Primary left atrial angiosarcoma mimicking pericarditis: A case report and review of the literature

2021 ◽  
Vol 148 (12) ◽  
pp. 115-121
Author(s):  
Trinh Le Huy ◽  
Pham Duy Manh
Keyword(s):  
Left Atrium ◽  
Treatment Options ◽  
Posterior Wall ◽  
Spindle Cell Sarcoma ◽  
Adjuvant Radiation ◽  
Curative Intent ◽  
Cardiac Angiosarcoma ◽  
Pet Ct ◽  
Probable Site ◽  
Flow Through

A 45-year-old male presented with symptoms mimicking pericarditis, including rapidly worsening dyspnea and retrosternal chest pain. On imaging workup, an abnormal mass of 50x53 mm in size was detected at the left atrium, which partially obstructed blood flow through the mitral valve. PET/CT was done in searching for the probable site of origin but revealed no abnormal uptake lesions. The tumorectomy and excision of the posterior wall of the left atrium were then performed with curative intent. The postoperative histology of the tumor was in favor of a spindle cell sarcoma, originating from the left atrium, grade 2, which was confirmed as epithelioid angiosarcoma by immunohistochemistry. The patient denied adjuvant radiation, thus we treated him with six cycles of Paclitaxel monotherapy, which was completed six months ago. At present, he is doing well with no signs of recurrence on the imaging technique. This paper illustrates the rarity of cardiac angiosarcoma, its complex presentation, and a brief review of available treatment options for this devastating disease.

scholarly journals Co-Clinical Trials: An Innovative Drug Development Platform for Cholangiocarcinoma

2021 ◽  
Vol 14 (1) ◽  
pp. 51
Author(s):  
Brinda Balasubramanian ◽  
Simran Venkatraman ◽  
Kyaw Zwar Myint ◽  
Tavan Janvilisri ◽  
Kanokpan Wongprasert ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Targeted Therapy ◽  
Drug Development ◽  
Surgical Resection ◽  
Treatment Options ◽  
Standard Of Care ◽  
Time Data ◽  
Current Standard ◽  
Innovative Drug ◽  
Curative Intent

Cholangiocarcinoma (CCA), a group of malignancies that originate from the biliary tract, is associated with a high mortality rate and a concerning increase in worldwide incidence. In Thailand, where the incidence of CCA is the highest, the socioeconomic burden is severe. Yet, treatment options are limited, with surgical resection being the only form of treatment with curative intent. The current standard-of-care remains adjuvant and palliative chemotherapy which is ineffective in most patients. The overall survival rate is dismal, even after surgical resection and the tumor heterogeneity further complicates treatment. Together, this makes CCA a significant burden in Southeast Asia. For effective management of CCA, treatment must be tailored to each patient, individually, for which an assortment of targeted therapies must be available. Despite the increasing numbers of clinical studies in CCA, targeted therapy drugs rarely get approved for clinical use. In this review, we discuss the shortcomings of the conventional clinical trial process and propose the implementation of a novel concept, co-clinical trials to expedite drug development for CCA patients. In co-clinical trials, the preclinical studies and clinical trials are conducted simultaneously, thus enabling real-time data integration to accurately stratify and customize treatment for patients, individually. Hence, co-clinical trials are expected to improve the outcomes of clinical trials and consequently, encourage the approval of targeted therapy drugs. The increased availability of targeted therapy drugs for treatment is expected to facilitate the application of precision medicine in CCA.

scholarly journals 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Concurrent Chemoradiotherapy ◽  
Curative Intent ◽  
Squamous Cell Esophageal Cancer ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

FDG PET/CT of Cardiac Angiosarcoma With Pulmonary Metastases

2018 ◽  
Vol 43 (10) ◽  
pp. 744-746 ◽  
Author(s):  
Nir Hod ◽  
Aryeh Shalev ◽  
Daniel Levin ◽  
Reut Anconina ◽  
Dina Ezroh Kazap ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Pulmonary Metastases ◽  
Cardiac Angiosarcoma ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals [68Ga]Ga-PSMA-11 PET-CT: Local preliminary experience in prostate cancer biochemical recurrence patients

2021 ◽  
Vol 93 (1) ◽  
pp. 21-25
Author(s):  
João Carvalho ◽  
Pedro Nunes ◽  
Edgar Tavares Da Silva ◽  
Rodolfo Silva ◽  
João Lima ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Complete Remission ◽  
Biochemical Recurrence ◽  
Detection Rate ◽  
Salvage Treatment ◽  
Clinical Approach ◽  
Curative Intent ◽  
Psma Pet ◽  
Pet Ct ◽  
Pelvic Relapse

Objectives: Clinical approach of prostate cancer (PCa) biochemical recurrence (BCR) is an ever-changing topic. Prostate-specific membrane antigen positron emission tomography ([68Ga]Ga-PSMA-11 PET-CTPSMA PET-CT) has shown good potential in this field. The aim is to evaluate PSMA PET-CT detection rate in PCa BCR and assess its impact on clinical outcome. Material and methods: Out of 319 patients with PCa who underwent PSMA PET-CT between October 2015 and June 2019, 70 had developed BCR after treatment with curative intent. Two groups were created: one with BCR after surgery (RP group) (N: 48; 68.6%) and other with BCR after radiotherapy (RT group) (N: 22; 31.4%). Clinical, analytical, pathological and PSMA PET-CT results were evaluated. Results: Initial age was different between groups (p = 0.008). RP patients were mainly at intermediate risk (85.1% vs 42.9%, p = 0.001) while RT patients were at low risk of recurrence (8.5% vs 47.6%, p = 0.001). In RP and RT groups, PSMA PETCT detected, respectively, pelvic relapse in 31.3% and 63.6%, and extrapelvic relapse in 18.8% and 31.8%. Salvage treatment was performed in 61.9% (n = 26) of RP patients and in 15% (n = 3) of RT patients, p < 0.001. Of RP patients submitted to salvage treatment, 59.1% achieved complete remission. Concerning these patients, local radiotherapy led to complete remission in 68.4% (n = 13). Of RT patients submitted to salvage treatment, two had complete remission and one had partial remission.Concerning detection rate, PSMA PET-CT was positive for pelvic relapse when pre-PET PSA ≥ 0.8 ng/mL (RP) or ≥ 2.3 ng/mL (RT) and for extrapelvic relapse when PSA ≥ 0.4 ng/mL (RP) or ≥ 3.5 ng/mL (RT), p > 0.05. Conclusions: Biochemical persistence rate after salvage therapy was similar (30-40%). The cut-off PSA values for pelvic relapse detected on PSMA PET-CT were ≥ 0.8 ng/mL (RP) and ≥ 2.3 ng/mL (RT).

scholarly journals A Patient with Giant Left Atrium Undergoes Orthotopic Heart Transplantation

2014 ◽  
Vol 41 (1) ◽  
pp. 87-90 ◽  
Author(s):  
Sergey Y. Boldyrev ◽  
Murat K. Lepshokov ◽  
Igor I. Yakuba ◽  
Kirill O. Barbukhatty ◽  
Vladimir A. Porhanov
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Posterior Wall ◽  
Orthotopic Heart Transplantation ◽  
Mechanical Prosthesis ◽  
Size Mismatch ◽  
Giant Left Atrium ◽  
Left Atrial Posterior ◽  
Rheumatic Heart

We present a novel technique for resolving the problem of radical size mismatch at the time of orthotopic transplantation. A 48-year-old man presented with chronic rheumatic heart disease and a giant left atrium. Twenty-three years before, he had undergone mitral valve replacement with a mechanical prosthesis. At the time of the repeated intervention, the volume of his left atrium was 350 mL. Surgical features of the transplantation included approximation of the pulmonary vein ostia by gathering sutures intentionally, in order to decrease the area of the left atrial posterior wall and thereby enable appropriate coaptation with the donor left atrium. After the operation, left atrial volume had been reduced to 60 mL.

scholarly journals Routine 18F-FDG PET/CT does not detect inflammation in the left atrium in patients with atrial fibrillation

2017 ◽  
Vol 33 (8) ◽  
pp. 1271-1276 ◽  
Author(s):  
Philipp S. Lange ◽  
Nemanja Avramovic ◽  
Gerrit Frommeyer ◽  
Kristina Wasmer ◽  
Christian Pott ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Fdg Pet ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Squamous Cell Carcinoma of the Paranasal Sinuses: A Single Center Experience

2019 ◽  
Vol 81 (06) ◽  
pp. 664-672 ◽  
Author(s):  
Marton König ◽  
Terje Osnes ◽  
Åse Bratland ◽  
Torstein R. Meling
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Paranasal Sinuses ◽  
Adjuvant Radiation ◽  
Curative Intent ◽  
Entire Cohort ◽  
High Stage ◽  
Oncologic Treatment

Abstract Objective Squamous cell carcinoma (SCC) of the paranasal sinuses is usually diagnosed at an advanced stage, making curative therapy difficult. The goal of this study was to evaluate the management and outcomes of patients with SCC treated at our institution. Methods In a population-based consecutive prospective cohort, we conducted an analysis of all patients treated for SCC between 1988 and 2017. Results A total of 72 patients were included, follow-up was 100%. Mean follow-up was 57 months for the entire cohort, and 108 months for patients with no evidence of disease. Eighty-two percent of all patients had high-stage (T4) disease. Fifty-seven patients underwent treatment with curative intent; consisting of surgery with or without oncologic treatment in 34, and of oncologic treatment only in 23 cases. Fifteen patients received palliative treatment. The rates of overall survival for the entire cohort were 55% at 2, 41% at 5, and 32% at 10 years, and corresponding disease-specific survival (DSS) rates were 55, 45, and 34%, respectively. DSS rates after surgical treatment with curative intent were 81% at 2, 65% at 5, and 54% at 10 years. Retromaxillary involvement and nonradical surgery were negative prognostic factors. Best survival was achieved with the combination of radical surgery and adjuvant oncologic treatment. Conclusion Surgical resection with a curative intent yielded 65% at 5-year DSS even in this cohort of patients with high-stage SCC and is still considered as the treatment of choice, preferably in combination with adjuvant radiation therapy and chemotherapy.

scholarly journals Posterior Wall of the Left Atrium

2019 ◽  
Vol 5 (11) ◽  
pp. 1262-1264
Author(s):  
Philipp Sommer
Keyword(s):  
Left Atrium ◽  
Posterior Wall

From palliative to curative intent: PET/CT findings in the light of breast cancer intrinsic subgroup

2019 ◽  
Vol 105 (6) ◽  
pp. NP79-NP82
Author(s):  
Maxime Brunet ◽  
Anne-Laure Cazeau ◽  
Houda Ben Rejeb ◽  
Vittorio Catena ◽  
Thomas Grellety
Keyword(s):  
Breast Cancer ◽  
Liver Lesion ◽  
Luminal A ◽  
Curative Intent ◽  
Palliative Intent ◽  
Ct Findings ◽  
Positron Emission ◽  
Pet Ct ◽  
Cancer Subtype ◽  
Contrast Ultrasound

Purpose: Among breast cancer subgroups, Luminal A is the subgroup with the best prognosis. We report the case of a young woman presenting with a localized luminal A breast cancer with a suspicious liver lesion on initial positron emission tomography (PET)/computed tomography (CT) scan staging. Case description: A 31-year-old woman presented with localized breast cancer accessible to curative treatment. However, PET/CT staging revealed an increase of focal activity in the liver, suspicious of a secondary malignant localization, changing the care towards palliative intent. Discrepancy between breast cancer luminal A subtype and the liver lesion led to further investigations (contrast ultrasound, magnetic resonance imaging, and biopsy), excluding a malignant process, and were in favor of toxic hepatitis, probably secondary to herbal tea consumption. Conclusions: Questioning PET/CT findings in light of the cancer subtype enabled us to rectify the diagnosis and allow this patient to be treated with curative intent.

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