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Breast cancer is one of the most common types of cancer in females worldwide, and metastasis to bone is an important characteristic of malignancy. The present study aimed to investigate the molecular mechanism of breast cancer to bone metastasis of secreted protein acidic and rich in cysteine (SPARC). Immunohistochemistry was performed to examine the expression of SPARC in primary breast tumors and bone metastatic foci. Western blotting and reverse transcription-quantitative polymerase chain reaction were performed to detect the expression level of SPARC in several types of breast cancer cell. A Transwell filter assay was used to assess the effect of SPARC on breast cancer cell invasion ability, and an osteoblast differentiation assay was employed to analyze the effect of SPARC on the differentiation ability of mesenchymal stem cells. Clinical data revealed that decreased stromal SPARC expression is associated with breast cancer to bone metastasis. Gain- and loss-of-function studies reveal that SPARC inhibits the migration and invasion of breast cancer cells, and suppresses osteoclast activation in the breast cancer microenvironment. SPARC serves an important role in breast cancer bone metastasis and may be a promising therapeutic target for the treatment of breast cancer bone metastasis.

Asymptomatic intrapelvic meningocele is rare. Here, we report the case of a 30-year-old Chinese man who underwent sigmoidectomy due to megacolon. During the operation, an intrapelvic cyst was found and resected. Meningocele was confirmed by histological examination. The patient recovered well postoperatively with the exception of liquorrhoea. Conservative therapy was initiated, including draining, anti-infection and specific posture maintenance. During the following week, liquorrhoea was generally relieved and the patient was discharged. This is the first known report of liquorrhoea associated with intrapelvic meningocele resection successfully treated by conservative therapy. Our case indicates that conservative treatment may be considered for similar cases so that a second surgery is avoided.

Chylous leakage is a rare occurrence after breast surgery. Trauma to the thoracic duct and its main distribution may be the main cause of chylous leakage, but the cause of such an injury during breast surgery is unknown. We herein report the first case of chylous leakage from many minimal lymph ducts in a skin flap. In all, four cases of chylous leakage were observed out of 1 096 breast cancer patients who underwent axillary lymph node dissection. Of these four cases, three cases were successfully treated conservatively; however, surgical exploration was performed in the fourth case because of the large drainage volume. Furthermore, we reviewed the recently published studies on chylous leakage after breast surgery; 20 cases (our 4 cases included) have been reported in all. Of the 20 pooled cases, most were cured with conservative treatment and only three cases were cured with surgical treatment.