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Successful multidisciplinary clinical approach and molecular characterization by whole transcriptome sequencing of a cardiac myxofibrosarcoma: A case report

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World Journal of Clinical Cases 2019年第19期7卷 3018-3026页

作者： Maristella Saponara Valentina Indio Carmine Pizzi Elena-Daniela Serban Milena Urbini Annalisa Astolfi Pasquale Paolisso Sofia Martin Suarez Margherita Nannini Davide Pacini Valentina Agostini Ornella leone Valentina Ambrosini Giuseppe Tarantino Stefano Fanti Fabio Niro francesco Buia Domenico Attinà Maria Abbondanza Pantaleo Department of Specialized Experimental and Diagnostic MedicineMedical Oncology UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy “Giorgio Prodi”Cancer Research Center University of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineCardiology and Transplantation UnitSant’Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Pathology Cardiovascular Pathology UnitSant’Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Departments of Cardiovascular Surgery and Transplantation Sant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineNuclear Medicine UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineRadiology UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy

BACKGROUND Cardiac tumors are rare and complex *** represents the cornerstone of therapy,while the role of adjuvant treatment remains unclear and,in case of relapse or metastatic disease,the prognosis is very *** of prospective,randomized clinical trials hinders the generation of high level evidence for the optimal diagnostic workup and multimodal treatment of cardiac ***,we describe the multidisciplinary clinical management and molecular characterization of a rare case of cardiac myxofibrosarcoma in an elderly *** SUMMARY A 73-year-old woman presented signs and symptoms of acute left-sided heart *** examination revealed a large,left atrial *** suspicion of a myxoma,she underwent surgery,and symptoms were promptly *** showed a cardiac myxofibrosarcoma,a rare histotype of cardiac *** months later,disease unfortunately relapsed,and after a multidisciplinary discussion,a chemotherapy with doxorubicin and then gemcitabine was started,achieving partial radiologic and complete metabolic response,which was maintained up to 2 years and is still *** report is focused on the entire clinical path of our patient from diagnosis to follow-up,through surgery and strategies adopted at ***,due to their rarity,very little is known about the molecular landscape of ***,we also performed and described preliminary genome analysis of the tumor tissue to get further insight on mechanisms involved in tumor growth,and to possibly unveil new clinically actionable *** We report a case of cardiac myxofibrosarcoma that achieved a very good prognosis due to an integrated surgical,cardiac and oncologic treatment strategy.

关键词： Cardiac sarcoma Myxofibrosarcoma Whole transcriptome sequencing Doxorubicin Gemcitabine Case report

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Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: An Italian position statement

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World Journal of Gastroenterology 2014年第40期20卷 14642-14651页

作者： Gianni Testino Patrizia Burra Ferruccio Bonino francesco Piani Alessandro Sumberaz Roberto Peressutti Andrea Giannelli Castiglione Valentino Patussi Tiziana Fanucchi Ornella Ancarani Giovanna De Cerce Anna Teresa Iannini Giovanni Greco Antonio Mosti Marilena Durante Paola Babocci Mariano Quartini Davide Mioni Sarino Aricò Aniello Baselice Silvia leone Fabiola Lozer Emanuele Scafato Paolo Borro Regional Alcohologic Centre Liguria Region Alcohol Unit and Related Diseases Department of Internal and Specialist Medicine IRCCS AOU San Martino-IST National Institute for Cancer Research 16100 Genova Italy Gastroenterology Department of Surgical and Gastroenterological Sciences University Hospital of Padova Veneto Region 35100 Padova Italy Internal Medicine University of Pisa 56100 Pisa Italy Department of DependenceASS4 Medio Friuli Regione Autonoma Friuli Venezia Giulia34100 Trieste Italy Regional Transplantation Centre Autonomous Region of Friuli Venezia Giulia 33100 Udine Italy Regional Transplantation Centre Liguria Region 16100 Genova Italy Regional AlcohologicCentre Toscana Region Alcohol Unit Careggi Hospital University of Firenze 50100 Firenze Italy Department of Dependence Molise Region 86100 Campobasso Italy Alcohol Unit Department of Dependence Molise Region 86100 Campobasso Italy Alcohol Unit ASL di Ravenna Emilia Romagna Region 48100 Ravenna Italy Alcohol Unit ASL 4 di Terni Umbria Region05100 Terni Italy Hepatology Unit Santa Maria Hospital 05100 Terni Italy Gastroenterology Ordine Mauriziano Hospital Piemonte Region 10100 Torino Italy Italian Clubs of Alcoholics in Treatment 84134 Salerno Italy Department of Toxicology University of Genova 16100 Genova Italy World Health Organization Collaborating Centre for Research and Health Promotion on Alcohol and Alcohol-related Health Problems Europe Region Istituto Superiore di Sanità 00100 Roma Italy

Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the “6-mo rule”. Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The “Group of Italian Regions” suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups.

关键词： Alcohol Alcoholic hepatitis Cirrhosis Hepatocellular carcinoma Liver transplantation

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