Tehran University Medical Journal

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Primitive Peripheral Malignant Neuroectodermal Tumor is a malignant neoplasm of neural origin with high mortality which occurs mostly in children and adolescents. The most common site of involvements are chest wall and paraspinal regions. Head and neck involvement is rare. The diagnosis is based upon histopathologic and immuno-histochemical studies. Treatment is combination of surgery, radiotherapy and chemotherapy. In this article we present a rather rare case of PNET which occurred in the neck area of a child.

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Background: Malignant melanoma is one of the fatal cutaneous neoplasms which are curable by early diagnosis. This neoplasm is diagnosed by the biopsy of the suspected lesion. It is essential to classify the tumor based on its histology, thickness, phase of growth, level of invasion, mitotic rate, presence of regression, inflammatory infiltration and ulceration. These descriptions yield some knowledge about the progression of disease and suggest an estimate of the status of the screening system for early diagnosis.

Methods: This is a cross-sectional retrospective descriptive study. Pathological slides with diagnosis of malignant melanoma from 1377 to 1379 that present in the pathology department were assessed according to mentioned pathological indices and the 10-year survival calculated in this regard.        

Results: We assessed 47 cases with mean age of 57.38 (SD=5.85) and the gender distribution was 51.1% male and 42.2% female. More than 42% of cases were in Clarke level I, 2.1% Clarke level II, 6.4% Clarke level III, 40.4% Clarke level IV and 8.5% Clarke level V. Fifty three percent of patients were breslow thickness equal to or less than 0.75 millimeter(mm) , 8.5% between 0.76 to 1.69 mm , 27.7% between 1.7 to 3.6 mm and 10.6% greater than 3.61 mm. Mean breslow thickness show no significant difference between males and females but there is a significant relation between thickness and age of the patients. Mean 10-year survivals of patients were 75% and were greater in females than males. We found a linear relation between patient age and breslow thickness that is calculated by the following equation: Log Breslow thickness (mm) = - 0.625 + 0.016×age (year)

Conclusion: Complete recording of clinical and pathological data of patients with malignant melanoma make a proper stream to reach a surveillance system.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Pleural malignant mesothelioma is an uncommon but extremely invasive tumor which originates from mesothelial cells and usually occures after prolonged exposure to asbestos. The aim of this study was to clinicopathologically evaluation of 40 patients with pleural malignant mesothelioma and the main factors influencing their prognosis.
Methods: In this study patients with definitive diagnosis, who had been followed up for at least three years were studied based on gender, age presenting symptoms, and clinicopathological patterns.
Results: Male to female ratio of the study patients was three to one any the average age of them was 55 years. Chest pain was the most common symptoms in 34(85%) patients. Most of the study patients were in Buchard stage I (37/5%) and the epithelial form was the most common pathological pattern 25(62.5%). 19(47.5%) of cases received only radiotherapy and chemotherapy. Extrapleural pneumonectomy was performed on eight (20%) patients, seven (17.5%) patients underwent decortication and pleurectomy beside adjuvant therapy and 15% of the cases rejected any type of treatment. Surgical mortality occurred in one patient and the most common surgical complication was wound infection. The average survival rate was 12±1.2 months and the main factors influencing it were the patient's physiologic status, pathological form, stage of the disease and the pattern of pleural involvement.
Conclusions: Because the low survival rate after multimodality invasive treatments in mesothelioma, aggressive therapeutic methods were recommended in selected patients

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Neuroleptic malignant syndrome is an idiosyncratic and potentially fatal reaction to neuroleptic drugs and is characterized by fever, muscular rigidity, altered mental status, autonomic dysfunction, elevated serum CPK and leucocytosis Neuroleptic malignant syndrome is treated with dantrolene, bromocriptin, amantadin and electroconvulsive therapy.
Case: A 22 years old, schizophrenic female was refered to the Emergency ward of Roozbeh hospital in Tehran, Iran in December 2008 with aggression, impulsivity, and reduced sleep. After injection of haloperidol, the patient developed a high grade fever, diaphoresis and muscular stiffness. She was diagnosed as neuroleptic malignant syndrome and the treatment with dantrolen, bromocriptin and amantadin initiated. Although fever subsided, other signs continued, therefore we applied electroconvulsive therapy to this case.
Conclusion: Due to excellent response of the patient to electroconvulsive therapy and the rare reports of electroconvulsive therapy in neuroleptic malignant syndrome in the Iranian population, this case may lead to develop studies for further investigations of this issue.

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Background: Cancer is the third cause of death in Iran. Approximately 5-10% of all human cancers are thought to be caused by occupational exposure to carcinogens. Dif-fuse mesotheliomas of the peritoneum and pleura are considered "signal tumors," or pa-thognomonic of exposure to asbestos. There is also evidence that nonasbestos agents can induce malignant mesotheliomas. So, we need to study the history of exposure to asbestos in patients suffering from mesothelima to determine relationship between them in Iran, especially in occupational settings. Methods: We received the data of 272 mesothelioma's patients having been registered in 1385 to 1389 in Cancer Bureau, in Ministry of Health. One hundred fifty four of them had telephone number. Finally we could interview with 60 families and gathered data of patient's history of occupation, cigarette smoking and residence place interred in the designed questionnaire. Then we brought out the variants of age, sex, the province of birth place and the involved organs from the data of Cancer Bureau. Analysis of frequency of variants was carried out and compared once in 272 patients being registered in Cancer Bureau and then in the interviewed 60 patients. Results: Distribution of age, sex, the province of birth and living place and the involved organ were similar in cancer registry's data and the interviewed patients. Distribution of cigarette smoking and exposure to asbestos in the interviewed patients were 28% and 63% respectively. Occupational distribution of interviewed patients consisted of con-struction workers 20%, oil company employees 13.3%, administrative staff 8.3% and drivers 6.7%. Conclusion: The results of our study specified the jobs with high risks of exposure to asbestos and approved the relationship between the exposure to asbestos and the inci-dence of mesothelioma in Iran, according to researches in other countries. So the con-sumption of asbestos in Iran, like 20 other countries in the world is necessary to be banned.

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