Non-clinical trial experience with omalizumab supported the finding of fewer exacerbations in the allergic asthma population while treated with omalizumab, and therapy was found to continue to have an attractive cost-effectiveness ratio.

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To report the signalment, staging, surgical treatment, and survival time of juvenile dogs treated surgically for oral squamous cell carcinoma (OSCC).Study design: Retrospective study. Animals or sample population: Twenty-five dogs, <2 years of age with OSCC treated with surgery.Methods: Cases were solicited from the Veterinary Society of Surgical Oncology. Data retrieved included sex, breed, age, weight, clinical signs, tumor location, preoperative diagnostics and staging, histopathological diagnosis with margin evaluation, disease-free interval, and date and cause of death. A minimum follow-up time of 3 months was required for inclusion.Results: Eighteen dogs were <12 months of age, and seven were <24 months. Various breeds were represented, with a mean body weight of 22.3 ± 14.4 kg.No dogs had evidence of metastatic disease prior to surgery. All dogs underwent partial maxillectomy or mandibulectomy. Histological margins were complete in 24 dogs and incomplete in one. No dogs had evidence of metastatic

Amniotic band syndrome is a rare cause of fetal head deformity. We report a case in which antenatal ultrasound in the first half of pregnancy indicated the presence of a fetal cranial deformity, reported as either anencephaly or encephalocele. At assessment autopsy, disruption of the fetal skull was associated with amniotic band formation. Appropriate genetic counselling can be offered to such patients only when detailed pathological examination of the aborted fetus is made. The recurrence rate of amniotic band syndrome does not warrant amniocentesis in a subsequent pregnancy.

BackgroundTotal laryngectomy is often utilised to manage squamous cell carcinoma of the larynx or hypopharynx. This study reports on surgical trends and outcomes over a 10-year period.MethodA retrospective review of patients undergoing total laryngectomy for squamous cell carcinoma was performed (n = 173), dividing patients into primary and salvage total laryngectomy cohorts.ResultsA shift towards organ-sparing management was observed. Primary total laryngectomy was performed for locoregionally advanced disease and utilised reconstruction less than salvage total laryngectomy. Overall, 11 per cent of patients developed pharyngocutaneous fistulae (primary: 6 per cent; salvage: 20 per cent) and 11 per cent neopharyngeal stenosis (primary: 9 per cent; salvage: 15 per cent). Pharyngocutaneous fistulae rates were higher in the reconstructed primary total laryngectomy group (24 per cent; 4 of 17), compared with primary closure (3 per cent; 3 of 90) (p = 0.02). Patients were significantly more likely to develop neopharyngeal stenosis following pharyngocutaneous fistulae in salvage total laryngectomy (p = 0.01) and reconstruction in primary total laryngectomy (p = 0.02). Pre-operative haemoglobin level and adjuvant treatment failed to predict pharyngocutaneous fistulae development.ConclusionComplications remain hard to predict and there are continuing causes of morbidity. Additionally, prior treatment continues to affect surgical outcomes.

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e19562 PBL are a group of highly aggressive neoplasms originally described in the oral cavity and jaws of HIV-infected patients. An AIDS-defining illness, PBL comprises 2.6% of AIDS-related lymphomas. PBL are best distinguished by their unique immunophenotype. They are terminally differentiated B-cell neoplasms, and typically lack common B-cell markers but uniformly express plasma cell markers. We report the first case of PBL that responded to bortezomib. A 42-year-old male with newly diagnosed AIDS presented with nausea, vomiting, bloody diarrhea and epigastric pain. EGD with biopsy revealed a high-grade PBL of the stomach. Flow cytometry was negative for CD45 and all common epithelial, T-cell and B-cell markers, but was positive for CD138 and p63(VS38c). Karyotyping revealed t(8;14), amongst other abnormalities. PET/CT showed significant hypermetabolism in multiple thoracic and abdominal lymph nodes, the left lung, liver and several bones. The diagnosis was stage IVBE PBL. Highly active anti-retroviral therapy was begun. Anthracycline-based chemotherapy was avoided due to persistent hyperbilirubinemia. Bortezomib was then administered at a dose of 1.3 mg/m2 IV on days 1, 4, 8 and 11. PET/CT on day 7 showed a marked decrease in hypermetabolism after only 2 doses, signifying a dramatic treatment response. After a total of 4 doses of bortezomib, he unfortunately succumbed to severe septic shock before a repeat PET/CT could be obtained. The prognosis of PBL is poor, with a median survival of about 6 months in most series. The WHO classifies PBL as a variant of diffuse large B-cell lymphoma. Accordingly, CHOP and CHOP-like regimens have mostly been used. However, studies of their immunophenotype and molecular histogenesis suggest that PBL are more closely related to plasma cell neoplasms. Bortezomib is a proteasome inhibitor widely used in multiple myeloma and mantle cell lymphoma. We chose bortezomib based on our patient's poor performance status and immune function, the desire to avoid combination chemotherapy, and translocations involving the immunoglobulin heavy chain gene locus (8;14) similar to those seen in multiple myeloma(4;14, 14;16) and mantle cell lymphoma(11;14). A shift in the paradigm of treatment of PBL towards agents effective in plasma cell malignancies may be necessary. [Table: see text]