scholarly journals Surgical treatment for the patient with the neuroendocrine lung tumor associated with ectopic ACTH-secretion syndrome: case report

2018 ◽  
Vol 12 (2) ◽  
pp. 96-101
Author(s):  
Michail Y. Pikunov ◽  
Alexey A. Pechetov ◽  
Yury S. Esakov ◽  
Alexey N. Lednev
Keyword(s):  
Lung Tumor ◽  
Clinical Manifestations ◽  
Perioperative Period ◽  
Carcinoid Tumors ◽  
Long Term Results ◽  
Optimal Method ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
Results Of Treatment ◽  
Topical Diagnosis

Among primary neoplasms of the lungs, the proportion of neuroendocrine tumors is up to 20–25%. According to the Surveillance Epidemiology and Results (SEER) database, since 1970 there has been a significant increase in primary carcinoid tumors of various organs with the highest incidence of morbidity in the broncho-pulmonary localization group. Carcinoid tumors of the lung level are approximately 2% of all primary lung tumors, but only 5% of these formations are associated with ACTH production. Despite the severity of clinical manifestations and the acceleration of hypercorticoid processes, the topical diagnosis of ACTH-ectopic syndrome often causes certain difficulties. The difficulty in diagnosing ectopic tumors is due to the fact that most of these formations are so small that they can be missed by standard methods of examination (X-ray, ultrasound, MSCT or MRI). After the diagnosis of ACTH-ectopic syndrome is completely optimal method of pathogenetic therapy is a radical removal of the tumor, which leads to the normalization of the functions of the adrenal cortex and the elimination of hypercorticoidism. However, the achievement of this goal in many cases is difficult due to late topical diagnosis, the prevalence of the tumor process and extensive metastasis. There is a clinical observation of a patient with a diagnosis of a neuroendocrine lung tumor with ACTH-ectopic syndrome. The importance of the multidisciplinary approach, the methods of differential diagnosis, the features of the perioperative period and the long-term results of treatment are described.

scholarly journals CHRONIC TRAUMATIC DISLOCATION OF II-V METACARPAL BONES: CASE REPORT

2014 ◽  
Vol 2 (4) ◽  
pp. 61-65
Author(s):  
Vladimir Ivanovich Zavarukhin ◽  
Ekaterina Sergeevna Morenko ◽  
Sergey Ivanovich Golyana ◽  
Anton Vladimirovich Govorov
Keyword(s):  
Clinical Manifestations ◽  
Primary Treatment ◽  
Long Term Results ◽  
Carpometacarpal Joints ◽  
Results Of Treatment ◽  
Metacarpal Bones ◽  
High Incidence ◽  
Traumatic Dislocation ◽  
Type Of Injury

Dislocations in the carpometacarpal joints of three-phalanx fingers are rare form of injury. Their clinical manifestations are often veiled by swelling, and radiographs in standard views provide little information, which leads to difficulty in diagnosis and a high incidence of unidentified dislocations in the primary treatment. The article describes the basic provisions of the diagnosis and treatment of this type of injury, a clinical case of surgical treatment of undiagnosed dislocations of II-V metacarpal bones in the acute period, and long-term results of treatment.

The use of Dimexide in the complex treatment of Peyronie's disease

1980 ◽  
Vol 61 (6) ◽  
pp. 53-54
Author(s):  
M. G. Muhamadeev ◽  
M. P. Trofimova
Keyword(s):  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Peyronie’S Disease ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Peyronie's Disease

We observed 9 patients with plastic induration of the penis (Peyronie's disease), 3 of them interrupted treatment. Long-term results of treatment were traced in 6 patients (age - from 48 to 60 years): in 5 patients, complaints and clinical manifestations of disease recurrence were not noted for 2-4 years.

scholarly journals Comparative Analysis of Clinical, Hormonal and Morphological Studies in Patients with Neuroendocrine ACTH-Producing Tumours

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
G. S. Kolesnikova ◽  
A. M. Lapshina ◽  
I. A. Voronkova ◽  
E. I. Marova ◽  
S. D. Arapova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Histological Structure ◽  
Acth Secretion ◽  
Ki 67 ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
Morphological Studies ◽  
Free Cortisol

This paper highlights the problem of neuroendocrine tumours (NETs) with clinical symptoms of hypercorticism caused by hypersecretion of adrenocorticotropic hormone (ACTH) by tumour cells. In most cases (85%), the tumours were localized in the pituitary gland (Cushing's disease); 15% of the patients had an extrapituitary tumour that manifest as an ectopic ACTH secretion (EAS). Comparative analysis of clinical, hormonal, histological, and immunohistochemical characteristics of pituitary and extrapituitary ACTH-secreting NET was performed. It included 46 patients with CD and 38 ones exhibiting ectopic ACTH secretion (EAS). Results of the study suggest differences between CD and EAS in terms of the severity of clinical manifestations and duration of the disease. Hormonal studies showed that EAS unlike CD was associated with high plasma ACTH and cortisol levels, late-evening salivary cortisol and daily urinary free cortisol, the absence of a 60% or greater reduction of cortisol in the HDDST test, and the presence of a low (less than 2) ACTH gradient in response to desmopressin administration with catheterization of cavernous sinuses. The study of morphofunctional characteristics of the removed NET demonstrated the ability of both pituitary and extrapituitary NETs to express ACTH as well as GH, PRL, LH, and FSH. The angiogenic markers (CD31 and VEGF) were detected with equal frequency regardless of the NET localization. The histological structure of all corticotropinomas suggested their benign origin, but extrapituitary NETs were represented by different morphological types with varying malignancy, invasiveness, and metastatic properties. A higher cell proliferation potential (Ki-67) was documented for NET in patients presenting with an ectopic ACTH secretion compared to those having corticotropinomas.

scholarly journals Surgical treatment and rehabilitation capabilities of patients with patellar fractures

2019 ◽  
Vol 26 (1) ◽  
pp. 11-16 ◽  
Author(s):  
E. I Solod ◽  
N. V Zagorodniy ◽  
A. F Lazarev ◽  
M. B Tsykunov ◽  
M. A Abdulhabirov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Conflict Of Interest ◽  
Long Term Results ◽  
Optimal Method ◽  
Results Of Treatment ◽  
Combination Osteosynthesis ◽  
Partial Patellectomy ◽  
Patellar Fractures

Relevance. Fractures of the patella represent about 1% of all fractures of the bones. Among surgeons there is no a single approach to the treatment of patients with many fragmentary patellar fractures. After surgical treatment of patients with patellar fractures, various complications could be observed. Aside from that, there is no consensus on the treatment of complex fractures of the patella, and in practice, trauma physicians use a variety of methods of osteosynthesis of the patella. In the light of the foregoing, the study of long-term results of patients after patellar fractures is of particular relevance. Purpose of study: to examine the results of patients after surgical treatment of patellar fractures with a view to devising best practices for its osteosynthesis. Patients and methods. A study of the results of treatment of 78 patients with patellar fractures was conducted. The following groups were identified depending on the type of surgery and the nature of the fracture: Weber osteosynthesis in fragmentary fractures; «cruciform osteosynthesis» and other identical options of osteosynthesis with spokes and wires at three or more fragmented fractures of the patella; combination osteosynthesis. A comparative analysis of the results of treatment of patients after partial patellectomy and osteosynthesis of the patella with spokes and tightening wire loops was conducted. We evaluated the results on the KOOS scale with clinical examination and x-ray examination of patients. Beyond that, we have supplemented this scale with the patients’ own opinion on the evaluation of the results of their treatment. Results. The average follow-up period was 22 months. A comparative analysis of the groups of patients after surgical treatment of patellar fractures on the KOOS scale showed the best results in osteosynthesis of transverse two-fragment patellar fractures by Weber’y - 72%. The results of treatment of patients with many fragmentary patellar fractures using 3-5 spokes and 2-3 wires was - 64%; after the rehabilitation of the lower pole was - 68%) and after partial patellectomy -51%. Conclusion. If a patient has three-fragmented patellar fractures, reasonable results could be achieved by using 3 spokes and 2 tightening wire loops. With four or more fragmentary fractures of the patella, the optimal method for its osteosynthesis is the use of a «cruciform» method with 4 or more spokes in combination with two or three wire loops. The use of patellectomy with subsequent fixation of the blocking wire loop should be avoided in all types of patellar fractures. Key words: patellar fracture, osteosynhesis, surgical treatment Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

scholarly journals Syndrome of ectopic ACTH secretion in a patient without a verified tumor

2018 ◽  
Vol 15 (3) ◽  
pp. 59-64
Author(s):  
Ekaterina V. Ershova ◽  
Evgeniya S. Senyushkina ◽  
Ekaterina A. Troshina
Keyword(s):  
Clinical Picture ◽  
Malignant Tumors ◽  
General Structure ◽  
Clinical Manifestations ◽  
Ectopic Acth Syndrome ◽  
Acth Secretion ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
Primary Focus ◽  
Timely Treatment

Рrevalence of endogenous hypercortisilism is about 56 cases per 1 million people. ACTH-dependent hypercortico- sis in the general structure is about 80%. Among this cohort of patients in 7075% the cause of hypersecretion of ACTH is corticotrophinoma, about 10% are diagnosed with hyperplasia of corticotrophs, in the remaining 1520% neuroendocrine tumors of different locations, producing ACTH and / or corticoliberin. With ectopic ACTH syndrome the development of clinical manifestations is faster than with corticotropinoma, which determines the nature of the clinical picture. Difficulties in identifying the primary focus hypersecretion of ACTH may be due to its small size, absence or nonspecificity of the clinical picture from the primary focus, early metastasis in the case of malignant tumors. Besides, clinical manifestations of hyper- cortisolism can be considered and as independent nosological units, which creates certain difficulties at the stages of early diagnosis and timely treatment of ectopic ACTH syndrome.

scholarly journals Cushing Syndrome Secondary to Primary Neuroendocrine Lung Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
A. Zainal ◽  
O. Akinsola ◽  
K. Rajamani
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Cushing Syndrome ◽  
Lung Tumor ◽  
Acth Secretion ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
X Ray ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Rare Diagnosis

Cushing syndrome (CS) is a disorder characterized by a result of chronic exposure to excessive glucocorticoids. This article describes a case of a 30-year-old female presenting with fatigue, abdominal striae, unintentional weight gain, and lipodystrophy. A rare diagnosis of ectopic adrenocorticotropic-dependent CS was determined and a neuroendocrine lung tumor (NET) was discovered on chest x-ray. After surgical resection, pathology confirmed lung NET that stained positive for adrenocorticotropic hormone (ACTH). The patient’s symptoms fully resolved. The authors aim to urge clinicians to maintain a high index of suspicion for ectopic ACTH secretion (EAS) through a multimodal approach when caring for patients with CS.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

2018 ◽  
Vol 64 (3) ◽  
pp. 408-413
Author(s):  
Grigoriy Zinovev ◽  
Georgiy Gafton ◽  
Sergey Novikov ◽  
Ivan Gafton ◽  
Yekaterina Busko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissues ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Long Term Results ◽  
Clinical Feature ◽  
National Medical ◽  
Results Of Treatment ◽  
Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

NEUROENDOCRINE TUMORS OF THE PANCREAS: ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND CURRENT TREATMENT APPROACHES

2018 ◽  
Vol 64 (6) ◽  
pp. 830-839
Author(s):  
Temuri Morgoshiya
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Manifestations ◽  
Gastrointestinal Hormones ◽  
Current Treatment ◽  
High Potential ◽  
Long Term Results ◽  
Considerable Part ◽  
Treatment Approaches ◽  
By Products

The overview of literature on modem classification issues, diagnostics and treatments of neuroendocrinal tumors of a pancreas is provided. According to modern views all neuroendocrinal tumors of a pancreas having clinical manifestations (in the form of the syndromes caused by products of specific hormones; increases in level of hormones in blood of patients without clinical manifestations; in the form of signs of existence of volume education in various departments of PZh) and/or the researches (more than 5 mm) revealed by means of beam methods are malignant in the biology as they have high potential to innidiation. In article it is shown that a considerable part of neuroendocrinal tumors of a pancreas are nonfunctioning, i.e. not cosecreting various gastrointestinal hormones and polypeptides in blood and thereof not followed characteristic clinical manifestations. It is noted that diagnostics of neuroendocrinal tumors of a pancreas is extremely difficult task on which solution the choice of a method of treatment and its long-term results depends...

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