Middle East Journal of Cancer
Volume:14 Issue: 1, Jan 2023

The aim of this research is to use bibliometric analysis to investigate the status and patterns of the 100 most frequently cited publications regarding the cytotoxic Tlymphocyte- associated protein (CTLA-4) research for cancer. The articles published on the topic were retrieved from the core collection database of Web of Science and PubMed using the Medical Subject Heading (MeSH) of “CTLA-4” from 1986 to December 6, 2020. The selected articles were examined and the bibliometric data compiled based on the number of citations, the author’s name, journal, publication year, institution, country, and co-occurrence keywords. 4,874 eligible papers were returned from the Web of Science Core Collection Database and PubMed. The citation frequency ranged from 2372 to 205, with a median of 460, and the top cited paper had 2372 citations. The journals with the most papers were Cell (n = 8, 3541 citations, Impact Factor (IF) = 41.577) and Journal of Experimental Medicine (n = 7, 2716 citations, IF = 10.790). Most of the published papers were from the United States of America (USA) (41.8%). A total of 485 institutes and 29 countries were involved in these 100 articles. There were 1192 authors and the author with the highest number of papers was the Nobel Prize winner, Professor James P. Allison (17 papers; 8700 citations). CTLA-4 blockade was the most frequent keyword (42.1%), followed by metastatic melanoma (4.26%). This work presents an important bibliographic source and can be saved as a reference for future medical health research on the function of CTLA-4 in cancer immunotherapy.

Tellurium- containing compounds are suggested as the treatment agents for different diseases. This study aimed to synthesize tellurium nanoparticles (TeNPs) and study their in vitro and in vivo effects on tumour cells.

In this experimental study, the synthesis of TeNPs in an aqueous solution was achieved with lactose as a reducing agent. The cells (2×104) were seeded, in triplicate, in 96-well plates and exposed to different concentrations of TeNPs for 48 hours. The determination of cell viability was done by MTT assay. In vivo studies were performed using breast cancer-bearing mice treated with TeNPs at different doses via intraperitoneal (IP) and intravenous (IV) injections.

After 48 hours of treatment with TeNPs at different concentrations, cancer cell line viability was significantly decreased compared with control at almost all concentrations. Moreover, the IC50 of TeNPs in the non-cancerous cell line CHO (50.53 μg/mL) was far above that of EJ138 (29.60 μg/mL) and 4T1 (7.41 μg/mL) cell lines, revealing their lower toxicity in normal cells in comparison with cancer cells. The in vivo study's findings also showed that both delivery methods significantly inhibited tumor development, and that breast cancer-bearing mice lived longer than control mice, particularly when the largest dosage (400 μg, injected three times a week) was used.

These results demonstrate TeNPs as promising therapeutic agents for cancer treatment. However, further investigation is still needed to determine the in vitro and in vivo anticancer mechanisms of TeNPs.

There is an ongoing need for targeted therapy and systemic treatment protocols for papillary thyroid carcinoma (PTC) patients. Yes activated protein-1 (YAP-1) has been found to control many targets of Hippo pathway. Annexin family is a huge family playing many roles in cellular processes. Annexin A10 (ANXA10) is a member of annexin family. Uncoordinated-5D (UNC5D), a recently discovered Unc5 family member which is found in normal tissues and downregulated in cancer cell lines and tissues. Aim of the study was to assess the expression of YAP-1, ANXA10, and UNC5D in PTC and in non-neoplastic tissues of thyroid gland using immunohistochemistry to evaluate their clinical significance and prognostic values in PTC patients. In the present prospective study, we took samples from 60 patients with PTC and 30 samples from non-neoplastic thyroid tissues for YAP-1, ANXA10, and UNC5D immunohistochemistry. All the patients were followed up for assessment of the prognostic, clinical, and pathological of their expression. Upregulation of YAP-1 and ANXA10 in addition to downregulation of UNC5D was found in PTC tissues more than non-neoplastic thyroid tissues. In PTC tissues, there were positive associations between high YAP-1 and ANXA10 expression, low UNC5D expression, tumor size (P = 0.022, 0.011, 0.014), presence of lymph node metastases (P = 0.005, < 0.001, 0.008), and inferior disease-free survival rate (P = 0.003, 0.01, 0.03). Upregulation of YAP-1 and ANXA10 expression and downregulation of UNC5D was associated with bad clincopathological criteria, disease progression, high incidence of disease recurrence, and poor survival.

The B-cell-specific Moloney murine leukemia virus integration site1 (BMI-1) is one of the famous members of the Polycomb ring finger group, which plays a crucial role in the gene transcription regulation through histone changes. Hence, it is believed to be necessary to further clarify the effects of the BMI-1 clinical.

This cross-sectional study was conducted on 70 acute myeloid leukemia (AML), 70 chronic myeloid leukemia (CML), and 20 healthy individuals, as the control group. We used real-time quantitative polymerase chain reaction in order to assess the BMI-1 level expression and its effect on prognosis in AML patients in the Molecular Pathology Research Center.

The results of the present work indicated that the BMI-1 overexpression was significantly higher in the AML and CML patients compared with that in the healthy controls (P < 0.001). Furthermore, a significant relationship was observed between the BMI-1 overexpression and poor prognosis in the AML patients (Hazard ratio=1.749, P < 0.001, 95% confidence interval = 1.31-2.32). Additionally, BMI- 1high was found in chronic and blastic phase in the CML patients (P < 0.001).

We concluded that investigation of BMI-1 gene expression pattern will be conducive to the prognosis and treatment of myeloid leukemia.

The transcription factor twist-related protein 1 (TWIST1) plays a major role in the prognosis of breast cancer. Our present study aimed to identify the network of TWIST1 with related oncogenes and their associated miRNAs. This in silico study included the differential expression analysis of genes and miRNA associated with breast carcinoma. The breast cancer patients’ data were retrieved from the Gene Expression Omnibus database and the differential expression analysis was done using GEO2R. Transfac analysis was performed to determine the binding sites of TWIST1. We predicted the target genes of MicroRNA-96 (miR-96) using miRBase. An integrated network was generated among TWIST1 and target genes of miR-96 through Gene MANIA. Survival analysis was carried out for TWIST1 using UALCAN. Experimental methods, including gene expression analysis, were performed in the MDA-MB-231 cell line for validating in silico findings. miR-96, the second differentially expressed miRNA among the top 250 miRNAs, was found to have eight binding sites for TWIST1. TWIST1 was observed to be significantly correlated with patient prognosis. ACTN4, BCL2, and FRMD4A were upregulated and CAMTA1, DAB2IP, and E- Cadherin were downregulated in the expression studies carried out in the MDA-MB-231 breast cancer cell line. A network between TWIST1 and target genes of miR-96 was analyzed. Hence, targeting the genes linked with miR-96 could work toward an efficient therapeutic option for breast cancer metastasis.

Reports correlating changes in salivary flow rate and amylase with radiation dose to parotid glands and development of salivary dysfunction for Head and Neck cancers (HNC) are lacking. In the current study, an attempt was made at understanding this. This was a prospective study carried out on people newly diagnosed with HNC requiring curative radiotherapy of more than 60 Gy. The salivary flow rate and levels of salivary α-amylase were evaluated before the start of radiation [day 1, before exposure to the first fraction of 2 Gy radiation], after 2 Gy [24 hours after the 1st fraction of 2 Gy, before exposure to 2nd fraction of 2 Gy on day 2 of the treatment], and on the completion of 30 Gy [(15 fraction of 2 Gy), before start of the 16th fraction, at the start of the fourth week on day 22] of radiation and development of salivary dysfunction was evaluated on a weekly basis. The demographic data were subjected to frequency and percentage, while biochemical data were stratified depending on dose to parotids and subjected to unpaired “t-test”. We also employed chi square/Fishers exact test to ascertain changes in the number of patients developing various degrees of salivary dysfunction on a weekly basis. A P value of <0.05 was considered significant. Radiation decreased salivary flow rate from 0.29 ± 0.02 to 0.20 ± 0.04 (P = 0.0001) and amylase from 147.69 ± 11.15 to 109.07 ± 23.21 U/L (P = 0.0005). Both salivary flow rate and amylase was less in patients with severe salivary gland dysfunction (P = 0.014) and cumulative dose of radiation to the parotid glands (P = 0.014). The number of patients with a severe degree of salivary dysfunction was seen in people exposed to more than 25 Gy to the parotids (P = 0.04). The results suggested that the evaluation of salivary amylase on day 22 could be a useful predictive marker to understand the development of radiation-induced dysfunction in patients with curative radiotherapy for their head and neck cancer.

Lung cancer is the leading cause of cancer deaths worldwide. Pharmacogenomics plays an important role in tailoring cancer patients’ treatment. Pemetrexed is widely used in first- and second-line chemotherapy of non-small cell lung cancer (NSCLC); however, there is no available predictive biomarker for pemetrexed treatment. The present study aimed to investigate the role of polymorphisms in thymidylate synthase and SLC19A1 polymorphisms with clinical outcome in patients with advanced NSCLC treated in first-line with pemetrexed or pemetrexed plus cisplatin.

This cohort study included 40 metastatic lung cancer patients treated with pemetrexed plus cisplatin. We utilized the tetra-primer amplification refractory mutation system-polymerase chain (ARMS-PCR) reaction for genotyping of rs3788189 and rs1051298. TYMS 28-VNTR and rs16430 were genotyped in the patients via PCR amplification and PCR-RFLP, respectively. Fisher's exact test and Kaplan-Meier curve were used for statistical analysis.

We recruited 40 patients in this research with a median age of 58.9 years. The median survival of all the 40 patients was 11.6 months. The overall survival of the patients, as well as their gender, age, and metastatic sites were not found to be statistically associated with rs1051298, rs3788189, TYMS VNTR, and rs16430.

Our study did not identify any associations between the SLC19A1 and TYMS VNTR and rs16430 and clinical outcomes in advanced NSCLC patients. However, further investigation will be conducive to finding effective clinical biomarkers for the treatment of patients with NSCLC.

Endometrial cancer (EC) is a common gynecological cancer ranks as fifth cancer worldwide and the tenth common cancer in Egypt. Termed DEL-1 (EGF like repeats and discoid domains 3), is an embryonic endothelial cell protein. EDIL3 was associated with regulation of angiogenesis. SOX (sex-determining region Y-related high-mobility-group box transcription factor). SOX4 expression was altered in many human cancers. This research aimed to study the expression of EDIL3, SOX4 in EC in atrial to explore their relationship with clinicopathological parameters prognostic and treatment outcome. This retrospective study included 50 paraffin blocks of cases of endometrial adenocarcinoma (endometroid type) with different grades which were selected from the archives of the Pathology Department, Zagazig University, Egypt during a period from January 2015 to last of December 2019. The expression of EDIL3, SOX4 was evaluated using immunohistochemistry. 56% of the studied patients were >45 years old. 54% had well-differentiated adenocarcinoma, and 56% absent lymph node metastasis. EDIL3 and SOX4 expression is found in 70% and 84% of the studied patients. A statistically significant relation was detected between EDIL 3 and tumor grade, stage, lympho-vascular invasion (LVI), and lymph node metastasis (P value was 0.001, <0.001, 0.002, and 0.005, respectively). SOX4 was significantly correlated with tumor grade, stage, lymph node metastasis, and LVI (P value was 0.039, 0.002, 0.006, and 0.015, respectively). expressions are associated with advanced clinicopathological parameters, unfavorable prognosis, and poor treatment response.

Acute lymphoblastic leukemia (ALL) accounts for 25% of cancers among children less than 15 years of age. This study aimed to evaluate and determine the prognostic factors affecting the survival of leukemia patients using cumulative incidence function. This was a retrospective study done on 176 children under 15 who had ALL between 2011 and 2019. Overall survival, event-free survival, disease-free survival (DFS), and non-relapse mortality served as the study's endpoints. Using the Fine-Gray model, the Kaplan-Meier, single-variable, and multivariable analyses were conducted. Schwenfeld weighted residuals were used to test the proportional hazard hypothesis. SAS was used to conduct the analysis. The hazard ratio (HR) of DFS for effective variables was calculated (girls compared to boys: 0.37 [95% confidence interval (CI): 0.15-0.91], positive testis test: 10.34 [95% CI: 4.44-24.05], children with central nervous system involvement: 2.95 [95% CI: 1.36-6.40], testicular swelling in children: 11.54 [95% CI: 4.21-31.59], children with hepatosplenomegaly larger than 2 cm: 0.30 [95% CI: 0.10-0.88], high risk of disease compared to low risk: 4.76 [95% CI: 1.12-20.22], children with complete remission in 28th day compared with no complete remission: 0.10 [95% CI: 0.04- 0.25]. Only hemoglobin was substantially linked with DFS in the multivariate DFS HR. Children who got radiation had a 77% reduced risk of non-recurrence death than those who did not (HR: 0.23, 95% CI: 0.08-0.60). Being a girl, having family history, and not having radiotherapy were the main factors to develop death before the first recurrence in children.

Survival after breast conserving surgery (BCS) vs. modified radical mastectomy (MRM) is a controversial issue. In this study, we want to compare the disease-free survival (DFS) of women who underwent BCS with those treated by MRM. In this historical cohort study, a total of 1097 women who were diagnosed with breast cancer between 2001 and 2007 and received modified MRM or BCS were entered into the study and followed up to March 2017. Kaplan-Meier estimator and extended cox model, and Cox proportional hazards model with propensity score weighting were implemented to compare overall survival between two groups. A total of 283 women with a maximum follow-up of 11.1 years and age 47.17 ± 11.278 were met the inclusion criteria. The results of the extended cox model did not show any difference between the survival of two groups (P = 0.35). After implementing the Cox model with propensity score weighting, the inferences remained unchanged (P = 0.67). The patients treated with BCS tend to have the same DFS rate as those who underwent a mastectomy in a randomized controlled trial-like setting using propensity score weighting.

Glioblastoma is the most prevalent and aggressive adult glial tumor. Patients who receive standard treatment have a mean survival of 12-14 months. Zinc is a micronutrient that has shown to have anticancerous effects. In the in vitro studies zinc had antineoplastic effects on gliobalstoma cells. This is a phase II randomized trial in which 60 patients in two groups were evaluated. The zinc group (29 patients) received zinc sulfate supplement 50 mg orally twice a day and the control group (31 patients) who were selected from historical case sreceived no supplements. Mean overall survival in the case and control groups were 9.93 (± 3.29) and 9.0 (± 3.56) months. In the case and control groups, the mean disease-free survival were 9.62 (SD ± 3.37) and 8.26 (SD ± 3.47) months. These differences were not statistically significant. Although overall survival and recurrence-free survival in patients in the case group was higher than the control group, there was no statistically significant difference (P = 0.485). Zinc consumption was associated with better survival, but these differences were not statistically significant, necessitating further studies.

Much is still unknown regarding the clinicopathology and prognosis of patients with multifocal/multicentric breast cancer (MMBC). We herein compared the clinicopathology and prognosis of patients with unifocal and MMBCs. This cross-sectional research is a part of Shiraz Breast Cancer Registry (SBCR). We studied all the patients in the SBCR (n=6145). Ultrasound reports were used to differentiate between MMBCs and unifocal breast cancers (BCs). All the patients were examined with mammography and the diagnosis was confirmed postoperatively via pathology reports. After exclusion, 4045 patients entered the study (n=1072 and n=2973 for multifocal/multicentric and unifocal BCs, respectively). The mean follow-up period was 57.9 (0.27-275) months. Patients with MMBCs had higher rates of mastectomy (48% vs. 40.1%; P < 0.001) and higher rates of HER-2 overexpression (32.1% vs. 26%; P = 0.001) compared with those with unifocal BCs. Tumor size, lymph node involvement, type of axillary management, chemotherapy, radiotherapy, hormonal therapy, recurrence rates, histological grade, lymphovascular invasion, axillary node involvement, estrogen and progesterone receptor expression status, tumor, node, and metastasis staging were not significantly different between the groups. Five-year overall survival was 88.3% and 89% (P = 0.8) for unifocal and MMBCs, respectively; moreover, five-year disease-free survival was 80.2% and 81.2% (P = 0.41), respectively. Despite the controversy regarding prognosis and surgical management in MMBCs, we found that MMBCs had similar clinicopathological features and prognosis compared to unifocal BCs. Survival, recurrence, and metastasis were similar among the two groups.

Chemotherapy-related diarrhea reduces patients' quality of life and sometimes changes or interrupts their treatment regimen. This study aimed to evaluate the effect of yogurt with probiotics on diarrhea caused by chemotherapy. The present study was a randomized controlled clinical trial. The sample consisted of 66 patients with colorectal cancer, recruited with convenience sampling method from patients who were referred to Buali Hospital of Tehran. The samples were randomly divided into three groups. The first group received yogurt with probiotics, the second group received yogurt alone, and the third group of control did not use yogurt during treatment. Data were gathered using the diarrhea section of adverse events. The number of defecations, the severity of diarrhea, and the consistency of stool in the seven days of the intervention were compared among the three groups. Analysis of variance and Tukey's post hoc test were performed through SPSS software. The number of defecations in the yogurt group with probiotics and yogurt was significantly lower than the control group (P < 0.05). The severity of diarrhea in the yogurt group with probiotics decreased more rapidly (P < 0.05). Stool consistency in the yogurt group with probiotics was significantly better than the control group (P < 0.05). Based on the results of the present study, yogurt with probiotics can reduce and improve diarrhea caused by chemotherapy. The results also showed that yogurt alone can reduce diarrhea and improve its symptoms.

Neoadjuvant chemotherapy (NAC) grants a modest survival benefit in localized muscle-invasive bladder cancer (MIBC). We evaluated the pathological response and survival outcome after NAC in stage II and IIIA MIBC and their correlation with body mass index (BMI). Our retrospective study included stage II (T2 N0) and IIIA (T3 N0, T4 N0, T1-4 N1) MIBC. They received NAC followed by radical cystectomy. The patients were categorized into level I: a BMI of 18.5 – 24.9 kg/m2, level II: a BMI of 25-29.9 kg/m2, and level III: a BMI of ≥ 30 kg/m2. 103 patients with localized MIBC were included. The median age was 63 years; 35 patients (34.0%) belonged to level I, 40 patients (38.8%) belonged to level II, and 28 patients (27.2%) belonged to level III. Smoking status was more common in level II (51.0%) and level III (36.7%) (P < 0.001). Only 18 patients had ECOG PS 2, all belonging to level III (P < 0.001). After NAC, the pCR was 34.3%, 25%, and 10.7% of level I, level II, and level III (P = 0.03), respectively. Of 19 patients who passed away, 10 patients belonged to level III and 6 patients belonged to level II (P = 0.007). For level I, level II, and level III, the disease-free survival was 23.2 months, 12.7 months, and 10.7 months and the overall survival was 61.9, 52.3, and 28.7 months, respectively. Obesity and overweight could be predictive and prognostic markers in localized MIBC. These factors are associated with low pCR after NAC, poor disease-free survival, and overall survival.

Following neoadjuvant chemoradiation, 25% of patients with rectal cancer experience pathologic complete response (pCR). With the appropriate imaging method for this group of patients, it would be possible to use less invasive methods. The aim of this study was to assess the ability of diffusion-weighted magnetic resonance imaging to predict pCR after neoadjuvant chemoradiation in patients with rectal cancer. In this prospective study, 19 patients with rectal cancer were examined. Magnetic resonance imaging of patients with diffusion-weighted imaging was performed in two stages: one week before the start of chemoradiotherapy (CRT) and seven weeks after the end of CRT to evaluate the results of treatment. Apparent diffusion coefficient (ADC) was measured before and after treatment. The percentage of ADC (% ΔADC) increment was also calculated. The patients were divided into three groups according to the surgical report: complete responders, partial responders, and non-responders. Optimal cut-off point was determined via ROC diagram. The mean age of the patients was 52.9 (29-73) years. There were no significant associations between pre and postoperative ADC values and pCR. However, % ΔADC had a significant relationship with complete response to treatment. Based on the ROC chart, the value of 15% was selected as cut-off with 56% specificity and 67% sensitivity. The positive and negative predicting values were 77.8% and 40%, respectively. The mean %ΔADC increase seems to be a valid tool to differentiate complete responders from non-responders after CRT in locally advanced rectal cancer.

In the present paper, the main diagnostic tool for re-evaluation of axillary lymph node involvement and planning of surgery after neoadjuvant chemotherapy (NAC) is ultrasound whose accuracy we aimed to determine herein. The high precision of ultrasound in diagnosis of metastatic axillary lymph nodes in untreated patients is well known; however, its worth in patients who received NAC is highly controversial. We enrolled 165 breast cancer patients receiving NAC in this retrospective cohort study. They all had undergone post-NAC ultrasound done before surgery. The ultrasound reports were reassessed and validated by a breast radiologist. Finally, the histopathology reports were compared to those of the ultrasound. Among 165 surveyed post-NAC ultrasounds, 53 women had positive results and 112 had negative results. Pathology and ultrasound reports were accordant in 93 women and adverse in 112 others. The false negative rate of post-NAC axillary ultrasound was calculated as 60.6%. The sensitivity and specificity of post-NAC AxUS were 39.4% and 79%, respectively. After NAC, there were certain changes in ultrasound reports from positive to negative in 50% and pathologic complete clearance was observed in just 28% of the women who were initially clinically lymph node positive. Ultrasound was not found to be an accurate and appropriate tool for evaluation of axillary lymph node involvement in breast cancer patients who receive NAC. By changing the primarily established surgical plan from ALND to SLNB, based on the ultrasound findings, patients may remain undertreated. Furthermore, the axillary nodes pathologic clearance after NAC was observed in less than one third of the women who were initially clinically node positive; accordingly, surgeons should be cautious about the optimum response of axillary metastatic lymph nodes to NAC.

Colorectal cancer (CRC) has a presumable low incidence in Egypt which did not rationalize for the development of screening programs up till now. The fecal immunochemical test (FIT) can facilitate colonoscopy uptake and increase enrollment in CRC screening programs. We aimed to explore the attitude of Egyptian individuals towards screening colonoscopy and establish the accuracy of FIT to detect advanced colonic neoplasia (AN). In this cross-sectional study, we offered a questionnaire to 1470 subjects with a family history of AN to establish their attitude towards the use of either direct colonoscopy (group A) or 2 step screening strategy; utilizing FIT followed by colonoscopy (Group B). Eventually, all included individuals underwent both FIT and colonoscopy. A total of 547 persons of the interviewed population (37.3 %) agreed to participate in the study, and group A cohorts were more likely to accept colonoscopy invitations. A single cycle FIT had a sensitivity of 76.2% a specificity of 92.2%, a positive predictive value of 28.1.2%, and a negative predictive value of 99%. The incidence of AN among the screened population was 3.9%, and CRC was found in 2 patients (0.4%). Uptake of colonoscopy is more likely, if the invitation strategy was a direct colonoscopy invitation. A single-round FIT test had good sensitivity and specificity to detect AN. Egypt has a low incidence of CRC in individuals with a family history of CRC.

Although squamous metaplasia is a well-known occurrence in papillary thyroid carcinoma (PTC), it is extremely uncommon to diagnose a PTC with squamous differentiation (PTC-SD), especially in a non-elderly patient, thus raising a diagnostic challenge when considering its broad histopathological differential diagnosis. Endoscopic thyroidectomy via axillo-bilateral breast approach (ABBA) has been recently validated as an appropriate surgical alternative to conventional thyroidectomy for treating PTC in the selected patients. Hereby, we report a rare case of PTC-SD diagnosed in a solitary thyroid nodule (STN) in a 30-year-old man with a family history of thyroid cancer who was operated using the endoscopic ABBA. In fact, detection of the squamous cell carcinoma component may not be feasible through fine needle aspiration cytology or frozen section examinations, while permanent paraffin sections and immunohistochemistry (if required) usually allows for its identification. Due to their diverse clinical and biological behaviors, it is important to differentiate PTC-SD from other conditions in which a thyroid specimen contains a squamous epithelium. PTCSD patients with favorable clinicopathological criteria as young age and localized disease can be fortunate candidates for the minimally invasive thyroidectomy approaches as endoscopic ABBA.

A solitary fibrous tumor (SFT) of the pleura is a rare chest wall mesenchymal neoplasm which usually arises from CD34-positive sub-mesothelial mesenchymal cells of visceral pleura. It is rare, accounting for less than 5% of all pleural neoplasms. Recently, steroid hormone receptors were recognized in the cells of extra-pleural SFT. Progesterone may participate as a growth factor in many CD34 (+) stromal neoplasms. During pregnancy, the amount of plasma progesterone gradually increases. As a result, it could promote the development of cancers that rely on progesterone. However, the link between SFT and pregnancy has not yet been established. There are only six extra-thoracic SFT-reported cases with accelerated growth during pregnancy, on the literature. Hence, we reported an interesting case of SFT which is the first reported case of thoracic SFT presenting during pregnancy. Moreover, we attempted to clarify the mechanism of this tumor's rapid growth by examining its hormonal receptors status in the cells of this tumor.

Malignant mixed mullerian tumors (MMMT) are infrequent and highly malignant tumors. MMMTs, emerging from the uterine cervix, are very rare and to the best of our knowledge, there are no specific symptoms for the diagnosis of MMMTs whose early diagnosis is challenging. Almost all of them are diagnosed with pathological tests and reports. A 52-year-old post-menopause woman was referred to us, who suffered from postmenopausal bleeding from four months earlier. Upon pelvic examination, the position of the biopsy was identified in the anterior lip of the cervix. In former fractional dilatation and curettage, we found a pathology report with MMMT in the anterior lip of cervix. We performed a radical hysterectomy type II. In the permanent pathological report, MMMTs stage IBI was established. The patient was followed by chemoradiation. After 20 months, examination showed no evidence of recurrence.