scholarly journals Undifferentiated Nasopharyngeal Carcinoma Presenting with Shoulder Mass

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Cosphiadi Irawan ◽  
Rahmat Cahyanur ◽  
Reyhan Eddy Yunus
Keyword(s):  
Palliative Chemotherapy ◽  
Nasopharyngeal Cancer ◽  
Bone Tumour ◽  
Undifferentiated Carcinoma ◽  
Neck Mass ◽  
Definitive Treatment ◽  
Unknown Primary ◽  
Common Cancer ◽  
Stage Ivb ◽  
The Right

Nasopharyngeal cancer (NPC) is the most common cancer among head and neck cancer that usually presented with unilateral neck mass. Unusual symptoms of NPC can lead us to diagnosis misleading and delayed definitive treatment. We present a case of NPC with bone metastasis in the shoulder. A 33-year-old female presented with right shoulder mass caused by undifferentiated carcinoma of unknown primary, based on biopsy of shoulder mass. After four months, she was complaining painless neck swelling, headache, and hearing impairment in the left ear. Bone MRI showed malignant bone tumour in the right humerus. Neck CT scan showed mass in the nasopharyngeal and bilateral lymphadenopathy. Biopsy in nasopharyngeal revealed undifferentiated carcinoma of nasopharyngeal cancer (WHO-3 type A). The patient was diagnosed as NPC stage IVb and thus was treated with palliative chemotherapy. After three cycles of cisplatin docetaxel, patient condition improved.

Neoadjuvant paclitaxel plus carboplatin followed by concomitant radiochemotherapy in stage IVb nasopharyngeal carcinoma: Preliminary results

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15521-15521
Author(s):  
H. Jouhadi ◽  
N. Tawfiq ◽  
S. Sahraoui ◽  
A. Benider
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Local Control ◽  
Distant Metastasis ◽  
Nasopharyngeal Cancer ◽  
Undifferentiated Carcinoma ◽  
High Rate ◽  
Weekly Schedule ◽  
Eligibility Criteria ◽  
Concomitant Radiochemotherapy ◽  
Stage Ivb

15521 Background: Nasopharyngeal cancer Is the first head and neck cancer in Morocco. undifferentiated carcinoma (WHO 3)is dominant. Loco regional advanced stages IVa and IVb (AJCC/UICC 1997) represents 60 to 78%. Classical treatment is neoadjuvant chemotherapy (3 courses of BEP protocol) followed by radiotherapy. Therapeutic results are characterised by a high rate of failure. For stage IVb failure is due to distant metastasis wich occur in 30 to 40% of cases needing more systemic therapy. The aim of this prospective study is to analyse for stage IVb the benefit of introducing paclitaxel associated to carboplatin as a neoadjuvante chemotherapy followed by chemoradiation in terms of reducing distant metastasis and improving local control. Tolerance of this protocol was also analysed. Methods: Between September 2003 and January 2004, a total of 33 previously untreated, histologically confirmed NPC adults, were enrolled in this study. The new protocol is based on 1-Four courses of neoadjuvant chemotherapy (1 course = paclitaxel: 175 mg/m2 day 1 + carboplatin: 300 mg/m2 day 1; 1 course every 21 days) 2-followed by a concomitant radiochemotherapy: -radiotherapy to a total dose of 65 gray -and low dose of cisplatine (30 mg/m2) delivered on a weekly schedule. Eligibility criteria were: histologically confirmed NPC, stage IVb, no prior treatment, and informed consent of patients. There were 21 male and 12 female patients and their ages ranged from 19 to 58 years. Results: The minimal follow up was 2 years. The 2 year DFS was 85% and the 2 year loco regional free survival was 91%. All patients completed radiotherapy. Neutropenia grade III-IV was observed in 6% without fever. According to NCI toxicity criteria, acute mucositis (due to radiation) grade 3 was observed in 15% and grade 2 in 24%. Xerostomia grade 1 was observed in 70%. Conclusion: This protocol is very effective with less toxicity. Radiation dose is reduced without decreasing local control rate. The 2 years DFS is increased with this protocol to 85%. No significant financial relationships to disclose.

Prevalence and Characteristics of Liver Cancer Patients in Immanuel Hospital Bandung within January 2013 until December 2014 Period

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Achmad R. Permadi ◽  
Hana Ratnawati ◽  
Teresa L. Wargasetia
Keyword(s):  
Liver Cancer ◽  
Cancer Patients ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Data Retrieval ◽  
Common Cancer ◽  
Key Words Liver Cancer ◽  
Liver Cancer Patient ◽  
Right Lobe ◽  
The Right

Liver cancer is the fifth most common cancer in Indonesia. This research is to find out the prevalence and characteristics of liver cancer patients in Immanuel Hospital Bandung within the January 2013 until December 2014 period based on age, gender, clinical symptoms and predilections. This study was a descriptive verificative research with data retrieval of patients medical records that have been diagnosed with liver cancer that were hospitalized in Immanuel Hospital Bandung within January 2013 until December 2014 period. The study showed that the liver cancer patient prevalence in Immanuel Hospital Bandung within the period of January 2013 until December 2014 was 46 people. Characteristics of liver cancer patients in Immanuel Hospital Bandung within January 2013 until December 2014 period showed that the most liver cancer patients were male, compare with female with ratio 4:1, the most common age group of 56-65 years old, the most common clinical symptoms were abdominal pain with or without reffered pain to the right scapular bone and the most common predilection was right lobe of the liver. Key words: liver cancer, patients' characteristics, prevalence 

scholarly journals Hodgkin lymphoma presenting as alcohol-induced back pain

2019 ◽  
Vol 12 (11) ◽  
pp. e228440
Author(s):  
Lucy Ma ◽  
Sanskriti Varma ◽  
Ashwini Niranjan-Azadi
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Hodgkin Lymphoma ◽  
Anterior Chest Wall ◽  
Marrow Transplant ◽  
Radiographic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Left Lower Extremity ◽  
Stage Ivb ◽  
The Right

A 32-year-old Chinese man without significant medical history presented with a 2-month history of worsening lumbosacral back pain radiating to the groin and left lower extremity. He also described a shooting pain in the sciatic nerve distribution that began with and was exacerbated by alcohol consumption, a rare but known symptom of Hodgkin lymphoma (HL). On exam, an anterior chest wall mass was noted. Radiographic evaluation of an anterior mediastinal mass showed osseous erosion into the manubrium. MRI of the lumbar spine showed diffuse osseous disease of the lower thoracic and lumbar spine with extension into the right sacroiliac joint and S2 neural foramen without vertebral body collapse or stenosis. Tissue biopsy revealed nodular sclerosis HL, stage IVB IPS2. The patient was primary refractory to ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) therapy. Salvage ICE (ifosfamide, carboplatin, etoposide) chemotherapy was used and then followed by non-myeloablative haploidentical bone marrow transplant was performed on 5 March 2019.

Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study.

1988 ◽  
Vol 6 (9) ◽  
pp. 1401-1410 ◽  
Author(s):  
A Rossi ◽  
R Molinari ◽  
P Boracchi ◽  
M Del Vecchio ◽  
E Marubini ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Randomized Study ◽  
Nasopharyngeal Cancer ◽  
Distant Metastases ◽  
Undifferentiated Carcinoma ◽  
Treatment Groups ◽  
Distant Failure ◽  
Curative Radiotherapy ◽  
Significant Difference ◽  
Base Of The Skull

To evaluate the effect of adjuvant chemotherapy in patients with local-regional nasopharyngeal carcinoma (NPC) (squamous or undifferentiated) in complete remission at the end of curative radiotherapy (RT) 229 patients were randomized from 1979 to 1983 in a multicenter study to no further therapy (116 patients) or a combination of vincristine, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (VCA) for six monthly cycles (113 patients). The RT and RT + VCA groups were well balanced for median age (50 v 49 years), histology (undifferentiated carcinoma, 73% v 70%), tumor extent (tumor limited to nasopharynx, 57% v 57%), and nodal extent (negative nodes 26% v 24%, nodes in the lower cervical levels, 17% v 16%). RT was delivered to the nasopharynx, the base of the skull, and bilateral cervical nodes using a split course technique over 10 weeks up to the dose of 60 to 70 Gy in involved sites and 50 Gy to negative nodes. Response to RT was evaluated within 65 days post-RT treatment. Analysis at 48 months did not show significant difference between the two treatment groups in terms of relapse-free survival (RT, 55.8%, RT + VCA, 57.7%, P = .45) and overall survival (RT, 67.3%, RT + VCA, 58.5%, P = .13). The pattern of relapse was similar in the two treatment arms. Distant metastases were the cause of treatment failure in about 50% of relapsing patients. Although the results of the present study did not show any benefit from VCA administered after curative RT, combined systemic chemotherapy should be further explored due to the high incidence of local and distant failure after intensive RT.

scholarly journals Orbital metastasis as primary clinical manifestation of thyroid carcinoma: case report and literature review

2008 ◽  
Vol 52 (9) ◽  
pp. 1497-1500 ◽  
Author(s):  
Francisco Dário Rocha Filho ◽  
Gabrielle Gurgel Lima ◽  
Francisco V. de Almeida Ferreira ◽  
Michelle Gurgel Lima ◽  
Miguel N. Hissa
Keyword(s):  
Thyroid Carcinoma ◽  
Clinical Manifestation ◽  
Palliative Chemotherapy ◽  
Distant Metastases ◽  
Histopathological Analysis ◽  
Free T4 ◽  
Follicular Variant ◽  
Orbital Metastasis ◽  
Uncommon Case ◽  
The Right

Capillary thyroid carcinoma (PTC) is the most common neoplasm of thyroid. It usually grows slowly and is clinically indolent, although rare, its aggressive forms with local invasion or distant metastases can occur. Metastatic thyroid carcinoma rarely involves the orbit. We reported an uncommon case of orbital metastasis of PTC. A 66-years-old woman presented proptosis of the right eye. The biopsy of the tumor in orbit revealed metastatic thyroid carcinoma. The ultrasensitive TSH level was 1,34 mUI/L and free T4 level was 1,65 ng/dL. A total thyroidectomy was performed and histopathological analysis of the nodule revealed follicular variant of papillary thyroid carcinoma. Currently, the patient has been receiving palliative chemotherapy with Clodronate Disodium. The importance of the case is due to its unusual presentation, which emerged as a primary clinical manifestation. Although rare, thyroid carcinoma should be suspected in orbit metastasis.

scholarly journals The hepatothorax: An unusual complication of right sided diaphragmatic injuries

2018 ◽  
pp. 22-25
Keyword(s):  
Surgical Repair ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Traumatic Rupture ◽  
Unusual Complication ◽  
Key Words Trauma ◽  
Acute Setting ◽  
Liver Herniation ◽  
Post Traumatic ◽  
The Right

Right diaphragmatic post-traumatic rupture with liver herniation is an extremely rare condition. The diagnosis is mainly radiological and the rupture may go unnoticed in the acute setting. Depending on the size of the right diaphragmatic defect, the initial herniation can be partial and the total hepatothorax is established progressively. The diagnosis may be delayed and made with the onset of the first symptoms. Hepatothorax leads usually to severe right lung atelectasis with respiratory and cardiac impairment. Definitive treatment consists in surgical repair of the diaphragm. We present hereby the case of an hepatothorax diagnosed 4 years after a penetrating thoracoabdominal trauma. Key words: Trauma, diaphragmatic rupture, hepatothorax.

Idiopathic Atrial Fibrillation and Coronary Arteriovenous Fistulae: Is There a Link?

Cardiology ◽  
2016 ◽  
Vol 134 (4) ◽  
pp. 433-435 ◽  
Author(s):  
Hina K. Jamali ◽  
Umara Raza ◽  
Fahad Waqar
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrhythmias ◽  
Similar Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Definitive Treatment ◽  
Arteriovenous Fistulae ◽  
Coronary Arteriovenous Fistula ◽  
The Right ◽  
New Onset

Despite being one of the most prevalent cardiac arrhythmias, the cause of atrial fibrillation (AF) in a vast majority of patients remains unknown. There is growing evidence of associated AF in patients diagnosed with coronary arteriovenous fistula. In this discussion, we have included an example of a patient who presented with new-onset AF and was subsequently diagnosed with an anomalous fistula between the right coronary artery and the superior vena cava. Definitive treatment of the fistula resulted in permanent resolution of the AF. Based on this case and a similar case reported in the literature, it is proposed that further research will unmask this possibly underdiagnosed and very treatable cause of AF.

Video-Assisted Thoracoscopic Surgical Rib Fixation for Costochondral Separation Injury

2021 ◽  
pp. 155698452110492
Author(s):  
Tessa C. M. Geraedts ◽  
Jean H. T. Daemen ◽  
Yvonne L. J. Vissers ◽  
Erik R. de Loos
Keyword(s):  
Thoracic Trauma ◽  
Plate Osteosynthesis ◽  
Definitive Treatment ◽  
Blunt Thoracic Trauma ◽  
Video Assisted ◽  
Rib Fixation ◽  
Rare Phenomenon ◽  
Secondary Injuries ◽  
The Right ◽  
Surgical Rib Fixation

Costochondral separation is a rare phenomenon following blunt thoracic trauma that can also be associated with secondary injuries. We present a case with complete costochondral separation of the right second rib with concomitant mediastinal compression. Definitive treatment was provided through video-assisted thoracoscopic surgical plate osteosynthesis.

scholarly journals Pediatric Parathyroid Carcinoma: A Case Report and Review of the Literature

2019 ◽  
Vol 3 (12) ◽  
pp. 2224-2235 ◽  
Author(s):  
Aditya Dutta ◽  
Rimesh Pal ◽  
Nimisha Jain ◽  
Pinaki Dutta ◽  
Ashutosh Rai ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Parathyroid Carcinoma ◽  
Pediatric Population ◽  
Surgical Excision ◽  
Neck Mass ◽  
Hormone Levels ◽  
Metastatic Relapse ◽  
Right Lobe ◽  
The Right

Abstract Primary hyperparathyroidism (PHPT) is a rare endocrine disease in the pediatric population. Sporadic parathyroid adenomas remain the most common cause of pediatric PHPT. Parathyroid carcinoma (PC) is an extremely rare cause of pediatric PHPT. We report a 16-year-old boy presenting with a nonhealing fragility fracture of the right leg along with florid features of rickets. Examination revealed a neck mass, mimicking a goiter. Biochemical findings were consistent with PHPT. Imaging was suggestive of a right inferior parathyroid mass infiltrating the right lobe of thyroid. The patient underwent en bloc surgical excision of the parathyroid mass along with the right lobe of thyroid. Histopathology was suggestive of a PC. He achieved biochemical remission with normalization of serum calcium and parathyroid hormone levels. At follow-up, there was no biochemical or imaging evidence of recurrence or metastasis. Genetic analysis revealed heterozygous germline deletion of CDC73. An extensive literature search on PC was conducted, with an emphasis on the pediatric population. Thirteen cases of pediatric PC were identified. The median age of presentation was 13 years; there was no sex predilection. All cases were symptomatic; 31% had a visible neck mass. The median serum calcium and intact parathyroid hormone levels were 14.3 mg/dL and 2000 pg/mL, respectively. All patients underwent surgical excision, with 27% showing metastatic relapse. Our findings indicate that the preoperative features that could point toward a diagnosis of PC in a child with PHPT are a tumor size of >3 cm, thyroid infiltration on imaging, and severe hypercalcemia at presentation.

Noninvasive Localization of Language Cortex in an Awake 4-Year-Old Child with Rasmussen Encephalitis: A Case Report

2019 ◽  
Vol 18 (5) ◽  
pp. E175-E180
Author(s):  
Shalini Narayana ◽  
Luke M Embury ◽  
Namrata Shah ◽  
Sarah Weatherspoon ◽  
Asim F Choudhri ◽  
...  
Keyword(s):  
Young Children ◽  
Young Patients ◽  
Definitive Treatment ◽  
Rasmussen Encephalitis ◽  
Mri Findings ◽  
Left Frontal Lobe ◽  
Epilepsia Partialis Continua ◽  
Language Functions ◽  
Mapping Tool ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE Presurgical mapping of eloquent cortex in young patients undergoing neurosurgery is critical for timely intervention, surgical planning, and minimizing postoperative deficits. However, invasive direct cortical stimulation has limited success in young children and noninvasive modalities, such as magnetoencephalography and functional MRI, require sedation, often precluding localization of critical language cortices. Transcranial magnetic stimulation (TMS), a noninvasive brain stimulation technique, is well suited to evaluate language areas in young children because it does not require the patient to remain still during mapping. CLINICAL PRESENTATION A 4-yr and 11-mo-old female patient diagnosed with epilepsia partialis continua of the right arm and face and right-sided weakness was evaluated at our institution. MRI findings and clinical examination led to the diagnosis of Rasmussen encephalitis involving left frontal lobe and insula. Language cortices were successfully identified in both hemispheres using TMS. The TMS findings aided in discussing with the family the risks of postsurgical deficits of left functional hemispherectomy, the definitive treatment for Rasmussen encephalitis. Postoperatively, the patient had intact speech and was seizure free. CONCLUSION We illustrate the feasibility and utility of TMS as a noninvasive functional mapping tool in this young child. The preoperative demonstration of bilateral language organization indicated a greater likelihood of preserved language functions postsurgery. We demonstrate that TMS is a safe and noninvasive tool to map language cortices in young children with serious epilepsy syndromes.

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