فهرست مطالب

  • Volume:11 Issue: 1, 2020
  • تاریخ انتشار: 1398/10/15
  • تعداد عناوین: 20
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  • Aznida Mohammad Zaki, Muhammad Aklil Abd Rahim, Zuraidah Zaidun, Abdul Rahman Ramdzan*, Zaleha Md Isa Pages 1-11
    Background

    A slight increase in the childhood cancer trend has been observed for the past few decades. Non-ionizing radiation is one of the environmental factors linked to childhood cancers. This review is conducted to assess the association between non-ionizing radiation and childhood cancer based on all original studies to date.

    Methods

    A systematic search was conducted on the titles and abstracts pertaining to non-ionizing radiation and childhood cancers using the PubMed, Scopus, SAGE and ScienceDirect databases from inception up to November 2018. Quality of each article was appraised using the Newcastle-Ottawa Scale, meta-analysis was performed with Review Manager, and fixed effects were used to estimate the pooled OR of the selected studies.

    Results

    A total of 15 articles met all the selection criteria. Twelve articles were included in the meta-analysis. Pooled risk estimates of the 12 studies, obtained via fixed effects model, showed that children exposed to 0.2 µT or more of EMF non-ionizing radiation run 1.33 times higher risks of contracting childhood cancer compared to those with less than 0.2 µT exposure (95% CI: 1.10, 1.60). The studies were statistically homogeneous (chi-squared P=0.71, I2=0%), and there was no evidence of publication bias.

    Conclusion

    It cannot be concluded that children exposed to non-ionizing radiation have higher risks of childhood cancer compared to those who were not exposed as claimed by the previous reviews. However, concerns about non-ionizing radiation exposure and childhood cancer should not be neglected.

    Keywords: Non-ionizing radiation, Childhood cancer, Electromagnetic fields, Meta-analysis
  • Sepideh Herizchi*, Iraj Asvadi, Isa Piri, Mehri Golchin, Reza Shabanlui, Zohreh Sanaat Pages 9-13
    Background

    Chemotherapy is an important treatment for cancer, yet some of its side effects are serious and painful. Many patients with cancer suffer from psychiatric disorders that most likely result from therapeutic drugs or mental strategies to cope with their illness. Progressive muscle relaxation is one of the cost effective, self-help methods that promotes mental health in healthy participants. This study aims to determine the effect of progressive muscle relaxation training on anxiety and depression in cancer patients undergoing chemotherapy.

    Methods

    This was a randomized, clinical study that enrolled 60 patients who received inpatient chemotherapy in the Tabriz Hematology and Oncology Research Center in 2010. We divided patients into two groups, intervention and control. All participants signed written formal consents and completed the Hospital Anxiety & Depression Scale questionnaires. Intervention group participants were trained in progressive muscle relaxation in groups of 3-6 to enable participants to perform this technique when they were alone in the hospital and after discharge, two to three times each day. After one and three months, questionnaires were completed again by both groups and the results compared. 17th version of SPSS software was used for data analysis.

    Results

    After data analysis, most participants were satisfied with learning and experiencing this technique. There was no significant difference between scales in the case and control groups after one month (P>0.05). However after three months, anxiety and depression considerably improved in patients who underwent progressive muscle relaxation training (P<0.05).

    Conclusion

    Progressive muscle relaxation training can improve anxiety and depression in cancer patients.

    Keywords: Chemotherapy, Quality of life, Cancer, Patients
  • Yousef Mortazavi, Robab Rahimi, Fatemeh Azimi*, Shahrbano Rostami, Minoosh Moghimi, Soghrat Faghihzadeh, Saeide Mazloomzadeh Pages 12-20
    Background

    Acute myeloid leukemia (AML) may originate from the combination of genetic susceptibility factors and environmental exposure. The aim of this study was to investigate the association of GSTM1 and GSTT1 null genotypes and CYP1A1*2A allele with susceptibility to AML in an Iranian population.

    Method

    In this case-control study, 200 patients with AML and 200 normal individuals as controls were included. GSTM1 and GSTT1 null genotypes were amplified using multiplex PCR and CYP1A1*2A polymorphisms were genotyped by PCR-RFLP.

    Result

    The frequency of GSTM1 null genotype was significantly higher in the control group compared to the case group. The frequency of GSST1 null genotype was significantly lower in the controls. No association was observed between the studied CYP1A1*2A variant and the risk of acute myeloid leukemia. The combination of GSTT1 null genotype and CYP1A1 *2A AA and AC alleles further increased the risk of AML.

    Conclusion

    GSTT1 null genotype can increase the risk of AML, particularly when combined with CYP1A1*2A allele. GSTM1 null genotype can also play a protective role and reduce the risk of AML. However, further studies are required on a larger number of patients.

    Keywords: GSST1, GSTM1, CYP1A1, AML
  • Mehdi Zardadi*, Hamidreza Sima, Mona Joudi, Kamran Ghafarzadegan, Sara LariAli Taghizadeh* Pages 21-32
    Background

    Gastric cancer is the second global leading cause of death from cancer and the most common gastrointestinal cancer in Iran. This condition is usually diagnosed at advance stages where treatment options are limited. Recently, heat shock proteins (HSPs) have been reported to be overexpressed in a wide range of malignancies and considered as promising candidate biomarkers and therapeutic targets for gastric adenocarcinoma. The aim of the present study was to compare HSPs protein expression between non-tumoral and tumoral sections from patients with gastric adenocarcinoma and determine HSPs protein expression correlation with histological stage, tumoral grade and prognosis.

    Methods

    Immunohistochemistry was used to assess the expression levels of HSP27, 70 and -90 proteins on both tumoral and non-tumoral (margin of tumor as control group) sections in 80 patients with gastric adenocarcinoma. Further analyses were histology, grade and stage of tumor (Tumor, node, and metastasis), HSPs expression level, clinicopathological significances, and survival rate.

    Results

    The expression of HSPs was significantly increased in tumoral sections compared with non-tumoral sections (P<0.001). The HSP27 expression was correlated with tumors on the corpus of stomach (P=0.049). Patients younger than 63 years revealed higher expression levels of HSP70 (P=0.040). High expression levels of HSP90 were further assessed in well-differentiated and intestinal types of tumors (P=0.009 and P=0.019). Overexpressed levels of HSP27 and 90 were associated with the reduced survival rate of patients (P=0.017 and P=0.018).

    Conclusion

    HSP27 and HSP 90 are potential prognostic biomarkers of patients’ survival rate. Patients harboring positive HSP27 and HSP 90 expression display worse disease-free survival compared to those with negative HSP27 and HSP 90 expression. Differential expression of HSPs may play crucial roles in the initiation and progression of gastric cancer and can be exploited as future therapeutic targets.

    Keywords: Gastric cancer, Heat shock protein, Adenocarcinoma
  • Shiva Roshankhah, Babak Arji Rodsari, Cyrus Jalili, Mohammad Reza Salahshoor*♦ Pages 34-41
    Background

    As a major tumor suppressor gene, P53 plays a principal role in the apoptosis of cancer cells. Harmine is a harmal-derived alkaloid with antioxidant and anticancer properties. This study was designed to assess the ability of harmine to express P53 gene and stimulate apoptosis in breast cancer cell line.

    Methods

    MCF-7 cell line was cultured and treated with harmine. Half maximal inhibitory concentration (IC50) assay was carried out through MMT method following 24 h of treatment. Flow cytometry technique was employed to measure apoptotic cells and real-time PCR was performed to estimate P53 gene expression in tumor cells.

    Results

    The IC50 for the harmine extract in MCF-7 cells was 30 μM. Harmine administration in all treated groups resulted in a significant increase in apoptosis and P53 gene expression in MCF-7 cells (P < 0.00001).

    Conclusions

    It seems that harmine administration is able to induce apoptosis in MCF-7 cells through the up-regulation of P53 expression.

    Keywords: Harmine, P53 gene, MCF-7, Apoptosis, Cell line
  • Navideh Haghnavaz, Faezeh Asghari, Najibeh Shekari, Dariush Shanehbandi, Mahsa Javadian, Ali Mohammadi, Behzad Baradaran, Tohid Kazemi* Pages 42-49
    Background

    Abnormal expressions of microRNAs are related to various cancers such as breast cancer for which paclitaxel is widely used as a chemotherapeutic agent. We aimed to investigate the effect of paclitaxel treatment on the expression level of miR-199a-5p and miR-10b, involved in epithelial-mesenchymal transition (EMT) process in breast cancer cell lines.

    Methods

    Human breast cancer cell lines BT-474, SKBR-3, MDA-MB-231, and MCF-7 were cultured and MTT assay was used to determine IC50 of paclitaxel. RNA was extracted, cDNA was synthesized, and the expression level of miRNAs and genes was quantitatively determined using real-time PCR.

    Results

    After treatment with paclitaxel, the expression level of miR-199a-5p significantly decreased in MCF-7 and SKBR-3 cell lines, while it increased in MDAMB-231 and BT-474. The expression level of miR-10b was also significantly reduced in MCF-7, MDA-MB-231, and SKBR-3 and increased in BT-474 cell lines following treatment with paclitaxel. Our results further indicated that paclitaxel reduced the expression level of vimentin and MMP-9 in MDA-MB-231 cell line.

    Conclusion

    Our findings revealed the increased expression of EMT-inhibitor miR-199a-5p and the decreased expression of metastamir miR-10b after treatment of MDA-MB-231 metastatic breast cancer cell line. Reduced expressions of vimentin and MMP-9 were also observed, corroborating the inhibition of metastasis markers in this type of breast cancer. The therapeutic effect of paclitaxel may in part be due to the change in the balance of EMT-promoting and EMT-inhibiting miRNAs.

    Keywords: Breast cancer, MiR-199a-5p, MiR-10b, Paclitaxel, Vimentin, MMP-9
  • Soad M. Abdel Ghany, Esraa MA. Ali*, Amr E. Ahmed, Walaa G. Hozayen, Aliae AR Mohamed Hussein, Maha Salah Elnaggar, Helal F. Hetta Pages 50-58
    Background

    Detecting non-small-cell lung cancer at an early stage has become a great challenge due to the lack of a specific non-invasive marker. MicroRNAs are small, non-coding RNA molecules that play a role in carcinogenesis and cancer progression, as indicated by their abnormal expression in the patients’ plasma. Herein, we investigated the plasma level of circulating miRNA-30a and miRNA-221 as noninvasive markers for an early detection of non-small-cell lung cancer.

    Method

    A cross-sectional study was conducted at Assiut University Hospital, Egypt, to investigate miRNA-30a and miRNA-221 expression via quantitative realtime PCR in the plasma of patients with non-small-cell lung cancer (n=70) and healthy controls (n=34). Receiver operating curves were used to evaluate the diagnostic value of miRNA-221 and miRNA-30a in non-small-cell lung cancer. The relationship between both markers and patient clinical parameters was further assessed.

    Result

    Circulating plasma miRNA-30a and miRNA-221 levels were significantly higher in the non-small-cell lung cancer patients compared with those in the healthy controls (P<0.05). There was a significant difference regarding the plasma miRNA30a level among the three groups (the highest levels were recorded in adenocarcinoma, followed by large cell carcinoma and squamous cell carcinoma). ROC curve analysis of miRNA-30a and miRNA-221 showed that specificity and sensitivity were 60% and 80%, and 40% and 75%, respectively.

    Conclusion

    miRNA-30a and miRNA-221 may be non-invasive biomarkers for early detection and screening or therapeutic targets in patients with NSCLC. Future studies are warranted regarding the use of biomarkers as therapeutic targets

    Keywords: Lung cancer, mRNA-30a, miRNA-231, Non-small-cell lung cancer, Biomarker
  • Inam Jasim Lafta * Pages 59-71
    Background

    The breast cancer susceptibility gene (BRCA1) encodes a tumor suppressor protein which plays a vital role in the DNA damage repair and transcriptional regulation among other functions. Bioinformatics is a newly-emerged discipline that uses computer, mathematics, and statistics in molecular biology in order to analyze the large amounts of biological data quickly, freely, and accurately.

    Methods

    The BRCA1 transcript (mRNA) levels were checked by using realtime quantitative polymerase chain reaction (RT-qPCR) in four sporadic breast cancer cell lines: MCF-7, T47D, MDA-MB-231, and MDA-MB-468 compared to the normal breast tissue. Bioinformatics tools were also used to compare and analyze different aspects of BRCA1 transcripts (multiple different mRNAs produced by a single gene) and splice variants (multiple proteins encoded by the same gene).

    Results

    The level of BRCA1 mRNA was overexpressed in the studied breast cancer cell lines relative to the normal breast cDNA. Also, the bioinformatics software tools provided many important features of this gene that would help explain numerous controversial laboratory findings.

    Conclusions

    The data presented here support a role for BRCA1 overexpression in the pathogenesis of sporadic breast cancer. The bioinformatics analysis of BRCA1 mRNA and protein variants can provide information essential for cancer diagnosis or therapy. The biological data gained from these tools can help authors make better decisions before launching expensive experiments.

    Keywords: Breast cancer, BRCA1, Tumor suppressor gene, Gene expression, Bioinformatics
  • Sedighe Tahmasebi*, Armin Amirian, Abdolrasul Talei Pages 65-69
    Background

    Seroma formation is a common problem following axillary dissection. It is probably caused by a local inflammatory response. Local steroids may prevent this problem by inhibiting inflammatory response at the wound site.

    Methods

    This randomized prospective study was undertaken to evaluate the effect of local triamcinolone injection on seroma formation following axillary dissection. In addition, other wound complications were recorded. A total of 44 women who underwent axillary dissection were randomized to receive either 40 mg intracavitary triamcinolone (Group T, n=22) or saline (Group C, n=22) on their first postoperative visit. Drains were removed if 24-hour drainage was <50 mL. The incidence of wound complications (including seroma) during the first postoperative month was recorded. Additionally, some patient and tumor characteristics possibly pertinent to wound complications were assessed.

    Results

    No wound complications (including seroma formation) were observed in either group in four follow-up visits during the first month after surgery.

    Conclusion

    In our study, in contrast to previous studies, seroma formation was not a common complication following axillary dissection. We could not evaluate the effect of local triamcinolone on seroma formation, although it apparently had no unfavorable effect on this potential complication. According to this study, axillary dissection can be a safe procedure if optimal surgical techniques and meticulous dissections are used, and if drain removal is timed appropriately

    Keywords: Seroma, Breast cancer, Axillary dissection, Triamcinolone
  • Sanaa A. El Benhawy, Khaled Matrawy, Rabie Ramadan, Yasser Hamed, Heba G. El Sheredy* Pages 69-78
    Background

    Although multifocal and multicentric breast cancers are a common entity, their clinical behavior is not well characterized. With the widespread use of mammographic screening and improved sensitivity of imaging modalities, the detection of multifocal and multicentric breast cancers is likely to continuously increase. Many studies have consistently shown a correlation between multifocality and multicentricity and the rate and extent of lymph node metastases. There is little clinical data on the impact of multifocal and multicentric breast cancers on survival outcomes. This study investigates the difference between multifocal and multicentric breast cancers and unifocal breast cancer regarding pathologic and clinical parameters. We have evaluated the impact of multifocal and multicentric breast cancers on disease-free and overall survival of breast cancer patients.

    Methods

    In this retrospective study, we reviewed the records of female patients newly diagnosed with breast cancer who presented to the department of Cancer Management and Research, Medical Research Institute, Alexandria University in the time period from January 2009 till December 2009. Patients with pathologically proven stages I-III invasive breast cancer were included in this study. Patients’ clinical and pathological characteristics were compared between the two studied groups. The disease free and overall survivals were analyzed using the Kaplan–Meier method.

    Results

    Multifocal and multicentric breast cancers were associated with a number of known adverse prognostic factors such as higher clinical stage, larger tumor size and lymphovascular invasion. There was a significant correlation between multifocal and multicentric breast cancers and increased rate of axillary lymph node metastasis and higher N stage. Multifocal and multicentric breast cancer patients had shorter median 5-year disease free survival and overall survival compared to unifocal breast cancer patients. In multivariate analysis, after adjustment of other factors, only clinical stage and multifocality/multicentricity were independent predictors of poor disease free and overall survival.

    Conclusion

    There is an association between multifocal and multicentric breast cancers and known adverse prognostic factors such as increased incidence of regional lymph node metastases. This association may suggest that multifocal and multicentric breast cancers have an aggressive biology and more propensity for metastasis. Whether multifocal and multicentric breast cancer is an adverse prognostic factor in breast cancer remains controversial.

    Keywords: :Multifocal, Multicentric, Breast cancer, Prognostic factors, Survival outcomes
  • Shaian Tavakolian, Hossein Goudarzi, Ebrahim Faghihloo* Pages 72-79
    Background

    Today, cancer is one of the serious health issues worldwide. In USA, colorectal cancer is the third cause of death. Reportedly, some risk factors, including family history of colorectal cancer, age, and infectious diseases can deteriorate the progression of colorectal cancer. One of the most common specifications in all gram-negative bacteria is bacterial cell wall, known lipopolysaccharide. Moreover, LPS probably can affect some microRNAs and cancer progression. We studied the effects of LPS on microRNA-9, -192, and -205 expressions in colorectal cell lines [SW480, HCT116], which are considered oncogene.

    Methods

    SW480 and HCT116 cell lines were treated with LPS to analyze microRNA-9, -192, and -205 expressions by quantitative real-time PCR in 48 hours at 10 ug/L of LPS.

    Results

    Quantitative real-time PCR illustrated that microRNA-9, -192, and -205 were upregulated after treating LPS. There was an increase in microRNA-9 level, six and eight times in SW480 and HCT116 cell lines, respectively. Furthermore, upregulation in the expression of microRNA-192, six times in HCT116 and four times in SW480 was observed. Moreover, there was an upregulation expression [almost four times in both cell lines] in microRNA-205. Our results show that treating LPS increases microRNA-9, -192 and -205, which may be related to cancer in colorectal cell lines [SW480 and HCT116].

    Conclusion

    Therefore, disrupting the balance of bacterial flora can be influential in colorectal cancer progression and increase the chances of getting colorectal cancer that further investigation is required.

    Keywords: MicroRNA-9, MicroRNA -192, MicroRNA -205, LPS, Colon cancer
  • Mohammad Mehdi Movahedi, Ali Zamani, Hossein Parsaei*, Ali Tavakoli Golpaygani, Mohammad Reza Haghighi Poya Pages 80-90
    Background

    Breast cancer is the second cause of death among women. Ultrasound (US) imaging is the most common technique for diagnosing breast cancer; however, detecting breast lesions in US images is a difficult task, mainly, because it provides low-quality images. Consequently, identifying lesions in US images is still a challenging task and an open problem in US image processing. This study aims to develop an automated system for the identification of lesions in US images

    Method

    We proposed an automatic method to assist radiologists in inspecting and analyzing US images in breast screening and diagnosing breast cancer. In contrast to previous research, this work focuses on fusing information extracted from different frames. The developed method consists of template matching, morphological features extraction, local binary patterns, fuzzy C-means clustering, region growing, and information fusion-based image segmentation technique. The performance of the system was evaluated using a database composed of 22 US videos where 10 breast US films were obtained from patients with breast lesions and 12 videos belonged to normal cases.

    Results

    The sensitivity, specificity, and accuracy of the system in detecting frames with breast lesions were 95.7%, 97.1%, and 97.1%, respectively. The algorithm reduced the vibration of the physician’s hands’ while probing by assessing every 10 frames regardless of the results of the prior frame; hence, lowering the possibility of missing a lesion during an examination.

    Conclusion

    The presented system outperforms several existing methods in correctly detecting breast lesions in a breast cancer screening test. Fusing information that exists in frames of a breast US film can help improve the identification of lesions (suspect regions) in a screening test.

    Keywords: Automatic lesion detection, Breast lesion, Ultrasound imaging segmentation, Ultrasound video analysis
  • Mohammad Amin Pourhoseingholi, Hadis Najafimehr, Nastaran Hajizadeh, Mohammad Reza Zali Pages 91-98
    Background

    The main aim of the present study was to map the real high risk regions of gastric cancer (GC) using corrected data for misclassification error in all Iranian provinces.

    Method

    In this cross-sectional study, the data were extracted from the reports of Ministry of Health and Medical Education and previous studies on correcting GC registered data including 30 provinces in 2008. The information about socioeconomic factors was extracted from the statistical centers of Iran. To estimate the model parameters, the Bayesian approach was used with regards to spatial correlation due to adjacent effects.

    Results

    The southern and northern provinces were introduced as high-risk regions and the central provinces were introduced as low-risk regions. The mean household income was inversely associated with the risk of GC.

    Conclusion

    The real high-risk regions of GC in Iran are the north and south border provinces which should be considered by health policy makers. It is also necessary to correct misclassified registered data which can lead to seduction in health service allocation.

    Keywords: Misclassification correction, Disease mapping, Risk factor, Gastric cancer, Iran
  • Mohsen Ayati, Shahryar Zeighami*, Majeed Safavi, Mohammad Reza Nowroozi, Hasan Jamshidian, Alipasha Meysamie Pages 95-99
    Background

    Insulin-like growth factor-1 can act in both an autocrine and paracrine manner to promote normal growth and malignant cellular proliferation. The importance of this factor as a major regulatory peptide has been established for cells, in vitro and in vivo. However, the role of serum insulin-like growth factor-1 levels in the etiology of benign prostatic hyperplasia and prostate cancer has not received sufficient attention. The aim of this study was to determine the relationship between benign prostatic hyperplasia, prostate cancer, and serum insulin-like growth factor-1 levels.

    Methods

    We collected blood samples from 68 individuals with prostate cancer (cases) and 68 individuals with benign prostatic hyperplasia (controls) who were patients at Imam Khomeini Hospital in Tehran, Iran. Those with benign prostatic hyperplasia had normal prostatic specific antigen levels <4 ng/ml and normal prostate according to digital rectal examination. The case group was selected from patients with pathologically confirmed prostate cancer. Insulin-like growth factor-1 concentrations were measured by a radio immunoassay kit. We used the t-test to compare insulin-like growth factor-1 levels between groups.

    Results

    Patients in the prostate cancer group had a mean age of 68 years, whereas those with benign prostatic hyperplasia had a mean age of 65 years (P>0.05). Mean serum insulin-like growth factor-1 levels were 219 ng/ml for the case group and 133 ng/ml for the control group, which was significant (P=0.0009). We did not observe any correlation between age and insulin-like growth factor-1 in the case group (P=0.83, r= -0.47), however there was a significant correlation in the control group (P=0.007, r=0.549). Although correlation between prostate volume and serum insulin-like growth factor-1 levels was not statistically significant in the case group (P=0.38, r=0.213), there was a positive correlation observed in the control group (P<0.008, r=0.537).

    Conclusion

    Our findings suggest that insulin-like growth factor-1 may have an etiologic role in prostate cancer. This interpretation is strengthened by the significant difference observed between serum insulin-like growth factor-1 levels in benign prostatic hyperplasia and prostate cancer patients. These results also offer additional opportunities for evaluating patients who have abnormal digital rectal exams or prostate specific antigen levels, yet their biopsies are normal. Under these circumstances, measurement of serum insulin-like growth factor-1 may assist with the decision for a second biopsy.

    Keywords: Insulin-like growth factor, BPH, Prostate cancer
  • Mostafa Shirkhani, Sahel Heydarheydari, Negin Farshchian, Mohammad Taghi Eivazi, Abbas Haghparast* Pages 99-104
    Background

    Up to 3% of breast cancers may be diagnosed in pregnancy, during which period radiation therapy is not preferred, yet sometimes inevitable. Due to fetal radiation sensitivity, the fetal radiation safety is of particular concern. The present study was performed to estimate fetal dose for pregnant breast cancer patients during radiotherapy using an in-house phantom.

    Method

    The fetal dose was estimated through phantom measurement using an ion chamber dosimeter. The phantom measurement was performed by simulating treatment planning on an in-house anthropomorphic phantom which consisted of natural human bone, cork, and paraffin. The right breast and the right supraclavicular area of the phantom were irradiated under the four-field technique with 6 and 10 MV photon beams for un-wedged and wedged fields.

    Results

    During the first trimester of pregnancy, the radiation dose delivered to the fetus was in the range of 0.11-0.14 Gy for a 50 Gy total tumor dose in 25 fractions. The fetal dose in the second and third trimester of pregnancy ranged from 0.14-0.19 Gy to 0.22-0.32 Gy, respectively.

    Conclusion

    According to the results, the fetal dose is strongly dependent upon the energy beam, treatment procedure, and gestational stage

    Keywords: Breast cancer, Radiation therapy, Fetal dose
  • Simon Raif Marcos, Bhanu Pratap Singh, Devesh Sanjeev Ballal, Faris Alaswad, Shakeel Akhtar, Gabriel Rodrigues* Pages 105-128

    Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that almost always arise from the GI tract and account for 0.1-3% of GI tumors. During pregnancy, GIST is highly unusual given the predilection of this tumor to appear in the fifth to seventh decade of life. The finding of GISTs outside the GI tract is also rare as the cell of origin of these tumors is believed to be the interstitial cell of Cajal, found only in the GI tract. Extra intestinal GISTs have been reported with a few cases arising from the uterus or metastatic to the ovary; however; an asymptomatic uterine GIST occurring at pregnancy as an incidental finding during cesarean section has not been reported so far. We present a 32-year-old lady who underwent an emergency caesarean section and was found to have a GIST of the uterus. The tumor was excised in toto and she started imatinib therapy postoperatively. At the end of three years of close follow-up, she has done well with no evidence of recurrence

    Keywords: GIST, Tumour, Pregnancy, Excision, Imatinib
  • Farnoosh Razmara, Reza Sharifi, Ghazal Shabankareh, Samira Derakhshan* Pages 109-113

    Metastatic tumors to the oral cavity are rare and account for only 1% of all oral cavity malignancies, and if occurs, it involves the jaws rather than the soft tissue. Diagnosis of a metastatic lesion in gingiva can be challenging owing to its rarity and atypical appearance. In this paper, we describe a rare case of breast cancer metastasis to the gingival soft tissue of mandible. A 68-year-old female referred to the department of oral and maxillofacial surgery with the chief complaint of a painful mass in the right buccal and lingual anterior region of the mandible with the mobility of the involved teeth. The patient also reported the history of a breast cancer dating back to eight years ago. Histopathologic findings and immunohistochemistry results supported a metatatic lesion. As a result, it is important to have a great clinical suspicion to diagnose such lesions in order to receive the most proper treatment to patients as soon as possible

    Keywords: Breast cancer, Gingiva, Metastasis, Oral cavity
  • Majd T. Mrayyan*, Marwan Shawish Pages 114-119

    Breast cancer is the most common cancer and the fifth most common cause of death from cancer in women. Ovarian cancer is the deadliest type of the gynecological cancers. Concerning women with BRCA1 or BRCA2 mutation, surgical alternatives for reducing their risk of developing breast and/or ovarian cancer are prophylactic mastectomy, skin-sparing mastectomy, and prophylactic salpingo-oophorectomy. The arguments of the proponents and opponents regarding prophylactic mastectomy and salpingo-oophorectomy are presented. Prophylactic surgeries are controversial; hence, mandating immediate interventions on the policy level.

    Keywords: Mastectomy, Salpingo-oophorectomy, Opponents, Proponents, Policy
  • Seyed Hossein Shahcheraghi*, Marzieh Lotfi*, Hamid Reza Rahimi, Jamshid Ayatollahi Pages 120-124
  • Akbar Safaei, Ahmad Monabati, Maral Mokhtari, Mehdi Montazer* Pages 339-343

    The emerging era of personalized medicine makes it increasingly important toc onsider intratumoral heterogeneity, which has been found in some breast cancerc ases. However, its identification criteria, form of reporting, and subsequent effects ont he clinical course of this disease remain controversial and not fully defined. Here, wer eport and discuss a case of breast invasive ductal adenocarcinoma with substantiali ntratumoral heterogeneity, discrepancy between Her2/neu immunostaining and ins ituhybridization, and disparity between estrogen receptor status before and aftern eoadjuvant therapy.

    Keywords: Breast, Estrogen receptor, ErbB-2, Genetic heterogeneity, Personalized medicine