RESUMO
Mature cystic teratoma of the ovary (MCT) occasionally undergoes malignant transformation (MT) that is resistant to chemotherapy and has a poor prognosis. We experienced a case of clinically aggressive MCT-MT that invades surrounding organs and tissues. Although tumor was resected entirely, a rapid tumor recurrence occurred during postoperative chemotherapy (paclitaxel + ifosfamide + cisplatin). The results of comprehensive genomic profiling test performed early in the postoperative period showed a high tumor mutational burden of 23 mutations/Mb. Treatment with nivolumab monotherapy has promptly been initiated and has been very successful for more than one year.
RESUMO
PURPOSE: This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME). PATIENTS AND METHODS: We analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT) were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT), central minimum macular thickness (CMMT), macular volume (MV) and best-corrected visual acuity (BCVA) were compared preoperatively and 1 and 6 months post surgery. RESULTS: CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01). Significant improvements in BCVA were only observed 6 months post surgery (P<0.01). No intra- or postoperative complications were observed in all patients. CONCLUSION: CRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes.
RESUMO
A 6-year-old girl who exhibited nonconvulsive status epilepticus (NCSE) as her main clinical seizure is reported. Her seizures involved abnormal eye movement that occurred every 1-2 months associated with a dulling of responsiveness and falling easily due to ataxic gait. During the seizure, her eyelids drooped so that the eyes appeared hooded and she seemed to be drunk. During the episode, she laughed or cried easily with no relation to her surroundings. Ictal EEG continuously showed diffuse high-voltage theta and slow waves with spikes and diffuse spike and waves, and interictal EEG showed spike and waves in the left frontal region. Brain magnetic resonance imaging revealed focal cortical dysplasia in the left frontal region. These findings suggested that the origin of NCSE is related to the frontal lobe.