Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.315
Filtrar
1.
Neurology ; 94(5): e521-e528, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-31907288

RESUMO

OBJECTIVE: The primary objective was to determine the sensitivity and specificity of epithelial cell adhesion molecule (EpCAM) immunoflow cytometry circulating tumor cells (CTC) analysis in CSF in patients with suspected leptomeningeal metastases (LM). The secondary objective was to explore the distribution of driver mutations in the primary tumor, plasma, cell free CSF (cfCSF), and isolated CTC from CSF in non-small cell lung cancer (NSCLC). METHODS: We tested the performance of the CTC assay vs CSF cytology in a prospective study in 81 patients with a clinical suspicion of LM but a nonconfirmatory MRI. In an NSCLC subcohort, we analyzed circulating tumor (ct)DNA of the selected driver mutations by digital droplet PCR (ddPCR). RESULTS: The sensitivity of the CTC assay was 94% (95% confidence interval [CI] 80-99) and the specificity was 100% (95% CI 91-100) at the optimal cutoff of 0.9 CTC/mL. The sensitivity of cytology was 76% (95% CI 58-89). Twelve of the 23 patients with NSCLC had mutated epidermal growth factor receptor (EGFR). All 5 tested patients with LM demonstrated the primary EGFR driver mutation in cfCSF. The driver mutation could also be detected in CTC isolated from CSF. CONCLUSION: CTC in CSF are detected with a high sensitivity for the diagnosis of LM. ddPCR can determine EGFR mutations in both cfCSF and isolated CTC from CSF of patients with EGFR-mutated NSCLC and LM. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that EpCAM-based immunoflow cytometry analysis of CSF accurately identifies patients with LM.


Assuntos
Carcinoma/líquido cefalorraquidiano , Carcinomatose Meníngea/líquido cefalorraquidiano , Células Neoplásicas Circulantes , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Carcinoma/diagnóstico , Carcinoma/secundário , Carcinoma Ductal de Mama/líquido cefalorraquidiano , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/secundário , Carcinoma Lobular/líquido cefalorraquidiano , Carcinoma Lobular/diagnóstico , Carcinoma Lobular/secundário , Carcinoma Pulmonar de Células não Pequenas/líquido cefalorraquidiano , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/secundário , Carcinoma de Células de Transição/líquido cefalorraquidiano , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/secundário , Molécula de Adesão da Célula Epitelial , Receptores ErbB/genética , Feminino , Citometria de Fluxo , Neoplasias Gastrointestinais/patologia , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Imagem por Ressonância Magnética , Masculino , Carcinomatose Meníngea/diagnóstico , Carcinomatose Meníngea/genética , Carcinomatose Meníngea/secundário , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Sensibilidade e Especificidade , Carcinoma de Pequenas Células do Pulmão/líquido cefalorraquidiano , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Carcinoma de Pequenas Células do Pulmão/secundário
2.
World Neurosurg ; 133: e252-e258, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31505283

RESUMO

BACKGROUND: Selection of appropriate treatment for patients with recurrent brain metastasis (BM) remains uncertain. Recent studies have demonstrated a significant response rate and acceptable toxicity using fractionated stereotactic radiosurgery (FSRS) in patients with locally recurrent large BM. The aim of this study was to evaluate efficacy and toxicity of FSRS with bevacizumab as a new salvage treatment for locally recurrent BM with previous high-dose irradiation. METHODS: Patients with recurrent BM previously irradiated were enrolled. Salvage FSRS dose was 9.5-29 Gy (2-5 fractions) with 62%-75% isodose line by CyberKnife according to the brain tumor volume, site, and previous dose. Bevacizumab was prescribed for 4 cycles (5 mg/kg, every 3 weeks). The primary objective was to identify the overall survival after salvage treatment. Secondary objectives included clinical response (Karnofsky performance scale), imaging response (magnetic resonance imaging) and treatment-related adverse events. RESULTS: From December 2009 to October 2016, 24 patients were enrolled. The 1-year overall survival after salvage stereotactic radiosurgery was 87.5%. Twenty-three (96%) patients had a positive imaging response with a T2 volume reduction range of 6-22 cm3 (median 14 cm3, P = 0.032, paired t test). Significant clinical improvement was achieved (best Karnofsky performance scale score, P < 0.05, paired t test). Grade 1/2 fatigue was observed in 8 (33%) patients. Grade 3 fatigue and headache occurred in 1 patient. CONCLUSIONS: FSRS with adjuvant bevacizumab treatment showed favorable clinical and radiologic control as a salvage treatment regimen. The diagnoses of radiation necrosis and local recurrence after salvage FSRS warrant further study.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Antineoplásicos/uso terapêutico , Bevacizumab/uso terapêutico , Neoplasias Encefálicas/secundário , Carcinoma/secundário , Recidiva Local de Neoplasia/cirurgia , Radiocirurgia/métodos , Terapia de Salvação/métodos , Adulto , Idoso , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Carcinoma/tratamento farmacológico , Carcinoma/radioterapia , Carcinoma/cirurgia , Terapia Combinada , Irradiação Craniana , Fracionamento da Dose de Radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Estudos Prospectivos
3.
Int Braz J Urol ; 45(6): 1270-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808417

RESUMO

Bladder cancer is a common cancer that may present as superficial, invasive, or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for significant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limi-ted case reports about early metastasis in the literature.


Assuntos
Carcinoma/secundário , Neoplasias de Cabeça e Pescoço/patologia , Metástase Linfática/patologia , Neoplasias da Bexiga Urinária/patologia , Idoso , Carcinoma/diagnóstico por imagem , Evolução Fatal , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X , Ultrassonografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem
4.
Bone Joint J ; 101-B(12): 1557-1562, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31786990

RESUMO

AIMS: The aim of this study was to present the long-term surgical outcomes, complications, implant survival, and causes of implant failure in patients treated with the modified Harrington procedure using antegrade large diameter pins. PATIENTS AND METHODS: A cohort of 50 consecutive patients who underwent the modified Harrington procedure for periacetabular metastasis or haematological malignancy between January 1996 and April 2018 were studied. The median follow-up time for all survivors was 3.2 years (interquartile range 0.9 to 7.6 years). RESULTS: The five-year overall survival rate was 33% for all the patients. However, implant survival rates were 100% and 46% at five and ten years, respectively. Eight patients survived beyond five years. There was no immediate perioperative mortality or complications. A total of 15 late complications occurred in 11 patients (22%). Five patients (10%) required further surgery to treat complications. The most frequent complication was pin breakage without evidence of acetabular loosening (6%). Two patients (4%) underwent revision for aseptic loosening at 6.5 and 8.9 years after surgery. Ambulatory status and pain level were improved in 83% and 89%, respectively. CONCLUSION: The modified Harrington procedure for acetabular destruction has low complication rates, good functional outcome, and improved pain relief in selected patients Cite this article: Bone Joint J 2019;101-B:1557-1562.


Assuntos
Acetábulo/cirurgia , Artroplastia de Quadril/métodos , Pinos Ortopédicos , Neoplasias Ósseas/cirurgia , Neoplasias Hematológicas/cirurgia , Falha de Prótese , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/instrumentação , Artroplastia de Quadril/mortalidade , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/secundário , Carcinoma/mortalidade , Carcinoma/secundário , Carcinoma/cirurgia , Feminino , Seguimentos , Neoplasias Hematológicas/mortalidade , Humanos , Linfoma/mortalidade , Linfoma/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida
6.
Medicine (Baltimore) ; 98(41): e17446, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593099

RESUMO

RATIONALE: The infiltration of tumor cells to pulmonary lymphatic system, as known as pulmonary lymphangitis carcinomatosis (PLC), is a rare presentation of pulmonary metastases. PATIENT CONCERNS: We reported a case of a 66-year-old man after surgery, chemotherapy, and radiation therapy for colon cancer. Two months after these therapies, the patient complained of nonproductive cough for 1 week. DIAGNOSES: 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scanning revealed increased FDG uptake along the thickened bronchovascular bundles, in bilaterally scattered ground-glass opacities and in mediastinal lymphadenopathy. The transbronchial biopsy and pathological study confirmed the diagnosis of PLC. INTERVENTIONS: Antineoplastic treatment (cetuximab) were administered after the patient was diagnosed with PLC. OUTCOMES: The patient died of respiratory failure within 3 months after the onset of his symptom. LESSONS: 18F-FDG PET/CT play an important role in identifying PLC, in selecting possible biopsy sites, and in accessing the extent of metastatic disease.


Assuntos
Carcinoma/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Linfangite/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Carcinoma/secundário , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Fluordesoxiglucose F18 , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Linfangite/etiologia , Masculino , Compostos Radiofarmacêuticos
7.
Nat Commun ; 10(1): 4695, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619685

RESUMO

Circular RNAs (circRNAs) have been implicated in cancer progression through largely unknown mechanisms. Herein, we identify an N6-methyladenosine (m6A) modified circRNA, circNSUN2, frequently upregulated in tumor tissues and serum samples from colorectal carcinoma (CRC) patients with liver metastasis (LM) and predicts poorer patient survival. The upregulated expression of circNSUN2 promotes LM in PDX metastasis models in vivo and accelerates cancer cells invasion in vitro. Importantly, N6-methyladenosine modification of circNSUN2 increases export to the cytoplasm. By forming a circNSUN2/IGF2BP2/HMGA2 RNA-protein ternary complex in the cytoplasm, circNSUN2 enhances the stability of HMGA2 mRNA to promote CRC metastasis progression. Clinically, the upregulated expressions of circNSUN2 and HMGA2 are more prevalent in LM tissues than in primary CRC tissues. These findings elucidate that N6-methyladenosine modification of circNSUN2 modulates cytoplasmic export and stabilizes HMGA2 to promote CRC LM, and suggest that circNSUN2 could represent a critical prognostic marker and/or therapeutic target for the disease.


Assuntos
Adenosina/análogos & derivados , Carcinoma/secundário , Neoplasias Colorretais/patologia , Proteína HMGA2/genética , Neoplasias Hepáticas/secundário , Metiltransferases/genética , /genética , Adenosina/metabolismo , Animais , Carcinoma/genética , Linhagem Celular Tumoral , Neoplasias Colorretais/genética , Células HCT116 , Células HEK293 , Humanos , Neoplasias Hepáticas/genética , Camundongos , Metástase Neoplásica , Transplante de Neoplasias , Processamento Pós-Transcricional do RNA , RNA Mensageiro/metabolismo , Proteínas de Ligação a RNA/metabolismo
8.
BMJ Case Rep ; 12(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31492727

RESUMO

Intracardiac microcavitations consist of airy microbubbles. They are typically found in patients with an intravascular line or device, mechanical heart valves or in decompression sickness. We report a case of a patient in mid-70s who was admitted due to weakness in both legs, left-thoracic pain and fever. Despite the lack of any of the risk factors mentioned above, spontaneous microcavitations were detected in the right sided cardiac cavities. After the detection of liver lesions suspicious for a metastatic disease, a colonoscopy was performed. An ulcerated colonic carcinoma at the ileocoecal valve was diagnosed and highly suspicious for being the entry port of the microcavitations. This unusual presentation of microcavitations together with a colonic neoplasia leads to hypotheses about the journey of the microbubbles from the ascending colon into the right heart. Gastrointestinal tumours are described as being the causes of microbubbles. Translocation of microbubbles through hepatopulmonary shunting are described in the context of locally applied particles of similar size during radioembolisation. A thorough aetiological workup is of importance since the underlying cause is potentially dangerous due to its own nature of disease and due the complications of the microcavitations such as paradoxical emboli or pulmonary sequelae.


Assuntos
Ar , Carcinoma/diagnóstico , Neoplasias do Colo/diagnóstico , Coração/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Idoso , Carcinoma/secundário , Neoplasias do Colo/patologia , Colonoscopia , Ecocardiografia , Humanos , Neoplasias Hepáticas/secundário , Masculino , Tomografia Computadorizada por Raios X
9.
BMJ Case Rep ; 12(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31492732

RESUMO

Parathyroid carcinoma is the rarest endocrine malignancy. Definitive diagnosis is challenging as it is difficult to distinguish malignant from benign disease. A 71-year-old man presented with weight loss and hypercalcaemia. CT scans revealed multiple lung nodules and lytic bone lesions that were consistent with metastatic dissemination. Technetium-99m-sestamibi-single-photon emission computed tomography scan showed an abnormal uptake in the right thyroid lobe. Fine-needle aspiration (FNA) was performed on three occasions. The patient underwent parathyroidectomy with ipsilateral hemithyroidectomy without postoperative complications. Microscopic examination showed a parathyroid neoplasm with fibrosis and intravascular tumour on a background of unremarkable thyroid parenchyma. This resulted in an initial impression of parathyroid carcinoma. Further review by two independent pathologists provided a final diagnosis of oncocytic parathyroid adenoma. This case highlights the subjectivity and interobserver variation with endocrine histological examination. FNA can induce changes that mimic parathyroid carcinoma on histology. An index of suspicion for benign parathyroid adenomas should be maintained.


Assuntos
Adenoma Oxífilo/diagnóstico , Hiperparatireoidismo Primário/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Neoplasias das Paratireoides/diagnóstico , Adenoma Oxífilo/patologia , Adenoma Oxífilo/cirurgia , Idoso , Biópsia por Agulha Fina , Carcinoma/secundário , Diagnóstico Diferencial , Humanos , Hiperparatireoidismo Primário/cirurgia , Neoplasias Pulmonares/patologia , Masculino , Esvaziamento Cervical , Metástase Neoplásica , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/secundário , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Tireoidectomia , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Ultrassonografia
10.
Medicine (Baltimore) ; 98(36): e17029, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490390

RESUMO

There is an increased enthusiasm in treating osteolytic metastatic acetabulum via injecting polymethyl-methacrylate (PMMA) as a bone filler to provide pain relief and potential structural support. The aim of this respective study is to determine the function and quality of life improvement after cement acetabuloplasty.Thirty two patients underwent acetabular cement augmentation between May 2014 and March 2018 were respectively reviewed. Isolated percutaneous acetabuloplasty (PA) was performed in 15 patients (group A) while radiofrequency ablation with PA (RFA-PA) in 12 patients (group B). Together with PA, open reconstructive surgery on ipsilateral femur was performed in another 5 cases (group C). Pre- and posttreatment functional evaluation and quality of life (QoL) assessment were carried out.The average followup duration was 11.5 (range, 3-36) months. None of major complications occurred. 81.2% (26/32) of patients achieved complete pain relief. Reduction of pain intensity and improvement of functional status achieved significantly differences after treatment (P = .00). Significant improvement (P = .00) was observed in scales of global QoL and pain-related restrictions in daily activities. Both isolated PA and RFA-PA procedures were equally effective towards the improvement of function and quality of life (P > .05). Regarding 5 patients in group C, pain intensity decreased when loading the affected limb and they could walk with crutches or cane.Bone cement acetabuloplasty is an adequate and effective mini-invasive procedure to relieve pain, restore function, and enhance the quality of life of patients for as long as possible in metastatic patients with short life expectancy. Ipsilateral surgery appears to be safe and well tolerated.


Assuntos
Acetabuloplastia/métodos , Acetábulo/cirurgia , Neoplasias Ósseas/cirurgia , Carcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cimentos para Ossos , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Carcinoma/radioterapia , Carcinoma/secundário , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Ablação por Radiofrequência , Recuperação de Função Fisiológica , Estudos Retrospectivos
11.
Zhonghua Fu Chan Ke Za Zhi ; 54(7): 452-457, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31365957

RESUMO

Objective: To analyze the clinicopathological features and prognosis of patients in endometrial cancer with bone metastases. Methods: A retrospective review of medical records was performed to analyze patients with endometrial cancer who developed bone metastases at Peking Union Medical College Hospital (PUMCH) from January 2004 to December 2017, including patients with bone metastases at the diagnosis of endometrial cancer and at recurrence of endometrial cancer. The patient's clinicopathological features, bone metastasis characteristics, treatment process and prognoses were also analyzed. Results: The incidence of bone metastasis of endometrial cancer in PUMCH from 2004 to 2017 was 0.57% (14/2 458). (1) General clinical pathological features: the median age of the 7 patients with bone metastases diagnosed at the time of initial diagnosis was 50 years old, and the main pathological type was endometrioid carcinoma (n=5). The median age of the other 7 patients was 57 years old, with no significant difference comparing to the former groups (P=0.559). (2) The majority site of bone metastasis in endometrial cancer were discovered in pelvic bones, followed by the tibia. (3) Treatment: according to the staging of endometrial cancer, a comprehensive treatment based on surgery was performed, and one patient with isolated bone metastases underwent resection of bone metastasis. (4) Prognosis: nine out of the 14 patients died during the follow-up period. The median over all survival time was 25.5 months (range: 7.7-258.0 months). The median survival of population after diagnosis of bone metastases was 15.0 months (range: 3.0-51.0 months). The survival rate of endometrial cancer at 1-year after diagnosis of bone metastasis was 71.4%. The 2-year survival rate was 40.8%. (5) No independent prognostic factors affecting survival was found (P>0.05). Conclusions: The incidence of bone metastasis in endometrial cancer is less than 1%. Bone metastasis could occur at the diagnosis of endometrial cancer or recurrence of endometrial cancer. Bone metastasis suggests a poor prognosis. There is no standard follow-up and treatment protocols so that individualized treatment is needed.


Assuntos
Neoplasias Ósseas/secundário , Carcinoma/secundário , Neoplasias do Endométrio/patologia , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/terapia , Carcinoma/mortalidade , Carcinoma/terapia , Neoplasias do Endométrio/mortalidade , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
12.
DNA Cell Biol ; 38(10): 1143-1146, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31464522

RESUMO

Cervical carcinoma is associated with high-risk human papillomavirus (HPV) DNA integration and usually occurs after age 21 (peak 45 years), as reflected in screening guidelines. Between 1999 and 2008, cervical carcinoma rate in adolescents aged 15-19 years was 0.15 per 100,000. HPV-negative cervical carcinoma is rare in adolescents. The youngest previously reported case was 15 years old. Treatment options for cervical carcinoma are limited after first-line therapy. Immune checkpoint inhibitors blocking programmed death receptor (PD-1) and its ligand, PD-L1, have shown objective clinical responses and are tolerable in adults with gynecologic cancers. This class of agents is well tolerated in pediatric patients. PD-1/PD-L1 is commonly expressed in gynecologic cancers but its expression may not predict clinical response. We describe an exceptional response to single agent nivolumab postradiation therapy in a 13-year-old adolescent with poorly differentiated cervical carcinoma and widespread metastatic disease.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Carcinoma/terapia , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/terapia , Nivolumabe/uso terapêutico , Neoplasias do Colo do Útero/terapia , Adolescente , Carboplatina/uso terapêutico , Carcinoma/secundário , Carcinoma/cirurgia , Feminino , Raios gama/uso terapêutico , Humanos , Histerectomia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo , Ovariectomia , Paclitaxel/uso terapêutico , Papillomaviridae , Salpingectomia , Resultado do Tratamento , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
13.
Folia Med (Plovdiv) ; 61(2): 277-288, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31301659

RESUMO

AIM: Secondary malignancies of the thyroid gland are rarely diagnosed but their incidence at autopsy is not uncommon. MATERIALS AND METHODS: To investigate the clinicopathological features of patients with metastatic tumours of the thyroid gland, we reviewed autopsy records and pathological features of 36 cases with thyroidal secondary tumours from 266 cases of malignant neoplasias (excluding cases of primary thyroid cancer), over a 16-year period. RESULTS: There were 19 men and 17 women in the study, ranging in age from 37 to 95 years (mean 70.4 years). The incidence of metastasis in thyroid gland was 0.9% in all autopsy cases, and 13.53% of the malignant tumours. The majority were carcinomas of epithelial origin. The lung was the most common primary tumour site (33.3%), followed by the breast (8.33%) and the kidney (8.33%). The most common non-epithelial malignancy was lymphoma, followed by leukaemia (total of both 25%). As for the microscopic morphological observations, diffuse infiltration pattern of tumour cells was noted in 63.89% of the cases, the formation of nodules in 33.33% of the cases and contiguous invasion in 2.79% of the cases. There were 35.71% cases of metastases associated with multinodular goitre and 28.57% cases associated with papillary microcarcinoma. CONCLUSION: Our study indicates that thyroid secondary malignancies are not infrequent and may constitute a diagnostic problem. Lung cancer is the most common neoplasm that metastasizes to the thyroid gland in north-western Greek population.


Assuntos
Carcinoma/secundário , Neoplasias da Glândula Tireoide/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Neoplasias dos Ductos Biliares/patologia , Neoplasias da Mama/patologia , Carcinoma/epidemiologia , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/secundário , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/secundário , Neoplasias Colorretais/patologia , Feminino , Grécia/epidemiologia , Humanos , Incidência , Neoplasias Renais/patologia , Infiltração Leucêmica/epidemiologia , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/patologia , Linfoma/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia
14.
Cancer Radiother ; 23(5): 385-394, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31300328

RESUMO

PURPOSE: The purpose of the study was to evaluate the outcomes of stereotactic radiation therapy for primary and secondary liver tumours in Jean-Perrin cancer centre (Clermont-Ferrand, France) in terms of efficacy and safety. MATERIALS AND METHODS: Between December 2013 and June 2016, 25 patients were included. Treatment was performed on a linear accelerator Novalis TX®. The prescription dose was 42 to 60Gy in three to five fractions. Local control at 1 year was evaluated with modified Response Evaluation Criteria in Solid Tumours (mRECIST) and RECIST criteria. Acute and late toxicity were evaluated with Common Terminology Criteria for Adverse Events (CTCAE) v4.0 criteria. RESULTS: Median follow-up was 10.5 months. Treatment tolerance was good with few side effects grade 3 or above, no acute toxicity and only one late toxicity. We have highlighted that hepatic artery haemorrhage was associated with the presence of a biliary prosthesis in contact with the artery (P=0.006) and in the irradiation field. There was no correlation with the dose delivered to the artery and hepatic artery haemorrhage. CONCLUSION: Stereotactic radiation therapy for liver tumours allows a good local control with few secondary effects. Caution should be exercised when treating patients with biliary prostheses in the vicinity of the target volume because there is a risk of haemorrhage of the hepatic artery in contact with the prosthesis.


Assuntos
Neoplasias Hepáticas/radioterapia , Hipofracionamento da Dose de Radiação , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Carcinoma/radioterapia , Carcinoma/secundário , Carcinoma/terapia , Carcinoma Hepatocelular/radioterapia , Carcinoma Hepatocelular/terapia , Colangiocarcinoma/radioterapia , Colangiocarcinoma/terapia , Terapia Combinada , Intervalo Livre de Doença , Embolização Terapêutica , Feminino , Seguimentos , França/epidemiologia , Hemorragia/etiologia , Hepatectomia , Artéria Hepática/efeitos da radiação , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Polietileno/efeitos da radiação , Polímeros/efeitos da radiação , Lesões por Radiação/epidemiologia , Planejamento da Radioterapia Assistida por Computador , Estudos Retrospectivos , Stents
16.
Rev Assoc Med Bras (1992) ; 65(6): 761-766, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340299

RESUMO

OBJECTIVE: CT perfusion (CTP) is an imaging technique that can be used to evaluate the changes in the microcirculation of tumor tissues. Our study aimed to investigate the role of CTP in predicting mediastinal lymph node metastasis. METHODS: Clinical data of 58 patients who received surgical resection of lung cancer and lymph node dissection in our hospital from June 2012 to December 2014 were collected. Patients were divided into a positive lymph node metastasis group and a negative lymph node metastasis group. Parameters of CTP, including peak enhancement intensity (PEI), perfusion value (PV), as well as blood volume (BV), were compared between the two groups. The receiver-operating characteristic (ROC) curve was used to predict mediastinal lymph node metastasis. RESULTS: The PV of the positive lymph node metastasis group was significantly higher than that of the negative group (p < 0.001). The ROC curve analysis showed that PV can be used as an index to predict mediastinal lymph node metastasis of lung cancer. The sensitivity and specificity of a PV greater than 7.5ml·min-1·ml-1 in predicting lymph node metastasis of lung cancer were 78.3 % and 91.4 %, respectively. CONCLUSION: The PV of low dose CT perfusion can be used as an index for predicting mediastinal lymph node metastasis of lung cancer.


Assuntos
Carcinoma/secundário , Neoplasias Pulmonares/patologia , Metástase Linfática/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/secundário , Imagem de Perfusão/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Padrões de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
17.
Clin Imaging ; 57: 124-130, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220677

RESUMO

AIM: To assess the ability of diffusion-weighted imaging (DWI) in predicting the overall survival in patients who underwent Yttrium 90 radioembolization (90Y-RE) for colorectal liver metastases (CLM) with other well-established clinical and imaging parameters by comparing the pre- and post-treatment apparent diffusion coefficient (ADC) values of the lesions. METHODS: A total of 81 metastatic lesions of 27 consecutive patients who underwent DWI before and after the 90Y-RE session were enrolled in the study. ADC values were calculated from the entire (ADCe) and peripheral (ADCp) tumor on pre- and post-treatment DWI, and any relative increase in ADC >0% accepted as a functional imaging response. The impact of functional imaging response in addition to other well-known parameters including Response Evaluation Criteria in Solid Tumors (RECIST), hepatic tumor burden, Eastern Cooperative Oncology Group performance status (ECOG-PS) and the presence of extrahepatic metastases in predicting overall survival (OS) was assessed using Kaplan-Meier curves and Cox-regression analyses. RESULTS: The median OS of the patients was 10 months (range, 6-20 months) while the median OS of the responders being significantly longer than the non-responders for ADCe and ADCp (median 11 vs 7 months, P = 0.003; median 12 vs. 7 months, P < 0.0001, respectively). The RECIST score was also significantly affected the OS (progressive or stable disease median 8 months vs. partial response 15 indent months, P = 0.019). The other parameters including hepatic tumor burden, gender, ECOG score, the involvement of the liver lobes, and the presence of extrahepatic metastases were not associated with the OS. In multivariate analysis, only ADCp remained as an independent predictor of OS (P = 0.003, HR = 19.878). CONCLUSION: Any increase in relative ADCp or ADCe values after Y90-RE treatment was associated with longer OS in CLM patients, and DWI seems to be valuable imaging biomarker in predicting OS in CLM patients during the early post-interventional period after 90Y-RE.


Assuntos
Carcinoma/diagnóstico por imagem , Carcinoma/terapia , Neoplasias Colorretais/patologia , Embolização Terapêutica/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Radioisótopos de Ítrio/uso terapêutico , Adulto , Idoso , Carcinoma/secundário , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Análise de Sobrevida , Carga Tumoral
18.
Dermatol Online J ; 25(5)2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31220903

RESUMO

Cutaneous epithelioid angiosarcoma is a rare neoplasm of vascular endothelial cell origin that can mimic a cutaneous lymphoma, metastatic carcinoma, or Kaposi sarcoma. It is one of the most malignant cutaneous tumors and early diagnosis is essential, as the tumor metastasizes quickly. We describe a 75-year-old man who presented with three tender, indurated violaceous plaques on his scalp. Biopsy revealed a poorly circumscribed infiltrate extending into the subcutaneous fat, composed of atypical epithelioid cells lining vascular spaces. We provide a brief review of the clinical presentation, histopathologic features, differential diagnosis, and management of this rare tumor.


Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Hemangiossarcoma/patologia , Neoplasias Induzidas por Radiação/patologia , Neoplasias Cutâneas/patologia , Idoso , Carcinoma/diagnóstico , Carcinoma/secundário , Procedimentos Cirúrgicos Dermatológicos/métodos , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/terapia , Humanos , Linfoma Cutâneo de Células T/diagnóstico , Masculino , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/terapia , Radioterapia/efeitos adversos , Radioterapia/métodos , Sarcoma de Kaposi/diagnóstico , Couro Cabeludo , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Tinha do Couro Cabeludo/radioterapia
19.
J Clin Pathol ; 72(8): 550-553, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31164444

RESUMO

AIMS: To describe a large tertiary care academic centre's experience with patients who achieve a complete pathological response (ie, ypT0N0) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) with emphasis on morphological features present in the RC and clinical outcome. METHODS: 41 patients with ypT0N0 disease following transurethral resection of bladder tumour (TURBT), NAC and RC with available clinical follow-up information were analysed. Slides from all RCs were reviewed to confirm pathological stage and assess for morphological parameters (eg, foreign body giant cell reaction, dystrophic calcification, scar and fat necrosis). RESULTS: With median follow-up of 32.8 months, the recurrence-free survival at 1 and 5 years was 97.4% and 93.5%, while the overall survival at 3 and 5 years was 94.2% and 88.6%, respectively. No patients died of urothelial carcinoma. Stage assigned at TURBT was 1 pTa (2%), 1 pT1 (2%), 38 pT2 (93%) and 1 pT3a (2%). 17 TURBTs demonstrated variant histology, with the majority of these being squamous (65%). The most common morphological features present at RC were scar (100%), foreign body giant cell reaction (80%), chronic inflammation within lamina propria (68%) and dystrophic calcifications (39%). Other morphological features were less common or absent. CONCLUSION: ypT0N0 disease at RC portends an excellent prognosis, regardless of stage or variant histology in the TURBT; scar, foreign body giant cell reaction, chronic inflammation and dystrophic calcifications are often present.


Assuntos
Carcinoma/terapia , Cistectomia , Terapia Neoadjuvante , Neoplasias da Bexiga Urinária/terapia , Urotélio/patologia , Idoso , Carcinoma/mortalidade , Carcinoma/secundário , Quimioterapia Adjuvante , Cistectomia/efeitos adversos , Cistectomia/mortalidade , Bases de Dados Factuais , Progressão da Doença , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/efeitos adversos , Terapia Neoadjuvante/mortalidade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Intervalo Livre de Progressão , Fatores de Risco , Fatores de Tempo , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA