Desmoid-Type Fibromatosis Garcia-Ortega, Dorian Yarih; Martín-Tellez, Karla Susana; Cuellar-Hubbe, Mario ...
Cancers,
07/2020, Letnik:
12, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Desmoid tumors represent a rare entity of monoclonal origin characterized by locally aggressive behavior and inability to metastasize. Most cases present in a sporadic pattern and are characterized ...by a mutation in the CTNNB1 gene; while 5–15% show a hereditary pattern associated with APC gene mutation, both resulting in abnormal β-catenin accumulation within the cell. The most common sites of presentation are the extremities and the thoracic wall, whereas FAP associated cases present intra-abdominally or in the abdominal wall. Histopathological diagnosis is mandatory, and evaluation is guided with imaging studies ranging from ultrasound, computed tomography or magnetic resonance. Current approaches advocate for an initial active surveillance period due to the stabilization and even regression capacity of desmoid tumors. For progressive, symptomatic, or disabling cases, systemic treatment, radiotherapy or surgery may be used. This is a narrative review of this uncommon disease; we present current knowledge about molecular pathogenesis, diagnosis and treatment.
Background
The COVID‐19 outbreak has resulted in collision between patients infected with SARS‐CoV‐2 and those with cancer on different fronts. Patients with cancer have been impacted by deferral, ...modification, and even cessation of therapy. Adaptive measures to minimize hospital exposure, following the precautionary principle, have been proposed for cancer care during COVID‐19 era. We present here a consensus on prioritizing recommendations across the continuum of sarcoma patient care.
Material and Methods
A total of 125 recommendations were proposed in soft‐tissue, bone, and visceral sarcoma care. Recommendations were assigned as higher or lower priority if they cannot or can be postponed at least 2–3 months, respectively. The consensus level for each recommendation was classified as “strongly recommended” (SR) if more than 90% of experts agreed, “recommended” (R) if 75%–90% of experts agreed and “no consensus” (NC) if fewer than 75% agreed. Sarcoma experts from 11 countries within the Sarcoma European‐Latin American Network (SELNET) consortium participated, including countries in the Americas and Europe. The European Society for Medical Oncology‐Magnitude of clinical benefit scale was applied to systemic‐treatment recommendations to support prioritization.
Results
There were 80 SRs, 35 Rs, and 10 NCs among the 125 recommendations issued and completed by 31 multidisciplinary sarcoma experts. The consensus was higher among the 75 higher‐priority recommendations (85%, 12%, and 3% for SR, R, and NC, respectively) than in the 50 lower‐priority recommendations (32%, 52%, and 16% for SR, R, and NC, respectively).
Conclusion
The consensus on 115 of 125 recommendations indicates a high‐level of convergence among experts. The SELNET consensus provides a tool for sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak.
Implications for Practice
The Sarcoma European‐Latin American Network (SELNET) consensus on sarcoma prioritization care during the COVID‐19 era issued 125 pragmatical recommendations distributed as higher or lower priority to protect critical decisions on sarcoma care during the COVID‐19 pandemic. A multidisciplinary team from 11 countries reached consensus on 115 recommendations. The consensus was lower among lower‐priority recommendations, which shows reticence to postpone actions even in indolent tumors. The European Society for Medical Oncology‐Magnitude of Clinical Benefit scale was applied as support for prioritizing systemic treatment. Consensus on 115 of 125 recommendations indicates a high level of convergence among experts. The SELNET consensus provides a practice tool for guidance in the decisions of sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak.
The COVID‐19 pandemic has caused deferral, modification, or cessation of treatment for patients with cancer. This article presents a consensus on prioritizing recommendations across the continuum of sarcoma patient care.
Osteosarcoma is the most common primary malignancy of bone in children and young adults, the highest incidence peak is during adolescence and doesn’t have any gender predominance. The main site of ...metastasis are the lungs and extrapulmonary cases are occasional. The incidence of metastasis in the Central Nervous System (CNS) is 2–6.5%, increase to 10–15% in patients with pulmonary metastases. Therefore, metastatic disease of the CNS is rare and the information on such patients is limited. Here, we describe a case of a 20-year old patient diagnosed with osteosarcoma in the left distal femur stage IIB, he developed pulmonary disease, during palliative chemotherapy experienced relapse to the brain classified as recursive partitioning analysis (RPA) class II, and was treated with external radiotherapy (30 Gy in 10 fractions) and later he had a poor evolution and died.
Acrometástasis en astrágalo de adenocarcinoma endometrioide Clara-Altamirano, Miguel Ángel; García-Ortega, Dorian Yarih; Caro-Sánchez, Claudia Haydee Sarai ...
Gaceta Mexicana de oncología,
January-February 2016, 2016-01-00, Letnik:
15, Številka:
1
Journal Article
Odprti dostop
El término acrometástasis se utiliza para definir a las metástasis distales de codos y rodillas, son poco comunes, y solo representan el 0.1% de todas las lesiones óseas metastásicas. El ...adenocarcinoma endometrioide (AE) es el cáncer más frecuente en el tracto genital femenino en los países desarrollados. Las metástasis óseas son raras en el AE.
Mujer de 57 años, que inicia con sangrado transvaginal, ultrasonido y biopsia de endometrio con reporte de AE moderadamente diferenciado, tratada inicialmente con histerectomía, linfadenectomía pélvica bilateral y paraaórtica más radioterapia externa 50.4Gy, y braquiterapia intracavitaria. Seis meses después refiere dolor en tobillo izquierdo e incapacidad para la deambulación. Se realiza tomografía axial computarizada donde se observa lesión lítica expansiva de predominio en astrágalo. Por lo que se biopsia ósea con reporte de AE moderadamente diferenciado metastásico, se inicia tratamiento con radioterapia 30Gy, se difiere el apoyo e inicia quimioterapia paliativa con paclitaxel y carboplatino en 6 ciclos, así como, aplicación mensual de ácido zoledrónico. Actualmente, a 12 meses de seguimiento, la paciente presenta buena evolución, sin dolor en tobillo izquierdo y tolerando la deambulación.
La estrategia de tratamiento en pacientes con acrometástasis aisladas continúa siendo motivo de controversia, existen pocos casos descritos en la literatura. Se considera habitualmente a la radioterapia externa como el manejo de elección de estas lesiones. Las acrometástasis son extraordinariamente raras, sin embargo debemos tenerlas en cuenta en aquellos pacientes con cáncer que presentan dolor intenso en manos y pies, sin causa aparente.
The term acrometastasis is given to those metastases distal to the elbows and knees. They are rare and account for only 0.1% of all metastatic bone lesions. Endometrioid adenocarcinoma (EA) is the most frequent in the female genital tract cancer in developed countries. Bone metastases are rare in EA.
A 57 year old female 57 years presenting with trans-vaginal bleeding (TVB). The ultrasound and endometrial biopsy reported a moderately differentiated AE. This was initially treated with a hysterectomy, bilateral pelvic and para-aortic lymphadenectomy plus 50.4Gy external radiotherapy, and intracavitary brachytherapy. Six months later she complained of pain in left ankle and inability to walk. Computed tomography showed an expansive lytic lesion, predominantly in the talus. As the bone biopsy reported a moderately differentiated metastatic endometrioid adenocarcinoma, treatment is initiated with radiotherapy of 30Gy. Support was deferred and palliative chemotherapy started with paclitaxel and carboplatin in six cycles, as well as monthly application of zoledronic acid. Currently, after twelve months follow-up the patient has made good progress, with pain in left ankle, and tolerating walking.
The treatment strategy in patients with isolated acrometastasis remains controversial, and there are few cases described in the literature. External radiotherapy is usually considered as treatment of choice for these lesions. Acrometastasis is rare but should be taken into account in patients with cancer, who have unexplained severe pain in hands and feet.
Central nervous system metastasis from osteosarcoma: Case report and literature review Nieto-Coronel, María Tereza; López-Vásquez, Allan David; Marroquín-Flores, Diana ...
Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology,
07/2018, Letnik:
23, Številka:
4
Report
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