RESUMO
Primary lung cancer may arise from the central (bronchial) or peripheral (bronchiolo-alveolar) compartments. However the origins of the different histological types of primary lung cancer are not well understood. Stem cells are believed to be crucial players in tumour development and there is much interest in identifying those compartments that harbour stem cells involved in lung cancer. Although the role of stem cells in carcinogenesis is not well characterised, emerging evidence is providing new insights into this process. Numerous studies have indicated that lung cancer is not a result of a sudden transforming event but a multistep process in which a sequence of molecular changes result in genetic and morphological aberrations. The exact sequence of molecular events involved in lung carcinogenesis is not yet well understood, therefore deeper knowledge of the aberrant stem cell fate signalling pathway could be crucial in the development of new drugs against the advanced setting (AU)
Assuntos
Humanos , Animais , Masculino , Feminino , Carcinoma de Pequenas Células do Pulmão/etiologia , Carcinoma de Pequenas Células do Pulmão/genética , Proteínas Hedgehog/metabolismo , Proteínas Hedgehog/fisiologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/genética , Receptores Notch/fisiologia , Células-Tronco/fisiologia , Proteínas Wnt/fisiologia , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/patologia , Proteínas Hedgehog/genética , Receptores Notch/genética , Receptores Notch/metabolismo , Transdução de Sinais , Proteínas Wnt/genética , Proteínas Wnt/metabolismoRESUMO
The association of mediastinal germ-cell tumours (MGCTs) with haematologic neoplasms is a rare though well known circumstance, and few cases are found in the literature. Most of these refer to non-seminomatous tumours in young males. The diagnosis of the haematological condition is usually either synchronic or metachronic with that of the germ-cell tumour. From those cases that have been published, we know that the prognosis is poor and basically determined by the haematologic neoplasia. The case report we present is that of a young male with an initial diagnosis of both conditions. It was possible to apply specific treatment, initially in the case of the leukaemia, and later in the case of the germ-cell tumour. The approach adopted is a multidisciplinary one.
Assuntos
Leucemia Megacarioblástica Aguda , Neoplasias do Mediastino , Neoplasias Embrionárias de Células Germinativas , Neoplasias Primárias Múltiplas , Adulto , Humanos , Leucemia Megacarioblástica Aguda/diagnóstico , Leucemia Megacarioblástica Aguda/terapia , Masculino , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/terapia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapiaRESUMO
The association of mediastinal germ-cell tumours (MGCTs) with haematologic neoplasms is a rare though well known circumstance, and few cases are found in the literature. Most of these refer to non-seminomatous tumours in young males. The diagnosis of the haematological condition is usually either synchronic or metachronic with that of the germ-cell tumour. From those cases that have been published, we know that the prognosis is poor and basically determined by the haematologic neoplasia. The case report we present is that of a young male with an initial diagnosis of both conditions. It was possible to apply specific treatment, initially in the case of the leukaemia, and later in the case of the germ-cell tumour. The approach adopted is a multidisciplinary one (AU)
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Assuntos
Humanos , Masculino , Adulto , Leucemia Megacarioblástica Aguda/diagnóstico , Leucemia Megacarioblástica Aguda/terapia , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/terapia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapia , Mediastino/patologia , PrognósticoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Humanos , Infusões Intra-Arteriais , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Invasividade NeoplásicaRESUMO
Thirty previously untreated patients with advanced germ cell testicular tumours received PVB or BEP. Four patients with bulky disease underwent debulking surgery before initiating chemotherapy and two between cycles of treatment. Twenty-seven (90%) complete responses, two (6.7%) partial responses and one (3.3%) no changes were observed. Both partial remissions were rendered disease-free with surgical removal of residual disease. Four patients presented tumour progression with PVB or BEP, three of whom developed a non-germ cell malignancy within the germ cell tumour. One toxic death and three patients with radiological evidence of reversible interstitial pneumonitis attributed to bleomycin were observed. With a median follow-up time of 38.5 months, range 2.5 to 130 months, 83.3% of the patients are alive and free of disease. Actuarial overall survival is 85.6%. This study confirms once again the high percentage of curability of this disease.
