1681/8157. Successful treatment of multifocal bronchioloalveolar cell carcinoma with ZD1839 (Iressa) in two patients. Multifocal bronchioloalveolar cell carcinoma (BAC) is a rare condition that often presents as bilateral lung infiltrates unsuitable for surgical and radiological treatment, with poor response to conventional chemotherapies. epidermal growth factor receptor (EGFR) pathways are closely related to the proliferation and metastasis of cancer cells. ZD1839 (Iressa) is a quinazoline-derived, orally active, selective inhibitor of the EGFR tyrosine kinase that shows promising effects in the treatment of non-small cell lung cancer. We report 2 cases of multifocal BAC successfully treated with ZD1839. Both patients had advanced disease, and had productive cough for more than 1 year. After the diagnosis of BAC, the first patient received chemotherapy, but was unresponsive. Within 2 weeks of starting treatment with ZD1839 250 mg per day, the amount of bronchorrhea decreased. Two months after the start of ZD1839 treatment, image study showed a marked decrease of lung infiltrates. The second patient developed respiratory failure after an operation on the spine. He received ZD1839 250 mg daily via nasogastric tube. Two weeks after the start of treatment, his dyspnea had improved and he was weaned from the mechanical ventilator. The side effects of ZD1839 treatment in these 2 patients consisted only of dry skin and acne over the face, trunk, and periungual areas. Although the precise mechanisms of the antitumor effects of ZD1839 remain unclear, these results suggest a role for the agent in the management of patients with advanced multifocal BAC. ( info) |
1682/8157. Pulmonary paragonimiasis mimicking lung cancer on FDG-PET imaging. The case of a 48-year-old man with pulmonary paragonimiasis mimicking lung cancer on positron emission tomography with fluorodeoxyglucose (FDG-PET) imaging is reported herein. Plain radiography and computed tomography (CT) of the chest showed a nodular lesion at the left pulmonary hilum. Lung cancer was strongly suggested from standardized uptake values determined on FDG-PET imaging; however, repeat chest CT revealed the lesion to have decreased in size. Pulmonary paragonimiasis was subsequently diagnosed after sputum microscopy demonstrated operculated parasitic eggs. To the best of our knowledge, this is the first reported case of pulmonary paragonimiasis mimicking lung cancer on FDG-PET imaging. ( info) |
1683/8157. Malignant fibrous histiocytoma of the lung. Primary malignant fibrous histiocytoma (MFH) of the lung is very rare. To date, only 32 reports of 63 cases of primary MFH of the lung have appeared in English, excluding tumors arising from the pulmonary arteries and pleura. We describe a patient with primary MFH of the lung who developed brain metastasis and involvement of pulmonary great vessels. In addition, we reviewed previously reported cases to establish the clinical characteristics and most appropriate management of primary pulmonary MFH. When disease is sufficiently limited, complete resection remains the mainstay of treatment. ( info) |
1684/8157. Synchronous solitary fibrous tumor of the pleura and lung cancer. We report herein on a 57-year-old woman with comorbid malignant solitary fibrous tumor (SFT) of the pleura and adenocarcinoma of the lung. To the best of our knowledge, this is the first report of a patient presenting with these two pathological entities simultaneously. The patient was treated successfully for both diseases via a one-stage operation through median sternotomy with good results. Although the incidence of multiple primary malignancy is rare, clinicians should be cautious not to discount the possibility of two coexisting primary malignancies. ( info) |
| We describe a patient with adenocarcinoma of the lung who developed hydronephrosis secondary to compression by right common iliac lymph node metastases. The most common primary sites of cancers causing ureteral obstruction are the cervix, prostate, bladder and colo-rectum. To date, few reports of ureteral obstruction attributable to lung cancer have been published. Although rare, physicians should be aware that hydronephrosis can complicate the course of patients with non-small cell lung cancer. ( info) |
1686/8157. Squamocellular carcinoma and chondrosarcoma: a true pulmonary carcinosarcoma. Report of a case. BACKGROUND: carcinosarcoma is one of the less common tumors of the lung and is composed of a mixture of malignant epithelial and mesenchymal elements of the type ordinarily seen in malignancies of adults. The carcinomatous component is mostly epidermoid and sometimes adenomatoid or undifferentiated. The mesenchymal part is mostly a spindle cell sarcoma and sometimes a polymorphocellular sarcoma. Differentiation as osteosarcoma and chondrosarcoma is rare. CASE REPORT: This report describes the case of a patient with carcinosarcoma of the lung composed of epidermoid carcinoma and chondrosarcoma. A left hilar mass was incidentally diagnosed. The patient was submitted to surgical exploration and a left lower lobectomy with dissection of local lymph nodes was performed. At microscopy the tumor was composed of both epithelial and stromal malignant component. The epithelial component consisted of poorly-differentiated squamous cell carcinoma and the stromal component consisted of chondrosarcoma. He remains well 30 months later. CONCLUSION: The prognosis of patients with carcinosarcoma is not always unfavourable. Potentially curative surgical resections should always be attempted. Pathologists should be aware of a wrong diagnosis of undifferentiated small cell lung carcinoma which eliminates the patient from surgery. ( info) |
1687/8157. Antirecoverin autoantibodies in the patient with non-small cell lung cancer but without cancer-associated retinopathy. The goal of the present study was to analyze serum and tumor tissue of a patient with non-small cell lung cancer (NSCLC) for the presence of autoantibodies against recoverin (anti-Rc) and recoverin expression, correspondingly. Using immunoblotting with recombinant recoverin as an antigen, we have detected anti-Rc in serum of the patient. At the same time, the patient did not manifest any signs of cancer-associated retinopathy (CAR). Polyclonal (monospecific) antibodies against recoverin used for immunohistochemical analysis of the patient's tumor revealed recoverin expression in the tumor sections. To our knowledge, this is the first case of the presence of serum anti-Rc in NSCLC patients in the absence of paraneoplastic retina degeneration. ( info) |
1688/8157. Small solitary pulmonary metastasis detected before primary sigmoid colon cancer: report of a case. We report the case of a 60-year-old woman referred to us after chest X-ray and mobile computed tomography screening detected an 8-mm nodule in right S2. Transbronchial aspiration cytology suggested a pulmonary metastasis from colorectal cancer. Therefore, we performed a colonoscopy and found a polypoid lesion, 2 cm in diameter, in the sigmoid colon. An analysis of a biopsy specimen from this polypoid lesion confirmed adenocarcinoma. Surgical resection of the primary sigmoid colon cancer was subsequently performed, followed 4 weeks later by a right S2 segmentectomy to remove the lung metastasis. The patient is currently well without any clinical signs of recurrence, 44 months after her operation. ( info) |
1689/8157. Bisphosphonates: expanded roles in the treatment of patients with cancer. Bisphosphonates are important inhibitors of osteoclastic bone resorption seen in patients with bone metastases associated with malignancy. Bisphosphonates are used in the treatment of patients with bone metastases and have been shown to reduce skeletal-related events and symptoms, contributing to improved patient outcomes and quality of life. These agents first were approved in the treatment of patients with osteoporosis and have been used for the past two decades in this role. Because bisphosphonates inhibit osteoclast-mediated bone resorption, the bone remodeling cycle slows down and an increase in bone mineral density occurs. These agents are useful in treatment for both hypercalcemia and pain, although they have not definitively shown improvement in survival time. Considerable interest exists in the use of bisphosphonates for prevention of bone metastases and their potential antitumor activity. These drugs are well tolerated and have minimal side effects, but they are not inexpensive. This article discusses the role of bisphosphonates in patients with cancer and future directions for further research. ( info) |
1690/8157. Pulmonary tumor embolism: a review of the literature. dyspnea in a patient with cancer may have several causes, including infection, thromboembolism, metastases, and therapeutically induced cardiopulmonary disease. Pulmonary tumor embolism is an uncommon cause. Occlusion of the pulmonary microvasculature by tumor cells and associated thrombi can produce a subacute and progressive clinical picture that resembles thromboembolic disease. Unfortunately, microscopic tumor embolism is recognized rarely before death because of difficulty in establishing the diagnosis. We provide a review of the literature about the evaluation and diagnosis of this rare clinical entity. ( info) |