Objective: Renal cell carcinoma (RCC) is a rare and difficult to treat cancer. The case series aimed to observe the effects of medicinal mushrooms and integrative oncology care for renal cell carcinoma.
Clinical Features: Patients diagnosed with RCC who were being treated with surgery and chemotherapy and were administered integrative treatment in the form of supplements and medicinal mushrooms and/or combinations of mushrooms.
Interventions and outcomes: Integrative care included a combination of supplements and the medicinal mushrooms Ganoderma lucidum, Trametes versicolor, Cordyceps sinensis, Grifola frondosa, and Lentinus edodes in combination or alone, which was initiated following adjuvant care. These patients experienced increased overall survival compared to standard adjuvant treatment alone.
Conclusion: Beneficial effects of integrative care were observed in this case series. Disease progression and symptoms related to adjuvant treatment were significantly decreased in these patients after integrative supportive care was initiated and effects persisted through the final observation period. Further controlled studies are needed among larger groups of patients to determine the clinical efficacy of medicinal mushrooms and integrative oncology in the treatment of RCC.

Background: Breast cancer remains a major health problem in women. The molecular mechanisms of tumor growth and progression are complicated but likely involve the interaction of tumor suppressor genes. Oncogenes, cell cycle regulatory proteins and other factors. Recently some studies showed that Cyclin D1 is a cell cycle regulatory gene emerging as a potentially significant oncogene in invasive breast cancers.
Objective: To evaluate immunohistochemical expression of cyclin D1 in women with breast cancer in our population and correlate its expression with different variables such as age, type of tumor and grade.
Materials and methods: We retrospectively analyzed data from 76 formalin-fixed of paraffin-embedded tissues diagnosed with breast cancer which were collected from teaching laboratory unit in Baghdad medical city, Iraq, during the period from 2009 till 2013 and compared with positive control. These samples were investigated immunohistochemically, nuclear and cytoplasmic staining of tumor cells was accepted as positive.
Results: The results showed that age distribution ranging from (28-67 years) with a mean age of 47.63 years. Regarding tumor types 68 (89.47%) cases were wit invasive ductal carcinoma, 6 (7.89%) cases were with invasive lobular carcinoma and 2 (2.63%) cases were recurrent carcinoma. Histologically the tumor grade ranges from well differentiated (grade 1) in 10 (13.15%) cases, moderately differentiated (grade 11) in 52 (68.42%) cases and poorly differentiated (grade 111) in 14 (18.42%) cases. Cyclin D1 expression was positive in 30 (39.47%) cases, while 46 (60%) cases negative. On the other hand most positive cases occurred within age group (41-55 years), invasive ductal carcinoma 26 (86.66%) and moderately differentiated 18 (60%) cases. significant differences noticed between IHC expressions of this marker with age, type of tumor and grade.
Conclusion: cyclin D1 is an important regulator of cell cycle progression and overexpression of cyclin D1 has been linked to the development and progression of cancer, Cyclin D1 expression was seen more in invasive ductal carcinoma also is considered a novel and good marker of invasiveness in breast cancer tissue and may be used for treatment.

Laparoscopic surgery and tyrosine kinase-inhibitor (TKI) therapy are frequently used to treat gastrointestinal stromal tumors (GISTs). The purpose of this review was to analyze the published data on minimally invasive treatment of GISTs, with special focus on tumor location and on the possible role of laparoscopy in association with imatinib mesylate therapy in the treatment of advanced forms. The MEDLINE® and Embase® databases were searched for potentially eligible English-language studies published through June 30, 2015. Laparoscopic surgery can be considered a treatment option for GISTs at all locations. Most gastric GISTs are suitable for laparoscopic wedge resection (44-100% in recent series). Gastric GISTs in difficult-to-treat areas may benefit from innovative approaches such as transgastric or intragastric resection. Few data are available for small-bowel and colonic GISTs, although laparoscopic resection complying with the oncologic principles seems feasible and safe with reported morbidity and mortality rates of 3.8-6.7% and 0%, respecively. Primary resection of large rectal GISTs carries a risk of recurrence up to 40%. To improve long-term results and reduce the invasiveness of surgery in this setting, as in other difficultto- treat areas, neoadjuvant imatinib therapy should be considered. In selected cases, the combination of imatinib mesylate therapy and laparoscopy can minimize surgical trauma. The appropriate adoption of laparoscopic surgery and TKI therapy can reduce surgical trauma and optimize long-term results.

Melatonin is a natural substance ubiquitously distributed and present in almost all living species, from unicellular organisms to humans. Melatonin is synthesized not only in the pineal gland but also in most tissues in the body where it may have a cytoprotective function via paracrine or autocrine effects. Melatonin is effective in suppressing neoplastic growth in a variety of tumors. The mechanisms involved include antiproliferative effects via modulation of cell cycle, ability to induce apoptosis in cancer cells, anti-angiogenic and antimetastatic effects, anti-estrogenic activity, the capacity to decrease telomerase activity, immune modulation, and direct and indirect antioxidant effects. Besides these oncostatic properties, melatonin deserves to be considered in the treatment of cancer for two other reasons. First, because its hypnotic-chronobiotic properties, melatonin use that can allow the clinician to effectively address sleep disturbances, a major co-morbidity in cancer. Second, because melatonin’s anxiolytic and antidepressant effects, it has a possible application in two other major co-morbidities seen in cancer patients, i.e. depression and anxiety. This report summarizes the possible mechanisms involved in melatonin oncostasis and reviews what is known about the clinical application of melatonin as an adjuvant therapy in cancer patients.

Background: Ewing's sarcomas and peripheral primitive neuroectodermal tumors are high grade malignant neoplasms, arising from bone and soft tissues and are grouped in the Ewing family of tumors. Primary localization in the mediastinum is extremely rare and was treated in only a few case reports. Lymphatic localization has never been reported. We present a case of an extraskeletal Ewing sarcoma arising from lymphadenopathy in the hilar and anterior mediastinal regions with literature review.
Case presentation: A 24 year old man was admitted to our institution for persistent cough, nocturnal diaphoresis, and weight loss of 6 kg. The chest X-ray displayed opacity of the left hilum at polycyclic contours. Chest Computed tomography scan confirmed supradiaphragmatic lymphadenopathy in the hilar and anterior mediastinal. Biopsy was performed. Histological and immunohistochemical analysis showed small and round cells tumor with positive staining for CD99 and vimentin, and negative staining of desmine, myogénine, actine muscle lisse, Protéine S-100, Chromogranine, CD56, pancytokeratin, myeloperoxidase and TTF1. Young age, morphological and immunohistological characters argued in favor of a tumor of Ewing group .We could not perform molecular cytogenetic analysis, because of the lack of technical structure. The staging was negative for any other metastatic disease or primitive bone tumor, and final diagnosis was primary localized Ewing sarcoma in mediastinal nodes. The patient received Ewing’s sarcoma chemotherapy regimen. Complete response was achieved after six courses. Radiotherapy was prescribed, and the same chemotherapy regimen was continued totaling a period of one year. The patient was well with no evidence of local relapse or metastasis three years after diagnosis.
Conclusion: Extraskeletal Ewing sarcoma should be contemplated in the differential diagnosis of mediastinal lymphadenopathy. With multimodal treatment, the patients are potentially curable.