ABSTRACT
PURPOSE OF REVIEW: Extramammary Paget disease (EMPD) is a rare entity which is more frequently localized at the vulva, though it only accounts for 1-2% of vulvar neoplasms. It is a primary cutaneous adenocarcinoma whose cell of origin is still a matter of controversy: it can either arise from apocrine/eccrine glands or from stem cells. The diagnosis demands a biopsy and entails a histopathological analysis by which cells show similar characteristics as breast Paget disease. RECENT FINDINGS: Treatment approach can entail surgery, radiotherapy, photodynamic therapy, systemic chemotherapy, and topical chemotherapy. For metastatic disease, many different chemotherapy regimens have been explored and even targeted therapy can play an important role in this disease. Since almost 30-40% of patients overexpress HER-2, trastuzumab and anti-HER-2 therapies can be employed in this setting. Due to its low incidence, there is almost no specific evidence on therapeutic interventions for this disease. Thus, there is a neat unmet need for molecular characterization of EMPD and diagnostic tools that allow clinicians to guide treatment both in the early and in the advanced disease settings. In this review, we aim to summarize available evidence about diagnosis and treatment of EMPD, both localized and metastatic, and to provide a comprehensive analysis that may help clinicians for therapeutic decisions.
ABSTRACT
OBJECTIVES: Videothoracoscopic visualization and/or palpation of pulmonary nodules may be difficult due to their location, small size or limited solid component. The purpose of this study is to present our experience with computed tomography (CT)-guided preoperative localization of pulmonary nodules by percutaneous marking with radio-labelled iodine-125 seeds. METHODS: A total of 34 pulmonary nodules were marked under CT with the placement of 33 radio-labelled iodine-125 seeds in 32 consecutive patients. RESULTS: All patients underwent biportal video-assisted thoracic surgery (VATS) and in no case was conversion to thoracotomy necessary. A total of 88.2% of the lung nodules were successfully resected. In the remaining 11.8%, migration of the seed to the pleural cavity occurred, although these nodules were still resected during VATS. Of all the patients with pneumothorax after the marking procedure, only one required chest tube placement (3.1%). No major postoperative complications were observed. CONCLUSIONS: Preoperative marking of pulmonary nodules with I-125 seeds under CT guidance is a feasible and safe technique that allows their intraoperative identification and resection.
Subject(s)
Lung Neoplasms , Multiple Pulmonary Nodules , Solitary Pulmonary Nodule , Humans , Iodine Radioisotopes , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/surgery , Preoperative Care , Retrospective Studies , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/surgery , Thoracic Surgery, Video-Assisted/methodsSubject(s)
Lung Neoplasms , Superior Vena Cava Syndrome , Thrombosis , Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Superior Vena Cava Syndrome/diagnostic imaging , Superior Vena Cava Syndrome/etiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Tietze's Syndrome/microbiology , Chest Pain/microbiology , Spondylitis/microbiology , Coronavirus Infections/complications , Candidiasis/microbiology , Risk Factors , Candidiasis/drug therapy , Adrenal Cortex Hormones/therapeutic use , Azithromycin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Coronavirus Infections/therapyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Lung Neoplasms/surgery , Adenocarcinoma of Lung/surgery , Iodine Radioisotopes/adverse effects , Lung Neoplasms/pathology , Adenocarcinoma of Lung/pathology , Thoracic Surgery, Video-Assisted/adverse effects , Tomography, X-Ray Computed , Pleural Cavity/drug effectsABSTRACT
PET/CT is an hybrid technique which allows both morfological and metabolical evalutaion. Three different morphometeabolical patterns are presented which reflect the evolutive phases of the COVID-19. This findings may help the clinician determine the correct treatment and security measure that need to be taken aaccording to the phase of the disease.
ABSTRACT
A 59-year-old man with a pacemaker who was admitted for evaluation of fever was found to have a redundant loop of the ventricular lead and a vegetation attached to it. An FDG PET/CT revealed a focus of FDG uptake at the ventricular lead loop. Surgical extraction of the pacemaker device confirmed a Propionibacterium acnes pacemaker endocarditis. We hypothesize that the redundant loop of the ventricular lead induced a chronic mechanical stress both to the tricuspid valve and to the lead itself, facilitating the bacterial colonization of the lead.
Subject(s)
Endocarditis, Bacterial/diagnostic imaging , Heart Ventricles/diagnostic imaging , Heart Ventricles/microbiology , Pacemaker, Artificial/microbiology , Positron Emission Tomography Computed Tomography , Propionibacterium acnes/physiology , Prosthesis-Related Infections/diagnostic imaging , Humans , Male , Middle AgedABSTRACT
No disponible
