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Internal Mammary Node Evaluation And Elective Nodal Treatment In Medial Breast Cancers: A Case Report And Review Of The Literature. 内侧乳腺癌乳腺内淋巴结评估及选择性淋巴结治疗:1例报告及文献复习。
Pub Date : 2012-01-24 DOI: 10.5580/2adc
E. Miles, C. Cinnamond, C. Allgeier, J. Nelson
The evaluation and treatment of the internal mammary nodes (IMNs) in patients with axillary node positive breast cancer undergoing breast conservation therapy is somewhat controversial. A recently reported randomized trial of radiation therapy to the local regional nodes (including the IMNs) in patients undergoing breast conservation therapy demonstrated an improvement in disease free survival and overall survival with this additional nodal irradiation. For patients with tumors in the medial quadrants of the breast, consideration of peritumoral sentinel lymph node procedures with or without periareolar injections should be considered as demonstrated lymphatic drainage to the IMNs may indicate a greater need to consider their inclusion in adjuvant radiation therapy fields, regardless of clinical or radiographic involvement. These nodes may be treated either with a separate IMN field or partially-wide tangents. The benefits of this inclusion must be weighed against the risks of side effects of increased radiation exposure of lung, heart and contralateral breast tissue. Additional long-term data from randomized trials currently underway and maturing may help to define the risks versus the benefits of IMN elective nodal irradiation
腋淋巴结阳性乳腺癌患者行保乳治疗后,其内乳淋巴结(IMNs)的评估和治疗存在一定的争议。最近报道的一项随机试验表明,在接受乳房保护治疗的患者中,局部区域淋巴结(包括imn)的放射治疗表明,这种额外的淋巴结照射可以改善无病生存和总生存。对于乳腺内象限的肿瘤患者,考虑采用或不采用乳晕周围注射的肿瘤周围前哨淋巴结手术,因为已证实的淋巴引流到imn可能表明更需要考虑将其纳入辅助放射治疗领域,无论临床或影像学是否涉及。这些节点可以用单独的IMN域或部分宽切线处理。这种纳入的好处必须与肺、心脏和对侧乳房组织辐射暴露增加的副作用风险进行权衡。来自目前正在进行和成熟的随机试验的额外长期数据可能有助于确定IMN选择性淋巴结照射的风险与收益
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引用次数: 0
Adenocarcinoma Of The Rete Testis With Secondaries In The Skin – Review Of Literature And Case Report 伴有皮肤继发的睾丸网腺癌——文献回顾及病例报告
Pub Date : 2012-01-24 DOI: 10.5580/2a8c
Ashwin Pai, H. S. Ram, T. Sarkar, S. Bhat, Ashfaque Mohammed
Adenocarcinoma of the rete testis is a rare tumour with a varied presentation. A total of 44 cases have been reported [1]. Of these testicular tumours, primary non germ cell tumours account for a minority of cases.Among this, adenocarcinoma originating in the rete testis is still rarer. It is a highly malignant tumour with poor prognosis. It is generally diagnosed clinically as a solid or cystic swelling. However, confirmation is madeonly on histological diagnosis.
摘要睾丸网腺癌是一种罕见的肿瘤,表现多样。共报告44例[1]。在这些睾丸肿瘤中,原发性非生殖细胞肿瘤占少数病例。其中,起源于睾丸网的腺癌仍然比较少见。它是一种预后不良的高度恶性肿瘤。临床上一般诊断为实性或囊性肿胀。然而,证实仅在组织学诊断。
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引用次数: 0
A Rare Case Of Dysgerminoma In A 58-Year Old Postmenopausal Woman In Makurdi, North Central Nigeria. 尼日利亚中北部马库尔迪一名58岁绝经后妇女罕见的无生殖细胞瘤病例。
Pub Date : 2012-01-24 DOI: 10.5580/2a8b
Hembah-Hilekaan Sk, M. Tp
The cause of ovarian cancers is not known but the most common risk factor is a positive family history of ovarian or breast cancer. Primary tumors of the ovaries may arise from the epithelium (82%), sex cord and germ cell (20%) areas. About 3-5% of all germ cell tumors (GCTs) are malignant with the most common being the dysgerminoma which also accounts for 4-5% of all ovarian cancers. Dysgerminomas are most commonly seen in women of reproductive age who are sexually active and they make up to 60% of all malignant ovarian tumors in women younger than 20 years. We present a rare case of ovarian dysgerminoma in a 58-year old post menopausal woman who, presented to the gynecological unit of a secondary health care center in Makurdi, Nigeria. She had staging laparotomy and cytoreductive surgery. Initial chemotherapy with bleomycin, etoposide and cisplatin showed a good response. The appearance of this cancer in this age group should be a reminder to practitioners of the need to develop effective screening methods for ovarian cancers and the sensitization of patients to present early while attempts are made to open up well equipped cancer treatment centers, with adequately trained personnel. This is important since, ovarian cancers are the second most common gynecological malignancies and have the highest case fatality world wide; but once diagnosed dysgerminomas respond well to treatment.
卵巢癌的病因尚不清楚,但最常见的危险因素是卵巢癌或乳腺癌的阳性家族史。卵巢的原发性肿瘤可能起源于上皮(82%)、性索和生殖细胞(20%)区域。大约3-5%的生殖细胞肿瘤(gct)是恶性的,最常见的是生殖细胞异常瘤,也占所有卵巢癌的4-5%。生殖细胞异常瘤最常见于性活跃的育龄妇女,占20岁以下女性恶性卵巢肿瘤的60%。我们提出一个罕见的卵巢异常生殖细胞瘤的58岁绝经后妇女,谁提出了在马库尔迪,尼日利亚二级卫生保健中心的妇科单位。她接受了分期剖腹手术和细胞减少手术。博来霉素、依托泊苷和顺铂初始化疗效果良好。这种癌症在这个年龄段的出现应该提醒从业人员,需要开发有效的卵巢癌筛查方法,并使患者对早期诊断敏感,同时尝试开设设备齐全的癌症治疗中心,配备训练有素的人员。这一点很重要,因为卵巢癌是第二大最常见的妇科恶性肿瘤,在世界范围内死亡率最高;但一旦诊断为异常生殖细胞瘤,治疗效果良好。
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引用次数: 1
Adjuvant Radiation Therapy For Wedge-Resected Non-Small Cell Lung Cancer Adjacent To A Large Thoracic Aortic Aneurysm: A Case Report And Review Of The Literature 楔形切除非小细胞肺癌伴大胸主动脉瘤的辅助放射治疗:1例报告及文献复习
Pub Date : 2012-01-24 DOI: 10.5580/2a8a
C. E. Miles, C. Strange
Lung cancer is the leading cause of cancer death in the United States, with an estimated 222,500 new cases diagnosed in 2010; non-small cell lung cancer (NSCLC) accounted for approximately 85% of these malignancies. Treatment for early stage NSCLC in an operable patient involves lobar resection. Thoracic aortic aneurysms form as a result of exposure to smoking, hypertension, atherosclerosis, and genetic connective tissue disorders. The literature is silent on the optimum course of action when the anatomic lobar resection for NSCLC is limited by a thoracic aortic aneurysm, particularly when a close surgical margin indicates consideration of adjuvant radiation therapy. Although there is some literature documenting the radiation injury pattern to intact great blood vessels, the literature is silent on the potential for further injury to the wall of the great vessels in the presence of an existing aneurysm. With the increase in the use of definitive stereotactic body radiotherapy for early stage NSCLC in medically inoperable patients, there is a potential for an increased risk of vascular injury secondary to radiation in patients whose vessels already have baseline atherosclerotic damage. Herein, we report a case of a patient diagnosed with wedge-resected early stage NSCLC with close margin in the immediate vicinity of a pre-existing large thoracic aortic aneurysm.
肺癌是美国癌症死亡的主要原因,2010年估计有222,500例新确诊病例;非小细胞肺癌(NSCLC)约占这些恶性肿瘤的85%。可手术的早期非小细胞肺癌患者的治疗包括肺叶切除术。胸主动脉瘤的形成是由于暴露于吸烟、高血压、动脉粥样硬化和遗传性结缔组织疾病。当非小细胞肺癌的解剖性肺叶切除术受到胸主动脉瘤的限制时,特别是当手术切缘较近时,需要考虑辅助放射治疗,文献对最佳行动方案保持沉默。虽然有一些文献记录了辐射对完整大血管的损伤模式,但这些文献对存在动脉瘤的大血管壁进一步损伤的可能性保持沉默。随着医学上不能手术的早期非小细胞肺癌患者明确立体定向放射治疗的使用增加,对于血管已经有基线动脉粥样硬化损伤的患者,放射继发血管损伤的风险可能增加。在此,我们报告一例患者被诊断为楔形切除的早期非小细胞肺癌,其邻近已存在的大胸主动脉瘤。
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引用次数: 0
Acute Pancreatitis Following VAD Chemotherapy Combination Consisting Of Vincristine, Doxorubicin, And Dexamethasone In A Newly Diagnosed Multiple Myeloma Patient: A Case Report. VAD联合长春新碱、阿霉素和地塞米松化疗后急性胰腺炎一例新诊断的多发性骨髓瘤患者
Pub Date : 2012-01-24 DOI: 10.5580/2b68
S. Toprak, S. Ocal, B. Erismis, E. Yıldırım, R. Altun, S. Karakuş, I. Tek, P. Topçuoğlu
Background/Aims: The frequency of drug-related gastrointestinal adverse effects, including pancreatitis, has increased with the development and use of chemotherapeutic agents. Methods: In our country, a combination of vincristine, doxorubicin, and dexamethasone is frequently used as the first line of therapy in newly diagnosed multiple myeloma. A case with acute pancreatitis that we believe to depend on this therapy is presented. Results: In this case, after treatment of the acute pancreatitis episode in a very dynamic process, a proteasome inhibitor and following high dose chemotherapy with melphalan were used for the primary disease. Currently the patient is under follow-up at remission. Conclusion: It is important to consider chemotherapeutic agents as a possible etiology for acute pancreatitis in patients presenting with gastrointestinal symptoms, even after a few exposures to the agent.
背景/目的:随着化疗药物的发展和使用,包括胰腺炎在内的药物相关胃肠道不良反应的发生率增加。方法:在我国,长春新碱、阿霉素和地塞米松联合治疗常被作为新诊断的多发性骨髓瘤的一线治疗方案。一个病例与急性胰腺炎,我们认为依赖于这种治疗提出。结果:本病例急性胰腺炎发作后,在一个非常动态的过程中,蛋白酶体抑制剂和随后的大剂量美法兰化疗用于原发疾病。目前,患者正在接受缓解期随访。结论:对于出现胃肠道症状的急性胰腺炎患者,即使在少量接触化疗药物后,也应考虑化疗药物作为一种可能的病因。
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引用次数: 3
A Rare Case Of Colon Cancer With Metastases To The Bone With Review Of The Literature 罕见结肠癌骨转移1例并文献复习
Pub Date : 2012-01-24 DOI: 10.5580/2c4e
J. Rodrigues, A. Ramani, N. Mitta, P. Joshi
Distant metastases from colon cancer spread most frequently to the liver and the lung. Risk factors include positive lymph nodes and high grade tumors.Colorectal cancer is the 3 leading cause of cancer related death in the world. Death is usually associated with recurrence and metastasis. Skeletal metastasis in primary colorectal carcinoma is an uncommon event. When such an event occurs it is usually a late manifestation of the disease. Isolated skeletal metastasis from primary colonic carcinoma is a rare event with incidence of 1.1% of all metastases from colonic cancers . The most common presenting symptom of skull metastases is a visible, localized swelling of skull produced by growing tumor that erodes outer table. Metastasis to bone gives rise to osteolysis or mixed osteolysis – osteoblastic appearance on radiography.
结肠癌的远处转移最常转移到肝脏和肺部。危险因素包括淋巴结阳性和高级别肿瘤。结直肠癌是世界上癌症相关死亡的第三大原因。死亡通常与复发和转移有关。摘要骨转移在原发性结直肠癌中并不常见。当这种情况发生时,通常是疾病的晚期表现。原发性结肠癌分离性骨转移是一种罕见的事件,其发生率仅占所有结肠癌转移的1.1%。颅骨转移最常见的症状是颅骨可见的局部肿胀,由肿瘤生长侵蚀外壁引起。骨转移引起骨溶解或x线片上骨溶解-成骨混合表现。
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引用次数: 6
Rhabdomyosarcoma with Bone Marrow Infiltration: A Diagnostic Dilemma 横纹肌肉瘤伴骨髓浸润:诊断困境
Pub Date : 2012-01-24 DOI: 10.5580/2a8d
R. Khanna, D. Nayak, C. Manohar, N. Suvarna, S. Belurkar, S. Ray, P. Srilatha
Rhabdomyosarcoma is the most common soft tissue sarcoma in children and adolescents. In adults, the prevalence is much lower. Most patients present with a mass in the head and neck region, urogenital region or even with distal extremity involvement. A bone marrow infiltration at the time of clinical presentation has also been documented in literature. But a simultaneous marrow infiltration can simulate a hematopoietic neoplasm, leading to diagnostic errors. We document one such challenging case of a 47 year old male patient presenting with bicytopenia. Patient was hospitalized following a referral due to a mass in the left cheek, diagnosed earlier as clear cell sarcoma. Bone marrow aspirates yielded a dry tap, with sinusoidal blood and both the aspirate as well as the imprint smear showed pleomorphic cells with vacuolated cytoplasm. The corresponding trephine biopsy showed diffuse and interstitial infiltrates of rhabdoid cells with focal areas of infarct. Considering the morphological details, a diagnosis of rhabdomyosarcoma was rendered after ruling out other possibilities. A review of the lesional biopsy with ancillary techniques eventually corroborated the bone marrow diagnosis.
横纹肌肉瘤是儿童和青少年中最常见的软组织肉瘤。在成人中,患病率要低得多。大多数患者表现为头颈部、泌尿生殖区甚至远端累及。在临床表现时骨髓浸润也有文献记载。但是同时发生的骨髓浸润可以模拟造血肿瘤,导致诊断错误。我们记录了这样一个具有挑战性的情况下,一个47岁的男性患者表现为自行车减少症。病人在转诊后因左脸颊肿块入院,早期诊断为透明细胞肉瘤。骨髓抽吸产生干栓,血呈正弦波,抽吸和印迹涂片均显示多形性细胞,细胞质呈液泡状。相应的穿刺活检显示横纹肌样细胞弥漫性和间质性浸润,伴有局灶性梗死区。考虑到形态学细节,排除其他可能性后,诊断为横纹肌肉瘤。病变活检和辅助技术的回顾最终证实了骨髓诊断。
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引用次数: 3
Dermatofibrosarcoma Protuberans: A Deceptive Neoplasm. 隆突性皮肤纤维肉瘤:一种具有欺骗性的肿瘤。
Pub Date : 2012-01-24 DOI: 10.5580/2b53
K. Vagholkar, Indumati Gopinathan, Shalini Nair, Siddartha Nachane, O. Joglekar, Amogh Vaishampayan
Dermatofibrosarcoma protuberans is a slow growing deceptive tumor. It is a low grade malignancy with potential to develop local recurrence as well as metastases especially to the lungs. Surgery is the mainstay of treatment. Neoadjuvant therapy is a useful adjunct in large and recurrent tumors. Molecular targeting with imatinib mesylate is a promising option. Optimum neoadjuvant therapy followed by Moh’s micrographic surgery is the best therapeutic modality with least morbidity and mortality. A case of recurrent dermatofibrosarcoma protuberans is presented along with a review of literature.
隆突性皮肤纤维肉瘤是一种生长缓慢的欺骗性肿瘤。它是一种低级别恶性肿瘤,具有局部复发和转移的潜力,特别是转移到肺部。手术是治疗的主要手段。新辅助治疗是治疗大肿瘤和复发性肿瘤的有效辅助手段。甲磺酸伊马替尼分子靶向是一个很有前途的选择。最佳新辅助治疗配合Moh显微摄影手术是发病率和死亡率最低的最佳治疗方式。本文报告一例复发性隆突性皮肤纤维肉瘤,并复习文献。
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引用次数: 1
Prostatic Leiomyosarcoma –A Rare Case Report With Review Of Literature 前列腺平滑肌肉瘤1例并文献复习
Pub Date : 2010-12-31 DOI: 10.5580/195d
A. Dubey, G. Sivananthan, T. Bradel, R. Koul
Majority of the prostate malignancies are adenocarcinoma in nature. Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% -3.7% of primary prostate malignancies. Prostate sarcomas are diagnostically and therapeutically very challenging. This neoplasm is a mesenchymal tumor that originates from smooth muscles of prostate and periprostatic tissue. We present a patient with primary leiomyosarcoma of the prostate and review of literature. The factors predictive of long-term survival are negative surgical margins and absence of metastatic disease at presentation. A multidisciplinary approach is necessary for appropriate management of this rare entity. The most effective treatment, if feasible, is radical surgery. The role of adjuvant treatments and their effects in terms of increasing local control, over all survival or disease free survival is not clearly defined in literature.
大多数前列腺恶性肿瘤本质上是腺癌。前列腺平滑肌肉瘤是一种极为罕见且侵袭性很强的肿瘤,占原发性前列腺恶性肿瘤的比例不到0.1% -3.7%。前列腺肉瘤的诊断和治疗都非常具有挑战性。这种肿瘤是一种起源于前列腺平滑肌和前列腺周围组织的间质肿瘤。我们报告一位原发性前列腺平滑肌肉瘤患者并复习文献。预测长期生存的因素是阴性手术切缘和无转移性疾病。多学科的方法是必要的适当管理这种罕见的实体。如果可行,最有效的治疗方法是根治性手术。辅助治疗的作用及其在增加局部控制、总体生存或无病生存方面的作用在文献中没有明确定义。
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引用次数: 6
Undiagnosed Cervical Cancer After Total Abdominal Hysterectomy In North Central Nigeria-Case Report 尼日利亚中北部全腹子宫切除术后未确诊的宫颈癌病例报告
Pub Date : 2010-12-31 DOI: 10.5580/1eff
S. Hembah-Hilekaan, J. Kigbu
Back ground: Total abdominal hysterectomy (TAH) is a commonly performed surgical procedure by many doctors in the developing world, for reasons ranging from mild benign to severe malignant conditions. This is because they are often confronted with cases where treatment has to be offered to their patients either due to lack of facilities and / or personnel for appropriate diagnosis or pressure and anxiety from clients and relatives, resulting in cases of undiagnosed cervical malignancy. Many of which could have been treated differently if properly diagnosed.Objective: This study was to evaluate the uterine specimen obtained after TAH and bilateral salpingo-oopherectomy (BSO) for undiagnosed cervical bleeding for unexpected histology.Design/ methods: This was a retrospective study design. The case of a 58-year old woman with post coital bleeding who was anxious to have hysterectomy for fear of cervical cancer was analyzed after surgery with the histology report of the surgical (TAH/BSO) specimen .Result: She had TAH/BSO with excision of a cuff of the vagina. The histology of the specimen showed evidence of early locally invasive cancer of the cervix. The surgical margins were microscopically disease free. She was referred for radiotherapy at a regional centre in Nigeria (Ibadan) where she had teletherapy and two years of outpatient followup showed no recurrence or complications.Conclusion: Cases of invasive cervical cancer usually present late in this part of the world with surgical treatment not considered an option. We present a case of undiagnosed early cervical cancer in a postmenopausal woman who had successful TAH/BSO and postoperative radiotherapy. Preventive screening measures coupled with accurate diagnosis, and the improvement in manpower and facilities have been known to give better results. This is a reminder to all doctors and gynecologists of the need for cervical screening, in our hospitals.
背景:腹式全子宫切除术(TAH)是发展中国家许多医生经常进行的外科手术,原因从轻度良性到严重恶性不等。这是因为他们经常面临这样的情况:由于缺乏适当诊断的设施和/或人员,或由于客户和亲属的压力和焦虑,导致未确诊的宫颈恶性肿瘤病例,他们不得不向患者提供治疗。如果得到正确的诊断,其中许多疾病本可以得到不同的治疗。目的:本研究对经TAH和双侧输卵管-卵巢切除术(BSO)后未确诊宫颈出血的子宫标本进行组织学分析。设计/方法:采用回顾性研究设计。本文对一例58岁妇女因性交后出血,因担心宫颈癌而急于行子宫切除术的病例,结合手术标本(TAH/BSO)的组织学报告进行分析。结果:患者行TAH/BSO并切除阴道一袖。标本的组织学显示早期宫颈局部浸润性癌的证据。手术边缘镜下无病变。她被转介到尼日利亚(伊巴丹)的一个区域中心接受放射治疗,在那里她接受了远程治疗,两年的门诊随访显示没有复发或并发症。结论:浸润性宫颈癌的病例通常出现在世界的这一部分,手术治疗不被认为是一种选择。我们报告一例未确诊的早期宫颈癌在绝经后妇女谁成功TAH/BSO和术后放疗。预防性筛查措施加上准确的诊断,以及人力和设施的改善,都能取得更好的结果。这是对所有医生和妇科医生的一个提醒,提醒他们在我们医院进行子宫颈检查的必要性。
{"title":"Undiagnosed Cervical Cancer After Total Abdominal Hysterectomy In North Central Nigeria-Case Report","authors":"S. Hembah-Hilekaan, J. Kigbu","doi":"10.5580/1eff","DOIUrl":"https://doi.org/10.5580/1eff","url":null,"abstract":"Back ground: Total abdominal hysterectomy (TAH) is a commonly performed surgical procedure by many doctors in the developing world, for reasons ranging from mild benign to severe malignant conditions. This is because they are often confronted with cases where treatment has to be offered to their patients either due to lack of facilities and / or personnel for appropriate diagnosis or pressure and anxiety from clients and relatives, resulting in cases of undiagnosed cervical malignancy. Many of which could have been treated differently if properly diagnosed.Objective: This study was to evaluate the uterine specimen obtained after TAH and bilateral salpingo-oopherectomy (BSO) for undiagnosed cervical bleeding for unexpected histology.Design/ methods: This was a retrospective study design. The case of a 58-year old woman with post coital bleeding who was anxious to have hysterectomy for fear of cervical cancer was analyzed after surgery with the histology report of the surgical (TAH/BSO) specimen .Result: She had TAH/BSO with excision of a cuff of the vagina. The histology of the specimen showed evidence of early locally invasive cancer of the cervix. The surgical margins were microscopically disease free. She was referred for radiotherapy at a regional centre in Nigeria (Ibadan) where she had teletherapy and two years of outpatient followup showed no recurrence or complications.Conclusion: Cases of invasive cervical cancer usually present late in this part of the world with surgical treatment not considered an option. We present a case of undiagnosed early cervical cancer in a postmenopausal woman who had successful TAH/BSO and postoperative radiotherapy. Preventive screening measures coupled with accurate diagnosis, and the improvement in manpower and facilities have been known to give better results. This is a reminder to all doctors and gynecologists of the need for cervical screening, in our hospitals.","PeriodicalId":22534,"journal":{"name":"The Internet Journal of Oncology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89957774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
The Internet Journal of Oncology
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