scholarly journals A Multidisciplinary Approach to the Treatment of COVID-Associated Complications After Pancreatoduodenal Resection (Case Report)

2021 ◽  
Vol 10 (3) ◽  
pp. 469-476
Author(s):  
T. E. Kim ◽  
D. A. Lebedev ◽  
M. M. Magomedbekov ◽  
K. A. Nugumanova ◽  
S. S. Petrikov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Infection Prevention ◽  
Multidisciplinary Approach ◽  
Clinical Observation ◽  
Malignant Tumors ◽  
Pancreatic Head ◽  
Thromboembolic Complications ◽  
Distal Common Bile Duct ◽  
Coronavirus Infection ◽  
Extensive Surgery

We report a clinical case of treatment of a complicated postoperative course in a patient who underwent pancreatoduodenal resection associated with coronavirus infection. Prevention and treatment of such complications have been suggested.Pancreatoduodenal resection (PDR) is indicated for malignant tumors of the pancreatic head, duodenum or its large papilla, distal common bile duct, as well as in chronic pancreatitis with a predominant lesion of the pancreatic head with severe pain syndrome.The given clinical observation describes an example of treatment of a patient who developed a series of thromboembolic complications in the early stages after PDR performed for a neuroendocrine tumor of the pancreatic head. The oncology disease, extensive surgery such as PDR, and the postoperative period itself are risk factors for the development of various thromboembolic complications. According to the literature, the incidence of thromboembolic complications after PDR is 3–3.3%.The reason for the atypical course of the postoperative period when performing pancreatoduodenal resection in patients with tumor of the pancreas may be conditions that are not directly related to either the pathology of the pancreas or the features of the surgical intervention. When analyzing the patient’s condition, one should take into account the conditions of treatment. In such situations, proper detection of COVID-19 and adequate correction of therapy can fundamentally change the outcome of the disease.

A RARE CASE OF METASTASIS OF GASTRIC CANCER IN THE SPLEEN

2017 ◽  
Vol 63 (1) ◽  
pp. 153-154
Author(s):  
Oleg Kit ◽  
Yevgeniy Kolesnikov ◽  
Mikhail Kozhushko ◽  
Aleksandr Snezhko
Keyword(s):  
Gastric Cancer ◽  
Rare Case ◽  
Clinical Observation ◽  
Malignant Tumors

The spleen’s damage by metastases of malignant tumors is occasional. There is presented a clinical observation of rare isolated metastasis of gastric cancer in the spleen without concomitant dissemination that is interesting.

scholarly journals Rheumatic Immune-Related Adverse Events—A Consequence of Immune Checkpoint Inhibitor Therapy

Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 561
Author(s):  
Anca Bobircă ◽  
Florin Bobircă ◽  
Ioan Ancuta ◽  
Alesandra Florescu ◽  
Vlad Pădureanu ◽  
...  
Keyword(s):  
Immune System ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Multidisciplinary Approach ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Cancer Cell Growth ◽  
Inhibitory Mechanisms ◽  
Checkpoint Inhibitor Therapy

The advent of immunotherapy has changed the management and therapeutic methods for a variety of malignant tumors in the last decade. Unlike traditional cytotoxic chemotherapy, which works by interfering with cancer cell growth via various pathways and stages of the cell cycle, cancer immunotherapy uses the immune system to reduce malignant cells’ ability to escape the immune system and combat cell proliferation. The widespread use of immune checkpoint inhibitors (ICIs) over the past 10 years has presented valuable information on the profiles of toxic adverse effects. The attenuation of T-lymphocyte inhibitory mechanisms by ICIs results in immune system hyperactivation, which, as expected, is associated with various adverse events defined by inflammation. These adverse events, known as immune-related adverse events (ir-AEs), may affect any type of tissue throughout the human body, which includes the digestive tract, endocrine glands, liver and skin, with reports of cardiovascular, pulmonary and rheumatic ir-AEs as well. The adverse events that arise from ICI therapy are both novel and unique compared to those of the conventional treatment options. Thus, they require a multidisciplinary approach and continuous updates on the diagnostic approach and management.

Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors

2018 ◽  
Vol 33 (2) ◽  
pp. 633-638 ◽  
Author(s):  
Jun Cao ◽  
Guo-lin Li ◽  
Jin-xing Wei ◽  
Wei-Bang Yang ◽  
Chang-zhen Shang ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Malignant Tumors ◽  
Pancreatic Head ◽  
Low Grade ◽  
Pancreatic Head Resection

scholarly journals А сlinical case report of mediastinal teratoma in an adolescent patient with Klinefelter syndrome

2020 ◽  
Vol 19 (4) ◽  
pp. 143-149
Author(s):  
S. S. Saliyeva ◽  
R. Z. Boranbayeva ◽  
B. M. Zhumadullayev ◽  
K. E. Khairov ◽  
E. V. Krivenko ◽  
...  
Keyword(s):  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Klinefelter Syndrome ◽  
Malignant Tumors ◽  
Complete Removal ◽  
Cell Tumor ◽  
Growing Teratoma Syndrome ◽  
Mediastinal Teratoma ◽  
Mature Type ◽  
Derivatives Of

Teratoma is a germ cell tumor, which consists of derivatives of three germ layers and has various malignant potentials – from benign mature forms to immature embryonic forms with a somatic type of malignancy. Even the mature type of teratoma is biologically unpredictable providing for an ability to grow locally with invasion. Necessity for complete removal of tumors, wherever they are located, is explained by the fact that there is a risk of a possible development of growing teratoma syndrome or transformation into malignant tumors. This article describes the clinical case of growing teratoma syndrome of mediastinal localization in a teenager with Klinefelter syndrome, also as an example of the multidisciplinary approach of pediatric oncologists, surgeons, radiotherapists and pathomorphologists in decision-making for optimal treatment. The patients' parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

scholarly journals Leiomyosarcoma of Prostate

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdeljalil Heddat ◽  
Younes Houry ◽  
Redouane Rabii
Keyword(s):  
Therapeutic Approach ◽  
Multidisciplinary Approach ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Multicenter Trial ◽  
Advanced Stage ◽  
Rare Tumor ◽  
Actuarial Survival ◽  
Term Survival

Prostate leiomyosarcoma is an extremely rare and very aggressive neoplasm that represents less than 0.1% of primary malignant tumors of the prostate. We present a patient with primary leiomyosarcoma of  prostate and examine the cases reported in the literature to discuss the clinical, diagnostic and therapeutic aspects of this rare tumor. Median survival was estimated at 17 months (95% CI 20.7–43.7 months) and the actuarial survival rates at 1, 3 and 5 years were 68%, 34% and 26%, respectively. The only predictors of long-term survival were negative surgical margins and the absence of metastatic disease at presentation. A multidisciplinary approach is necessary for the proper management of this terrible entity. Surgery with or without chemotherapy seems to be the main therapeutic method for operable leimyosarcomas, but in general there is no consensus on the best therapeutic approach. Most cases are diagnosed at an advanced stage of the disease. A global multicenter trial is needed to find therapies that would improve the prognosis.

scholarly journals Hypothyroidism and hypopituitarism as immune-related adverse events due to lenvatinib plus pembrolizumab therapy in the immediate postoperative period after laparoscopic hepatectomy for liver metastases from gastric cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kimimasa Sasaki ◽  
Shin Kobayashi ◽  
Masashi Kudo ◽  
Motokazu Sugimoto ◽  
Shinichiro Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Glucose ◽  
Adverse Events ◽  
Blood Glucose Level ◽  
Liver Metastases ◽  
Postoperative Period ◽  
Malignant Tumors ◽  
Fasting Blood Glucose ◽  
Laparoscopic Hepatectomy ◽  
Fasting Blood Glucose Level

Abstract Background Immune checkpoint inhibitors (ICIs) are emerging agents used for the treatment of various malignant tumors. As ICIs are generally used for unresectable malignant tumors, there have been only a few reports of patients who underwent surgery after receiving these drugs. Therefore, it remains unclear how immune-related adverse events (irAEs) affect the postoperative course. Here, we report a patient with advanced gastric cancer who underwent laparoscopic hepatectomy for liver metastases after an objective response with lenvatinib plus pembrolizumab and developed hypothyroidism and hypopituitarism as irAEs in the immediate postoperative period. Case presentation A 73-year-old man had undergone total gastrectomy for pT4aN2M0 gastric cancer followed by adjuvant chemotherapy with S-1 and docetaxel, and developed liver metastases in segments 6 and 7. He was enrolled in phase 2 clinical trial of lenvatinib plus pembrolizumab. He continuously achieved a partial response with the study treatment, and the liver metastases were decreased in size on imaging. The tumors were judged to be resectable and the patient underwent laparoscopic partial hepatectomy for segments 6 and 7. From the 1st postoperative day, the patient continuously presented with fever and general fatigue, and his fasting blood glucose level remained slightly lower than that before the surgery. On the 4th postoperative day, laboratory examination revealed hypothyroidism and hypopituitarism, which were suspected to be irAE caused by lenvatinib plus pembrolizumab after surgery. He received hydrocortisone first, followed by levothyroxine after adrenal insufficiency was recovered. Subsequently, his fever, general fatigue, and any abnormality regarding fasting blood glucose level resolved, and he was discharged on the 12th postoperative day. After discharge, his laboratory data for thyroid and pituitary function remained stable while receiving hydrocortisone and levothyroxine without recurrence of gastric cancer. Conclusion We present a case of laparoscopic hepatectomy after receiving lenvatinib plus pembrolizumab and developed hypothyroidism and hypopituitarism after surgery. Regarding surgery after ICI therapy, it is important to recognize that irAEs might occur in the postoperative period.

The case of comorbidity of sinus node dysfunction and new coronavirus infection with Sjogren’s disease and Thompson’s myotonia

2021 ◽  
Vol 25 (3) ◽  
pp. 35-40
Author(s):  
Maria O. Mohika Estepa ◽  
Nadezhda V. Muzhikina
Keyword(s):  
Respiratory System ◽  
Multidisciplinary Approach ◽  
Sinus Node ◽  
Cardiovascular Complications ◽  
Sinus Node Dysfunction ◽  
Therapeutic Approaches ◽  
Latent Form ◽  
Aged People ◽  
Coronavirus Infection ◽  
Sjögren’S Disease

Coronavirus infection, according to modern data, poses a threat not only to the respiratory system, in more than 15% of patients it can lead to cardiovascular complications, including in young and middle-aged people. COVID-19 is probably the trigger of a detailed clinical picture of chronic diseases occurring in a latent form. The article considers the case of sinus node dysfunction and polyneuropathy in a young patient after coronavirus infection against the background of concomitant diseases such as Sjogrens disease and Thompsons myotonia. To observe the dynamics of the three diseases, the timely organization of a multidisciplinary approach is important. It is necessary to consider all three diseases in the paradigm of the main and concomitant in order to timely and adequate therapy. Further study of the clinical features, therapeutic approaches and complications in patients with COVID-19 is required.

Benign and Premalignant Lesions of the Pancreas

2016 ◽  
Author(s):  
Abdurrahman Kadayifci ◽  
William R. Brugge
Keyword(s):  
Malignant Tumors ◽  
Balloon Dilation ◽  
Pancreatic Head ◽  
Premalignant Lesions ◽  
World Health ◽  
Pancreatic Tumors ◽  
Thick Wall ◽  
Cystic Lesions ◽  
Cystic Neoplasms

Pancreatic cancer is among the most aggressive human cancers, with few symptoms and clinical findings until it is detected in an advanced stage. Today, the only favorable treatment is surgical resection before progression to an invasive stage. There are a variety of benign and premalignant conditions of the pancreas that may appear similar to malignant tumors; early detection and management of those premalignant pancreatic lesions may provide a significant improvement in patient outcome. This review covers cystic neoplasms of the pancreas, premalignant solid lesions of the pancreas, and inflammatory lesions of the pancreas. Figures show a 30 mm diameter hypoechoic lesion without septae in the pancreatic head, an oval 20 mm diameter pancreatic mass with mixed solid and cystic components, a 24 mm diameter hypoechoic mass with well-defined borders in the tail of the pancreas, a 22 × 18 mm cystic lesion with a thick wall and internal debris in the head of the pancreas, and an endoscopic cyst gastrostomy after balloon dilation. Tables list World Health Organization (WHO) 2010 classification of pancreatic tumors, classification of pancreatic cystic lesions, main characteristics of common pancreatic cystic lesions, high-risk stigmata and worrisome features of intraductal papillary mucinous neoplasm on cross-sectional imaging, and WHO classification of pancreatic neuroendocrine tumors.   This review contains 5 highly rendered figures, 5 tables and 55 references

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