1/12. Subcutaneous tumor growth complicating the positioning of Denver shunt and intrapleural port-a-cath in mesothelioma patients.patients with malignant ascites and malignant pleural fluid from abdominal or pleural mesothelioma underwent the positioning of Denver type peritoneovenous shunt or intrapleural catheter. They developed tumor growth in the subcutaneous tissue surrounding the devices throughout their courses. Neoplastic seeding is a potential complication of the positioning of shunts and catheters in cavities filled with fluid rich in tumor cells.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/12. Shunt-related abdominal metastases in a child with choroid plexus carcinoma: case report.OBJECTIVE AND IMPORTANCE: Metastasis of primary brain neoplasms to the abdomen through a ventriculoperitoneal shunt (VPS) has been described for many types of tumors, including medulloblastoma, germ cell tumors, astrocytoma, oligodendroglioma, lymphoma, ependymoma, and melanoma. choroid plexus tumors (CPTs) are located within the cerebrospinal fluid-containing spaces of the brain and frequently disseminate throughout the craniospinal subarachnoid space, yet VPS-related metastasis of a CPT to the abdomen has not been reported previously. CLINICAL PRESENTATION: We present the case of a 3-year-old boy with choroid plexus carcinoma of the lateral ventricle and preoperative intraventricular dissemination of the tumor. The patient later developed VPS-related abdominal metastases causing abdominal ascites. INTERVENTION: Surgical resection of the tumor was followed by chemotherapy and craniospinal radiation, but the tumor further disseminated throughout the craniospinal subarachnoid space. When the child presented with abdominal ascites, the distal VPS catheter was externalized and drained cerebrospinal fluid at a rate of more than 750 ml/d. paracentesis was performed for persistent ascites, and cytological analysis of the fluid revealed metastatic tumor cells. CONCLUSION: The child died from widely metastatic tumor and aspiration pneumonia. CPT metastasis to the abdomen through a VPS should be considered in patients with the appropriate clinical findings. This condition may exacerbate overproduction of cerebrospinal fluid, which can occur with CPTs, and treatment must be individualized. Unusual options may be considered, such as long-term shunt externalization or paracentesis.- - - - - - - - - - ranking = 0.5keywords = catheter (Clic here for more details about this article) |
3/12. Percutaneous catheter drainage of necrotic tumors: CT demonstration.Percutaneous drainage catheter placement in large necrotic or cystic tumor masses represents an unconventional companion to more traditional modes of therapy for cancer patients. In the three patients cited here, significant symptomatic improvement was achieved by the use of a percutaneously placed drainage catheter.- - - - - - - - - - ranking = 3keywords = catheter (Clic here for more details about this article) |
4/12. renal artery spasm: a cause of acute renal failure following abdominal surgery for neuroblastoma.Interruption of arterial blood supply to the kidney results in acute renal failure (ARF). We describe a case of ARF caused by renal artery spasm following resection of a large abdominal neuroblastoma, combined with paraaortic lymph node dissection and ipsilateral nephrectomy. The blood flow was reestablished by administration of local anesthetics (lidocaine) into the obliterated renal artery through the angiographic catheter. An urgent angiography was of value for the early diagnosis and treatment of this lesion.- - - - - - - - - - ranking = 0.5keywords = catheter (Clic here for more details about this article) |
5/12. Desmoid tumor arising around the distal tubing of a cerebrospinal fluid shunt.A case of desmoid tumor in the abdominal wall as a cause of malfunction of a cerebrospinal fluid shunt is presented. The desmoid tumor arose from the reactive fibrose tissue formed around the silastic distal tubing and caused the catheter to become disconnected from the reservoir.- - - - - - - - - - ranking = 0.5keywords = catheter (Clic here for more details about this article) |
6/12. Transcatheter brush biopsy of intravenous tumor thrombi.Transcatheter brush biopsy of intraluminal filling defects demonstrated during venography was performed in 6 patients with abdominal neoplasms. Tissue specimens consistent with either known or subsequently proved tumor were obtained from 4 patients. biopsy was negative in the other 2 patients, who lacked surgical confirmation of the intraluminal mass. This technique is useful in establishing histological proof of neoplasm and in determining the extent of known tumor.- - - - - - - - - - ranking = 2.5keywords = catheter (Clic here for more details about this article) |
7/12. Intravenous digital subtraction angiography for the evaluation of renal artery blood flow following the removal of a neuroblastoma.There have been several reports of acute renal failure following the resection of an abdominal neuroblastoma combined with ipsilateral nephrectomy as well as the atrophy or disappearance of an unresected kidney after tumor resection. Spasms or thrombosis of the renal artery during tumor excision are considered to be the major cause. Since 1989, intravenous digital subtraction angiography (IVDSA) has been used to evaluate the renal artery blood flow immediately following surgery in seven patients with abdominal neuroblastomas. IVDSA was performed using a central venous catheter inserted prior to surgery. In all seven patients, IVDSA provided clear images for the evaluation of renal artery blood flow. In one of the two patients whose kidneys briefly became cyanosed during tumor excision, IVDSA demonstrated an occlusion of the renal artery and prompt measures could be taken to reestablish the blood flow. No complications of IVDSA occurred in any of the seven patients. IVDSA using a central venous catheter was thus considered to be useful for evaluating the renal artery blood flow in patients with a suspected renal artery blood flow disturbance without any risk of complications, and this modality obviated the need for intraarterial angiography.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
8/12. chylothorax: a complication of a left subclavian vein thrombosis.The development of a chylothorax is a rare complication of a superior vena caval thrombosis. We describe a unique case of chylous pleural effusion occurring in a patient with an underlying lymphoma who had a Hickman-Broviac catheter and a left subclavian vein thrombosis. The effusion resolved after the initiation anticoagulant therapy. This potentially reversible cause of a pleural effusion needs to be considered in any patient with a central venous catheter who is undergoing treatment for an otherwise malignant disorder.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
9/12. hemorrhage from abdominal non-Hodgkin's lymphoma treated successfully by emergency transcatheter arterial embolization.A 49-year-old Japanese woman with follicular lymphoma who presented with severe abdominal and back pain is reported. She was known to have malignant lymphoma and had been previously treated with combination chemotherapy. An abdominal tumor occurring at the root of the mesentery and involving the superior mesenteric artery (SMA) had been diagnosed by computed tomography (CT), magnetic resonance imaging, and abdominal angiography. Emergent ultrasonography and CT findings showed intraperitoneal bleeding from the abdominal tumor. Selective SMA angiography revealed extravasation from a small branch originating from the dorsal pancreatic artery, which was embolized through a catheter by using platinum coils. It should be noted that a large tumor of malignant lymphoma, involving large vessels, may bleed, and in such a case selective transcatheter arterial embolization may be one of the effective modalities for hemostasis.- - - - - - - - - - ranking = 3keywords = catheter (Clic here for more details about this article) |
10/12. Mechanisms of tumor-induced hypoglycemia with intraabdominal hemangiopericytoma.The association of hypoglycemia with nonislet cell tumors is well recognized and in nearly all instances has been related to the production of hormones with insulin-like activity. To determine the mechanism of such tumor-induced hypoglycemia and the response to pharmacological intervention, we studied a 54-yr-old man with refractory hypoglycemia and a large intraabdominal hemangiopericytoma. During a supervised fast, plasma glucose decreased to 2.2 mmol/L. Circulating insulin (< 7 pmol/L), C peptide (< 0.04 nmol/L), and GH levels (< 0.6 microgram/L) were all undetectable, insulin-like growth factor i (IGF-I; 5 nmol/L) was low, IGF-II was in the normal range (87 nmol/L), and free IGF-II and big IGF-II (E1-21 fragment) were elevated at 18 and 142 nmol/L, respectively. On another day, after maintaining euglycemia overnight with a 20% dextrose infusion, a euglycemic (5.0-5.5 mmol/L) glucose clamp study using [3-3H]glucose tracer infusion combined with arteriovenous leg catheterization was performed in the postabsorptive basal state and during 3 h of crystalline somatostatin infusion (0.08-0.24 pmol/kg min). In the postabsorptive state at euglycemia, free IGF-II and big IGF-II remained elevated at 16 and 162 nmol/L, respectively. Whole body glucose disposal was elevated at 21.1 mumol/kg.min, whereas the rate of glucose infusion was 12.1 mumol/kg.min, and depatic glucose output was 7.8 mumol/kg.min. The leg arterio-venous plasma glucose difference was increased at 0.6 mmol/L, as was leg glucose uptake at 203.9 mumol/min. After 3 h of somatostatin infusion, both free and big IGF-II decreased by 35-40% to 10 and 102 nmol/L, respectively. Whole body glucose disposal also decreased to near normal (12.8 mumol/kg.min), whereas leg arterio-venous plasma glucose difference and leg glucose uptake became negligible. The plasma glucose level remained at 5.0-5.5 mmol/L despite a marked fall in hepatic glucose output to 2.9 mumol/kg.min and a decrease in glucose infusion rate to 8.7 mumol/kg.min. During somatostatin treatment, GH remained suppressed at less than 0.6 microgram/L, and glucagon decreased from 99 to 78 ng/L. In this patient with a hemangiopericytoma, hypoglycemia was associated with increased circulating insulin-like activity from elevated free and big IGF-II, which stimulated glucose uptake primarily into muscle tissue. A continuous infusion of crystalline somatostatin effectively reduced the elevated levels of IGF-II and glucose uptake, but was unable to adequately control hypoglycemia without the simultaneous infusion of exogenous glucose or glucagon.- - - - - - - - - - ranking = 0.5keywords = catheter (Clic here for more details about this article) |
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