A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran). Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%), followed by lung (40.3%), kidney (7.7%), colorectal (4.6%), lymphoma (3.1%) and melanoma (1.5%). Most patients were presented with features of increased intracranial pressure (headaches and vomiting), seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%). Twenty cases (15.5%) had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%).

Intraocular metastatic tumors have been increasingly reported in the recent past. Unlike choroidal metastasis, metastasis to retina is very rare and so far has been reported in very few case reports only. A 56 year-old male who presented with a history of adenocarcinoma of the cecum and underwent lap colectomy for the primary cecal tumor, received adjuvant chemotherapy for a year after surgery and decided to stop. He was also diagnosed with metastasis to liver and lung at this time. He presented with left eye pain, pressure and decreased vision suspicious for retinal metastasis from cecal primary lesion, 2 years after initial diagnosis. A mass of 5 x 10 mm was found on ophthalmoscopic examination and on ultrasound of the eye, in spite of normal results of MRI of the orbit. Palliative radiation therapy of the left eye resulted in decreased eye pressure and improved vision. As retinal metastasis carries a poorer prognosis due to higher risk of spread to central nervous system, the diagnosis of retinal metastasis in case of gastrointestinal cancers patients who present with vision changes should be made urgently. These patients should be thoroughly investigated with a synergistic approach of opthalmoscopic examination, ultrasound of the eye along with other imaging modalities like MRI of the orbit and just not MRI of orbit. Immediate action in the form of surgical or radiation treatments of the metastatic tumors of the eye should be instituted early on for a better prognosis.

BACKGROUND: The recurrence of colorectal cancers is considered to be one of the greatest post-surgical complications that is affected by various factors. This study was designed to investigate the prognostic factors that affect the recurrence and survival of patients with colon and rectal cancers. METHODS: A retrospective study was performed on 380 patients with colorectal cancers who underwent surgery were enrolled in the study (152 patients with colon cancer and 228 patients with rectal cancer). Preoperative serum albumin level, type of surgery, tumor size, differentiation grade, proximal, distal and radial, and marginal involvement, the total number of excised lymph nodes, the number of involved lymph nodes, and tumor stage were recorded. Also, the incidences of recurrence and metastasis were recorded during the study. RESULTS: 380 patients with a mean age of 57. 11 years were enrolled in the study. 152 patients with an average age of 57. 57 years were diagnosed as having colon cancer. Recurrence and metastasis occurred in two patients (1. 3%) and five patients (3. 3%), respectively. 18 patients (11. 8%) died because of colon cancer. 228 patients with a mean age of 56. 81 had rectal cancer. Recurrence was seen in 19 patients (8. 3%) and metastasis in 33 patients (14. 5%). 38 patients (16. 7%) died because of rectal cancer. Tumor size and involved lymph nodes were independent prognostic factors for the recurrence and metastases of colon cancer. Only involved lymph nodes were associated with death due to colon cancer. Independent prognostic factors for rectal cancer metastasis include serum albumin level and age. The total number of excised lymph nodes was the only predictor of tumor recurrence and death in rectal cancer. The median survival times of colon and rectal cancers were 90 and 110 months, respectively. CONCLUSION: The size of the tumor and the number of involved lymph nodes were independent prognostic factors for recurrence and metastasis of colon cancer. Also, the number of involved lymph nodes was associated with colon cancer-related deaths. In the case of rectal cancer, serum albumin levels and age predicted metastases. Only the total number of excised lymph nodes had a reverse relationship with recurrence and rectal cancerrelated death.

On encountering an eyelid or orbital mass, apart from common skin lesions, the diagnosis requires systemic evaluation, radiological and eventually histological confirmation. The majority are uncommon conditions for ophthalmologists.1 The presenting signs in all soft tissue neoplasms and carcinomas are rather similar with lid swelling and proptosis. In this edition Langerhans cell histiocytosis (LCH), granular cell tumor (GCT) and eyelid conjunctival amyloidosis have been reported. In all the diagnosis is based on confirmation of an adnexal mass and by imaging followed by a histopathological report along with systemic investigation.

Dear Editor:Tuberculosis is a global problem. According to the World Health Organization, more than 2 billion people are currently infected with tuberculosis bacilli and 1.7 million deaths attributed to TB in 2006 (1). TB usually occurs in lung and other form of it like primary abdominal TB is not uncommon and 6-38% of patients with active pulmonary TB have abdominal TB (2). Hepatic tuberculosis is usually associated with military tuberculosis or active pulmonary and isolated liver tuberculosis (ILT) is a rare type of TB (3, 4).

Background: This report analyses an experience with 42 liver resections for metastatic colorectal carcinoma.Methods: Forty-two patients underwent curative resection for liver metastasis from colorectal cancer between January 2004 and December 2007, with a follow up period that ranged from 3 to 66 months. In this retrospective study, early postoperative 30 day mortality and morbidity in addition to the effects of Dukes’ stage, type of resection, number and size of the tumor, synchronous or metachronous metastases, resection margin, sex, age and chemotherapy protocol on three year survival were analyzed retrospectively.Univariate analyses of survival were estimated using the Kaplan-Meier method. Multivariate analysis was evaluated using Cox regression method. The value of P<0.05 was accepted as signicant.Results: Early postoperative morbidity and mortality rates were 7.14% and 0%, respectively. Fourteen patients died during the follow-up period of 3 to 66 months (mean, 40.40±12.87) . Median survival was 56 months and three year survival rate was 71.30%. Recurrence occurred in 11 patients (26.00%) after liver resection and additional surgery was performed for two of them.At univariate analysis, the number of tumors (<4), tumor size (<4 cm), type of resection and negative resection margins were signicantly correlated with three year survival. Sex, age, Dukes’ stage, synchronous or metachronous metastasis, recurrence and chemotherapy protocol were not predictive of long-term prognosis. Multivariate analysis revealed that tumor size > 4 cm and presence of more than four tumors before surgery were associated with a 5.89 and 2.18-fold increased risk of death, respectively.Conclusion: Curative resection is one of the most important treatment options that can demonstrate long-term survival for patients.

Background: The hydatid cyst fluid antigens have high homology with cancer cell antigens and also exhibit considerable immunogenicity. Therefore, their utilization for cancer immunization can cause an effective antitumor immune response. However, the main challenge is identifying the most effective antigens for this purpose. Methods: Hydatid cyst fluid fractions including the glycolipid fraction, glycoprotein fraction, 78 kDa fraction, and antigen B fraction were prepared. Then, the BALB/c mice were immunized against different antigens and, subsequently, 4T1 cells were subcutaneously implanted. The tumors’ growth, metastasis, and tumor‑ bearing mice survival were assessed in different immunized groups. In addition, IL‑ 2, IL‑ 4, IFN‑ γ , and TNF‑ α serum levels were estimated to evaluate the immune system response. Results: BALB/c mice immunization against the complete hydatid cyst fluid antigens exhibited more significant inhibition of the tumors’ growth and metastasis and increase of tumor‑ bearing mice survival in comparison with its derived fractions. However, the 78 kDa fraction exhibited the best results according to the same factors in comparison with all the prepared fractions. Conclusions: The 78 kDa fraction of the hydatid cyst fluid was the most effective fraction of hydatid cyst fluid for immunization against 4T1 breast tumors.

Background: To assess the accuracy, specificity, and sensitivity of dynamic contrast-enhanced magnetic resonance imaging (MRI) in assessing lymph node metastasis (LNM) and prognosis after cervical cancer surgery. Materials and Methods: Fifty cervical cancer patients admitted to our hospital from April 2022 to April 2023 were selected. 27 patients were in stage I-IIA and processed radical hysterectomy combined with pelvic lymph node dissection. Twenty-three patients were in stage IIB and beyond and underwent laparotomy with key site biopsy combined with pelvic lymph node biopsy. Postoperative pathological diagnosis was used as the gold standard for diagnosis. All patients underwent MRI scanning, including conventional MRI scanning such as DWI, T2WI, and T1WI of the pelvic cavity. Gadolinium-diethylene triamine pentaacetate (Gd-DTPA) was injected for dynamic contrast-enhanced scanning. The data of postoperative pathological staging, MRI staging, LNM, deep muscle layer invasion, and postoperative recurrence were analyzed. Results: There was no marked difference between MRI staging and postoperative pathological staging (P>0.05). When comparing preoperative clinical staging and MRI staging with postoperative pathological staging as the control group, there was no significant difference in accuracy. Both postoperative pathological diagnosis and MRI diagnosis had high specificity and sensitivity in assessing LNM and deep muscle layer invasion, but the differences were not significant (P>0.05). Conclusion: Dynamic contrast-enhanced MRI examination has high accuracy in assessing lymph node metastasis for cervical cancer patients. It has high sensitivity and specificity in assessing parametrial invasion, LNM, deep muscle layer invasion, and vaginal involvement, as well as has good prognostic value in assessing postoperative recurrence.

The penis is an uncommon site for metastasis originated from the prostate cancer despite their proximity (0.3%). If develops, it usually presents as painless nodules in the glans penis. Conservative management is generally advocated with emphasis on improving the quality of life. Here, we present a case of a penile lesion which was diagnosed as metastasis from a prostate cancer.