Carcinosarcoma of the Pancreas

2002 ◽  
Vol 126 (9) ◽  
pp. 1114-1117 ◽  
Author(s):  
Farbod Darvishian ◽  
James Sullivan ◽  
Saul Teichberg ◽  
Kevin Basham
Keyword(s):  
Fibrous Histiocytoma ◽  
Pancreatic Neoplasm ◽  
Complete Resection ◽  
Ductal Adenocarcinoma ◽  
High Grade ◽  
Pathologic Examination ◽  
Vein Thrombosis ◽  
High Grade Sarcoma ◽  
Head Of The Pancreas ◽  
Deep Vein

Abstract We report the case of a 74-year-old white man with a mass in the head of the pancreas, which was found incidentally on computerized tomographic scan during a workup for deep vein thrombosis. Endoscopy with pancreatic duct brushings yielded a diagnosis of adenocarcinoma. A pancreaticoduodenectomy followed, with complete resection of the tumor. Pathologic examination showed 2 distinct components. One component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component was high-grade sarcoma with features of malignant fibrous histiocytoma. To our knowledge, this carcinosarcoma is the seventh reported case of a primary pancreatic neoplasm with mixed carcinomatous and sarcomatous elements.

Deep vein thrombosis, vena cava inferior stenosis in combination with May-Thurner syndrome

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 172-175
Author(s):  
G. Asciutto ◽  
B. Geier ◽  
B. Strohmann ◽  
A. Mumme ◽  
T. Hummel
Keyword(s):  
Deep Vein Thrombosis ◽  
Conservative Therapy ◽  
Vena Cava ◽  
Operative Therapy ◽  
Preoperative Imaging ◽  
High Grade ◽  
Venous Thrombectomy ◽  
Vein Thrombosis ◽  
Vena Iliaca ◽  
Deep Vein

SummaryWe report a case of a patient with deep vein thrombosis including the iliac vessels, after conservative therapy of the same disease at the contralateral leg in the past. Due to a beginning compartment syndrome an operative therapy was preferred. Because of a renal insufficiency a preoperative imaging could not be performed. After venous thrombectomy we found causal for the thrombosis a high grade vena cava and vena iliaca communis stenosis. We performed an interventionel therapy. The follow-up examination showed a complete asymptomatic leg, which undervent operative treatment, by unchanged continuous symptomatic contralateral leg, which undervent conservative therapy. The high grade vena cava stenosis is probably based on a unknown ascensation of the deep vein thrombosis of the contralateral leg.

scholarly journals MicroRNAs and Neutrophil Activation Markers Predict Venous Thrombosis in Pancreatic Ductal Adenocarcinoma and Distal Extrahepatic Cholangiocarcinoma

2020 ◽  
Vol 21 (3) ◽  
pp. 840 ◽  
Author(s):  
Julia Oto ◽  
Silvia Navarro ◽  
Anders C. Larsen ◽  
María José Solmoirago ◽  
Emma Plana ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Neutrophil Activation ◽  
Ductal Adenocarcinoma ◽  
Extrahepatic Cholangiocarcinoma ◽  
Activation Markers ◽  
Mortality And Morbidity ◽  
Vein Thrombosis ◽  
Risk Patients ◽  
Deep Vein

Cancer-associated venous thrombosis (VTE) increases mortality and morbidity. However, limited tools are available to identify high risk patients. Upon activation, neutrophils release their content through different mechanisms, thereby prompting thrombosis. We explored plasma microRNAs (miRNAs) and neutrophil activation markers to predict VTE in pancreatic ductal adenocarcinoma (PDAC) and distal extrahepatic cholangiocarcinoma (DECC). Twenty-six PDAC and 6 DECC patients recruited at cancer diagnosis, were examined for deep vein thrombosis and pulmonary embolisms, and were then followed-up with clinical examinations, blood collections, and biCUS. Ten patients developed VTE and were compared with 22 age- and sex-matched controls. miRNA expression levels were measured at diagnosis and right before VTE, and neutrophil activation markers (cell-free DNA, nucleosomes, calprotectin, and myeloperoxidase) were measured in every sample obtained during follow-up. We obtained a profile of 7 miRNAs able to estimate the risk of future VTE at diagnosis (AUC = 0.95; 95% Confidence Interval (CI) (0.987, 1)) with targets involved in the pancreatic cancer and complement and coagulation cascades pathways. Seven miRNAs were up- or down-regulated before VTE compared with diagnosis. We obtained a predictive model of VTE with calprotectin as predictor (AUC = 0.77; 95% CI (0.57, 0.95)). This is the first study that addresses the ability of plasma miRNAs and neutrophil activation markers to predict VTE in PDAC and DECC.

scholarly journals Bevacizumab and temozolomide in secondary gliomatosis from gemistocytic astrocytoma: a case report

2012 ◽  
Vol 6 (2) ◽  
pp. 43-50
Author(s):  
Elisa Trevisan ◽  
Michela Magistrello ◽  
Roberta Rudà ◽  
Riccardo Soffietti
Keyword(s):  
Monoclonal Antibody ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Side Effects ◽  
De Novo ◽  
Gliomatosis Cerebri ◽  
Diffuse Glioma ◽  
High Grade ◽  
Vein Thrombosis ◽  
Deep Vein

Gliomatosis cerebri is a rare diffuse glioma with a growth pattern consisting of exceptionally extensive infiltration of the CNS with involvement of at least three lobes. It may appear de novo (primary gliomatosis) or result from the spreading of a focal glioma (secondary gliomatosis). Bevacizumab is a monoclonal antibody anti-VEGF active against recurrent high grade gliomas after standard therapy. We report the case of a 41-year-old man with a secondary gliomatosis treated with bevacizumab and temozolomide who responded and the response lasted 17 months. Moreover, we focus on the side effects (hypertension, deep vein thrombosis) induced by bevacizumab and their effective treatments.

Phlegmasia cerulea dolens – an uncommon but alarming manifestation of deep vein thrombosis

VASA ◽  
2020 ◽  
Vol 49 (5) ◽  
pp. 422-426
Author(s):  
Manuela Nickler ◽  
Sebastian Haubitz ◽  
Adriana Méndez ◽  
Martin Gissler ◽  
Peter Stierli ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Bleeding Risk ◽  
Venous Intervention ◽  
Aggressive Treatment ◽  
Vein Thrombosis ◽  
Prompt Treatment ◽  
Surgical Thrombectomy ◽  
Deep Vein ◽  
Phlegmasia Cerulea Dolens

Summary: In phlegmasia cerulea dolens (PCD), immediate diagnosis and prompt treatment is crucial for limb salvage. Aggressive treatment options including venous intervention, thrombolysis and/or surgical thrombectomy should be considered. Due to the lack of data, the most appropriate intervention depends upon etiology of PCD, clinical presentation and patient’s bleeding risk.

Feasibility Study of Catheter-directed Thrombolysis with Recombinant Staphylokinase in Deep Venous Thrombosis

1998 ◽  
Vol 79 (03) ◽  
pp. 517-519 ◽  
Author(s):  
Stephane Heymans ◽  
Raymond Verhaeghe ◽  
Luc Stockx ◽  
Désiré Collen
Keyword(s):  
Deep Vein Thrombosis ◽  
Continuous Infusion ◽  
High Speed ◽  
Minor Bleeding ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Long Term Follow Up ◽  
Valve Function ◽  
Rotating Impeller ◽  
Deep Vein

SummaryThe feasibility of catheter-directed thrombolysis with recombinant staphylokinase was evaluated in six selected patients with deep vein thrombosis. The patients underwent intrathrombus infusion of recombinant staphylokinase (2 mg bolus followed by a continuous infusion of 1 mg/h). Heparin was given via the catheter as a bolus (5000 U) and as a continuous infusion (1000 U/h). Complete lyis was obtained in five patients and partial lysis in one patient. Complications consisted of minor bleeding in four subjects. Symptomatic reocclusion occurred in one. Debulking of the thrombus mass by a high speed rotating impeller (n = 1) and stenting (n = 3) were used as additional interventions. An underlying anatomical abnormality was present in two patients. Long term follow up revealed normal patency in all patients and normal valve function in four patients. Symptomatic venous insufficiency with valve dysfunction was present in the two with a second thrombotic episode.Thus catheter-directed infusion of recombinant staphylokinase in patients with deep vein thrombosis appears feasible and may be associated with a high frequency of thrombolysis. Larger studies to define the clinical benefit of this treatment appear to be warranted.

Deep Vein Thrombosis and Fibrinolysis

1991 ◽  
Vol 66 (04) ◽  
pp. 426-429 ◽  
Author(s):  
Marcel Levi ◽  
Anthonie W A Lensing ◽  
Harry R Büller ◽  
Paolo Prandoni ◽  
Gerard Dooijewaard ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Tissue Type ◽  
Controlled Study ◽  
First Episode ◽  
Control Group ◽  
Vein Thrombosis ◽  
Type Plasminogen Activator ◽  
Deep Vein

SummaryIn the present study 57 consecutive patients with a first episode of venographically proven deep vein thrombosis were investigated to evaluate the release of tissue-type plasminogen activator (t-PA) and of urokinase-type plasminogen activator (u-PA) in response to DDAVP stimulation as well as the resting plasminogen activator inhibitor (PAI) concentration, comparing this to the results obtained in 66 similar patients with a clinical suspicion of thrombosis but with a normal venogram. All assays were performed without knowledge of the patient's status.Four patients in the deep vein thrombosis-group (7%) had an absent u-PA antigen response upon DDAVP infusion, while a normal response was observed in all control subjects. Patients and controls showed similar increases in t-PA antigen level upon DDAVP. High resting PAI antigen levels were encountered in 5 patients in the deep vein thrombosis-group (9%) and in 6 subjects in the control group (9%).The results from this controlled study indicate that a defective release of u-PA may occur in patients with deep vein thrombosis and may have pathogenetic significance. Furthermore it is concluded that elevation of PAI levels cannot be considered as a specific risk factor for venous thrombosis.

Acute Deep Vein Thrombosis Treated with Porcine Plasmin

1974 ◽  
Vol 32 (02/03) ◽  
pp. 468-482 ◽  
Author(s):  
O Storm ◽  
P Ollendorff ◽  
E Drewsen ◽  
P Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Initial Dose ◽  
Treated Group ◽  
Allergic Reactions ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Thrombolytic Effect ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

SummaryThe thrombolytic effect of pig plasmin was tested in a double blind trial on patients with deep venous thrombosis in the lower limb. Only patients with not more than three days old thrombi were selected for this study. The diagnosis of deep vein thrombosis was made clinically and confirmed by phlebography. Lysofibrin Novo (porcine plasmin) or placebo (porcine plasminogen) was administered intravenously to the patients. The enzyme and the placebo were delivered as lyophilized powder in labelled bottles - the contents of the bottles were unknown to the doctor in charge of the clinical administration of the trial. An initial dose of plasmin/plasminogen of 30 unit per kg body weight given slowly intravenously (1-1% hours infusion) was followed by a maintenance dosis of 15 per cent the initial dose per hour for the following 5-7 hours. In most cases a similar maintenance dosis was given the next day. In all patients heparin was administered after ending the plasmin/plasminogen infusion. The results of the treatment was evaluated clinically as well as by control phlebo- grams the following days.A statistically significant improvement was found in the plasmin treated group compared with the placebo (plasminogen) treated group. Thrombolysis was obtained clinically and phlebographically in 65 per cent of the plasmin treated group, but only in 15 per cent of the control patients were improvements found.This study has thus demonstrated that plasmin treatment according to a standard scheme was able to induce thrombolysis. There were only a few and insignificant side effects. Allergic reactions have not been seen and only very simple tests are required.

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