RESUMO
Bone and bone marrow involvement in sarcoidosis have been infrequently reported. We aimed to describe the clinical features, radiological descriptions, pathological examinations, and outcomes of three patients with osseous sarcoidosis and one patient with bone marrow sarcoidosis seen at our institution. Our case series included fluorodeoxyglucose positron emission tomography descriptions in assessing the whole-body extent of sarcoidosis. In the era of advanced imaging, large bone and axial skeleton sarcoidosis lesions are more common than previously reported.
Assuntos
Doenças Ósseas/diagnóstico , Doenças da Medula Óssea/diagnóstico , Medula Óssea , Úmero , Ílio , Sarcoidose/diagnóstico , Adulto , Biópsia , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/tratamento farmacológico , Doenças Ósseas/patologia , Medula Óssea/diagnóstico por imagem , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/tratamento farmacológico , Doenças da Medula Óssea/patologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Glucocorticoides/administração & dosagem , Humanos , Úmero/diagnóstico por imagem , Úmero/efeitos dos fármacos , Úmero/patologia , Hidroxicloroquina/administração & dosagem , Ílio/diagnóstico por imagem , Ílio/efeitos dos fármacos , Ílio/patologia , Imunossupressores/administração & dosagem , Imageamento por Ressonância Magnética , Masculino , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Patela/diagnóstico por imagem , Patela/efeitos dos fármacos , Patela/patologia , Tomografia por Emissão de Pósitrons , Prednisona/administração & dosagem , Compostos Radiofarmacêuticos/administração & dosagem , Sarcoidose/diagnóstico por imagem , Sarcoidose/tratamento farmacológico , Sarcoidose/patologia , Resultado do Tratamento , Imagem Corporal TotalRESUMO
PURPOSE: Small-cell carcinoma is very aggressive, metastasizes early and often, and does not respond to most chemotherapy regimens. In approximately 50% of cases of prostate cancer, tumors are a combination of small-cell carcinoma and androgen-sensitive adenocarcinoma. It is widely believed that no successful treatment exists for androgen-independent prostate cancer. METHODS: A 67-year-old man had undergone androgen ablation therapy and radical prostatectomy for prostate cancer followed by bilateral orchiectomy, limited radiation therapy, and unsuccessful chemotherapy for pain-causing metastatic bone disease. Biopsy and immunohistochemical analysis revealed neuroendocrine differentiation of the cancer. The full extent of metastatic disease was assessed successfully using In-111, a somatostatin derivative. Octreotide acetate was used to treat the tumors. RESULTS: In-111 OctreoScan scintigraphy was more sensitive in the diagnostic demonstration of metastatic foci than was bone scanning. Therapy with the cold somatostatin derivative resulted in a rapid and significant relief of pain with significant tumor shrinkage. The patient remained in remission for at least 10 weeks, when he was lost to follow-up. CONCLUSIONS: Somatostatin analogs and their radionuclide and cytotoxic derivatives are recommended as adjuvant treatments for prostate carcinoma, especially in those patients who are at high risk for carcinoma recurrence after radical prostatectomy and who have advanced prostate carcinoma at the time of relapse. Because small-cell carcinomas of the prostate and lung are identical, these analogs may be useful in the detection and treatment of these tumors as well.