1/17. Synergism between radiotherapy and vascular risk factors in the accelerated development of atherosclerosis: a report of three cases.radiotherapy is commonly used in the management of testicular tumors. However, to date the risk of radiation-induced vascular occlusive disease in men following radiotherapy for testicular cancer has not been regarded as a major factor in their long-term care. Several animal studies have shown the importance of established vascular risk factors such as hypercholesterolemia and hypertension in the pathogenesis of radiation-induced atherosclerosis. This report presents three cases of premature chronic iliofemoral arterial disease presenting 5,13, and 16 years following exposure to therapeutic irradiation for the treatment of testicular cancer. The patients were in the age group of 40-45 years and all demonstrated associated known atherosclerotic risk factors. The patients had received radiotherapy in the dose of 3,500-4,000 rads in a standard "dog-leg" fashion to the ipsilateral aortoiliac lymphatic chain. Our results showed that young men treated with radiotherapy for testicular cancer may be targeted from the outset for atherosclerotic risk factor reduction to minimize the risk of development of late chronic occlusive arterial disease. It may be that a cohort of men so treated with historical regimes of radiotherapy and now entering middle age should be screened for arterial disease and risk factor reduction.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/17. Simultaneous occurrence of acute myelogenous leukemia and seminoma of the testis.Simultaneous tumors are rarely encountered during the course of acute leukemias. We report on a case of seminoma of the testis that occurred during the evolution of acute myelogenous leukemia. To our knowledge, this simultaneous association has not previously been described, but a causal relationship was not apparent in the present case. The likelihood of a common carcinogenesis existed, but direct exposure to carcinogens could not be established. Although the results of a physical examination and echography were normal at the time of diagnosis, we cannot exclude the presence of microscopic cancer of the testis. Since the dissemination pattern of seminoma is usually slower than that observed in this case and the disease remains limited to the lymph nodes for long periods following dissemination, the rapid development of the present case might have been attributable to the immunosuppression and the scrotal sepsis that occurred during the induction therapy. immunosuppression might have stimulated the progression of a primary microscopic seminoma and the development of metastasis, whereas the scrotal sepsis and inflammation might have favored the occurrence of metastasis through bypass of the lymphatic barrier.- - - - - - - - - - ranking = 0.06687532552814keywords = leukemia (Clic here for more details about this article) |
3/17. osteosarcoma following radiotherapy: a case report.The case of a patient with postirradiation osteosarcoma is presented. The 20-year-old female was diagnosed as having osteosarcoma by histological examination of an open biopsy specimen. She underwent surgery for pure dysgerminoma and received adjuvant postoperative radiotherapy, 40 Gy to the pelvis and 30 Gy to the para-aortic region, 11 years ago. This case satisfied the criteria for radiation-induced osteosarcoma proposed by Cahan et al. radiation-induced osteosarcoma is rare, but the possibility of that must be borne in mind.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
4/17. Cerebellar malignant glioma after radiation therapy for suprasellar germinoma--case report.A 39-year-old male was discovered to have a malignant glioma in the right cerebellar hemisphere 8 years after surgical excision of a suprasellar germinoma and postoperative irradiation (4250 cGy). The clinical and pathological details are presented, and the literature on radiation-induced gliomas is reviewed.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
5/17. Chronic myelogenous leukemia following radiation therapy for testicular seminoma.A 43-year-old man was treated with orchiectomy and radiotherapy for testicular seminoma. Four years later, he developed a typical philadelphia chromosome positive chronic granulocytic leukemia. Since the patient was not eligible for bone marrow transplantation, he was treated with busulfan. Long term follow-up of patients who received radiotherapy for testicular seminoma is warranted in order to detect possible secondary tumors.- - - - - - - - - - ranking = 0.055729437940117keywords = leukemia (Clic here for more details about this article) |
6/17. Neurogenic fibrosarcoma following radiation therapy for seminoma.We report a case of radiation-induced neurogenic fibrosarcoma that developed in a patient who received radiation therapy for seminoma. The sarcoma developed within the irradiated field after a latency period of nineteen years. Although the occurrence of a secondary neoplasm is unusual, this possibility should be included in the differential diagnosis of patients who present with tumor growth after a long interval following radiation therapy.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
7/17. radiation-induced angiosarcoma.A 47-year-old woman presented with an angiosarcoma of the terminal ileum 14 years after receiving adjuvant radiation therapy for ovarian dysgerminoma. Her clinical course is described, and the previously reported cases of radiation-induced angiosarcoma are reviewed.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
8/17. seminoma in an adult with acute lymphocytic leukemia.We present a unique case of a seminoma in an adult with acute lymphocytic leukemia in clinical remission. As survival improves with modern multimodal chemotherapy testicular relapse of acute lymphocytic leukemia is becoming more common. A histopathological diagnosis is needed to initiate appropriate local and systemic therapy. In children a transscrotal approach for testis biopsy is used. However, the approach in adults with presumed testicular relapse has not been addressed. The risk factors of testicular relapse, the use of ultrasound in the diagnosis and the need to consider the classic differential diagnosis of a testicular mass are discussed.- - - - - - - - - - ranking = 0.06687532552814keywords = leukemia (Clic here for more details about this article) |
9/17. leukemia following treatment of germ cell tumors in men.We investigated the incidence of leukemia occurring subsequent to the treatment of germ cell tumors in men at our institution over a 30-year interval and found four patients with acute nonlymphocytic leukemia (ANLL) and one patient with chronic myelomonocytic leukemia. The relative risk (observed/expected cases) estimates for the development of leukemia ranged from 13.7 (P = .0005) in the total population to 50.1 (P = .0001) in the group treated with cytotoxic agents alone. All three patients with ANLL treated with contemporary antileukemic therapy had complete responses, with survivals of 7, 29, and 133 months. In a review of the literature, 14 additional cases of germ cell tumors were found in which the men subsequently developed leukemia. It is concluded that leukemia following germ cell tumors is increased in incidence and is likely to be treatment induced. Complete responses and long-term survival are possible in secondary leukemia and aggressive antileukemic therapy should be given.- - - - - - - - - - ranking = 0.078021213116164keywords = leukemia (Clic here for more details about this article) |
10/17. Management of radiation ulcers.Despite more efficient and safer technics of radiation therapy, the problem of radiation-induced injury to the skin and soft tissue persists. The problem of adequate coverage of these painful, ischemic, and fibrotic ulcers remains challenging. Split-thickness skin grafts are seldom sufficient coverage, as the graft almost always has areas that do not take. Although these areas may eventually heal by epithelialization, the result is never ideal. Most often flap coverage is required, but elevation of local flaps is jeopardized because the tissue surrounding the ulcer crater frequently has been sufficiently compromised to cause loss of at least part of the flap. In the past, this necessitated use of pedicled flaps, tubed and transposed from a distance. With the development of axial-pattern musculocutaneous and muscle flaps, as well as microvascular free flaps, the difficulty in dealing with these ulcers has been decreased. Surgeons can now recommend earlier use of adequate debridement, many times of the entire irradiated area, and immediate coverage with a well vascularized axial-pattern musculocutaneous flap or revascularized free flap.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
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