Metastatic anorectal malignant melanoma causing ileocaecal junction obstruction due to contiguous spread

2021 ◽  
Vol 14 (4) ◽  
pp. e240621
Author(s):  
Swanit Hemant Deshpande ◽  
Vishal Narkhede ◽  
Sai Krishna Eswaravaka ◽  
Jayashri Sanjay Pandya
Keyword(s):  
Malignant Melanoma ◽  
Early Diagnosis ◽  
Anal Canal ◽  
Loop Ileostomy ◽  
Multiple Metastases ◽  
Diverting Loop Ileostomy ◽  
Ileocaecal Junction ◽  
Contiguous Spread ◽  
Significant Mortality

Malignant melanoma of the anal canal is a rare and aggressive tumour associated with significant mortality. Early diagnosis and early curative surgical resection have shown to offer a survival advantage. We present a case of 53-year-old woman, who was accidentally diagnosed to have a localised lesion of malignant melanoma of the anal canal on histopathology report of the specimen of haemorrhoidectomy done for thrombosed external haemorrhoids. She refused any form of treatment and did not return for follow-up. Two years after the initial diagnosis, she presented with intestinal obstruction. The malignant melanoma had become advanced with multiple metastases to the lungs, the liver, the peritoneum and the spine. The patient underwent a diverting loop ileostomy. At the time of surgery, it was found that the primary malignant melanoma of anal canal had contiguously involved the entire large intestine up to the ileocaecal junction and hence transverse colostomy could not be done.

scholarly journals Recurrence of uveal malignant melanoma: a case report

2013 ◽  
Vol 5 (2) ◽  
pp. 275-278
Author(s):  
Madhu Thapa ◽  
GB Shrestha ◽  
AK Sharma ◽  
S Karki ◽  
S Khanal
Keyword(s):  
Case Report ◽  
Adjuvant Chemotherapy ◽  
Malignant Melanoma ◽  
Early Diagnosis ◽  
Uveal Melanoma ◽  
Unusual Case ◽  
Uveal Tract ◽  
Uveal Malignant Melanoma ◽  
Ocular Morbidity

Background: Malignant melanoma of uveal tract is a rare ocular malignancy. It is one of the significant causes of ocular morbidity and mortality which is less commonly seen in children. Case: We report an unusual case of orbital recurrence of malignant melanoma in a 14-yearold boy who had previously undergone enucleation of the left painful blind eye 8 months ago. He was diagnosed to have uveal malignant melanoma elsewhere which was confirmed by histopathology. Orbital recurrence was managed with modified exenteration with adjuvant chemotherapy and radiotherapy. Conclusion: In all treated cases of uveal melanoma, close follow up examination and monitoring is necessary for early diagnosis of the recurrence and to plan for further management. Nepal J Ophthalmol 2013; 5(10): 275-278 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8744

scholarly journals P147 Systematic review: diverting loop ileostomy as treatment option in severe inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S211-S211
Author(s):  
M STEENHUIS ◽  
K van Son
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Improvement ◽  
Literature Search ◽  
Loop Ileostomy ◽  
Acute Setting ◽  
Stoma Reversal ◽  
Diverting Loop Ileostomy ◽  
Inflammatory Bowel ◽  
Severe Colitis

Abstract Background Severe colitis in the setting of inflammatory bowel disease (IBD), refractory to medical treatment, has traditionally been treated with an emergent colectomy, typically consisting of a two-step approach with a loop diversion in a setting of acute colitis, followed by a colectomy when inflammation has decreased as to minimise the risk of post-operative complications. More recently, several studies have questioned the need for secondary colectomy or have considered stoma reversal a viable option after diversion. We conducted a literature search primarily looking at the incidence of successful reversal or acute colectomy during follow-up. Secondary outcomes were post-surgical complications and clinical improvement after diversion. Methods We identified articles using a literature search using six medical databases. Articles were selected on the following criteria; severe colitis (either Crohn’s disease (CD) or ulcerative colitis (UC)), refractory to medical treatment, treated using a temporary loop ileostoma instead of an acute setting colectomy and scoring of clinical improvement parameters, such as decreased medication use and improvement of nutritional state. Results Seven studies, of which one was an extension and one was paediatric, were included. All were small studies with 13 to 33 participants, resulting in a total of 145 patients. A range of 16–60% underwent stoma reversal of the diversion based on mucosa and clinical remission with a follow-up rate varying from 4 to 33 months. In six studies, 15–29% of patients undergoing stoma reversal were symptom free during follow-up. Two studies showed partial remission in 55.2% and 69% of participants. Total colectomy in the diverted group, described in 5 studies, was seen in 9–53%. Complication rates ranged from 12–29%. Overall clinical improvement was seen in >80% % of diverted patients. Only 2 studies made subgroup analyses of CD and UC, which showed a better result in CD patients regarding clinical improvement (>90% improvement vs. >80% improvement in UC patients) and rates of successful diversion, which was seen in 3/14 (21%) CD patients and 3/19 (16%) UC patients. Conclusion Diverting loop ileostomy in severe IBD is an effective treatment to avoid acute setting colectomy, with improvement in clinical status in >80% of patients and a chance of 15–29% of successful stoma reversal without symptoms of IBD.

Postural Changes in Essential Hypertension under Treatment and their Effect on the Renogram

1971 ◽  
Vol 10 (01) ◽  
pp. 39-46
Author(s):  
C. Alexandrou ◽  
E. Papadakis ◽  
E. Gyftaki ◽  
J. Darsinos
Keyword(s):  
Renal Function ◽  
Essential Hypertension ◽  
Early Diagnosis ◽  
Postural Hypotension ◽  
Antihypertensive Treatment ◽  
Normal Subjects ◽  
Upright Position ◽  
Postural Changes ◽  
Significant Impairment

SummaryRadioisotope renograms were obtained in the upright and prone position in 9 normal subjects, in 5 patients with untreated essential hypertension and in 21 hypertensives under treatment, showing moderate postural hypotension.No significant renographic change were seen in the two positions in normal subjects and untreated hypertensives. Treated hypertensives with postural hypotension showed significant impairment of renal function in the upright position in 15 cases and no change in 6. Renal creatinine clearance was lower in the group that showed renographic changes. Renography in the upright position is suggested as a convenient test for early diagnosis and follow-up of the adverse effects of antihypertensive treatment.

Malignant Melanoma of Anal Canal – A Diagnostic Dilemma

2016 ◽  
Vol 2 (2) ◽  
Author(s):  
Bushra Siddiqui ◽  
Shahbaz Habib Faridi ◽  
Syed Shamshad Ahmad ◽  
Kafil Akhtar ◽  
Suhailur Rehman ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Anal Canal ◽  
Diagnostic Dilemma

scholarly journals A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ikuma Nozaki ◽  
Yumi Tone ◽  
Junko Yamanaka ◽  
Hideko Uryu ◽  
Yuko Shimizu-Motohashi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Malignant Transformation ◽  
Poor Prognosis ◽  
Mediastinal Mass ◽  
Bone Biopsy ◽  
Systematic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Malignant Teratoma ◽  
Experienced Pain

We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

scholarly journals Clinical complications in patients with primary and recurrent Clostridioides difficile infection: A real-world data analysis

2021 ◽  
Vol 9 ◽  
pp. 205031212098673
Author(s):  
Paul Feuerstadt ◽  
Mena Boules ◽  
Laura Stong ◽  
David N Dahdal ◽  
Naomi C Sacks ◽  
...  
Keyword(s):  
Loop Ileostomy ◽  
Charlson Comorbidity Index Score ◽  
Real World Data ◽  
Infection Group ◽  
Bowel Surgery ◽  
Clinical Complications ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Infection Episode

Objective: Clostridioides difficile infection and recurrent C. difficile infection result in substantial economic burden and healthcare resource use. Sepsis and bowel surgery are known to be serious complications of C. difficile infection. This study evaluated clinical complications in patients with C. difficile infection and recurrent C. difficile infection during a 12-month period following the primary C. difficile infection. Methods: A retrospective analysis of commercial claims data from the IQVIA PharMetrics Plus™ database was conducted for patients aged 18–64 years with an index C. difficile infection episode requiring inpatient stay or an outpatient visit for C. difficile infection followed by a C. difficile infection treatment. Each C. difficile infection episode ended after a 14-day C. difficile infection-claim-free period was observed. Recurrent C. difficile infection was defined as a further C. difficile infection episode within an 8-week window following the claim-free period. Clinical complications were documented over 12 months of follow-up and stratified by the number of recurrent C. difficile infection episodes (0 rCDI, 1 rCDI, 2 rCDI, and 3+ rCDI). Results: In total, 46,571 patients with index C. difficile infection episode were included. During the 6-month pre-index, the mean (standard deviation) baseline Charlson comorbidity index score, by increasing the recurrent C. difficile infection group, was 1.2 (1.9), 1.5 (2.2), 1.8 (2.3), and 2.3 (2.5). During the 12-month follow-up, sepsis occurred in 16.5%, 27.3%, 33.1%, and 43.3% of patients, and subtotal colectomy or diverting loop ileostomy was performed in 4.6%, 7.3%, 8.9%, and 10.5% of patients, respectively, by increasing the recurrent C. difficile infection group. Conclusions: Reduction in recurrent C. difficile infection is an important step to reduce the burden of serious clinical complications, and new treatments are needed to reduce C. difficile infection recurrence.

scholarly journals The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016667 ◽  
Author(s):  
Herng-Ching Lin ◽  
Sudha Xirasagar ◽  
Cha-Ze Lee ◽  
Chung-Chien Huang ◽  
Chao-Hung Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Reflux Disease ◽  
Treatment Guidelines ◽  
Population Based ◽  
Oesophageal Reflux ◽  
Study Patient ◽  
Oesophageal Reflux Disease ◽  
Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

A randomized trial of levamisole versus placebo as adjuvant therapy in malignant melanoma.

1991 ◽  
Vol 9 (5) ◽  
pp. 736-740 ◽  
Author(s):  
L E Spitler
Keyword(s):  
Malignant Melanoma ◽  
Adjuvant Therapy ◽  
Randomized Trial ◽  
Control Groups ◽  
Disease Free Interval ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
And Control

We conducted a long-term follow-up (median, 10.5 years) of patients included in a randomized trial of levamisole versus placebo as surgical adjuvant therapy in 203 patients with malignant melanoma. Of the patients randomized, 104 received levamisole, and 99 received placebo. The results show that there is no difference between the treatment and control groups with regard to any of the three end points analyzed. These included disease-free interval, time to appearance of visceral metastasis, and survival. Moreover, there was no significant difference between the treatment and control groups after adjusting for age, sex, or stage of disease.

Laryngeal cancer

2021 ◽  
pp. 175573802110105
Author(s):  
Kelvin Miu
Keyword(s):  
Head And Neck Cancer ◽  
Early Diagnosis ◽  
Head And Neck ◽  
Patient Outcomes ◽  
Laryngeal Cancer ◽  
Neck Cancer ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

Sign in / Sign up

Export Citation Format

Share Document