Gurvits Syndrome: Black Esophagus in the Postoperative Setting

Background: Total ankle replacements (TARs) have higher rates of osteolysis than hip or knee replacements. It is unclear whether this is a pathologic immunologic process in response to wear debris, or expansion of pre-existing osteoarthritic bone cysts. We aimed to determine the incidence of bone cysts in patients with end-stage ankle arthritis prior to surgery and review the literature on bone cysts and osteolysis in relation to TAR. Methods: This is a descriptive/prevalence study in which all patients with end-stage ankle arthritis underwent plain radiographic imaging and computed tomographic (CT) scans prior to TAR surgery. Their imaging was assessed for the presence of cysts, measured on sagittal, axial, and coronal slices of the CT scan at the widest diameter. All cysts that would be removed as a result of the bone resection for the implant were excluded using digital analysis software. We assessed 120 consecutive patients with mean age of 63.4 years. Results: Seventeen patients (14%) did not have any bone cysts based on CT images. Ten patients (8%) had cysts that would have been completely removed by surgery, leaving 93 patients for analysis (78%). In 60% of these cases, the cysts were not seen on the plain radiographs. In 39 patients (33%), the cysts were greater than 5 mm in size. The medial (36%) and lateral malleoli (33%) were the most common location for the cysts (mean diameter 4.6±2.0 and 4.2±2.3 mm, respectively). Conclusion: Bone cysts outside of the resection margins for a TAR were present in 78% of patients with ankle arthritis prior to undergoing surgery. In 30% of cases, cysts were greater than 5 mm in size. In 60% of cases, the cysts were not seen on plain radiographs. Preoperative 3-dimensional imaging can provide a foundation to observe and quantify cyst presence, expansion, and time of onset in the postoperative setting. Level of Evidence: Level IIc, diagnostic/prevalence study.

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Celecoxib Can Prevent Tumor Growth and Distant Metastasis in Postoperative Setting

Cancer Research ◽

10.1158/0008-5472.can-03-3050 ◽

2004 ◽

Vol 64 (9) ◽

pp. 3230-3235 ◽

Cited By ~ 29

Author(s):

Jong-Lyel Roh ◽

Myung-Whun Sung ◽

Seok-Woo Park ◽

Dae-Seog Heo ◽

Dong Wook Lee ◽

...

Keyword(s):

Tumor Growth ◽

Distant Metastasis ◽

Prevent Tumor Growth ◽

Postoperative Setting

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Adjuvant Radiation for Gynecologic Cancers

10.2310/obg.19169 ◽

2019 ◽

Author(s):

Joanne Jang

Keyword(s):

Cervical Cancer ◽

Radiation Therapy ◽

Endometrial Cancer ◽

Vulvar Cancer ◽

Vaginal Cancer ◽

External Beam Radiation ◽

Adjuvant Radiation ◽

Gynecologic Cancers ◽

Beam Radiation ◽

Postoperative Setting

Radiation therapy plays a significant role in the treatment of nearly all gynecologic cancers, including endometrial cancer, cervical cancer, vaginal cancer, and vulvar cancer. Radiotherapy can be given as the primary modality for curative treatment of gynecologic cancers, most often for cervical, vaginal, and vulvar cancers, but can also be used adjuvantly in the postoperative setting. Radiation can be delivered in the form of external beam radiation therapy or as gynecologic implants for brachytherapy, which is radiation that is delivered internally. This review highlights the data supporting radiation therapy for gynecologic cancers and explains the different methods of radiation delivery. This review contains 5 figures, and 4 tables, and 40 references. Key Words: adjuvant treatment, brachytherapy, cervical cancer, endometrial cancer, IMRT, ovarian cancer, radiation therapy, vaginal cancer, vulvar cancer

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Influence on morbidity and mortality of neoadjuvant radiation and chemotherapy among cranial malignancy patients in the postoperative setting

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2015.01.005 ◽

2015 ◽

Vol 22 (6) ◽

pp. 998-1001 ◽

Cited By ~ 9

Author(s):

Paul Narayan Hein ◽

Bryan Lieber ◽

Eliza Bruce ◽

Blake Taylor ◽

Geoffrey Appelboom ◽

...

Keyword(s):

Morbidity And Mortality ◽

Postoperative Setting

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The emerging use of immune checkpoint blockade in the adjuvant setting for solid tumors: a review

Immunotherapy ◽

10.2217/imt-2019-0087 ◽

2019 ◽

Vol 11 (16) ◽

pp. 1409-1422 ◽

Cited By ~ 9

Author(s):

Elissar Moujaess ◽

Fady Gh Haddad ◽

Roland Eid ◽

Hampig Raphael Kourie

Keyword(s):

Solid Tumors ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitor ◽

Checkpoint Inhibitor ◽

Checkpoint Inhibitors ◽

Immune Checkpoint Blockade ◽

Adjuvant Setting ◽

Lung Cancers ◽

Metastatic Setting ◽

Postoperative Setting

The use of immune checkpoint inhibitors has been approved in the advanced and metastatic setting for many types of solid tumors. Nonetheless, their role in the adjuvant setting is limited to the treatment of surgically resected melanoma. Ipilimumab was the first immune checkpoint inhibitor approved for this indication, followed by nivolumab and pembrolizumab. Many ongoing trials are evaluating these molecules in the postoperative setting, alone or in combination with other therapies. Preliminary results are promising regarding the treatment of other cutaneous tumors, lung cancers, head and neck squamous cell carcinomas, bladder cancer and renal cell carcinomas. Some data assessing their use for the adjuvant treatment of esophageal, colorectal, ovarian cancer and other solid tumors are similarly emerging.

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Necrose esofágica aguda (“Black Esophagus”) em paciente portador de neoplasia neuroendócrina do pâncreas: relato de caso

Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo ◽

10.26432/1809-3019.2018.63.2.126 ◽

2018 ◽

Vol 63 (2) ◽

pp. 126

Author(s):

Carolina Pontes de Moraes Hungria ◽

Isabella Moreira Hueb ◽

Marina Santos Noia ◽

Lilian Nomura da Silva ◽

Tiago Bezerra de Freitas Diniz ◽

...

Keyword(s):

Sao Paulo ◽

São Paulo ◽

Black Esophagus ◽

Endoscopia Digestiva

Necrose Esofágica Aguda (NEA) é uma síndrome rara, caracterizada pela presença de pigmentação escura difusa no esôfago observada por endoscopia. O diagnóstico é frequentemente incidental em pacientes com sintomas de sangramento gastrointestinal superior. Neste artigo apresenta-se o caso de um paciente do sexo masculino, de 72 anos, encaminhado ao Departamento de Cirurgia da Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP) com história de dor epigástrica persistente e úlceras gástricas refratárias ao tratamento clínico. Foi realizada Endoscopia Digestiva Alta (EDA) de controle que visualizou lesão no bulbo duodenal, cuja biópsia e imunohistoquímica revelaram tumor carcinoide e neuroendócrino. Paciente foi submetido à cirurgia de enucleação de tumor na cabeça do pâncreas, evoluindo com fístula pancreática no sétimo dia de pós operatório. No décimo dia de pós-operatório, retornou ao Pronto Socorro do Serviço de Emergência com queixa de dor abdominal intensa, fezes escurecidas e presença de melena ao toque retal. A EDA diagnosticou necrose esofágica aguda. Após a identificação da NEA, foi introduzido antibioticoterapia de amplo espectro (Piperacilina + Tazobactan), sintomáticos e vigilância infecciosa, evoluindo bem ao tratamento conservador.Descritores: Necrose, Esôfago/patologia, Doença aguda, Esofagite, Tumores neuroendócrinos, Pâncreas, Endoscopia do sistema digestório

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