How I do it: Percutaneous stabilization of symptomatic sacral and periacetabular metastatic lesions with photodynamic nails

Author(s):  
Mitchell S. Fourman ◽  
Duncan C. Ramsey ◽  
Erik T. Newman ◽  
Kevin A. Raskin ◽  
Daniel G. Tobert ◽  
...  
2017 ◽  
pp. 8-17
Author(s):  
A. A. Ermakova ◽  
O. Yu. Borodin ◽  
M. Yu. Sannikov ◽  
S. D. Koval ◽  
V. Yu. Usov

Purpose: to investigate the diagnostic opportunities of contrast  magnetic resonance imaging with the effect of magnetization transfer effect in the diagnosis of focal metastatic lesions in the brain.Materials and methods.Images of contrast MRI of the brain of 16  patients (mean age 49 ± 18.5 years) were analysed. Diagnosis of  the direction is focal brain lesion. All MRI studies were carried out  using the Toshiba Titan Octave with magnetic field of 1.5 T. The  contrast agent is “Magnevist” at concentration of 0.2 ml/kg was  used. After contrasting process two T1-weighted studies were  performed: without T1-SE magnetization transfer with parameters of pulse: TR = 540 ms, TE = 12 ms, DFOV = 24 sm, MX = 320 × 224  and with magnetization transfer – T1-SE-MTC with parameters of pulse: ΔF = −210 Hz, FA(МТС) = 600°, TR = 700 ms, TE = 10 ms,  DFOV = 23.9 sm, MX = 320 x 224. For each detected metastatic  lesion, a contrast-to-brain ratio (CBR) was calculated. Comparative  analysis of CBR values was carried out using a non-parametric  Wilcoxon test at a significance level p < 0.05. To evaluate the  sensitivity and specificity of the techniques in the detection of  metastatic foci (T1-SE and T1-SE-MTC), ROC analysis was used. The sample is divided into groups: 1 group is foci ≤5 mm in size, 2  group is foci from 6 to 10 mm, and 3 group is foci >10 mm. Results.Comparative analysis of CBR using non-parametric Wilcoxon test showed that the values of the CBR on T1-weighted  images with magnetization transfer are significantly higher (p  <0.001) that on T1-weighted images without magnetization transfer. According to the results of the ROC analysis, sensitivity in detecting  metastases (n = 90) in the brain on T1-SE-MTC and T1-SE was  91.7% and 81.6%, specificity was 100% and 97.6%, respectively.  The accuracy of the T1-SE-MTC is 10% higher in comparison with  the technique without magnetization transfer. Significant differences (p < 0.01) between the size of the foci detected in post-contrast T1- weighted images with magnetization transfer and in post-contrast  T1-weighted images without magnetization transfer, in particular for  foci ≤5 mm in size, were found. Conclusions1. Comparative analysis of CBR showed significant (p < 0.001)  increase of contrast between metastatic lesion and white matter on  T1-SE-MTC in comparison with T1-SE.2. The sensitivity, specificity and accuracy of the magnetization transfer program (T1-SE-MTC) in detecting foci of  metastatic lesions in the brain is significantly higher (p < 0.01), relative to T1-SE.3. The T1-SE-MTC program allows detecting more foci in comparison with T1-SE, in particular foci of ≤5 mm (96% and 86%, respectively, with p < 0.05).


2019 ◽  
Vol 22 (6) ◽  
pp. 13-22
Author(s):  
E. V. Kryaneva ◽  
N. A. Rubtsova ◽  
A. V. Levshakova ◽  
A. I. Khalimon ◽  
A. V. Leontyev ◽  
...  

This article presents a clinical case demonsratinga high metastatic potential of clear cell renal cell carcinoma combined with atypical metastases to breast and paranasal sinuses. The prevalence of metastatic lesions to the breast and paranasal sinuses in various malignant tumors depending on their morphological forms is analyzed. The authors present an analysis of data published for the last 30 years. The optimal diagnostic algorithms to detect the progression of renal cell carcinoma and to evaluate the effectiveness of the treatment are considered.


2018 ◽  
Vol 64 (2) ◽  
pp. 253-255
Author(s):  
Oleg Kit ◽  
Yevgeniy Kolesnikov ◽  
Roman Myagkov ◽  
Leonid Kharin ◽  
Yevgeniya Nepomnyashchaya

Most of melanomas of the gallbladder are metastatic lesions of cutaneous melanoma. Primary melanomas of the gallbladder are described as single, polypoid, intraluminal masses emanating from the mucous membrane. The most important characteristic is the absence of melanoma damage to the skin. If it is not possible to localize primary melanoma a multidisciplinary approach to diagnostic search comes to the fore. Predicting for primary melanoma of the gallbladder is a difficult task due to the small number of cases and the absence of long-term follow-up for this category of patients.


2019 ◽  
Vol 65 (6) ◽  
pp. 868-876
Author(s):  
Anton Yarikov ◽  
Anton Yermolaev ◽  
Igor Smirnov ◽  
Anton Denisov ◽  
Olga Perlmutter ◽  
...  

Epidemiological studies show an increase in the number of people with cancer. Bone metastases are a frequent manifestation of generalized cancer, because it is in malignant tumors of the spine more often than other bones of the skeleton becomes a target for metastasis. The article describes in detail the methods of diagnosis of spinal lesions in cancer pathology. Particular attention is paid to the scales reflecting the severity of the patient’s condition, the degree of spinal cord damage, the severity of pain in metastasis to the spine, the prognosis of survival in oncovertebrology and evaluation of the stability of the spine in metastatic lesions. Further, the paper presents non-radical (decompression, vertebroplasty) and radical (spondylectomy, corporectomy) surgical methods of treatment


1970 ◽  
Vol 6 (1) ◽  
pp. 25-42
Author(s):  
Rogério Mariotto Bitetti da Silva ◽  
Rosyane Rena de Freitas ◽  
Thiago Santos Rocha

RESUMOObjetivo: Avaliar o perfil dos pacientes com neoplasia maligna de estômago, que receberam atendimento e tratamento no Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Métodos: Estudo retrospectivo a partir do levantamento de prontuários. Análises foram feitas com uma amostragem e proporções esperadas desiguais e Quadros de contingência. Para se verificar associação entre as variáveis, utilizado o teste Qui–Quadrado de Pearson, considerando-se p ≤ 0,05, em um grau de confiabilidade de 95%. Resultados: O sexo masculino é o com maior número de casos na proporção de 2:1. A idade média ao diagnóstico é 65,16 anos. A queixa mais comum apresentada por estes pacientes foi a epigastralgia seguido pela inapetência. A maioria dos tumores encontrava-se no antro gástrico. Cinquenta e nove destes pacientes foram submetidos a cirurgia sendo 45 com intuito curativo. A sobrevida média foi de 15 meses e a taxa de sobrevida em 5 anos de apenas 6%.  Conclusão: O CG é uma doença muito agressiva e de prognóstico ruim. Suas manifestações iniciais são inespecíficas, o que torna seu diagnóstico em fases iniciais muito difícil.Palavras chave: Câncer Gástrico, Úlcera gástrica, Perfil de SaúdeABSTRACTObjective: Evaluate the profile of patients with malignant neoplasia of stomach, receiving care and treatment in Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Methods: Retrospective study based on a survey of medical records. Analysis were made with a sampling and unequal expected ratios and contingency tables. To assess the association between variables, will be used the chi-square test, considering p ≤ 0.05, at a reliability level of 95%. Results: The largest number of cases are male, ratio of 2:1. The average age at diagnosis is 65.16 years. Caucasians followed by mulatto were the most frequent with Gastric Cancer. The most common complaint presented by these patients was abdominal pain followed by loss of appetite. Most tumors found in the gastric antrum. Fifty-nine of these patients underwent surgery with curative intent in 45. Twenty of them had some type of metastasis intraoperatively and 12 outpatients progressed to metastatic lesions. The median survival was 15 months and the survivor rate in 5 years was only 6%. Conclusion: The Gastric Cancer is a very aggressive and poor prognosis disease. Its initial symptoms are nonspecific, making diagnosis difficult in the early stages.Keywords: Gastric Cancer, Gastric Ulcer, Health Profile.


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