scholarly journals Selection of treatment for hepatic epithelioid hemangioendothelioma: a single-center experience

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Linping Cao ◽  
Jiawei Hong ◽  
Lingfeng Zhou ◽  
Yufu Ye ◽  
Yuanxing Liu ◽  
...  
Keyword(s):  
Treatment Options ◽  
Needle Aspiration ◽  
Epithelioid Hemangioendothelioma ◽  
Multiple Strategies ◽  
Single Center Experience ◽  
Appropriate Treatment ◽  
Significant Disease ◽  
Selection Of ◽  
Observation Period

Abstract Background Hepatic epithelioid hemangioendothelioma (HEHE) is a rare angiogenic tumor with no recognized effective treatment. Treatment options used worldwide include liver transplantation (LT), liver resection (LR), radiofrequency ablation (RFA), chemotherapy, and observation. The aim of this study was to describe the efficacy of different treatment options used for HEHE at our center. Methods The medical charts of 12 patients with HEHE (9 women and 3 men) who were diagnosed and treated at the First Affiliated Hospital of Zhejiang University, China, between January 2011 and December 2017 were retrospectively reviewed. Results The patients were diagnosed by postoperative histopathology or fine needle aspiration biopsy. Two patients with diffuse lesions received LT and were alive without recurrence at the last follow-up. Three patients received LR as the initial treatment, and all of them developed recurrence during the follow-up period. One patient received RFA and remained free of disease, while the remaining six patients opted for simple observation rather than treatment. One of the patients who received LR passed away because of tumor recurrence within 32 months after surgery; the other patients showed no significant disease activity after treatments for their recurrent lesions. As of April 2018, the mean follow-up duration was 39.6 ± 20.1 months (15–82 months). Conclusions There are multiple strategies for HEHE. Considering its indolent course, initial observation for assessment of the lesion behavior may aid in the selection of appropriate treatment. Surgery or LT is suitable for patients with disease progression during the observation period. However, our sample size was small, and further studies are required to gather more information that can aid in optimal treatment selection.

scholarly journals Open surgery retrieval of a missing guidewire causing cerebral infarctions after cerebral angiography: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Cerebral Angiography ◽  
Open Surgery ◽  
Foreign Bodies ◽  
Treatment Options ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Long Time ◽  
Multiple Cerebral Infarctions ◽  
Selection Of

Abstract Background Intra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guidewire fragments, intravascular clipping of the guidewire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions. Case presentation A 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful. Conclusion It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

scholarly journals Open Surgery Retrieval Of A Missing Guidewire Causing Cerebral Infarctions After Cerebral Angiography: A Case Report

2021 ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Cerebral Angiography ◽  
Open Surgery ◽  
Guide Wire ◽  
Treatment Options ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Long Time ◽  
Multiple Cerebral Infarctions ◽  
Selection Of

Abstract Background: Intra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guide wire fragments, intravascular clipping of the guide wire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions.Case presentation: A 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful.Conclusion: It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

scholarly journals What is New on Thyroid Cancer Biomarkers

2008 ◽  
Vol 3 ◽  
pp. BMI.S669 ◽  
Author(s):  
Rosaria M. Ruggeri ◽  
Alfredo Campennì ◽  
Sergio Baldari ◽  
Francesco Trimarchi ◽  
Maria Trovato
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Epithelium ◽  
Routine Practice ◽  
Appropriate Treatment ◽  
Follicular Lesions ◽  
Needle Aspiration Cytology ◽  
Well Differentiated

Thyroid cancer harbours in about 5% of thyroid nodules. The majority of them are well-differentiated cancers originating from the follicular epithelium, and are subdivided into papillary and follicular carcinomas. Undifferentiated carcinomas and medullary thyroid carcinomas arising from C cells are less common. Although most thyroid nodules are benign, distinguishing thyroid cancer from benign lesions is crucial for an appropriate treatment and follow-up. The fine needle aspiration cytology (FNAC) allows the diagnosis of nature of thyroid nodules in the majority of cases. However, FNAC has some limitations, particularly in the presence of follicular lesions which can appear dubious in rare instances even at histology. In an effort to improve diagnostic accuracy and offer new prognostic criteria, several immunohistochemical and molecular markers have been proposed. However, most of them have to be validated on large series before being used in routine practice.

Surgical and Endovascular Management of Patients with Chronic Mesenteric Ischemia: A Single Center Experience

2017 ◽  
Vol 83 (12) ◽  
pp. 1453-1457 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Giorgio C. Ginesu ◽  
Alessandro Fancellu ◽  
Aldo Pischedda ◽  
Mario Maiore ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Celiac Trunk ◽  
Chronic Mesenteric Ischemia ◽  
Therapeutic Approaches ◽  
Single Center Experience ◽  
Appropriate Treatment ◽  
The Mean ◽  
Clinical Records ◽  
Prognostic Data ◽  
Selection Of

Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years. Postprandial pain was present in all the cases, whereas sitophobia and weight loss were detected in 87 per cent of them. Eight patients were treated with open surgery; no perioperative deaths or relevant complications occurred. One patient had a restenosis of the celiac trunk and superior mesenteric artery 10 months after surgery. No deaths or relevant complications occurred in the remaining patients, who underwent an endovascular procedure. One patient presented a restenosis distal to the vascular stent, whereas two patients died due to comorbidities. The low rates of postoperative morbidity, mortality, and restenosis obtained suggest that surgical or endovascular correction of chronic mesenteric ischemia is satisfactory when performed by experienced surgeons, with an adequate selection of the patients.

scholarly journals Management of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy: a single-center experience

2020 ◽  
Author(s):  
Yuchen Wu ◽  
Xuefei Sun ◽  
Xueyan Bai ◽  
Jun Qian ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Systemic Disease ◽  
Central Nervous System Involvement ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Induction Treatment ◽  
High Dose ◽  
Free Survival ◽  
Single Center Experience ◽  
Appropriate Treatment

Abstract Introduction Secondary central nervous lymphoma(SCNSL) was defined as lymphoma involvement of both within and outside CNS at initially diagnosis or CNS relapse of a systemic disease. The prognosis of SCNSL was poor and the most appropriate treatment remained unestablished. Methods We conducted a retrospective study addressing the feasibility of R-MIADD regimen which comprised rituximab, high dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, dexamethasone in 19 consecutive SCNSL patients. Results Nineteen SCNSL patients with newly diagnosed CNS lesions were included with median age of 58 years (range 20 to 72 years). Eleven out of 19(57.9%) patients achieved complete remission(CR) and 2(10.5%) patients achieved partial remission by the end of induction treatment, the overall response rate (ORR) was 68.4%. The median follow-up time after the onset of CNS was 11.1 (3.2-35.5) months, the median progression-free survival after CNS was 28.0 months (95% CI: 11.0-44.9), and the median overall survival after CNS were 34.5months, by the time of this report, 8 patients remained CR. Treatment-related deaths was found in only one patient. Conclusions This is the largest series of SCNSL patients in China, and these date underscore the feasibility and efficacy of R-MIADD as induction treatment of SCNSL, further investigation is warranted.

Headache Associated With Sexual Activity: Prognosis and Treatment Options

Cephalalgia ◽  
2007 ◽  
Vol 27 (11) ◽  
pp. 1265-1270 ◽  
Author(s):  
A Frese ◽  
A Rahmann ◽  
N Gregor ◽  
K Biehl ◽  
I-W Husstedt ◽  
...  
Keyword(s):  
Sexual Activity ◽  
Treatment Options ◽  
Preemptive Therapy ◽  
Β Blockers ◽  
First Interview ◽  
Chronic Course ◽  
Activity Prognosis ◽  
Baseline Examination ◽  
Observation Period

The aim of this study was to provide data on the prognosis and treatment options of headache associated with sexual activity (HSA). Sixty patients diagnosed with HSA between 1996 and 2004 were followed up between 2003 and 2006 at least 12 months after the first interview. The further course of the disease and their contentedness with therapy were requested. On average, the second interview was performed 35.9 months after the first examination. Of the 45 patients who had suffered from single attacks or bouts prior to baseline examination, 37 had no further attacks. Seven patients suffered from at least one further bout with an average duration of 2.1 months. One patient developed a chronic course of the disease after an episodic start. Of the 15 patients with chronic disease at the first examination, seven were in remission and five had ongoing attacks at follow-up. Ten patients received indomethacin for preemptive therapy, with good results in nine patients. Eighteen patients received β-blockers for prophylaxis, with good results in 15 patients. Episodic HSA occurs in approximately three-quarters and chronic HSA in approximately one-quarter of patients. Even in chronic HAS, the prognosis is favourable, with remission rates of 69% during an observation period of 3 years. For patients with longer-lasting bouts or with chronic HSA, prophylactic treatment with β-blockers or preemptive therapy with indomethacin are often successful.

scholarly journals HDR Brachytherapy and SBRT as Bridging Therapy to Liver Transplantation in HCC Patients: A Single-Center Experience

2021 ◽  
Vol 11 ◽  
Author(s):  
Franziska Walter ◽  
Frederik Fuchs ◽  
Sabine Gerum ◽  
Maya C. Rottler ◽  
Robert Erdelkamp ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Treatment Options ◽  
Time Interval ◽  
Impaired Liver Function ◽  
Single Center Experience ◽  
Explanted Liver ◽  
Impaired Liver ◽  
Grade 3 ◽  
Hcc Recurrence

BackgroundIn the treatment of patients with HCC awaiting liver transplantation (LT), local ablative treatments (LAT) are available either for downstaging or as bridging treatment. We present our clinical experience with both available radiation-based techniques, brachytherapy (BT), and stereotactic body radiotherapy (SBRT).MethodsAll patients diagnosed with HCC and who were treated with BT or SBRT at our institution between 2011 and 2018 were retrospectively reviewed. The current analysis included all patients who subsequently underwent LT.ResultsA total of 14 patients (male=9; female=5) were evaluated. Seven underwent BT for bridging before LT, and seven were treated with SBRT. BT was performed with a prescribed dose of 1 × 15 Gy, while SBRT was applied with 37 Gy (65%-iso) in three fractions in six patients, and one patient was treated with 54 Gy (100%-iso) in nine fractions. The treatment was generally well tolerated. One case of grade 3 bleeding was reported after BT, and one case of liver failure occurred following SBRT. All patients underwent LT after a median time interval of 152 days (range 47–311) after BT and 202 days (range 44–775) following SBRT. In eight cases, no viable tumor was found in the explanted liver, while four liver specimens showed vital tumor. The median follow-up after SBRT was 41 months and 17 months following BT. Overall, no hepatic HCC recurrence occurred following LT.ConclusionBoth SBRT and BT are feasible and well tolerated as bridging to LT when applied with caution in patients with impaired liver function. Radiation-based treatments can close the gap for patients not suitable for other locally ablative treatment options.

scholarly journals Pyogenic brain abscess

2008 ◽  
Vol 24 (6) ◽  
pp. E2 ◽  
Author(s):  
Ersin Erdoğan ◽  
Tufan Cansever
Keyword(s):  
Treatment Options ◽  
Neurological Status ◽  
Diagnostic Techniques ◽  
Diagnosis And Treatment ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Brain Abscesses ◽  
Lower Morbidity

✓ Brain abscesses have been one of the most challenging lesions, both for surgeons and internists. From the beginning of the computed tomography (CT) era, the diagnosis and treatment of these entities have become easier and less invasive. The outcomes have become better with the improvement of diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. Atypical bacterial abscesses are more often due to chemotherapy usage in oncology, long life expectancy in patients with human immunodeficiency virus (HIV) infection, and immunosuppression in conjunction with organ transplantation. Surgical treatment options showed no significant difference with respect to mortality levels, but lower morbidity rates were achieved with stereotactically guided aspiration. Decompression with stereotactically guided aspiration, antibiotic therapy based on results of pus culture, and repeated aspirations if indicated from results of periodic CT follow-up scans seem to be the most appropriate treatment modality for brain abscesses. Immunosuppression and comorbidities, initial neurological status, and intraventricular rupture were significant factors influencing the outcomes of patients. The pitfalls and evolution in the diagnosis and treatment of brain abscesses are discussed in this study.

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