scholarly journals A Case of Metastatic Melanoma in the Ureter

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
James Macneil ◽  
Tania Hossack
Keyword(s):  
Case Report ◽  
Metastatic Melanoma ◽  
Endoscopic Resection ◽  
Metastatic Disease ◽  
Disease Recurrence ◽  
Viable Alternative ◽  
Endoscopic Management ◽  
Left Ureter ◽  
Radical Approach

Advances in the treatment of melanoma are resulting in patients living for extended periods after being diagnosed with metastatic disease. Metastases to the ureter are rare, but they have been described in the literature on a number of occasions. In this case report, we describe a patient with established metastatic melanoma who, whilst taking and responding to immunomodulatory therapy, was found to have an obstructive mass in the middle of his left ureter. Rather than performing either a nephroureterectomy or partial resection of the ureter, we opted to perform an endoscopic resection of the melanoma. Follow-up imaging at 12 months shows no evidence of local disease recurrence. We submit that primary endoscopic management of metastatic melanoma in the ureter is a viable alternative to a radical approach.

Endoscopic Management of Frontal Sinus Osteomas Revisited

2009 ◽  
Vol 23 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Kristin Seiberling ◽  
Steve Floreani ◽  
Simon Robinson ◽  
Peter-John Wormald
Keyword(s):  
Endoscopic Resection ◽  
Frontal Sinus ◽  
Ct Scans ◽  
Endoscopic Management ◽  
Grading System ◽  
Tumor Removal ◽  
Successful Removal ◽  
Grade Iii

Background Recent articles have published guidelines regarding the role of endoscopic surgery in the removal of frontal sinus osteomas. These guidelines recommend the endoscopic approach for small osteomas but recommend an osteoplastic flap for larger tumors. This study presents a series of endoscopically resected tumors both large and small. Methods Retrospective chart reviews were performed. Charts were reviewed of all patients who underwent surgical resection of a frontal sinus osteoma from 1998 to 2008. Sinus CT scans were reviewed and each tumor was staged according to Kennedy's grading system proposed in 2005. Results Twenty-three patients, 8 with a grade IV tumor, 6 with a grade III tumor, and the remaining with a grade I or II tumor, underwent endoscopic resection of a frontal sinus osteoma. In 15 patients a modified Lothrop procedure was performed for tumor removal. In addition, a blepharoplasty incision was used in one patient for removal of a large orbital extension of the tumor and another underwent an enlarged frontal sinus trephine performed via a browline incision. In the remaining patients a frontal sinusotomy with minitrephination provided enough access for tumor removal. Over an average follow-up of 36 months no recurrences were noted. Symptoms improved in all but one patient. There were no postoperative complications. Conclusion Endoscopic resection of both large and small frontal sinus osteomas is feasible. In this article we have shown successful removal of large osteomas that fill the entire frontal sinus with the modified Lothrop procedure.

Challenges in the Management of Sphenoid Inverted Papilloma

2005 ◽  
Vol 19 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Samer Fakhri ◽  
Martin J. Citardi ◽  
Stephen Wolfe ◽  
Pete S. Batra ◽  
Richard A. Prayson ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Sphenoid Sinus ◽  
Inverted Papilloma ◽  
Endoscopic Management ◽  
Intraoperative Bleeding ◽  
Postoperative Surveillance ◽  
Skull Base Lesions ◽  
Tumor Extent ◽  
Sinonasal Symptoms

Background Inverted papilloma (IP) arising in the sphenoid sinus is extremely rare. Management of sphenoid sinus IP is especially challenging because of the paucity of sinonasal symptoms on presentation and the inherent surgical risks associated with the anatomic location of the sphenoid sinus. Methods We performed a retrospective review of medical records of all patients with IP arising within the sphenoid sinus. Results A total of five patients were identified. All patients were managed with endoscopic resection. The most common presenting symptom was headache (three patients). The mean follow-up period was 37.6 months (range, 10–79 months). Two patients with erosive skull base lesions adjacent to the internal carotid artery were managed with a staged endoscopic resection. Only one patient developed a recurrence after 38 months and underwent revision endoscopic resection. Conclusions Endoscopic management of sphenoid IP allows maximal resection with minimal morbidity and facilitates endoscopic postoperative surveillance. Complete preoperative radiological assessment of tumor extent is essential. Preoperative medical therapy can help normalize inflamed mucosa and minimize intraoperative bleeding. For large erosive IP, surgical risks may be minimized by considering a staged resection and using computer-aided surgery.

scholarly journals Spinal metastasis: diagnosis, management and follow-up

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190211 ◽  
Author(s):  
Mahmud Mossa-Basha ◽  
Peter C. Gerszten ◽  
Sten Myrehaug ◽  
Nina A. Mayr ◽  
William TC Yuh ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Metastatic Disease ◽  
Spinal Metastasis ◽  
Surgical Techniques ◽  
Spinal Column ◽  
Disease Recurrence ◽  
Current Treatment ◽  
Post Treatment ◽  
Pre Treatment

Spine metastatic disease is an increasingly common occurrence in cancer patients due to improved patient survival. Close proximity of the bony spinal column to the spinal cord limits many conventional treatments for metastatic disease. In the past decade, we have witnessed dramatic advancements in therapies, with improvements in surgical techniques and recent adoption of spine stereotactic radiotherapy techniques leading to improved patient outcomes. Multidisciplinary approaches to patient evaluation, treatment and follow-up are essential. Imaging plays an ever increasing role in disease detection, pre-treatment planning and assessment of patient outcomes. It is important for the radiologist to be familiar with imaging algorithms, best practices for surgery and/or radiotherapy and imaging findings in the post-treatment period that may indicate disease recurrence. In this review, we present a multidisciplinary discussion of spine metastases, with specific focus on pre-treatment imaging, planning, current treatment approaches, and post-treatment assessment.

scholarly journals Endoscopic full-thickness resection for T1 early rectal cancer: a case series and video report

2017 ◽  
Vol 05 (11) ◽  
pp. E1081-E1086 ◽  
Author(s):  
Paola Soriani ◽  
Gian Tontini ◽  
Helmut Neumann ◽  
Germana de Nucci ◽  
Domenico De Toma ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Endoscopic Resection ◽  
Surgical Approach ◽  
Case Series ◽  
Disease Recurrence ◽  
Colorectal Polyps ◽  
Early Rectal Cancer ◽  
Full Thickness ◽  
En Bloc

Abstract Background and study aims Endoscopic treatment of malignant colorectal polyps is often challenging, especially for early rectal cancer (ERC) localized close to the dentate line. Conversely, the surgical approach may result in temporary or definitive stoma and in frequent post-surgical complications. The Full-Thickness Resection Device (FTRD®) System (Ovesco Endoscopy, Tübingen, Germany) is a novel system that, besides having other indications, appears to be promising for wall-thickness excision of intestinal T1 carcinoma following incomplete endoscopic resection. However, follow-up data on patients treated with this device are scarce, particularly for ERC. Patients and methods Six consecutive patients with incomplete endoscopic resection of T1-ERC were treated with the FTRD and their long-term outcomes were evaluated based on a detailed clinical and instrumental assessment. Results The endoscopic en bloc full-thickness resection was technically feasible in all patients. The histopathologic analysis showed a complete endoscopic resection in all cases, and a full-thickness excision in four. Neither complications, nor disease recurrence were observed during the 1-year follow-up period. Conclusions The FTRD System is a promising tool for treating ERC featuring a residual risk of disease recurrence after incomplete endoscopic mucosal resection in patients unfit for surgery or refusing a surgical approach.

Long-term Survival of Metastatic Melanoma to the Ileum with Evidence of Primary Cutaneous Disease after 15 years of follow-up: A Case Report

2010 ◽  
Vol 96 (4) ◽  
pp. 640-643 ◽  
Author(s):  
Venerina Sciacca ◽  
A Alida Ciorra ◽  
Concetta Di Fonzo ◽  
Rosalinda Rossi ◽  
Giorgio Pistillucci ◽  
...  
Keyword(s):  
Case Report ◽  
Metastatic Melanoma ◽  
Term Survival ◽  
Long Term Survival ◽  
Cutaneous Disease

The use of CA15.3 in breast cancer: A single institution experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21017-21017
Author(s):  
R. Sheikh ◽  
A. T. Behbehani ◽  
M. Peader ◽  
J. McCaffrey
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Disease Recurrence ◽  
Prognostic Information ◽  
Chemotherapeutic Regimen ◽  
Transmembrane Glycoprotein ◽  
Asymptomatic Patients ◽  
Metastatic Setting ◽  
Group B

21017 Background: Breast cancer is a significant cause of morbidity and mortality worldwide. Recent advanced its treatment are promising. Gathering prognostic information may optimise treatment delivery. In addition to clinical parameters, the use of tumour markers may aid this process. CA 15.3, is a transmembrane glycoprotein.. Its clinical application varies from detecting disease recurrence in asymptomatic patients, assessing response in metastatic setting and monitoring the clinical course of the disease. Methods: A retrospective analysis was conducted evaluating medical record data of all the patients treated for breast cancer in our institution between 1999- 2005. CA15.3 was carried out using Roche 2010 (Elecsys system). Results: A total of 176 patients were identified. Table (1) Group A, one hundred patients remained disease free at follows up (58%). 95 patients had their CA15.3 within normal range, a diagnostic specificity of 95%. Group B, 61 patients developed metastatic/recurrent disease at follow up. 39 patients (64%) developed metastatic disease later. Group C, 15 patients had metastatic disease at diagnosis. We found that CA15.3 has a sensitivity value of 64% and a specificity of 95% in our institution.. This correlates well with ASCO review 67% and 92% respectively. In patients with no evidence of metastatic disease at diagnosis, a postive CA15.3 during follow up is strongly suggestive of disease recurrence. Giving a positive predictive value of 89%. In Two patients (5%) CA15.3 was the first predictor of recurrence. Radiology was the first indicator of recurrence in six cases (15%), while both radiological and serological correlation was noted in 31 patients (80%). Conclusions: We found CA15.3 a reliable marker in assessing response for therapy. In clinical practice, raised CA15.3 can be incorporated in decision making to change current chemotherapeutic regimen whenever there is a delay in obtaining prompt radiological evaluation. [Table: see text] No significant financial relationships to disclose.

Metastatic Melanoma in Sentinel Node–Negative Patients: The Ottawa Experience

2017 ◽  
Vol 22 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Chloe E. Ward ◽  
Jennifer L. MacIsaac ◽  
Caroline E. Heughan ◽  
Louis Weatherhead
Keyword(s):  
Lymph Node ◽  
Metastatic Melanoma ◽  
Metastatic Disease ◽  
Primary Melanoma ◽  
Disease Free Survival ◽  
Anatomical Location ◽  
Node Negative ◽  
Long Term Follow Up

Background: Lymph node involvement is a major independent prognostic factor for survival in patients with malignant melanoma. Sentinel lymph node biopsy (SLNB) detection of microscopic nodal melanoma has been shown to improve both 5-year survival and 5-year disease-free survival. Objective: To determine the rate of metastatic melanoma in SLNB-negative patients at long-term follow-up. Methods: Study subjects include all 152 patients who had a negative SLNB and were followed at the Ottawa Regional Cancer Centre (ORCC) between 1999 and 2004. Patients with a follow-up period less than 6 months, more than 1 primary melanoma, and metastatic melanoma at diagnosis were excluded. Age at diagnosis, sex, Breslow thickness, ulceration, mitoses, regression, Clark level, anatomical location, development of metastatic melanoma, time to detection of metastatic disease, and time to death from melanoma were studied. Results: In this retrospective study at the ORCC, 40 of 140 (28.6%) patients with a single primary melanoma developed metastatic melanoma following negative SLNB at a mean follow-up of 63 months. Conclusion: The rate of metastatic melanoma following negative SLNB at long-term follow-up at the ORCC is higher than the upper limit of rates reported in the literature (6%-24%). The reason for this is multifactorial, and the long follow-up period of 5 years allowed for detection of metastatic disease at a mean of 3.9 years. Long-term prognosis may be guarded in node-negative patients with a primary cutaneous melanoma, and surveillance by a multidisciplinary team is crucial.

scholarly journals Dissection-enabled scaffold-assisted resection (DeSCAR): a novel technique for resection of residual or non-lifting gastrointestinal neoplasia of the colon, expanded experience and follow-up

2020 ◽  
Vol 08 (06) ◽  
pp. E724-E732
Author(s):  
Edward Villa ◽  
Matthew Stier ◽  
Kianoush Donboli ◽  
Christopher Grant Chapman ◽  
Uzma D. Siddiqui ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Lesion Size ◽  
Endoscopic Management ◽  
Original Cohort ◽  
Delayed Bleeding ◽  
Technical Success Rate ◽  
Average Patient ◽  
Bleeding Episodes ◽  
Small Perforation

Abstract Background and study aims Colonic lesions may not be amenable to conventional endoscopic mucosal resection (EMR) due to previous manipulation, submucosal invasion, or lesion flatness. In 2018, we described Dissection-enabled Scaffold Assisted Resection (DeSCAR) to be safe for the endoscopic resection of non-lifting or residual colonic lesions 1 In this study, we expand our original cohort to describe our expanded experience with patients undergoing DeSCAR and assess the efficacy, safety, and feasibility of DeSCAR for endoscopic resection of non-lifting or residual colonic lesions. Patients and methods We retrospectively reviewed 57 patients from 2015–2019 who underwent DeSCAR for colonic lesions with incomplete lifting and/or previous manipulation. Cases were reviewed for location, prior manipulation, rates of successful resection, adverse events, and endoscopic follow up to assess for residual lesions. Results Fifty-seven lesions underwent DeSCAR. Of the patients, 51 % were female, and average patient age was 69 years. Lesions were located in the cecum (n = 16), right colon (n = 27), left colon (n = 10), and rectum (n = 4). Average lesion size was 27.7 mm. Previous manipulation occurred in 54 cases (72 % biopsy, 44 % resection attempt, 18 % intralesional tattoo). The technical success rate for resection of non-lifting lesions was 98 %. There were two delayed bleeding episodes (one required endoscopic intervention) and one small perforation (managed by endoscopic hemoclip closure). Endoscopic follow up was available in 31 patients (54 %) with no residual adenoma in 28 patients (90 % of those surveilled). Conclusions Our expanded experience with DeSCAR demonstrates high safety, feasibility, and effectiveness for the endoscopic management of non-lifting or residual colonic lesions.

Complete spontaneous regression of a metastatic melanoma of the mandible – A case report and Follow up Recommendations

2017 ◽  
Vol 55 (10) ◽  
pp. e106
Author(s):  
Juergen Schlabe ◽  
Ketan Shah ◽  
Fintan Sheerin ◽  
Miranda Payne ◽  
Adekunmi Fasanmade
Keyword(s):  
Case Report ◽  
Metastatic Melanoma ◽  
Spontaneous Regression
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