11/14. cryotherapy and photocoagulation in the management of retinoblastoma: treatment failure and unusual complication.Ophthalmologists treating children with retinoblastoma need to be aware of the limitations of new forms of therapy and their complications. For this reason the following case of a child with a small peripheral retinoblastoma that failed to respond to treatment with both cryotherapy and photocoagulation is recorded. The development of a rapidly growing juxtapapillary lesion prompted immediate enucleation. Histological examination revealed viable tumor cells remaining in the areas that were previously treated. The juxtapapillary mass consisted of optic nerve and detached peripapillary retina that were "dragged" towards the tumor by a thick fibrocellular membrane containing many myofibroblasts.- - - - - - - - - - ranking = 1keywords = treatment failure (Clic here for more details about this article) |
12/14. Evaluation of carcinoembryonic antigen as a plasma monitor for human breast carcinoma.plasma CEA levels have been determined in 92 normal women and 768 women with benign or malignant breast diseases. Only one of 92 normal women had a CEA level above 5 ng/ml. Of 253 women with benign breast diseases (gross cystic disease, adenofibroma, fibrosis, etc.) only one had a CEA level above 5 ng/ml. Ninety-four percent of the above two groups of women had CEA levels below 3 ng/ml. Of 164 women operated upon for Columbia Clinical classification Stage A or B breast carcinoma, preoperative CEA levels were above 5 ng/ml in seven (4%). patients with a preoperative CEA level above 3 ng/ml seemed to have an increased incidence of tumor recurrence. Elevated CEA levels (greater than 10 ng/ml) in our postmastectomy population of 288 patients have correlated with development of metastases in 14 of 46 subjects. Of 216 patients under treatment for metastatic breast carcinoma, CEA levels above 10 ng/ml have been detected in 15 percent of patients with soft tissue metastases, 38% of patients with visceral metastases and 50% of patients with osseous metastases. Of metastatic breast carcinoma patients with CEA levels above 10 ng/ml serial measurements have correlated with the patients response to therapy, progressively increasing in treatment failures and decreasing in treatment responders.- - - - - - - - - - ranking = 0.25keywords = treatment failure (Clic here for more details about this article) |
13/14. Two unusual recurrences of intracranial germinoma.Two recurrent cases of intracranial suprasellar germinoma, with relapses at 55 and 16 months, respectively, after the end of primary therapy strongly effective against pure germinoma, are presented. Human chorionic gonadotropin beta subunit was elevated in the cerebrospinal fluid and in the serum in both patients at the time of recurrence but not before. This and resulting treatment failures suggest that there were also other, more resistant elements within the primary tumor, which have not been identified in biopsy specimens. The problem of adequate diagnosis and its impact on patients' survival are discussed.- - - - - - - - - - ranking = 0.25keywords = treatment failure (Clic here for more details about this article) |
14/14. Perilesional and topical interferon alfa-2b for conjunctival and corneal neoplasia.OBJECTIVE: To evaluate the role of combined subconjunctival and topical interferon alfa-2b (IFN alpha 2b) in the treatment of conjunctival and corneal intraepithelial neoplasia (CIN). DESIGN: Noncomparative case series. PARTICIPANTS: Six patients with histologically proven CIN or recurrences of histologically proven CIN were studied prospectively. INTERVENTION: patients were given a single subconjunctival/perilesional injection of recombinant IFN alpha 2b (Schering Plough, Kenilworth, NJ) 3 million international units (IU) in 0.5 ml and then started receiving topical interferon drops (1 million U/ml) four times a day. patients were followed weekly until complete resolution of the tumor. After 1 week, patients with minimal response while receiving topical therapy were retreated with perilesional injections three times a week until resolution. patients received topical interferon drops for a month after clinical resolution of the lesion. MAIN OUTCOME MEASURES: patients were followed clinically and photographically for evidence of tumor resolution. RESULTS: The authors present a series of six patients who were treated successfully with a combination of subconjunctival/perilesional and topical IFN alpha 2b. All six patients had complete clinical resolution of the CIN lesion within 6 weeks of initiation of treatment. In the time of follow-up (average, 7.2 months; range, 2-11 months), there have been no treatment failures or recurrences. CONCLUSION: IFN alpha 2b may be a viable medical alternative to surgical excision for primary or recurrent CIN.- - - - - - - - - - ranking = 0.25keywords = treatment failure (Clic here for more details about this article) |
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