ABSTRACT
Unresectable, symptomatic unicentric Castleman disease (UCD) can represent a formidable therapeutic challenge. UCD masses are often highly vascularized offering the opportunity for therapeutic embolization. Herein, we report on 6 patients in which therapeutic embolization was combined with other medical interventions including surgery (n = 3), rituximab (n = 6), cryoablation (n = 2), and chemotherapy (n = 3). Five patients had significant tumor volume reductions (median: 83.2%; range: 76.7-100). All five responding patients had resolution of symptomatology. There were no serious complications in the patients who received embolization and proceeded to surgery. In conclusion, effective disease and symptom control can be obtained in patients with symptomatic, unresectable UCD by combining different therapeutic interventions.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Castleman Disease/therapy , Combined Modality Therapy/methods , Cryosurgery/methods , Embolization, Therapeutic/methods , Adult , Axilla , Castleman Disease/diagnostic imaging , Castleman Disease/pathology , Castleman Disease/surgery , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Female , Humans , Male , Mediastinum , Middle Aged , Pelvis , Prednisone/therapeutic use , Rituximab/therapeutic use , Treatment Outcome , Vincristine/therapeutic useSubject(s)
Accident Prevention/instrumentation , Accidents, Traffic/prevention & control , Athletic Injuries/prevention & control , Sports , Accidents, Traffic/statistics & numerical data , Automobiles , Engineering , Humans , Injury Severity Score , Motorcycles , Protective Devices/statistics & numerical data , Risk Factors , SafetySubject(s)
Choriocarcinoma/pathology , Stomach Neoplasms/pathology , Adult , Choriocarcinoma/diagnosis , Choriocarcinoma/drug therapy , Choriocarcinoma/surgery , Chorionic Gonadotropin, beta Subunit, Human/blood , Diagnosis, Differential , Female , Gastrectomy , Humans , Stomach Neoplasms/diagnosis , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgeryABSTRACT
BACKGROUND: Cryoablation is a recent technological advance and has been used for the percutaneous treatment of breast fibroadenomas. Herein, we provide a retrospective summary of the early experience from a nationwide group. METHODS: We organized a national registry to document the community practice and adoption of an office-based system of cryoablation for breast fibroadenoma. Data were abstracted during the first 6 weeks after the procedure to assess acute outcome and potential complications. At 6-and 12-month follow-up intervals, additional data were collected regarding fibroadenoma resolution, cosmesis, and patient satisfaction. RESULTS: Fifty-three sites ablated 310 fibroadenomas. Early follow-up data on 256 lesions showed that the procedure was well tolerated with infrequent minor complications immediately after the procedure. At 6 and 12 months postprocedure, the remaining fibroadenoma volume progressively involuted. At both intervals, cosmesis was excellent, and patient satisfaction was rated high. CONCLUSIONS: An early community experience with office-based cryoablation of breast fibroadenomas is encouraging and comparable to the initial experience of high-volume tertiary centers. More follow-up is necessary to determine long-term results and residual mammographic changes.