scholarly journals Primary angiosarcoma of the lung and pleura

2004 ◽  
Vol 61 (4) ◽  
Author(s):  
G.C. Maglaras ◽  
S. Katsenos ◽  
J. Kakadelis ◽  
C. Katsanos ◽  
Z. Metafratzi ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Fiberoptic Bronchoscopy ◽  
X Rays ◽  
Male Smoker ◽  
Epithelioid Angiosarcoma ◽  
Rare Tumour ◽  
Chest Computed Tomography ◽  
Primary Angiosarcoma ◽  
Open Lung ◽  
Right Thoracotomy

A 46 year old male smoker was admitted for severe continuing hemoptysis. Chest-X-rays and chest computed tomography revealed nodular infiltrates and bilateral hemothorax. Fiberoptic bronchoscopy resulted to non-diagnostic cytological and microbiological findings. Open lung and pleural biopsies after right thoracotomy revealed epithelioid angiosarcoma and further staging assessment showed secondary brain and liver foci. The patient received several courses of chemotherapy but he died one month later. The clinical, radiological, pathological, histochemical and therapeutic aspects of the disease are discussed. Angiosarcoma, a rare tumour with poor prognosis should be taken into consideration in the differential diagnosis of hemoptysis.

scholarly journals Fiberoptic Bronchoscopy-Assisted Endotracheal Intubation in a Patient With a Large Tracheal Tumor

2015 ◽  
Vol 100 (4) ◽  
pp. 589-592 ◽  
Author(s):  
Lei Pang ◽  
Yan-Hua Feng ◽  
Hai-Chun Ma ◽  
Su Dong
Keyword(s):  
Sleep Deprivation ◽  
Airway Obstruction ◽  
Endotracheal Intubation ◽  
Tracheal Stenosis ◽  
Imaging Techniques ◽  
Tumor Resection ◽  
Fiberoptic Bronchoscopy ◽  
X Rays ◽  
Tissue Mass ◽  
Tracheal Tumor

In the event of a high degree of airway obstruction, endotracheal intubation can be impossible and even dangerous, because it can cause complete airway obstruction, especially in patients with high tracheal lesions. However, a smaller endotracheal tube under the guidance of a bronchoscope can be insinuated past obstructive tumor in most noncircumferential cases. Here we report a case of successful fiberoptic bronchoscopy-assisted endotracheal intubation in a patient undergoing surgical resection of a large, high tracheal tumor causing severe tracheal stenosis. A 42-year-old Chinese man presented with dyspnea, intermittent irritable cough, and sleep deprivation for one and a half years. X-rays and computed tomography scan of the chest revealed an irregular pedunculated soft tissue mass within the tracheal lumen. The mass occupied over 90% of the lumen and caused severe tracheal stenosis. Endotracheal intubation was done to perform tracheal tumor resection under general anesthesia. After several failed conventional endotracheal intubation attempts, fiberoptic bronchoscopy-assisted intubation was successful. The patient received mechanical ventilation and then underwent tumor resection and a permanent tracheostomy. This case provides evidence of the usefulness of the fiberoptic bronchoscopy-assisted intubation technique in management of an anticipated difficult airway and suggests that tracheal intubation can be performed directly in patients with a tracheal tumor who can sleep in the supine position, even if they have occasional sleep deprivation and severe tracheal obstruction as revealed by imaging techniques.

scholarly journals Sarcomatoid Carcinoma of the Lung Mimicking a Thromboembolic Disease

2016 ◽  
Vol 02 (02) ◽  
pp. 58
Author(s):  
Mona Mlika ◽  
Selma Chaieb ◽  
Sonia Baccari ◽  
Tarek Kilani ◽  
Faouzi Mezni ◽  
...  
Keyword(s):  
Case Report ◽  
Lung Carcinoma ◽  
Poor Prognosis ◽  
Sarcomatoid Carcinoma ◽  
Thromboembolic Disease ◽  
Rare Tumour ◽  
Radiological Features ◽  
Mode Of Presentation ◽  
Specific Symptoms ◽  
Radiologic Features

Background:Sarcomatoid carcinoma of the lung is a rare tumour with a poor prognosis.Observation:We present a case report of sarcomatoid carcinoma and its mode of presentation with a complete illustration. In this case, the tumour, which is generally peripheral, was proximal and was revealed by non-specific symptoms and radiological features suggesting a thromboembolic disease.Conclusion:This observation is interesting because it highlights the necessity of evoking the diagnosis of lung carcinoma when dealing with radiologic features related to a thromboembolic disease.

scholarly journals Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

2020 ◽  
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Verónica Buonaiuto ◽  
Michele Ricci ◽  
Jesica Martín-Carmona ◽  
Diana Paredes-Ruíz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Atherosclerotic Cardiovascular Disease ◽  
X Rays ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Male Sex

Abstract Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index < 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation < 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate < 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes < 0.8 × 103/μL; and monocytes < 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.

scholarly journals A rare case of primary epithelioid angiosarcoma of the ureter

2016 ◽  
Vol 98 (8) ◽  
pp. e184-e185 ◽  
Author(s):  
P Padaki ◽  
R Hutton ◽  
T Amer ◽  
R Hasan ◽  
D Pugh ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Soft Tissues ◽  
Distant Metastases ◽  
Clinical Decision ◽  
Epithelioid Angiosarcoma ◽  
Primary Angiosarcoma ◽  
Atypical Manifestations ◽  
Urothelial Malignancy ◽  
Tumour Origin ◽  
Do So

Angiosarcoma is an extremely rare vascular malignancy with a 1-year survival rate of 50%, regardless of tumour origin. Distant metastases are common and occur in the lungs, bone, lymph nodes and soft tissues. The majority of patients with angiosarcoma present with localised disease, although 25–45% have distant metastases at presentation. There are few reported cases of angiosarcomas of the bladder and we report the second case in the literature of primary angiosarcoma of the ureter. We suggest that, in atypical manifestations of suspected urothelial malignancy, the multidisciplinary team considers the possibility of rarer, aggressive tumours early. This may influence clinical decision making towards offering radical treatments earlier, before it is too late to do so owing to aggressive oncological behaviour.

Adenocarcinoma in pulmonary sequestration

2011 ◽  
Vol 19 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Lukman Lawal ◽  
Dimitrios Mikroulis ◽  
Savvas Eleftheriadis ◽  
Panagiotis Karros ◽  
Ioannis Bougioukas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Fluid Level ◽  
Male Smoker ◽  
Recurrent Pneumonia ◽  
Chest Computed Tomography ◽  
Lower Lobectomy ◽  
Intralobar Sequestration

A 67-year-old male smoker presented with hemoptysis and recurrent pneumonia. Chest computed tomography showed an emphysematous cyst and air-fluid level cavities in the left lower lobe. A left lower lobectomy was performed. The intraoperative finding was intralobar sequestration. Histopathology revealed adenocarcinoma within the sequestrated lobe. Only 8 cases of lung cancer and sequestration have been reported since 1963.

scholarly journals High aspartate aminotransferase to alanine aminotransferase ratio on admission as risk factor for poor prognosis in COVID-19 patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheng Qin ◽  
Yingxin Wei ◽  
Xiaoyu Lyu ◽  
Bangbo Zhao ◽  
Yunlu Feng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Platelet Count ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Chest Computed Tomography ◽  
Severity Scores ◽  
Laboratory Results

Abstract This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992–0.998]) and hemoglobin (OR 0.984, 95% CI [0.972–0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1–4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.

scholarly journals Malignant Melanoma of the Urethra: A Rare Histologic Subdivision of Vulvar Cancer with a Poor Prognosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Veronika Günther ◽  
I. Alkatout ◽  
C. Lez ◽  
S. Altarac ◽  
R. Fures ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Local Excision ◽  
Poor Prognosis ◽  
Vulvar Cancer ◽  
Residual Tumour ◽  
Rare Tumour ◽  
Pathological Analysis

Malignant melanoma of the urethra is a rare tumour that is difficult to diagnose and treat, resulting in a poor prognosis. In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle. The tumour was removed by local excision, and a pathological analysis revealed a malignant melanoma. Distal urethrectomy was performed after three months with no evidence of residual tumour. There was no evidence of disease at a six-year followup. In this paper, we compare the epidemiology, treatment, staging, and prognosis of vulvar cancer in general to malignant melanoma of the vulva in particular.

scholarly journals High Aspartate Aminotransferase to Alanine Aminotransferase Ratio on Admission as Risk Factor for Poor Prognosis in COVID-19 Patients

2020 ◽  
Author(s):  
Cheng Qin ◽  
Yingxin Wei ◽  
Xiaoyu Lyu ◽  
Bangbo Zhao ◽  
Yunlu Feng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Platelet Count ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Chest Computed Tomography ◽  
Severity Scores ◽  
Laboratory Results

Abstract This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Poor prognosis included death and transfer to other hospitals due to deterioration. Of 567 patients, 56 (9.9%) had AST/ALT ≥ 2. Of the 56 patients, older age (median age 65.5 years), fatigue (29 [51.8%] cases), comorbidities (33 [58.9%] cases) and outcomes were significantly different from patients with AST/ALT < 2. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR = 0.989, 95% CI [0.983-0.996]) were independently associated with AST/ALT ≥ 2 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR = 22.02, 95% CI [1.84-263.2]), especially in patients with AST levels > 40 U/L. In subsequent monitoring, the AST/ALT ratio was decreased in both patients with AST/ALT < 2 or ≥ 2 on admission. COVID-19 patients who are older, or have fatigue, comorbidities are more likely to have AST/ALT ≥ 2 on admission, which might be the indication of worse status and outcomes.

scholarly journals Metastatic Intimal Sarcoma of the Pulmonary Artery Sensitive to Carboplatin-Vinorelbine Chemotherapy: Case Report and Literature Review

2018 ◽  
Vol 11 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Marie Cantaloube ◽  
Laurence Moureau-Zabotto ◽  
Lena Mescam ◽  
Audrey Monneur ◽  
Valeria Deluca ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Pulmonary Artery ◽  
Poor Prognosis ◽  
Objective Response ◽  
Standard Chemotherapy ◽  
Rare Tumour ◽  
Intimal Sarcoma ◽  
Metastatic Relapse ◽  
Advanced Stages

Pulmonary artery intimal sarcoma (PAIS) is a very rare tumour with a very poor prognosis. In advanced stages, chemotherapy and radiotherapy are poorly efficient, and no standard chemotherapy guideline is currently available. Here, we report on a 37-year-old woman with PAIS initially treated with surgical resection who developed metastatic relapse refractory to anthracycline-based chemotherapy, then trabectedin, then pazopanib. The patient was then given carboplatin-vinorelbine chemotherapy. The treatment was well tolerated, and, rapidly, a CT scan showed an objective response that lasted 8 months despite the 4th therapeutic line. We review the literature and show that our case is the second one that provides evidence of the efficacy of platinum-vinorelbine regimens in this aggressive tumour.

scholarly journals High risk of delayed or missed diagnosis of mucinous appendiceal neoplasm by transvaginal ultrasound: A case series

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Francesca Rizzello ◽  
◽  
Giulia Vannucci ◽  
Maria Elisabetta Coccia ◽  
◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Clinical Presentation ◽  
Transvaginal Ultrasound ◽  
Case Series ◽  
Rare Tumour ◽  
Adnexal Masses ◽  
Appendiceal Neoplasm ◽  
Missed Diagnosis ◽  
The Right ◽  
Different Origin

Appendiceal Neoplasm is a rare tumour with a vague and nonspecific clinical presentation. Delayed or missed diagnosis could result in mucin spill into the peritoneal cavity because of cancer infiltration or spontaneous rupture of appendix. This condition is called Psuedomyxoma Peritonei (PMP) and has a very poor prognosis if not treated properly. We present 4 cases of Appendiceal Neoplasm misdiagnosed as adnexal masses of different origin: Dermoid cyst of the right ovary; stump of the previously removed tube; ectopic pregnancy; ovarian malignancy. It is important for gynaecologists to recognize mucinous appendiceal neoplasm in the differential diagnosis of right adnexal masses in order to reduce the risk of misdiagnosis. Keywords: Appendiceal Neoplasm, Adnexal Masses, Transvaginal Ultrasound, Misdiagnosis.

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