Early postoperative MRI after resection of brain metastases—complete tumour resection associated with prolonged survival

2019 ◽  
Vol 161 (3) ◽  
pp. 555-565 ◽  
Author(s):  
Ida Christine Olesrud ◽  
Mette Katrine Schulz ◽  
Ljubo Marcovic ◽  
Bjarne Winther Kristensen ◽  
Christian Bonde Pedersen ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Prolonged Survival ◽  
Tumour Resection ◽  
Postoperative Mri ◽  
Complete Tumour Resection ◽  
Complete Tumour

scholarly journals Intralesional and subarachnoid bleeding of a spinal schwannoma presenting with acute cauda equina syndrome

2019 ◽  
Vol 12 (7) ◽  
pp. e229251
Author(s):  
Mauro Dobran ◽  
Davide Nasi ◽  
Martina Della Costanza ◽  
Francesco Formica
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Tumour Resection ◽  
Subarachnoid Bleeding ◽  
Thoracic Spinal ◽  
Complete Tumour Resection ◽  
Complete Tumour ◽  
Full Neurological Recovery ◽  
A Minor ◽  
Spinal Cord Decompression

We present an unusual case of spinal neurinoma with intralesional and subarachnoid bleeding with acute cauda equina syndrome. A 38-year-old man was admitted to our department after a minor thoracic spinal trauma with right lower limb plegia and urinary retention. MRI showed a T11 intradural tumour with intralesional and subarachnoid haemorrhage. The patient was operated of spinal cord decompression and complete tumour resection. The histological examination documented a schwannoma with large haemorrhagic intratumoural areas. A full neurological recovery was documented at 6-month follow-up.

Giant cell sarcoma managed with forelimb amputation in a harbour seal (Phoca vitulina geronimensis)

2019 ◽  
Vol 7 (3) ◽  
pp. e000709
Author(s):  
Molly Martony ◽  
Judy St Leger ◽  
Claire Erlacher-Reid ◽  
Hendrik Nollens ◽  
Todd Schmitt
Keyword(s):  
Giant Cell ◽  
Needle Aspiration ◽  
Phoca Vitulina ◽  
Harbour Seal ◽  
Tumour Resection ◽  
Complete Excision ◽  
Cell Sarcoma ◽  
Complete Tumour Resection ◽  
Complete Tumour ◽  
The Right

A 22-year-old harbour seal (Phoca vitulina geronimensis) presented with a subcutaneous mass on the right dorsal carpus. The mass measured 5 cm by 2 cm and was firmly attached to the underlying tissues. Cytology from fine-needle aspiration was consistent with a soft tissue sarcoma. Surgical resection was attempted, however complete excision was prohibited by extensive local invasion. Histopathology results confirmed a moderately cellular, infiltrative, non-encapsulated giant cell sarcoma. Subsequent surgical amputation of the forelimb was performed successfully, with the animal making a full recovery. No radiographic evidence of reoccurrence was identified three years following the surgical procedure. This is the first described case of forelimb amputation in a pinniped. When complete tumour resection is unattainable, forelimb amputation may serve as an alternative or adjunct to medical management of neoplasia in phocids.

Pre-operative chemotherapy with epirubicin, cisplatin and 5FU/capecitabine in patients with operable oesophageal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14011-14011
Author(s):  
E. Boleti ◽  
D. Sharland ◽  
D. Weeden ◽  
I. Bailey ◽  
A. Bateman ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Oesophageal Carcinoma ◽  
Tumour Resection ◽  
Who Grade ◽  
Disease Response ◽  
Complete Tumour Resection ◽  
Complete Tumour ◽  
Grade 3 ◽  
Neo Adjuvant Chemotherapy ◽  
The Uk

14011 Background: The MRC OE02 study demonstrated pre-operative chemotherapy in patients with potentially operable oesophageal cancer improved survival. Pre-operative chemotherapy has been widely adopted in the UK. At our institution for the past 5 years patients with operable oesophageal cancer have routinely been given pre-operative chemotherapy with 3 cycles of Epirubicin, Cisplatin and Protracted Venous Infusion (PVI) 5FU (ECF). Recently, PVI 5FU has been replaced by Capecitabine (ECX). Methods: From March 2000 to October 2005, patients with operable oesophageal carcinoma have received 3 cycles of ECF or ECX (Epirubicin 50mg/m2, Cisplatin 60mg/m2, and PVI 5FU 200mg/m2 per day or Capecitabine 625mg/m2 po bd for 21 days). Disease response was assessed by CT scan and surgery was performed 4–6 weeks after completion of chemotherapy. Results: 59 patients received neo-adjuvant chemotherapy (48 received ECF, 11 ECX). Median age was 64. Fifty-three patients (89.8%) completed the planned 3 cycles of chemotherapy. WHO grade 3 or 4 toxicity occurred in 7 patients (11.8%): 6 haematological with 1 toxic death among them (1.7%) and 1 mucositis. Forty-four of 49 patients (89.7%) with dysphagia reported improvement of their symptoms as a result of chemotherapy. Fifty-two patients (88.1%) proceeded to surgery of which 47 (90.3%) underwent complete tumour resection, 4 patients (7.7%) were found to have inoperable/metastatic disease and 1 patient had incomplete excision (1.9%). Median follow-up was 26.8 months with overall median survival of 36.2 months and a 2-year survival of 63.2%. Thirty-four (57.6%) patients remain alive to date of which, 30 are disease-free and 4 are alive with recurrent disease. Conclusions: These encouraging results demonstrate that 3 cycles of preoperative ECF/ECX chemotherapy in patients with operable oesophageal cancer allow surgery to be safely performed in the vast majority of patients and our 2-year survival compare favourably with previously reported series. These results suggest that 3 cycles of pre-operative treatment with ECF/ECX chemotherapy may improve survival in this group of patients and is worthy of further research. No significant financial relationships to disclose.

scholarly journals Spinal Nerve Root Haemangioblastoma Associated with Reactive Polycythemia

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Eric K. C. Law ◽  
Ryan K. L. Lee ◽  
James F. Griffith ◽  
Deyond Y. W. Siu ◽  
Ho Keung Ng
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Resected Specimen ◽  
Tumour Resection ◽  
Spinal Nerve Root ◽  
Intramedullary Spinal Cord ◽  
Ct Guided ◽  
Complete Tumour Resection ◽  
Complete Tumour ◽  
Ct Guided Biopsy

Haemangioblastomas are uncommon tumours that usually occur in the cerebellum and, less commonly, in the intramedullary spinal cord. The extramedullary spinal canal is an uncommon location for these tumours. Also haemangioblastoma at this site is not known to be associated with polycythemia. We present the clinical, imaging, and histological findings of an adult patient with extramedullary spinal haemangioblastoma and reactive polycythemia. Radiography and computed tomography (CT) revealed a medium-sized tumour that most likely arose from an extramedullary spinal nerve root. This tumour appeared to be slow growing as evidenced by the accompanying well-defined bony resorption with a sclerotic rim and mild neural foraminal widening. Magnetic resonance imaging revealed prominent flow voids consistent with tumoural hypervascularity. CT-guided biopsy was performed. Although preoperative angiographic embolisation was technically successful, excessive intraoperative tumour bleeding necessitated tumour debulking rather than complete tumour resection. Histology of the resected specimen revealed haemangioblastoma. Seven months postoperatively, the patients back pain and polycythemia have resolved.

VEGF-A and i-NOS expression are prognostic factors in serous epithelial ovarian carcinomas after complete surgical resection

2009 ◽  
Vol 62 (5) ◽  
pp. 448-454 ◽  
Author(s):  
K Engels ◽  
A du Bois ◽  
P Harter ◽  
A Fisseler-Eckhoff ◽  
F Kommoss ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Tumour Resection ◽  
Residual Tumour ◽  
Serous Ovarian Cancer ◽  
Free Survival ◽  
Complete Tumour Resection ◽  
Complete Tumour

Aims:Clinical stage at the time of diagnosis and achievement of complete macroscopic resection during initial surgery are key factors determining the outcome of ovarian cancer. However, prediction of outcome lacks accuracy and more reliable prognostic factors are required. Therefore, an analysis and evaluation of key angiogenic factors was carried out to determine their diagnostic and prognostic value in serous ovarian cancer.Methods:Expression levels of vascular endothelial growth factor (VEGF)-A, hypoxia-inducible factor (HIF)1-α and inducible nitric oxide synthase (i-NOS) were analysed by immunohistochemistry in a homogenous group of 112 patients with serous adenocarcinoma of the ovary. Vascular density as an indicator of angiogenesis was assessed using the Chalkley eyepiece method after staining for CD34. The correlation of these data with survival and established prognostic factors such as histological grade, Federation of Gynecology and Obstetrics (FIGO) stage, and residual tumour after surgery, was evaluated. Survival analyses, multivariate analyses and correlation tests were performed.Results:In the patient group with macroscopic complete tumour resection (R0) there was a significant correlation between VEGF-A and i-NOS expression. Kaplan–Meier analysis further revealed improved progression-free survival for R0 patients with VEGF-A-positive and i-NOS-negative tumours. The predictive relevance of VEGF-A regarding progression-free survival was sustained in multivariate analysis using FIGO stage, grading and resection status as fixed variables.Conclusion:VEGF-A and i-NOS are prognostic markers for clinical outcome in serous ovarian cancer patients with macroscopic complete tumour resection (R0). Hence, pre-therapeutic assessment of VEGF-A as predictive factor for an antiangiogenic therapy might be of clinical value.

Intralaryngeal paraganglioma workup and discussion of surgical approach

2020 ◽  
Vol 13 (6) ◽  
pp. e234745
Author(s):  
Nicholas B Abt ◽  
Andrew J Holcomb ◽  
Stuti Shroff ◽  
Daniel G Deschler
Keyword(s):  
Decision Making ◽  
Head And Neck ◽  
Surgical Approaches ◽  
Tumour Resection ◽  
Transcervical Approach ◽  
Uncommon Presentation ◽  
Complete Tumour Resection ◽  
Bilateral Carotid ◽  
Complete Tumour ◽  
Head And Neck Paragangliomas

Laryngeal paragangliomas are an uncommon presentation of head and neck paragangliomas, with laryngeal paragangliomas along with a synchronous paraganglioma being exceptionally rare. We present two challenging cases of laryngeal paragangliomas with extralaryngeal extension, completely resected through a transcervical approach without endolaryngeal disruption, with one case having synchronous bilateral carotid body tumours. Both patients had excellent results with complete tumour resection and no resultant functional impact. The surgical approaches for large laryngeal paraganglioma are discussed with considerations for endolaryngeal, transcervical and combined approaches as well as decision-making when approaching these rare lesions in the setting of synchronous head and neck paragangliomas.

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