Exemestane represents an active and well-tolerated treatment option in pretreated patients with advanced breast cancer who have received standard first- and second line hormonal therapies. By extending the sequence of hormonal therapy, disease progression and the need for chemotherapy may be significantly delayed.

spherical hollow structure with a smooth muscle coat, lined by a mucous membrane and attached to any part of the gastrointestinal (GI) tract from the base of the tongue to the anus [1] . These malformations are believed to be congenital and are formed before differentiation of the lining epithelium and, therefore, are named for the organs with which they are associated [2] . Foregut duplications may or may not communicate with the GI tract and usually are diagnosed in a younger age; in adults non-specific symptoms delay diagnosis, which is established during surgical exploration [3] . Herein, two gastric duplication cysts with respiratory epithelium are reported. CASE REPORTA 46-year-old female patient was admitted to our Surgical Department from another medical center, where the patient was evaluated for an episode of loss of consciousness. Past medical history, present status and physical examination were non disease-specific. Diagnostic workup included an abdominal computed tomography (CT) which demonstrated a cystic lesion measuring 6 cm × 6 cm × 7 cm attached to the posterior wall of the gastric fundus, was well circumscribed and had no contrast enhancement ( Figure 1). Interestingly CT coronary sections revealed a pulmonary sequestration in the basal segment of the left lower lobe (Figure 2). Moreover, upper GI endoscopy showed a bulging deformation of the gastric fundus by an extrinsic mass, without any mucosal abnormalities. An exploratory laparotomy was performed and revealed two cystic lesions; the first was attached to the fundus of the stomach and the second was embedded within the gastrosplenic ligament, close to the spleen. Therefore, intact excision of both cysts and splenectomy were carried out. Postoperative course was uneventful and the patient has been asymptomatic since then.Pathologic examination of the surgical specimens reported a large cyst, measuring 8 cm × 5.5 cm in diameter and 0.3 cm thick and a smaller cyst (removed from the gastrosplenic ligament), measuring 3 cm in diameter and 0.2 cm thick. Both consisted of a smooth muscular wall, were lined by a pseudostratified, ciliated and columnar (respiratory type) epithelium and contained a clear, gelatinous fluid. Sub-epithelium seromucous glands were microscopically identified (Figure 3), a histologic appearance reminiscent of bronchial wall; however no cartilage was present. CASE REPORT Foregut duplication cysts of the stomach with respiratory epithelium AbstractGastrointestinal duplication is a congenital rare disease entity. Gastric duplication cysts seem to appear even more rarely. Herein, two duplications cysts of the stomach in a 46 year-old female patient are presented.Abdominal computed tomography demonstrated a cystic lesion attached to the posterior aspect of the gastric fundus, while upper gastrointestinal endoscopy was negative. An exploratory laparotomy revealed a non-communicating cyst and a smaller similar cyst embedded in the gastrosplenic ligament. Excision of both cysts along with the spleen was performed and pathology...

Adrenal cysts are rare and form a heterogeneous group of lesions that includes (a) parasitic cysts, (b) epithelial cysts, (c) pseudocysts, and (d) endothelial cysts. There is evidence (immunohistochemical and ultrastructural) that both pseudocysts and endothelial cysts are variants of vascular cysts. Adrenal vascular cysts account for 84% of adrenal cysts. They are more common in women and present clinically with abdominal pain or are incidental findings. Their imaging features are not specific. Grossly, both types of adrenal vascular cysts are encapsulated. Pseudocysts are unilocular, thick-walled, and devoid of endothelial lining, whereas endothelial cysts are thin-walled, multilocular, and lined by endothelium. Adrenal vascular cysts probably originate from a preexisting vascular hamartoma. The treatment of choice is surgical excision. The prognosis is excellent.

Abdominal aortic aneurysm (AAA) progression and disease resistance are related to transmural degenerative processes and an inflammatory infiltration (INF). Diabetes is associated with low prevalence and growth rate of AAA. We sought to characterize INF in established AAA (INFAAA), in diabetic patients. From 89 male patients aged 52 to 83 years, aneurysm specimens obtained at open asymptomatic nonruptured AAA repair were graded for INF and immunostained using antibodies against T-lymphocytes (CD3) and macrophages (CD68). Diabetic patients had an odds ratio (OR) 3.8, 95% confidence interval ([CI] 1.14-12.96), P = .03, of experiencing above-median INFAAA. These associations were affected by serum glucose (SG) levels (OR 3.6, 95% CI [0.72-18.77]; P = .1). Macrophage subpopulations higher in diabetic patients (1.44 ± 0.78 versus 0.98 ± 0.76; P = .02) were correlated with SG (r = .21, P = .044). Abdominal aortic aneurysms in diabetic patients are associated with higher INF. Macrophage densities are correlated with SG.

Introduction Solitary fibrous tumor is a rare type of mesenchymal, spindle-cell tumor reported mostly in the pleura. Retroperitoneal occurrence is rare and histopathological diagnosis is challenging. Case Presentation A 55-year-old woman with nonspecific abdominal pain was found to have a retroperitoneal/pelvic mass adjacent to the upper rectum. The patient underwent surgical resection in clear margins of this pelvic tumor, entering the total mesenteric excision surgical plane. Final histopathology revealed a solitary fibrous tumor and the case is presented herein. Discussion Solitary fibrous tumor in the retroperitoneum is rarely found in the literature and to the best of our knowledge less than a hundred cases are described so far. Histopathological diagnosis is mostly based on a “patternless pattern” on microscopic examination, which is a storiform arrangement of spindle cells combined with a “hemangiopericytoma-like appearance” and increased vascularity of the lesion. Surgery is the mainstay of treatment and recurrence rates are generally low.