scholarly journals Palliative Radiotherapy Provided Good Pain Relief for Painful Adrenal Metastasis

2021 ◽  
pp. 1266-1270
Author(s):  
Masashi Endo ◽  
Yukiko Fukuda ◽  
Kazunari Ogawa ◽  
Satoru Takahashi ◽  
Michiko Nakamura ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Abdominal Pain ◽  
Pain Relief ◽  
Adverse Effects ◽  
Adrenal Tumor ◽  
Palliative Radiotherapy ◽  
Adrenal Metastasis ◽  
Adrenal Metastases ◽  
Good Pain Relief ◽  
Strong Opioids

Adrenal metastases often occur in patients with metastasized lung cancer, but symptoms rarely develop. A 45-year-old man presented with right abdominal pain requiring strong opioids due to large right adrenal metastasis of lung adenocarcinoma. The tumor was 7.3 × 5.6 × 8.4 cm in size. He was treated with palliative radiotherapy (RT) up to 39 Gy in 13 fractions for this lesion without severe adverse effects. After RT, he had good pain relief, and opioids were no longer needed. Palliative RT for a large adrenal tumor can provide a good analgesic effect without relevant toxicity.

scholarly journals Adrenal metastases: clinical manifestations and surgical outcomes

2018 ◽  
Vol 14 (2) ◽  
pp. 79-87 ◽  
Author(s):  
V. R. Latypov ◽  
O. S. Popov ◽  
V. N. Latypova ◽  
M. Yu. Grishchenko
Keyword(s):  
Lung Cancer ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Size ◽  
Renal Cell ◽  
Clinical Manifestations ◽  
Adrenal Metastasis ◽  
Adrenal Metastases ◽  
The Mean ◽  
Mean Time

Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.

Pain management

2020 ◽  
pp. 629-633
Author(s):  
Marie Fallon
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Daily Functioning ◽  
Opioid Analgesia ◽  
Patients With Cancer ◽  
Good Pain Relief

Pain occurs in more than 50% of patients with advanced disease, interferes with daily functioning and quality of life, and is very often undertreated. Patients can find it difficult to articulate the character of their pains, but it is important to determine whether it is somatic, neuropathic, or visceral since this has important implications for management. For most patients with cancer pain, a three-step approach combining simple or opioid analgesia (depending on severity) along with an adjuvant analgesic (depending on cause) will result in good pain relief, but the challenge is to achieve good pain relief without unacceptable adverse effects.

scholarly journals Palliative Radiotherapy Versus Esophageal Stent Placement in the Management of Patients With Metastatic Esophageal Cancer

2020 ◽  
Vol 18 (5) ◽  
pp. 569-574 ◽  
Author(s):  
Emily J. Martin ◽  
Andrew R. Bruggeman ◽  
Vinit V. Nalawade ◽  
Reith R. Sarkar ◽  
Edmund M. Qiao ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Esophageal Cancer ◽  
Pain Relief ◽  
Adverse Effects ◽  
Multivariable Analysis ◽  
Palliative Radiotherapy ◽  
Fistula Formation ◽  
Severe Adverse Effect ◽  
Esophageal Stenting ◽  
Over Time

Background: Patients with advanced esophageal cancer often experience pain and dysphagia, yet the optimal palliative management remains unclear. This retrospective study evaluated outcomes and adverse effects of palliative radiotherapy (RT) compared with esophageal stenting among a cohort of U.S. veterans with metastatic esophageal cancer. Patients and Methods: We identified 1,957 veterans in the United States with metastatic esophageal cancer who received palliative RT to the esophagus or esophageal stenting, and assessed the risks of severe adverse effects, including esophageal fistula formation, perforation, obstruction, hemorrhage, and esophagitis. We determined palliative efficacy by evaluating pain and dysphagia scores before and after intervention. Multivariable analyses were used to control for potential confounding factors. Results: In our cohort, 1,593 patients underwent RT and 364 underwent esophageal stenting. The cumulative incidence of any severe adverse effect at 6 months was higher among patients who received stents compared with those who received RT (21.7% vs 12.4%; P<.0010). In multivariable analysis, patients who received stents had an increased risk of any severe adverse effect, including fistula, perforation, and hemorrhage (all P<.0500). Multivariable analysis also showed that, compared with stenting, RT was associated with more rapid and durable pain relief (P<.0010) with no difference in relief of dysphagia over time when accounting for pretreatment dysphagia scores (P=.1029). Conclusions: Compared with esophageal stenting, RT was associated with a decreased risk of adverse effects, greater pain relief, and equivalent relief of moderate to severe dysphagia over time. Unmeasured patient- or tumor-related factors could have influenced the choice of intervention, thereby impacting our study outcomes. To our knowledge, this is the largest study to date analyzing the comparative risks and benefits of palliative RT and esophageal stenting among patients with metastatic esophageal cancer.

Computed Tomography of Adrenal Metastases in Hepatocellular Carcinoma

1989 ◽  
Vol 30 (5) ◽  
pp. 550-552 ◽  
Author(s):  
K. Nakamura ◽  
Y. Sato ◽  
H. Nakata
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Tumor Necrosis ◽  
Adrenal Tumor ◽  
Central Area ◽  
Adrenal Metastasis ◽  
Low Density ◽  
Solid Mass ◽  
Common Site ◽  
Adrenal Metastases

Four patients with adrenal metastases from hepatocellular carcinoma (HCC) diagnosed with computed tomography are described. In three, the metastases showed a central area of low density due to tumor necrosis, irregular contrast enhancement, and a well-defined margin. They measured 8 cm or more in diameter. In one, the adrenal metastasis was at first a relatively small homogeneously solid mass, but later, when it grew larger, a central low density developed. Since the adrenal gland is the second most common site of metastasis from HCC at autopsy, a combination of an adrenal tumor and a liver tumor should suggest this possibility.

scholarly journals Acute Abdominal Pain after Intercourse: Adrenal Hemorrhage as the First Sign of Metastatic Lung Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Jeremy Wang ◽  
Clifford D. Packer
Keyword(s):  
Lung Cancer ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdominal Pain ◽  
Arterial Embolization ◽  
Adrenal Hemorrhage ◽  
Abdominal Pressure ◽  
Metastatic Lung Cancer ◽  
Adrenal Metastases ◽  
Metastatic Lung

Although the adrenal glands are a common site of cancer metastases, they are often asymptomatic and discovered incidentally on CT scan or autopsy. Spontaneous adrenal hemorrhage associated with metastatic lung cancer is an exceedingly rare phenomenon, and diagnosis can be difficult due to its nonspecific symptoms and ability to mimic other intra-abdominal pathologies. We report a case of a 65-year-old man with a history of right upper lobectomy seven months earlier for stage IB non-small cell lung cancer who presented with acute abdominal pain after intercourse. CT scan revealed a new right adrenal mass with surrounding hemorrhage, and subsequent FDG-PET scan confirmed new metabolic adrenal metastases. The patient’s presentation of abdominal pain and adrenal hemorrhage immediately after sexual intercourse suggests that exertion, straining, or increased intra-abdominal pressure might be risk factors for precipitation of hemorrhage in patients with adrenal metastases. Management includes pain control and supportive treatment in mild cases, with arterial embolization or adrenalectomy being reserved for cases of severe hemorrhage.

scholarly journals Severe Hyperkalemia and Bilateral Adrenal Metastasis

2009 ◽  
Vol 2009 ◽  
pp. 1-2 ◽  
Author(s):  
Michael Nagler ◽  
Beat Müller ◽  
Verena Briner ◽  
Ralph Winterhalder
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Clinical Symptoms ◽  
Adrenal Metastasis ◽  
Common Finding ◽  
Metastatic Lung Cancer ◽  
Adrenal Metastases ◽  
Metastatic Lung ◽  
Severe Hyperkalemia

Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.

Clinical Characteristics, Molecular Phenotyping, and Management of Isolated Adrenal Metastases From Lung Cancer

2019 ◽  
Vol 20 (6) ◽  
pp. 405-411 ◽  
Author(s):  
Antonio Mazzella ◽  
Mauro Loi ◽  
Audrey Mansuet-Lupo ◽  
Antonio Bobbio ◽  
Helene Blons ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Characteristics ◽  
Adrenal Metastases ◽  
Molecular Phenotyping

scholarly journals Prolonged SARS-CoV-2-RNA Detection from Nasopharyngeal Swabs in an Oncologic Patient: What Impact on Cancer Treatment?

2021 ◽  
Vol 28 (1) ◽  
pp. 847-852
Author(s):  
Anna Ferrari ◽  
Marco Trevenzoli ◽  
Lolita Sasset ◽  
Elisabetta Di Liso ◽  
Toni Tavian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Clinical Symptoms ◽  
Palliative Radiotherapy ◽  
Rt Pcr ◽  
Cancer Treatments ◽  
Global Challenge ◽  
Viral Culture ◽  
Pcr Assays

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient’s infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1258-1262 ◽  
Author(s):  
Allan H. Friedman ◽  
Blaine S. Nashold ◽  
Janice Ovelmen-Levitt
Keyword(s):  
Pain Relief ◽  
Dorsal Root ◽  
Post Herpetic Neuralgia ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Adequate Pain Relief ◽  
Good Pain Relief ◽  
Transcutaneous Nerve Stimulation

✓ Post-herpetic pain was treated in 12 patients using dorsal root entry zone (DREZ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

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