RESUMO
A 77-year-old transgender man (assigned female sex at birth, gender identity male, i.e. female-to-male) was referred for a palpable mass of the right chest wall. Biopsies revealed invasive lobular breast carcinoma. After discussion by a multidisciplinary tumour board meeting, the patient was treated with total mastectomy, adjuvant hypofractionated radiation therapy, and hormone therapy. At 1.5-year follow-up, there was no sign of recurrence or long-term radiation side effects. To our knowledge, this is the first reported case of adjuvant hypofractionated radiation therapy in a transgender patient with breast cancer.
Assuntos
Neoplasias da Mama , Hipofracionamento da Dose de Radiação , Pessoas Transgênero , Humanos , Idoso , Masculino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Mastectomia , Carcinoma Lobular/radioterapia , Carcinoma Lobular/patologia , Radioterapia Adjuvante , Neoplasias da Mama Masculina/radioterapia , Neoplasias da Mama Masculina/patologia , Neoplasias da Mama Masculina/cirurgiaRESUMO
A 77-year-old woman was referred for a one-eyed palpebral edema associated with diplopia. An orbit magnetic resonance imaging showed an orbital mass in the superior medial portion of the internal right orbit without any intraorbital involvement. Biopsies demonstrated a nodular lymphoma with mixed follicular grade 1-2 (60%) and large cell components. The tumor mass was treated with a low-dose radiation therapy (4Gy in 2 fractions) with a complete disappearance of diplopia within one week. At 2-year follow-up, patient was in complete remission. To the best of our knowledge, this is the first case of mixed component follicular and large components orbital lymphoma managed by first-intent low-dose radiation therapy.
Assuntos
Linfoma Folicular , Neoplasias Orbitárias , Feminino , Humanos , Idoso , Linfoma Folicular/radioterapia , Diplopia/etiologia , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/radioterapia , Neoplasias Orbitárias/patologiaRESUMO
Rectal leiomyosarcoma is a very rare entity. Surgery is the main treatment, but the place of radiation therapy remains unclear. A 67-year-old woman was referred for a few-weeks' history of bleeding and anal pain intensified during defecation. Pelvic magnetic resonance imaging (MRI) showed a rectal lesion and biopsies revealed a leiomyosarcoma of the lower rectum. She was free of metastasis on computed tomography imaging. The patient refused radical surgery. After discussion by a multidisciplinary team, the patient received pre-operative long-course radiotherapy followed by surgery. The tumor was treated with 50Gy delivered in 25 fractions, within 5 weeks. The aim of radiotherapy was local control, allowing organ-preservation. Four weeks after radiation therapy, organ-preservation surgery could be performed. She had no adjuvant treatment. At 38-months follow-up, she had no local recurrence. However, distant recurrence (lung, liver, and bone) was detected 38 months after the resection and was managed by intra-venous doxorubicin 60mg/m2 and dacarbazine 800mg/m2 every 3 weeks. The patient was in a stable condition for nearly 8 months. The patient died 4 years and 3 months after the diagnosis.
Assuntos
Leiomiossarcoma , Neoplasias Retais , Feminino , Humanos , Idoso , Reto/cirurgia , Leiomiossarcoma/radioterapia , Leiomiossarcoma/cirurgia , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Pelve , BiópsiaRESUMO
We present the case of a 40-year-old patient with ß-Thalassemia major who underwent decompressive palliative radiotherapy on symptomatic intracanal extra medullary hematopoiesis on three occasions between 2016 and 2020. We delivered normo-fractionated radiotherapy at a dose of 10Gy in five fractions on vertebrae T4 to T10 and L3 to S2, 20Gy in ten fractions on vertebrae C7 to T11, and 12Gy in six fractions on vertebrae C7 to T9. The treatment was well tolerated with complete recovery of the symptomatology during the first two irradiations, and almost complete recovery after the 3rd irradiation.
Assuntos
Radioterapia (Especialidade) , Reirradiação , Humanos , Adulto , Medula Óssea , Hematopoese , Cuidados PaliativosRESUMO
An 80 year-old woman was referred for a one-eyed palpebral edema. She had ptosis and oblique diplopia resistant to corticotherapy. An orbit magnetic resonance imaging showed a mass infiltrating the optic nerve, with an enhancement of the whole orbital musculature. Biopsies of the lacrimal gland were positive for immunoglobulin light chain amyloidosis. Debulking surgery is the main treatment modality for symptomatic patients with localized orbital amyloidosis. Diffuse orbital involvement may make excision difficult. We managed to treat her through radiation therapy to allow a surgical procedure, delivering 20Gy in 10 fractions. The main aim of radiation therapy was to eradicate the B cells that produced the amyloid light chain deposition. After radiation therapy, the orbital inflammatory caused by the lymphoid infiltration diminished and corticotherapy could be stopped. The surgery could be performed with excellent clinical results. At 2-year follow-up, neither tumor regrowth nor late complications were detected.