scholarly journals Breast sarcomas. A review of the possible treatment modalities

2017 ◽  
Vol 12 (2) ◽  
pp. 23-27
Author(s):  
Nicolae BACALBASA ◽  
◽  
Olivia IONESCU ◽  
Keyword(s):  
Surgical Treatment ◽  
Adjuvant Chemotherapy ◽  
Connective Tissue ◽  
Adjuvant Radiotherapy ◽  
De Novo ◽  
The Body ◽  
Treatment Modalities ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Tumor Type

Background. Breast sarcomas (BS) are rare tumors which origin within the connective tissue of the breast. A clear delimitation from breast carcinoma should be established because the management and evolution and prognosis are different. BS can develop “de novo” – primary BS or can be related to a previously treated malignant breast tumor – for example after breast conservative surgery and adjuvant radiotherapy. Aim. Owing to the rarity of this tumor type, there is limited evidence with regard to the optimal treatment possibilities. The information comes primary from small retrospective studies so that the treatment principles resemble that of primary mesenchymal malignancies arising in other parts of the body (e.g. leiomyosarcoma, angiosarcoma or liposarcoma). We aimed to make a review of the current treatment possibilities of the BS emphasizing on the type and extent of the surgical treatment, the utility of the axillary lymph node (LN) dissection and the feasibility and benefit of an adjuvant chemotherapy. Method. We performed an online research on Pubmed using the following key words: “sarcoma”, “radiotherapy”, “surgery”, “chemotherapy”. We tried to select the data referring to sarcoma developing with the connective tissue of the breast as well as the information of BS developing after irradiation of the breast in women previously diagnosed with breast cancer (BC) who received adjuvant radiotherapy. We further looked for reports about the role of an adjuvant treatment, namely chemotherapy. Conclusion. The only treatment proved to have a benefit on the prognosis is the surgical treatment with the achievement of a wide, radical, complete resection (R0-resection). For angiosarcomas, either primary or therapy-related, the margins of resection should be more than 1 cm for small tumors and more than 3 cm for larger tumors. Adjuvant chemotherapy has limited benefits and should be applied in selected cases.

scholarly journals Axillary Nodal Metastasis of Operated Gallbladder Carcinoma – First Remote Site of Aggression.

2021 ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background: Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer.Case summary: A 63-year-old gentleman presented with the complaint of a non-healing ulcer at epigastrium for the last 1 month, after having undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed bilateral axillary metastasis. He then underwent bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later.Conclusion: Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of bilateral axillary lymph nodes as the first distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

Vaginal malignant melanoma: a case report and literature review

2004 ◽  
Vol 14 (4) ◽  
pp. 687-689
Author(s):  
M. Moodley ◽  
M. Daya ◽  
J. Moodley
Keyword(s):  
Case Report ◽  
Adjuvant Chemotherapy ◽  
Malignant Melanoma ◽  
Local Excision ◽  
Adjuvant Radiotherapy ◽  
Pelvic Surgery ◽  
Treatment Modalities ◽  
High Dose ◽  
The Past ◽  
Worse Prognosis

Vaginal melanomas are rare genital malignancies occurring mainly in the 6th and 7th decades of life. In general, they have a worse prognosis than cutaneous melanomas. In the past, various treatment modalities have been recommended including radical pelvic surgery. However, the prognosis is poor in spite of such radical approaches. More recently, more conservative treatment in the form of wide local excision combined with adjuvant chemotherapy, high-dose radiotherapy, and immunotherapy seem to have promising results. We describe a patient with vaginal malignant melanoma treated with conservative local excision as well as adjuvant radiotherapy, chemotherapy, and interferon.

scholarly journals Axillary nodal metastasis of operated gallbladder carcinoma: remote site of aggression—a case report

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer. Case presentation A 63-year-old gentleman presented with the complaint of a non-healing ulcer at upper abdomen for the last 1 month. He had undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed isolated bilateral axillary metastasis and the patient underwent a bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later. Conclusion Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of isolated bilateral axillary lymph nodes as a distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

Medical treatment of nasal squamous papilloma with imiquimod cream

2003 ◽  
Vol 117 (9) ◽  
pp. 720-722 ◽  
Author(s):  
Marco Caversaccio ◽  
Stefan Aebi
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
The Body ◽  
Treatment Modalities ◽  
Imiquimod Cream ◽  
Skin Tumours ◽  
Squamous Papilloma ◽  
Human Papilloma Viruses

Warts are common lesions. The prevalence and incidence of squamous papilloma of the nasal vestibulum are not known, and it is not certain how often human papilloma viruses are involved. Numerous medical or surgical treatment modalities have been reported in the literature with variable, sometimes unsatisfactory results. Imiquimod cream is a topically applied immunomodulator. It is used for warts and other skin tumours on different locations of the body. We report results of six patients treated with imiquimod five per cent cream for nasal squamous papilloma.

scholarly journals Treatment and Outcome of Patients with Uterine Carcinosarcoma in a Comprehensive Cancer Network

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
K. Hapsari ◽  
C. Bhugwandass ◽  
G. W. J. van Rijn ◽  
A. A. M. van der Wurff ◽  
M. van ‘t Veer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adjuvant Chemotherapy ◽  
Late Stage ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Uterine Carcinosarcoma ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Cancer Network

Abstract Aim To determine clinical characteristics, treatment modalities and survival of uterine carcinosarcoma (UCS). Methods Data on treatment of UCS patients in the Comprehensive Cancer Network south region in the Netherlands between 2004 and 2014 were retrospectively evaluated. Results Data of 62 patients with UCS were retrieved. Mean age at diagnosis was 69.2 years (45–95 years). Data of six patients were excluded because they did not receive any treatment. Of the 56 patients included in this study, 57.1% presented with early-stage (FIGO I–II) disease and 42.9% with late-stage (FIGO III–IV) disease. 46.9% of the patients with FIGO early-stage disease received only surgical treatment, whereas 9.4% received adjuvant chemotherapy and 43.8% received adjuvant radiotherapy. Median DFS in patients with early-stage disease was 47.0 months (17.5–72.0). Adjuvant therapy did not seem to alter prognosis (p = 0.261). 16.7% of the patients with late-stage disease received only surgical treatment, 12.5% received only chemotherapy, whereas 50% received adjuvant chemotherapy and 20.8% adjuvant radiotherapy after surgery. Median DFS in late-stage disease was 8.5 months (2.5–23.5). Adjuvant therapy did not seem to alter prognosis (p = 0.30). Conclusion UCS with both FIGO stages I–II and III–IV has a dismal prognosis. The addition of adjuvant treatment did not seem to increase survival.

Biocompatible Nanovesicular Drug Delivery Systems with Targeting Potential for Autoimmune Diseases

2020 ◽  
Vol 26 (42) ◽  
pp. 5488-5502 ◽  
Author(s):  
Yub Raj Neupane ◽  
Asiya Mahtab ◽  
Lubna Siddiqui ◽  
Archu Singh ◽  
Namrata Gautam ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Drug Delivery Systems ◽  
Drug Carriers ◽  
Immunological Tolerance ◽  
Delivery Systems ◽  
The Body ◽  
Autoimmune Response ◽  
Treatment Modalities

Autoimmune diseases are collectively addressed as chronic conditions initiated by the loss of one’s immunological tolerance, where the body treats its own cells as foreigners or self-antigens. These hay-wired antibodies or immunologically capable cells lead to a variety of disorders like rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, multiple sclerosis and recently included neurodegenerative diseases like Alzheimer’s, Parkinsonism and testicular cancer triggered T-cells induced autoimmune response in testes and brain. Conventional treatments for autoimmune diseases possess several downsides due to unfavourable pharmacokinetic behaviour of drug, reflected by low bioavailability, rapid clearance, offsite toxicity, restricted targeting ability and poor therapeutic outcomes. Novel nanovesicular drug delivery systems including liposomes, niosomes, proniosomes, ethosomes, transferosomes, pharmacosomes, ufasomes and biologically originated exosomes have proved to possess alluring prospects in supporting the combat against autoimmune diseases. These nanovesicles have revitalized available treatment modalities as they are biocompatible, biodegradable, less immunogenic and capable of carrying high drug payloads to deliver both hydrophilic as well as lipophilic drugs to specific sites via passive or active targeting. Due to their unique surface chemistry, they can be decorated with physiological or synthetic ligands to target specific receptors overexpressed in different autoimmune diseases and can even cross the blood-brain barrier. This review presents exhaustive yet concise information on the potential of various nanovesicular systems as drug carriers in improving the overall therapeutic efficiency of the dosage regimen for various autoimmune diseases. The role of endogenous exosomes as biomarkers in the diagnosis and prognosis of autoimmune diseases along with monitoring progress of treatment will also be highlighted.

Asymmetric Dopaminergic Dysfunction in Brain-First versus Body-First Parkinson’s Disease Subtypes

2021 ◽  
pp. 1-11
Author(s):  
Karoline Knudsen ◽  
Tatyana D. Fedorova ◽  
Jacob Horsager ◽  
Katrine B. Andersen ◽  
Casper Skjærbæk ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Specific Binding ◽  
Asymmetry Index ◽  
The Body ◽  
Specific Binding Ratio ◽  
Dat Spect ◽  
Vagal Innervation ◽  
Nigrostriatal Degeneration

Background: We have hypothesized that Parkinson’s disease (PD) comprises two subtypes. Brain-first, where pathogenic α-synuclein initially forms unilaterally in one hemisphere leading to asymmetric nigrostriatal degeneration, and body-first with initial enteric pathology, which spreads through overlapping vagal innervation leading to more symmetric brainstem involvement and hence more symmetric nigrostriatal degeneration. Isolated REM sleep behaviour disorder has been identified as a strong marker of the body-first type. Objective: To analyse striatal asymmetry in [18F]FDOPA PET and [123I]FP-CIT DaT SPECT data from iRBD patients, de novo PD patients with RBD (PD +RBD) and de novo PD patients without RBD (PD - RBD). These groups were defined as prodromal body-first, de novo body-first, and de novo brain-first, respectively. Methods: We included [18F]FDOPA PET scans from 21 iRBD patients, 11 de novo PD +RBD, 22 de novo PD - RBD, and 18 controls subjects. Also, [123I]FP-CIT DaT SPECT data from iRBD and de novo PD patients with unknown RBD status from the PPPMI dataset was analysed. Lowest putamen specific binding ratio and putamen asymmetry index (AI) was defined. Results: Nigrostriatal degeneration was significantly more symmetric in patients with RBD versus patients without RBD or with unknown RBD status in both FDOPA (p = 0.001) and DaT SPECT (p = 0.001) datasets. Conclusion: iRBD subjects and de novo PD +RBD patients present with significantly more symmetric nigrostriatal dopaminergic degeneration compared to de novo PD - RBD patients. The results support the hypothesis that body-first PD is characterized by more symmetric distribution most likely due to more symmetric propagation of pathogenic α-synuclein compared to brain-first PD.

scholarly journals NI-19 Use of 11C-methionine PET for decision of discontinuation of adjuvant chemotherapy with temozolomide

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii14-ii14
Author(s):  
Takaaki Beppu ◽  
Yuichi Sato ◽  
Toshiaki Sasaki ◽  
Kazunori Terasaki ◽  
Kuniaki Ogasawara
Keyword(s):  
Adjuvant Chemotherapy ◽  
Small Sample Size ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Small Sample ◽  
Tumor Type ◽  
Diffuse Astrocytoma ◽  
Significant Difference ◽  
Met Pet

Abstract Background: The aim was to clarify whether positron emission tomography with 11C-methyl-L-methionine (met-PET) is useful to decide on discontinuation of TMZ-adjuvant therapy in patients with residual diffuse astrocytic tumor. Methods: Subjects were 44 patients with residual tumor comprising 17 with IDH1-mutant diffuse astrocytoma (DA), 13 with IDH1-mutant anaplastic astrocytoma (AA), and 14 with IDH1-wild glioblastoma (GB). All patients received TMZ-adjuvant chemotherapy (median, 12 courses), and whether to discontinue or continue TMZ-adjuvant chemotherapy was decided on the basis of the tumor-to-normal ratio in standardized uptake value from met-PET (T/N); patients with T/N < 1.6 immediately discontinued TMZ, and patients with T/N > 1.6 were either to continued or discontinued TMZ. Progression-free survival (PFS) was compared between patients with T/N > 1.6 and T/N < 1.6 in each tumor type. Median observation period was 434 days after met-PET scanning. Results: The number of patient who underwent recurrence was 10 in DA, 7 in AA, and 11 in GB. All patients showing T/N > 1.6 underwent tumor recurrence. PFS was significantly longer in patients with T/N < 1.6 than T/N > 1.6 in DA and AA (p < 0.01 in both types), but was no significant difference between 2 groups in GB (p = 0.06). Sixteen of 17 patients (94%) in DA and AA showed recurrence from residual tumor, whereas 4 of 11 patients (36%) in GB showed recurrent tumor at remote regions which were different from residual tumor. Conclusions: The present study suggested that met-PET is beneficial to decide to discontinue adjuvant chemotherapy with TMZ in patients with residual tumors of DA and AA, but not useful for patients with GB. Reasons for unsuccessful results in GB might have been small sample size, failure of establishing the cut off value in T/N, recurrences at remote regions where not be assessed by met-PET.

scholarly journals Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Murat Gözüküçük ◽  
Esra Gülen Yıldız
Keyword(s):  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Medical Treatment ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Laboratory Findings ◽  
Factors Affecting ◽  
Laboratory Infection ◽  
Major Factors

Abstract Background This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission. Materials and methods Between January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded. Results The records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05). Conclusions Although the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.

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