ABSTRACT
This paper is a report on a case of gastric carcinoma of diffuse type in a young female patient aged 38. The patient was still asymptomatic at hospital admission, her only pathological sign being the finding of malignant cells of indeterminate origin at a routine Pap-test examination. Subsequent investigations showed the presence of a poorly differentiated gastric carcinoma, with metastatic diffusion to uterus, ovaries and peritoneum. Only a few cases of gastric carcinomas without cervical localization, detected by Pap-test, are reported in literature. A few other cases with cervical localization have been described. The aim of this work is to point out that a Pap-test smear may reveal the presence of extragenital tumors still unappreciated.
Subject(s)
Adenocarcinoma/secondary , Carcinoma/diagnosis , Carcinoma/pathology , Ovarian Neoplasms/secondary , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Uterine Neoplasms/secondary , Vaginal Smears , Adult , Female , HumansABSTRACT
Clinical data have supported the combination of subcutaneous r-interleukin-2 (rIL-2) and r-interferon-alpha (rIFN-alpha) as a promising combination for advanced renal cell carcinoma (RCC), with a reduced toxicity. We evaluated the activity and safety of this outpatient immunotherapy and report on the clinical results and the long-term survival analysis. Objective responses was observed in 9 of 50 (18%) patients, 6 of whom (12%) achieved a complete response. Overall median survival is 12 months, six patients were surviving at a median follow-up of 24 months, and three (6%) are still progression-free.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Renal Cell/drug therapy , Immunotherapy, Active , Interferon-alpha/administration & dosage , Interleukin-2/administration & dosage , Kidney Neoplasms/drug therapy , Adult , Aged , Carcinoma, Renal Cell/secondary , Female , Humans , Injections, Subcutaneous , Interferon alpha-2 , Interferon-alpha/therapeutic use , Interleukin-2/therapeutic use , Male , Middle Aged , Prognosis , Recombinant Proteins , Remission Induction , Survival AnalysisABSTRACT
Recent clinical studies have suggested that the combination of subcutaneous recombinant human interleukin 2 (rIL-2) and interferon alpha (rIFN-alpha) is especially promising in advanced renal cell carcinoma. We assessed the safety, activity and toxicity of home therapy with these two agents in 50 patients. Each treatment cycle consisted of a 2 day pulse phase, with 9 x 10(6) IU m-2 of rIL-2 being given subcutaneously every 12 h, followed by a 6 week maintenance phase during which rIL-2 1.8 x 10(6) IU m-2 was administered subcutaneously every 12 h on days 1-5 and rIFN-alpha 2b 5 x 10(6) IU m-2 once a day on days 1, 3 and 5. Objective responses (CR+PR) occurred in 9/50 (18%) patients, six of whom (12%) achieved a complete response. Disease stabilisation was observed in 17 cases (34%) and 18 patients progressed during therapy. In the other six cases, treatment was interrupted early for toxicity or patient refusal. One patient died of myocardial infarction during the second cycle. The overall median survival was 12 months. Home therapy with subcutaneous rIL-2 + rIFN-alpha 2b proved to be active, feasible and moderately toxic, but serious adverse events can sometimes occur.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Renal Cell/therapy , Kidney Neoplasms/therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Drug Administration Schedule , Feasibility Studies , Female , Humans , Injections, Subcutaneous , Interferon alpha-2 , Interferon-alpha/administration & dosage , Interleukin-2/administration & dosage , Male , Middle Aged , Recombinant ProteinsABSTRACT
Meningitis caused by Listeria monocytogenes is a rare affection: it develops from close contagion as professional illness (veterinarians, butchers) or in newborns by infected mothers; in indirect way for ingestion of contaminated food in subjects at high risk: elderly, immunosuppressed patients, alcoholics, diabetics. Clinically it is not diversified from the other bacterial meningitises. In this paper we present a case of Listeria monocytogenes meningitis in an adult female, without a sure occasion of infection and in absence of the factors of typical risk.
Subject(s)
Listeria monocytogenes/isolation & purification , Meningitis, Listeria/microbiology , Adult , Diagnosis, Differential , Female , Humans , Meningitis, Listeria/diagnosis , Meningitis, Listeria/etiology , Risk FactorsABSTRACT
BACKGROUND: A Phase II confirmatory multicenter trial was performed to evaluate a combination of epirubicin, cisplatin, and continuous infusion 5-fluorouracil (ECF) in treating patients with advanced gastric cancer. METHODS: Fifty-three patients with locally advanced (n = 7) or metastatic (n = 46) gastric cancer received a dose of epirubicin (50 mg/m2) and cisplatin (60 mg/m2) intravenously every 21 days for eight cycles with 5-fluorouracil (200 mg/m2/day) by intravenous continuous infusion for 21 consecutive weeks, administered through a central line using an external pump. RESULTS: Eight complete responses and 22 partial responses (response rate = 56%, 95% confidence interval +/- 13) were achieved. Twelve patients had stable disease. The median duration of response was 10 months (range, 3-21 months), and the median survival for all the patients was 9+ months (range, 2-28 months). Overall toxicity, which was primarily hematologic, was mild with only three patients requiring hospitalization for neutropenic fever. No death due to toxicity occurred. CONCLUSIONS: This study found that the ECF regimen is substantially active in treating patients with advanced gastric cancer and has a favorable pattern of toxicity. This schedule clearly deserves randomized comparative trials for palliation of metastatic disease and for adjuvant purposes.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Stomach Neoplasms/drug therapy , Adult , Aged , Cisplatin/administration & dosage , Epirubicin/administration & dosage , Female , Fluorouracil/administration & dosage , Humans , Infusions, Intravenous , Male , Middle AgedABSTRACT
A case of primary lymphoma of the liver in a 72-year-old man is reported. The patient showed a three to four month history of abdominal ache, low grade fever, and weight loss. The presence of a large mass occupying the V and VT hepatic segments was demonstrated; no other organs were involved and no evidence of lymphoadenopathy was found. Laboratory tests showed a remarkable increase in ESR, LDH and alkaline phosphatase while CEA and alpha-1 fetoprotein were within the normal values. Two ultrasound-guided needle biopsies on the hepatic lesion did not produce any significant tissue for diagnosis. Therefore the V and VI hepatic segments were excised; a hard, greyish mass with the largest diameter of 6.5 cm, was found at laparatomy. Histology of the surgical specimen showed the presence of a malignant non-Hodgking's B-cell lymphoma, centroblastic-centrocytic, diffuse type (working formulation: G) of intermediate grade of malignancy. Staging was completed with lymphography, and bone marrow biopsy; both proved normal. After the operation adjuvant chemotherapy was commenced (COP for six cycles). Follow-up has so far shown no signs of recurrence after 24 months. In conclusion, the diagnosis of primary lymphoma of the liver is very difficult and is often reached only after histologic evaluation of the surgical specimen. Moreover, this disease has a much more favourable prognosis than the hepatocellular carcinoma and other primary or secondary liver cancers; therefore accurate investigations are important to reach the correct diagnosis.
ABSTRACT
The authors report a case of gastric carcinoid in a 69-years-old white, male. The lesion was discovered incidentally during an endoscopic examination of the stomach and an excisional biopsy was done. Because of the closeness of the cardiac to the lesion that was > 1 cm of diameter and because there was a suspicion of other microscopical lesions, the surgeon planned and carried out a total gastrectomy. The lesion was totally excised by the biopsy and no other lesions or lymph node involvement were find. After 1 year the patient is doing wall. The authors discuss carcinoids in general and gastric carcinoids in particular. They emphasize the role of the endoscopy in the early diagnosis of gastric carcinoid.