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No disponible
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Humanos , Masculino , Adulto , Neoplasias de Tecido Muscular/cirurgia , Neoplasias Brônquicas/cirurgia , Hemorragia/cirurgia , Neoplasias de Tecido Muscular/patologia , Neoplasias Brônquicas/patologia , Doenças Raras , Tomografia Computadorizada por Raios X , BroncoscopiaAssuntos
Adenocarcinoma/secundário , Leucemia Linfocítica Crônica de Células B/patologia , Metástase Linfática , Neoplasias do Mediastino/patologia , Segunda Neoplasia Primária/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Humanos , Hospedeiro Imunocomprometido , Leucemia Linfocítica Crônica de Células B/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
This study was conducted with the aim of evaluating a 10-year experience in the Pulmonology Department of a cancer center for percutaneous endoscopic gastrostomy through transnasal route (TN-PEG) in patients with head and neck cancer whose oral access is precluded. This study was a retrospective analysis of 40 consecutive head and neck cancer patients referred for PEG placement, between 2005 and 2014, using a transnasal route because of the impossibility of intubation through the oral cavity. Demographics, outcome of TN-PEG procedure, indications for bronchoscopic approach (prophylactic/palliative), clinical need for bronchoscopy (trismus, oropharyngeal obstruction), location of cancer, complications, and overall survival were reviewed. In 40 TN-PEG procedures, executed by 1 of 3 pulmonologists, 39 were successfully placed and there were no immediate complications. All except 1 complication were minor, but no surgery or PEG removal was required. There was a rapid learning curve among all operators. A combined TN-PEG placement by a gastroenterologist and a pulmonologist is a safe and useful option for these patients; the learning curve for successfully performing the procedure was short.
Assuntos
Broncoscópios , Gastroscopia/instrumentação , Gastrostomia/métodos , Neoplasias de Cabeça e Pescoço/complicações , Adolescente , Adulto , Idoso , Criança , Feminino , Gastroenterologia , Gastroscopia/métodos , Gastrostomia/efeitos adversos , Humanos , Curva de Aprendizado , Masculino , Desnutrição/prevenção & controle , Pessoa de Meia-Idade , Nariz , Apoio Nutricional , Cuidados Paliativos , Equipe de Assistência ao Paciente , Pneumologia , Estudos Retrospectivos , Trismo/etiologia , Adulto JovemRESUMO
No disponible
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Humanos , Masculino , Idoso , Neurilemoma/diagnóstico , Neoplasias Brônquicas/diagnóstico , Obstrução das Vias Respiratórias/etiologiaRESUMO
Metastatic prostate cancer recurrence after definitive local therapy can occur in any tissue. Usually, the first affected site is the bone. Lung metastases without bone or lymph node involvement are extremely rare in patients with prostate cancer, and only a handful of cases are reported in the literature. In several other malignancies, such as breast cancer, sarcomas, colorectal cancer, and renal cell carcinoma, long-term disease-free survival has been reported after resection of solitary pulmonary metastases. We present three unusual cases of isolated pulmonary recurrence of prostate cancer after initial definitive local therapy. One of the patients underwent resection of the lung metastasis, resulting in a long-term disease-free survival. Both surgical excision of solitary and oligometastatic lung secondary lesions and systemic therapy can play an important role in long-term disease control. Surgery should be considered for selected and well-informed patients with pulmonary metastasis after primary localised treatment for prostate cancer.
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INTRODUCTION: Recurrent respiratory papillomatosis (RPP) is a rare benign neoplasm caused by human papillomavirus (HPV). RPP is characterized by recurrent proliferation of the papillomata in the respiratory tract. OBJECTIVES AND METHODS: Retrospective analysis of all adult patients with diagnosis of recurrent respiratory papillomatosis admitted to our endoscopic unit between 2000 and 2013 with histological proved papillomatosis. RESULTS: Four patients were included (3 women) with an average age of 53±19 years (27-72). Before endoscopy unit admission, all the patients have been previously submitted to surgical removal of the papillomas with a median number of surgeries per patient of 6.5. These patients were submitted to therapeutic endoscopy and the most frequent endoscopic treatments were Laser YAG and local injection of cidofovir. All the patients treated with cidofovir presented complete remission of the disease. The median follow-up was 6 years: 2 presented malignant transformation to epidermoid carcinoma and 1 had severe dysplasia on the histological examination. We describe the four cases due to different forms of presentation. CONCLUSION: Papillomatosis of the airway is a rare condition predisposing to malignant transformation. RRP tends to recur and repeated surgeries are needed to remove papillomatas. Endoscopic treatment is important for the removal of the papillomas that are not accessible via laryngoscopy (YAG Laser, cryotherapy, etc.) and for resistant moderate/severe cases of RPP because it allows intralesional administration of adjuvant therapy like cidofovir.
Assuntos
Broncoscopia , Infecções por Papillomavirus/cirurgia , Infecções Respiratórias/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções Respiratórias/diagnóstico , Estudos RetrospectivosRESUMO
Endobronchial balloon tamponade has been used to control life-threatening hemoptysis. With the classical balloon tamponade technique, the bleeding airway is occluded by inflating a balloon catheter, which is passed through the bronchoscope. We describe a modified technique of endobronchial balloon tamponade with the introduction of the balloon catheter parallel to the bronchoscope, which allows keeping the balloon for a longer period and improves suction capacity. We report 3 patients with persistent hemoptysis who were successfully managed by this modified endobronchial balloon tamponade technique. In the 3 cases, a snare inserted through a bronchoscope is used to grasp a balloon catheter, outside the bronchoscope. After the correct position of the balloon proximal to the bleeding, the snare is removed and the balloon inflated. The bronchoscope is then withdrawn and the balloon is left in the airway. The balloon was kept inflated 72 hours in the bleeding airway in the first 2 cases with complete resolution of the hemoptysis. In the last case, the balloon was kept inflated 9 hours, until surgery. There are several advantages of this technique. As the balloon catheter is inserted outside the bronchoscope, it provides a better view because of the best suction ability, allowing adequate positioning of the balloon during the procedure. Moreover, the inflated balloon catheter can be left in place for long periods allowing a definitive control of the bleeding in some cases or a stabilization of the patient until more invasive and definitive solutions as bronchial artery embolization or surgery can be performed.
Assuntos
Oclusão com Balão/métodos , Hemoptise/terapia , Idoso , Broncoscópios , Broncoscopia/métodos , Dilatação , Feminino , Hemorragia/prevenção & controle , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We present four patients with non-small cell lung cancer treated in second and third line with Erlotinib. These are selected patients that obtained a good clinical response. Almost all presented cutaneous side effects. Rev Port Pneumol 2008; XIV (Supl 3): S65-S69.