amphotericin-b and Carcinoma--Squamous-Cell

Blastomycosis is a relatively uncommon fungal disease that most commonly affects the lungs. Other organs may be involved, usually secondary to dissemination of the organism. Laryngeal blastomycosis may occur in isolation from active pulmonary disease. The signs, symptoms, clinical features, and pathological findings of laryngeal blastomycosis mimic those of squamous cell carcinoma. Misdiagnosis may result in inappropriate treatment with potential morbidity. Proper understanding of the clinical presentation and familiarity with the histopathologic features of this disease are therefore imperative. In this paper, we report 2 cases of laryngeal blastomycosis, 1 of which was misdiagnosed as squamous cell carcinoma, clinically and microscopically, with consequent radiotherapy and laryngectomy. In the other case, a clinical diagnosis of glottic squamous cell carcinoma was rendered. However, blastomycosis was identified in a biopsy specimen. We also review cases of isolated laryngeal blastomycosis that have been reported in the English-language literature during the last 80 years. A number of those cases were misdiagnosed clinically and microscopically as squamous cell carcinoma.

Topics: Amphotericin B; Antifungal Agents; Blastomyces; Blastomycosis; Carcinoma, Squamous Cell; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Laryngeal Neoplasms; Laryngitis; Male; Middle Aged

Cationic antimicrobial peptides are ancient natural broad-spectrum antibiotics, and several compounds also exhibit anticancer activity. However, most applications pertain to bacterial infections, and treatment for skin cancer is less frequently considered. The cytotoxicity of melittin, cecropin A, protegrin-1 and histatin 5 against squamous skin cancer cell lines and normal human keratinocytes was evaluated and compared to established drugs. The results show that melittin clearly outperforms 5-fluorouracil regarding antitumor activity. Importantly, combined melittin and 5-fluorouracil enhanced cytotoxic effects on cancer cells and reduced toxicity on normal keratinocytes. Additionally, minimum inhibitory concentrations indicate that melittin also shows superior activity against clinical and laboratory strains of Candida albicans compared to amphotericin B. To evaluate its potential for topical applications, human skin penetration of melittin was investigated ex vivo and compared to two non-toxic cell-penetrating peptides (CPPs), low molecular weight protamine (LMWP) and penetratin. The stratum corneum prevents penetration into viable epidermis over 6 h; however, the peptides gain access to the viable skin after 24 h. Inhibition of digestive enzymes during skin penetration significantly enhances the availability of intact peptide. In conclusion, melittin may represent an innovative agent for non-melanoma skin cancer and infectious skin diseases. In order to develop a drug candidate, skin absorption and proteolytic digestion by skin enzymes need to be addressed.

Topics: Amphotericin B; Antifungal Agents; Antimicrobial Cationic Peptides; Antineoplastic Agents; Candida albicans; Carcinoma, Squamous Cell; Carrier Proteins; Cell Line, Tumor; Cell Proliferation; Cell Survival; Cell-Penetrating Peptides; Enzyme-Linked Immunosorbent Assay; Fluorouracil; Humans; Keratinocytes; Melitten; Peptides; Protamines; Skin; Skin Neoplasms

Oral lichen planus is a mucosal inflammatory disease whose pathogenesis is unclear. The chronic inflammation leads to development of a squamous cell carcinoma in 1-2% of the patients; we present an exemplary case.

Topics: Administration, Oral; Amphotericin B; Antifungal Agents; Carcinoma, Squamous Cell; Humans; Lichen Planus, Oral; Male; Middle Aged; Nystatin; Skin Neoplasms; Treatment Outcome

We present a case of visceral leishmaniasis confirmed after the histological investigation of an ulcerate lesion of the scalp in an HIV-1-infected patient receiving highly active antiretroviral therapy (HAART). Histological examination of the skin lesion revealed a squamous cell carcinoma superinfected by amastigotes of Leishmania infantum from the bloodstream. Because HIV-1-infected individuals can harbour parasitic infections in normal and neoplastic tissue, it is necessary to examine carefully any skin lesions, particularly those with uncommon aspects or a worsening course, to exclude superinfections by unsuspected pathogens.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Carcinoma, Squamous Cell; Humans; Keratinocytes; Leishmania infantum; Leishmaniasis, Visceral; Male; Middle Aged

The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare.. To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions.. A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin.. Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions.

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Carcinoma, Squamous Cell; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Leishmaniasis; Male; Mouth Diseases; Mouth Neoplasms; Oral Ulcer; Palate, Hard; Palate, Soft; Paracoccidioidomycosis; Tuberculosis, Oral

Topics: Adult; Amphotericin B; Carcinoma, Squamous Cell; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Conjunctival Neoplasms; Eye Infections, Parasitic; Histiocytes; HIV Seropositivity; HIV-1; Humans; Lacrimal Apparatus Diseases; Leishmania infantum; Leishmaniasis, Visceral; Liver Diseases, Parasitic; Macrophages; Male; Tomography, X-Ray Computed; Viral Load

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autosomal recessive disease caused by mutations in the AIRE gene. We report the case of a female patient with a 967-979del13 mutation in the AIRE gene. Her medical history included autoimmune hypoparathyroidism, Addison disease, and chronic mucocutaneous candidiasis. At the age of 40, she developed multiple white verrucous plaques on the oral mucosa. Histologically, the lesions appeared as moderately differentiated squamous cell carcinomas. The patient subsequently developed multiple local recurrences and therefore required repeated surgery. Notably, a higher incidence rate of oral and esophageal squamous cell carcinoma has been observed in this syndrome. However, the critical pathogenetic pathways implicated in squamous cell carcinoma development in APECED are far from being well understood.

Topics: Adult; Amphotericin B; Antifungal Agents; Candidiasis, Chronic Mucocutaneous; Carcinoma, Squamous Cell; Female; Humans; Nystatin; Polyendocrinopathies, Autoimmune

Aspiration of oropharyngeal bacteria and fungi is occasionally suspected in patients with pneumonia. A patient with oral carcinoma underwent chemoradioimmunotherapy and, about 4 weeks from the start of the therapy, the patient suffered from severe oral mucositis induced by chemoradiotherapy, and candidal pneumonia was subsequently induced. The candidal pneumonia was insufficiently improved by potent antifungal drugs, taking a lethal course. Randomly amplified polymorphic DNA analysis and DNA sequence examination of strains isolated from the oral cavity 1 week before the onset of pneumonia and autopsied lung revealed the identity of both strains as Candida albicans, and the DNA analysis supported aspiration of oral Candida. These results indicate that the pathogen of the pneumonia, C. albicans, was aspirated from the oral cavity and that oral Candida is easily aspirated and becomes the pathogen of pneumonia.

Topics: Aerosols; Aged; Aged, 80 and over; Amphotericin B; Antifungal Agents; Antineoplastic Agents; Base Sequence; Candida albicans; Candidiasis; Candidiasis, Oral; Carcinoma, Squamous Cell; DNA, Fungal; Fatal Outcome; Female; Fluconazole; Humans; Miconazole; Mouth Neoplasms; Pneumonia, Aspiration; Random Amplified Polymorphic DNA Technique

We report a case of aspergillosis in the right temporomandibular joint (TMJ) with a history of parotid carcinoma and post-irradiation otitis. Previous treatment attempts with surgery and antibiotics were unsuccessful. Radical debridement of the glenoid fossae, supplemented with amphotericin B and adjunct hyperbaric oxygen (HBO) therapy, was provided to resolve the symptoms. This case report highlights the need to be aware of the possibility of invasive mycosis in immunocompromised patients.

Topics: Aged; Amphotericin B; Antifungal Agents; Aspergillosis; Carcinoma, Squamous Cell; Humans; Hyperbaric Oxygenation; Male; Osteoradionecrosis; Parotid Neoplasms; Radiotherapy; Temporomandibular Joint; Temporomandibular Joint Disorders; Treatment Outcome

Platinum drugs comprise one of the main classes of chemotherapy drugs that can induce remissions in various solid tumors. Although tumors often regress on treatment with cis-diamminedichloroplatinum II (cisplatin) or cis-diammine-1,1-cyclobutane dicarboxylate platinum II (carboplatin), they usually relapse as a drug-resistant tumor. Most mechanisms of platinum resistance could be overcome by increasing the amount of drug that is accumulated by tumor cells. Amphotericin B (Amph B) is efficient at increasing platinum drug uptake, but because of nephrotoxicity associated with extended usage, and the potential for synergistic nephrotoxicity when used with platinum drugs, Amph B has not been used clinically for this purpose. A liposomal preparation of Amph B (LipoAmph B), which is substantially less nephrotoxic, was studied for its ability to enhance platinum-drug toxicity to a human oral squamous cell carcinoma line, HN-5a, and its carboplatin-resistant variant, 5a/carbo-15a, in which cisplatin accumulation was reduced by approximately 40%. Amph B at 10 microg/ml enhanced cisplatin accumulation by approximately 100% in both cell lines, enhancing cytotoxicity of the drugs by 35 to 60%, and completely reversed resistance to both cisplatin and carboplatin. LipoAmph B in the presence of phospholipase A(2)-II (PLA2-II) was able to enhance cisplatin and carboplatin cytotoxicity as effectively as free Amph B in both cell lines. At optimal concentrations, LipoAmph B plus PLA2-II enhanced drug uptake sufficiently to abolish resistance in the platinum-resistant line. Because PLA2-II is elevated in some tumor microenvironments and in plasma of ill patients, LipoAmph B has potential clinical usefulness as a modulator of platinum-drug efficacy.

Topics: Amphotericin B; Antineoplastic Agents; Biological Transport; Carboplatin; Carcinoma, Squamous Cell; Cisplatin; Drug Resistance, Neoplasm; Drug Screening Assays, Antitumor; Drug Synergism; Group II Phospholipases A2; Head and Neck Neoplasms; Humans; Liposomes; Phospholipases A; Phospholipases A2; Tumor Cells, Cultured

Topics: Amphotericin B; Blastomycosis; Carcinoma, Squamous Cell; Humans; Lung Neoplasms; Male; Middle Aged

Eighteen patients with unresectable bronchogenic carcinoma were treated with amphotericin B (7.5 mg/m2 on day 1, 15 mg/m2 on day 2, and 30 mg/m2 on days 3 and 4) plus BCNU (250 mg/m2 on day 4 following amphotericin B) with courses of therapy repeated every 8 weeks. All patients had metastatic disease, and 5 had received prior chemotherapy. Antitumor responses were observed in 8 patients. Six patients had partial responses (greater than 50% decrease in tumor area): 1 of 3 with small cell undifferentiated carcinoma, 1 of 4 patients with large cell undifferentiated carcinoma, 2 of 7 patients with adenocarcinoma, and 2 of 4 patients with epidermoid carcinoma. Two patients had objective improvement (25--50% decrease in tumor area): 1 with small cell undifferentiated carcinoma and 1 with epidermoid carcinoma. The median duration of remission was 3 months. The median duration of survival was 7 months for patients achieving partial response, and only 2 months for other patients. Myelosuppression was the dose limiting toxicity. One patient died with hepatocellular dysfunction, possibly related to BCNU. Transient hypotension was observed in 2 patients. We conclude that amphotericin B plus BCNU produced an encouragingly high response rate in patients with bronchogenic carcinoma, and that a randomized phase III trial is warranted to determine whether amphotericin B enhances the antitumor effects of nitrosoureas or other known antitumor agents.

Topics: Adenocarcinoma; Adult; Aged; Amphotericin B; Bone Marrow; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Carmustine; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Lung Neoplasms; Male; Middle Aged

Topics: Amphotericin B; Biological Transport; Carcinoma, Squamous Cell; Carrier Proteins; Cells, Cultured; Colonic Neoplasms; Female; Humans; Kinetics; Mechlorethamine; Neoplasms, Experimental; Ovarian Neoplasms; Stimulation, Chemical

Topics: Acute Kidney Injury; Aged; Amphotericin B; Candidiasis; Carcinoma, Squamous Cell; Enterocolitis, Pseudomembranous; Female; Humans; Parenteral Nutrition; Radiotherapy; Sepsis; Uterine Cervical Neoplasms

Topics: Abortion, Septic; Adult; Amphotericin B; Anti-Bacterial Agents; Candida; Candidiasis; Carcinoma, Squamous Cell; Female; Genital Diseases, Female; Humans; Immunosuppressive Agents; Middle Aged; Nystatin; Postoperative Complications; Pregnancy; Uterine Cervical Neoplasms

Topics: Adult; Aged; Amphotericin B; Candidiasis, Oral; Carcinoma, Squamous Cell; Chronic Disease; Humans; Hyperplasia; Male; Middle Aged; Mouth Neoplasms; Precancerous Conditions