1/23. Spontaneous regression of neuroblastoma.Case of spontaneous regression of neuroblastoma continue to occur in the present multimodal therapy era at institutions where physicians are prepared to withhold treatment on certain patients with residual primary or metastatic disease. From a survey of the 22 member institutions of Children's Cancer Study Group, seven hospitals submitted data on 24 neuroblastoma patients whose disease underwent regression after minimal, unusual, or no treatment. An analysis of these patients and of 33 patients form two large series in the literature shows that the majority of patients are infants with Stage II or Stage IVS disease. The spontaneous regression usually consists of complete disappearance of the disease, but in some neuroblastomas, maturation to ganglioneuroma takes place. The various factors that may influence regression are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/23. Occult breast cancer detection with technetium-99m-sestamibi: a case report.A 74-y-old woman with a 4-y history of left arm lymphedema and multiple negative mammography studies presented to her physician with a palpable subcutaneous nodule in the left upper arm. After biopsy the nodule was read pathologically as secondary breast carcinoma. We report a finding of a positive 99mTc-sestamibi scintimammography in the presence of an unremarkable mammogram. The study also revealed a positive uptake in a metastatic lesion in the manubrium of the sternum.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/23. A case of poorly differentiated hilar lung adenocarcinoma of an unidentified histological type.The patient was a 74-year-old man, a physician, whose chief complaint was an unproductive cough. The shadow of a mass was seen at the hilum of the left lung, and the mediastinal lymph nodes on both sides were swollen. No histological diagnosis was obtained even after bronchoscopy, including transbronchial needle aspiration biopsy, but large-cell carcinoma of the lung was diagnosed on the basis of ultrasound-guided biopsy of a shadow in the liver suspected of being a metastatic tumor (T2N3M1, Stage IV). Two courses of chemotherapy (CBCDA VDS) failed to gain any improvement, and the pain resulting from recurrent bone metastases was managed mainly by the administration of the best supportive care. The patient was readmitted to the hospital after development of numbness in the right upper extremity followed by complication of pneumonia and heart failure, and he passed away. autopsy revealed a primary hilar lung tumor with a histological diagnosis of poorly differentiated adenocarcinoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/23. Carcinomatous meningitis in a patient with metastatic breast cancer.Metastases are defined as the appearance of neoplasms in parts of the body remote from the site of the primary tumor. Metastasis can occur through one of three processes: direct seeding of body cavities or surfaces, lymphatic spread, and hematogenous spread. The importance of laboratory utilization in the diagnosis of metastasis is explored using a case study of a 39-year-old female with metastatic breast carcinoma to the brain. This case study was carried out using clinical records, laboratory results, pathology reports, and physician interviews. cerebrospinal fluid was obtained and examined in hematology, chemistry, and microbiology. Tissue from the breast was examined both before and after chemotherapy. Morphologic comparisons of both primary and metastatic tumor cells were carried out. The breast tissue showed infiltrating mammary carcinoma, ductal type, with 8/11 auxiliary lymph nodes showing metastasis. Evaluations of cerebrospinal fluid cell count results revealed the presence of malignant cells in remarkable numbers. Based on cytological and hematological results, a diagnosis of meningeal carcinomatosis was determined and treatment was started. Following the intrathecal chemotherapy, serial cerebrospinal fluid examinations showed the percentage of malignant cells decreased and no cells were detected 11 days after treatment. Metastasis, including meningeal carcinomatosis is a common occurrence with breast carcinoma. An effective chemotherapeutic treatment is evaluated for this disease when an accurate diagnosis is made. As demonstrated by this case study, proper use of the laboratory can help establish the diagnosis of metastasis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/23. Adjuvant therapy of melanoma.In 2001, the American Joint Committee on Cancer melanoma Staging Committee proposed and created a new staging system for melanoma. This new system will become official in 2002, with the publication of the sixth edition of the AJCC Cancer Staging Manual. The new system identifies significant prognostic variables in patients with melanoma and validates them in an analysis of 17,600 patients, making it possible to precisely determine the patient's chance for survival In light of physicians' ability to determine with more precision which patients are at high risk for melanoma recurrence, they face the dilemma of which, if any, surgical adjuvant therapy to choose. Alpha-interferon is the only agent approved for adjuvant therapy of melanoma in the united states, but its questionable benefits and substantial side effects make it hard to justify recommending it to patients. Discussion of trials of high- and low-dose interferon is presented here. The author's group has conducted trials of granulocyte-macrophage colony-stimulating factor (GM-CSF [Leukine]) as surgical adjuvant treatment of patients at high-risk for melanoma recurrence. One of the most important activities of GM-CSF is its ability to activate macrophages and cause them to become cytotoxic for human melanoma cells, at doses low enough to avoid the toxicity associated with other cytokines. The author presents promising trial results, discusses GM-CSF in other malignancies, and includes discussion of tumor vaccines, biochemotherapy, and other agents being studied as adjuvant therapy of melanoma. It is hoped that these newer approaches will result in therapies that are more effective and less toxic than interferon.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/23. Three cases of papillary carcinoma and three of adenoma in thyroglossal duct cysts: clinical-diagnostic comparison with benign thyroglossal duct cysts.The clinical and diagnostic findings of 3 cases of papillary thyroid carcinoma in thyroglossal duct cyst (TDC) were compared to those of 3 cases of adenoma in TDC and 2 cases of benign TDC. The neck masses of the subjects with benign TDC grew slowly, whereas those of 2 patients with papillary carcinoma and 1 of the patients with adenoma grew rapidly (especially those with carcinoma). On the other hand, one case of carcinoma, and two cases of adenoma in TDC were diagnosed incidentally. Benign TDC had an anechoic pattern at US, whereas the cysts containing carcinoma and adenoma showed the presence of a mural nodule at US. Microcalcifications in the mural mass were present in one patient with carcinoma. The 3 patients with carcinoma in TDC underwent total thyroidectomy. The histology was negative in all 3 patients for thyroid cancer and thyroid nodules. However, in 2 of them it revealed the carcinoma invading the cyst wall and adjacent tissues, 1 of which also exhibited 2 metastatic lymph nodes in the central neck area. The cases reported illustrate the utility of enhancing one's clinical suspicion of carcinoma in patients bearing TDC, even when incidentally discovered. In particular, rapid growth of the cystic mass, and the presence of a mural nodule on US, especially with calcifications, must raise the physician's suspicion for a cancer arising in TDC.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/23. Case report of metastatic carcinoid tumor to the neck.Since their origianl description in 1838 carcinoid tumors have interested physicians. This case represents another unusual presents another unusual presentation of a carcinoid tumor in which the cervical area has rarely been reported. In addition, it demonstrates the elusiveness of the tumor despite exhaustive diagnostic studies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/23. hydronephrosis as a complication of adenocarcinoma of the lung.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.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/23. AIDS presenting as primary testicular lymphoma.A case of AIDS presenting as a primary testicular lymphoma is reported. Despite the lack of evident systemic disease, such a presentation in a young patient should alert the physician to the possible presence of an underlying human immunodeficiency virus infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/23. Metastatic penile cancer in a young Caucasian male: impact of delayed diagnosis.Penile cancer is an uncommon malignancy in the developed world, with only 1200 estimated cases per year in the united states. This is usually a cancer of older men and often the diagnosis is delayed because of lack of suspicion on the part of the patient or primary care provider. We report a case of penile cancer in a young Caucasian male in whom a delay in diagnosis had a deleterious impact on outcome. We describe and illustrate how, to palliate his symptoms, the patient required a hemipelvectomy plus a total pelvic exenteration. We present this case to alert physicians of the possibility of penile cancer in young Caucasian males as well as to demonstrate the significant morbidity and mortality that can ensue from a delay in diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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