The Primary Mediastinal Seminoma (PMS) is a rare extragonadal malignant germ-cell tumor. We report a clinical case of our practice, which is the reason for this literature review and try to find the optimal multimodal therapeutic option and the role of radiotherapy.
The occurrence of hepatocellular carcinoma (HCC) on a healthy liver is exceptional and represents a real diagnosis challenge for the clinician. Recently a particularly increased risk of cancer during Behc¸et’s disease (BD) was reported by several studies. Only a few sporadic cases of liver cancer associated with this vascultis have been reported. We report an original observation of non-fibrolamellar HCC occurring on healthy liver in a Tunisian patient followed for BD. A 43-year-old man, followed since the age of 25 for BD with isolated cutaneous and mucosal involvement, and treated by colchicine, was admitted for exploration of a pain of the right hypochondrium evolving since a few months associated with an important slimming, anorexia, and evening fever. The clinical examination noted a firm and painful hepatomegaly. Radiological exploration (ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI)) showed a bulky hepatic tumor with highly developed arterial blood supply. Ultrasound-guided biopsy concluded at HCC without signs of fibrolamellar type or cirrhosis. Biological tests were without abnormalities and specific investigations eliminated underlying chronic hepatopathy (chronic viral hepatitis B or C, hemochromatosis, Wilson’s disease or autoimmune hepatitis). The patient was treated symptomatically given the advanced stage of cancer. He quickly died after a month because of a multi-organ failure. HCC on healthy liver is exceptional and BD was suggested as a possible contributing factor. Thus, regular radiological monitoring seems to be recommended in any patient followed for BD, especially those with hepatic veins thrombosis.
The overall prognosis in patients with advanced and metastatic lung cancer is poor, however a subset of these patients has durable survival and they are called long-term survivors (LS). The definition of LS varies in published series from 18 months to 5 years. Few studies have focused on them. We report six cases of LS patients: three cases of non-small- cell lung cancer (stage IIIB and stage IV), two case of small cell lung cancer, and a case of composite carcinoma (small cell carcinoma and squamous carcinoma), all having a survival of five years or more. Our patients show clinical and evolutionary similarities with LS in the literature regarding the prognostic factors associated with prolonged survival namely performance status and good response to first-line chemotherapy.
As breast cancer relative survival continues to increase, many breast cancer patients face many issues, including recurrence of cancer and cancer-related side effects that impact several aspects of their quality of life. With breast cancer patients living longer, there is more of a concern for negative breast cancer outcomes. Although physical activity is an affordable and relatively convenient way to improve breast cancer outcomes, only about one-third of breast cancer survivors engage in the recommended level of physical activity. This article reviews articles published to date to examine whether home-based physical activity interventions are effective in improving physical activity and other outcomes among breast cancer survivors who have completed primary therapy for the disease. The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1980 through February 28, 2019 were identified. A total of 360 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, 20 studies that met the eligibility criteria. Three of the studies were pre-/post-test trials and 17 were randomized controlled trials. Home-based exercise programs are effective in improving physical activity among breast cancer survivors who have completed primary therapy for the disease. Home-based exercise programs such as walking programs offer a convenient and affordable option for women who wish to increase their physical activity and maintain a healthy lifestyle.