Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

In the article results of examinations got in case of surgical accesses through the flank and ventral wall of the stomach’s implementation on purpose to the cats’ ovariohysterectomy are given. The research work was carried out on healthy sexually-mature cats. Surgeries were done in the upper third of the right flank abdominal wall and in the behind the umbilical zone. The cross-cut on the boundary of groin and illium area in the direction from the hook-bone’s front border to the fourth nipple of the mammary gland of the appropriate side was applied on the side abdominal wall. It is established that in case of the accomplishment of cat’s ovariohysterectomy with the use of suggested surgical access through the side abdominal wall a duration of an operation and a period of healing are in line with those which are in case of application of median laparotomy. It is proved that the surgical access with the cross-cut done in the upper third of the right flank abdominal wall and on the boundary of groin and illium area in case of cat’s ovariohysterectomy secure better opportunities for the fulfillment of the surgical method than the median one. It is also noted that in case of cat’s ovariohysterectomy the surgical access through the upper third of the right flank abdominal wall with the cut in the direction from the hook-bone’s front border to the fourth nipple of the mammary gland of the appropriate side could be recommended as an alternative of an access through the middle line of the stomach.

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Difficulty Diagnosing a Brain Tumor during Clinical Maintenance of a Complete Response to anti-HER2 Treatments for Metastatic Breast Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000511051 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1311-1316

Author(s):

Ryoko Semba ◽

Yoshiya Horimoto ◽

Atsushi Arakawa ◽

Yoko Edahiro ◽

Tomoiku Takaku ◽

...

Keyword(s):

Breast Cancer ◽

Brain Tumor ◽

Ductal Carcinoma ◽

Metastatic Breast ◽

Stage Iv ◽

B Cell Lymphoma ◽

High Dose ◽

Her2 Positive ◽

Stage Iv Breast Cancer ◽

The Right

A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). Since she responded well to these therapies, only Tmab + Pmab was continued thereafter. Twenty-three months after starting treatment, she developed a headache. A tumor was identified in the right temporal lobe. Craniotomy was performed for definitive diagnosis. Intraoperative pathological assessment suggested the tumor to be brain metastasis of breast cancer. However, the final pathological diagnosis was diffuse large B-cell lymphoma of central nervous system (DLBCL-CNS) based on re-assessment with immunohistochemical examinations. Therefore, the Tmab + Pmab was discontinued, and 6 courses of high-dose methotrexate therapy were administered. This case highlights the importance of considering rare entities, such as DLBCL, when diagnosing a solitary brain tumor in a patient with a primary cancer, based on imaging and pathological findings.

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Infection of lung cavitations in a young dog owner with Hodgkin’s lymphoma caused by Pasteurella multocida, without a dog bite: confirmed zoonotic transmission by tagmentation microbiome analysis

BMJ Case Reports ◽

10.1136/bcr-2018-226646 ◽

2018 ◽

Vol 11 (1) ◽

pp. bcr-2018-226646 ◽

Cited By ~ 1

Author(s):

Mirek van der Reijden ◽

Lesley F V Riethoff ◽

Wil A van der Reijden ◽

Anita Griffioen-Keijzer

Keyword(s):

Hodgkin’S Lymphoma ◽

Pasteurella Multocida ◽

Stage Iv ◽

Domestic Animal ◽

Hodgkin's Lymphoma ◽

Immunocompromised Patients ◽

Dog Bite ◽

Animal Contact ◽

History Of ◽

The Right

Pasteurella multocida is a known pathogen in humans, mostly reported after animal bite incidents. Atraumatic infections have been described, especially in immunocompromised patients. A 20-year-old patient with a history of stage IV Hodgkin’s lymphoma with cavitating pulmonary lesions presented with a bilateral pneumonia. Shortly after finishing antibiotic treatment, she quickly developed the same symptoms of pneumonia. Bronchoscopy showed a large cavity in the right upper lobe and P. multocida was isolated from all bronchial cultures. The transmission route of P. multocida via the patient’s dog was confirmed by sampling the full genome of the dog’s mouth, which matched the unique P. multocida sequences found in the patient. This case demonstrates the importance of accurately determining the aetiology of the patient’s symptoms, and Pasteurella infection should be considered in all immunocompromised patients with domestic animal contact, even without a bite incident.

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Outcomes of appendiceal adenocarcinomas compared to right and left-sided colorectal adenocarcinomas: An analysis from the National Cancer Database (NCDB).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.42 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 42-42

Author(s):

Kanika Gupta Nair ◽

Wei Wei ◽

Michael Cruise ◽

Katherine Tullio ◽

Bassam N. Estfan

Keyword(s):

Stage Iv ◽

Stage I ◽

Disease Stage ◽

Rank Test ◽

National Cancer Database ◽

Kaplan Meier ◽

Stage Iv Disease ◽

The Difference ◽

The Right ◽

Colorectal Adenocarcinomas

42 Background: Appendiceal carcinomas (AC) account for 1-2% of colorectal cancers (CRC) and are generally treated like other CRC. However, there is limited data to guide treatment. While AC originate on the right side of the colon, it is unclear if they behave like as right-sided CRC (R-CRC). We seek to learn how AC differ from right versus left-sided CRC (L-CRC). Methods: We identified histologically confirmed cases of appendiceal and colorectal adenocarcinomas with information about stage and overall survival (OS) diagnosed between 2004 and 2016 from the National Cancer Database. Kaplan-Meier method and log-rank test were used to estimate and compare OS. Results: 833,939 patients met our inclusion criteria: 15,138 (1.8%) AC, 447,551 (53.7%) L-CRC, 308,794 (37.0%) R-CRC, and 62,456 (7.5%) transverse CRC (T-CRC). Median age at diagnosis of all patients was 68 years (range:18-90); AC was lowest at 61 years for stage I-III disease and 58 years for stage IV disease. Stage IV AC was more common in females 3628/5739 (63.22%). AC had the best OS among site groups in stage I-III. Median OS for stage I-III AC was 128.8 months (95% CI: 117.9-139.0), with 5-year OS rate of 0.69 (95% CI: 0.67-0.70); L-CRC median OS was 111.6 months (95% CI: 110.9-112.4), with 5-year OS rate of 0.681 (95% CI: 0.680-0.683); R-CRC median OS was 88.5 months (95% CI: 87.8-89.1), with 5-year OS rate of 0.613 (95% CI: 0.611-0.615); and T-CRC median OS was 86.2 months (95% CI: 84.7-87.6), with 5-year OS rate of 0.608 (95% CI: 0.604-0.613) (p <0.0001) (Table). Similar difference was observed in stage IV patients (Table). Conclusions: Patients with AC had significantly better OS for stages I-III and stage IV compared to patients with L-CRC, R-CRC, and T-CRC, though outcomes were more similar to L-CRC. The difference is more evidence for patients with stage IV disease. T-CRC had similar OS to R-CRC, as anticipated. [Table: see text]

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A Rare Presentation of Stage IV Large Cell Neuroendocrine Carcinoma of the Cervix with Metastasis to the Cranium

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/2812306 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Neema Hooker ◽

Sveta Mohanan ◽

R. Tucker Burks

Keyword(s):

Neuroendocrine Carcinoma ◽

Uterine Cervix ◽

Female Genital Tract ◽

Stage Iv ◽

Large Cell ◽

Large Cell Neuroendocrine Carcinoma ◽

Neuroendocrine Cells ◽

Caucasian Woman ◽

Body Tissues ◽

The Right

Neuroendocrine tumors (NETs) are aggressive diseases developing from neuroendocrine cells that most frequently involve the gastro-entero-pancreatic tract and the lung, but more rarely are found in almost all body tissues. Limited biological and clinical data are currently available for NETs in uncommon sites, such as female genital tract. NETs represent 0.9% to 1.5% of the tumors of the uterine cervix. This case is reported on a 75-year-old Caucasian woman, presenting with dental and generalized pain for two weeks. Later during her admission, facial droop and diplopia were noticed. Radiological findings ruled out cerebrovascular accident but revealed multiple bone marrow lesions involving the left and the right clivus, right Meckel's cave, and posterior margin of the right cavernous sinus. Findings also included pulmonary nodules and adenopathy supporting diagnosis of likely stage IV metastatic carcinoma. Further imaging revealed homogeneous enhancement of the uterus suggestive of diffusely infiltrative carcinoma; pathology results confirmed large cell neuroendocrine carcinoma of the uterine cervix (LCNEC) giving her a 1.5-month median survival range.

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Irinotecan-induced muscle twitching from a possible drug interaction: A case report

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217723696 ◽

2017 ◽

Vol 24 (7) ◽

pp. 555-560 ◽

Cited By ~ 2

Author(s):

SS Peters ◽

J Bettinger ◽

J Philip ◽

B Karhan ◽

SH Wrzesinski

Keyword(s):

Drug Interaction ◽

Stage Iv ◽

Potential Drug ◽

Triceps Brachii ◽

Ethical Concerns ◽

Slowing Down ◽

Muscle Twitching ◽

Immunodeficiency Virus ◽

Concomitant Medications ◽

The Right

We report the case of a 50-year-old human immunodeficiency virus-positive patient with stage IV KRAS-mutated colorectal cancer who experienced visible muscle twitching in the right lateral triceps brachii from irinotecan administration for which typical supportive care measures were unsuccessful, including the administration of atropine and slowing down the infusion rate. The patient was able to tolerate this reaction and received 20 cycles of irinotecan-based chemotherapy despite experiencing the muscle twitching with every cycle at the same onset, duration, and severity. It is possible that competitive metabolism by concomitant medications metabolized by CYP3A4 or UGT1A1 was responsible for this event. Due to ethical concerns, we were unable to formally assess the drug interaction by discontinuing the suspected interacting medications and re-initiating them to evaluate the effects. A formal pharmacokinetic study may be warranted to better elucidate these potential drug interactions.

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Exophiala Endophthalmitis after Cataract Surgery

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.10.1435 ◽

2021 ◽

Vol 62 (10) ◽

pp. 1435-1439

Author(s):

Tae Hwan Kim ◽

Moon Kyung Shin ◽

Yoon Hyung Kwon

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Anterior Chamber ◽

Intraocular Lens ◽

Early Stage ◽

Vitreous Body ◽

Complete Removal ◽

Eye Drops ◽

Second Surgery ◽

The Right

Purpose: To report a case of Exophiala endophthalmitis after cataract surgery, which has not been reported previously in Korea.Case summary: A 70-year-old woman visited the hospital 7 days after cataract surgery in her right eye with unilateral vision impairment. At the time of the visit, visual acuity of the right eye was hand motion, and the fundus was not clearly observed due to numerous inflammatory cells with hypopyon in the anterior chamber. With an initial diagnosis of suspected bacterial endophthalmitis, vitrectomy was performed immediately with intravitreal injection of antibiotics and steroid. On day 14 after vitrectomy, inflammation in the anterior chamber and vitreous opacity worsened, and complete vitrectomy, including of the vitreous base, and removal of the intraocular lens and capsule was performed. Exophiala was detected in the biopsy specimen on day 6 after the second surgery, and the patient was discharged with a prescription for voriconazole eye drops. On day 23 after the second surgery, the best-corrected visual acuity in the right eye had improved to 1.0, and there was no evidence of endophthalmitis recurrence and no observed additional abnormal findings of the fundus until 6 months after second surgery.Conclusions: In a case of fungal endophthalmitis that occurred after cataract surgery, good results were obtained by vitrectomy involving complete removal of the peripheral vitreous body, including the intraocular lens and lens capsule, which was the basis for growth of the fungus in the early stage of endophthalmitis.

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HugeNon-Organ Retroperitoneal Tumor inCombination with aCystoma of Uterine Appendages

Acta biomedica scientifica ◽

10.29413/abs.2019-4.2.20 ◽

2019 ◽

Vol 4 (2) ◽

pp. 140-143

Author(s):

N. I. Bogomolov ◽

A. G. Goncharov ◽

N. N. Tomskikh ◽

Y. Y. Goncharova

Keyword(s):

Intestinal Anastomosis ◽

Abdominal Cavity ◽

Lymph Node Biopsy ◽

Tumor Formation ◽

Retroperitoneal Space ◽

Abdominal Tumor ◽

Mesenteric Vessels ◽

Median Laparotomy ◽

Horizontal Portion ◽

The Right

The article describes the experience of successful diagnostics and treatment of giant non-organ extraperitoneal tumor combined with a cystoma of uterine appendages.Patient P., 43 years old, was hospitalized in the oncology department, diagnosed with “Abdominal tumor, right ovary?” The state was satisfactory, after palpation of the abdomen, a lumpy formation of a densely elastic consistency, from the womb to the epigastric region, was found. An ultrasound revealed a homogeneous tumor formation 30×28 cm from the border of the uterus to the liver. When performing median laparotomy, a dumbbell-shaped tumor (36×26×20 cm) was found in the retroperitoneal space with involvement of the mesentery of the small intestine, lower horizontal portion of the duodenum, mesentery of the transverse colon, superior mesenteric vessels, aorta and jejunum. In the right appendages, a cystoma 12–15 cm in diameter was found, with inversion and necrosis. Adnexectomy was performed. An express lymph node biopsy revealed cells suspicious for malignancy. The tumor was mobilized and removed as a single unit with retroperitoneal tissue, lymph nodes in combination with resection of 70 cm of the jejunum and fenestrated resection of the duodenum. The resulting gut defect 9×7 cm was sutured with a precision single-row suture. Inter-intestinal anastomosis “endto-end” was formed. Nasointestinal intubation was performed. The abdominal cavity was sutured, and two tubular drainages were installed. The postoperative period was uneventful. The histological conclusion: fibrous histiocytoma of the mesentery of the intestine with malignancy in the center of the node, in the ovary – total hemorrhagic infiltration of all layers, edema. The tumor conference consultation was recommended. After 1.5 years, the patient was admitted with the same clinical picture. During laparotomy, a tumor recurrence was discovered, the nodes of which were located in the retroperitoneal space, in the abdominal cavity with invasion to organs and large vessels. The case was recognized as inoperable, the laparotomic wound was closed completely. Sixteen days after surgery the patient was discharged.

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Pathological Complete Response After Immune-Checkpoint Inhibitor Followed by Salvage Surgery for Clinical Stage IV Pulmonary Adenocarcinoma with Continuous Low Neutrophil-to-Lymphocyte Ratio: A Case Report

10.21203/rs.3.rs-127794/v1 ◽

2020 ◽

Author(s):

Mitsunori Higuchi ◽

Takahiro Kawamata ◽

Ikuro Oshibe ◽

Nobutoshi Soeta ◽

Takuro Saito ◽

...

Keyword(s):

T Cells ◽

Partial Response ◽

Lymph Nodes ◽

Pathological Complete Response ◽

Clinical Stage ◽

Lower Lobe ◽

Stage Iv ◽

Complete Response ◽

Mediastinal Lymph Nodes ◽

The Right

Abstract Background: Immune-checkpoint inhibitors (ICIs) play a crucial role in the treatment of advanced non-small cell lung cancer (NSCLC), however, most patients fail this treatment after a limited period. We here report a patient with a pathological complete response (CR) after treatment with ICI for stage IV pulmonary adenocarcinoma.Case presentation: A 73-year-old man was referred to our hospital because of hoarseness. A roentgenogram and chest CT scan revealed a huge (78-mm diameter) pulmonary tumor in the right upper lobe and a tumor with cavitation in the left lower lobe. A CT scan also showed enlarged upper mediastinal lymph nodes. Transbronchial lung biopsy (TBLB) of the tumors showed adenocarcinomas in both. The tumor in the right upper lobe was considered to be the primary with mediastinal lymph nodes metastasis and that in the left lower lobe a pulmonary metastasis. The disease was determined to be cT4N2M1a stage IVA after whole body evaluation . He was treated with first line chemotherapy comprising cisplatin, pemetrexed, and bevacizumab for six cycles, achieving a partial response. However, 6 months after initial treatment, the primary and metastatic tumors enlarged and he was treated with second line anti-PD-1 therapy for 7 months with a partial response. 18-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed weak accumulation of FDG in the primary tumor only with no accumulation in the left pulmonary metastasis or mediastinal lymph nodes, despite the lymph nodes still being enlarged. He was diagnosed as having ycT1bN0M0 stage IA2 disease and underwent right upper lobectomy. Postoperative pathological findings revealed that cancer tissues had been replaced by scar tissue and that CD4 positive T cells, rather than CD8 positive T cells, were predominant. It was also noted that he had a lower neutrophil-to-lymphocyte ratio (NLR) during immunotherapy than before immunotherapy and after surgery. He was diagnosed to be ypT0N0M0 stage 0 (Ef.3). His postoperative course was uneventful and he remained well for twelve months after surgery with no further treatment.Conclusions: Neoadjuvant chemotherapy with ICIs for advanced NSCLC may be a promising modality, even for clinical stage IV disease, in the near future. Furthermore, NLR during immunotherapy may be a promising biomarker of ICIs treatment.

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Case Report: Sporadic Burkitt lymphoma misdiagnosed as dental abscess in a 15-year-old girl

F1000Research ◽

10.12688/f1000research.16390.1 ◽

2018 ◽

Vol 7 ◽

pp. 1567

Author(s):

Marco Cabras ◽

Paolo G. Arduino ◽

Luigi Chiusa ◽

Roberto Broccoletti ◽

Mario Carbone

Keyword(s):

Burkitt Lymphoma ◽

Stage Iv ◽

Cell Tumor ◽

Odontogenic Infections ◽

Dental Abscess ◽

Dental Practitioners ◽

Oral Biopsy ◽

Methotrexate Chemotherapy ◽

The Right ◽

Endodontic Disease

Background: Burkitt lymphoma (BL) is a non-Hodgkin’s B-cell tumor that can be classified into three variants, based on clinical characteristics and epidemiology: endemic, human immunodeficiency-related and sporadic. Oral sporadic BL is quite an unusual entity, with the gastrointestinal trait being often the first site of appearance. Clinical finding: A 15-year-old patient that presented a symptomatic swelling of the right maxilla, unsuccessfully treated as a primary endodontic disease, displaying solid tissue on CT scan, “starry sky” pattern on oral biopsy, multifocal bone and lymph node uptake on PET. Diagnoses, interventions, and outcomes: A diagnosis of stage IV BL was formulated; Rituximab was then administered for three months according to Inter-B-NHL ritux 2010 protocol and CYM (cytarabine and methotrexate) chemotherapy. The patient was followed-up for three years, with no recurrence. Conclusion: It is important for general dental practitioners to suspect a malignancy in the differential diagnosis of unresponsive odontogenic infections in young healthy patients.

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