[Metastasis in maxilar sinus as only manifestation of disseminate renal adenocarcinoma]. / Metástasis en seno maxilar como única manifestación de adenocarcinoma renal diseminado.

Paranasal sinuses and nose metastasis are very uncommon. About 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lug. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment.

[Maxillary sinus metastasis of renal cell carcinoma]. / Adenocarcinoma renal metastásico en seno maxilar.

Paranasal sinuses and nose metastasis are very uncommon tumors, about 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lung. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment.

[Disphagia secondary to cervical osteophytes]. / Disfagia como manifestación de exóstosis vertebral cervical.

Disphagia is a common cause of medical query in the ENT field, in which could be involved a variety of medical reason. One of those is the extrinsic compression of the digestive tract due to a tumoral process, or as the case we report, secundary to a large osteophyte at the anterior side of the cervical spine, after a surgical intervention in this area.

[Esthesioneuroblastoma. Description of a case and review of the literature]. / Estesioneuroblastoma. Presentación de un caso clínico y revisión de la bibliografía.

The esthesioneuroblastoma is a malignant and rare type of the nasal cavity. Affected patients usually present with a progressive nasal obstruction, rhinorrea and epistaxis. Metastasis occurs in about 30% of patiens, the most common sites for metastasis are the cervical lymph nodes, less frequent in anothers organs. The optimum management is probably surgery combined with radiotherapy, the chemotherapy is usually reserved for local advanced tumor

Practical guidelines for dose individualization of anticancer targeted drugs

For drugs such as anticancer agents every effort should be made to minimize inter-patient variability in drug exposure in order to maximize the benefit while maintaining an acceptable risk level of serious adverse effects. Anticancer drugs generally have a preferential route of elimination, either in urine or in bile and feces. In consequence, dose individualization to renal and liver function permits excessive toxicity to be avoided and expected therapeutic benefit to be achieved. However, less is known about the most appropriate starting doses of antineoplastic agents in these individuals. In this review, we discuss trials that have specifically assessed new targeted agents dosing strategies (mainly monoclonal antibodies and tyrosine kinase inhibitors) in the setting of overt biochemical renal and liver dysfunction and we proportionate recommendations and practical guidelines for dose individualization (AU)

Adenocarcinoma renal metastásico en seno maxilar / Maxillary sinus metastasis of renal cell carcinoma

Los tumores metastásicos en senos paranasales y fosas son excepcionales. Se han descrito en la literatura unos 50 casos localizados en seno maxilar. El adenocarcinoma renal es la neoplasia primaria que más frecuentemente metastatiza en la región nasosinusal, seguido de tumores mamarios y pulmonares. Presenta una sintomatología inespecífica siendo la epistaxis el síntoma más frecuente debido a la gran vascularización tumoral. Tienen un pronóstico pobre con una tasa de supervivencia en torno al 15-30% a los 5 años. El tratamiento de elección es la cirugía

Paranasal sinuses and nose metastasis are very uncommon tumors, about 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lug. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment

Limited impact of palliative chemotherapy on survival in advanced solid tumours in patients with poor performance status

AIM: Oncologists should carefully weigh up the risks and benefits of palliative chemotherapy in patients with advanced solid tumours (AST) and poor general status from the standpoint both of medical and ethical issues and of healthcare resources required. This study is intended to assess the impact on overall survival of palliative chemotherapy in patients with AST and admitted to hospital as a result of their poor ECOG status. MATERIALS AND METHODS: We performed a retrospective analysis of 92 hospitalised patients with AST, ECOG 3-4, who were treated with palliative chemotherapy. Uni- and multivariate statistical analyses were conducted to determine the impact of clinical and disease variables (number of previous chemotherapy lines, presence of comorbidities, presentation of anorexia-cachexia syndrome, delirium, dyspnoea, ascitis, brain metastases, T-cell count, albumin, haemoglobin and LDH) on survival in this patient population. RESULTS: Mean age was 54 years (range 15-80). No chemotherapy had been given for advanced disease in 74%, 13% had received one line, 6% 2 lines and 7% ≥3 lines. Median survival, i.e., after initiation of chemotherapy to death, in these patients was 33 days (range 1-1390). The median of chemotherapy cycles was 1. In the multivariate analysis, no previous chemotherapy, and absence of anorexia-cachexia syndrome and of comorbidities was associated with significantly improved survival in patients. Forty-nine percent of patients died within 30 days of therapy, 28% died between days 30 and 90, and only 23% of patients lived longer than 90 days. Grade 3-4 toxicities mainly entailed blood disorders, namely anaemia 8%, neutropenia 13% and thrombocytopenia 8%. Six patients (5%) developed sepsis after therapy; of these, 3 died from this toxicity, 1 patient suffered cardiac toxicity, one patient leukoencephalopathy and 1 patient acute pulmonary thromboembolism. CONCLUSION: Palliative chemotherapy given to patients with AST and ECOG 3-4 with short life expectancy provided no benefit for survival. As a result, we may be over-treating these patients and contributing to poor-quality care (AU)

Metástasis en seno maxilar como única manifestación de adenocarcinoma renal diseminado / Metastasis in maxilar sinus as only manifestation of disseminate renal adenocarcinoma

Los tumores metastásicos en senos paranasales y fosas son excepcionales. Se han descrito en la literatura unos 50 casos localizados en seno maxilar. El adenocarcinoma ranal es la neoplasia primaria que más frecuentemente metastatiza en la región nasosinusal, seguido de tumores mamarios y pulmonares. Presenta una sintomatología inespecífica siendo la epistaxis el síntoma más frecuente debido a la gran vascularización tumoral. Tienen un pronóstico pobre con una tasa de supervivencia en torno al 15-30% a lso 5 años. El tratamiento de elección es la cirugía

Paranasal sinuses and nose metastasis are very uncommon. About 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lug. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment

Disfagia como manifestación de exóstosis vertebral cervical / Disphagia secondary to cervical osteophytes

La disfagia es un motivo de consulta frecuente en el ámbito de la otorrinolaringología, en la que pueden estar implicados diferentes mecanismos de producción. Uno de estos mecanismos son las compresiones extrínseca del tracto digestivo ya sea de origen tumoral o como en el caso que presentamos como consecuencia de un osteofito o hiperóstosis de gran tamaño a nivel de columna cervical anterior tras cirugía ortopédica en la zona

Disphagia is a common cause of medical query in the ENT field, in which could be involved a variety of medical reason. One of those is the extrinsic compression of the digestive tract due to a tumoral process, or as the case we report, secundary to a large osteophyte at the anterior side of the cervical spine, after a surgical intervention in this area

Estesioneuroblastoma. Presentación de un caso clínico y revisión de la bibliografía / Esthesioneuroblastoma. Description of a case and review of the literature

El estesioneuroblastoma es un tumor maligno poco frecuente de fosas nasales. Suele manifestarse con una progresiva obstrucción nasal, rinorrea y epistaxis. Las metástasis aparecen en tomo al 30% de los pacientes ocurriendo con mayor frecuencia en ganglios linfáticos cervicales regionales y con menor frecuencia en otros órganos. El tratamiento más adecuado parece ser la combinación de cirugía más radioterapia reservando el tratamiento quimioterápico para los casos localmente agresivos. Presentamos un caso clínico y realizamos una revisión bibliográfica de los aspectos clínicos, diagnósticos y terapéuticos de estos tumores

The esthesioneuroblastoma is a malignant and rafe type of the nasal cavity. Affected patients usually present with a progressive nasal obstruction, rhinorrea and epistaxis. Metastasis occurs in about 30% of patiens, the most common sites for metastasis are the cervical lymph nodes, less frequent in anothers organs. The optimum management is probably surgery combined with radiotherapy, the chemotherapy is usually reserved for local advanced tumor

Estudio multicéntrico del tratamiento empírico de la neutropenia febril en el enfermo oncohematológico / Multicentric study of empiric treatment of febrile neutiropenia in cancer patients

En el presente trabajo se analiza un estudio multicéntrico de tipo prospectivo, cuyo principal objetivo es conocer el perfil de utilización de antibióticos y antifúngicos empleados en el tratamiento de la neutropenia febril en el paciente oncohematológico y establecer el grado de adhesión a los protocolos instaurados en siete hospitales de la zona Andalucía Oriental. Se incluyeron en el estudio los pacientes que recibieron tratamiento durante el período mayo-junio de 1998 (65 episodios), utilizando para su evaluación unas hojas de recogida de datos consensuadas por los hospitales participantes. En ellas también se recoge la utilización de factores estimulantes de colonias en estos pacientes. Los resultados muestran que la monoterapia genera un interés creciente como alternativa a la terapia combinada, especialmente en pacientes de bajo riesgo. La mayoría de los hospitales participantes poseen protocolos instaurados que recogen el tratamiento antiinfeccioso empírico de la neutropenia febril, variando el grado de adhesión entre un 50 y un 75 por ciento. Destaca la utilización de factores estimulantes de colonias en un alto porcentaje de pacientes (72,3 por ciento) como terapia adyuvante (AU)