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A bstractIntroduction and pur pose. Primary Ewing's sarcoma arising from the bones of the head and neck region is extremely rare representing only 1± 4% of all Ewing's sarcoma cases. Previous reports suggest a better prognosis for that particular anatomic site. The purpose of this study was to analyze the clinico-epidemiologic characteristics of that rare clinical presentation, as well as its patterns of failure and prognosis following treatment. M ater ials and methods. This study included a retrospective review of the medical records of patients with the diagnosis of Ewing's sarcoma of the head and neck region treated at King Faisal Specialist Hospital and Research Center between 1975 and Results . Out of a total number of 24 cases analyzed, there were 17 males and 7 fem ales with a ratio of 2.4:1. The m edian age at diagnosis was 16.5 years. A painful swelling was the m ost comm on clinical presentation. The m axilla was the m ost common site of presentation (9/24 cases). There were 3/24 cases who presented with metastatic disease at diagnosis. The m ajority of patients (16/24 cases) had a tum or size >10 cm . M ost patients were treated with systemic chem otherapy plus localized irradiation following an initial biopsy. W ith a m ean follow up of 3.4 years, the 5-year actuarial overall survival (OS) for the whole group was 53% , while the 5-year actuarial disease-free survival (DFS) was 30% . These ® gures were higher than those reported from our institution for young patients (£ 14 years treated for Ewing' s sarcom a in other anatom ic locations (30 % v 15% ). The response to chem otherapy was the only prognostic factor that affected both the OS and DFS. C onclusio n. The prognosis of Ewing's sarcoma of the head and neck region is slightly better than that of other anatomic sites. The response to systemic chem otherapy is one of the m ost important prognostic factors affecting both DFS and OS of Ewing's sarcoma of the head and neck. M ultimodality therapy consisting of an initial biopsy, aggressive combination chem otherapy and localized radiotherapy is the treatment of choice for Ewing's sarcoma of the head and neck region and m ay result in long-term survival.

This series characterized the clinicopathologic features and outcome of adult patients with early stage WR-NHLs. No survival difference was noted between stage I and stage II, and the outcome was favorable. Primary tonsillar site and the low-risk group of the modified IPI predicted favorable OS and EFS. CMT is probably superior to single modality treatment; however, prospective studies are warranted.

Medulloblastoma is an aggressive primary brain tumor that arises in the cerebellum of children and young adults. The Sonic Hedgehog (Shh) signaling pathway that plays important roles in the pathology of this aggressive disease is a promising therapeutic target. In the present report we have shown that curcumin has cytotoxic effects on medulloblastoma cells. Curcumin suppressed also cell proliferation and triggered cell-cycle arrest at G(2)/M phase. Moreover, curcumin inhibited the Shh-Gli1 signaling pathway by downregulating the Shh protein and its most important downstream targets GLI1 and PTCH1. Furthermore, curcumin reduced the levels of beta-catenin, the activate/phosphorylated form of Akt and NF-kappaB, which led to downregulating the three common key effectors, namely C-myc, N-myc, and Cyclin D1. Consequently, apoptosis was triggered by curcumin through the mitochondrial pathway via downregulation of Bcl-2, a downstream anti-apoptotic effector of the Shh signaling. Importantly, the resistant cells that exhibited no decrease in the levels of Shh and Bcl-2, were sensitized to curcumin by the addition of the Shh antagonist, cyclopamine. Furthermore, we have shown that curcumin enhances the killing efficiency of nontoxic doses of cisplatin and gamma-rays. In addition, we present clear evidence that piperine, an enhancer of curcumin bioavailability in humans, potentiates the apoptotic effect of curcumin against medulloblastoma cells. This effect was mediated through strong downregulation of Bcl-2. These results indicate that curcumin, a natural nontoxic compound, represents great promise as Shh-targeted therapy for medulloblastomas.

This series characterized the clinico-pathologic features and outcome of patients with primary intestinal DLCL. While surgical resection in primary intestinal NHL seems beneficial, only prospective randomized studies can ascertain its precise role. Compared with patients with PG NHL, patients with primary intestinal disease had more prevalence of adverse prognostic features.