scholarly journals Epidural Brain Metastases in a Patient with Early Onset Pancreatic Cancer: A Case Report and Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Aibek E. Mirrakhimov ◽  
Farah N. Khan
Keyword(s):  
Pancreatic Cancer ◽  
Pulmonary Embolism ◽  
Case Report ◽  
Brain Metastases ◽  
Early Onset ◽  
Brain Mri ◽  
Malignant Ascites ◽  
Cranial Irradiation ◽  
History Of ◽  
New Onset

We present a case of early onset pancreatic cancer related extra-axial brain metastases. A 46-year-old Caucasian non-Jewish nonobese male with a history of PC diagnosed 3 months ago with metastases to the liver, omentum, malignant ascites, and a history of a pulmonary embolism was admitted to the hospital because of a new onset headache, nausea, and vomiting which started 2 days prior to the encounter. Brain MRI was ordered, which showed acute bihemispheric subdural hematomas and left hemispheric extra-axial heterogeneously enhancing lesions consisting with metastatic disease. The patient was started on ondansentron, metoclopramide, and dexamethasone. The cranial irradiation was started, and the patient’s headache and nausea significantly improved. There are only 9 published reports of extra-axial brain metastases related to the pancreatic cancer, whereas our paper is the first such case reported on a patient with epidural metastases and early onset pancreatic cancer.

Familial thrombophilia associated with fibrinogen Paris V: Dusart syndrome

Blood ◽  
2000 ◽  
Vol 96 (3) ◽  
pp. 1191-1193 ◽  
Author(s):  
Takashi Tarumi ◽  
Danko Martincic ◽  
Anne Thomas ◽  
Robert Janco ◽  
Mary Hudson ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Early Onset ◽  
Family Members ◽  
Initial Presentation ◽  
Pulmonary Emboli ◽  
Common Cause ◽  
History Of ◽  
Prophylactic Anticoagulation ◽  
Fibrin Clots

Abstract We report on a family with a history of venous thromboembolism associated with fibrinogen Paris V (fibrinogen A-Arg554→Cys). Ten members experienced thrombotic events, including 4 with fatal pulmonary emboli. Pulmonary embolism was the presenting feature in 4. Those with the mutation and a history of thrombosis had somewhat higher fibrinogen concentrations than those with the mutation and no thrombosis (294 ± 70 mg/dL vs 217 ± 37 mg/dL, respectively). The Paris V mutation consistently caused a prolongation of the reptilase time, and fibrin clots containing the abnormal fibrinogen were more translucent than normal clots. Given the early onset of symptoms and the initial presentation with pulmonary embolism in some family members, it was justifiable to offer prophylactic anticoagulation with warfarin to carriers of the mutation. Fibrinogen Paris V has now been reported in 4 apparently unrelated families, indicating that it is a relatively common cause of dysfibrinogenemia-associated thrombosis.

scholarly journals Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy

2020 ◽  
Vol 13 (3) ◽  
pp. 1239-1243
Author(s):  
Shenthol Sasankan ◽  
Lorraine Rebuck ◽  
Gloria Darrah ◽  
Moises Harari Turquie ◽  
Ian Rabinowitz
Keyword(s):  
Pancreatic Cancer ◽  
Case Report ◽  
Targeted Therapy ◽  
Therapeutic Response ◽  
Case Reports ◽  
Clinical History ◽  
P53 Mutation ◽  
Metastatic Pancreatic Cancer ◽  
First Case ◽  
History Of

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.

Familial thrombophilia associated with fibrinogen Paris V: Dusart syndrome

Blood ◽  
2000 ◽  
Vol 96 (3) ◽  
pp. 1191-1193
Author(s):  
Takashi Tarumi ◽  
Danko Martincic ◽  
Anne Thomas ◽  
Robert Janco ◽  
Mary Hudson ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Early Onset ◽  
Family Members ◽  
Initial Presentation ◽  
Pulmonary Emboli ◽  
Common Cause ◽  
History Of ◽  
Prophylactic Anticoagulation ◽  
Fibrin Clots

We report on a family with a history of venous thromboembolism associated with fibrinogen Paris V (fibrinogen A-Arg554→Cys). Ten members experienced thrombotic events, including 4 with fatal pulmonary emboli. Pulmonary embolism was the presenting feature in 4. Those with the mutation and a history of thrombosis had somewhat higher fibrinogen concentrations than those with the mutation and no thrombosis (294 ± 70 mg/dL vs 217 ± 37 mg/dL, respectively). The Paris V mutation consistently caused a prolongation of the reptilase time, and fibrin clots containing the abnormal fibrinogen were more translucent than normal clots. Given the early onset of symptoms and the initial presentation with pulmonary embolism in some family members, it was justifiable to offer prophylactic anticoagulation with warfarin to carriers of the mutation. Fibrinogen Paris V has now been reported in 4 apparently unrelated families, indicating that it is a relatively common cause of dysfibrinogenemia-associated thrombosis.

Metastatic Liposarcoma of the Brain with Response to Chemotherapy: Case Report

Neurosurgery ◽  
1988 ◽  
Vol 23 (6) ◽  
pp. 777-780 ◽  
Author(s):  
Harold Haft ◽  
George C. Wang
Keyword(s):  
Case Report ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Abdominal Mass ◽  
Response To Chemotherapy ◽  
History Of ◽  
In The Beginning ◽  
The Brain

Abstract Metastatic liposarcomas to the brain are rare. The authors describe a patient with a 20-year history of liposarcoma originating in the thigh and metastatic to the brain 18 years later. The brain metastasis was removed by surgery. Nine months later, the patient developed metastases to the retroperitoneum and liver. At that same time, she had recurrent brain metastasis. She was then treated with chemotherapy. The abdominal mass shrank considerably in the beginning, and the recurrent brain metastases totally disappeared. The patient eventually succumbed to widespread liposarcoma. Autopsy revealed extensive liposarcoma involving the retroperitoneum, liver, and lung, but no trace of tumor was found in the brain.

scholarly journals Thyrotoxic periodic paralysis in new-onset hyperthyroidism – a case report and review of the literature

2014 ◽  
Vol 12 (4) ◽  
pp. 531
Author(s):  
Joaquim Custódio da Silva Junior ◽  
Helton Estrela Ramos
Keyword(s):  
Case Report ◽  
Previous History ◽  
Rare Condition ◽  
Periodic Paralysis ◽  
Emergency Physicians ◽  
Review Of The Literature ◽  
Font Size ◽  
Thyrotoxic Periodic Paralysis ◽  
History Of ◽  
New Onset

<p class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;"><em><span style="font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ansi-language: EN-US;" lang="EN-US">Thyrotoxic periodic paralysis (TPP) is a rare condition related to hyperthyroidism, with specific clinical and physiopathological features. In this article, we discuss a case report of a patient that develops TPP with no previous history of thyroid illness, highlighting semiological characteristics that can help Emergency physicians to suspect of this condition. Subsequently, we review the recent articles about TPP, with focus in the molecular basis of ion channelopathies and predisposing factors, and discuss the therapeutic approach at acute phase of TPP and prevention of crisis recurrence.</span></em></p>

Prophylactic cranial irradiation (PCI) significantly decreases risk of brain metastases in patients with bulky, higher stage small-cell urothelial cancer.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 486-486 ◽  
Author(s):  
Seungtaek Choi ◽  
Matthew T Campbell ◽  
Amishi Yogesh Shah ◽  
Neema Navai ◽  
Ashish M. Kamat ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Urothelial Cancer ◽  
Systemic Disease ◽  
Brain Mri ◽  
Prospective Trial ◽  
Cranial Irradiation ◽  
Prophylactic Cranial Irradiation ◽  
Small Cell ◽  
Developing Brain

486 Background: Patients with bulky, higher-stage small cell urothelial cancer (≥T3b, N+, and/or M+) have a high risk of developing brain metastases. Siefker-Radtke et al reported a 50% risk of brain metastases in this patient population. Therefore, a prospective trial evaluating the potential benefit of PCI was undertaken. Methods: Thirty patients with stage ≥T3b, N+, and/or M+ disease (without brain metastases on MRI) were treated between 12/2008 and 5/2018 with PCI. Patients were treated to a total dose of 30 Gy in 2 Gy fractions over 3 weeks. The patient had baseline brain MRI and mini-mental status exam (MMSE) before the treatment began. After treatment, patients underwent MRI and MMSE every 3-4 months for one year and every 6 months thereafter. If the patients did not have M+ disease at diagnosis, they were also treated with neoadjuvant chemotherapy (usually consisting of cisplatin/etoposide alternating with Adriamycin/ifosfamide), followed by a radical cystectomy. The PCI was either given between the last cycle of chemotherapy and surgery or after the surgery. Both acute and chronic toxicity from PCI were measured using CTCAE 3.0. Change in the MMSE after PCI was evaluated using a t-test. Results: Twenty-nine patients were evaluable. Twenty-four patients had ≥T3b and/or N+ disease and 5 patients had M1 disease. Median follow-up was 22 months (range 8-103 months). Four patients have developed brain metastases with a median time of 11.5 months after PCI (range 3-23 months). Two of these patients have died. Nine other patients have died from progressive systemic disease, but they did not have evidence of brain metastases. PCI was well-tolerated, with no grade ≥2 toxicity seen. Acute grade 1 toxicity seen included headache, nausea, and dermatitis. MMSE were available for 19 patients with a median follow-up of 13 months (range 3-87 months). There was no significant change in the MMSE scores after the PCI when compared to baseline (p = 0.61). Conclusions: In this study, PCI decreased the risk of developing brain metastases in patients with bulky, higher-stage small cell urothelial cancer from 50% (historical) to 13.8% without significant toxicity. Clinical trial information: NCT00756639.

scholarly journals Metasztázis miatt végzett máj- és hasfalreszekció 11 évvel a pancreatoduodenectomia után

2017 ◽  
Vol 158 (28) ◽  
pp. 1109-1111
Author(s):  
Zsanett Biró ◽  
Róbert Papp ◽  
Levente Kucserik ◽  
Yousuf Al-Farhat ◽  
András Fincsúr ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Case Report ◽  
Liver Metastasis ◽  
Male Patient ◽  
Disease Recurrence ◽  
Redo Surgery ◽  
History Of ◽  
Solitary Liver ◽  
Solitary Liver Metastasis

Abstract: Pancreatic cancer has adverse prognosis. Disease recurrence is typical and it occurs mainly within the first 2 years postoperatively. However late and soliter metastases are rare. This case report shows the history of a male patient, who was radically operated on for pancreatic cancer. 11 years later a solitary liver metastasis has developed and it was completely removed by resection. 1 year postoperatively the patient is doing well. Our case demonstrates that in patients after resection for pancreatic cancer, redo surgery might be justified in case of late and isolated metastasis. Orv Hetil. 2017; 158(28): 1109–1111.

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