1/122. Metastasis-induced acute pancreatitis in a patient with small cell carcinoma of the lung.Acute pancreatitis in cancer patients can be secondary to the malignant process itself or a complication of antineoplastic agent administration. However, acute pancreatitis caused by metastatic carcinoma of the pancreas is an uncommon condition with a poor prognosis. We report a case of a 63-year-old man with small cell carcinoma of the lung, who developed acute pancreatitis lately. Thirteen months earlier, he developed small cell carcinoma of the lung and received 6 cycles of chemotherapy. Abdominal CT scan showed swelling of the pancreas with multiple masses. The patient was managed conservatively and pancreatitis subsided. This case indicates that metastasis induced acute pancreatitis can be a manifestation of lung cancer, especially in small cell carcinoma.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/122. small cell lung carcinoma associated with paraneoplastic limbic encephalitis.limbic encephalitis is an unusual presentation of paraneoplastic syndrome. We report a case of small cell lung carcinoma associated with limbic encephalitis. A 67-year-old man presented with convulsions, memory impairment, and neuropsychiatric disturbances as initial symptoms. Subsequently, small cell lung carcinoma was diagnosed by bronchoscopic biopsy. The cerebrospinal fluid studies, electroencephalography, and magnetic resonance imaging findings had distinctive features compatible with paraneoplastic limbic encephalitis. The neuropsychiatric symptoms improved significantly after six cycles of systemic chemotherapy and adjuvant radiotherapy, resulting in partial remission of the tumor. A follow-up computed tomography scan of the head showed no evidence of intracranial metastasis 7 months after the diagnosis of cancer. limbic encephalitis may be an initial manifestation of lung cancer. Greater awareness for diagnosis and early treatment of the primary tumor offers the best chance for improvement in patients with lung cancer presenting with limbic encephalitis.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
3/122. The marked anticancer effect of combined VCR, MTX, and indomethacin against drug-resistant recurrent small cell lung carcinoma after conventional chemotherapy: report of a case.In a previous study, we discovered that indomethacin was an effective modulator of the sensitivity of pulmonary carcinoma cells to vincristine (VCR), methotrexate (MTX), adriamycin (ADR), and etoposide (VP-16). We describe herein the case of a 61-year-old-man with multiple brain, lung, liver, and bone metastases from small cell lung carcinoma (SCLC) that recurred after intensive chemotherapy, who showed no signs of remission following conventional chemotherapy. The general condition of the patient deteriorated until he required morphine sulfate to control his severe diffuse pain. In an attempt to improve this patient's quality of life (QOL), he was discharged from hospital and treated at the outpatient clinic with modulation therapy using indomethacin as an anodyne instead of morphine sulfate. Signs of almost complete remission to only one cycle of combination therapy with VCR, MTX, and indomethacin were observed without any obvious adverse effects. This case report serves to demonstrate that modulation therapy combined with VCR, MTX, and indomethacin may be useful in the treatment of patients with drug-resistant recurrent SCLC.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
4/122. Successful treatment of malignant placental site trophoblastic tumor with combined cytostatic-surgical approach: case report and review of literature.OBJECTIVE: Although rare among gestational trophoblastic diseases, the clinical relevance of malignant placental site trophoblastic tumor (PSTT) derives from its potential malignancy associated with early systemic tumor cell dissemination and manifestation of fatal metastases. Because of the low number of cases reported so far worldwide, several treatment strategies have been under consideration, which will be debated following this case report. METHOD: We present the case of a 33-year-old female with PSTT and metastases to the vagina and lung. A 9-month delay in accurate diagnosis was caused by a misinterpretation of her symptoms as signs of a spontaneous abortion. Specialized pathological examination finally led to the diagnosis of PSTT. Primary surgical treatment consisting of abdominal hysterectomy and unilateral salpingo-oophorectomy was followed by multiple resections of recurrent vaginal disease. After the completion of six cycles of EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine) chemotherapy, hCG titers stayed within the normal range. The patient is without evidence of disease 39 months after primary diagnosis. RESULT: This is the third case of documented long-term remission (>1 year) in metastatic PSTT after combined cryostatic-surgical treatment. CONCLUSION: Since the few previously reported cases with prolonged remission have been treated with the described combined cytostatic-surgical approach consisting of cytoreductive surgery and adjuvant chemotherapy, this approach may be recommended for metastatic PSTT.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
5/122. Double high-dose chemotherapy supported by autologous transplantation of peripheral blood stem cells for treatment of an elderly patient with small-cell lung cancer.We report a 62-year-old male with extensive disease small-cell lung cancer (SCLC) who was successfully treated with double high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (auto-PBSCT). This patient achieved a partial response with 3 cycles of induction chemotherapy. After the peripheral blood stem cell mobilization, two cycles of high-dose ice regimen (ifosfamide 3,000 mg/m2 at days 1 to 5, carboplatin 400 mg/m2 at days 1, 3, 5, and etoposide 500 mg/m2 at days 1, 3, 5) could be given with further regression of the tumor and acceptable toxicities. This successful case suggests the feasibility of double high-dose ice with auto-PBSCT in elderly patients with SCLC.- - - - - - - - - - ranking = 2keywords = cycle (Clic here for more details about this article) |
6/122. Docetaxel is effective in the treatment of metastatic endometrial cancer.BACKGROUND: Systemic treatment of endometrial carcinoma with distant metastases is currently performed, inter alia, with anthracyclines, platinum, paclitaxel, if osfamid or progestins. This is the first report presenting experience in treatment of metastatic endometrial carcinoma with docetaxel. CASE REPORT: A 69-year-old women with adenocarcinoma of the endometrium was treated with primary combined radiotherapy. Two years later disseminated bilateral pulmonary metastases were detected and the patient was submitted to chemotherapy with epirubicin. After three cycles of chemotherapy with epirubicin examinations revealed metastatic progression. Thus, chemotherapy was changed to docetaxel. RESULTS: After three cycles of chemotherapy with docetaxel examinations revealed remission of the described pulmonary metastases more than 50%. A further three cycles of chemotherapy with docetaxel lead to continuing shrinkage of the detectable metastases to less than 25% of the original size. Because of various side effects, like increasing fatigue and asthenia, uncomfortable acral paresthesia and allergic skin reactions, the patient refused to continue chemotherapy. CONCLUSION: We conclude that docetaxel may be an active agent in patients with metastatic endometrial cancer, but care should be taken to minimize side-effects.- - - - - - - - - - ranking = 3keywords = cycle (Clic here for more details about this article) |
7/122. Primary lymphoepithelioma-like carcinoma of the lung.Lymphoepithelioma is an undifferentiated carcinoma with prominent lymphoid stroma in the nasopharynx. Tumors with similar histology have been reported with other localizations, including the lungs, and are designated as lymphoepithelioma-like carcinomas (LELC). Primary LELC of the lung is very rare, and scant information is available in the scientific literature. This paper details the case of a 25-year-old Caucasian male patient with the diagnosis (determined by thoracotomy) of primary LELC of the lung. Immunohistochemical analysis was negative for Epstein-Barr virus, as was the in situ hybridization of the tumor cells. observation of the nasopharynx and a magnetic resonance image of the cavum were normal. Because the tumor (T4N2M0) could not be resected, the patient was treated with chemotherapy, carboplatin/5-fluorouracil, completing two cycles. The patient's condition worsened when he developed contralateral pneumonia, which was then followed by pericardial effusion. The patient died 36 h later from cardiac tamponade. Presented here is a revision of this rare pathology, not often reported in the literature.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
8/122. Metastatic extramedullary plasmacytoma of the lung.Extramedullary plasmacytomas (EMP) comprise 4% of all plasma cell neoplasms and commonly in the upper airway or digestive tract but rarely develop in the lungs. We present a case of primary pulmonary plasmacytoma in an 89 year old man, presented as a hilar mass with associated intrathoracic and extrathoracic lymph node metastases, but without evidence of myeloma. Treatment options for EMP include surgery, surgery and radiotherapy, surgery and chemotherapy or chemotherapy alone. Local recurrence rate is reported as 10-30%, with 17-48% progressing to multiple myeloma and median survival being 63-101 months. In view of the advanced age of this patient, who was initially treated unsuccessfully with intravenous cyclophosphamide and subsequently with two cycles of VAMP chemotherapy with good resolution of his disease, he is undergoing regular follow-up only.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
9/122. Successful low-dose concurrent chemotherapy and radiation for locally advanced or inoperable non-small cell lung carcinoma: a report of six cases.Many studies now demonstrate high overall response rates with concurrent chemotherapy and radiation (CCR) for locoregionally advanced or inoperable non-small cell lung carcinoma (NSCLC) but often with severe toxicity and only modest improvement in survival beyond 3 years. We report a simple CCR protocol for NSCLC that has resulted in long-term disease-free survival with low toxicity. In this retrospective review, 84 patients with NSCLC were seen between 1985 and 1991. Of these, 10 patients had stage IIIa or IIIb NSCLC without effusion or inoperable NSCLC, with no failed prior treatment at the time of referral for oncology evaluation. Six of these were treated with CCR consisting of three cycles of cisplatin and 5-fluorouracil administered concurrently with radiation treatment followed by maintenance chemotherapy for at least five additional cycles. All six patients treated with this protocol had complete response with minimal side effects. Survival times ranged from 4.5 to more than 10 years. Three patients survived in complete remission; three others were in complete remission at the time of death due to unrelated causes. Stage III NSCLC without effusion and inoperable NSCLC can be treated effectively with concurrent local and systemic treatment without significant toxicity. In patients with complete response, maintenance chemotherapy may overcome residual microscopic systemic disease, leading to long-term survival and possible cure. The CCR strategy that resulted in this favorable outcome is noteworthy and should be pursued in larger numbers of patients.- - - - - - - - - - ranking = 2keywords = cycle (Clic here for more details about this article) |
10/122. Complete pathological response to chemotherapy for non-small cell lung cancer demonstrated by gamma camera positron emission tomography.We report the case history of a 61-year-old female smoker who presented with an inoperable T2N2M0 squamous cell carcinoma of the right upper lobe bronchus. This was staged by computed tomography (CT), positron emission tomography (PET) using a modified dual-headed gamma camera, and mediastinoscopy. She then underwent three cycles of cisplatin-containing chemotherapy. After the chemotherapy, CT demonstrated a residual 10 mm mass in the right upper lobe and a considerable reduction in size of the mediastinal lymphadenopathy. Functional tumour imaging with PET showed no abnormality, suggesting that there was no remaining viable tumour. At right upper lobectomy a complete pathological response was confirmed. We discuss PET, the potential new applications of gamma camera technology, and the use of cisplatin-containing chemotherapy in non-small cell lung cancer.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
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