scholarly journals Refractory Craniopharyngioma: Successful Treatment with LINAC Based Stereotactic Radiosurgery(SRS): First Case in Nepal

2021 ◽  
Author(s):  
Subhash Thakur ◽  
Saloni Chawla
Keyword(s):  
Adjuvant Radiotherapy ◽  
Tumour Volume ◽  
Complete Resection ◽  
Subtotal Resection ◽  
Safe Procedure ◽  
Gross Tumour Volume ◽  
First Line ◽  
Case Presentation ◽  
Non Invasive ◽  
First Case

Abstract Purpose: To present first case of refractory craniopharyngioma treated successfully with SRS in Nepal.Background: Craniopharyngioma is a benign tumour, which progresses slowly and compresses the pituitary gland and nearby structures. First line of treatment is surgery followed by adjuvant radiotherapy as complete resection is usually not feasible. Here, we are reporting a case of recurrent craniopharyngioma treated with LINAC based SRS.Case Presentation: A 43 years old man diagnosed case of craniopharyngioma in May 2019. He underwent left pterional craniotomy and subtotal resection of tumour and kept on observation. He developed symptomatic as well as radiological recurrence in July 2020. Second debulking was not possible, so we did SRS on 23rd August 2020; 14Gy Dose was delivered to gross tumour volume. Six months after SRS, Patient is doing well.Conclusions: LINAC based SRS is a frameless, non-invasive and safe procedure with excellent clinical outcomes for recurrent or residual craniopharyngioma.

scholarly journals Refractory Craniopharyngioma: Successful Treatment with LINAC Based Stereotactic Radiosurgery (SRS): First Case in Nepal

2021 ◽  
Vol 6 (4) ◽  
pp. 529-531
Author(s):  
Subhash Thakur ◽  
Saloni Chawla
Keyword(s):  
Adjuvant Radiotherapy ◽  
Tumour Volume ◽  
Complete Resection ◽  
Subtotal Resection ◽  
Safe Procedure ◽  
Gross Tumour Volume ◽  
First Line ◽  
Case Presentation ◽  
Non Invasive ◽  
First Case

Purpose: To present first case of refractory craniopharyngioma treated successfully with SRS in Nepal. Bckground: Craniopharyngioma is a benign tumour, which progresses slowly and compresses the pituitary gland and nearby structures. First line of treatment is surgery followed by adjuvant radiotherapy as complete resection is usually not feasible. Here, we are reporting a case of recurrent craniopharyngioma treated with LINAC based SRS. Case Presentation: A 43 years old man diagnosed case of craniopharyngioma in May 2019. He underwent left pterional craniotomy and subtotal resection of tumour and kept on observation. He developed symptomatic as well as radiological recurrence in July 2020. Second debulking was not possible, so we did SRS on 23rd August 2020; 14Gy Dose was delivered to gross tumour volume. Six months after SRS, Patient is doing well. Conclusions: LINAC based SRS is a frameless, non-invasive and safe procedure with excellent clinical outcomes for recurrent or residual craniopharyngioma.

scholarly journals Refractory Craniopharyngioma: Successful Treatment with LINAC Based Stereotactic Radio surgery (SRS): First Case in Nepal

2021 ◽  
Author(s):  
Subhash Thakur ◽  
Birendra Yadav ◽  
Karthik Nagamuthu ◽  
Saloni Chawla ◽  
Amit Dubey
Keyword(s):  
Adjuvant Radiotherapy ◽  
Tumor Volume ◽  
Benign Tumor ◽  
Complete Resection ◽  
Subtotal Resection ◽  
Safe Procedure ◽  
First Line ◽  
Case Presentation ◽  
Non Invasive ◽  
First Case

Abstract Purpose: To present first case of refractory craniopharyngioma treated successfully with SRS in Nepal. Background: Craniopharyngioma is a benign tumor, which progresses slowly and compresses the pituitary gland and nearby structures. First line of treatment is surgery followed by adjuvant radiotherapy as complete resection is usually not feasible. Here, we are reporting a case of recurrent craniopharyngioma treated with LINAC based SRS. Case Presentation: A 43 years old man diagnosed case of craniopharyngioma in May 2019. He underwent left pterional craniotomy and subtotal resection of tumor and kept on observation. He developed symptomatic as well as radiological recurrence in July 2020. Second debulking was not possible, so we did SRS on 23rd August 2020; 14Gy Dose was delivered to gross tumor volume. Six months after SRS, Patient is doing well.Conclusions: LINAC based SRS is a frameless, non-invasive and safe procedure with excellent clinical outcomes for recurrent or residual craniopharyngioma.

BRAF-MAD1L1 and BRAF-ZC3H7A: novel gene fusion in Rhabdomyosarcoma and Lung adenocarcinoma

2021 ◽  
Author(s):  
Jiang Da ◽  
Hui Jin ◽  
Xinliang Zhou ◽  
Shaoshuang Fan ◽  
Mian Xu ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Gene Fusion ◽  
Tumor Resection ◽  
Kinase Domain ◽  
Rapid Progression ◽  
First Line ◽  
Case Presentation ◽  
First Case ◽  
Exon 11 ◽  
Domain Exon

Abstract Background: Rhabdomyosarcoma (RMS) and lung adenocarcinoma (LADC) epitomizes the success of cancer prevention by the development of conventional therapy, but huge challenges remain in the therapy of advanced diseases.Case presentation: We reported two cases of novel BRAF gene fusion. The first case was a 34-year-old female with RMS harboring a BRAF-MAD1L1 fusion. She suffered tumor resection, recurrence and rapid progression. The second case was a 72-year-old female with LADC harboring a BRAF-ZC3H7A fusion, and she gained rapid progression after receiving a first-line course of chemotherapy.Conclusions: These two BRAF fusions retain the intact BRAF kinase domain (exon 11-18) and showed poor prognosis in RMS and LADC.

Adrenocortical cancer

2017 ◽  
Author(s):  
Steve Ball ◽  
Sajid Kalathil
Keyword(s):  
Adjuvant Radiotherapy ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Advanced Disease ◽  
Radiological Finding ◽  
Complete Resection ◽  
Overall Survival Rate ◽  
Adrenocortical Cancer ◽  
First Line ◽  
Symptoms And Signs

Adrenocortical cancer (ACC) is rare and associated with poor prognosis. The incidence is estimated at 0.7–2 cases per one million. Overall survival rate at five years for ACC is 37–47%. While the pathogenesis of ACC is incompletely understood, inherited predisposition syndromes are common in childhood ACC. Clinical presentation can be with symptoms and signs of hormone excess (functional tumours), mass effects, or as an incidental radiological finding. A multidisciplinary approach combining radiology, biochemistry, and tissue-based pathology is needed to establish a diagnosis to guide a surgical approach aimed at complete resection of the tumour where possible. At present, recommended first-line therapies for advanced disease are mitotane monotherapy or etopiside, doxorubicin, and cisplatin plus mitotane. Metronomic capecitabine and gemcitabine have been used as alternatives. Adjuvant radiotherapy to the tumour bed should be considered for patients considered to be at high risk of recurrence.

scholarly journals Case Report: When Exercise Went Wrong

2020 ◽  
pp. 5-8
Author(s):  
Heng Shee Kim
Keyword(s):  
Myocardial Infarction ◽  
Stress Test ◽  
High Risk Patient ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Safe Procedure ◽  
Coronary Angiogram ◽  
First Line ◽  
Case Presentation ◽  
St Elevation

Background: Exercise stress test (EST) is recommended as the first-line investigation in major guidelines. It believed as a safe procedure. However, there is unignorable complications include hospitalisation, acute myocardial infarction and sudden cardiac death. Case Presentation: We describe a case of a 56-year-old male who underwent exercise stress test and complicated with hemodynamically unstable ventricular tachycardia. He was resuscitated and diagnosed with acute anterior ST-elevation myocardial infarction. Subsequent coronary angiogram showed severe two vessels disease. Conclusion: This illustrates the importance to identify a cohort of high-risk patient pre-EST, along with proper supervision and well-staffed exercise stress test lab in order to provide appropriate lifesaving treatment.

Isolated carcinoid tumor of the terminal filum

2001 ◽  
Vol 94 (2) ◽  
pp. 313-315 ◽  
Author(s):  
Jay Locke ◽  
Lawrence D. True
Keyword(s):  
Carcinoid Tumor ◽  
Adjuvant Radiotherapy ◽  
Primary Site ◽  
Neurological Symptoms ◽  
Subtotal Resection ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ The authors describe a patient with neurological symptoms caused by a carcinoid tumor at the terminal filum without carcinoid “flushing” syndrome or endocrinological abnormalities. The patient underwent subtotal resection and adjuvant radiotherapy. Extensive postoperative workup revealed no primary site of disease. To the authors' knowledge, this patient represents the first case of terminal filum carcinoid tumor.

scholarly journals Refractory Trigeminal Neuralgia: Successful Treatment with LINAC Based Stereotactic Radiosurgery (SRS): First Case in Bangladesh

2020 ◽  
Vol 10 (1) ◽  
pp. 123-129
Author(s):  
Taohida Yasmin ◽  
Narendra Kumar ◽  
Sandip K Das ◽  
Murugan Appasamy ◽  
KM Masud Rana ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Pain Control ◽  
Pain Syndrome ◽  
Safe Procedure ◽  
Non Invasive ◽  
First Case ◽  
The Face ◽  
Lancinating Pain

Purpose: To present first case of refractory trigeminal Neuralgia treated with SRS in Bangladesh, procedural technique, and outcomes in terms of pain relief. Background: Trigeminal neuralgia (TN), classically known as tic doloureaux is a chronic and recurrent disabling pain syndrome, which described as episodes of lancinating pain over the face along the sensory distribution of trigeminal nerve. First line management of TN is medical with different permutation & combination to control the pain. After the failure of medical management, non-invasive SRS is an established modality to achieve long term pain control. Here, we are reporting a case of TN treated with LINAC based SRS. Case Presentation: A 61 years old, gentleman who developed piercing pain inside his left eye for a duration 1-1.5 sec, precipitated while shaving, brushing teeth in year 2015, occurred 4-5 time a day. He was diagnosed as left TN of V1, started on Carbamazepine, Pregabalin. In 3 years, pain progressed to involve all 3 branches. Even combination Carbamazepine, Gabapentin, Tramadol, Amitriptyline, Clonazepam, & Morphine could not control the pain. Pain was persisting all over the day and he also developed suicidal tendency. Later he has been referred to us for SRS. SRS was done in April-2019, a dose of 90Gy was delivered to the Distal Retrogasserian (RG) also called Marseille point of trigeminal nerve root. Eight months after the SRS patient is almost free of pain without any Medicine. Conclusions: LINAC based SRS is a non-invasive, frameless, and safe procedure with excellent pain control for refractory Trigeminal neuralgia. Bang. J Neurosurgery 2020; 10(1): 123-129

A STUDY OF ENDOMETRIAL THICKNESS IN TRANS VAGINAL SONOGRAPHY IN RELATION WITH HISTOPATHOLOGY REPORT IN DILATION & CURRATAGE IN AUB WOMEN

2019 ◽  
pp. 1-2
Keyword(s):  
Comparative Study ◽  
Endometrial Thickness ◽  
P Value ◽  
First Line ◽  
Non Invasive ◽  
Dilation And Curettage ◽  
Study Results ◽  
Vaginal Sonography ◽  
In Trans

A study of of endometrial thickness on TVS in relation with histopathology report on dilation and curettage. AIM AND OBJECTIVE-To set a cut off limit of endometrial thickness on TVS for differtiating between normal and abnormal endometrium. MATERIAL AND METHOD-hospital based comparative study. RESULTS-TVS is non invasive ,simple first line procedure in AUB women. Mean endometrial thickness in normal endometrial group was 8.00±2.44 mm and in abnormal endometrial group was 15.16±33 mm.The difference was found highly significant (p value<.001)

scholarly journals The effect of adjuvant radiotherapy on overall survival in adults with intracranial ependymoma

2019 ◽  
Vol 7 (4) ◽  
pp. 391-399
Author(s):  
Roshan S Prabhu ◽  
Christopher D Corso ◽  
Matthew C Ward ◽  
John H Heinzerling ◽  
Reshika Dhakal ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Adjuvant Radiotherapy ◽  
Subtotal Resection ◽  
National Cancer Database ◽  
Risk Of Death ◽  
Increased Risk ◽  
Intracranial Ependymoma ◽  
Male Sex ◽  
Grade 3

Abstract Background Adult intracranial ependymoma is rare, and the role for adjuvant radiotherapy (RT) is not well defined. Methods We used the National Cancer Database (NCDB) to select adults (age ≥ 22 years) with grade 2 to 3 intracranial ependymoma status postresection between 2004 and 2015 and treated with adjuvant RT vs observation. Four cohorts were generated: (1) all patients, (2) grade 2 only, (3) grade 2 status post–subtotal resection only, (4) and grade 3 only. The association between adjuvant RT use and overall survival (OS) was assessed using multivariate Cox and propensity score matched analyses. Results A total of 1787 patients were included in cohort 1, of which 856 patients (48%) received adjuvant RT and 931 (52%) were observed. Approximately two-thirds of tumors were supratentorial and 80% were grade 2. Cohorts 2, 3, and 4 included 1471, 345, and 316 patients, respectively. There was no significant association between adjuvant RT use and OS in multivariate or propensity score matched analysis in any of the cohorts. Older age, male sex, urban location, higher comorbidity score, earlier year of diagnosis, and grade 3 were associated with increased risk of death. Conclusions This large NCDB study did not demonstrate a significant association between adjuvant RT use and OS for adults with intracranial ependymoma, including for patients with grade 2 ependymoma status post–subtotal resection. The conflicting results regarding the efficacy of adjuvant RT in this patient population highlight the need for high-quality studies to guide therapy recommendations in adult ependymoma.

scholarly journals Immediate hypersensitivity reaction followed by successful oral desensitization to ursodiol

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika Yue Lee ◽  
Christine Song
Keyword(s):  
Hypersensitivity Reaction ◽  
Primary Biliary Cholangitis ◽  
Line Treatment ◽  
Second Line ◽  
Immediate Hypersensitivity ◽  
First Line ◽  
Case Presentation ◽  
Desensitization Protocol ◽  
First Line Treatment ◽  
Oral Desensitization

Abstract Background Immediate hypersensitivity reaction to ursodiol is rare and there is no previously published protocol on ursodiol desensitization. Case presentation A 59-year-old woman with primary biliary cholangitis (PBC) developed an immediate hypersensitivity reaction to ursodiol—the first-line treatment for PBC. When she switched to a second-line treatment, her PBC continued to progress. As such, she completed a novel 12-step desensitization protocol to oral ursodiol. She experienced recurrent pruritus after each dose following desensitization, which subsided after a month of being on daily ursodiol. Conclusion Immediate hypersensitivity reaction to ursodiol is uncommon. Our case demonstrated that this novel desensitization protocol to ursodiol could be safely implemented when alternative options are not available or have proven inferior in efficacy.

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