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1.
Cancer Biother Radiopharm ; 34(4): 218-223, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30810349

RESUMO

Background: The treatment of abdominal wall metastasis presents a challenge, because resection can be followed by poor healing and external radiotherapy is associated with serious adverse events. This study aimed to evaluate the efficacy and safety of interstitial 125I seed implantation under ultrasound (US) guidance for treating abdominal wall metastasis. Materials and Methods: The cases of 21 patients with 28 abdominal wall metastases who received brachytherapy with 125I seeds at the department from August 2010 to March 2015 were retrospectively reviewed. 125I seeds were implanted in the abdominal wall lesions under US guidance and with the help of a treatment planning system. Follow-up was performed using computed tomography at 1 d and at 3, 6, and 12 months after implantation. The lymphocyte count before the surgery was compared with the 3-month postoperative count. The main indicators observed were changes in tumor size, side effects, and complications. Results: All 21 patients were successfully treated with 125I seed implantation under US guidance. The median follow-up since 125I seed implantation was 15 months (range 6-23 months). The response rates and local tumor control after 3, 6, and 12 months were 78.6% and 89.3%, 64.3% and 85.7%, and 52.4% and 71.4%, respectively. The mean preoperative lymphocyte count was 0.262 ± 0.117 × 109/L, which did not differ significantly from the postoperative count, which was 0.259 ± 0.094 × 109/L (p = 0.122). Procedure-related complications included fever, bleeding, and pain, but all these were Grade 1-2. No severe side effects or complications were noted. Conclusions: Percutaneous interstitial implantation of 125I seeds under US guidance is safe and feasible for abdominal wall metastases. However, its long-term efficacy requires further investigation.


Assuntos
Neoplasias Abdominais/radioterapia , Braquiterapia/métodos , Carcinoma/radioterapia , Radioisótopos do Iodo/administração & dosagem , Lesões por Radiação/epidemiologia , Neoplasias Abdominais/sangue , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/secundário , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Parede Abdominal/efeitos da radiação , Adulto , Idoso , Braquiterapia/efeitos adversos , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Carcinoma/secundário , Estudos de Viabilidade , Feminino , Febre/epidemiologia , Febre/etiologia , Seguimentos , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Radioisótopos do Iodo/efeitos adversos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/etiologia , Lesões por Radiação/etiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Carga Tumoral/efeitos da radiação , Ultrassonografia de Intervenção/métodos
2.
Ann Surg Oncol ; 25(12): 3660-3666, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30178394

RESUMO

BACKGROUND: Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the associations between pre- and postoperative hsCRP levels and 90-day postoperative mortality among patients who underwent surgery for abdominal or thoracic cancers. METHODS: This retrospective cohort study included 7933 patients who underwent elective surgery between January 2010 and December 2016. Cox regression analysis and receiver operative characteristic curve analyses were used to evaluate the prognostic values of preoperative hsCRP (< 1 month before surgery) and postoperative hsCRP (< 3 days after surgery). RESULTS: For predicting 90-day mortality, the area under the receiver operating characteristic curve was significantly larger for preoperative hsCRP than for postoperative hsCRP [0.76; 95% confidence interval (CI) 0.71-0.81 vs 0.65 95% CI 0.57-0.72; P < 0.001]. The optimal cutoff values were 0.5 mg/dL for preoperative hsCRP and 9.7 mg/dL for postoperative hsCRP. Based on these cutoff values, increased risks of 90-day mortality were significantly associated with preoperative hsCRP levels higher than 0.5 mg/dL [hazard ratio (HR) 7.60; 95% CI 4.43-13.03; P < 0.001] and postoperative hsCRP levels higher than > 9.7 mg/dL (HR 1.83; 95% CI 1.12-2.98; P = 0.016). CONCLUSION: Both elevated pre- and postoperative hsCRP levels were associated with increased risks of 90-day mortality after surgery for thoracic and abdominal cancer. However, preoperative hsCRP had better prognostic value than postoperative hsCRP.


Assuntos
Neoplasias Abdominais/mortalidade , Biomarcadores Tumorais/sangue , Proteína C-Reativa/análise , Complicações Pós-Operatórias , Cuidados Pré-Operatórios , Neoplasias Torácicas/mortalidade , Neoplasias Abdominais/sangue , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias Torácicas/sangue , Neoplasias Torácicas/patologia , Neoplasias Torácicas/cirurgia
4.
Eur J Endocrinol ; 176(2): K1-K7, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27879325

RESUMO

CONTEXT: Pituitary microadenomas and adrenal tumours are the most common causes for endogenous Cushing syndrome (CS) in children. CASE DESCRIPTION: We describe a two-year old girl with Cushing syndrome due to ectopic pro-opiomelanocortin (POMC) production from an abdominal yolk sac tumor. Cortisol concentrations were elevated but adrenocorticotropic hormone (ACTH) concentrations were equivocal. The use of antibodies specifically detecting ACTH precursors revealed that plasma ACTH precursors were elevated. Additionally, an ACTH assay with a low cross-reactivity for precursors showed low concentrations of ACTH. Immunohistochemistry suggested POMC but not ACTH production by the tumour. CONCLUSION: We describe a yolk sac tumour as a novel source of ectopic POMC production leading to CS in a young girl.


Assuntos
Neoplasias Abdominais/complicações , Síndrome de Cushing/etiologia , Tumor do Seio Endodérmico/complicações , Pró-Opiomelanocortina/metabolismo , Neoplasias Abdominais/sangue , Neoplasias Abdominais/metabolismo , Hormônio Adrenocorticotrópico/sangue , Pré-Escolar , Síndrome de Cushing/sangue , Tumor do Seio Endodérmico/sangue , Tumor do Seio Endodérmico/metabolismo , Feminino , Humanos
5.
W V Med J ; 112(4): 38-41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27491101

RESUMO

Neuroblastoma is a malignant tumor arising from nerve tissue that accounts for approximately 15 percent of pediatric cancer fatalities. Primary tumors most commonly arise in sympathetic nervous tissue of the abdomen and metastasize to the bone marrow, liver, and lymph nodes. This case report depicts a 3-year-old girl who presented with a recurring fever, runny nose, and a positive test for rhinovirus suggesting a simple case of the common cold. Further investigation, however, revealed stage 4 neuroblastoma. This patient experience emphasizes the importance of having a high level of suspicion to rule out more serious underlying pathology in a seemingly unremarkable patient presentation.


Assuntos
Neoplasias Abdominais/patologia , Neoplasias da Medula Óssea/secundário , Neuroblastoma/secundário , Neoplasias Abdominais/sangue , Neoplasias Abdominais/complicações , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias da Medula Óssea/sangue , Neoplasias da Medula Óssea/complicações , Pré-Escolar , Resfriado Comum/complicações , Feminino , Febre/complicações , Humanos , Neuroblastoma/sangue , Neuroblastoma/complicações , Rhinovirus , Tomografia Computadorizada por Raios X
6.
Anal Sci ; 31(12): 1215-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26656808

RESUMO

Direct trapping of a single floating cell, i.e. a white blood cell from a drop of blood, within a nanospray tip was followed by super-sonication after the addition of ionization solvent. Molecular detection of an increased number of peaks with a higher intensity and a wider m/z range, which extends from metabolites to lipids, was acquired than of that without sonication. This method was applied to a few separated circulating tumor cells (CTC) from a neuroblastoma patient's blood to obtain their lipido-metabolomic molecular profile at the single cell level. In addition to vital molecules such as amino acids, catechol amine metabolites, which are specific to neuroblastoma, and drugs included in the patient's course of therapy were detected. This established "direct single-cell lipido-metabolomic method" seems to be useful for direct and wide range molecular detection not only for many live single-cells, but also for rare cells, such as CTCs, for future molecular diagnosis.


Assuntos
Leucócitos/metabolismo , Metabolismo dos Lipídeos , Metabolômica/métodos , Células Neoplásicas Circulantes/metabolismo , Análise de Célula Única/métodos , Espectrometria de Massas em Tandem/métodos , Neoplasias Abdominais/sangue , Neoplasias Abdominais/metabolismo , Criança , Humanos , Masculino , Metabolômica/instrumentação , Neuroblastoma/sangue , Neuroblastoma/metabolismo , Análise de Célula Única/instrumentação
7.
Chirurgia (Bucur) ; 110(6): 506-10, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26713823

RESUMO

Matrix metalloproteinase 9 is a zinc-dependent extracellular matrix remodeling endopeptidase directly involved in the local invasion mechanisms and in metastasis. The current review aims to evaluate the expression of MMP-9 and its prognostic value in the most common epithelial and lymphatic neoplasia of the pelvic-abdominal region. We included 19 studies published between January 1st, 1995 and July 31st 2015, involving a total of 1523 patients. The analysis indicate that MMP-9 is valid marker of poor survival in epithelial and lymphatic neoplasia.


Assuntos
Neoplasias Abdominais/diagnóstico , Biomarcadores Tumorais/sangue , Carcinoma/diagnóstico , Linfoma/diagnóstico , Metaloproteinase 9 da Matriz/sangue , Neoplasias Pélvicas/diagnóstico , Neoplasias Abdominais/sangue , Carcinoma/sangue , Medicina Baseada em Evidências , Humanos , Linfoma/sangue , Neoplasias Pélvicas/sangue , Valor Preditivo dos Testes , Sensibilidade e Especificidade
8.
Chest ; 148(4): 1027-1033, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26066372

RESUMO

BACKGROUND: Lymphangioleiomyomas occur in 38% of patients with sporadic lymphangioleiomyomatosis (LAM) and may cause pain and increased abdominal girth, mimicking the presence of a malignancy. Lymphatic involvement in LAM is closely associated with elevated serum levels of vascular endothelium growth factor-D (VEGF-D). Because lymphangioleiomyomas undergo diurnal variation in volume, we hypothesized that daytime ingestion of food, by increasing chyle formation and lymphatic flow, is the cause of an increase in lymphangioleiomyoma volume. METHODS: Subjects had abdominopelvic sonograms and blood drawn for measurement of serum VEGF-D levels under nonfasting (day 1) and fasting (day 2) conditions. The size of the lymphangioleiomyomas was determined by a radiologist who was blinded to the subjects' status. The Wilcoxon signed rank test was used to determine whether the nonfasting tumor size was different from the fasting tumor size. RESULTS: Thirty-five women were studied (aged 45.2 ± 8.5 years; FEV1, 82% ± 25%; diffusing capacity of the lung for carbon monoxide, 64% ± 25% predicted). Images suitable for volume measurements were obtained in 30 subjects. Fasting decreased the tumor size by 20.7 ± 39.3 cm3 (24% ± 40%, P < .001). Fasting VEGF-D levels (10,650 ± 900 pg/mL) were not significantly different from nonfasting values (12,100 ± 800 pg/mL, P = .56). CONCLUSIONS: Lymphangioleiomyoma volume decreased during the fasting state. Conversely, a combination of food intake and decreased chyle flow through lymphatics partially obstructed by LAM cells may account for increases in lymphangioleiomyoma size. Imaging studies performed under fasting conditions may help in determining whether an abdominal tumor is a result of LAM or malignancy.


Assuntos
Neoplasias Abdominais/diagnóstico , Jejum , Linfangioleiomiomatose/diagnóstico , Linfangiomioma/diagnóstico , Estadiamento de Neoplasias , Tomografia Computadorizada por Raios X , Neoplasias Abdominais/sangue , Adulto , Biomarcadores Tumorais/sangue , Feminino , Seguimentos , Humanos , Linfangioleiomiomatose/sangue , Linfangioleiomiomatose/complicações , Linfangiomioma/sangue , Linfangiomioma/complicações , Índice de Gravidade de Doença , Fator D de Crescimento do Endotélio Vascular/sangue
10.
Braz. j. med. biol. res ; 47(11): 1003-1007, 11/2014. tab
Artigo em Inglês | LILACS | ID: lil-723896

RESUMO

Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Abdominais/cirurgia , Mediadores da Inflamação/metabolismo , Trombose Venosa/etiologia , Neoplasias Abdominais/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Citocinas/sangue , Selectina E/sangue , /sangue , /sangue , NF-kappa B/sangue , Período Pós-Operatório , Medição de Risco , Fatores de Risco
11.
Braz J Med Biol Res ; 47(11): 1003-7, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25296364

RESUMO

Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.


Assuntos
Neoplasias Abdominais/cirurgia , Mediadores da Inflamação/metabolismo , Trombose Venosa/etiologia , Neoplasias Abdominais/sangue , Adulto , Proteína C-Reativa/análise , Estudos de Casos e Controles , Citocinas/sangue , Selectina E/sangue , Feminino , Humanos , Interleucina-10/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , NF-kappa B/sangue , Período Pós-Operatório , Medição de Risco , Fatores de Risco
12.
Eur Radiol ; 24(10): 2435-48, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25113646

RESUMO

OBJECTIVES: To investigate underlying conditions of patients with elevated CA 19-9 at screening tests and to evaluate diagnostic performance of abdominopelvic CT. METHODS: One hundred and thirteen patients with elevated CA 19-9 (>37 U/ml) who underwent abdominopelvic CT in a screening program were selected. Underlying conditions were determined by reviewing all available data and follow-up records. Patients were categorized into malignancy, benign, and normal/non-related disease groups. Their mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml were compared. Diagnostic sensitivity of CT for detecting underlying conditions of elevated CA 19-9 was analysed. RESULTS: Seventeen patients (17/113, 15 %) had 17 elevated CA 19-9-related malignancies, and 55 patients (55/113, 48.7 %) had 70 benign diseases. Mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml in the malignancy group were significantly higher than in the two other groups. CT detected all except one malignant lesion with a detection sensitivity of 94.1 % (16/17). Of 70 CA 19-9-related benign diseases, CT detected 34 benign diseases (48.6 %) providing an alternative diagnosis for elevated CA 19-9. CONCLUSION: Abdominopelvic CT is not only useful in detecting malignancies, but can also diagnose alternative benign causes of elevated CA 19-9 in asymptomatic screening tests. KEY POINTS: • Fifteen percent of asymptomatic patients with elevated CA19-9 may have intra-abdominal malignancies. • Mean value of CA19-9 is different among malignant, benign, and non-related groups. • CT shows excellent sensitivity for intra-abdominal malignancies as causatives of elevated CA19-9. • CT provides alternative benign diagnoses as causatives of elevated CA19-9. • Detection of causatives of elevated CA19-9 using CT alleviates concerns and uncertainty.


Assuntos
Neoplasias Abdominais/diagnóstico , Antígeno CA-19-9/sangue , Programas de Rastreamento/métodos , Radiografia Abdominal/métodos , Tomografia Computadorizada por Raios X/métodos , Neoplasias Abdominais/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos
13.
Klin Khir ; (10): 20-2, 2014 Oct.
Artigo em Ucraniano | MEDLINE | ID: mdl-25675781

RESUMO

The investigations were conducted in 44 children, operated on for abdominal cavity tumors and tumors of ovaries. In patients of the first group a combined spinal-epidural analgesia and a continuous intravenous phentanyl infusion were applied; while in the second group--the intravenous continuous infusion of phentanyl. Conduction of a multimodal analgesia have had reduced significantly a negative outcomes of insufficient analgesia in children and secured an effective analgesia after traumatic operations.


Assuntos
Cavidade Abdominal/cirurgia , Neoplasias Abdominais/cirurgia , Anestesia Epidural/métodos , Raquianestesia/métodos , Neoplasias Ovarianas/cirurgia , Cavidade Abdominal/patologia , Neoplasias Abdominais/sangue , Neoplasias Abdominais/patologia , Adolescente , Anestésicos Intravenosos , Bupivacaína , Criança , Feminino , Fentanila , Humanos , Hidrocortisona/sangue , Masculino , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/patologia , Resultado do Tratamento
14.
J Clin Endocrinol Metab ; 98(7): E1266-71, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23640968

RESUMO

CONTEXT: Up to 60% of pheochromocytoma (PCC) and paraganglioma (PGL) are associated with either somatic or germline mutations in established PCC and PGL susceptibility loci. Most unexplained cases are characterized by an increased activity of the RAS/RAF/ERK signaling pathway. Mutations in RAS subtypes H, K, and N are common in human cancers; however, previous studies have been inconsistent regarding the mutational status of RAS in PCC and PGL. OBJECTIVES: The aim of this study was to identify novel disease causing genes in PCC and PGL tumors. DESIGN, SETTING, AND PARTICIPANTS: Four benign and sporadic PCC and PGL tumors were subjected to whole exome sequencing using the Illumina HiSeq Platform. Sequences were processed by CLC genomics 4.9 bioinformatics software and the acquired list of genetic variants was filtered against the Catalogue of Somatic Mutations in Cancer database. Findings were validated in an additional 78 PCC and PGL tumor lesions. RESULTS: Exome sequencing identified 2 cases with somatic mutations in the H-RAS. In total, 6.9% (n = 4/58) of tumors negative for mutations in major PCC and PGL loci had mutations in H-RAS: G13R, Q61K, and Q61R. There were 3 PCC and 1 PGL; all had sporadic presentation with benign tumor characteristics and substantial increases in norepinephrine and/or epinephrine. H-RAS tumors were exclusively found in male patients (P = .007). CONCLUSIONS: We identified recurrent somatic H-RAS mutations in pheochromocytoma and paraganglioma. Tumors with H-RAS mutations had activation of the RAS/RAF/ERK signaling pathway and were associated with male PCC patients having benign and sporadic disease characteristics. H-RAS could serve as a prognostic and predictive marker as well as a novel therapeutic target.


Assuntos
Neoplasias Abdominais/genética , Neoplasias das Glândulas Suprarrenais/genética , Mutação , Paraganglioma/genética , Feocromocitoma/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Abdominais/sangue , Neoplasias Abdominais/metabolismo , Neoplasias Abdominais/patologia , Adolescente , Neoplasias das Glândulas Suprarrenais/sangue , Neoplasias das Glândulas Suprarrenais/metabolismo , Neoplasias das Glândulas Suprarrenais/patologia , Adulto , Idoso , Substituição de Aminoácidos , Estudos de Coortes , Análise Mutacional de DNA , Exoma , Feminino , Humanos , Sistema de Sinalização das MAP Quinases , Masculino , Pessoa de Meia-Idade , Paraganglioma/sangue , Paraganglioma/metabolismo , Paraganglioma/patologia , Feocromocitoma/sangue , Feocromocitoma/metabolismo , Feocromocitoma/patologia , Proteínas Proto-Oncogênicas p21(ras)/sangue , Proteínas Proto-Oncogênicas p21(ras)/química , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Estudos Retrospectivos , Distribuição por Sexo , Suécia , Adulto Jovem
15.
Pancreas ; 42(2): 348-52, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23407483

RESUMO

OBJECTIVES: Gastroenteropancreatic neuroendocrine tumors (NETs) are rare tumors of the endocrine and nervous systems. Whereas early surgical resection can significantly reduce tumor mass, there are few data available concerning the control of hormonal secretion and associated symptoms. Studies have shown that the tyrosine kinase inhibitor sunitinib significantly prolongs progression-free survival in patients with pancreatic NETs. Here, we present 2 case reports of sunitinib in patients with different types of NETs. METHODS: The patients were a 12-year-old boy with metastatic vasoactive intestinal polypeptide-producing tumor (VIPoma) and a 70-year-old woman with metastatic paraganglioma/NET. Both were treated in an outpatient clinical setting. Sunitinib was titrated to 37.5 mg on a continuous daily dosing schedule in the patient with VIPoma, and the dose was 50 mg/d (4 weeks on, 2 weeks off) in the patient with the paraganglioma/NET. RESULTS: The patient with the paraganglioma/NET had a confirmed complete radiographic response and the patient with VIPoma had a confirmed partial response (Response Evaluation Criteria in Solid Tumors). In both patients, improvements were observed in biochemical tumor markers, clinical responses, and quality of life. CONCLUSIONS: In these patients, sunitinib reduced biochemical markers and stabilized or reduced tumor bulk and may therefore be a potential therapeutic option for these tumor types.


Assuntos
Neoplasias Abdominais/tratamento farmacológico , Antineoplásicos/administração & dosagem , Indóis/administração & dosagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pancreáticas/tratamento farmacológico , Paraganglioma/tratamento farmacológico , Inibidores de Proteínas Quinases/administração & dosagem , Pirróis/administração & dosagem , Vipoma/tratamento farmacológico , Neoplasias Abdominais/sangue , Neoplasias Abdominais/enzimologia , Neoplasias Abdominais/patologia , Idoso , Biomarcadores Tumorais/sangue , Criança , Esquema de Medicação , Feminino , Humanos , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/enzimologia , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/secundário , Metástase Linfática , Imagem por Ressonância Magnética , Masculino , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/enzimologia , Neoplasias Pancreáticas/patologia , Paraganglioma/sangue , Paraganglioma/enzimologia , Paraganglioma/secundário , Sunitinibe , Fatores de Tempo , Resultado do Tratamento , Vipoma/sangue , Vipoma/enzimologia , Vipoma/secundário
16.
J Obstet Gynaecol Res ; 38(3): 605-9, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22353601

RESUMO

Although yolk sac tumors (YSTs) are the second most common malignant germ cell tumor of the ovary, those arising from the omentum or pelvic peritoneum are extremely rare and have no established treatment guidelines. We report a case of a primary YST disseminated throughout the abdomen and associated with a high serum alpha-fetoprotein (AFP) elevation (441 611 ng/ml). Optimal cytoreduction was not achieved in order to preserve the patient's fertility and avoid adjacent organ injury. Residual tumor responded to adjuvant chemotherapy with a sharp decline in AFP levels, and confirmed remission was documented by serial (18)F-fluorodexyglucose-positoron emission tomography and computerized tomography (FDG-PET/CT). In cases of advanced YST with unresectable residual disease, AFP levels combined with FDG-PET/CT scans may be a helpful way to monitor treatment response and assist in treatment planning for a disease that primarily affects young women who may desire to preserve fertility.


Assuntos
Neoplasias Abdominais/diagnóstico por imagem , Tumor do Seio Endodérmico/diagnóstico por imagem , Fluordesoxiglucose F18 , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , alfa-Fetoproteínas/metabolismo , Neoplasias Abdominais/sangue , Adulto , Tumor do Seio Endodérmico/sangue , Feminino , Humanos
17.
Vet Radiol Ultrasound ; 51(6): 681-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21158247

RESUMO

Combination chemotherapy is standard care for feline lymphoma, although clinically relevant improvements in remission duration are unlikely to result from manipulations of chemotherapy agents alone. Lymphopoietic tissues generally are sensitive to radiation, and support for chemoradiotherapy as a treatment for lymphoma is found in both humans and dogs. The goal of this prospective pilot study was to determine the normal tissue tolerance to 15 Gy total abdomen fractionated radiation therapy following induction chemotherapy in cats with lymphoblastic lymphoma. Eight cats with lymphoblastic gastrointestinal or multicentric lymphoma confined to the abdominal cavity were treated with a 6-week combination chemotherapy protocol followed 2 weeks later by whole-abdomen radiation therapy consisting of 10 daily fractions of 1.5 Gy. Treatment was well tolerated; renal insufficiency documented in one cat at the start of radiation therapy progressed to stable chronic renal failure. One cat not in complete remission at the time of radiation therapy relapsed 2 weeks later, one cat with multicentric lymphoma relapsed with hepatic large granular lymphoma, and one cat was euthanatized 3 weeks following completion of radiation therapy for other reasons; no evidence of lymphoma or radiation toxicoses was identified on post mortem evaluation. The remaining five cats remain in remission at least 266 days after starting therapy; median remission duration has not been reached (range, > 266 to > 1332 days). Results of this study suggest that 15 Gy total abdomen fractionated radiation therapy after induction chemotherapy is tolerated satisfactorily. This protocol is suitable for further testing to quantify efficacy.


Assuntos
Neoplasias Abdominais/veterinária , Doenças do Gato/radioterapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/veterinária , Neoplasias Abdominais/sangue , Neoplasias Abdominais/tratamento farmacológico , Neoplasias Abdominais/radioterapia , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doenças do Gato/sangue , Doenças do Gato/tratamento farmacológico , Gatos , Terapia Combinada/veterinária , Projetos Piloto , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Dosagem Radioterapêutica , Indução de Remissão/métodos , Resultado do Tratamento
18.
Blood Coagul Fibrinolysis ; 20(5): 347-52, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19474701

RESUMO

D-dimers may be elevated after surgery. However, the kinetics of postoperative D-dimers remains unknown hampering the use of D-dimer testing in surgical patients with suspected venous thromboembolism. D-dimer levels were prospectively measured in 154 patients after general surgery at predefined time points (kinetics were determined in an initial cohort of 108 patients; for validation, these findings were applied to a second cohort of 46 patients). Clinical factors influencing the peak of D-dimers were analyzed using multivariate regression. Surgical operations were stratified based on severity (type I: not entering abdominal cavity; type II: intraabdominal; type III: retroperitoneal/liver surgery). D-dimer levels increased postoperatively reaching a peak on day 7. After type I surgery, peak D-dimer levels did not exceed normal range (300 ng/ml, 100-500). After type II procedures, peak D-dimer level was 1500 ng/ml (200-7800) and returned to normal values after 25 days (+/-14). Peak level was 4000 ng/ml (500-14 400) after type III surgery normalizing within 38 days (+/-11). Clearance of D-dimer was exponential after having reached the peak with 6.0% per day (95% confidence interval 4.8-7.1%). By this clearance, D-dimer values could be adequately predicted in the validation cohort after day 7 (r2 = 0.63). Peak D-dimer levels were independently influenced by the type of surgery (P < 0.001), the operation time (P < 0.001) and by preoperatively elevated D-dimer levels (P < 0.001). Based on this data, duration of postoperative D-dimer elevation after abdominal surgery is predictable. This study indicates for the first time when D-dimers may be used again in the diagnostic algorithm for venous thromboembolism exclusion after surgery in patients with low or moderate clinical probability.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Complicações Pós-Operatórias/sangue , Trombofilia/sangue , Abdome/cirurgia , Neoplasias Abdominais/sangue , Neoplasias Abdominais/cirurgia , Adulto , Idoso , Anticoagulantes/uso terapêutico , Estudos de Coortes , Dalteparina/uso terapêutico , Feminino , Humanos , Incidência , Cinética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Período Pós-Operatório , Estudos Prospectivos , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/etiologia , Meias de Compressão , Trombofilia/tratamento farmacológico , Trombofilia/etiologia , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle
19.
Bull Exp Biol Med ; 148(4): 634-7, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20396759

RESUMO

The initial (before treatment) levels of VEGF, endostatin, and tumor necrosis factor-beta (TNF-beta) were measured in the sera of 20 patients with malignant and benign neuroendocrine tumors of the abdominal organs and 25 healthy controls. The initial levels of VEGF, endostatin, and TNF-beta in the total group of patients with neuroendocrine tumors of abdominal organs did not differ from the control. A significant difference was detected between the mean serum concentrations of endostatin in patients with benign and malignant neuroendocrine tumors: 64.1+/-14.7 and 107.8+/-14.1 ng/ml, respectively (p=0.043). The content of VEGF, endostatin, and TNF-beta did not correlate with patients' gender and age. A direct correlation between endostatin, TNF-beta concentrations and maximum size of the primary tumor was detected in patients with malignant neuroendocrine tumors. Direct correlations between the initial levels of VEGF and endostatin and an inverse correlation between VEGF and TNF-beta concentrations were detected in patients with benign neuroendocrine tumors. Relapse-free survival was significantly lower in patients with serum endostatin concentration >100 ng/ml and TNF-beta<30 pg/ml.


Assuntos
Neoplasias Abdominais , Endostatinas/sangue , Linfotoxina-alfa/sangue , Tumores Neuroendócrinos , Fator A de Crescimento do Endotélio Vascular/sangue , Neoplasias Abdominais/sangue , Neoplasias Abdominais/patologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/sangue , Tumores Neuroendócrinos/patologia , Taxa de Sobrevida
20.
Gan To Kagaku Ryoho ; 35(12): 2112-4, 2008 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-19106540

RESUMO

We report a case of advanced unresectable pancreatic cancer (cT4N1M0/stage IVa). The patient was a 68-year-old man. Chemo-radiation therapy (CRT) with GEM (1,000 mg/body) was administered once a week on days 1, 8 and 15 for 3 weeks. The radiotherapy dose was 45 Gy (1.5 Gy x 2/day, 15 days). After CRT, the patient was treated with a GEM+ UFT-E combination chemotherapy. When that was done, CT scan revealed metastases of umbilicus (Sister Mary Joseph's nodule) and the liver. Microwave Coagulation Therapy for the liver metastasis and tumorectomy for metastasis of umbilicus were performed. But he died after 4 months from the therapies.


Assuntos
Neoplasias Abdominais/secundário , Neoplasias Pancreáticas/patologia , Umbigo/patologia , Neoplasias Abdominais/sangue , Neoplasias Abdominais/terapia , Idoso , Antígenos de Neoplasias/sangue , Biomarcadores Tumorais/sangue , Evolução Fatal , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Masculino , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Tomografia Computadorizada por Raios X , Falha de Tratamento
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