Primitive neuroectodermal tumor (PNET) is a very aggressive neoplasm, considered to have an unfavorable prognosis, and renal location is extremely rare. We present the findings and clinical course of ...a patient with localized disease who is free of disease more than 3 years after first presentation. In suspicious cases we recommend to surgically explore renal masses as early as possible.
Summary
Background and Objective: Response rates of cutaneous‐subcutaneous or lymph node metastases of melanoma to systemic chemotherapy are rather low. We report our clinical experience with ...superficial and deep regional hyperthermia in combination with radiotherapy and/or chemotherapy with carboplatin.
Patients/Methods: We treated 15 patients with metastatic melanoma (6 men, 9 women; age 39 – 84 years, mean age 60 years) by using superficial or deep regional hyperthermia produced by electromagnetic energy. Superficial hyperthermia was delivered to skin or lymph node metastases in combination with radiochemotherapy in 12 patients, while deep regional hyperthermia was administered with an annular array applicator to lymph node metastases either in combination with radiochemotherapy (1 patient) or with carboplatin alone (2 patients). The clinical response was assessed by clinical evaluation and/or computer tomography and/or ultrasonography at monthly intervals.
Results. Both superficial and deep regional hyperthermia was well tolerated. We observed 5 complete local remissions (34 %), 6 partial local remissions (40 %) and 2 patients with stable disease (13 %). The best results were obtained in cutaneous or retroperitoneal metastases.
Conclusions. Local response can be achieved in inoperable metastatic melanoma using superficial or deep regional hyperthermia in combination with radiochemotherapy or chemotherapy.
Zusammenfassung
Hintergrund: Die Ansprechraten von Haut‐ oder Lymphknotenmetastasen des Melanoms auf die systemische Chemotherapie sind gering. Wir berichten über unsere klinische Erfahrung mit Oberflächenhyperthermie und tiefer regionärer Hyperthermie in Kombination mit Strahlentherapie und/oder Chemotherapie mit Carboplatin.
Patienten/Methodik: Wir behandelten 15 Patienten mit metastasiertem Melanom (6 Männer und 9 Frauen im Alter von 39 bis 84 Jahren, mittleres Alter 60 Jahre) mit Oberflächenhyperthermie oder tiefer regionärer Hyperthermie hervorgerufen durch elektromagnetische Energie. Die Oberflächenhyperthermie mit einem lokalen Applikator wurde bei Haut‐ und Lymphknotenmetastasen in Kombination mit Strahlen‐ und Chemotherapie bei 12 Patienten angewandt, die tiefe regionäre Hyperthermie mit einem ringförmigen Applikator wurde bei Lymphknotenmetastasen bei einem Patienten in Kombination mit Strahlen‐ und Chemotherapie und bei 2 Patienten in Kombination mit Carboplatin allein eingesetzt. Das Ansprechen wurde klinisch und/oder computertomographisch und/oder sonographisch evaluiert.
Ergebnisse: Die Hyperthermiebehandlungen wurden gut toleriert. Wir konnten lokal 5 komplette Remissionen (34 %), 6 partielle Remissionen (40 %) und bei 2 Patienten eine stabile Erkrankung (13 %) beobachten. Die besten Ergebnisse konnten bei retroperitonealen Lymphknotenmetastasen und Hautmetastasen erzielt werden.
Schlussfolgerungen: Unsere Ergebnisse zeigen, dass bei inoperablen Melanommetastasen ein lokales Ansprechen mit Oberflächenhyperthermie und tiefer regionärer Hyperthermie in Kombination mit Strahlentherapie und/oder Chemotherapie erzielt werden kann.
To assess the efficacy of amplitude coded colour Doppler US (aCDS) in the evaluation of renal masses as shown by multiphasic contrast-enhanced CT.
Eighty patients (155 kidneys) with suspicion of ...renal masses underwent aCDS and spiral CT. The findings were classified into normal kidneys, kidneys with tumours, kidneys with cysts, and those with "other findings" (i.e. bleeding, calcifications, inflammation, parenchymal hypertrophy). The aCDS findings were compared to CT results and to histological findings or clinical, laboratory and follow-up data.
Eighteen renal cell carcinomas and 8 other tumours were found; 78 kidneys had cysts, 12 polycystic kidneys and 10 fibrotic kidneys were detected, 20 kidneys showed other findings. Diagnostic aCDS data were obtained in 129 kidneys (83.2%) showing pathology with an accuracy of 94%. CT adequately showed pathology in all patients with some diagnostic uncertainty in the evaluation of complicated cysts.
Though contrast-enhanced multiphasic spiral CT is the method of choice for evaluating renal masses, US including aCDS can provide valuable information, particularly in differentiating vascularized from non-vascularized lesions and in the evaluation of complicated renal cysts.
We describe the case of a 71-year-old male with a huge left-sided paratesticular tumour, whose walking was increasingly handicapped by this vast mass. Two palliative excisions of tumour tissue were ...performed. Histology revealed a poorly differentiated paratesticular liposarcoma. The patient achieved satisfying mobility for several months before he died of cachexia.
The purpose of our study was to evaluate quantitative multiphasic CT enhancement patterns of malignant renal neoplasms to enable lesion differentiation by their enhancement characteristics. We used a ...new method to standardize enhancement measurement in lesions on multiphasic CT not being influenced by intrinsic factors like cardiac output.
The new correction method is a simple tool for excluding intrinsic influences on the enhancement of lesions. Quantitative enhancement evaluation with this method of the influence of intrinsic factors enables accurate differentiation between renal clear cell carcinoma and renal papillary carcinoma.
To determine interobserver variability in the morphometric measurement of abdominal organs with US and spiral CT, and to compare the results obtained with these two modalities.
US and spiral CT ...examinations of the abdomen were performed in 25 patients. In each patient, 13 defined distances were measured in the liver, spleen and both kidneys with US and spiral CT by two pairs of radiologists in a blinded manner. The interobserver variations of these measurements were evaluated for the US and CT examinations, and the data of both modalities were compared with one another.
The measurement of distances in the abdomen with US and spiral CT is subject to considerable interobserver variability in both modalities. The relative interobserver variations showed marked differences, according to which distance was measured. The average interobserver variations were higher in US than in CT. A direct comparison of US and spiral CT revealed that distances obtained with CT frequently exceeded those obtained with US.
Morphometric measurements of abdominal organs with US and with spiral CT showed considerable differences. The follow-up examinations should therefore be performed with the same imaging modality as used in the original examination.
CT-anatomy of the nasolacrimal sac and duct Groell, R; Schaffler, G J; Uggowitzer, M ...
Surgical and radiologic anatomy (English ed.),
1997, Letnik:
19, Številka:
3
Journal Article
Recenzirano
Recent developments in ophthalmology such as balloon dilatation, stent implantation, laser therapy and endoscopy of the lacrimal drainage system raise the need for a detailed anatomical knowledge of ...this system. In this study morphometric measurements of the lacrimal drainage system were performed with thin-section axial computed tomography (CT) examinations in 147 patients with no signs of pathology related to the lacrimal drainage system. The mean length of the nasolacrimal duct measured 11.2 +/- 2.6 mm (range: 6-21 mm), the narrowest diameter was 3.7 +/- 0.7 mm (range: 2-7 mm). The mean length of the nasolacrimal sac was 11.8 +/- 2.5 mm (range: 6-18 mm). The width of the nasolacrimal sac did not exceed 4 mm unless filled with air. In 43 (29.3%) of the subjects air was visible within the nasolacrimal sac or duct. The knowledge of the morphometry of the lacrimal drainage system enables the ophthalmologist to plan intervention on the lacrimal drainage system precisely and avoid unnecessary manipulations.
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