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Kourie H.R.,Raymond and Aida Najjar Medical Center | Kattan J.,Raymond and Aida Najjar Medical Center | Antoun J.,Raymond and Aida Najjar Medical Center | Sleilaty F.,Raymond and Aida Najjar Medical Center
Onkologie(Czech Republic)

Background: Granulosa cell tumors (GCT) are malignant tumors of the sex cord stroma representing 5% of all malignant ovarian tumors. Their treatment is surgery, and rarely chemotherapy and radiotherapy. Recently, salvage treatment with aromatase inhibitors was suggested based on few reported clinical cases. Case Report: We present the case of a 61-year-old woman with unresectable recurrent GCT of the right ovary treated with the aromatase inhibitor letrozole. Tumor mass and peritoneal carcinomatosis decreased in size allowing almost complete surgical resection. The patient remained in complete clinical remission for at least 24 months after surgery while under letrozole. Conclusion: Aromatase inhibitors represent an innovative treatment for these rare and refractory tumors offering promising results while avoiding toxic and marginally active chemotherapeutic agents. © 2013 S. Karger GmbH, Freiburg. Source

Kattan J.,Raymond and Aida Najjar Medical Center | Chemaly A.,Raymond and Aida Najjar Medical Center | Chemaly M.,Raymond and Aida Najjar Medical Center | Jamal D.,Raymond and Aida Najjar Medical Center | And 2 more authors.
Journal Medical Libanais

Excessive amounts of vasoactive intestinal polypeptide (VIP) cause a special clinical syndrome characterized by secretory diarrhea, hypokalemia and dehydration. A careful clinical workup of a 62-year-old female admitted for refractory diarrhea revealed a neglected inflammatory right breast ductal carcinoma with VIP hypersecretion without any localized abdominal tumor. Immunohistochemistry of the breast biopsy showed neuroendocrine characteristics with positive staining for VIP, and Octreotide scan showed hyperfixation to the right breast and axilla. Primary therapy of breast cancer with hormones and chemotherapy achieved transitory regression of diarrhea, VIP level decrease, and tumor border reduction. Bilateral modified radical mastectomy and irradiation of the tumor failed to prevent liver and bone dissemination of the disease. Once more, partial response was obtained by octreotide and salvage chemotherapy ; however, the patient died from progressive disease 23 months after initial diagnosis. To our best knowledge, this unusual presentation of a breast carcinoma with related VTPoma syndrome is the first reported case in the literature. Source

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