| A case of unilateral ureteral obstruction in extensive endometriosis in a 21-year-old patient is reported. The present patient received danazol therapy following conservative surgery, and restoration of the renal function was achieved 5 months after initiation of the danazol administration. ( info) |
422/720. The fate of the bladder in patients with metastatic bladder cancer treated with cisplatin, methotrexate and vinblastine: a Northern california Oncology Group study. We report the efficacy and toxicity of combined cisplatin, methotrexate and vinblastine for the treatment of metastatic transitional cell carcinoma of the bladder in 50 evaluable patients. Of these 50 patients 17 had not undergone cystectomy and had residual invasive bladder cancer. Of these 17 patients 11 had complete response of the bladder lesions following cisplatin, methotrexate and vinblastine for metastatic disease, including 6 of 12 treated by cisplatin, methotrexate and vinblastine alone, and 5 of 5 treated with cisplatin, methotrexate and vinblastine plus palliative or preoperative pelvic irradiation. Complete response was confirmed in 10 of the 11 patients by endoscopy and biopsy, and in 1 by cystectomy. One patient whose liver metastasis responded to cisplatin, methotrexate and vinblastine had conversion to complete response by cystectomy for persistent bladder cancer. Of these 17 patients 7 are alive, including 5 without disease, 4 to 41 months after treatment. The bladder appears to be responsive to this combination chemotherapy for invasive transitional cell carcinoma. This experience underscores the need for regular pathological re-staging of the bladder cancer in patients receiving chemotherapy. ( info) |
423/720. Pelvic kidney presenting as tumor praevia: report of a case diagnosed by ultrasound. A case is described in whom pelvic kidney presented as tumor praevia in early labor. Ultrasound examination revealed that the mass was a ptotic, functioning pelvic kidney, indicating that abdominal delivery should be resorted to in order to avoid its damage. ( info) |
424/720. Bladder cancer after pelvic irradiation for cervical cancer. Pelvic irradiation for gynecologic malignancy is associated with several late neoplastic and nonneoplastic complications in the irradiated field; however, this association has been infrequently recognized in primary care literature. We present two cases of bladder cancer that developed 16 and 19 years, respectively, after pelvic irradiation for cervical cancer. The frequent occurrence in older women of cystitis, hematuria, and nonspecific bowel and bladder symptoms of a benign origin obscures identification of late neoplastic complications after pelvic irradiation. Based on experimental and epidemiologic evidence, we believe cost-effective screening methods should be investigated to allow earlier detection of neoplasms; and, in the interim, a high index of suspicion for bladder cancer is warranted in this growing population of high-risk patients. ( info) |
425/720. carcinoma in chronic pressure sores: a fulminant disease process. Four cases of squamous cell carcinoma arising from chronic pressure sores in paraplegic and tetraplegic patients are presented and the literature reviewed. These pressure-sore carcinomas are characterized by a shorter latency period and a fulminant clinical course with a very high metastatic rate. Very aggressive treatment including even hemicorporectomy must be considered if a cure is to be achieved. ( info) |
426/720. The use of interstitial radiation therapy in the treatment of persistent, localized, and unresectable cancer in children. Two children with cancer that persisted after multiple exploratory laparotomies, external beam radiation therapy, and multidrug chemotherapy had gold 198 (198Au) seeds implanted into their localized but unresectable tumor. Both children are alive, are receiving no therapy, and are disease-free more than 2 years later. These two cases indicate the value of interstitial implant therapy in the treatment of some children with cancer. ( info) |
| A case of hemangiopericytoma in the male pelvis is presented in which computed tomography demonstrated a well-circumscribed, homogeneous enhancing mass with feeding vessels. ( info) |
428/720. rhabdomyosarcoma involving the genitourinary organs, retroperitoneum, and pelvis. We report on 17 patients with rhabdomyosarcoma of the genitourinary organs, retroperitoneal, pelvic, or perineal regions. Treatment was refused by three patients with either bladder or prostatic lesions. The remaining patients were treated with combined modality therapy. Five of 6 patients with bladder lesions are free of tumor 24 to 108 months (mean 51) after diagnosis, while one patient died 4 months postoperatively; two patients with paratesticular lesions are free of disease 3 years and 10 months following diagnosis, respectively. Of two patients with perineal lesions, one patient died, probably due to metastases 21 months after diagnosis, while another patient with local tumor recurrence was treated by reexcision with follow-up for 12 months without evidence of tumor recurrence. The worst results were obtained with the four patients with retroperitoneal pelvic lesions; one patient died 3 months after gross resection of tumor, and the other three patients deteriorated in the 4 months after diagnosis. overall, 7 of 8 operated patients with bladder or paratesticular lesions are free of disease with follow-up for 10 to 108 months. The biological behavior of embryonal rhabdomyosarcoma, with the sex and age distribution and the management are discussed. ( info) |
429/720. Solitary pelvic neural tumors with high steroid receptor content. Two pelvic benign neural tumors, a neurofibroma and a neurilemmoma, were found to have high levels of cell nuclear estrogen receptors and both cytoplasmic and nuclear progestin receptors. A review of the literature reveals that neurogenic tumors occur predominantly in young women. This observation together with the recent findings of elevated sex steroid receptor proteins in meningiomas supports a hypothesis for the common hormonal dependence of neoplasms arising from the neural supporting tissues. ( info) |
| ventriculoperitoneal shunt metastases from primary intracranial germinomas are extremely rare. To date, only three case reports of this phenomenon have appeared in the literature. We present the case of a 25-year-old black male who developed ventriculoperitoneal shunt metastases 10 months following diagnosis of an intracranial germinoma. radiotherapy destroyed most of the intracranial tumor, but abdominal metastases became progressive and were not treated with radiotherapy. The role of radiotherapy in the treatment of ventriculoperitoneal shunt metastases is examined and previous cases in the literature are reviewed. ( info) |