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Ovarian metastasis is common with secondary tumors representing up to 15% of ovarian neoplasms. The malignancies most commonly involving the ovaries are carcinomas of the stomach, colon, breast, endocervix, endometrium, and lymphoma. Secondary ovarian involvement by kidney carcinoma occurs very rarely and is usually associated with widespread dissemination.We conducted a review of kidney carcinoma with ovarian metastasis in the literature using the keywords clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma collecting duct carcinoma, and ovarian metastasis on Google Scholar and PubMed indices in April 2018, including a case diagnosed in our department. To date, 30 articles presenting 41 cases of kidney carcinoma with ovarian metastasis are reported in the literature. All reviewed cases were analyzed for diagnosis, surgical and systemic therapy, and outcome.Diagnosis may sometimes be challenging, requiring appropriate immunohistochemical markers in difficult cases. A combination of surgery and adjuvant therapy offers significant benefit in disease control or palliation of symptoms. Due to inconsistency in the reported data, further studies are needed to make safe conclusions regarding survival.

Biweekly gemcitabine/nab-paclitaxel seems to have a similar safety and efficacy profile as the original regimen.

Background/Aim: Subcutaneous (s.c.) trastuzumab was introduced in the (neo)adjuvant setting, based on the non-inferiority results and patient preference. In the advanced setting, preliminary safety data have only been reported. We conducted an observational study of s.c. trastuzumab in combination with i.v. pertuzumab and docetaxel in the firstline setting of human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer. Patients and Methods: In this single-institution study, patients received 600 mg s.c. trastuzumab in combination with 840 mg pertuzumab for the first cycle and 420 mg for the following cycles, and 75-100 mg/m 2 docetaxel, followed by maintenance with s.c. trastuzumab and pertuzumab until disease progression or unacceptable toxicity. Endpoints were efficacy and safety. Results: Forty patients were enrolled. The median number of cycles with docetaxel was six, while the median number of maintenance cycles was 21. With a median follow-up of 37 months, median progression-free survival and overall survival were 24 and 35 months. Conclusion: Subcutaneous trastuzumab in combination with pertuzumab and docetaxel is well tolerated and effective in HER2-positive advanced breast cancer.Breast cancer is the most common cancer and the second leading cause of cancer-related death among women worldwide. It is recognized as a heterogeneous disease. Human epidermal growth factor receptor 2 (HER2) overexpression in breast cancer is related to a more aggressive subtype. The addition of pertuzumab to trastuzumab and docetaxel significantly improved the median overall survival (OS) for patients with HER2-positive metastatic breast cancer (MBC). Thus, the combination of intravenous (i.v.) trastuzumab, pertuzumab and docetaxel is considered to be the standard first-line treatment in this setting (1, 2). Subcutaneous (s.c.) trastuzumab was first introduced in the (neo)adjuvant setting based on the results of the HannaH study reporting comparable safety and noninferiority (3, 4), as well as the PrefHer study pointing out patient preference for s.c. trastuzumab versus i.v. administration (5). This transition led to time and cost reductions (6). Based on that, we adopted a combination of s.c. trastuzumab, pertuzumab and docetaxel in patients with HER2-positive MBC. We present the results of our observational study. Patients and MethodsStudy design. This study was a retrospective single-arm analysis of fixed-dose s.c. trastuzumab combined with pertuzumab and docetaxel as first-line treatment in HER2-positive advanced breast cancer (metastatic or locally advanced). The data collected derived from a single center, the Saint-Savvas Anticancer Hospital, Athens, Greece. The primary endpoint of the study was to assess the efficacy of the combination by means of progression-free survival (PFS). Secondary endpoints were: i) Safety profile as determined by National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v. 4.03 (7) and ii) overall survival (OS). All patients gave their written in...

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Gastric cancer (GC) is the fifth most commonly diagnosed malignancy and the fourth leading cause of cancer death worldwide. Skin metastases from internal organs are rare; skin metastasis from GC occurs even more rarely than skin metastases originating from other organs, and is associated with systematic disease and poor prognosis. The present study described an interesting and rare case of an extensive skin rash in a 42-year-old man diagnosed with GC, which was mainly affecting his left hemithorax, abdomen and back. The rash masqueraded as erysipelas and was initially treated as such; however, it did not respond to antibiotics, corticosteroids and antihistamines. Due to its persistence and location, the rash was biopsied and GC metastasis was confirmed. Thirdline chemotherapy was administered and the rash decreased in size; however, the patient suffered from disease deterioration with lung metastases and respiratory failure. The patient eventually died 4 months after the diagnosis of skin metastasis. In conclusion, cutaneous metastasis should be considered as a late and difficult to treat metastasis of GC, which requires high surveillance from medical oncologists, and a multidisciplinary approach for prompt and accurate diagnosis.

A 61-year-old female patient with no previous medical history presented to our hospital with a palpable right breast mass as well as palpable axillary lymph nodes. Microscopic examination revealed a bifocal primary carcinoma of the breast displaying characteristics similar to that of follicular variant of papillary thyroid carcinoma. Three axillary lymph nodes contained metastases. Immunohistochemical study for TTF-1, Thyroglobulin, GATA-3, ER and PR was consistent with a primary breast carcinoma, excluding the possibility of a metastatic tumor.The above unusual morphological features were caused by improper fixed tissue. Suboptimal fixation may cause tissue artifacts such as shrinkage, streaming, diffusion, vacuolation and nuclear or cytoplasmic changes as well as decreasing tissue antigenicity. Occasionally, altered morphology may mislead to major diagnostic pitfall.