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Cellular angiofibroma of the vulva 外阴细胞血管纤维瘤
Pub Date : 2009-12-31 DOI: 10.5580/296c
S. Saichandran, V. Koothan, S. Ghose
Cellular angiofibroma of vulva was first described in 1997; a twenty-two year old female with a large mass of vulva for two years was managed successfully by simple excision with no evidence of reccurrence for a follow-up period of three years.
1997年首次报道外阴细胞血管纤维瘤;一例22岁女性外阴大肿块2年,经简单切除成功,随访3年无复发迹象。
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引用次数: 0
Ovarian cancer and dermatomyositis. 卵巢癌和皮肌炎。
Pub Date : 2009-12-31 DOI: 10.5580/2785
A. Choudry, Gurjeet Pamma, M. Ali
A 65 year old lady with no relevant past medical history was diagnosed in February 2006 with stage 3c ovarian adenocarcinoma. She underwent laparotmy, total abdominal hysterectomy, bilateral salpingo oophorectomy, omentectomy and intra peritoneal catheter insertion. It was noted in surgery there was widespread peritoneal disease. She made a slow recovery and in May 2006 she commenced the first of 6 cycles of intra peritoneal carboplatin. Post chemotherapy she was in clinical remission with no reoccurrence of symptoms and CA-125 was 32. She was doing well nine months post chemotherapy with normal examination and CA-125 of 19.
65岁女性,无相关病史,于2006年2月被诊断为3c期卵巢腺癌。她接受了腹腔镜手术、腹部全子宫切除术、双侧输卵管卵巢切除术、网膜切除术和腹膜内导尿管置入。手术中发现有广泛的腹膜疾病。她恢复缓慢,并于2006年5月开始了6个腹膜内卡铂疗程的第一个疗程。化疗后临床缓解,无复发症状,CA-125为32。化疗后9个月,检查正常,CA-125为19。
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引用次数: 1
Hand- Foot Syndrome And Cutaneous Reactıons Followıng Fırst Dose Of Chemotherapy 手足综合征与皮肤Reactıons Followıng Fırst化疗剂量
Pub Date : 2009-12-31 DOI: 10.5580/1a1e
M. Yıldırım, B. Karabulut
A 63-year-old female with stage IIIA breast cancer was treated in our department with adjuan chemotherapy containing 5fluoruracil,epirubicine and cyclophosphamide. Clinical and anamnetic findings revealed no signs of any disorder and physical examination was unremarkable. The patient received, 5fluoruracil 720 mg/m 2 , epirubicine 145mg/m and cyclophosphamide 720 mg/m administered as a infusion on day one, repeated every three weeks. Treatment given on day 1 was preceded by dexametasone 4 mg i.v. and granisetron 3 mg i.v. for the prophylaxis of nausea and vomiting. The same anti-emetic treatment was repeated i.v.on day 2 and orally on days 3 and 4. The first treatment cycle was uneventful. Four days after administration of the second cycle the patient was admitted to our clinic with hand-foot syndrome(HFS), associated with nail changes on hand (hyperpigmentation) and maculopapuler eruptions on the trunk(Figure 1,2,3,4 and 5).
我科收治1例63岁女性IIIA期乳腺癌患者,采用5氟尿嘧啶、表柔比星、环磷酰胺联合化疗。临床和精神检查没有发现任何疾病的迹象,体格检查也不明显。患者接受5氟尿嘧啶720 mg/ m2,表柔比星145mg/ m2,环磷酰胺720 mg/ m2,第1天输注,每3周重复一次。在第1天开始治疗之前,静脉注射地塞米松4mg和格拉司琼3mg,以预防恶心和呕吐。同样的止吐治疗在第2天静脉注射,第3天和第4天口服。第一个治疗周期平安无事。在给药第2个周期4天后,患者因手足综合征(HFS)入院,伴有手部指甲变化(色素沉着)和躯干斑疹丘疹(图1、2、3、4和5)。
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引用次数: 0
Rectal Cancer Perforation: A Rare Complication Of Neo-Adjuvant Radiotherapy For Rectal Cancer 直肠癌穿孔:直肠癌新辅助放疗中一种罕见的并发症
Pub Date : 2009-12-31 DOI: 10.5580/1889
A. Khan, Y. Suhaibani, A. Sharief
Purpose: Despite having a well established role in the treatment of locally advanced rectal cancer neoadjuvant radiotherapy is associated with various acute but usually self limited side effects, which can be occasionally severe thus outweighing the potential benefits.Method: We present a case of 51-year old male who experienced a spontaneous rectal perforation after neoadjuvant radiotherapy for transmural (T3) rectal cancer located 8cms from anal verge. Clinical circumstances were highly suggestive of acute radiation toxicity leading to tumor perforation. To our knowledge, such a complication of radiotherapy is extremely rare, albeit known with only few cases reported in English literature.Conclusion: Rectal cancer perforation, albeit rare, is a dangerous early complication of neo-adjuvant radiotherapy for transmural rectal cancer which may be worthy of consideration and discussion with the patient when commencing treatment. Role of prophylactic diverting colostomy in such patients with cancer above peritoneal reflection remains an open question which needs to be redressed by further studies.
目的:尽管新辅助放疗在局部晚期直肠癌的治疗中具有良好的作用,但它与各种急性但通常是自限性的副作用相关,这些副作用有时可能很严重,因此超过了潜在的益处。方法:我们报告了一例51岁男性经新辅助放疗后自发性直肠穿孔的经壁(T3)直肠癌,位于肛门边缘8cm处。临床情况高度提示急性辐射毒性导致肿瘤穿孔。据我们所知,这种放疗并发症是极其罕见的,尽管在英语文献中只有少数病例报道。结论:直肠癌穿孔虽然罕见,但却是经壁直肠癌新辅助放疗的早期危险并发症,值得患者在开始治疗时考虑和讨论。预防性转移结肠造口术在这类腹膜上反射癌患者中的作用仍然是一个悬而未决的问题,需要进一步的研究来解决。
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引用次数: 6
Fungating malignant phyllodes tumour- Still a reality in this day and age !!! 真菌恶性叶状瘤-在这个时代仍然是一个现实!!
Pub Date : 2009-12-31 DOI: 10.5580/129f
Mervyn Correia, D. Amonkar, Y. Dias, A. Ramani, G. Kamat, Mallidu Shashidar
Cystosarcoma phyllodes is an uncommon neoplasm of the breast, constituting 0.3 �0.9% of all breast tumors. The incidence of malignant phyllodes tumor is even lower. The tumor is similar to fibroadenoma in structure, but it is distinguished from it histologically by large leaf-like projections of stroma with increased stromal cellularity [1] . Although surgical removal is the mainstay of treatment, the extent of surgery required (excision vs. mastectomy) and the need for additional local therapy, such as radiotherapy, are unclear [2] . We report a case of a 35 year old married woman who presented to our out patient department with a fungating, foul smelling mass in the right breast that turned out to be a malignant phyllodes tumour. The malignant variant of the cystosarcoma phllodes tumour is indeed a very rare mammary tumour.
叶状囊肉瘤是一种罕见的乳腺肿瘤,约占乳腺肿瘤的0.3% ~ 0.9%。恶性叶状瘤的发病率更低。该肿瘤在结构上与纤维腺瘤相似,但在组织学上与纤维腺瘤的区别在于间质呈叶状突起,间质细胞增多[1]。虽然手术切除是治疗的主要方法,但手术的范围(切除与乳房切除术)以及是否需要额外的局部治疗,如放疗,目前尚不清楚[2]。我们报告一例35岁的已婚妇女谁提出了我们的门诊部真菌,恶臭的肿块在右乳房,原来是一个恶性叶状瘤。囊肿肉瘤的恶性变异确实是一种非常罕见的乳腺肿瘤。
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引用次数: 0
A case of B-cell lymphoma of Bronchus-Associated Lymphoid Tissue (BALTOMA) masquerading as an atypical interstitial pneumonia 支气管相关淋巴组织b细胞淋巴瘤(BALTOMA)伪装成非典型间质性肺炎一例
Pub Date : 2009-12-31 DOI: 10.5580/275b
H. Shaaban, A. Ko, J. Sensakovic, G. Guron
We describe a 60-year-old patient with symptoms of chest pain, chronic non-productive cough, generalised malaise and weight loss for four years. Bilateral interstitial infiltrates were observed radiologically. Bronchoscopy with bronchoalveolar lavage (BAL) came back positive for Mycobacterium Xenopi. She was treated with rifampin, ethambutol and azithromycin for 6 months but no clinical improvement. She became progressively dyspneic and subsequently had a Video-assisted thorascopic surgery (VATS) and histological examination of lung biopsy revealed replacement of normal lung parenchyma with diffuse infiltration of monotonous cells with scanty cytoplasma and little nuclear irregularity. In immunohistochemical examination it was detected that the LCA and B cell markers of the cells were stained positive for CD20 and CD79; whereas epithelial markers were stained negative for cytokeratin and EMA, and T cell markers were stained negative for CD3. The molecular path revealed Ig heavy chain gene clonal rearrangement consistent with neoplastic proliferation of the B-cell lineage. These features were compatible with the diagnosis of primary pulmonary BALT (bronchus-associated lymphoid tissue) lymphoma or BALTOMA. We recommend that BALTOMA should be included in the differential diagnosis of patients with slow-progressing nonspecific pulmonary symptoms and radiographic interstitial infiltrates. Biopsy under CT guidance or VATS provides sufficient tissue in peripheral lung lesions for immunologic studies to assist in diagnosis.
我们描述了一位60岁的患者,其症状为胸痛,慢性非生产性咳嗽,全身不适和体重减轻四年。影像学观察双侧间质浸润。支气管镜检查伴支气管肺泡灌洗(BAL)检出异种分枝杆菌阳性。给予利福平、乙胺丁醇、阿奇霉素治疗6个月,临床无改善。患者逐渐出现呼吸困难,随后进行了电视胸腔镜手术(VATS)和肺活检组织学检查,发现正常肺实质被弥漫性浸润的单一细胞所取代,细胞浆稀少,细胞核不规则。免疫组化检查发现细胞LCA和B细胞标记CD20和CD79阳性;上皮标记细胞角蛋白和EMA呈阴性,T细胞标记细胞CD3呈阴性。分子路径显示Ig重链基因克隆重排与b细胞谱系的肿瘤增殖一致。这些特征与原发性肺BALT(支气管相关淋巴组织)淋巴瘤或BALTOMA的诊断相符。我们建议将BALTOMA纳入进展缓慢的非特异性肺部症状和影像学间质浸润患者的鉴别诊断。CT引导下或VATS下的活检为免疫研究提供了足够的周围肺病变组织,以协助诊断。
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引用次数: 0
Peri-Operative Brachytherapy In Soft-Tissue Sarcomas. Hospital USM Experience 软组织肉瘤的围手术期近距离放疗。医院USM经验
Pub Date : 2009-12-31 DOI: 10.5580/47f
B. M. Biswal, N. R. N. Idris, Zulmi Wan, W. Ismail, A. S. Halim
Overview: Radiotherapy is an important adjuvant modality in the management of extremity soft-tissue tumors. Interstitial brachytherapy implantation is a precise technique of delivering radiation that conforms to the tumor bed. Materials and Method:Selected extremity soft-tissue sarcomas were managed with wide-excision followed by preoperative implantation of brachytherapy catheters. The implant was irradiated 3-5 th day post-surgery to a dose of 3Gy BID for 3-5 days using high dose rate (HDR) system. Further additional external radiotherapy dose of 40- 50Gy in conventional fractionation was delivered to the tumor bed. Observations: 17 patients with soft tissue sarcoma were treated from 2001 to 2007.The median age of patient was 26 years (4-74 years) with male to female ratio of 12:5. Three out of 17 patients develop local recurrence and 7-patient relapse as lung metastases. At the time of reporting, 2-year local control rate was 88% and 24 month overall survival rate was 50%. The complication was minimal and manifested as subcutaneous fibrosis, pigmentation and wound dehiscence. Conclusions: Perioperative interstitial brachytherapy is an option of radiotherapy for better local control in high grade large volume and recurrent soft-tissue tumor. Proper case selection and optimal multidisciplinary management could improve survival in future.
综述:放射治疗是四肢软组织肿瘤治疗中一种重要的辅助方式。间质近距离放射治疗植入是一种精确的放射技术,它能使放射符合肿瘤床。材料与方法:对选择的肢体软组织肉瘤进行大面积切除,术前置入近距离放射线导管。术后3-5天,采用高剂量率(HDR)系统对种植体进行3Gy BID剂量照射3-5天。在常规分割的基础上再给予肿瘤床外放疗剂量40 ~ 50Gy。观察:2001 ~ 2007年共收治软组织肉瘤17例。患者中位年龄26岁(4 ~ 74岁),男女比例为12:5。17例患者中有3例局部复发,7例复发为肺转移。报告时,2年局部控制率为88%,24个月总生存率为50%。并发症极少,表现为皮下纤维化、色素沉着和创面裂开。结论:对于高级别、大体积、复发性软组织肿瘤,围手术期间质性近距离放疗能较好地局部控制。正确的病例选择和优化的多学科管理可以提高未来的生存率。
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引用次数: 1
Clear Cell Variant Of Pindborg’s Tumor In Anterior Mandible: Case Study And Overview Of Other Histological Variants. 前下颌骨平堡肿瘤的透明细胞变异:病例研究和其他组织学变异的概述。
Pub Date : 2009-12-31 DOI: 10.5580/45a
.R Sudhakar, .N Vezhavendhan, M. Devi
Pindborg tumour or calcifying epithelial odontogenic tumor (CEOT) is a rare and benign odontogenic neoplasm that was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955. The most common clinical manifestation of CEOT is that of a localized, slow growing hard tissue swelling of the posterior jaws. Radiographically, it presents as a mixed radiolucentradiopaque lesion. Though the histopathological presentation is quite distinct, cases have been reported to show slight variations from the usual picture. One such rare variant is the presence of abundant clear cells intermixed with the tumor cells. The significance of this variant is that it has been shown to have a more aggressive behaviour with greater tendency to recur if inadequately removed. We report a case of clear cell variant of CEOT with an uncommon site of presentation in the anterior mandible.
Pindborg肿瘤或钙化上皮性牙源性肿瘤(CEOT)是一种罕见的良性牙源性肿瘤,由荷兰病理学家Jens Jorgen Pindborg于1955年首次描述。CEOT最常见的临床表现是后颌骨的局部,缓慢生长的硬组织肿胀。x线摄影表现为混合性放射线室不透明病变。虽然组织病理表现是相当不同的,病例报告显示轻微的变化,从通常的图片。其中一种罕见的变异是大量透明细胞与肿瘤细胞混杂在一起。这种变异的意义在于,如果移除不充分,它会有更大的复发倾向,具有更强的攻击性行为。我们报告一例透明细胞变异的CEOT与一个不寻常的位置呈现在前下颌骨。
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引用次数: 0
Planned Pregnancy for a Patient with Chronic Myeloid Leukemia 慢性髓性白血病患者的计划妊娠
Pub Date : 2009-12-31 DOI: 10.5580/bea
P. Ault, J. Cortes
Management of chronic myeloid leukemia (CML) during pregnancy can be difficult for patients, their families and care providers. Treatment of CML and pregnancy remains a clinical challenge. Current recommendations, for women of childbearing potential, are to use adequate contraception and avoid pregnancy while taking kinase inhibitors. Consequences of exposure to kinase inhibitors to a fetus during pregnancy are unknown. Treatment may result in an increased risk of serious fetal abnormalities or spontaneous abortion. Lack of treatment for CML, during a pregnancy, may result in disease progression. In the absence of detailed information, difficulty arises to guide this patient through a decision making process. Patients who wish to interrupt therapy and become pregnant should receive intense counseling for both parents, using the most recent data available. Decisions concerning patients with CML and pregnancies must be based on individual cases. This report describes a 25 year old woman with newly diagnosed CML who purposefully arranged harvesting and storage of her unfertilized ova, prior to commencing bosutinib chemotherapy for CML
慢性髓性白血病(CML)在怀孕期间的管理可能是困难的患者,他们的家人和医护人员。治疗慢性粒细胞白血病和妊娠仍然是一个临床挑战。目前的建议,对于有生育潜力的妇女,使用适当的避孕措施,避免怀孕,同时服用激酶抑制剂。胎儿在怀孕期间暴露于激酶抑制剂的后果尚不清楚。治疗可能导致严重胎儿畸形或自然流产的风险增加。在怀孕期间,缺乏对CML的治疗可能导致疾病进展。在缺乏详细信息的情况下,引导患者通过决策过程出现困难。希望中断治疗并怀孕的患者应该接受父母双方的密集咨询,使用最新的可用数据。关于CML患者和妊娠的决定必须基于个案。本报告描述了一名新诊断为CML的25岁女性,在开始博舒替尼化疗治疗CML之前,她有目的地安排了未受精卵子的采集和储存
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引用次数: 5
Does Ethnicity Influence Response To Docetaxel Based-Chemotherapy For Patients With Castration Resistant Prostate Cancer? The New Mexico Perspective. 种族是否会影响去势抵抗性前列腺癌患者对多西紫杉醇化疗的反应?新墨西哥视角
Pub Date : 2009-12-31 DOI: 10.5580/107e
Shalini Ravi-Kumar, Sang-Joon Lee, I. Rabinowitz, C. Verschraegen
INTRODUCTION: Metastatic prostate cancer is lethal in 15 % of the patients. Ethnic variations in response to docetaxel in patients with metastatic prostate cancer have not been studied. The aim of this study was to identify ethnic differences in the response to docetaxel, among patients with castration resistant metastatic prostate cancer.PATIENTS AND METHODS: We queried the New Mexico Cancer Registry then the electronic charts of all castration resistant metastatic prostate cancer patients who were treated with docetaxel between 1999 and 2010 at the University of New Mexico Cancer Center. Patient characteristics that might influence the response to docetaxel such as age, prior treatment including hormones, chemotherapy, radiotherapy, and surgery, concurrent chemotherapy, site of disease, baseline PSA, and number of docetaxel courses were recorded. Progression of disease after start of treatment was defined as identification of new lesions or a biochemical recurrence. The primary end point was overall survival. Secondary end points were progression-free survival and PSA response to docetaxel. RESULTS: Despite a lower incidence of prostate cancer in NM, the death rate is higher than the national average. Although not statistically significant, the overall survival for patients treated with docetaxel is highest among Non Hispanic Whites, followed by Native Americans and worst among the Hispanic population. The progression free survival was greatest in the Native American population followed by Non Hispanic Whites, followed by Hispanics. Compared to published data, the survival of New Mexicans with prostate cancer treated with docetaxel is worse.CONCLUSION: Hispanic males with castration resistant metastatic prostate cancer on docetaxel, tended to have the lowest overall survival and progression free survival, but overall the differences between New Mexican ethnicities were not statistically significant.
简介:转移性前列腺癌在15%的患者中是致命的。转移性前列腺癌患者对多西他赛反应的种族差异尚未研究。本研究的目的是确定在去势抵抗性转移性前列腺癌患者对多西他赛反应的种族差异。患者和方法:我们查询了新墨西哥癌症登记处,然后查询了1999年至2010年间在新墨西哥大学癌症中心接受多西他赛治疗的所有阉割抵抗性转移性前列腺癌患者的电子图表。记录可能影响多西紫杉醇反应的患者特征,如年龄、既往治疗(包括激素)、化疗、放疗和手术、同期化疗、疾病部位、基线PSA和多西紫杉醇疗程数。治疗开始后的疾病进展定义为发现新的病变或生化复发。主要终点为总生存期。次要终点是无进展生存期和对多西紫杉醇的PSA反应。结果:尽管NM的前列腺癌发病率较低,但死亡率高于全国平均水平。虽然没有统计学意义,但多西他赛治疗患者的总生存率在非西班牙裔白人中最高,其次是美洲原住民,在西班牙裔人群中最差。美洲原住民的无进展生存率最高,其次是非西班牙裔白人,其次是西班牙裔。与已发表的数据相比,用多西他赛治疗前列腺癌的新墨西哥患者的生存率更差。结论:接受多西他赛治疗的西班牙裔男性去势抵抗性转移性前列腺癌患者的总生存率和无进展生存率最低,但新墨西哥种族之间的总体差异无统计学意义。
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引用次数: 1
期刊
The Internet Journal of Oncology
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