1/369. Gastro-intestinal Kaposi's sarcoma, with special reference to the appendix.Kaposi's sarcoma (KS) of the gastro-intestinal tract is a common disease in the AIDS setting, although it is often asymptomatic. In this paper we wish to highlight the occurrence of gastro-intestinal KS with appendiceal involvement. Two of the patients presented with features of acute appendicitis, and KS of the appendix was not suspected at the time of surgery. In the remaining patient KS of the appendix was part of generalised gastro-intestinal involvement. It is important to remember that KS can cause appendicitis by producing a submucosal nodule that abuts into the lumen and thereby causes obstruction. KS of the gastro-intestinal tract may therefore masquerade as 'simple' appendicitis, or indeed remain asymptomatic.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
2/369. Endoscopic features of intestinal smooth muscle tumor in a child with AIDS.Intestinal leiomyosarcomas are exceedingly rare in immunologically intact children, except during infancy. While leiomyosarcomas account for less than 2% of all soft tissue tumors in childhood, they are the second most frequent malignancy in children with the acquired immunodeficiency syndrome (AIDS). In this cohort they are often located in unusual sites for primary soft tissue tumors. This report describes a young girl with advanced AIDS, referred for evaluation of abdominal pain, hematochezia, and wasting syndrome. colonoscopy revealed two 1- to 2-cm submucosal nodules with central umbilication. Repeat colonoscopy 18 months later revealed no changes in these lesions. biopsy revealed a submucosal spindle-cell lesion, with necrosis and cellular atypia. Initially it was characterized as a partially excised low-grade leiomyosarcoma. However, the final consensus diagnosis was smooth muscle tumor of uncertain malignant potential. Because of her advanced AIDS, there was no attempt at surgical resection or chemotherapy. Thirty-six months after initial referral, she remains alive without radiographic or clinical evidence of local extension or metastases. Additional data are required to determine the long-term outcome of these indolent submucosal tumors in the digestive tracts of children with AIDS.- - - - - - - - - - ranking = 0.60005091805917keywords = sarcoma, spindle, soft (Clic here for more details about this article) |
3/369. paclitaxel in the treatment of human immunodeficiency virus 1-associated Kaposi's sarcoma--drug-drug interactions with protease inhibitors and a nonnucleoside reverse transcriptase inhibitor: a case report study.PURPOSE: To describe the pharmacokinetics of paclitaxel and to investigate the interaction potential with protease inhibitors (indinavir, ritonavir, saquinavir) and the nonnucleoside reverse transcriptase inhibitor nevirapine, for which strong theoretical indications for clinically relevant drug interactions exist. methods: The 24-h plasma pharmacokinetics of paclitaxel (Taxol, given at 100 mg/m2 by 3-h intravenous infusion) and concomitantly infused antiretroviral drugs were determined in a human immunodeficiency virus 1 (hiv-1)-infected male patient with refractory Kaposi's sarcoma (KS) during high-activity antiretroviral therapy and after discontinuation of this regimen. The plasma pharmacokinetics of paclitaxel, indinavir, ritonavir, saquinavir, and nevirapine were closely monitored. Since all these drugs are extensively metabolized via the cytochrome P450 enzyme system and are substrates for the multidrug transporter p-glycoprotein, investigation of drug-drug interactions was considered important. RESULTS: In this case report study the pharmacokinetics of paclitaxel given concomitantly with various antiretroviral drugs were comparable with those of historical controls who had been treated with single-agent paclitaxel. The pharmacokinetics of indinavir, ritonavir, saquinavir, and nevirapine were also not statistically significantly different from those recorded for historical controls. paclitaxel was well tolerated and resulted in a significant clinical response in this patient. CONCLUSION: Dose adjustments of paclitaxel, indinavir, ritonavir, saquinavir, or nevirapine are apparently not needed if hiv-1-associated KS is treated with paclitaxel at a dose of 100 mg/m2 as shown in the present case. It is stressed, however, that controlled studies are necessary to substantiate these preliminary case report findings.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
4/369. Extent of surgical intervention in primary soft-tissue aspergillosis.Primary invasive aspergillus Infection of the soft tissue is rare and typically affects immunocompromised patients in several distinct patterns of clinical presentation. In general, the role of surgery in the treatment of this disease is the removal of infected or necrotic tissue to prevent dissemination and mortality. However, the specific surgical recommendations have varied widely among reports due to the varied clinical circumstances in each series. The authors present the case of a patient with a primary invasive aspergillus infection. They review the reported surgical experience with this disease, and discuss outcomes and surgical approaches in the context of several variations in clinical presentation. In all situations, antifungal therapy and prompt surgical intervention are critical in treating these initially localized but potentially lethal infections. The extent of intervention can range from minor debridement to amputation, and is based on the presence of persistent immunocompromise, the presence and extent of tissue necrosis, and the rate of progression during antifungal therapy.- - - - - - - - - - ranking = 7.9826585919772E-6keywords = soft (Clic here for more details about this article) |
5/369. Case of the month: March 1999--A 26 year old HIV positive male with dura based masses.A 26-year-old male with AIDS presented with a chief complaint of headaches and neck pain. An MRI revealed two enhancing extra-axial dura based masses, one in the area of the left sphenoid wing and one at the level of C2-3. In both cases, microscopic sections showed actin positive spindle cell neoplasms with long slender nuclei, consistent with leiomyomas. Both tumors were positive for Epstein Barr virus by in situ hybridization. This case report serves to emphasize the importance of considering soft tissue tumors such as leiomyoma in the differential diagnosis of mass lesions that occur in the central nervous system in AIDS and discusses the role of EBV in tumorigenesis.- - - - - - - - - - ranking = 0.00022099989880161keywords = spindle cell, spindle, soft (Clic here for more details about this article) |
6/369. Penile intraepithelial neoplasia overlying Kaposi's sarcoma lesions: role of viral synergy?Several viral agents have been detected in the lesional tissue of Kaposi's sarcoma (KS). Their precise oncogenic role remains to be determined. A 32-year-old heterosexual man with acquired immunodeficiency syndrome (AIDS) who had penile lesions of KS with overlying epithelial changes characteristic of intraepithelial neoplasia associated with concurrent infection by human papillomavirus (HPV) and human herpesvirus 8 (HHV-8) is reported. The absence of viral dna from uninvolved skin suggests that this coinfection is more than coincidental and may involve synergy between these viruses, as has already been suggested for HPV and herpes simplex 2 virus.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
7/369. dermatofibrosarcoma protuberans in two patients with acquired immunodeficiency syndrome.dermatofibrosarcoma protuberans (DFSP) is a locally aggressive cutaneous tumor of intermediate malignancy. Most commonly, it arises as an asymptomatic, indurated plaque on the trunk within which protuberant nodules develop over time. We describe its occurrence in two patients with human immunodeficiency virus, a previously unreported association. The first patient, a 41-year-old woman, complained of painful lesions around the left shoulder that developed within a scar from previous trauma to the area. The second patient, a 50-year-old man, developed a recurrent DFSP within the scar from a previous surgical procedure. dermatofibrosarcoma protuberans was confirmed in both cases by the histopathologic and immunohistochemical findings.- - - - - - - - - - ranking = 1.2keywords = sarcoma (Clic here for more details about this article) |
8/369. Kaposi's sarcoma of the breast.Kaposi's sarcoma of the breast is extremely rare. We report a case of a patient with AIDS presenting with Kaposi's sarcoma localized to the breast and review another published case of a patient with AIDS and disseminated cutaneous Kaposi's sarcoma with breast involvement. Although rare, the diagnosis should be considered in patients with breast lumps.- - - - - - - - - - ranking = 1.4keywords = sarcoma (Clic here for more details about this article) |
9/369. Orbital Kaposi's sarcoma in acquired immunodeficiency syndrome.A 28-year-old white male with AIDS-C3 staging, presented with an extensive hemorrhagic dark mass localized in the left orbit. No other ophthalmic findings were disclosed. ultrasonography and computed axial tomographic scans showed orbital involvement. Orbital Kaposi's sarcoma is a rare finding and only a few cases have been reported. Systemic examination revealed other lesions suggestive of disseminated mucocutaneous Kaposi's sarcoma, oral candidiasis, membranous esophagitis and granulomatous hepatitis. Eyelid incisional biopsy disclosed Kaposi's sarcoma. Despite intensive chemotherapy progression was aggressive with a fatal outcome.- - - - - - - - - - ranking = 1.4keywords = sarcoma (Clic here for more details about this article) |
10/369. central nervous system leiomyosarcoma in patients with acquired immunodeficiency syndrome. Report of two cases.Leiomyosarcomas (LMSs) of the central nervous system are extremely rare; however, they are becoming more prevalent in immunocompromised patients. The authors present the cases of two patients with acquired immunodeficiency syndrome: one with LMS of the thoracic vertebral body and the other with LMS originating from the region of the cavernous sinus. The epidemiological and histological characteristics of LMS and its association with latent Epstein-Barr virus are discussed, as well as the treatments for this neoplasm.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
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