Title: Theory and mechanisms of carcinogenesis and metastasis; breast cancer; endocrinology
Chondrosarcomas are cartilage-matrix-forming tumors that make up 30% of primary malignant bone tumors and are the third most common primary bone malignancy after multiple myelomas and osteosarcomas. Although wide en bloc surgical excision offers the best chance for a cure, achieving negative surgical margins can be challenging because of the high morbidity of surgery in different anatomic areas. Therefore, adjuvant radiation therapy plays an important role in improving the local control rate when negative margins are not achieved. However, delivery of a sufficient dose of radiation can be difficult because of the proximity to normal organs/tissues that are sensitive to radiation therapy and therefore dose-limiting. New techniques such as Volumetric Modulated Arc Therapy (VMAT) allow us to achieve an optimal conformation of the radiation beam, avoiding healthy organs and minimizing the undesirable acute and chronic side effects. We report a case of costal chondrosarcoma with positive post-surgery margins treated with adjuvant radiation therapy using VMAT technique that appears free of disease two years after finishing radiation therapy with a mild asymptomatic radiation-induced pneumonitis as the only late side effect.
Dr. Rui-An Wang received his M.D degree from Nanfang Medical University, and his Ph.D degree from the 3rd Military Medical University of China. He had been a lecturer of histology for years and then did his postdoctoral training in USA, at M.D.Anderson Cancer Center and worked as a faculty there for eight years. His scientific research experience has been very extensive, as in the field of endocrinology, male reproductive biology, developmental biology and cancer biology. His publications include those high rank journals as Nature, Nature Cell Biology, EMBO J, JCB, PNAS, Oncogene, etc. He is now a professor of pathology of the Fourth Military Medical University of China. What is special of him is that he proposed a new cancer theory, the stem cell misplacement theory, which posits that in situ carcinoma is not cancer, nor the origin of invasive cancer. The invasive cancer grows out de novo in the stroma fromdislodged epithelial stem cells. Apoptosis, instead of being a barrier of carcinogenesis as generally believed, stimulates carcinogenesis, cancer growth and metastasis.