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1.
Urologiia ; (4): 95-99, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-32897021

RESUMO

A clinical case of the successful surgical treatment of patient with multiple primary cancers, including locally-advanced right renal cell cancer, transitional-cell cancer bladder cancer and metachronous transitional-cell cancer of the left kidney with one of the longest follow-up and survival time described in the literature.


Assuntos
Carcinoma de Células Renais , Carcinoma de Células de Transição , Neoplasias Renais , Neoplasias Primárias Múltiplas , Neoplasias da Bexiga Urinária , Humanos
2.
Medicine (Baltimore) ; 99(35): e21721, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871890

RESUMO

The aim of this study was to provide an innovative nomogram to predict the risk of >2 positive nodes in patients fulfilling the Z0011 criteria with 1-2 sentinel lymph nodes (SLNs) only retrieved.From 2007 to 2017, at the Breast Unit of ICS Maugeri Hospital 271 patients with 1-2 macrometastatic SLNs, fulfilling the Z0011 criteria, underwent axillary dissection and were retrospectively reviewed.A mean of 1.5 SLNs per patient were identified and retrieved. One hundred eighty-seven (69.0%) had 1-2 positive nodes, and 84 (31.0%) had >2 metastatic nodes. Independent predictors of axillary status were: positive SLNs/retrieved SLNs ratio (odds ratio [OR] 10.95, P = .001), extranodal extension (OR 5.51, P = .0002), and multifocal disease (OR 2.9, P = .003). A nomogram based on these variables was constructed (area under curve after bootstrap = 0.74).The proposed nomogram might select those patients fulfilling the Z0011 criteria, with 1-2 SLNs harvested, in whom a high axillary tumor burden is expected, aiding to guide adjuvant treatments.


Assuntos
Neoplasias da Mama/patologia , Neoplasias Primárias Múltiplas/patologia , Nomogramas , Linfonodo Sentinela/patologia , Idoso , Antineoplásicos Hormonais/uso terapêutico , Área Sob a Curva , Axila , Neoplasias da Mama/terapia , Quimioterapia Adjuvante , Feminino , Humanos , Metástase Linfática , Mastectomia Segmentar , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia Adjuvante , Carga Tumoral
4.
Medicine (Baltimore) ; 99(30): e21354, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791739

RESUMO

INTRODUCTION: Pancreatic pseudocyst is one of the most common cystic lesions. It always occurs following pancreatitis and is rarely found in combination with pancreatic adenocarcinoma. The coexistence of exocrine and neuroendocrine tumors of the pancreas is also infrequent. We herein report a case of simultaneous occurrence of a pancreatic ductal adenocarcinoma (PDAC), pseudocyst, and neuroendocrine tumor (NET), showing a "side-by-side pattern." PATIENT CONCERN: A 74-year-old man was hospitalized for epigastric pain and poor appetite. He had no history of pancreatitis, alcohol consumption, or smoking. DIAGNOSIS AND INTERVENTION: Abdominal enhanced computed tomography and magnetic resonance imaging revealed a 15 × 8 cm cystic lesion with poor enhancement located in the tail of the pancreas. The distal aspect of the main pancreatic duct was dilated. The pancreatic parenchyma adjacent to the cystic lesion showed slightly heterogeneous enhancement on computed tomography and magnetic resonance imaging. Laboratory examination showed an elevated carbohydrate antigen 19-9 serum level. The patient was preoperatively diagnosed with intraductal papillary mucinous neoplasm and subsequently underwent laparotomy. During the operation, a hard white tumor measuring about 4 × 3 cm was palpated adjacent to the cystic lesion on the duodenal side, and a 0.6-cm nodule was simultaneously found in the pancreatic tail. Therefore, total pancreatectomy and splenectomy were performed. Histopathological examination showed that the tumor was PDAC with an adjacent pseudocyst, and the small nodule was suggestive of a NET. OUTCOMES: The patient survived without recurrence or metastasis in the follow-up visit 10 months after the operation and adjuvant chemotherapy. CONCLUSIONS: The concomitant occurrence of a PDAC, pseudocyst, and NET has not been previously reported. We suggest that if a pancreatic cyst is found, the coincidental occurrence of a malignant tumor should be considered, especially if the carbohydrate antigen 19-9 level is increased. Additionally, dilation of the pancreatic duct may be a diagnostic clue. Furthermore, the simultaneous occurrence of pancreatic endocrine and exocrine tumors is very uncommon. Preoperative diagnosis becomes difficult because of the lack of specific symptoms and radiological features.


Assuntos
Carcinoma Ductal Pancreático/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Idoso , Humanos , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
5.
Medicine (Baltimore) ; 99(32): e21560, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769897

RESUMO

Breast cancer and ovarian cancer are closely related. The major common risk factors of these 2 types of cancer are likely genetic factors. However, few studies have shown any common characteristics in patients who have both types of these 2 cancers. The purpose of this retrospective study is to explore the clinical characteristics and survival outcomes of patients with both primary breast cancer and primary ovarian cancer.A cohort of patients who had a history of both primary breast cancer and primary ovarian cancer were enrolled, and they received treatment in the Peking Union Medical College Hospital between January 1, 2010, and December 31, 2018. Both descriptive statistics analysis and survival analysis were performed for analysis.A total of 114 patients with both primary breast cancer and primary ovarian cancer were included in the study. The median (range) follow-up was 129.5 (20-492) months. The average interval time between the diagnosis of 2 types of cancer was 79.4 months in patients having ovarian cancer firstly and was 115.9 months in patients having breast cancer firstly. The 5- and 10-year overall survival (OS) rates were 91.5% and 81.7% for patients with ovarian cancer following breast cancer, respectively, and 90.6% and 87.5% for patients with breast cancer following ovarian cancer, respectively. Multivariate analysis revealed that independent predictors of OS were the age of diagnosis of the first tumor and the time interval between two types of tumor in patients with ovarian cancer following breast cancer.Most breast cancer or ovarian cancer occurred within 5 years after being diagnosed with the first tumor, and the interval time was significantly shorter in patients with previous ovarian cancer. The prognosis is likely positively correlated to the interval time between the occurrences of two types of cancer.


Assuntos
Neoplasias da Mama/mortalidade , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Ovarianas/mortalidade , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Taxa de Sobrevida , Fatores de Tempo
6.
Zhonghua Wai Ke Za Zhi ; 58(8): 589-595, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727188

RESUMO

Hypopharyngeal cancer and esophageal cancer often occur synchronously or metachronously. Timely screening, diagnosis and individual treatment are important to improve the prognosis of patients. At present, there is no clinical guideline or consensus in this cross-cutting area in China, and there is a need of consistent diagnosis and treatment recommendation for these patients. Under the sponsorship of the Committee of Esophageal Cancer in China Anti-Cancer Association, the Chinese Working Group on Cooperative Diagnosis and Treatment of Hypopharyngeal and Esophageal Cancer was established by domestic experts in the fields of otolaryngology head and neck surgery, radiation oncology, and gastrointestinal endoscopy. This consensus document on multiple primary cancers (simultaneous or metachronous) of the hypopharynx and esophagus was developed through literature review, collective experience and expert discussions. The goals of the consensus include: (1) raising concern for this cross-cutting field; (2) establishing a preliminary clinical diagnosis and treatment recommendation; (3) preparing for the establishment of future high-level guidelines through standardized clinical practice.


Assuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Neoplasias Hipofaríngeas/diagnóstico , Neoplasias Hipofaríngeas/terapia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapia , China , Consenso , Humanos , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/terapia , Prognóstico
7.
J Nippon Med Sch ; 87(3): 157-161, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32655092

RESUMO

Screening esophagogastroduodenoscopy of a 65-year-old man revealed a 4.7-cm polypoid in the gastric high body. Clinical and laboratory findings, including serum gastrin level (460 pg/mL) and biopsy findings, were consistent with a diagnosis of type I neuroendocrine tumor (NET). Histologically, the mass consisted of dilated tortuous glands at the surface and grade 1 NET in deeper tissue. Some hyperplastic glands exhibited a transition to adenocarcinoma, which invaded the NET, simulating a "tumor in tumor" appearance. Next-generation sequencing revealed that the adenocarcinoma component harbored a TP53 mutation, whereas the NET component showed no pathogenic mutation. To our knowledge, this unusual collision of adenocarcinoma and NET within a single gastric hyperplastic polyp has not been previously described. This case suggests that large gastric hyperplastic polyps should be carefully examined because of the possibility of underlying NET and malignant transformation of surface epithelium.


Assuntos
Adenocarcinoma/patologia , Pólipos Intestinais/patologia , Neoplasias Primárias Múltiplas/patologia , Tumores Neuroendócrinos/patologia , Neoplasias Gástricas/patologia , Idoso , Transformação Celular Neoplásica/patologia , Humanos , Masculino
8.
Tokai J Exp Clin Med ; 45(2): 92-96, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32602108

RESUMO

A 69-year-old man was referred to the hematology department for the evaluation of pancytopenia. He had been treated with radiation and epirubicin for hepatocellular carcinoma, and with docetaxel and pembrolizumab for lung adenocarcinoma. Bone marrow smears exhibited markedly increased promyelocytes, and polymerase chain reaction (PCR) study demonstrated chimeric fusion genes of PML-RARA. He was diagnosed with therapy-related acute promyelocytic leukemia (t-APL) and treated with all trans-retinoic acid (ATRA). After 30 days of ATRA treatment, complete hematological response was achieved. To the best of our knowledge, this case represents the first description of successfully treated t-APL diagnosed after treatment with pembrolizumab.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma/tratamento farmacológico , Docetaxel/efeitos adversos , Epirubicina/efeitos adversos , Leucemia Promielocítica Aguda/induzido quimicamente , Leucemia Promielocítica Aguda/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Primárias Múltiplas , Tretinoína/uso terapêutico , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Docetaxel/uso terapêutico , Epirubicina/uso terapêutico , Humanos , Masculino , Resultado do Tratamento
9.
Anticancer Res ; 40(7): 4029-4032, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620648

RESUMO

The synchronous diagnosis of two or more primary malignancies in a patient is overall rare. This is a case report of a 70-year-old female with a history of skin squamous cell carcinoma presenting with occult hematochezia. Colonoscopy and biopsy results confirmed a microsatellite stable (MMS) adenocarcinoma in the ascending colon, and subsequent computed tomography (CT) scans identified a 3.2 cm right colonic mass and a 5.0 cm mass in the pancreatic body. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) confirmed the presence of pancreatic ductal adenocarcinoma (PDAC). The patient underwent neo-adjuvant FOLFIRINOX (folinic acid, fluorouracil, irinotecan and oxaliplatin) chemotherapy prior to the simultaneous distal pancreatectomy and right hemicolectomy for both pancreatic and colonic tumors. The pathology diagnoses included moderately differentiated pancreatic ductal carcinoma (PDAC) with histiocyte-like features (tumor stage: ypT3N1M0) and moderately differentiated colonic adenocarcinoma, intestinal type (tumor stage: ypT3N0M0). To the best of our knowledge, this is the first documented case of synchronous primary colonic adenocarcinoma and PDAC in the English literature.


Assuntos
Adenocarcinoma/diagnóstico , Carcinoma Ductal Pancreático/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adenocarcinoma/patologia , Idoso , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Ductal Pancreático/patologia , Carcinoma de Células Escamosas , Neoplasias do Colo/patologia , Feminino , Fluoruracila/uso terapêutico , Humanos , Irinotecano/uso terapêutico , Leucovorina/uso terapêutico , Neoplasias Primárias Múltiplas/patologia , Oxaliplatina/uso terapêutico , Neoplasias Pancreáticas/patologia , Neoplasias Cutâneas
10.
Medicine (Baltimore) ; 99(29): e20865, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702827

RESUMO

RATIONALE: Synchronous pulmonary lymphoma and carcinoma is relatively rare. And synchronous pulmonary lymphoma and adenocarcinoma in the same site is extremely rare. PATIENT CONCERNS: We presented a 69-year-old female with a tumor mass in right upper lung. DIAGNOSIS: Pathological and immunohistochemical findings revealed lung adenocarcinoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. INTERVENTIONS: The patient received thoracoscopic guided right upper lobectomy and focal lymph node dissection after systemic anesthesia. Besides, 6 cycles of chemotherapy were given based on meprednisone, gemcitabine and cisplatin in local hospital. OUTCOMES: In the 12-month follow-up, the patient was still alive with no local recurrence, metastasis and lymph node involvement. LESSON: A comprehensive literature research was performed, and 6 cases of synchronous pulmonary lymphoma and adenocarcinoma in the same site and 10 cases in different sites were identified since 2000. Most patients with synchronous pulmonary lymphoma and carcinoma were middle-aged and elderly with the median age was 64 years presenting a male predisposition. The most frequent type of primary pulmonary lymphoma was B-cell non Hodgkin lymphoma, especially mucosa-associated lymphoid tissue lymphoma, and the lung cancer is predominantly adenocarcinoma.


Assuntos
Adenocarcinoma/patologia , Neoplasias Pulmonares/patologia , Linfoma de Zona Marginal Tipo Células B/patologia , Neoplasias Primárias Múltiplas/patologia , Adenocarcinoma/terapia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Humanos , Neoplasias Pulmonares/terapia , Excisão de Linfonodo , Linfoma de Zona Marginal Tipo Células B/terapia , Neoplasias Primárias Múltiplas/terapia , Pneumonectomia
12.
Medicine (Baltimore) ; 99(27): e20941, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629697

RESUMO

RATIONALE: Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare. PATIENT CONCERNS: A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day. DIAGNOSIS: Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0-3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0-35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition. INTERVENTIONS: The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well. LESSONS: We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.


Assuntos
Adenocarcinoma/diagnóstico , Cistos/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Retais/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Biomarcadores Tumorais/sangue , Antígeno Carcinoembrionário/sangue , Cistos/diagnóstico por imagem , Cistos/patologia , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Proteínas Ligadas por GPI/sangue , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Tomografia Computadorizada por Raios X
14.
Zhonghua Zhong Liu Za Zhi ; 42(6): 449-455, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575939

RESUMO

Objective: To investigate the high resolution CT (HRCT) features of lung adenocarcinoma for differentiating synchronous multiple lung adenocarcinoma from lung adenocarcinoma with intrapulmonary metastasis. Methods: The clinical and imaging features of 131 lesions from 62 patients of synchronous multiple primary lung adenocarcinoma (primary group) and 67 lesions from 31 patients of lung adenocarcinoma with intrapulmonary metastases (metastasis group) were retrospectively analyzed. According to the types of lesion, including pure ground glass nodule (pGGN), mixed ground glass nodule (mGGN) and solid nodule (SN), the image feature matching types of patients were divided into 7 types. The differences of image feature matching types between the primary group and the metastasis group were compared. Multiple lesions in the lung of patients were classified into the main lesion and the concomitant lesions according to their size. The differences including the size of the main lesion and the concomitant lesion (long diameter of nodule, long diameter of solid component in nodule), whether it contains ground glass components in nodule, shape, lobulation, margin, spiculation, bubble-like lucency, pleural retraction and pleural attachment were recorded and analyzed. The differences of image features of main lesion and the concomitant lesion in the primary group and the metastasis group were compared. Results: The image feature matching types of pGGN + mGGN and mGGN + mGGN were more common in the primary group, and the ground glass component contained pGGN or mGGN was accounted for 62.9%(39/62). At least one lesion containing the ground glass component was accounted for 96.8% (60/62). There were two types in metastatic groups, mGGN+ SN and SN+ SN accounting for 6.5% (2/31) and 93.5% (29/31), respectively. There were significant differences in image feature matching types between the primary group and metastatic group (P<0.01). Univariate analysis of the main lesions between the two groups showed that the gender, smoking history, long diameter of the main lesion, long diameter of the solid component, the ground glass component and pleural attachment were statistically different (P<0.05). Further analysis by multivariate logistic regression showed that the male (OR=5.742, P=0.010), SN (OR=41.291, P<0.01) and pleural attachment (OR=9.288, P=0.001) were the three significant risk factors associated with the main lesions in metastasis group.The most common concomitant lesions in primary group were pGGN, containing the ground glass component. However, all of the concomitant lesions in the metastatic group were SN (P<0.01), showing round lesions with well-defined margin, attaching the pleura (P<0.05). Conclusions: The HRCT features of lung adenocarcinoma can differentiate synchronous multiple lung adenocarcinoma from lung adenocarcinoma with intrapulmonary metastasis. At least one lesion contains ground glass components (pGGN or mGGN) in synchronous multiple primary lung adenocarcinoma, while SN is more common in lung adenocarcinoma with lung metastasis. Lung cancer with intrapulmonary metastasis can be considered when the main lesion is SN with pleural attachment and the intrapulmonary accompanying lesion is also solid nodules without lobular, speculation and bubble-like lucency.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/patologia , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Invasividade Neoplásica , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos
15.
Medicine (Baltimore) ; 99(26): e20491, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590732

RESUMO

BACKGROUND: Atypical polypoid adenomyoma (APA) is a rare uterine tumor typically found in fertile age and associated with infertility. Among young nullipara women, conservative treatment is proposed despite the high recurrence rate and the association with endometrial cancer.Our aim was to assess the risk of recurrence with different conservative treatments in fertile ages and the prevalence of malignant or pre-malignant associated lesions to better address an adequate patient counselling when treatment modalities are discussed. METHODS: This study is a systematic review and meta-analysis of case reports and case series about APA management and follow-up. A literature search was carried from Medline and Scopus for studies published from January 1, 1980 to December 31, 2018. RESULTS: We included 46 observational studies and 296 cases in fertile women. The prevalence of APA relapse was 44% (CI.95 33-57%) and was lower in cases treated with operative hysteroscopy (22%; CI.95 11-39%) than in cases treated with blind curettage and polypectomy (38%; CI.95 15-67%). The prevalence of the concomitant or during the follow-up diagnosis of endometrial carcinoma was 16% (CI.95 9-29%). The risk of cancer development during follow-up was significantly less in cases treated with histeroscopy (10.56% new cumulative diagnosis at 5 years follow up; CI.95 0-23.7%) than blind curettage and polypectomy (35.5% new cumulative diagnosis at 5 years; CI.95 11.65-52.92%; P < .05). Medical treatment with medroxyprogesterone acetate after surgery does not reduce APA recurrence. Pregnancy was observed in 79% cases in which the desire was expressed. CONCLUSION: This review suggests that conservative treatment performed by operative hysteroscopy is the optimal choice because it lowers the risk of recurrence, improves the accuracy of concomitant carcinoma or hyperplasia diagnosis, and leaves the possibility of future pregnancies.


Assuntos
Adenomioma/terapia , Recidiva Local de Neoplasia/patologia , Neoplasias Uterinas/terapia , Adenomioma/patologia , Antineoplásicos Hormonais/uso terapêutico , Quimioterapia Adjuvante , Tratamento Conservador , Curetagem , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/patologia , Feminino , Humanos , Histeroscopia , Acetato de Medroxiprogesterona/uso terapêutico , Neoplasias Primárias Múltiplas , Gravidez , Taxa de Gravidez , Neoplasias Uterinas/patologia
16.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(6): 584-588, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32521979

RESUMO

Objective: To investigate the short-term outcomes of laparoscopic simultaneous resection of primary colorectal cancer and liver metastases in patients with resectable synchronous colorectal liver metastases (SCRLM). Methods: A descriptive case series study was performed. Clinicopathological data of patients with SCRLM who underwent laparoscopic simultaneous resection of colorectal cancer and liver metastases in Zhongshan Hospital between December 2015 and September 2018 were retrieved from a prospective colorectal cancer database. Perioperative presentations and short-term outcomes were analyzed. Results: A total of 53 patients were enrolled with average age of(61.7±11.3) years. Among them, 32 were male (60.4%) and 21 were female (39.6%). Twenty-five patients (47.2%) were American Society of Anesthesiologists (ASA) grade I and 28 (52.8%) were grade II. All the patients completed laparoscopic simultaneous resection without conversion. The average operation time was (320.2±114.5) min. The estimated blood loss was 150.0 (45.0-2000.0) ml, and only 2 cases (3.8%) received intraoperative transfusion. Postoperative pathologic results revealed that the average primary tumor size was (5.4±1.9) cm; 4 cases (7.5%) were T1-2 stage and 48 cases (90.6%) were T3-4 stage; 40 patients (75.5%) had lymph node metastasis; 19 (35.8%) had vascular involvement; 24 (45.3%) had neural invasion. The median number of liver metastases was 1.0 (1-8), and the average size of largest liver metastases was (3.0±1.9) cm. The median margin of liver metastases was 1.0 (0.1-3.5) cm, and only 1 case was R1 resection. The average time to the first postoperative flatus was (67.9±28.9) h, and the average time to the liquid diet was (107.0±33.8) h. The average postoperative indwelling catheterization time was (85.6±56.4) h. The average postoperative hospital stay was (9.2±4.4) d, and the average cost was (82±26) thousand RMB. No death within postoperative 30-day was found. The morbidity of postoperative complication was 32.1% (17/53) and 3 patients developed grade III to IV complications which were improved by conservative treatment. The median follow-up period was 23.2 months. During follow-up, 19 patients (35.8%) developed recurrence or metastasis, and 4 (7.5%) died. The 1- and 2-year disease-free survival (DFS) rates were 68% and 47% respectively, and the 1- and 2-year overall survival rates were 95% and 86% respectively. Conclusions: Laparoscopic simultaneous resection of primary colorectal cancer and liver metastases is safe and feasible in selected patients with SCRLM. Postoperative intestinal function recovery is enhanced, and morbidity and oncological outcomes are acceptable.


Assuntos
Neoplasias Colorretais/cirurgia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Idoso , Neoplasias Colorretais/patologia , Estudos de Viabilidade , Feminino , Humanos , Laparoscopia , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
17.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(6): 619-622, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32521988

RESUMO

Liver metastasis is one of the main causes of death in patients with colorectal cancer. About 15%-25% of patients with colorectal cancer have synchronous liver metastasis at the initial diagnosis. With the development of new evidence and concept of surgery, there is a improvement in the understanding of the surgical treatment, transformation treatment, criteria of surgical resectability and prognosis of patients with colorectal liver metastasis (CRLM). Based on latest progress, specialized multi-disciplinary team decides the best individualized treatment strategy. This paper reviews the current situation and progress of CRLM.


Assuntos
Neoplasias Colorretais/cirurgia , Neoplasias Hepáticas/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Colectomia , Neoplasias Colorretais/patologia , Hepatectomia , Humanos , Neoplasias Hepáticas/secundário , Protectomia , Prognóstico
18.
Khirurgiia (Mosk) ; (6): 114-117, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32573542

RESUMO

Patients with anterior mediastinum tumors fall into a difficult category due to high risk of invasion of vital structures and complexity of surgical correction. We report resection of recurrent hemangioma of anterior mediastinum with aortic arch replacement and simultaneous resection of left atrial myxoma in a 35-year-old woman. Successful treatment of these patients correlates with aggressive surgical approach followed by total resection of tumor and all affected vessels and other tissues.


Assuntos
Neoplasias Cardíacas/cirurgia , Hemangioma/cirurgia , Neoplasias do Mediastino/cirurgia , Mixoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Adulto , Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Cirúrgicos Cardiovasculares/métodos , Feminino , Átrios do Coração/cirurgia , Humanos , Mediastino/cirurgia
19.
World Neurosurg ; 139: 410-414, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32376377

RESUMO

BACKGROUND: Cerebral cavernomas are vascular malformations characterized by networks of abnormally dilated capillaries. They typically present as nodules with mixed signal intensity and a surrounding hemosiderin rim on magnetic resonance imaging. They may occur as multiple lesions in the autosomal-dominant familial form. In rare cases, cavernomas may form cystic masses, mimicking other pathologies. CASE DESCRIPTION: A 35-year-old man presented with recurrent seizures, aphasia, and gait disturbance with onset at age 14 years. He had previously undergone surgical drainage of multiple cysts across the brain with suspected parasitic infection. On magnetic resonance imaging, 22 cystic lesions were seen across the brain. A large cyst was located in the midline cerebellum, compressing the fourth ventricle. Occipital craniotomy and transvermian dissection allowed total resection of the cyst along with its wall. The postoperative course was uneventful and symptoms progressively improved. Histological analysis revealed cavernoma. Three more surgeries were performed for removal of large supratentorial cavernomas. CONCLUSIONS: In patients with cystic lesions of the brain, the neurosurgeon should consider the possibility of cavernoma. Total excision along with the cyst wall is crucial for timely diagnosis and therapy.


Assuntos
Neoplasias Encefálicas/patologia , Hemangioma Cavernoso do Sistema Nervoso Central/patologia , Neoplasias Primárias Múltiplas/patologia , Adulto , Neoplasias Encefálicas/cirurgia , Cistos/patologia , Cistos/cirurgia , Hemangioma Cavernoso do Sistema Nervoso Central/cirurgia , Humanos , Masculino , Neoplasias Primárias Múltiplas/cirurgia
20.
Hinyokika Kiyo ; 66(3): 77-80, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32316702

RESUMO

A 66-year-old man was referred to our hospital because of positive fecal occult blood test. Gastric and rectal cancers were diagnosed by upper and lower endoscopic biopsy, respectively. Enhanced computed tomography (CT) indicated a pulmonary tumor and a left adrenal mass with a diameter of 15 mm presenting heterogenous enhancement. The pulmonary tumor was diagnosed as adenocarcinoma by bronchoscopic biopsy. F18 fluoro-2-deoxy D-glucose (FDG) PET/CT showed abnormal FDG accumulation (maximum standardized uptake value=26. 1) in the left adrenal mass consistent with a metastatic adrenal tumor. Although radical surgical therapy was performed for the synchronous triple cancers of gastric, colon, and lung cancer, the patient refused adrenalectomy for the left adrenal tumor. One year after surgery, CT revealed an increase in the adrenal tumor diameter to 18 mm without development of new metastases. Laparoscopic adrenalectomy was performed for the left adrenal tumor which was strongly suspected of being a metastatic tumor. Pathological diagnosis was adrenal cortical adenoma. There has been no recurrence for 5 years after surgery for simultaneous triple cancer.


Assuntos
Adenoma , Neoplasias das Glândulas Suprarrenais , Adenoma Adrenocortical , Neoplasias Primárias Múltiplas , Idoso , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Recidiva Local de Neoplasia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X
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