The most common sites of metastatic differentiated thyroid cancer are the neck lymph nodes, while distant metastases typically involve the lungs, the bones, and less frequently the brain. Uncommon metastatic sites include the liver, adrenal gland, kidney, pancreas, and skin. The epidemiological aspects of thyroid metastases in rare sites are largely unknown and their identification could have a significant impact on patients management. A mini-series of unusual metastatic sites of thyroid carcinoma is proposed as a contribution to current knowledge on anatomopathological characteristics and clinical outcome. Of the six cases that were assessed, the metastases were the following: skin metastases (2), skin and pancreas metastases (1), renal metastasis (1), adrenal metastasis (1), and liver metastasis (1). In our experience, metastases in rare sites do not always represent a negative prognostic factor for disease outcome. In fact they can occur as single distant lesion and if surgically resectable, their treatment can also lead to local disease remission.

We confirm that unplanned surgery does not compromise patients' prognosis; scar re-excision guarantees at least the same SS, LR and DM rates compared to STS primarily treated in a referral center. Routine use of radiation therapy after re-excision could improve local control. Distant metastases seem to be negatively affected by the presence of residual tumor, and therefore, the use of CT in deep and large STS is suggested. The main goal is to avoid unplanned surgery by referring suspected lumps (especially deep, large, increasing in size) to a specialist center.

Age, pattern of recurrence, RFI, and response to second-line chemotherapy influence post-relapse survival in patients with recurrent Ewing sarcoma. No survival advantage was observed from chemotherapy consolidation with HDT.

No abstract

Radiation studies on salivary function in the rat show the typical response with respect to dose (5-15 Gy) and time (1-3 days). This differs from reported findings with light microscopy. Therefore, the extent of apoptosis induced by radiation cannot explain the observed gland malfunction. Alternative mechanisms are proposed.

PurposeNon melanoma skin cancers (NMSC) of eyelid are uncommon. Many treatments approach are available with surgery being considered as the gold standard. Radiotherapy is an effective alternative in patients unfit for surgery. Brachytherapy (BT) might be a better therapeutic option due high radiation dose concentration to the tumor and rapid dose fall-off resulting in normal tissues sparing. The aim of this review is to evaluate local control, toxicity, and functional cosmetic outcome of BT in NMSC of eyelid.Material and methodsA systematic search of the bibliographic databases PubMed, Scopus, and Cochrane Library from the earliest possible date through October 2015 was performed. Only studies published in English were included.ResultsSix articles fulfilled the selection criteria and were included in our review. Due to high risk of bias, all studies were classified to provide a low level of evidence (according to Scottish Intercollegiate Guidelines Network Classification). No randomized controlled trials or case control studies were founded. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 95.2%). Functional and cosmetic outcome were reported in five study as acceptable good functional-cosmetic outcome (median: 100%).ConclusionsTo date, few evidences are available on the role of BT in eyelid NMSC, and they show satisfactory results in terms of local control and functional cosmetic outcome. Therefore, prospective controlled trials are justified.

Cholangiocarcinoma (CC) is an uncommon neoplasm representing 3% of gastrointestinal (GI) cancers and the second most common primary liver malignancy. 1 They represent a very heterogeneous group of neoplasm arising from the epithelial cells of the bile duct. CC are classified according to their anatomical location as intra hepatic or extra hepatic. Radical surgery with negative histological margins is the only treatment allowing long-term survival but even after tumor resection, the prognosis is dismal with 5 year overall survival (OS) <20%. 1 Moreover, most of these patients have advanced disease at the time of diagnosis and are candidates for non-surgical treatments. Furthermore, in patients undergoing surgery, 15 to 25% microscopic (R1) or macroscopic (R2) residual disease was reported. 2 Some studies have demonstrated that external beam radiotherapy (EBRT) with or without systemic chemotherapy (CHT) is a treatment option in unresectable or R1-R2 residual CC with median OS ranging between 10 and 15 months. [3][4][5] Furthermore, a significant correlation between radiotherapy (RT) dose and OS has been reported. [6][7][8] However, the possibility to deliver very high RT dose on this site is limited by the low radiation tolerance of both liver and GI tract.In the last decade, technological improvements in EBRT delivery accuracy and in respiratory motion compensation has enabled the widespread implementation of stereotactic body radiation therapy (SBRT). Particularly, due to its ability to deliver a high and focused dose in few

Our study showed that ECT produces high response rate with significant reduction of pain and improvement of local symptoms.