RESUMO
Placental mesenchymal dysplasia (PMD) is a rare, recently recognized placental vascular anomaly. About 20% of patients with this placental anomaly have Beckwith-Wiedemann syndrome. We report a case of a phenotypically normal neonate with anemia and thrombocytopenia associated with PMD. Histologic examination of the placenta showed findings consistent with PMD, including chorangioma. The patient's hematologic abnormalities resolved during the week following birth. Normal phenotypic fetuses with PMD seem to exhibit hematologic disorders at birth in some cases, especially in the presence of chorangioma.
Assuntos
Anemia/etiologia , Hemangioma/complicações , Neoplasias de Tecido Vascular/complicações , Doenças Placentárias/patologia , Trombocitopenia/etiologia , Adulto , Feminino , Hemangioma/patologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/etiologia , Mesoderma/patologia , Neoplasias de Tecido Vascular/patologia , Placenta/irrigação sanguínea , Placenta/patologia , GravidezRESUMO
A 53-year-old woman with choriocarcinoma (high-risk gestational trophoblastic disease: FIGO score 17) was treated with paclitaxel (175 mg/m(2)) and carboplatin (AUC=5). The patient was treated with an EMA/CO regimen as initial chemotherapy, but she developed EMA/CO-induced interstitial lung disease after the 3rd course of treatment. After high-dose steroid therapy, she received combination chemotherapy with paclitaxel and carboplatin. Her hCG-/b dropped to <0.1 ng/mL after 11 courses of the chemotherapy. A paclitaxel+carboplatin regimen is potentially effective for high-risk GTD, but a more effective combination or schedule with a platinum-taxane regimen should be explored.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/uso terapêutico , Coriocarcinoma/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Paclitaxel/uso terapêutico , Neoplasias Uterinas/tratamento farmacológico , Carboplatina/administração & dosagem , Coriocarcinoma/sangue , Coriocarcinoma/diagnóstico por imagem , Coriocarcinoma/patologia , Gonadotropina Coriônica Humana Subunidade beta/sangue , Feminino , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Gravidez , Indução de Remissão , Tomografia Computadorizada por Raios X , Neoplasias Uterinas/sangue , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/patologiaRESUMO
OBJECTIVES: We evaluated safety and activity of intraperitoneal paclitaxel [=PTX (ip)] for neoadjuvant chemotherapy (NAC) of patients with advanced gynecologic cancer. METHODS: 13 patients with gynecologic cancer who had diffuse peritoneal dissemination received PTX (ip) with systemic chemotherapy (TC regimen) for NAC. After 3-6 courses of NAC, interval debulking surgery (IDS) was done. At IDS, we explored intraperitoneal cavity and debulked as much as possible, and examined pathological effects of NAC. RESULTS: PTX (ip) was well tolerated with apparent anti-cancer activity. Eleven patients were done with IDS after 3-6 NAC courses. Ten of 11 patients were completed an optimal surgery without extended resections. Eight of 11 patients with IDS had grade 2 (5 cases) or grade 3 (3 cases) effects of pathological examination. CONCLUSION: According to this exploratory research, we considered PTX (ip)=80 mg/m2 with PTX (iv)=115 mg/m2 and CBDCA (iv) AUC=4 as an optimum drug dose. Although evaluated in a small number of patients, PTX (ip) appeared to have safety and anti-cancer activity, and should be evaluated further.
