Incidence of bone metastases among children with cancer in Denmark.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1579-1579 ◽  
Author(s):  
Rohini Khorana Hernandez ◽  
Vera Ehrenstein ◽  
Merete Lund Mægbæk ◽  
Alexander Liede ◽  
Henrik Toft Sørensen
Keyword(s):  
Bone Metastases ◽  
Cancer Diagnosis ◽  
Case Reports ◽  
Rare Event ◽  
Case Series ◽  
Incidence Rates ◽  
Tumor Type ◽  
Children With Cancer ◽  
Registration System

1579 Background: There are no published population-based studies on the incidence of bone metastases (BM) among children with cancer. The current literature is limited to small case series or case reports. Methods: We used the Danish Cancer Registry (DCR) to identify children <18 years old diagnosed with cancer between 1/1/1994 and 12/31/2009. Patients were followed from cancer diagnosis to BM, emigration, death, or end of study (1/1/2011). DCR data were linked to (1) Danish Civil Registration System to obtain information on death and emigration, and (2) Danish National Registry of Patients to identify ICD-10 codes for BM. We estimated incidence rates (IRs) of BM and mortality rates overall and stratified by gender, calendar year, age, and primary tumor type. Results: During the study period, 2,652 children were identified with a first-time diagnosis of cancer, of whom 35 (1.3%) developed BM (mean follow-up of 7.0 years). The IR of BM was 1.9 per 1,000 person-years (95% CI: 1.4 – 2.6); the highest rates occurred in children aged 12 – 17 years and among those with osteosarcoma (Table). Twenty-one (60%) children with BM died during follow-up, yielding a mortality rate of 192 per 1,000 person-years (95% CI: 125 – 295). The median time from cancer diagnosis to BM was 221 days and from BM to death was 283 days. Conclusions: This study represents the first comprehensive examination of BM in children and reveals that BM is a rare event, with median survival of less than one year from diagnosis. [Table: see text]

Pneumocystis pneumonia incidence in metastatic solid tumor and lymphoma patients from an administrative health care claims database.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12500-e12500
Author(s):  
Margaret Elizabeth McCusker ◽  
Jian Huang ◽  
Robert Walls
Keyword(s):  
Incidence Rate ◽  
Cancer Diagnosis ◽  
Metastatic Cancer ◽  
Case Series ◽  
Pneumocystis Pneumonia ◽  
Incidence Rates ◽  
Cancer Type ◽  
Tumor Type ◽  
Claims Database ◽  
Hiv Negative

e12500 Background: Pneumoncystis jiroveci pneumonia (PJP) causes severe, often life-threatening illness in immunocompromised patients, including patients with cancer. PJP incidence estimates have been reported for several different cancer types based on case series from single institutions. In order to obtain incidence estimates from a larger pool of patients, we studied PJP claims among patients with metastatic solid tumors (MSTs) or lymphomas in a large administrative healthcare claims database. Methods: Adults diagnosed with MSTs or lymphomas between January 1999-September 2011 were identified in the MarketScan commercial, Medicare supplemental and Medicaid databases based on ICD-9 diagnosis codes. First PJP after cancer diagnosis was defined by PJP ICD-9 code (136.3) associated with an inpatient hospital stay of at least 1 day. Patients with a PJP claim before their cancer diagnosis were excluded. PJP incidence proportions and rates (with 95% CIs) were calculated by age group, sex, HIV status, and tumor type. Results: There were 158 PJP cases (0.04%) among 392,369 HIV-negative MST patients, an incidence rate of 3.0/10,000 pt-yrs (95% CI 2.6-3.5). Incidence rates by metastatic cancer type were 6.8/10,000 pt-yrs for lung, 5.4/10,000 pt-yrs for pancreas, 4.1/10,000 pt-yrs for prostate, 3.0/10,000 pt-yrs for breast, and 0.9/10,000 pt-yrs each for colorectal and ovary. There were 337 PJP cases (0.21%) among 162,799 HIV-negative lymphoma patients, an incidence rate of 9.4/10,000 pt-yrs (95% CI 8.5-10.5). Incidence was higher among males compared to females in both MST and lymphoma patients. PJP incidence rates in HIV-positive patients were approximately 14 times higher than in HIV-negative patients. Conclusions: PJP is a rare occurrence among patients with MSTs or lymphomas. In this analysis of a large administrative healthcare claims database, PJP incidence was higher among lymphoma patients compared to MST patients. Incidence estimates were lower than reports from institutional case series, but patterns of occurrence were consistent in terms of higher incidence in patients with lymphomas or HIV. Differences in incidence by tumor type were also observed among MST patients.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jurr Boer
Keyword(s):  
Total Dose ◽  
Hidradenitis Suppurativa ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Postal Survey ◽  
Long Term Follow Up ◽  
Late Treatment

<b><i>Background:</i></b> Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. <b><i>Objectives:</i></b> To evaluate the long-term efficacy of RT in early-stage HS. <b><i>Methods:</i></b> A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. <b><i>Results:</i></b> The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. <b><i>Conclusions:</i></b> RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

Malignant thyroid teratoma: an integrated analysis of case series and case reports

2021 ◽  
Author(s):  
Huy Gia Vuong ◽  
Truong P.x. Nguyen ◽  
Hanh T.t. Ngo ◽  
Lewis Hassell ◽  
Kennichi Kakudo
Keyword(s):  
Clinical Course ◽  
Case Reports ◽  
Case Series ◽  
Seer Program ◽  
Integrated Analysis ◽  
Continuous Variables ◽  
Chi Square ◽  
Large Tumor ◽  
Exact Test

Malignant thyroid teratoma (MTT) is a very rare thyroid malignancy. These neoplasms have been reported only in case reports and small-sized case series so far. In this study, we searched for MTTs in the Surveillance, Epidemiology, and End Result (SEER) program during 1975-2016. Subsequently, we incorporated the SEER data with published MTT cases in the literature to analyze the characteristics and prognostic factors of MTTs. Integrated data were analyzed using Chi-square or Fisher’s exact test for categorical covariates, and t-test or Mann-Whitney test for continuous variables. We included 28 studies with 36 MTT cases and found additional 8 cases from the SEER program for final analyses. Our results showed that MTT is typically seen in adult females. These neoplasms were associated with an aggressive clinical course with high rates of extrathyroidal extension (80%) and nodal involvement (62%). During follow-up, the development of recurrence and metastases were common (42% and 46%, respectively), and one-third of patients died at the last follow-up. Large tumor size (p = 0.022) and the presence of metastases during follow-up (p = 0.008) were associated with a higher mortality rate. In conclusion, our study demonstrated the characteristic features of MTT patients and outlined some parameters associated with a negative outcome which could help clinicians better predict the clinical course of these neoplasms.

scholarly journals A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET

2020 ◽  
Author(s):  
Francesco Lancellotti ◽  
Luigi Solinas ◽  
Davide Telesco ◽  
Andrea Sagnotta ◽  
Augusto Belardi ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Colorectal Adenocarcinoma ◽  
Retrospective Studies ◽  
Case Reports ◽  
English Literature ◽  
Case Series ◽  
Population Based ◽  
Review Articles ◽  
Gastrointestinal Neuroendocrine Tumor

Abstract Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.

Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series

2021 ◽  
Author(s):  
Mohammed Alahmari ◽  
Fahad Alkherayf ◽  
Andrea Lasso ◽  
Fatmahalzahra Banaz ◽  
Sepideh Mohajeri ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Pituitary Apoplexy ◽  
Case Series ◽  
Surgical Decompression ◽  
Tumor Type ◽  
Visual Deficit ◽  
Nerve Recovery ◽  
Sixth Nerve

Abstract Background Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification. Design Present study is a single-institution retrospective cohort. Methods A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient. Results Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery. Conclusion In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients.

scholarly journals Application of flow diverters in the treatment of aneurysms in the internal carotid artery bifurcation region

2020 ◽  
Vol 33 (4) ◽  
pp. 297-305
Author(s):  
Mostafa Mahmoud ◽  
Ahmed Farag ◽  
Mostafa Farid ◽  
Ahmed Elserwi ◽  
Amr Abdelsamad ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Case Reports ◽  
Therapeutic Option ◽  
Case Series ◽  
Flow Diversion ◽  
Occlusion Rate ◽  
Flow Diverters

Introduction The treatment of aneurysms in the internal carotid bifurcation region (ICABR), including aneurysms of the true internal carotid artery (ICA) terminus, those inclined on the proximal A1 or M1 segments or at the most distal pre-bifurcation (ICA) segment, is often challenging in microsurgical clipping and endovascular surgery. Few reports had discussed flow diversion as a therapeutic option for this group. Methods This was a retrospective study analysing flow diversion in treating ICABR aneurysms. Seven patients harbouring eight aneurysms in the ICABR were treated with flow diversion. Five aneurysms were inclined on the proximal A1 segment, and three were located at the most distal pre-bifurcation segment. Patients’ demographics, presentation, procedure technical description, angiographic and clinical follow-up were recorded. PubMed and Ovid MEDLINE were also reviewed for articles published in English, including case series or case reports, for ICABR aneurysms treated with flow diverters. Results All patients except one underwent angiographic follow-up. The Karman–Byrne occlusion scale was used to determine the occlusion rate. All six patients with documented angiographic follow-up had a class IV occlusion score. No permanent or transient neurological or non-neurological complications were encountered in this study. Conclusion Treating ICABR aneurysms using flow diversion is feasible, with a promising angiographic occlusion rate. Further studies are needed to analyse long-term clinical and angiographic results.

Nevus Lipomatosus Superficialis Unseen or Unrecognized: A Report of Eight Cases

2013 ◽  
Vol 17 (5) ◽  
pp. 335-339 ◽  
Author(s):  
Muthu Sendhil Kumaran ◽  
Tarun Narang ◽  
Sunil Dogra ◽  
Uma Nahar Saikia ◽  
Amarinder Jit Kanwar
Keyword(s):  
Treatment Outcome ◽  
Health Care Providers ◽  
Case Reports ◽  
Case Series ◽  
Care Providers ◽  
Reticular Dermis ◽  
Disease Characteristics ◽  
Long Term Follow Up

Background: Nevus lipomatosus superficialis (NLS) is a unique developmental anomaly or nevoid form of lipoma characterized by the ectopic presence of mature adipocytes in reticular dermis. The condition is rare; apart frrom isolated case reports, there are no large case series dealing with the clinicoepidemiologic characteristics and posttreatment long-term follow-up in patients with NLS and little published information on treatment outcome. Objective: To study the clinicoepidemiologic characteristics and long-term posttreatment follow-up in patients with NLS. Methods: This was an 11-year retrospective study analyzing disease characteristics and treatment outcome in eight patients with NLS. Results: There were eight (six males, two females) patients with NLS, of whom three were children. The classic variant of NLS was the predominant presentation. One patient demonstrated a combination of both classic and solitary variants. Most patients, especially those with solitary variants, were commonly misdiagnosed before presenting to us. Four patients, including two with the solitary variant, one each with the classic and the combined type, underwent surgical resection without any recurrence over 8 years of follow-up. Conclusions: The rare nature of the disorder, which is commonly misdiagnosed, and the absence of long-term follow-up data prompted us to share our experience about NLS to increase its awareness among health care providers.

scholarly journals Solitary prostatic cancer metastasis to the testis: A case report and lessons to learn

2020 ◽  
Vol 91 (4) ◽  
pp. 265-266 ◽  
Author(s):  
Asmaa Ismail ◽  
Hazem Elmansy ◽  
Walid Shahrour ◽  
Owen Prowse ◽  
Ahmed Kotb
Keyword(s):  
Prostatic Cancer ◽  
Cancer Metastasis ◽  
Complex Disease ◽  
Ureteropelvic Junction Obstruction ◽  
Case Reports ◽  
Preoperative Staging ◽  
Family Doctor ◽  
Case Series ◽  
Testicular Mass

Prostate cancer (Pca) is a complex disease. Several case series and reports have described the spread of Pca to unusual organs, like esophagus, eye and periureteric fat causing ureteropelvic junction obstruction. Spread of Pca to the testis has been reported in few case reports, however Pca was always firstly diagnosed in all published cases and testicular spread of cancer has been diagnosed during follow up of the patients. This case is unique in that, the patient initially presented with a testicular mass and histologic examination after orchiectomy allowed to diagnose prostatic cancer. This patient was 81 years old and he never had PSA screening by his family doctor. PSA was not even done initially by us considering his age and the presentation with testicular mass. This case may impact clinical practice in several ways: 1) considering Pca always in the differential diagnosis of any disease of an adult man, regardless of its presentation because we did not do that at initial patient evaluation and PSA was only measured after orchiectomy when pathology demonstrated metastatic Pca; 2) suggesting standard orchiectomy with epididemectomy for surgical castration instead of the current surgical technique of subcapsular/subepididymal orchiectomy, because our patient had cancer involving his epididymis as well; 3) suggesting to include PSMA as a part of preoperative staging for high risk Pca patients, in consideration that PSMA is proving to be a promising new imaging technique that can help diagnosing metastatic Pca in unusual locations.

scholarly journals Synovial Sarcoma of the Nerve—Clinical and Pathological Features: Case Series and Systematic Review

Neurosurgery ◽  
2019 ◽  
Vol 85 (6) ◽  
pp. E975-E991 ◽  
Author(s):  
Stephen Shelby Burks ◽  
Ross C Puffer ◽  
Iahn Cajigas ◽  
David Valdivia ◽  
Andrew E Rosenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Statistical Analysis ◽  
Synovial Sarcoma ◽  
Tumor Size ◽  
Clinical Course ◽  
Case Reports ◽  
Case Series ◽  
Pathological Features ◽  
Eligibility Criteria

Abstract BACKGROUND Synovial sarcoma of the nerve is a rare entity with several cases and case series reported in the literature. Despite an improved understanding of the biology, the clinical course is difficult to predict. OBJECTIVE To compile a series of patients with synovial sarcoma of the peripheral nerve (SSPN) and assess clinical and pathological factors and their contribution to survival and recurrence. METHODS Cases from 2 institutions collected in patients undergoing surgical intervention for SSPN. Systematic review including PubMed and Scopus databases were searched for related articles published from 1970 to December 2018. Eligibility criteria: (1) case reports or case series reporting on SSPN, (2) clinical course and/or pathological features of the tumor reported, and (3) articles published in English. RESULTS From patients treated at our institutions (13) the average follow-up period was 3.2 yr. Tumor recurrence was seen in 4 cases and death in 3. Systematic review of the literature yielded 44 additional cases with an average follow-up period of 3.6 yr. From pooled data, there were 10 recurrences and 7 deaths (20% and 14%, respectively). Adjuvant treatment used in 62.5% of cases. Immunohistochemical markers used in diagnosis varied widely; the most common are the following: Epithelial membrane antigen (EMA), cytokeratin, vimentin, cluster of differentiation (CD34), and transducin-like enhancer of split 1 (TLE1). Statistical analysis illustrated tumor size and use of chemotherapy to be negative predictors of survival. No other factors, clinically or from pathologist review, were correlated with recurrence or survival. CONCLUSION By combining cases from our institution with historical data and performing statistical analysis we show correlation between tumor size and death.

Sign in / Sign up

Export Citation Format

Share Document