result of the STAT1 band in the Western blot analysis in Fig. 2C to convince readers that the STAT1 was really well transfected into U87 glioma cells. To address this point, we suggest they could put the result of STAT1 Western blot analysis in their response to this letter. Moreover, as shown in the left panel of Fig. 2C, the expression level of cleaved caspase-3 seems not significantly higher in STAT1-transfected U87 glioma cells than in the mock or vector control groups in the Western blot analysis.Despite these minor limitations, their findings raised the possibility of an important role of STAT1 in glioblastoma, suggesting that STAT1 overexpression is one of the therapeutic targets in human gliomas. Further studies performed using in vivo stereotactic orthotopic xenografts to investigate the effect of STAT1 overexpression on survival and tumor size are warranted.Tri-Service General Hospital National Defense Medical Center Taipei, Taiwan DisclosureThe authors report no conflict of interest. 1 In that paper we reported on 72 patients with more than 10 brain metastases from different primaries, including but not limited to lung cancer, breast cancer, melanoma, and renal carcinoma treated with GKS. A total of 147 treatment sessions were required to treat 1304 sites in the 72 patients. The mean tumor volume was 1.7 cm 3 . The median number of tumor sites during the first treatment session was 11. We noted in a multivariate survival analysis that the most significant prognostic factors for improved survival were 1) female sex, 2) total tumor volume < 30 cm 3 , and 3) Karnofsky Performance Scale score higher than 70. The origin of the primary neoplasm, patient age, radiosurgical dose, and previous whole-brain radiation therapy were not significant. The total intracranial tumor volume treated was of greater prognostic significance than the absolute number of metastases treated. In our previously published study 2 of 22 patients with brain metastases from renal cell carcinoma, in which we treated with GKS an average of 6 lesions per patient, we achieved local control in 20 patients. In another previo...
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