1/92. Progression of a Nelson's adenoma to pituitary carcinoma; a case report and review of the literature.A 25-year-old woman developed Nelson's syndrome, 3 years after successful bilateral adrenalectomy for Cushing's disease. Despite pituitary surgery and radiotherapy the tumour showed invasive growth, leading to visual disturbance, paresis of the oculomotor nerve and, 34 years after adrenalectomy, to death by widespread purulent leptomeningitis. autopsy revealed a large adenohypophyseal carcinoma with a metastasis attached to the dura, both tumours showing immunocytochemical staining for ACTH and TSH. We review the literature on metastatic adenohypophyseal carcinoma in Cushing's disease and Nelson's syndrome and discuss the role of proliferation markers as indicators of malignant progression.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
2/92. Therapeutic effect of a water-salt extract from BCG in two patients with advanced breast cancer.Two cases of advanced breast cancer treated with a water-salt extract from BCG are presented, showing a positive response -- marked and durable regression of the breast tumor and of the axillar metastases, parallel in the second case with a disappearance of lung metastases.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
3/92. Kaposi's sarcoma of the conjunctiva.A 75-year-old man with known Kaposi's sarcoma of three-years' duration developed chronic hemorrhagic thickening of the conjunctiva. biopsy demonstrated histopathologically that the conjunctiva thickening represented sarcoma involvement. Although surgically untenable, the conjunctival lesion responds satisfactorily to radiotherapy.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
4/92. Drug-induced lupus associated with COL-3: report of 3 cases.BACKGROUND: Anti-angiogenesis is an exciting new approach to anticancer therapy. COL-3, a tetracycline derivative, is a novel anti-angiogenesis agent with potent preclinical anticancer activity. During the conduct of a phase 1 clinical trial for refractory metastatic cancer at the National Institutes of health, we observed 3 individuals who developed phototoxicity followed by clinical and laboratory features of drug-induced lupus. OBSERVATIONS: Three of 35 patients treated with COL-3 developed sunburnlike eruptions accompanied by fever and a positive antinuclear antibody titer within 8 to 29 days of starting treatment. Two of 3 had positive antihistone antibody levels and arthralgia. One patient had marked systemic manifestations including pulmonary infiltrates and elevated erythrocyte sedimentation rate remittent for more than 1 year after discontinuing COL-3 treatment. The other 2 patients' symptoms and rash abated within 2 weeks of discontinuing therapy although the serologic markers remained abnormal for the duration of follow-up. CONCLUSIONS: COL-3 is the second tetracycline derivative to be implicated in the development of drug-induced lupus. A sunburnlike eruption immediately preceded or accompanied the systemic and serologic changes in these 3 patients. The rapid onset and the phototoxic appearance of the accompanying eruptions might suggest that damage to the keratinocytes caused the formation of neoantigens to which autoantibodies formed.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
5/92. Carcinoma in isolated bladder after ileoconduit diversion.A thirty-six-year-old Caucasian male paraplegic of sixteen years' duration, who was found to have carcinoma of the bladder about twenty-three months after an ileoconduit diversion had been performed for decompensated neurogenic bladder is presented. Chronic infection and residual urine may irritate or accelerate the process of neoplastic change in transitional epithelium. Obviously the supravesical diversion of urine in this patient did not avoid the occurrence of cancer. A plea is made for periodic checks using bladder exfoliative cytology and cystoscopy of the isolated bladder for early detection of vesical neoplasm.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
6/92. Cancer of the colon during pregnancy. A review of the literature and report of a case associated with ulcerative colitis.The first case of adenocarcinoma of the transverse colon and splenic flexture during pregnancy associated with ulcerative colitis is reported. The patient presented with perforation and widespread metastatic disease. After 10 years' duration of symptoms of ulcerative colitis, the risk of coexisting cancer of the colon is 3 to 5% each year. As ulcerative colitis frequently coexists with pregnancy, the obstetrician needs to be alert to the potential for malignant changes in these patients. With the addition of this patient, there are now 18 reported cases of cancer of the colon during pregnancy. These 18 cases are reviewed especially as to management, outcome of the pregnancy, and prognosis.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
7/92. Treatment of metastatic melanoma with autologous, hapten-modified melanoma vaccine: regression of pulmonary metastases.A human cancer vaccine composed of autologous tumor cells modified with the hapten dinitrofluorobenzene (DNP) induces cell-mediated immunity to the tumor cells and the development of inflammatory responses within metastatic sites. In this study we determined whether DNP vaccine could induce regression of established metastases. Ninety-seven patients (83 evaluable) with surgically incurable metastatic melanoma were treated with DNP vaccine preceded by low-dose cyclophosphamide. Tumor regression was assessed by standard criteria. The development of cell-mediated immunity to melanoma-associated antigens was measured by delayed-type hypersensitivity (DTH) testing before and after DNP vaccine treatment. survival analysis was performed by the Kaplan-Meier method. There were 11 antitumor responses: 2 complete, 4 partial and 5 mixed. Both complete responses and 2 of the 4 partial responses occurred in patients with lung metastases. Response durations were as follows: partial responses-5, 6, 8 and 47 months; and complete responses-12 and 29 months. Tumor regression required at least 4 months to become evident and in 2 cases maximum regression was not observed until 1 year after beginning treatment. patients who exhibited tumor regression survived longer than those who did not (median survival times: responders, 21.4 months; non-responders, 8.7 months; p = 0.010). DTH to DNP-modified and unmodified autologous melanoma cells was induced in 87% and 42% of patients, respectively. The DTH response to unmodified cells was significantly associated with prolonged survival. Autologous DNP-modified melanoma vaccine can induce clinically meaningful regression of metastases and small lung metastases appear to be unusually sensitive. The development of DTH to unmodified, autologous tumor cells may be an important indicator of the vaccine's efficacy.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
8/92. Metastatic carcinoid presenting as a spinal tumor.A case of carcinoid tumor metastatic to the thoracic spine with associated myelopathy is described. Multiple posterior explorations were singularly unsuccessful in locating and indentifying the metastasis, but an anterior transthoracic exposure allowed identification of the tumor, removal of the osteoblastic epidural mass, and fusion of the spine with a rib graft. The patient's myelopathy improved steadily following surgery without evidence of tumor recurrence or regression of neurologic status. The reasons for the relative absence of central nervous system carcinoid metastases are not known.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
9/92. Perianal verrucose carcinoma spreading to the rectum: report of a case.The case of a 39-year-old man with a perianal verrucose carcinoma of 12 years' duration is presented. After local resection the tumor recurred several times and spread to the rectum. An abdominoperineal resection revealed neither infiltration of deeper layers nor lymph-node metastasis. Five other cases of perianal verrucose carcinoma, only two of which were described in detail, have been reported. Probably other examples have been reported under the names of "perianal florid papillomatosis,"13,23 "giant condyloma acuminatum"26 and "condyloma acuminatum with malignant transformation."9,12,27- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
10/92. Neurologic complications of prostate cancer.Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord compression. Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy. Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis. Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important. physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age. spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
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