Abstract Purposes: Hepatocellular carcinoma with portal vein tumor thrombosis (HCC-PVTT) has a poor prognosis, while the optimal treatment remains controversial. The objective of this retrospective study was to evaluate the efficacy and safety of γ- ray SBRT in treatment of patients with HCC-PVTT. Methods: The study was designed to examine the effects of γ- ray SBRT on toxicity and survival in patients with HCC-PVTT. To this end, data from patients with HCC-PVTT who received γ- ray SBRT during May 2008 to December 2011 was collected and analyzed. Response and (acute and late) toxicity were evaluated using the established international criteria. Log-rank test and Cox regression model were used to identify predictive factors and multivariate for survival, respectively. Results: The median follow up was 11 months. Fifty four consecutive patients with HCC-PVTT received daily fraction of 2.6 - 6Gy and six fractions per week for the total dose of 32.4 - 54Gy in 6 - 13 days. Six complete response (CR; 11.1%) and twenty five partial response (PR; 46.3%) were observed (overall response rate 57.4%). Twenty three patients displayed a stable disease (SD; 42.6%), while no patient experienced progressive disease (PD; 0%). The treatment was well tolerated with no radiation-related complication and no ≤ Grade 3 toxicity. One- and two-year overall survival rate were 33.4% and 13.6% respectively, and median overall survival was 10.7 months. The prognostic factors for survival included ECOG performance status (P=0.04), Child-Pugh score (P=0.05), PVTT size (P=0.02) and location (P=0.05). Conclusions: Individual γ - ray SBRT appears to be feasible for treatment of patients with HCC-PVTT in whom other current therapies are contraindicated. PVTT size and ECOG performance status may represent the strongest predictive factors for survival.
Keywords: therapy-related myelodysplastic syndrome (t-MDS); therapy-related acute myeloid leukemia (t-AML); t(9;22); t(3;21); Philadelphia chromosome; follicular lymphoma; imatinib; chemotherapy

Abstract Introduction: Rhabdomyosarcoma is the commonest soft tissue sarcoma of childhood. The tumour commonly occurs in the body regions of the head and neck, genitourinary and extremities. Primary rhabdomyosarcoma of the breast is extremely rare and present diagnostic challenges especially in resource limited centers. It is an aggressive tumour with a poor prognosis especially when diagnosed late. Case presentation: We present a case of 13 year old female with primary rhabdomyosarcoma of breast metastasized to regional axillary lymph nodes, lung and heart. The patient failed to respond to chemotherapy mainly due diagnostic challenges and succumbed to the disease. Conclusion: Breast masses in young patients should be diagnosed early and accurately, and optimal treatment promptly instituted. The incidence of primary rhabdomyosarcoma of breast is increasing in teenagers, and the tumour has a bad prognosis especially in late stage. We think this case will add knowledge and skills required in histological and cytological diagnosis of breast rhabdomyosarcoma.
Keywords: rhabdomyosarcoma; breast tumour; metastatic disease; cardiopulmonary metastases