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hondrosarcoma of head and neck is a very rare tumor. Ïn this article a single case referred to Ë.N.T. department of Rasoul-e-Âkram hospital is being reported. Ân extensive tumor which involved nasal, posterior ethmoidal sinuses, sphenoid and intracranial regions which could cause a difficulty in its treatment. Delay in consultation and diagnosis could be the reasons for massive extention of the tumor. The most important symptoms are nasal block and epistaxis and the treatment is complete resection by a selective surgery.

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A rare case of extensive spontaneous retropritoneal hemorrhage from a reptured angiomolipoma is described. A 34- year- old woman was admitted to our department with a complaint of acute abdominal pain. Obvious right side abdominal distention, abdominal tenderness and guarding and hypovolumic shock were noted on physical exam. Abdominal ultrasonography and CT scan showed massive retroperitoneal hemorrhage with a mass in lateral of Rt. Kindney. After appropriate resuscitation, laparatomy and Rt. Nephrectomy was done. Pathological study revealed angimyolipoma. Because of hemorrhagic shock at admittance and during operation Rt. Nephrectomy was preferred.

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We report a case of paraesophageal varices presenting as a posterior mediastinal mass in a patient with long-standing portal hypertension and cirrhosis. The case is unusual because the varices were considerably larger than those usually encountered in portal hypertension. This report is a reminder that portal hypertension with paraesophageal varices can present as a retrocardiac mass on the chest radiogram. We suggest that in diagnostic work-up of patients with cirrhosis and masses in mediastinum modern imaging techniques, such as dynamic CT, color Doppler sonography and MRI, are most helpful (because they can demonstrate the vascular nature of these masses and have multiplanar capabilities) and precutaneous needle biopsy may be hazardous.

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In this report we introduce an 8 years old boy with Transverse colon inflammatory pseudotumor. The patient was admitted to Boo-Ali Sina Hospital with abdominal pain, fever and vomiting. In clinical examinations an abdominal mass in splenic flexure was palpated. Imaging study with CT-Scan revealed a calcified mass in transverse colon wall with lymphadenopathy and lymphoma was suggested. Histological study showed inflammatory pseudotumor. After surgical excision the patient was recovered. The recurrence was not seen after one year follow up. This case showed that in differential diagnosis of pediatric colonic mass, inflammatory pseudotumor should be considered in order to prevent unneccesary and harmful chemotherapy and radiotherapy.

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Background and purpose: In spite of the increasing progress in tumor treatment by current methods like surgery, chemotherapy and etc, medical sciences are unable to treat tumors. In this respect, immunology has opened a new window for tumor treatment nowadays tumor immunotherapy is an accepted strategy for treatment of some tumors at least in some animal models. The goal of this study is the evaluation of immunotherapy using gp96- tumor peptide complex and its combination with naloxon as an opioid receptor antagonist to achieve of cellular immunity against tumors
Materials and methods: In this study firstly, gp96 – tumor peptide complexes were purified from WEHI164 cells line using srivastava method. In the next stage, the mice, made tumoric befor by the injection of tumor cells, then were divided in to four groups. Control group were injected by PBS, test group1 were injected by naloxon, test group2 were injected by gp96 – tumor peptide complex and test group3 were injected by combination of naloxon and gp96 – tumor peptide complex. To evaluation the efficacy of vaccination, after several days, tumor volume was recorded then the mice were killed and the spleanic cells were extracted in sterile condition. MTT test was done for cells proliferation study. Supernatant of cultured cells were collected and assayed by ELISA kits for measuring IL-4 and IFN-γ.
Results: Result of protein purification had showen , purified gp96 Isoform has Molecular Weight of 66 kilo dalton.Results of tumor volume had shown that, there is no significant difference between test and control groups. Results of MTT test had shown that, there is no significant difference between test and control groups. IL-4 assay study had showed that, there is no significant difference between test group1, group2 and control group but test group3 has significantly decreased in IL-4 amount when compared with control group. Results of IFN-γ assay showed that, there is no significant difference between test group1 and control group, but test group2 and group3 has significantly increased in IFN-γ amount when compared with control group.
Conclusion: It can be concluded from this study is that, prophylactic immunotherapy of tumor by combination of gp96-tumor peptide complex and naloxon, can increase IFN-γ, and, probably in a higher dosage, it may stimulate immune system more to become more potent to even decrease tumor volume.

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Primary heart tumors are not common. Âlthough myxoma is the most common tumor of the heart, mitral valve myxoma is extremely rare. The patient is a 55 years old woman who had atypical retrosternal pain, retinal artery emboli and visual deficit. Ïn transesophageal echocardiography a (4x3x3) cm mass was detected in posterior leaflet of mitral valve. The posterior leaflet of mitral valve was totally resected and the mitral valve was successfully replaced with prosthetic mechanical valve. Histopathology result confirmed myxoma.

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Background and purpose: Germ cell tumor is the most common malignancy of men between 15-34 years of age. Proper treatment is highly dependent on accurate histologic diagnosis, and different markers such as cytokeratin, CD3, GPC3 and etc. were proposed. It was reported that GPC3 is over expressed in testicular germ cell tumors by micro array assay. The aim of this study was to evaluate the expression of GPC3 using IHC in all testicular germ cell tumors to assess its possible application as a diagnostic marker. Materials and methods: GPC3 was immunohistochemically assessed among 55 cases of germ cell tumors, including 23 seminoma, 10 embryonal carcinoma, 8 teratocarcinoma, 4 mixed germ cell tumor, 3 mature teratoma, 3 immature teratoma and 4 yolk sac tumors. Results: All yolk sac tumors and yolk sac components of mixed germ cell tumors showed diffuse membranous and cytoplasmic positivity for GPC3. The positive results decreased to 33% , 25% and 20% in immature teratomas, teratocarcinomas and embryonal carcinomas, respectively. No reactivity in seminoma, mature teratoma and normal testicular tissue was seen. Conclusion: It seems that GPC3 is a usefull marker in the histopathologic diagnosis of yolk sac tumors or yolk sac elements of mixed germ cell tumors.

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Background and purpose: Incidence of neuroendocrine tumors in the world is increasing during these years. These tumors have a high complexity in clinical presentation, tumor stage and grade. In addition, using of markers like Ki67 level could help to estimate tumor grade. Assessing hospital prevalence of neuroendocrine tumors, Their origin and association between pathology and immunohistochemistry with Ki67 level was the purpose of conducting this study. Materials and methods: All patients’ records during 2004-2010 were reviewed to select patients with neuroendocrine diagnosis, then their pathology and histochemistry samples were examined again. Patients’ characteristics in addition to type, grade and origin of tumors were entered to check list. Results: Incidence of neuroendocrine tumors was 8 in 1000 patients. Data was gathered from 189 patients with neuroendocrine tumor diagnosis. Mean age was 49/6 years and Prevalence of each sex was 52/9% and 47/1% in men and women respectively. Pathology diagnoses were Carcinoid (27%), Round cell tumor (21.2%) and undifferentiated carcinoma (18.5%). Mean of Ki67 levels were significantly different by tumor grade, location, necrosis, pathology and immunohistochemistry. Conclusion: Based on this study, using Ki67 marker is helpful for diagnosing and determining tumor status, which could be effective on choosing the type of treatment.

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Background and purpose: In most cases, drugs used for chemotherapy are ineffective and have unpleasant side-effects. This has made scientists to find more effective drugs with less toxicity. Lagenaria siceraria is an important medicinal plant in the world and anti-tumoral activity of Lagenaria species has been reported in some studies. This study was designed to evaluate the anti-tumoral effect of methanolic extract isolated from Lagenaria siceraria on lung cancer cell line. Materials and methods: Hydroalcoholic extract of Lagenaria siceraria was prepared by percolation method. Cultivated cancer cell line of lung (A549) was incubated with different concentrations (0.1, 1, 10, 100, 250, 1000, 500, and 5000 µg/ml) of the extract for 72 hours and cell growth inhibition was determined using MTT assay. Cisplatin was considered as positive control. The resulting data was analyzed using ANOVA and t-test. Results: Results of MTT assay showed strong and dose-dependent inhibition of cancer cell growth by the extract of Lagenaria siceraria. This extract caused a significant decrease in proliferation of lung cancer cell line (IC50 = 93.094 ± 6.5 μg/ml). Conclusion: The results of this study suggest anti-tumoral activity of Lagenaria siceraria, however, isolation of efficient compounds of this extract and evaluation of their effects on tumor-bearing animal models are suggested.

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Oncocytoma is a rare benign tumor of salivary gland. The name of the tumor is selected due to presence of large granular oncocytes with acidophilic cells.These tumors occur most commonly in the sixth decade of life and sex incidence is equal in men and women.The incidence of this tumor is 78% in parotid gland and 9% in submandibular gland. Oncocytoma are usually solid round tumors that could occure in every major salivary glands but it is extremely uncommon in intraoral minor salivary gland. We present a case of oncocytoma in intraoral minor salivary gland in a 45- year- old woman.

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Schwannomas are benign tumors of the nerve sheath and are usually single encapsulated and slow growing in peripheral or sympathetic nervous system. In this report a 49 year-old man is presented with one year complain of abdominal pain and intermittent hematospermia. The CT scan of the abdomen showed a 60 × 65 × 60 mm mass in anterior pelvic cavity with deviation to the sacral bone, originated from nerve. Several examinations revealed neurofibroma. Due to the large size of the tumor and it's position to the pelvic nerves, to remove the mass the patient only underwent laparotomy with partial resection. Pathology tests confirmed Ancient Schwannoma with degenerative changes. Radiotherapy was done with the aim of reducing the size of the rest of tumor. In our case, schwannoma was diagnosed incidentally. The size of the tumor indicated a relatively long period from the time that tumor was generated until the time of diagnosis. Despite using paraclinical findings, a definite diagnosis of the disease was made by histopathological tests.

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Background and purpose: Bombesin shows very high-affinity for the Gasterin releasing peptide (GRP) receptors which are over expressed in different human tumors such as breast and prostate. The aim of this study was to identify a new bombesin derivative labeled with 99mTc via HYNIC that might be used as a noninvasive tool for diagnosis of GRP receptor expressing tumors. Materials and methods: Prepared bombein derivatives were radiolabeled with 99mTc at 100 °C for 10 min by exchange method and radiochemical analysis was performed using ITLC and HPLC methods. The stability of radiopeptide was checked in the presence of human serum at 37 °C and saline for up to 24 h. Results: [99mTc-EDDA/tricin/HYNIC-(Ser)3-D-Phe13]BN(7-14) and [99mTc-EDDA/tricin/ HYNIC-(Gly)3-D-Phe13]BN (7-14) were obtained with radiochemical purities of >95%. Results of in-vitro studies demonstrated a high stability in serum and saline. Conclusion: Radiolabeling of this novel conjugates with 99mTc were easily performed using exchange labeling. The prepared 99mTc-HYNIC-BN conjugates demonstrated some potential as site-directed diagnostic radiopharmaceuticals. Therefore, more in vivo studies are required.

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Cancer stem cells are believed to be responsible for the cancer-initiating step and resistance to chemotherapy drugs. Studies have shown that cancer stem cells are silent and have no metabolic activity. The main reasons behind tumors resistant to therapies are lack of activity of cancer stem cells and division of cancer cells. This cell population, like normal stem cells, is capable of self-renewing and responsible for survival of tumor and its genetic and metabolic differences. Cancer stem cells can undergo chemotherapy during the treatment, but, the incidence of secondary tumor occurs due to unequal division of cancer stem cells and new tumor cells grow that are multi resistant to chemotherapeutic agents. Therefore, identifying and characterizing cancer stem cell will lead to a better understanding of its controlling pathways and developing better diagnostic and therapeutic methodologies in basic and clinical cancer researches. In this review the role of cancer stem cells in development of cancer and their heterogenic properties in gene expression and metabolism of the tumor has discussed. Finally, new therapeutic strategies that are often based on the use of nanocarriers are presented.

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Background and purpose: The 4T1 cell line is a laboratory model used in the study of tumors biology. This cell line is very tumorigenic with high metastatic capacity in different organs. In this study, histology and immunohistochemistry methods were used to investigate the structure and localization of Na⁺/K⁺- ATPase enzyme in 4T1 cells induced breast cancer tumor in Balb/c nu mice.

Materials and methods: The histological sections (4 µm) were stained using Hematoxilin-Eosin and IgGα₅ special antibody was used for immunohistochemistry study.

Results: Study of tumor structure showed abnormal proliferation and high mitogenicity in epithelial cells with high proliferation rate. Immunohistochemistry analysis revealed significant immunofluorescence, indicating abundant presence of Na⁺/K⁺-ATPase enzymes (sodium potassium pump) in tumor cells.

Conclusion: Current results showed high rate of sodium potassium pump in plasma membrane of tumor cells. Immunofluorescence characteristic of 4T1 tumor cell lines make them appropriate candidate for antitumor studies.

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Background and purpose: Medicinal plants have received much attention in treatment and control of many diseases due to rich nutritional values and antioxidant properties. Garlic is one of these plants that is mentioned in Islamic sources because of its beneficial effects on human health. In traditional medicine it was used to treat different diseases. This review study aimed at presenting the nutritional properties of garlic according to Islamic sources and its therapeutic applications in traditional medicine.

Materials and methods: A narrative review study was carried out, searching online databases including Google Scholar, Scopus, Pub med, Science direct, ISC, Magiran, and SID. Articles published in 1994-2015 were selected.  Also, Holy Quran, Islamic narrations and hadith, traditional medicine and medicinal plants books were studied. The search keywords were Allium stivum, medicinal plant, and Holy Quran. Data was then categorized and analyzed.

Results : Garlic contains some antioxidant compounds and micronutrients such as selenium and alicin, diallyl disulfide and diallyl trisulfide that are effective in improving joint diseases. Also, ajoene, diallyl disulfide and diallyl trisulfide which are found in garlic have proapoptotic activities and reduce cancer cell growth.

Conclusion: Garlic contains antioxidant compounds such as selenium, allicin and diallyl trisulfid that have antimicrobial and antitumor activities. Identifying its effective compounds and mechanisms could help in deciphering the inspiration of holy Quran about some specific plants.

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Multiple myeloma is a monoclonal malignant proliferation of plasma cells that causes osteolytic lesions in the vertebrae, ribs, pelvic bone, skull and jaw. We report a case of a 66 year-old-woman with pain and right facial swelling. Radiographic examination showed a well-defined radiolucent lesion in left posterior mandible. An incisional biopsy was performed and histopathological examination revealed proliferation of malignant plasma cell with off-center and hyper chrome nucleus. The results of biopsy, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This maxillofacial manifestation of multiple myeloma is not that rare, but dentist knowledge about maxillofacial manifestation can help in early diagnosis and consequently better prognosis of the disease.

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Background and purpose: Bombesin is a 14-amino acid peptide with high biological functions which has a high affinity to GRP )Gastrin releasing peptide( receptor. GRP receptors are overexpressed in many malignant tumors such as prostate and breast cancers. The purpose of this study was to prepare [HYNIC-(Gly)_3-D-Phe¹³]Bombesin(7-14) to label it easily by ^99mTc and to evaluate it as a potential agent for imaging the tumors that have GRP receptors.

Materials and methods: In this experimental study, the prepared derivative Bombesin was radiolabelled by ^99mTc at 100°C in 10 minutes using the exchange method and radiolabelling analysis was applied by TLC and HPLC. Specific absorption test and specific internalization using prostate cancer cells PC-3 was done by blocking and unblocking the receptors. Biodistribution were determined in normal mice.

Results: More than 95% radiolabelling was obtained. Specific absorption and internalization after 4 hours were 17.9% and 9.5%, respectively in PC-3 cancer cells. Biodistribution data showed rapid clearance from blood with major renal excretion and specific binding to tissues that have GRP receptors such as pancreas.

Conclusion: Conjugated peptide radiolabelled with ^99mTc has promising characteristics as potential agent for imaging the tumors that overexpress the GRP receptors.

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Background and purpose: Breast cancer is the second leading cause of cancer death in women and the most common cancer causing liver metastases. Radiofrequency ablation (RFA) is a new method in treatment of liver metastases. This study was designed to evaluate the efficacy of RFA on liver metastatic breast tumors.
Materials and methods: In a randomized clinical trial, 52 patients with liver metastases from breast cancer who had less than 5 lesions < 5 cm enrolled. They were divided into two groups; an intervention group that received both chemotherapy and RFA and a control group who had only chemotherapy. Different variables were evaluated e.g. changes in lesion size, residual tumor status, and therapy complications. Data was analyzed in SPSS V20.  
Results: In a randomized clinical trial, 52 patients with liver metastases from breast cancer who had less than 5 lesions < 5 cm enrolled. They were divided into two groups; an intervention group that received both chemotherapy and RFA and a control group who had only chemotherapy. Different variables were evaluated e.g. changes in lesion size, residual tumor status, and therapy complications. Data was analyzed in SPSS V20.  
Conclusion: RFA was found as a safe and efficient method in treatment of liver metastases from breast carcinoma and showed a significant synergistic effect in patients under ingesting chemotherapy drugs.
 

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Pan-hypopituitarism is a rare but life threatening disorder that occurs due to reduction of anterior pituitary hormones. In this condition, major depressive disorders are presented by depressed mood and markedly diminished interest in many activities during a day. Some disorders are associated with psychiatric symptoms at presentation, therefore, the diagnosis of mood disorder due to a medical condition should also be considered. This study presents a middle aged man admitted with symptoms of major depressive disorder involving suicidal ideation whose condition did not improve despite treatment with different antidepressant agents. He had past history of brain tumor surgery, chemotherapy, and radiotherapy. Due to the possibility of pituitary axis deficits since the time that radiotherapy was initiated, the patient was evaluated for these axes and the decrease in adrenal, thyroid, gonad and growth hormone axis function was confirmed by lab tests.In patients with persistent and severe depression, underlying medical causes such as endocrine disorders especially hypo-pituitarism should also be considered.

 

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Inflammatory Myofibroblastic Tumor (IMT) is an uncommon benign neoplasm with unknown etiology that rarely affect parotid gland. Clinical and pathologic diagnosis of this neoplasm is difficult and is occasionally misdiagnosed as malignant. This reports presents the case of a 42 year old woman with IMT in the right parotid gland. Using fine needle aspiration cytology, pleomorphic adenoma and mucoepidermoid carcinoma were suggested as differential diagnosis and right parotidectomy was performed. Histopathologic examination along with immunohistochemical analysis confirmed an IMT. During microscopic examination of parotid mass, especially in presence of myxoid background along with inflammatory cells infiltration, inflammatory myofibroblastic tumor should also be considered.