Evaluation of the effectiveness of 4% formalin in the treatment of hemorrhagic actinic proctitis

Radiotherapy is an important discovery as to the treatment of pelvic tumors. Proctitis is frequently observed nowadays, and can be divided into acute and chronic. Treatment with 4% formalin solutions has been used with positive results in literature. Objective: To evaluate the effectiveness and morbidity rates related to the use of 4%formalin in hemorrhagic chronic actinic proctitis. Methods: We evaluated the sigmoidoscopy records and reports of 11 patients with chronic hemorrhagic actinic proctitis from February to December 2010, coming from the Serbian colorectal University Hospital of the State of Sergipe. Results: The study was comprised of 11 patients (36.36% were females and 63.63% were males). Mean age was 67.7 years. Mean time between the end of radiotherapy and the onset of symptoms was 6.6 months. The treatment was completely effective in 27.27% of the cases, and reduced rectal bleeding in 100% of patients. The following main complications were observed: chills (9%), tenesmus (18.18%) and mild stenosis (9%). Conclusions: The 4%formalin solution has fewer side effects, and its administration is very inexpensive. The treatment is effective and reduces bleeding in almost 100% of cases. (AU)

A radioterapia foi uma importante descoberta, no que tange o tratamento das neoplasias de pelve. A proctite é uma das complicações bastante observadas atualmente, podendo ser dividida em aguda e crônica. O tratamento com solução de formalina a 4% vem sendo utilizado com resultados positivos na literatura. Objetivo: Avaliar a eficácia e morbidade do uso da formalina a 4% na retite actínica crônica hemorrágica. Métodos: Foram avaliados os prontuários e laudos das retossigmoidoscopias de 11 pacientes portadores de retite actínica crônica hemorrágica entre o período de fevereiro a dezembro de 2010, oriundos do Serviço de Coloproctologia do Hospital Universitário do Estado de Sergipe. Resultados: O estudo foi composto de 11 pacientes (36,36% feminino e 63,63% masculino). A média das idades foi de 67,7 anos. O tempo médio entre o término da radioterapia e o início dos sintomas foi de 6,6 meses. O tratamento foi completamente efetivo em 27,27%, sendo reduzido sangramento retal em 100% dos pacientes. Como principais complicações foram observadas: calafrio (9%), tenesmo (18,18%) e estenose leve (9%). Conclusão: A solução de formalina a 4% apresenta poucos efeitos colaterais, sendo muito barata a sua administração. O tratamento é efetivo, reduzindo, em praticamente 100% dos casos, o sangramento. (AU)

Obstrução urinária aguda por rabdomiossarcoma pélvico / Acute urinary obstruction due to pelvic rhabdomyosarcoma

Os autores relatam um caso raro de obstrução urinária aguda por rabdomiossarcoma pélvico envolvendo a próstata em uma criança de quatro anos e seis meses de idade. São comentados as características desses tumores, as formas de apresentação clínica, os aspectos diagnósticos por imagem — ultra-som, cistografia e tomografia computadorizada —, o tratamento com poliquimioterapia e o prognóstico.

The authors report a rare case of acute urinary obstruction caused by pelvic rhabdomyosarcoma in a 4-year-old children. The diagnosis aspects for imaging e some therapeutic considerations are related.

[Sarcomas of the vulva. Report of 2 cases]. / Sarcomas de la vulva. Informe de dos casos.

We report two cases of vulvar sarcomas that are our Institutional experience in 29 years. The first case was a teenager of 14 years-old with a low grade leiomyosarcoma surgically treated. Along a 22 years follow-up the disease has had four local recurrences of more than 5 cm each one: two after surgery and two after surgery plus chemotherapy and surgery plus radiotherapy respectively. She is alive disease evidence after two years from the last combined treatment. The second one, was a 26 years-old patient with a malignant schwannoma of 12 cm in diameter treated with combined radical surgery, radiotherapy, and chemotherapy. She is alive and without disease evidence 52 months after surgery. We emphasized that these tumors are very rare and the fact that the first patient is the youngest and with more years of follow up according the bibliography consulted. Treatment of vulvar sarcomas is radical local excision followed mainly by radiotherapy with infiltrating margins. The value of postoperative adjuvant chemotherapy is uncertain. According to the natural history and behavior of vulvar sarcomas, we conclude that the elective treatment of these tumors should be carry out in institutions of high level.

Multimodal therapy for children and adolescents with Ewing sarcoma: results of the First National Chilean Trial (1986-1991).

Thirty-seven patients with Ewing sarcoma were treated in the First National Chilean Trial for Ewing's Sarcoma (1986-1991), which comprised the St. Jude Ewing's 78 Study. All patients received cyclophosphamide, doxorubicin, vincristine, and Dactinomycin for a total treatment period of about 10 months, and all prescribed therapy was administered. Local therapy consisted of irradiation (RT) to the primary tumor, complete surgical resection, or a combination of both surgery and RT. Twenty-nine of these patients had localized tumors, 24% had pelvic primary tumors, 21 were males, and 20 were greater than 10 years of age at diagnosis. Twenty-one patients had tumors that were greater than 8 cm in largest diameter. Fourteen of the 29 patients with localized disease remain disease free at 23 to 91 months from diagnosis. Fourteen patients have died of-tumor-related complications and 1 of a secondary malignancy. Relapse was local only in 4, metastatic in 9, and local plus metastatic in 1. Only 1 of the 8 patients with metastatic disease at presentation remains disease free. Toxicity consisted primarily of myelosuppression and mucositis. We conclude that this form of relative intense multimodal therapy for children/adolescents with localized Ewing sarcoma is curative in about half of affected children as in the original St. Jude study, and that it can be safely given in a developing country, provided that careful attention to supportive care and treatment planning is given. Although these results represent improvement in outcome for our patients, more effective therapy is needed for children with Ewing sarcoma, especially those with metastatic disease at presentation.

Osteossarcoma multicentrico: relato de um caso com lesoes sincronicas / Multicentric osteosarcoma: report of a case with synchronous lesions

E feito o registro de caso de crianca portadora de osteossarcoma multicentrico, submetida a quimioterapia, com resposta terapeutica de curta duracao e rapida progressao subsequente. Sao discutidos os aspectos peculiares desta forma de osteossarcoma e as hipoteses possiveis para sua ocorrencia

Comparative efficacy of gestrinone and danazol in infertile women with endometriosis.

The relationship between endometriosis and infertility is observed frequently. Patients with both conditions require a conservative approach to their management. Since hormonal therapy is one of those approaches, we sought to compare the efficacy of Danazol and Gestrinone in 80 infertile patients (48 and 32, respectively). Therapy lasted 6 months in both treatment groups, and all patients studied had laboratory tests performed and were clinically evaluated and classified through laparoscopy before and after therapy. The improvement of symptoms and favorable follow-up were similar with both treatments. The reestablishment of menstrual patterns and fertility were also nearly alike in both groups. However, Gestrinone was associated with fewer secondary effects and is easier to administer than Danazol. We conclude that Gestrinone is a useful medication in the management of the infertile patient with endometriosis.

A therapeutic approach to childhood pelvic rhabdomyosarcoma without pelvic exenteration.

A therapeutic approach using chemotherapy rather than radical surgery as the initial modality of treatment was employed in 13 children with pelvic rhabdomyosarcoma. One patient failed to respond to chemotherapy and required anterior pelvic exenteration. Eight patients are alive and free of disease 24 to 96 months after diagnosis. Limited surgery for minimal residual disease was used in two patients. Radiation therapy at lower than conventional doses was used in seven of eight patients. This experience supports a therapeutic approach to childhood pelvic rhabdomyosarcoma with an initial chemotherapy regimen, resulting in the use of surgical procedures less detrimental to pelvic organs without compromising survival.