No abstract

No abstract

Prostate cancer is a very prevalent disease in men, especially in Western countries. The treatment of this neoplasm, both localized and locally advanced, is based on the clinical risk analysis (Gleason, tumor size, PSA, and other factors) and is founded on surgery and/or radiotherapy with or without androgen blockade with a GnRH analog (hormone gonadotropin releaser). However, in patients who invariably progress to a metastatic disease scenario, the tumors may present a heterogeneous behavior, depending on whether or not they are sensitive to androgen blockade therapy. Due to the poor prognosis of the metastatic castration-resistant scenario, current research carried out in the molecular biology and genetics field has identified several gene alterations associated with the development of prostate cancer, which correlate with clinical risk, therapeutic predictive responses, and prognosis. Among the associated gene alterations, the genes of the DNA repair pathway are correlated with diseases that present: a higher risk of recurrence; early metastasis; worse cancer-specific survival; familial risk, and predictive responses to new targeted therapies. Therefore, the breast cancer susceptibility genes, BRCA1 and BRCA2 (and other variants), present in the DNA repair machinery are being investigated to provide more (and better) therapeutic options for the treatment of the disease in the advanced scenario. This review was aimed to describe the malignant prostate disease, especially with regard to DNA repair mechanisms, genomic analysis of prostate cancer, predictive and prognostic implications, as well as on the development of poly-(ADP-ribose) polymerase (PARP) inhibitors, synthetic lethality mechanisms, and BRCAness phenomenon.

Introduction and Objectives: HER-2 overexpression occurs in 20% to 30% of invasive breast carcinomas. Even in localized disease, it is considered aggressive and can spread rapidly if not treated early. This report depicts the case of a patient with Luminal HER breast cancer with extensive cutaneous and lymph node disease, without visceral metastasis. Case Report: A 58-year-old woman with a lesion in the anterior thoracic region, ulcerated, painful, and friable to manipulation, with approximately 13 cm in the largest axis, initially diagnosed as dermatofibrosarcoma protuberans. The lesion evolved with rapid progression in size, 17 cm in the longest axis, and was re-biopsied, revealing invasive breast carcinoma with positive immunohistochemistry for ER (90%), RP (50%), HER2+ (3+), positive FISH, and Ki67 (20%). Staging examinations, extensive disease in the anterior thoracic region and right lymph node, other examinations were negative for visceral metastatic disease. Discussion: This case presents an atypical evolution of Luminal HER breast carcinoma in which the unusual clinical presentation delayed diagnosis. Unlike the identified common presentation, in this case, an extensive ulcerated and friable lesion on the anterior chest wall with extensive cutaneous and lymph node involvement is observed. Furthermore, we emphasized the relevance of the pathological findings for the correct identification of the tumor, since after reanalysis, the diagnosis of dermatofibrosarcoma protuberans was disregard, and the presence of molecular breast carcinoma subtype luminal HER was identified, which brings changes in prognosis and therapy. Conclusion: Therefore, a completely atypical manifestation of a luminal malignant HER mammary neoplasm, without visceral disease, is perceived. Furthermore, the importance of the clinical and pathological findings in the diagnosis and therapeutic management for the case resulting from atypical clinical manifestations is emphasized. Therefore, the importance of this report to expose a completely anomalous manifestation of breast cancer, which without a good investigation would receive incorrect treatment, is noted.

Introduction/Objectives: Breast cancer is one of the most common malignancies among women, with 10% resulting from genetic predisposition. Li-Fraumeni syndrome is an autosomal dominant disease that predisposes to multiple primary tumors and is responsible for less than 0.1% of breast cancers, being considered in early-onset tumors. The aim of this report was to describe a fast evolution of three primary tumors in a young patient with Li-Fraumeni syndrome, including ductal breast carcinoma. Case Report: In 2017, a 27-year-old female patient was diagnosed with malignant cancer of the right breast, Luminal HER KI67 70%, clinical stage IV (liver and lung), underwent first-line cancer treatment, maintaining endocrinotherapy and Double Block, with a positive genetic panel test for TP53 mutation, inferring SLF. In 2018, screening colonoscopy showed colon adenocarcinoma, pT53pN1, treated with total colectomy with ileal pouch, followed by suspension of endocrinotherapy and maintenance of Double Block and adjuvant FOLFOX. At the end of chemotherapy, endocrinotherapy was adopted again. Reassessment tests showed partial response in the liver, but the primary nodules were unchanged. Biopsy after thoracoscopy described lung adenocarcinoma, pT3pN2, submitted to adjuvant with Gemzar and Navelbine, followed by Double Block and interruption of endocrinotherapy. It evolved with the appearance of nodules in the right breast, suggestive of progression of breast disease, under treatment with Xeloda, Herceptin, and Perjeta, showing good clinical response. Discussion: Breast cancer in young people increases the possibility of heredity, thus raising the need for investigations of genetic syndromes. Although rare, the identification of FHL brings an important implication for the genetic counseling. Early diagnosis is the best form of management, enabling the preventive screening and intervention of multiple malignancies. Conclusion: Cases of breast cancer in young women should raise a suspected diagnosis of Li-Fraumeni syndrome, which can change the therapeutic and investigation of other cancers at an early stage.

No abstract

No abstract

No abstract