RESUMEN
A pyogenic granuloma of the cornea developed on the vascularized cornea of a 79-year-old woman after "snake oil" accidentally dripped in her eye. The snake oil was being used to relieve forehead pain, which may have been referred. The five previously reported examples of corneal pyogenic granuloma are similar to this case in that trauma preceded development of the lesion. However, the chemical trauma induced by the snake oil appears to be a unique mechanism of injury.
Asunto(s)
Enfermedades de la Córnea/inducido químicamente , Granuloma Piogénico/inducido químicamente , Materia Medica/efectos adversos , Anciano , Animales , Córnea/efectos de los fármacos , Córnea/patología , Enfermedades de la Córnea/patología , Dolor Facial/tratamiento farmacológico , Femenino , Granuloma Piogénico/patología , Humanos , Linimentos , Aceites/efectos adversos , SerpientesRESUMEN
Between 1983 and 1992, 21 patients with extremity stage IIIA or IIIAB melanoma underwent hyperthermic isolation limb perfusion (HILP) with cisplatin in dosages varying from 26 to 237 mg/m2 as part of a pharmacokinetics and maximum-tolerated dose study. Extremity temperatures were up to 40 degrees C and the pH was controlled near 7.4. There were no major complications in this series of patients. Overall survival was 55% at 2 years and 47% at 5 years. Local control rates excluding regional nodal control was 79% at 2 years and 53% at 5 years. Local control, including regional nodal control, was 61% at 2 years and 36% at 5 years, indicating that cisplatin is not as effective at nodal control as it is at control of dermal or subcutaneous metastases. Three patients who failed cisplatin HILP have responded to re-perfusion with melphalan and actinomycin D. Two of the three patients had complete responses. It is concluded that cisplatin is an active agent against melanoma when employed by HILP. The drug is well tolerated at the doses and temperature employed, but it is not superior to HILP with melphalan.
Asunto(s)
Quimioterapia del Cáncer por Perfusión Regional , Cisplatino/administración & dosificación , Hipertermia Inducida , Melanoma/terapia , Adulto , Terapia Combinada , Extremidades , Femenino , Humanos , Masculino , Melanoma/tratamiento farmacológico , Persona de Mediana Edad , Estadificación de NeoplasiasAsunto(s)
Neoplasias Óseas/terapia , Cisplatino/uso terapéutico , Extremidades , Hipertermia Inducida , Melanoma/terapia , Osteosarcoma/terapia , Neoplasias Cutáneas/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Óseas/tratamiento farmacológico , Quimioterapia Adyuvante , Quimioterapia del Cáncer por Perfusión Regional , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Cisplatino/farmacocinética , Terapia Combinada , Dacarbazina/administración & dosificación , Dactinomicina/administración & dosificación , Estudios de Evaluación como Asunto , Humanos , Incidencia , Melanoma/tratamiento farmacológico , Melfalán/administración & dosificación , Metástasis de la Neoplasia , Osteosarcoma/tratamiento farmacológico , Rabdomiólisis/inducido químicamente , Neoplasias Cutáneas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Between 1983 and 1990, 59 patients with malignant melanoma were retrospectively reviewed to assess the safety, efficacy and the maximal tolerated dose of cisplatin used in hyperthermic isolated limb perfusion. The median follow-up was 29 months (range 3-54 months). The local recurrence rate was 12% in Stage I, 33% in Stage II and 30% in Stage III patients. The maximal tolerated dose of cisplatin in hyperthermic isolated limb perfusion was 3.2 mg/kg for forequarter perfusions and 6 mg/kg for hindquarter perfusions based on lean body weight. At these dosages, there is an 8% major complication rate and only one patient experienced long-term sequelae. Hyperthermic isolated limb perfusion using cisplatin in the dosages of 3-6 mg/kg lean body weight is associated with low morbidity and appears to have efficacy comparable to L-phenylalanine mustard for the control of locally recurrent malignant melanoma.