Ischemic stroke during cisplatin-based chemotherapy for testicular germ cell tumor: case report and review of the literature.

Testicular germ-cell tumors are the most common solid tumor in young men, with an incidence peak between the ages of 20 and 35 years. Even if rare, arterial thromboembolism is a serious and possible complication during cisplatin-based chemotherapy in young patients. The strong association between rapid treatment and favorable outcome is well known. Oncologists need to recognize the symptoms and to alert a stroke unit as soon as possible. We report the management of a young patient affected by non seminomatous testicular neoplasm without cardiovascular risk factors who developed an ischemic stroke during cisplatin-based treatment. We also review the relevant literature.

Otolaryngological manifestations of velocardiofacial syndrome: a retrospective review of 35 patients.

OBJECTIVE: Because many patients with velocardiofacial syndrome (VCFS) are first examined by otolaryngologists for ear or speech problems before being diagnosed with VCFS, we describe a series of patients with this genetic disorder, which is associated with multiple anomalies, including velopharyngeal insufficiency, cardiac defects, characteristic facial features, and learning disabilities. STUDY DESIGN: We retrospectively analyzed the medical charts and available nasoendoscopic observations for 35 patients who were diagnosed with VCFS and who had a microscopic deletion in chromosome 22q11 as shown by DNA probe and fluorescence in situ hybridization. RESULTS: For most patients, the medical chart documented cardiac anomalies, velopharyngeal insufficiency with hypernasal speech, and characteristic facial features including nasal, auricular, craniofacial, and ocular abnormalities. Incidence of middle ear infection with associated conductive hearing loss was also high and necessitated early placement of pressure equalization tubes. Some patients were treated with adenoidectomy for chronic otitis media; consequently, velopharyngeal insufficiency and hypernasal speech worsened. Nasoendoscopic examination as documented in the medical chart showed occult cleft palate, a small adenoid pad, and pulsation in the muscular wall. CONCLUSION: Otolaryngologists have an important role in diagnosis and treatment of persons with VCFS and therefore should familiarize themselves with the typical history and most frequent head and neck manifestations of this syndrome.

[Therapeutic implications of the peculiar clinical characteristics of Hodgkin's disease in clinical stages I-II with isolated neck presentation]. / Implicazioni terapeutiche delle peculiari caratteristiche cliniche del morbo di Hodgkin negli stadi clinici I-II con presentazione cervicale isolata.

Among 703 patients with supradiaphragmatic clinical stages I-II Hodgkin's disease consecutively treated 1960 through 1989 at the Florence Radiotherapy Department, we identified 98 cases presenting with cervical and supraclavicular nodes involvement only. The latter cases were retrospectively reviewed to assess: a) if they presented any peculiar clinicopathologic features and b) the possible prognostic and therapeutic implications (if any) of these features. The high incidence of lymphocytic predominance histology (33%) and Waldeyer's ring (WR) involvement (24%) and the very low risk of occult infradiaphragmatic involvement (observed in only 2 of 44 patients submitted to staging laparotomy with splenectomy, 4.5%) are among the distinctive features of the patients with supradiaphragmatic clinical stages I-II Hodgkin's disease. All the 98 patients were treated at presentation with irradiation alone. Actuarial cause-specific survival 20 years after the end of treatment was 87%; the corresponding value for relapse-free survival was 78%. The most frequent complications were irradiation pneumonia, most often asymptomatic, and xerostomia. Our data seem to suggest that, for the majority of these patients: a) staging laparotomy could be avoided and b) "mini mantle" irradiation is an adequate treatment. Moreover, WR irradiation could be avoided in the patients without clinical WR involvement.

[Intraoperative radiotherapy with electrons (IORT). Dosimetry problems, first experience]. / Terapia intraoperatoria con elettroni (IORT). Problemi dosimetrici, prime esperienze.

In this paper, preliminary results on the IORT dosimetry performed on the two radiotherapy centers, "Regina Elena National Cancer Institute" and "S. Cuore Catholic University", are presented. The absolute dosimetry has been performed with ion chambers (ENEA chamber and Markus flat chamber) using a water phantom. The relative measurements have been performed with solid state diodes and radiographic films, calibrated on absolute dosimetry system.