scholarly journals Pelvic Lymphanedectomy due to metastatic breast cancer causing postrenal acute kidney injury

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Ana Beatriz Charantola Beloni ◽  
Ana Clara Charantola Beloni ◽  
Leandro Beloni ◽  
Lúcio Fábio Caldas Ferraz

Introduction: About 30% of the patients healed from breast cancer recurred with metastasis, and the lymphatic is the main path of dissemination. Usually, postrenal acute kidney failure (AKI) is a result of gynecological, urological, gastrointestinal and retroperitoneal cancer, but unusual in breast cancer. Objectives: To report the unusual metastatic behavior of the carcinoma for diagnostic elucidation. Method: Anamnesis and review of medical charts and bibliography. Results: White, female, 69-year old women being retreated for invasive ductal breast cancer, luminal B type, was hospitalized in June, 2018, with hypothesis of bronchopneumonia and AKI due to dehydration and infection. Laboratory examinations indicated urea at 75 mg/dl, creatinine at 2.56 mg/dl, sodium at 141 mmol/L, and potassium at 4.2 mmol/L. The initial conduct included antibiotics and hydration with 0.9% saline solution. Abdominal and bladder ultrasound indicated dilatation of the pelvicalyceal systems system and proximal ureters, without pointing a location and cause of obstruction; urinary bladder with conserved shape and capacity; absence of images compatible with calculi and expansive solid, cystic or complex injuries. Due to the worsened glomerular filtration rate and oliguria, a double J catheter was inserted to the left. However, there was no improvement in kidney function. Then, a nephrostomy was performed to the right, which restituted urine traffic. In February, 2019, urotomography showed dilatation of the pelvicalyceal system and right ureters to the pelvis (L5), where it became narrow, with a 1.5 cm caliber ureter obstruction; multiple metastasis in the pelvic bones and bilateral pleural effusion. A double J catheter was inserted in the right ureter through a cateter via anterograde pathway, thus recovering kidney function and comfort. After 5 months, computed tomography showed pelvic lymphadenopathy as the cause of obstruction. Currently, the patient has a metallic catheter in the right side, with good general status and on anastrozole. Conclusions: Metastatic breast cancer is still challenging and prone to complications. Therefore, its knowledge allows a better approach of patients by correlating them with more diagnostic and care possibilities.

2014 ◽  
Vol 8 ◽  
pp. BCBCR.S14920
Author(s):  
Victor C. Kok ◽  
Sheng-Chung Wu ◽  
Chien-Kuang Lee

Sequential palliative chemotherapy for metastatic breast cancer incorporating weekly gemcitabine administered as three-weeks-on, one-week-off schedule is widely adopted throughout the East Asia region. Hemolytic-uremic syndrome (HUS) associated with weekly gemcitabine for a breast cancer patient is extremely rare. We report here a case of 43-year-old woman with metastatic breast cancer who received weekly gemcitabine as a third-line palliative chemotherapy for her disease. She developed HUS after a cumulative dose of 11,000 mg/m2 gemcitabine, evidenced by microangiopathic hemolytic anemia (MAHA) with schistocytes seen in peripheral blood smear, decreased haptoglobin level (<0.29 mmol/L), thrombocytopenia, negative direct Coombs test, and acute kidney injury. Owing to the ease of administration of weekly gemcitabine, gemcitabine-induced thrombocytopenia, multifactorial anemia in metastatic breast cancer, and possibility of cancer progression, HUS could have gone unnoticed. Breast cancer oncologist should be cognizant of this rare HUS even during weekly gemcitabine treatment.


e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Putu Krishna B. S. Putra ◽  
I Wayan J. Sumadi ◽  
Ni Putu Sriwidyani ◽  
IG Budhi Setiawan

Abstract: Breast cancer is the most common cancer in woman. Metastasis often occurs especially to the bones. This study was aimed to determine the characteristics of breast cancer patients with bone metastasis. This was a descriptive study with a cross-sectional design. Samples were 46 breast cancer patients with bone metastasis recorded at Sanglah Hospital from 2014 until 2018. Data of pathological examination archives of Oncology Surgery Division Medical Faculty of Udayana University/Sanglah General Hospital were used to obtain the clinicopathological characteristics of metastatic breast cancer patients based on age, lateralization, histopathological type, and tumor molecular subtype. The results showed that most cases of metastatic breast cancer were aged 40-49 years as many 21 patients (45.7%), minimal difference in lateralization between right breast as many 22 patients (47.8%) and left breast 23 patients (50%). The most common histopathological type was invasive carcinoma of no special type as many 34 patients (73.9%). The most common tumor subtype was the luminal B subtype as many 21 patients (45.7%). In conclusion, most patients of breast cancer with bone metastasis were 40-49 years old, invasive carcinoma of no special type, molecular subtype of luminal B, and no significant difference between lateralization to the right and left breast.Keywords: breast cancer, bone, metastasis, clinicopathological caharacteristics Abstrak: Kanker payudara merupakan jenis kanker yang paling sering dijumpai pada wanita. Metastasis sering terjadi terutama pada tulang. Penelitian ini bertujuan untuk mengetahui karakteristik pasien kanker payudara dengan metastasis tulang di RSUP Sanglah Denpasar. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah 46 pasien kanker payudara dengan metastasis tulang yang tercatat di RSUP Sanglah tahun 2014-2018. Data diambil dari arsip hasil pemeriksaan patologi di Subdivisi Bedah Onkologi, Departemen/Kelompok Staf Medis (KSM) Bedah Fakultas Kedokteran Universitas Udayana (FK UNUD)/RSUP Sanglah untuk mendapatkan karakteristik klinikopatologi pasien kanker payudara metastasis tulang berdasarkan usia, lateralisasi, tipe histopatologik, dan subtipe molekuler tumor. Hasil penelitian menunjukkan kasus terbanyak terjadi pada rentang usia 40-49 tahun sebanyak 21 orang (45,7%), dengan lateralisasi tidak jauh berbeda antara payudara kanan sebanyak 22 orang (47,8) dan kiri sebanyak 23 orang (50%). Tipe histopatologik yang lebih sering ditemukan yaitu invasive carcinoma of no special type sebanyak 34 orang (73,9%). Subtipe molekuler yang paling banyak ditemukan ialah subtipe luminal B sebanyak 21 orang (45,7%). Simpulan penelitian ini pasien kanker payudara dengan metastasis tulang berada pada rentang usia 40-49 tahun, invasive carcinoma of no special type, subtipe molekuler luminal B. dan lateralisasi payudara kanan dan kiri tidak jauh berbeda.Kata kunci: kanker payudara, metastasis, tulang, karakteristik klinikopatologik


2021 ◽  
Vol 14 (3) ◽  
pp. e241601
Author(s):  
Victor Ken On Chang ◽  
Samuel Thambar

Cancer metastasis to the oral and maxillofacial region is uncommon, and metastasis to the mandibular condyle is considered rare. We present a case of a 56-year-old woman with a history of invasive ductal cell carcinoma of the right breast, 10 years in remission, presenting with a 6-month history of symptoms typical of temporomandibular joint (TMJ) dysfunction. Imaging revealed an osteolytic lesion of her right TMJ and subsequent open biopsy confirmed the diagnosis of metastatic breast cancer. Despite the rarity of metastatic cancer to the head and neck region, it is still important for clinicians from both medical and dental backgrounds to consider this differential diagnosis, particularly in patients with a history of hormonal positive subtype of breast cancer. Given that bony metastasis can manifest even 10 years after initial diagnosis, surveillance which includes examination of the head and neck region is important, and may include routine plain-film imaging surveillance with an orthopantomogram (OPG).


2018 ◽  
Vol 25 (7) ◽  
pp. 1738-1742 ◽  
Author(s):  
Kristyn E Yemm ◽  
Laura M Alwan ◽  
A Bilal Malik ◽  
Lupe G Salazar

There is no preferred treatment option for metastatic breast cancer; therefore, treatment should provide palliation, prolong survival, control symptoms, and improve quality of life. Liposomal doxorubicin formulations have been shown to have less alopecia, nausea, vomiting, and myelosuppression than traditional doxorubicin, but more skin toxicities and infusion reactions. Prolonged use of liposomal doxorubicin may be associated with unrecognized or less well-defined toxicities. We report a case of acute kidney injury and progressively worsening chronic kidney disease necessitating dialysis in a patient who received prolonged therapy with liposomal doxorubicin for treatment of metastatic breast cancer. This case report should give caution to providers considering prolonged use of liposomal doxorubicin in the metastatic breast cancer setting as we observed sustained renal toxicity, long past the cessation of treatment.


2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 197-197 ◽  
Author(s):  
Musa Mayer ◽  
Matthew Sussman ◽  
Anthony Masaquel ◽  
Tripthi Kamath ◽  
Catherine Lai ◽  
...  

197 Background: Advances in targeted therapy have led to an increase in the median overall survival in patients with HER2+ metastatic breast cancer (MBC). However, patient attributions related to living longer have not been studied. Methods: A one-time, web-based survey was administered through multiple US-based breast cancer organizations. The inclusion criteria were being female, age 18+, having HER2+ MBC, and living in the US. The surveys included health related quality of life (HRQL), symptom burden, activities of daily living, satisfaction with medical care, work productivity, and attributes of living longer. To assess beliefs about length of survival with HER2+ MBC, participants were asked to rate the importance of 16 items. Descriptive results were stratified by time since metastatic diagnosis and HRQL. Results: Of 560 attempted surveys, 365 (65%) participants met inclusion criteria. Mean (SD) age was 53.6 (10.5) years, 93% were white, and 27% reported having participated in a clinical trial. 59% of respondents reported living ≥4 years since HER2+ MBC diagnosis. Common reasons patients gave for living longer included: choosing the right doctor/medical team (91%), having a positive outlook on life (79%), and learning about the disease or treatments (79%). Women with <4 years since HER2+ MBC diagnosis were more likely to report having a positive outlook on life (85% vs 76%), using complementary and alternative medicine (45% vs 36%) and exercising regularly (74% vs 66%) compared with those having ≥4 years since diagnosis. Women reporting a better compared with a poorer HRQL reported more frequent regular exercise (73% vs 49%) and more often had a positive outlook on life (86% vs 64%). Conclusions: To our knowledge, this is the first study of women with HER2+ MBC and their attributions about length of survival. Having the right medical team, remaining positive, and being educated about the disease and its treatments were most important to participants. Women reporting better quality of life were more likely to report multiple attributions of living longer. HRQL and patient perceptions about their survival are important factors that should be considered in providing patient-centered care.


2009 ◽  
Vol 338 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Masahiko Nagahama ◽  
Domenic A. Sica ◽  
Domenic A. Sica

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11502-e11502
Author(s):  
Fatima Zahra Hijri ◽  
Samia Arifi ◽  
Sami Aziz Brahmi ◽  
Nezar Bouyahia ◽  
Zineb Benbrahim ◽  
...  

e11502 Background: Few studies demonstrated that surgical resection of the primary tumor in patients with metastatic breast cancer at diagnosis is associated with significant improvement of survival. The aim of this study is to evaluate the correlation impact of local surgery in metastatic breast cancer at diagnosis with molecular subtypes. Methods: A retrospective study was conducted from 2007 to 2011 in our institution, of all stage IV breast cancer patients; who undergo breast surgery. Clinical , tumor characteristics, molecular subtypes, prognostic factors, therapeutic results data were analyzed. Results: We selected 59 cases. The mean age was 36 years (range: 22-44). 55 % women presented with locally advanced breast cancer with 13% T4 d . All patients underwent mastectomy except 4 who underwent conservative surgery .41 patients had axillary lymph node dissection. 63% were luminal A, 17% were luminal B, 7% were Her2-positive and 13% were basal-like . All patients received anthracycline based regimen and only 33% received taxanes. Loco regional radiotherapy (RT) was given to 6 women. Average follow-up was 13 months: - 20 patients represented partial response : 15 patients in luminal A , 3 patients in luminal B ,1 patients in basal-like and 1 patient in HER2-positive. - 11 patients (19%) were stable : 9 patients in luminal A and 2 patient in luminal B . -24 patients represented a progressive disease including 11 patients presented locoregional recurrence : 75 % in HER-positive, 40 % in basal-like, 50% in luminal B and 30% in luminal A (p=0.4). - 4 patients died in basal-like. The median local recurrence-free survival was 19 months and the median progression-free survival was 20 months. The local relapse is less observed in patients who: have a small tumor size (p = 0.003), had axillary lymph node dissection (p = 0.02) and loco regional radiotherapy (p = 0.03). The metastatic progression is less observed in patients with small tumor size (p = 0.01). Conclusions: Local Therapy of the primary tumor improves local control of disease, particularly in women with Small tumors. However, no significant correlation between impact of locale therapy and Molecular Subtypes was observed.


2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e20701-e20701 ◽  
Author(s):  
Sneha Purvey ◽  
Konstantinos Leventakos ◽  
Mutsa S Munjoma ◽  
Michael J Sherman ◽  
Sameer Desale ◽  
...  

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Putu Krishna B. S. Putra ◽  
I Wayan J. Sumadi ◽  
Ni Putu Sriwidyani ◽  
IG Budhi Setiawan

Abstract: Breast cancer is the most common cancer in woman. Metastasis often occurs especially to the bones. This study was aimed to determine the characteristics of breast cancer patients with bone metastasis. This was a descriptive study with a cross-sectional design. Samples were 46 breast cancer patients with bone metastasis recorded at Sanglah Hospital from 2014 until 2018. Data of pathological examination archives of Oncology Surgery Division Medical Faculty of Udayana University/Sanglah General Hospital were used to obtain the clinicopathological characteristics of metastatic breast cancer patients based on age, lateralization, histopathological type, and tumor molecular subtype. The results showed that most cases of metastatic breast cancer were aged 40-49 years as many 21 patients (45.7%), minimal difference in lateralization between right breast as many 22 patients (47.8%) and left breast 23 patients (50%). The most common histopathological type was invasive carcinoma of no special type as many 34 patients (73.9%). The most common tumor subtype was the luminal B subtype as many 21 patients (45.7%). In conclusion, most patients of breast cancer with bone metastasis were 40-49 years old, invasive carcinoma of no special type, molecular subtype of luminal B, and no significant difference between lateralization to the right and left breast.Keywords: breast cancer, bone, metastasis, clinicopathological caharacteristics Abstrak: Kanker payudara merupakan jenis kanker yang paling sering dijumpai pada wanita. Metastasis sering terjadi terutama pada tulang. Penelitian ini bertujuan untuk mengetahui karakteristik pasien kanker payudara dengan metastasis tulang di RSUP Sanglah Denpasar. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah 46 pasien kanker payudara dengan metastasis tulang yang tercatat di RSUP Sanglah tahun 2014-2018. Data diambil dari arsip hasil pemeriksaan patologi di Subdivisi Bedah Onkologi, Departemen/Kelompok Staf Medis (KSM) Bedah Fakultas Kedokteran Universitas Udayana (FK UNUD)/RSUP Sanglah untuk mendapatkan karakteristik klinikopatologi pasien kanker payudara metastasis tulang berdasarkan usia, lateralisasi, tipe histopatologik, dan subtipe molekuler tumor. Hasil penelitian menunjukkan kasus terbanyak terjadi pada rentang usia 40-49 tahun sebanyak 21 orang (45,7%), dengan lateralisasi tidak jauh berbeda antara payudara kanan sebanyak 22 orang (47,8) dan kiri sebanyak 23 orang (50%). Tipe histopatologik yang lebih sering ditemukan yaitu invasive carcinoma of no special type sebanyak 34 orang (73,9%). Subtipe molekuler yang paling banyak ditemukan ialah subtipe luminal B sebanyak 21 orang (45,7%). Simpulan penelitian ini pasien kanker payudara dengan metastasis tulang berada pada rentang usia 40-49 tahun, invasive carcinoma of no special type, subtipe molekuler luminal B. dan lateralisasi payudara kanan dan kiri tidak jauh berbeda.Kata kunci: kanker payudara, metastasis, tulang, karakteristik klinikopatologik


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